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HomeMy WebLinkAbout11-11364 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 11364 BUILDING PERMIT Permit Number: 11364 Address: 37405 TEABERRY LP Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: WEDGEWOOD MANOR Est. Value: Parcel Number: 10- 26 -21- 0120 - 00000 -0040 Improv. Cost: 1,057.00 Date Issued: 1/04/2011 Name: LORENZ, ROBERT & NANCY Total Fees: 67.50 Address: 37405 TEA BERRY LP Amount Paid: 67.50 ZEPHYRHILLS, FL. 33542 Date Paid: 1/04/2011 Phone: (813)788 -7447 Work Desc: REPLACE 9 X 7 GARAGE DOOR SIZE /SIZE . .5, r ,_.....7 \ Z // hi FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE -SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. 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 fr be recording your notice of commencement." (LajtC/ _ji- \,0,/,a(-4t., allr i I 41. , 1 // j1 CONTRACTO 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 Permitting 1 I - tTI� - Owner's Name 1V8. IL L c r t 1 Z- Owner Phone Number gi 3 �� - J "1'4 7 Owner's Address 3 1 1 / d S T he b e rev' Lcc P Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 3 ?etcS 'Teaherrv, LOc,e LOT# [ SUBDIVISION Vie-d yetvvrcl PARCEL ID# r c - c ; - C0000 -0 c -fr (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT 1 1 SIGN n T ] DEMOLISH INSTALL _ REPAIR PROPOSED USE r SFR Q COMM 1 1 OTHER TYPE OF CONSTRUCTION 1 BLOCK 9 C 0 FRAME 1 I STEEL n DESCRIPTION OF WORK Re.PIR I CC- X i -t✓ <'- 1)ud" Wt -�(,t St \ ►'rlt S( z e • , BUILDING SIZE SQ FOOTAGE HEIGHT I !BUILDING $ 1� ( ? - VALUATION OF TOTAL CONSTRUCTION F ELECTRICAL $ AMP SERVICE 1 PROGRESS ENERGY n W.R.E.C. in PLUMBING $ 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION GAS r- ROOFING n SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA nYES NO BUILDER COMPANY Mar-Li el (,'ttiI c; 0104.'1. S✓K SIGNATURE 9 r 4'/ 7'e C REGISTERED ! Y / N I FEE CURREN (;T REF I Y N I Address g7 / Jt`',1S J4-, -F C - FPO 3 License # P 5 - ' S& ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURREN 1 Y/ N 1 Address I License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N 1 Address 1 License # MECHANICAL COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN I Y/ N Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN I Y/ N I Address License # 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t 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 $7500) 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 if shingles 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. 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 811 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 1 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 • ATTORNEY BEFORE RECORDING YOUR N •TICE OF COMM NCEMENT. FLORIDA JURAT (F.S. 117.03) 't _pia OWNER OR AGENT t - CONTRACTOR Al ' f L � _ Subscrib and sworn • • affirmed) betq me ibis � f fr) 7aft'6 D /' Subscribed and s orn to (or affirm '.) before me}This b y C i �affirmed) 1 t yr (, . C � �i -�"t . Lt ,- 1.4 t t (4" Who is/arepersonally known to me or has /have pfoduced Who is /are personally known to me or has/have produced as identification. - _ cation. identification. r it l A. Notary Public t,:_. ' • �` :. ^.. Notary Public Commission Ple. Commission No. "" LINDA MANCUSO ❑NUA Mwvt,mu µY ill .� t'y.Y A. MY COM ISSION #DD671967 Name of N. R' • t"9:� rnw nit i • Name of Notary y� ` e or s t EXPIRES: MAY 08, 2011 EX IR S: MAY 08, 2011 nt- Bonded through 1st State Insurance � Bonded through 1st State Insurance Aco ® CE RTIFICATE OF LIABILITY INSURANCE DATE(MMIDDmw) `...� NCE 1/3/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT pact King Y g #E131203 _ PrimeGroup Insurance Services, Inc. Luc o Exh: (813) 890 -0415 FAX No (813)885 -4311 5440 Beaumont Center Blvd. ADDDR : ek i ng @primegroupins.com Suite #445 PR UCER n00005778 CUSTOMER K) (F ' Tampa FL 33634 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INsuRERABridgefield Casualty Ins. Co. INSURER B : Mar -Lin Quality Finishes, Inc, INSURER C : 8509 Sunstate St, Ste 202 INSURERD: INSURER E : Tampa FL 33634 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1091007889 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLI CIES. LIMITS SHOWN MAY HAVE BEEN REDU CED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POUCY