HomeMy WebLinkAbout10-10013 • CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 10013
BUILDING PERMIT
" 4
Permit Number: 10013 Address: 4755 19TH 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: 14 -26- 2100010 - 02600 -0030
Improv. Cost: 3,500.00
Date Issued: 1/20/2010 Name: DAHLBACK, DANIEL& GELONEK, BRITT
Total Fees: 50.00 Address: 4755 19TH ST
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 1/20/2010 Phone: (813)205 -2397
Work Desc: REROOF SHINGLE SINGLE FAMILY
Po , y ' y , #. ,1 ? 3 .' ... r
A. :ARTL R•• I •FC N `ALF - - •OF - IDE AL 50.00
V 7
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IA 1
PRYIN - ••FIN -
TAPE JOINTS FOOFIDI
FINAL (( Z
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 �, your property. If you intend to obtain financing, consult with your lender or an attorney
before reco . ; your notice . _ . mmencement."
I 1 "1V/
Jr OR SIGNATURE PERMIT OFFI �R
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 rax -t Ii- eau -uuz i
Building Department
Date Received P • ne Contact f , r Permitting
Owner's Name `. • C - W W / Owner Phone Number
Owner's Address L T 7_3 --(7 ` Owner Phone Number
Fee Simple Titleholder Nang,_. • 1 _44.0.... H i • ^ er • one Number
_ ,
Fee Simple Titleholder Address
JOB ADDRESS LOT #
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I I MOVE I I DEMOLISH
INSTALL REPAIR
PROPOSED USE I SFR I I COMM I $ OTHER I
TYPE OF CONSTRUCTION ( $ BLOCK FRAME 1 1 STEEL I I OTHER I I
DESCRIPTION OF WORK
BUILDING SIZE S OOTAGE HEIGHT
■ ■■
I I BUILDING 11,, $ -� 7,) VALUATION OF TOTAL CONSTRUCTION
I I ELECTRIC L $ AMP SERVICE 1 1 PROGRESS ENERGY I I W.R.E.C.
PLUMB' G $
I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
I ( GAS I I ROOFING I I SPECIALTY I 1 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 $YES I $NO
-1 . _ _ — .T. _ _ - . _ WSJ _ .
BUILDER COMPANY
SIGNATURE REGISTERED I Y/ N $ FEE CURRENT I Y/ N I
•
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N
Address L , ense #
OTHER �I/ COMPANY
AY
SIGNATURE ' � �� ' / REGISTERED 1 Y / , FEE CURREN Y
Address !1=1ir.. License # I
4 41 1 - N 1-1 t- 4- 4- 41-
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.
lIIIIIIIlltlIlltIlll
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 CONTRACTORS 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 Transportation 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 Protection Agency- Asbestos abatement.
- Federal Aviation Authority- Runways.
1 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
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the 'ob is onsidered abandoned.
WARNING TO OWNE 0 R FAILURE TO RECORD A NOTICE OF COM E NT MAY RESULT IN YOUR
PAYING TWICE F • - , ' ;r ' 0 EMENTS TO YOUR PROPERTY. IF YOU 1 T 0 •
COMMENCEMENT. AFINANCING, CONSULT
WITH YOUR LE ; �..L' �;/ �
' TTORNEY BEFORE RECORDING YOU i
FLORIDA JURAT
O
f
WNE' • ' y� I / '/ /
CONTRACT
Subscri e. : • y��f ' r '� i T before me this Subscribed a •�s' orn 4 e• before me this
Z� i by 27 — ' y
Who is /are personall r:.wn to m- /•r has /have produced
Who is /are personally known to -4...r ha asadentifi produced
identification.
" :Lee. '�', ,,��.1. *GB Notary Public
Notary Public
/{ r • .1n11, rr.; � , ry i .
