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HomeMy WebLinkAbout09-9378 CITY OF ZEPHYRHILLS 5335 — 8T1-1 STREET (813)780 -0020 9378 BUILDING PERMIT Permit Number: 9378 Address: 5328 17TH ST Permit Type: RE -ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11- 26 -21- 0010 - 17300 -0190 Improv. Cost: 6,900.00 2 z iA , m, „ra : , Date Issued: 7/29/2009 Name: VINE, GREG & SUSAN Total Fees: 65.00 Address: 5328 17TH ST Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542 Date Paid: 7/29/2009 Phone: (941)488 -8143 Work Desc: REROOF 0 4 � c*� r �,, � � ° e : s ;.. .,, �s .. � AR w� � � & . _. .i. ,: ,y ' � 7, d^ ,t'`:., #: C �,,. �' .� .; ;..:'. d° .. p�' -« :'k ip., ,'.', : ° � .. °- r '_. x� E€� SHINGLE MASTERS ROOFING & CO REROOF RESIDENTIAL 65.00 xa ' s 0 ' 0 77.7,7r ja.:: a € "s, .. 7 �:0;;i '. fit, 12W v, � li "��x *, %K _. t DRY IN INSP R �.��� ",..� �.._.n<� OOF . _ € TAPE JOINTS OF INSP FINAL �— `t 9 REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." / to CONTRACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813 -780 -0020 City of Zephyrhills Permit Application Fax- 813 -780 -0021 Building Department Date Received ■ 07 t i l j l o g P h o n e Contact for Permitting -- 1I I I I I I I I 1 11 11 1 Owner's Name 5 /3krJ grin G ra O V: N - -- Owner Phone Number VI y'd--c" '? (Owner's Address ' 3 20 t7 S + ® .�Z e Y r 1. it S T1 1 1( I Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address (JOB ADDRESS 532Z f7 + S4, i Za r►. its ( F1. 33 4Yz- LOT # I .0 SUBDIVISION CC .r) F Z*7,rriAllt s PARCEL ID# / 1 - 2 " 24 - °°/ 0 -- / 71° o -01949 1 v 1 (OBTAINED FROM PROPERTY TAX NOTICE) 'WORK PROPOSED NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH INSTALL REPAIR PROPOSED USE K SFR 1 i I COMM 1 I OTHER I I TYPE OF CONSTRUCTION I I r B - LOCK FRAME 1 I STEEL n OTHER 1 1 ( DESCRIPTION OF WORK 140 T tf1r «/N e... T BUILDING SIZE SQ FOOTAGE HEIGHT 1 BUILDING $ (p / 900 VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY I W.R.E.C. I 1 PLUMBING $ I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1 1 GAS tic ROOFING I I SPECIALTY n OTHER FINISHED FLOOR ELEVATIONS ' FLOOD ZONE AREA 1 IYES 1 INO BUILDER OMPANY 5k1/401C �ee$ ROARe `} ` 'T►w" tW SIGNATURE REGISTERED L Y/ N 1 FEE CURRENT 1 N 1 cat Address 2-s ca kr.t.i'4'/'1 C- C* 1 JA rco F( .33596 [License # Cc G. 13 2.8 72.y ELECTRICIAN COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1 Address License # PLUMBER COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y/ N 1 Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y / N 1 Address License # I RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: . Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed. restrictions. UNLICENSED CONTRAOTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division — Licensing Section at 727 -847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Trahsportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco county Ordinance number 89 -07 and 90 -07, as amended. The undersigned also understands, that such fees, as may be due, will be'identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the " Florida Construction Lien Law — Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner ", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land.development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: Department of Environmental Protection - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers - Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment, Septic.Tanks. - US Environmental Protectibn`Agency- Asbestos abatement. Federal Aviation Authority- Runways. I ,understand that the following restrictions apply to the use of fill: Use of fill is not allowed in Flood Zone "V" unless expressly permitted. - If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate job is considered abandoned. justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the j WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.' CONSULT WITH YOUR LEND R OR AN FLORIDA JURAT (F.5. 