EFF POUCY EXP LTR INSR WVD POUCY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) UMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED E:XP (Any one person) $ — PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP /OPAGG $ POLICY n JECT n LOC AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULEDAUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON -OWNED AUTOS $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ — EXCESS LIAR CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' UABIUTY Y / N X TORY I IMITS ER ANY PROPRIETOR/PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 100 000 OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) 0196 -16757 10/31/2010 10/31/2011 E.L. DISEASE - EA EMPLOYEE $ 100 , 000 If yyes desaibe under ERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESG�RIPTION DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Zephyrhills ACCORDANCE WITH THE POLICY PROVISIONS. Bldg. Dept. 5335 8th Street AUTHORIZED REPRESENTATIVE Zephyrhills, FL 33542 E Ellsasser #A077187/ y •o ACORD 25 (2009/09) ©1988 -2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD 4 0.,... MAR- JIN Quality Finishes, Inc. 8509 Sunstate St. Suite 202 / Tampa, FL 33634 CBC 1254953 Phone: 888 - 271 -9000 Fax: 813- 886 -1134 January 3, 2011 City of Zephyrhills Building Permits To Whom It May Concern: The intent of this letter is to grant permission to Cesar A. Berrera, (Armondo), allowing him to pick up Permits for Mar -Lin Quality Finishes, Inc. If you have any questions, please do not hesitate to contact me at 813 - 886 -1604. Thank you for you cooperation. Mar -Lin Quality Finishes, Inc. /1 4'6' ft Salvatore J. Basile President STATE OF FLORIDA HILLSBOROUGH COUNTY Sworn to and subscribed before me this day of'-', , , 2011 \-° Personally Known or produced identification Start • LINDA MANCUSO :4, MY COMMISSION #DD671957 EXPIRES: MAY 08, 2011 Bonded through 1st State Insurance ice- 4 O P r ' - " ,. - City of Zephyrhills BUILDING PLAN REVIEW COMMENTS C___ ontracto omeowner: AA— f / i (;,j-,44725 r j_ , 4 1 ' Date Received: n 1." , ■ �, Site: o" / C 1, u. OA I. / , Permit Type: _a :f ,,ice L X I/ r f3g Approved w /no comments ( ig Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment shee : .1 be .t with the permit and/or plans. /1 7 , -11 Kal Switzer !' ans Examiner Date Contractor and/or Homeowner (Required when comments are present) Del; -22 -10 01:41P 8509 Sunstate St. 813 886 1134 P.02 .813.780 -0020 City o f� ephyrhills Permit Application Fax -813. 780 -0021 r / /� Building Department Dale Received SM / � Phone Contact for Parmittln p 1 813 8840 .- ) (y L' � ! ' ! / S / y ' /y 1 3 Owner's Name NArl L'. Lore el Z Owner Phone Number 1 3 - IV? -1.44 Owner's Address 3 9 y 0S TT" b e fr N L O P ( Owner Phone Number F Fee Simple Titleholder Name ( 1 Owner Phone Number r Fee Simple Titleholder Address JOB ADDRESS ( 39'fc5 Tec.ber^ry 1.-0C.19 �� ,/ �� r I �" l� LOTN SUBDIVISION ( 1r ed ie.. ,o d I PARCEL ID* 1I0 — �y7 '�d i ^ O) -1. 0000 ` IOETMNED FROM PROPERTY TA( NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT 1 S IGN = [� DEMOLISH INSTALL 8 1 REPAIR PROPOSED USE = SFR 0 COMM r-- O THER 1 TYPE OF CONSTRUCTION (= BLOCK Q F FRAME r STEEL = [ I DESCRIPTION OF WORK f g/rriQC G q X1 C -■ r[l e 00C f W f4 SA vrl [. Si z C.. BUILDING SIZE ( SO FOOTAGE I 1 HEIGHT' 1 =BUILDING IS 1. 0 5 3-1 VALUATION OF TOTAL CONSTRUCTION nELECTRICAL $ I AMP SERVICE n PROGRESS ENERGY = W R.E.C. nPLUMBING $ I nMECHANICAL .$ 1 VALUATION OF MECHANICAL INSTALLATION =GAS = ROOFING O SPECIALTY F O THER FINISHED FLOOR ELEVATIONS ( I FL a eD ZONE AREA I1YES NO jj / TT SIGNATURE BUILDER f( [L! � � COMPANY (Ma r-L. ^ WU��It Jam/ ell S{Iri. �,�� v REGISTERED 1 Y/ N I FEE CURREI Y/ N Address I g501 S6ns+a , TPn 3 License N It-' ;L 1.% ELECTRICIAN COMPANY ( SIGNATURE REGISTERED 1 Y/ N I FEE CURREN 1 Y/ N Address ( 1 License N F PLUMBER COMPANY ( SIGNATURE REGISTERED I Y/ N 1 FEE CURREA I Y/N 1 Address �`'` License N l MECHANICAL COMPANY ( SIGNATURE REGLSTEREO l V/ N I FEE CURREA 1 Y/ N 1 Address I 1 License N F OTHER COMPANY ( SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN 1 Y/ N 1 Address I 1 License N 111111I11I1 1111E 11111 1ffffE111111E1f11IIIf1111111 E111f11allaalll RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans: (1) set 01 Energy Forms: R-O-W Permit for new const Minimum ten (10) working days after submittal date. Required omits. Construction Plans, Slornwatei Plans w/ Sill 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 P.trmit for new construction. Minimum ten (10) working days alter submittal date. Required onade. Construction Plans, Slormwater 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. 