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Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
L E G A L D E S C R I P T I O N :
ASSESSED IN SECTION 14, TOWNSHIP 26 SOUTH, RANGE 21 EAST,
PASCO COUNTY, FLORIDA
MOORES FIRST ADDN PB 1 PG 57 LOT 3 BLOCK 26
OR 6955 PG 1429 11II11I11I11IIII1IIIIIIIIIIIIIIIIII111111111IIIII111110IIII
2010005726
Rcpt: 1282737 Ree : 10.00
DS: 0.00 IT: 0.00
01/14/10 _Dpty Clerk
NOTICE OF COMMENCEMENT
PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER
01/14/10 liggp 1 of
OR BK 55 P6 7
Permit No. i
Property Identification No. /V"; G - Z / D O/0 - Q Zb 0D - (>OJ1)
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and in accordance with
Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description:) S'eeE ,9.6pv
a) Street Address: 4755 19th Street Zephyrhills, FL 33542
2. General description of improvements: R e r o o f House 3 tab Shingles
3.Owner Information
a) Name and address: Daniel Doglback 4755 19th St. Zephyrhills, FL 33542
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property.
_
4.ContractorInformation A Bartlett Roofing 38408 3rd. Ave. Zephyrhills, F1 33542
a) Name and address:
b) Telephone No.: 813 Fax No. (Opt.) R 1 '1- 7 S {1 -1 R () 5
5.Surety Information l
a) Name and address:
b) Amount of Bond:
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:
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(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is
specified):
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 • ■ • TTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMEN' .. k ENT.
STATE OF FLORIDA , / _ )4t,
COUNTY OF PASCO
re , er Ii lit to' O lc r Director/P ztnerlManaQer
Print Name
The foregoing instrument was acknowledged before me this (/ day of "i )4: 20 by
as ( (type of authority, e.g. officer, trustee, attorney
in fact) for (name of party on behalf of whom in•,A , ent was ex cuted).
Personally Known OR Produced Identification Notary Signature di,: . �r
.■_ 'Alr
Type of Identification Produced N s
Name (print) J i •
Verification pursuant to Section 92.525, Florida Statutes. Under penaltie • f perj I d e that I ha e read th regoing and that
the facts stated in it are true to the best of my knowledge and belief.
NOTARY PUBLIC -STATE OF FLORIDA %,.
l�� "b•, Richard C. Bartlett Si y r e o I atu Person Signing Above
Ae
FORMS /NOC,rvsd2007 _ _ . 1. CO IIlII1 1 S S 10II DDg�8490
$ Expires: JULY 31, 2013
B ONDED THRU ATLANTIC SON'DINO C0.1NC.
•
STATE OF FLORIDA, COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT
ON FILE OR OF PUBLIC RECORD IN THIS OFFICE
WITNESS MY HAND AND OFFICIAL SEAL THIS
I t DAY OF , JAAI 2 % 0
PAULA S. O'NEIL, CLERK & COMPTROLLER
BY f t(,t 1/L4 G,(-.ct DEPUTY CLERK
A. tA a rt bet t Rani ing Of (Central ifilariba, 3h u.
C/O Richard Bartlett
38408 3rd Ave. _
Zephyrhills, FL 33542
One of the Largest, Oldest, Most Dependable OFFICE
Roofing Companies in Central Florida PHONE
Specializing in Mobile Home JP Stevens White Rubber Roofs (813) 782 - 5585
& Insulated Aluminum Roof Overs
(813) 973 -7737
RESIDENTIAL • COMMERCIAL • MOBILE HOME (352) 523 -1944
LICENSED - INSURED - BONDED Lic. #RC 0031769
• MEMBER OF THE CHAMBER OF COMMERCE •
Serving Zephyrhills, Dade City, Quail Hollow, Wesley Chapel, Land 0' Lakes and Surrounding Areas
We have re roofed more roofs (16, 000) in the past 35 years than the four local leading roofing companie,. combined .
Date /' /
Name
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Address �- -/' � J � "- � ` ,�
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Phone ' i , r ' -' r' G t,ti ''
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President 8. Ouvner �A ' Bartlet Ft6ofipg of Central FL, Inc.
Sign: -
- / ( Richard C.;f
THAT JK O r
Your Business is Appreciated.
Payment upon completion unless previous arrangement made. Warranties pertain to original owner. F //
All arrangements contingent upon strikes, accidents or delays beyond our control. Owner to carry tire, tornado and other necessary insurance. X ;
Our workers are fully covered by Workmen's Compensation Insurance. Customer is liable for any charges incurred in collecting this bill.