11 .03) CONTRACTOR OWNER OR AGENT Subscribed and swo o or • '� ed befQe me , is / Subscribed and y'o (of affirm) b�for a Is by Who is /are personally known to me or has /have produced Who is /are personally known to me or has /have produced as identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped ROOFING RESIDENTIAL CONTRACT Phone 813 - 661 -4600 / Fax 813 - 200 -1034 — www.SHIN.GLE- MASTERS.com Florida Certified General & Roofing Contractor CGC — 1513621 / CCC - 1328724 THIS CONTRACT IS ENTERED INTO THIS DATE /OWNER/BUYER NAME 07/20/09 OWNER'S ADDRESS Susan and Greg Vine 5328 17 St. OWNER'S CITY, STATE & POSTAL CODE OWNER'S HOME PHONE OWNER'S WORK PHONE Zephyrhills, FL. 33642 (941) 488 -8143 (813) Unknown PROJECT NAME PROJECT ADDRESS Vine Roof vine @comcast.net PROJECT CITY, STATE & POSTAL CODE PROJECT PHONE PROJECT PHONE 2 Same as above Same as above Same as above CONSTRUCTION LENDER IS (Name and address of construction fund holder) No Lender — cash contract — System Plus Warranty given on shingles. Limited Lifetime warranty given on Workmanship * * PERMITTING INCLUDED ** (Name and Branch Address of Bank, Saving and Loan Assn., Escrow Agent, Joint Control or Other) DESCRIPTION OF THE PROJECT (including materials and equipment to be used or installed): Contractor will furnish all labor, materials and equipment to construct in a good workmanlike manner (Describe Labor, Materials, and Equipment to be furnished): Complete ReRoof — Remove Existing Shingles, Felt, Nails, Staples, Vents, Valley Material, Lead Boots, Eaves Drip, and ALL Damaged Plywood. Make all Plywood, Sub - Fascia, Rafter, and Flashing Repairs. Nail Plywood to Hurricane code. Install Vents, Peel +Stick Under lament, 6" Eaves Drip, Vents, Lead Boots with Squirrel Guards Painted to Match Roof , and New Shingles. Clean up all work areas, and remove all old material from property. New Shingle Color- GAF 3 Tab — Golden Cedar, Eaves Drip- 6" Brown, Vents and Boots- Brown Use Matching GAF Liberty Cap Roll Roofing on Rear Flat Roof, Cut down and roof over or cap Chimney. WORK PERFORMED AT: Same As Above TIME FOR COMPLETION: The work to be performed by Contractor pursuant to this Agreement shall be commenced within ( 10 ) days or approximately on 07/30/09 and shall be substantially completed within ( 2 ) days or approximately on 07/31/09 Commencement of work shall be defined as Dumpster Delivery, weather permitting (Briefly describe type of work representing "commencement') INTEREST: Overdue payments will bear interest at the rate of 1 % per month. PAYMENT: Owner agrees to pay Contractor a total cash price of: 6,900.00 Six Thousand Nine Hundred Dollars Dollars ($ $6,900.00 ) Down payment (if any) $ -0- with payments to be made as follows: Payment to be made in full upon Completion - $6,900.00 — 100% Upon satisfactory payment being made for any portion of the work performed, the Contractor shall, prior to any further payment being made furnish to the person contracting for the residential improvement, a full and unconditional release from any claim or Mechanic's Lien, for that portion of the work for which payment has been made. ALLOWANCES: The following items or specific prices as indicated are included in the contract price as allowances. The contract price shall be adjusted upward / downward based upon actual amounts rather than estimated amounts herein if approved by homeowner. No Allowances, the contract price is the contract price. TERMS AND CONDITIONS: The Terms and