1 1" 1 1 / I' 1 1' Directions: Fill out application completely. Owner £ Contractor sign back of application, notarized If over $2500, a Notlu of Commencement Is required. (A/C upgrades over $7500) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner au horizing same OVER THE COUNTER PERMITTING (Front of Application Only) Retools N shingles Sewers Service Upgrades NC Fences (Plot/Survey/Footage) Driveways -Not over Counter if on public roadways..needs ROW Dec -22 -10 01:41P 8509 Sunstate St. 813 886 1134 P.03 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 responsib lity 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 fdr a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing reqi. irements 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 lave 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, wil 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 cork is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Constructio, 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 - to 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 regulation; in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the ntended 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 preparec 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 nct adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owns" may be cited for violating the conditions of the building permit issued under the attached permit applicaticn, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If 1 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 Bu (ding 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 issuar ce, 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 COMMENCEMEI%T MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAJN FINANCING, CONSULT WITH YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR N • TICE OF ON N EMENT. FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT / • C. , R10 7 CONTRACTOR /tea= tip Sub d d sworn • or affirmed) •, • me Subscribed ands to (or affirm '•) ,rte i ore s 1, c a lan by �x.t l n L•••••' S , > 'a b y _l• Lz t. l-. .L1 L r' Who is/are personally known to me or has/have uced Who is/are personally known to me or has/hat, e produced as identification. - ._...-_ as identification. • • _ _. ' ! y.. `L.. Notary Pudic : it, t ' / •( t i . L Notary Public Comrnissioe•Ne• Commission No. ' LINDA MANCUSO LINDA I r ' ' ". 1 Y Name of N a 1 Name of Notary ty r or C SS . : ~" : ' EXPIRES: MAY OS, 2011 y� j� S: MAY OB, 2011 ■ Bonded through 1st State huurmce 1 3i Bonded through 1st Std Wynne Dec -22 -10 01:41P 8509 Sunstate St. ,813 886 1134 P.04 g , 1,,d3S et t th Ot� .. U , s,; , - i 0. °d q 04.4 , ,c4 i r A yy _: ;_. gi R ! dd �� 9 w �r�o i J r 118 A hh ihi 3 g. a1 iv. 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Sheimerdine developed the Evaluation Report Florida Ucense PE- 0048579 Quality Assurance Entity Intertek Testing Services NA Inc Quality Assurance Contract Expiration Date 01/01/2099 Validated By Steven M. Urlch, PE Validation Checklist - Hardcopy Received Certificate of Independence FL5302 R1 CDI Tom Shelmerdine Letter of Independence 7.24.2007.odf Referenced Standard and Year (of Standard) itandad Year ANSI/DASMA 108 2002 ASTM E 330 2002 Equivalence of Product Standards Certified By htt : / /floridab uilding.org/pr /pr_ app_ dtl. aspx? param= wGEVXQwtDqunL7seVZMFLLe0... 