Rotten wood is an extra $35.00 per sheet (4 -ply). Rotten fascia is $2.00 per linear foot. 'total ' /
Pasco County Tax Collector Parcel Search Result Page 1 of 1
Mike Olson TAX COLLECTOR PASCO COUNTY FLORrDA
HOME I Real Estate Search 1 Tangible Search 1 Business Tax Receipt Search
Tax 1 Driver License 1 Motor Vehicle 1 Boat 1 Business Tax Receipt 1 Fishing /Hunting License
2008 Pasco County Tax Certificates Now Available for Purchase @ 18%
Real Estate Property Search Results
CURRENT AS OF: 01/19/2010 19:00:51•
* * * THE INFORMATION CONTAINED HEREIN DOES NOT CONSTITUTE A TITLE SEARCH AND
SHOULD NOT BE RELIED ON AS SUCH. ADDITIONAL LIENS AND DELINQUENCIES MAY EXIST
THAT ARE NOT INCLUDED BELOW. THE PASCO COUNTY TAX COLLECTOR ACCEPTS NO
RESPONSIBILITY FOR THE ACCURACY OF THE INFORMATION PROVIDED. ALL FIGURES ARE
SUB3ECT TO CHANGE OR CORRECTION..(SEE FLOR .IDA_STATUTE_1E7.122)
Parcel ID 2009 Tax Year
14 26 21 0010 02600 0030 ASSESSED VALUE 66,609
Owner of Record HMSTD EXEMPT 25,000
DAHLBACK DANIEL D & ADD'L HMSTD EX 16,609
GELONEK BRITTANY M OTHER EXEMPT
n 4755 19TH LLST NON -SCH TAX VALUE 25,000
' ZEPHYRHIS FL 33542 5213 SCHOOL TAX VALUE 41,609
r, Physical Address AREA 30ZH
V 4755 19TH ST MILEAGE 20.09459
Legal Description (F:rst 4 Lines} GROSS TAX
(INCLUDING SPECIAL DISTRICTS) 686.28
MOORES FIRST ADDN PB 1 PG 57 Special Districts
LOT 3 BLOCK 26 SOLID WASTE 62.00
OR 6955 PG 1429 PASCO COUNTY STREETLIGHT
Mail To Information PASCO COUNTY STORMWATER
SAME AS ABOVE Current Tax
Escrow Code DATE RECEIPT AMOUNT PAID
NONE 12/08/09 677468 665.69
Tax Lien (Homestead Denial)
NONE
Unpaid Delinquent Taxes
NONE
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http:// www .pascotaxes.com/search/prclmain .asp ?parcel = 1426210010026000030 1/20/2010
01/22/2010 09:55 8137801805 BARTLETT ROOFING PAGE 03
City of Zephyrhills
B. 1 0 DING DEPARTMENT
RE: Permit 1 tbI 3 9/17/07
•
Inspection Affidavit
T �
�( J , as a(n) ' Contractor * /Engineer /Architect,
(please print name and circle tic. Type) FS 468 Building Inspector*
License #; c S oZ
On or about 1.- 22.- /0 • • , r did personally inspect the roof
(Date & iime)
•
deck nailing and/or secondary water barrier work at D41,1 I , ap ,Q,
(circle one) (Job Site Addzeis)
SS j . Z ' j
Based upon that examination T have • - - • • ' • ed the installation was done according to the
Huai . • . Y lion Retrofit .0 (Based on 553.844 F.S.)
Si e
•
STATE OF FLORIDA
COUNTY OF
Sworn to and subscribed before me this. Z day of r.(aly . 200L
By _ y
Notary Public, State of Florida
(Print, 41' \.':! .1.11. +., , - •1:. BOG ES
•
•*= e miss o n rD621833
�,�,,, -:.. `} Expires December 12, 2010
CoMIIAiss ABU. Thn+T ''''"'"'""" ' 04040,9
P ersonally known , or-
Produced Identification
Type of identification produced.
* General, Building, Residential, or Roofing Contractor or any individual certified under 468 F.S. to make such an
inspection. Include photographs of each plane of the roof with the permit # or address # clearly shown marked on the
deck for each inspection_
•