Conditions attached are expressly incorporated into this Agreement. You, the buyer, may cancel this transaction at any time prior to midnight five business days before the commencement of work. Cancellation by the buyer after the right to rescind has passed shall be deemed a material breach of this agreement and entitles Contractor to damages . „drib 07/20/2009 �j ct. Seller t..1410 07/20/2009 Contra Date Owner /Buyer Authorized a e Date 07/20/2009 07/20/2009 TERMS AND CONDITIONS 1. CHANGES IN THE WORK. Should the Owner, constriction is an agency coupled with an interest. In the event the Owner occupies the lender, or any public body or inspector direct any modification or addition project or any part thereof before the Contractor has received all payment to the work covered by this contract, the contract price shall be adjusted due under this contract, such occupancy shall constitute full and accordingly. Extra Work and Change Orders become part of the contract unqualified acceptance of all the Contractor's work by the Owner and the once the order is prepared in writing and signed by the parties prior to the Owner agrees that such occupancy shall be a waiver of any and all claims commencement of any work covered by the new change order. The order against the Contractor. must describe the scope of the extra work or change, the cost to be added or subtracted from the contract, and the effect the order will have on the 8. INSURANCE AND DEPOSITS. Owner will procure at schedule of progress payments. Failure to have written authorization shall Owner's expense and before the commencement of any work not be deemed fatal to the collection of the extra work. hereunder, fire insurance with course of construction. vandalism and malicious mischief clauses attached, such insurance to be a sum at least 2. RESPONSIBILITIES OF THE PARTIES. Contractor shall equal to the contract price with loss, if any, payable to any beneficiary promptly notify the Owner of (a) subsurface or latent physical conditions under any deed of trust covering the project, such insurance shall also at the site differing materially from those indicated in this contract, or (b) name the Contractor and any subcontractors as additional insured, and tc unknown physical conditions differing materially from those ordinarily include sufficient funds to protect Owner, Contractor, subcontractors and encountered and generally recognized as inherent in work of the character construction lender as their interests may appear. Should Owner fail to do provided for in this contract. Owner as added work shall pay for any so, Contractor may procure such insurance as agent for and at the expense incurred due to such conditions. expenses of Owner, but is not required to do so. The Owner is responsible to supply water, gas, sewer and electrical If the project is destroyed or damaged by accident. disaster or calamity, utilities unless otherwise agreed to in writing. Electricity and water to the such as fire, stone, earthquake, flood, landslide, or by theft or vandalism, site is necessary. any work done by the Contractor in rebuilding or restoring the project shall Owner agrees to al low and provide Contractor and his equipment access be paid by the owner as extra work. to the property and provide toilet facilities. Owner shall obtain and pay for insurance against injury to Owner's own The Owner is responsible for having sufficient funds to comply with employees and persons under Owner's direction and persons on the job this agreement. This is a cash transaction unless otherwise specified. site at Owner's invitation. Contractor provides workman's compensation The Owner is responsible to remove or protect any personal property Insurance. and Contractor is not