HomeMy WebLinkAbout10-10455 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 10455
BUILDING PERMIT
Wit, r t . " z —s :. ',. a ,. -' ,t t . t!. ;; o" , :7 R eps. $ � )7 ' ; i o .., s , I „v
Permit Number: 10455 Address: 5806 18TH - B . T
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 - 07600 -0150
Improv. Cost: 3,825.00 j:,w Fri_ ...7 �77 W 11:7Zia '',;AA
Date Issued: 5/19/2010 Name: KUCHERICK, REBECCA
Total Fees: 50.00 Address: 5806 18TH ST
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/12/2010 Phone: (813)788 -4458
Work Desc: RE -ROOF WITH 30 YR GAF TIMBERLINE 17 SQS
S • BLIP KMAN - • • IN NC RER• • - 1 N IAL 50.00
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DRY IN R• • IN -
TAPE JOINTS ROOF I S
FINAL 5-Lc- (.0 P
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."
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iAb
ONTRACTOR 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 Phone Contact for Permittin —
Owner's Name g b C cc y `-V G t G✓ t c k 7 Owner Phone Number
Owner's Address f 5i lv /r1 f Z I tls Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS a C) ( 1 h 5+ 2 I, l 1 s 3 3 s Va LOT #
SUBDIVISION PARCEL ID# // — 2-6 ` Z-1 - G0 (CT - 0-7 (0 0 0 - U /
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT I SIGN I I MOVE n DEMOLISH
INSTALL REPAIR
PROPOSED USE 1 1 SFR 1 1 COMM ( 1 OTHER
TYPE OF CONSTRUCTION 1 1 BLOCK 1 1 FRAME n STEEL ( 1 OTHER 1
DESCRIPTION OF WORK "- t.A. Gt L !4 6 A 1 ! ! / -e I! -, / S
BUILDING SIZE SQ FOOTAGE HEIGHT
BUILDING $ 3 0 ac- VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY I 1 W.R.E.C.
1 PLUMBING $ h
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIO !�
GAS ROOFING I 1 SPECIALTY n OTHER l!
FINISHED FLOOR ELEVATIO S FLOOD ZONE AREA I]YES [NO
BUILDER COMPANY
SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N 1
Address 1 License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N j FEE CURRENT I Y/ N I
Address I 1 License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y/ N I
Address License # I
MECHANICAL COMPANY I
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address ( License #
OTHER / COMPANY J` ` ` , z 'At
SIGNATURE ! REGISTERED I Y / N I FEE CURRENT I %r / N I
Address � PD d3 Pk /f Jqh AIL AA,. % 3 3Si`I License # Cc 7 5S 7
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 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 IMPACTIUTILITIES 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.
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
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
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.
FLORIDA JURAT (F.S. 117.03) ��,
OWNER OR AGENT .. CONTRACTOR ��
Subscribed and swom to (or affirmed) before me this Subscribed and s om to (or affirmed) before me this
s
by 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
gra& e Proposal /Contract
Scat Veddeateut R , o) tc.
5 P.O. Box 1188 • 33010 R 52
6 San Antonio, FL 33576 deee•Ased,
(352) 588 -ROOF (7663) • (813) 782 -1330 Wooded A
":" Fax (352) 588 -9763 7igssoad
"7Ke, www.scottblackmanroofing.com
eee 5 's s tetevr email: blackmanroofing @aol.com Date f r" ! 1 -
PROPOSAL SUBMITTED TO WORKED TO BE PERFORMED AT
Name e,1C44-t td (- ev Street
i C k_ -- —
_— — — -- —_ — —
Street __ gut) o _ City - -- - -- -- -- —
City c 'kt i'//3 — — — - -- State Zi p -- - —
State t ___.__.------ ___- _ - - - - -- Zip -_ -- - - - - -- Owner of Property
Phone Number 2r - `- Y Fax Phone Number — __ — Fax
Wei reby propose to furnish all the materials and perform all the labor necessary for the completion of:
dfiemove existing shingle roof k epiace bad fascia boards at $_ c= d per foot
J Remove existing built -up roof,, U Replace 1 x ____—_,_____ decking at $ per foot
" . 1 D ry -in with U 1 5 lb. " z e r k - lb. ''�
nstaH _ SPi `�� feet of ridge vents
J Dry-in with a fully adhered underlayment $ . . U Install modified bitimen (granulated) torch down roofing
U Install ne ga l va nized valley metal a ddi t f ° "a
.. black, white or other color
slnst""ll new lead boots U Install 25 yr. fungus resistant 3 -tab shingles
U1 ;;stall new exhaust vents U Install 30 yr. fungus resistant dimensional shingles f ilt) ,
Ui stall new drip edge, color U Shingle manufacturer - . colo t
J Install new flashing as needed U Install TPO, white rubberized ro• ng membrane
Replace plywood at $ 2 r _ `'' " ___ -- per sheet a Other: 7 f C_t) 1 ' ' 0 0".. )c )
repair rotten trusses at $_ 3.0 tJ per foot 3 t., (r i --/ . 4 - - ( ' a ,.... MY • C"
*Woodwork is an additional charge, see pricing above 1 51. (...j s i wed p -1( /44 ,./e q/
All material is guaranteed to be as specified, and the above work is to be performed is accordance with the drawings ani specifi-
cations submitted for above work and completed in a substantial workmanlike manner for the sum of $ -, - _ '' 'r;,.•,1. f 1
with payments to be made as follows: Payment due in full on completion, unless otherwise noted. Than You,
Credit cards accepted, additional 2.8% charge.