responsible for it or for any driveways, lawns, shrubs, etc. The Owner will point out and warrant the property lines to 9. RIGHT TO STOP WORK. Contractor shall have the right to stop contractor. work if any payment shall not be made, when due, to Contractor under this agreement. Contractor may keep the job idle until all payments due are 3. DELAYS. Contractor agrees to start and diligently pursue work received. This remedy is in addition to any other right or remedy that the through to completion, but shall not be responsible for delays for any of Contractor may have. Such failure to make payment when due, is a the following reasons: failure of the issuance of all necessary building material breach of this agreement. Owner acknowledges that the permits within a reasonable length of time, funding of loans, disbursement additional costs for the delay in stopping and starting the project shall he of funds into funding control or escrow, acts of neglect or omission of treated as an extra and allow Contractor additional costs in accordance Owner or Owner's employees or Owner's agent, acts of God, stormy or with paragraph one hereof. inclement weather, strikes, lockouts, boycotts, or other labor union activities, Extra Work ordered by Owner, acts of public enemy, riots of 10. CLEAN -UP. Contractor will remove from Owner's property debris civil commotion, inability to secure material through regular recognized and surplus material created by this operation and leave it in a neat and channels, imposition of government priority or allocation of materials. broom clean condition. failure of Owner to make payments when due, or delays caused by inspection or changes ordered by the inspectors of authorized 11. LIMITATIONS. No action of any character arising from oi governmental bodies, or for acts of independent contractors, or holidays, or related to this contract, or the perfomtance thereof shall be commenced other causes beyond Contractor's reasonable control. by either party against the other more than two years after completion of 4. PLANS & SPECIFICATIONS. If plans and specifications are the project or cessation of work under this contract. prepared for this job, they shall be attached to and become apart of the 13. ATTORNEY FEES. In the event there is any litigation 01 agreement arbitration arising out of this agreement, the revailin� a p a party shall be 5.SUBCONTRACTS. The Contractor may subcontract portions of this entitled to its reasonable attorney fees and costs. work to properly licensed and qualified subcontractors except roofing 14. PAYMENT. Upon satisfactory payment being made for any portion 6. FEES, TAXES AND ASSESMENTS. Owner will pay for taxes of the work performed, the Contractor shall, prior to any further payment P Y being made, furnish to the persons contracting for the improvement, a full and assessments of all descriptions. Contractor will obtain and pay for and unconditional release from any claim or Mechanic's Lien, for that all required building permits, but Owner will pay assessments and portion of the work for which payment has been made. charges required by public bodies and utilities for financing or repaying the cost of sewers, storm drains, water service, schools and school 15. ASBESTOS AND HAZARDOUS WASTE. Unless the contract facilities, other utilities, hook -up charges and the like. specifically calls for the removal disturbance, or transportation of asbestos or other hazardous substances. the parties acknowledge that such work 7. COMPLETION AND OCCUPANCY. Owner agrees to sign and requires special procedure, precautions, and%or licenses. Therefore, unless record a Notice of Completion within five (5) days after the project is the contract specifically calls for same, if Contractor encounters such complete and ready for occupancy. If the project passes final inspection substances, Contractor shall immediately stop work and allow the Owner by the public body but Owner fails to record Notice of Completion, then to obtain duly qualified asbestos and /or hazardous material contractor tc Owner hereby appoints Contractor as Owner's agent to sign and record a perform the work or the Contractor may perform the work at contractor's Notice of Completion on behalf of Owner. This agency is irrevocable and option. Said work will be treated as an extra under the contract. .4.-- _ 77WO Pasco County Parcel: 11- 26 -21- 0010 - 17300 -0190 001 Page 1 of 2 . -0 1 6 Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: ( Weekly Archive - Saturday, July 25, 2009 I Parcel ID 1 11 26 -21- 0010 - 17300 -0190 (Card: 001 of 001) I I Classification 11 01 - Single Family Mailing Address Property Value JENKINS TROY & Ag Land $0 WINEFORDNER KATHRYN L Land $25,704 2704 BEE RIDGE RD 2ND FLOOR Building $17,701 SARASOTA, FL 342396403 Physical Address Extra Features $261 5328 17TH ST Market Value $43,666 ZEPHYRHILLS, FL 33542 -5005 Assessed (Save Our Homes) $0 Legal Description (First 4 Lines) See Plat for this Subdivision « Taxable Value $43,666 CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 19 & 20 BLOCK 173 OR 5379 PG 664 Land Detail (Card: 001 of 001) Line II Use I °DescriptionI Zoning II Units II Type II Price II Condition II Value 1 II 0100 II SFR II 00R2 II 8,400.00 0 SF 11 $3.06 II 1.00 0 $25,704 I Additional Land Information Acres II 0.19 II Tax Area 0 30ZH II FEMA Code II X ( °Residential Code) ZHLHLP2 I Building Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1935 Stories 2.0 Exterior Wall 1 Aluminum Siding Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall 1 Wall Board or Wood Wall Interior Wall 2 None Flooring 1 Pine or Soft Wood Flooring 2 None Fuel Gas Heat Convection A/C Window Unit Baths 1.0 Line II Description I Sq. Feet II Repi. Cost New 1 II FOP D 192 0 $1,463 2 p BAS II 768 II $23,409 3 II FUS II 216 II $5,913 Extra Features (Card: 001 of 001) Line II Description Year II Units II Value 1 I DCFENCE 1999 II 300 II $261 Sales History Previous Owner CLARK LAURA L & Year II. Month Book /Page. II Type II Amount 2003 II 05 5379 / 0664 II WD II $45,000 1994 I 09 3346 / 0527 0 WD II $38,000 1980 II 04 1063/1828 I I $24,900 Search Again Show Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes http : / /appraiser.pascogov. com/search/parcel. aspx? sec =11 &twn= 26 &rng=21 &sbb= 0010 &b... 7/29/2009 1 11111111111111111 MIMI 11111 MI 11111 1111111111 I111 1111 9% NOTICE OF COMMENCEMENT 2009102803 ■ Rcpt:1255159 Rec: 10.00 Permit No. DS : 0.00 IT: 0.00 07/24/09 Dpty Clerk Tax Folio No. 11 " ." Z1 'ON O- J73o 6 /90 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section J 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. ° � co 1.Description of property (legal ti ,� - k , n): CT •F . • 1i 1 (ifs - . W..3, 3 P� � / cets f 2 o Lin a) Street (job) Address: TT 2.General description of improvements: laan / Ir,wr w 3.Owner Information d " a) Name and address: . V ► 14: _ p•__ x.10 K O • F1. 3 ' N Di" b) Name and address of fee simple 'tleholder (if other than owner) ,A1104 if N(►r) c) Interest in property Nl �} _i N� F14.Contractor Information w a) Name and address: CA < wgiivri Reb r..4 Cp b : S < ryi ced 4 lJt • N 0 m le b) Telephone No.: t 1; / (goo Fax No. (Opt.) $ 3 2.o* Soli y 5.Surety Information 25'12 • C.+1 {or.4 4 Ca a c1-. IV k e ce, Ps. ;3S9 L a N wr o a) Name and address: f` b) Amount of Bond: Elsa c) Telephone No.: Fax No. (Opt.) --- 6.Lender a) Name and address: ...--- Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: G V;.8 a n3 0 11.4e.J P:44' d If-al If-al 4 00 IGs 14143 P1 . 