Not responsible for satelite signal when satelite is reinstalled *Not responsible for A/C & electrical lines too close to roof decking
Any alteration or deviation from above specifications involving extra costs will
be executed only upon written orders, and will become an extra charge over and , .$eeree '
—
above the estimate. At agreements contingent upon strikes, accidents or delays
Officer/Agent ent Scott Blackman Roofing
beyond our control, Owner to carry fire, tornado and other necessary insurance g 9
upon above work. Workers' Compensation and Public Liability insurance an above Note: This proposal may be withdrawn by us if not acceptec
work to be taken out by Roofing Contractor. Extreme caution should be
used during and after construction for debris and nails missed during within 7 days.
cleanup_
- ___-- - - - - -- - - - -- - --- - - - - -- - - - -- — - -- -_- --- - -- - -- ---- --- - -- -
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified. I have read the back of this Proposal /Contract, which contains Florida Statu s 713.001- 713.37. Payment will be made as
outlined above. Client gives permission to drive on driveway to deliver materials.
Accepte ! t L k' Signatur C . r,a-. .1 7 f
STATE OF FLORIDA, COUNTY OF PASCO
THIS IS TO, CERTIFYTIHAT FOREGOING ISA
TRUE AND CORRECT COPY,OF THE DOCUMENT
ON FILE OR OF PUBLIC REORD IN THIS OFFICE
WITNE,, S MY AN Da0FFICiAL SEAL THIS I111111111111N111111111111 iii 11111 11111 1111111111 MI 1111
DAY PAULA S. O'NEIL„ C RK CO ,PTROLLER 2010066684
BY DEPUTY CLERK Rept :1304819 Rec: 10.00
DS: 0.00 IT: 0.00
NOTICE OF COMMENCEMENT 05/12/10 K. Garcia, Dpty Clerk
•
PAULA S. O'NEIL, PASCO CLERK & COMPTROLLER
Permit No. 05/12/10 12_5Iro P f o
OR BK 0 3 0 18
Property Identification No. gip" --•.Z Ir Z 1 -CO/ Ll _C 26 CO — 0/5 - 0
THE UNDERSIGNED hereby gives notice that improvements 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.
pa it-3c, y 1. Description of property (legal description :) / 4 -7 11- /C - P(. - 7 V (3
a) Street Address: Sit (,, /g- "/ A $ 2 ��,�,, a , //j ,r/ 335 y',�
2. General description of improvements: � � yC w ‘L. 3D ( 4 � r
3. Owner Information II C
a) Name and address: tic C c.i u C ( e. Y l C 1 ._Skt to Jr"
b) Name and address of fee simple titleholder (if other than owner) //i 3351.2
c) Interest in property
4. Contractor Information
a) Name and address: Jet 6fr(C ho- 4 H / � gs h 33ce: S c7.1.. ee.3 ,x /rj
b) Telephone No.: _ -) G 3 ✓ '� %7h //5'35-7 ..
5. Surety Information F ax No. (Opt.) S -���,
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6. Lender
a) Name and address:
7. Identity of person within the State of Florida designated by owner upon whom notices es 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 AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF PASCO
Signature of Owner or Owner's Authorized Officer/Director/Partner /Manager
4 -1 1 7 1 444 4ert,r0 v d.
Print Name
T going instrument was acknowledged before me this day of
� L �- WIG( (/1 as � C 1 ° 1 �'(N r1 C �� Q � y Or � C �. , 20 �d , by �� L'1C. t
in act) for Z5 � ) (type of authority, e.g. officer, trustee, attorney
r (name of party on behalf ofwhom instrument was executed).
Personally Known kOR Produced Identification Notary Signature
Type of Identification Produced Name (print) ( 8 ✓ ( 6. in fr, ' s
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.
FORMS /NOC,rvsd2oo7 Signature Of Natural Person Signing • .o -
" " "„ CORI ANN KEOUGH
-, 1 �- Notary Public - Slate of Florida
';;; • y Commission Expires Aug 17, 2010
.. er r Commission # DD 356503
Bonded By National Notary Assn.