141.15 b) Telephone No.: Fax No. (Opt.) 8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided In Section 713.13(1xb), Florida Statutes: a) Name and address: t ecAv et ,,,c 2 S Cu 14,444. Ce■It C$ V p l c ei Pi .; 3 Sg 4 b) Telephone No.: / 3 W. I Y l Otr Fax No. (Opt.) ai 3 Zia 141 3 Y 9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified): Og 3 O c t WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. \ STATE OF FLORIDA COUNTY OF HILLSBOROUGH / ` � ZeA∎ /! Signature of Owner or Owner's Author ic / Director/Partner/Manager PrintN . Vi&{ The foregoing instrument was acknowledged before me this ZO day of 3 , 20 Q', by bet t r, t. V r as Cw..he r (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on si was executed). Personally Known OR Produced Identification X Notary Signature Alf . � �'�of Z$S'•S'S- t' Type of Identification Produced _p i� Name (Print) Ml�ltwl ir+Q . , ,h'b:be - — Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief VA FORMSMOC,rvsd2007 . /:► Signature of Natural Pigning (in line # 10.) Above ,.r r +COmm# MMUS • • l� Expires 5/8/2011 Florida NotalyAssn.. kw STATE OF FLORIDA, COUNTY OF PASCO THIS IS TO CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE • ` OF PUBLIC RECORD IN THIS OFFICE WI - Y ■ ' ND •FFICIAL SF THIS DAY.. F 'A UL . O'NEIL, LE'• & CO PTROLLE B ti 'UTY CLERK JUL- 29- 200901E0) 09:00 P.001 /001 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID EIM 1]ATE (MM/DDIYYYY) 9HINM -1 07/29/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fairchild, Addison & MoKone HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR P P. 0 . Box 1030 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Brandon FL 33509 -1030 Phone: 813 -681 -4893 Fax: 813- 685 -8610 INSURERS AFFORDING COVERAGE NAIC f! INSURED INSURER A Hemritaga Insuranr.4 Company INS(IRFR R: Shingle Masters Roofing & Construction Svcs, Inc. INSURER C. 2502 Culbre th Cove Ct INSURER D Valrico FL 33594 .. _ INEI IRF.R F. — COVERAGES TI IC POLICIES OT INSURANCE LISTED OCLOW UAW MGR I$$IJFD TO THE INSURED NAMED ABOVE ron THE POLICY PERIOD INDICATFD, NOTWI) HS IANUINC ANY REOUIREMENT. TERM OR CONDITION or ANY CONTRACT OR OTHFR DOCUMENT WI I M RESPECT TO WHICH THIS CERTIFICATE MAY OC !MUM OR MAY PFRTAIN, TUC INSURANCE AFFORDFD RYTHF POLICIES DESCRIBED HEREIN IS SUOJCCT TO ALL TI IF. TFRMS, FXCI USIONS AND CONDITIONS OF SUCH POLICIES. AUCRCA'f t LIMITS SHOWN MAY HAVE BEEN REDUCED OY PNO CI AIMS INSR MOIL — POLICY EFFECTIVE POLICY EXPIRATIWT' LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE (MM/DO/TY) DATE (MMJDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 100 , 000 A X COMMERCIAL UENERAL LIABILITY HGL543326 -08 06/03/09 06/03/10 P (Ea RENTE Pence) 150,000 X I CLAIMS MADE U OCCUR MEU tXP (My one person) S 1 , 0 PERSONAL &ADV INJURY S 100,000 GENERAL AGGRFGATF $ 300,000 GCN'LAGGRCGATCP� IT APPLICSPFR PHOLUC1$- CUMt/UPACU 1 300,000 - 7 pOUCY n JFCT n LOC AUTOMOBILE LIABILITY COMbINEU SINCLE LIMI I' ANY AUTO (Es accident) s ALL /WNEpAUTOS • OODILY INJI IRY SCHEDULED AUTOS (Per perenn) I IIRCD AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per awiderd) PHOFEN I Y UAMACt (Per accident) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT S ANY AUTO OTHFR THAN FA ACC 1 AUIOONLY: ACC S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 7 OCCUR n CLAIMS MADE AGGREGATE S RE PENrIUN 1 $ WORKERS COMPENSATION AND WC S IA I U- O t M- EMPLOYERS' LIABILITY FURY uMITS ER ANY PROPRIETORR'ARTNER/EXECUTIVE E.L EACH ACCIDENT g OrTICER/MEMBER EXCLUDED? If Tee, Ge■cnbe under E.L DISEASE - CA EMPLOYEE S SPECIAL PROVISIONS below E.L. DISFASF . POI ICY 1 IMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ^� Fax: 813 780 -0021 CERTIFICATE HOLDER CANCELLATION CxTYZ-1 SHOULD MY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED E„ BEFORE THE EXPIRA . 0N DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Zephyrhills NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Building Department IMPOSE NO OBLIGATION IN LIGATION OR LIABILITY OF ANY D UPON THE INSURER, ITS AGENTS OR Zo ph 8th Stet REPRESENTATIVES. 110.011 Zephyrhilla FL 33542 AUTHORIZED REPRESENTA _ Fairchild, Addison & McKone ACORD 26 (2001108) ® ACORD CORPORATION 1988 fi g r L : 1 1 t z 1 Ns .�. 11 ..,. x s �,. © _'� ' .... � L7FfW -I saw°' Q _� _ _ •. -r, �,.n � � _.. o rs 2502 Culbreath Cove Ct., Valrico, FL. 33504 813 - 661 -4600 Phone - 813 - 200 -1034 Fax CCC 1328724 / CGC 1513621 Ed(ieSHINGLE- MASTERS.com / www.SHINGLE- MASTERS.com July 29, 2009 City of Zephyrhills Building Dept. Re: Authorization to Sign for and Pick up Permits To Whom It May Concern: The following are authorized to sign for and pickup permits for Shingle Masters Roofing & Construction Services, Inc. Michael E. "ED" Beauchaine, aka, Edward Beauchaine Michael E. Beauchaine II Christopher B. Beauchaine SiI ly: 41110 ' 6° 44-11111. Mich 1 E. "Ed" Beauchaine Certified General & Roofmg Contractor 813- 333 -3752 Cell 813- 661 -4600 Office 813 -200 -1034 Fax STATE OF FLORIDA COUNTY OF PASCO The foregoing instrument was acknowledge before me this 29 day of July 29, 2009, By Edward Beauchaine, produced identification, fl. Drivers license 13250- 220-59 -413 -0. (Sigatur Notary 4,9‘..`:* JACQUELINE BOGES Commission DD 621833 =� •�..�- Expires December 12, 2010 '' , ..... r .y °.` Bonded Thor Troy Fain Inswing, 800415.7919 l , STATE OF FLORIDA �r4- DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ' `': CONSTRUCTION INDUSTRY LICENSING BOARD 3 � ', 1940 NORTH MONROE STREET (850) 487 -1395 TALLAHASSEE FL 32399 -0783 BEAUCHAINE, MICHAEL E SHINGLE MASTERS ROOFING & CONSTRUCTION SERVICES INC 2502 CULBREATH COVE CT VALRICO FL 33594 SATE OF FLORIDA AC# -7 6 D Congratulations! With this license you become one of the nearly one million 4 Floridians licensed by the Department of Business and Professional Regulation. . . D P R OFES S " RE G U LA TI 'AP]Dli II Our professionals and businesses range from architects to yacht brokers, from F RD' SIONAL ;RLG x,ON boxers to barbeque restaurants, and they keep Florida's economy strong. g• : I ',I CCC13.2°81.24 A7- /291%08 0702.6 . 9.1I6` Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myflorida CERTIFIED R OOFING CONTRACTOR There you can find more information about our divisions and the regulati that BEAUCHAI 'MICHAEL .E impact you, subscribe to department newsletters and learn more about the I i SEINGIiE MASTERS- _ROOFING _CONSTR Department's initiatives. III I' I ,',' .1'.' Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. (� Thank you for doing business in Florida, and congratulations on your new license! z cs da a D u s 3 the provisions :of'_Ca 48 �s �.- ,ation date. AUG 31, - .1,0 . ' Q8 7 „ DETACH HERE _ `AC# , . ), Y i E) `O A " II '' lul 'I ill ...,.,,,,,,,....',I '. • • 8y -. kiS a ; t - - - - � O ` =S REGUL il' , I a' , A ae s �' x C BOARD I ' - I I III. •S L08 9 � 7 DA7E Bd CI- H.PIESER �f7 9 F z ' The ROOFING � I I / s:,7 ' `I _ - _ - .. ee� l o, IyI,, , Name . I bel I I i itt I I CERTTF w.,,t, t '-. . —, �. .: 'nI II d' I I, i t II �l ii II - _ v'r the 'provi,si l' I W } 'of Cha ~:. - i z ' ca' :,,,,..,,,,,',..,A1..,',,,,,„.,, , c; - _ ` Eacgir ata � on apt a AUG :�;; t i %, ' _ -° _ ' I1I I , Il ii 1 IM il1Wi , �t xa�r srz �' - - - --__ BEAUC' AINE Sr I ; � ' y' ' 2J /� f} � T, b "+ I I , - _ VISE INC - . © ��Y���� � I � � � I�� �MI I � bfsL � ` z � _ — - - _ __ VA�LRICO FL O '' QI I wI I ,.i I i t 1 . 1 ; li u , �' r - .} , ,_„ I ' l',."''',.,,,,.' '''�. � , III , V ' ' : I s t = r 1 I .II Ih 11 � I ,, I i i III I' II I 'm t : �rr� , i I I. i �i 'LIE I � DRA rlf ' . _ - ---' ,SS s , y I ' I ii III II l I o II R�.H CR E C R E O I III ,_ „ - .- irl ri'i w..l :ntkr'I' ,II i ''T ! 'SECRETARY__ HILLSBOROUGH COUNTY BUSINESS TAX RENEWAL INSTRUCTIONS • Chapter 205.0535 (5) Florida Statutes requires one of the following: FEDERAL EMPLOYER IDENTIFICATION NUMBER OR SOCIAL SECURITY NUMBER 1. SIGN and return entire form in enclosed envelope. Your validated Business Tax receipt will be returned to you. 2. Business Tax receipts expire midnight, September 30th. Failure to display a valid Business Tax receipt after September 30th is a violation of Hillsborough County Ordinance 95 -4, as amended by 02 -5. MAKE CHECK PAYABLE TO: DOUG BELDEN, TAX COLLECTOR P O Box 172920 TAMPA, FL 33672 -0920 2008 -2009 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9 -30 -2009 FOLIO NO I FACILITIES OR MACHINES 0 ROOMS O 0 SEATS I EMPLOYEES 6 193405 H. WASTE TAX OCC. CODE BUSINESS TYPE SURCHARGE 090.028 CONTRACTOR - GENERAL & ROOFING 18.00 MY J \� � 5 L i.-+• h:.i -F. •• 0. fp C C _• :`n , Co 4.. BUSINESS 2502. CULBREATH ::COVE CT "'-' =' LOCATION VALRICO 33596 i n t...) s X -i to to :..J r• -. NAME BEAUCHAINEMICHAEL E /OBA/ SHINGLE MASTERS v v J MAILING ROOFING &"CONSTRUCTION "SERVICES INC o. " T Y T Cr In ADDRESS 2502 CULBREATH COVE CT a ^I VALRICO FL 33596 !3 `'� 6 BUSINESS TAX • 0 Ai. DOUG BELDEN, TAX COLLECTOR °- •• HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE r C fo 813 - 635 -5200 co •• . 5 IN BUSINESS, PROFESSION, OR OCCUPATION SPECIFIED HEREON. THIS BECOMES A TAX RECEIPT WHEN VALIDATED. F - + r ; E co 0. c '5 t 4206 19340500008 000018002 000040006 —— it "t HE • 6 ` `' 08 -05 -2008 • ALEX SINK ' STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 08/05/2008 EXPIRATION DATE: 08/05/2010 PERSON: BEAUCHAINE MICHAEL E FEIN: 223953546 BUSINESS NAME AND ADDRESS: SHINGLE MASTERS ROOFING & CONSTRUCTION SERVICES iNC 2502 CULBREATH COVE CT VALRICO FL 33594 SCOPES OF BUSINESS OR TRADE: 1- REMODELING 2— CERTIFIED ROOFING CONTRACTOR 3- CERTIFIED GENERAL CONTRACTOR IMPORTANT: Pursuant to Chapter 440. 051141, F.S., an officer of a corporation who elects exemption fpom this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(121, F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. )WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 QUESTIONS? (850) 413-1609 • • • • 08/02/2009 19:58 8136639493 BEAZER HOMES PAGE 01/01 ,fie + h•, mss. B i fl DING DEPARTMENT • RE: 'Permit # q37g 9/17/07 Inspection Affidavit 1 th. 1 ejvk.d £ "EJ f rdvc 441 ve ,licensed as a(n o> btracto grocer /Architect, (please print name and circle Lic. Type) FS 468 Building Inspector* • License #; C C G / V 7 ? . - ' On or about 7v1.4 3 l Zoo", /O A lb , Z did personally inspect the roc Abate & time) deck nailing and/or secondary water barrier work at 532.`a 17 5+. (circle one) (Job Site Address) z e p }Irk; Its , Fi . % Wf z Based upon that examination'I have determined the installation was done according to the Hurricane Mitigati etrofit Manual (Based on 553.844 F.S.) Signature • • STATE OF FLORIDA COUNTY OF Sworn to and subscribed before me this 31 ' day of . 2004_ By th: 4441 ' t "ea. at/04444. Notary Public,. State of Florida • N. SUSAN WN I •t/ � &•-4.-0/1r .�' CD�SSION/ODAl2S37 a,, yes: n awe 111 06, 2012 ANN. I40 (Pest, type or stamp name) 47� Y Pt. �'MIM'Df10M111 N00. CO. Commission No.: • Personally known V or Produced Identification Type of identification produced. General, Building, Residential; or Roofmg Contractor or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof witb, the permit # or address # clearly shown marked on the , • deck for each inspection. •