12/22/2010 Dec -22 -10 01:43P 8509 Sunstate St. 813 886 1134 P.07 Florida Building Code Online Page 2 of 5 Sections from the Code Product Approval Method Method 1 Option D Date Submitted 12/15/2008 Date Validated 01/07/2009 Date Pending FBC Approval 01/13/2009 Date Approved 02/03/2009 • ummary of Products - -- — - i FL 4' Model, Number or Name Description 5302.1 Stratford (M600) and Heritage Dwg. IRC- 6009- 110-i1,Thru 9' wide. (M950) Limits of Use Installation Instructions Approved for use in HVHZ: No FL5302 R1 II IRC- 6009 - 110- 11.od( Approved for use outside HVHZ: Yes Verified By: TOM SHELMERDINE 0048579 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: +19.1/ -22.6 Evaluation Reports Other. Design Pressure +19.1/ -22.6, Not for use In FL5302 R1 AE ASCE 7 -98 -02 - 05.od( HVHZ. Glazing option shall not be used in wind -borne FL5302 R1 AE PTID 5302 T IRC -6009- 110- 11.odf debris region unless structure is designed as partially Created by Independent Third Party: Yes nclosed or door is a replacement door. 5302.2 Stratford (M600) and Heritage Dwg. IRC- 6009 - 100 -11, Thru 9' wide. �(M950) Limits of Use Installation Instructions Approved for use In HVHZ: No FL5302 R1 II IRC-6009- 100- 11.odf Approved for use outside HVHZ: Yes Verified By: TOM SHELMERDINE 0048579 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: +15.8 / -18.7 Evaluation Reports Other: Design Pressure +15.8/- 18.7,Not for use In FL5302 R1 AE ASCE 7 -98 -02 -05.odt HVHZ. Glazing option shall not be used in wind -bome FL5302 R1 AE PTID 5302 T IRC- 6009- 100- 11.od( • ebris region unless structure Is designed as partially Created by Independent Third Party: Yes enclosed or door is a replacement door. _ 5302.3 Stratford (14600) and Heritage Dwg. IRC- 6009 - 120- 15,Thru 9' wide. 1(14950) Limits of Use Installation Instructions Approved for use In HVHZ: No FL5302 Ri II IRC - 6009 - 120- 15,0( Approved for use outside HVHZ: Yes Verified By: TON SHELMERDINE 0048579 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: +22.8/ -26.9 Evaluation Reports Other: Design Pressure +22.8/ -26.9, Not for use in FL5302 R1 AE ASCE 7 -98 -02 - 05.pdf HVHZ. Glazing option shall not be used In wind -bome FL5302 R1 AE PTID 5302 T IRC -6009- 120- 15.odf debris region unless structure is designed as partially Created by Independent Third Party: Yes enclosed or door Is a replacement door. 5302.4 Stratford (M600) and Heritage Dwg. IRC -6009- 130 -15, Thru 9' wide. (14950) imits of Use Installation Instructions Approved for use In HVHZ: No FL5302 R1 II IRC - 6009 - 130- 15.odf Approved for use outside HVHZ: Yes Verified By: TOM SHELMERDINE 0048579 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: +26.7 / -31.6 Evaluation Reports Other. Design Pressure +26.7/ -31.6, Not for use in FL5302 Ri AE ASCE 7 -98 -02 - 05.odf HVHZ. Glazing option shall not be used in wind -borne FL5302 R1 AE PTID 5302 T IRC -6009- 130- 15.odf debris region unless structure is designed as partially Created by Independent Third Party: Yes enclosed or door is a replacement door. 5302.5 tratford (M600) and Heritage Dwg. IRC- 6009 - 140 -15, Thru 9' wide. l(M950) Limits of Use Installation Instructions Approved for use In HVHZ: No FL5302 Ri II IRC -6009- 140- 15.odf Approved for use outside HVHZ: Yes Verified By: TOM SHELMERDINE 0048579 Impact Resistant: No Created by Independent Third Party: Yes p. Design Pressure: +31.0/ -35.1 Evaluation Reports Other: Design Pressure +31.0/ -35.1, Not for use in FL5302 R1 AE ACE 7 -98 -02 - 05.odf HVHZ. Glazing option shall not be used In wind -bome FL5302 R1 AE PTID 5302 T 1RC- 6009 - 140- 15.odf debris region unless structure is designed as partially Created by Independent Third Party: Yes http: / /floridabuilding.org/pr /pr app dtl. aspx? pararn— wGEVXQwtDqunL7seVZMFLLe0... 12/22/2010 Dec -22 -10 01:44P 8509 Sunstate St. 813 886 1134 P.08 Mar -Lin Quality Garage Door Estimate & Proposal Finishes, Inc. Phone OF )n/ 9000 1 • NAY €: PHONE• DESIGN C ULTANT ESTIMATE DATE: 1" �j Lo,P IL ��� -Site— 5:4-r, l ei / 7 -. s —/ 0 ADDRESS: OFFICE 1 CELL INSTALL ADDRESS Tracking II '3149 o� lea CITY , S TA ZIP CUSTOMER EMAIL ADDRESS 2 e l 0141, 4i 1Ic 3 3s 1 17 IANe. the owners of a premises described above hereinafter referred to as the - purchaser offer to contract with Sears Garage Doors and irs Authorized Contractors hereinafter referred to as the - Contractor. to furnish. deliver, end arrange for installation of all matarlats necessary to srprove the premises located at the install address above. GARAGE DOuk - SIZE & rv1ODEL SIZE & QUANTIT 1 MODEL SIZE (1): X ! , _ QTY: , ❑ Sears 3000 ❑ Premier 1000 ❑ Wood Carriage House SIZE (2): X _ QTY: ❑ Sears 2000 ❑ Premier 3000 ❑ SIZE (3): X _ _ QTY: **ors 1000 ❑ Premier 2000 ❑ SIZE (4): X _ ,_ QTY: Notes: Width He ht [PANEL DESIGN: Short Panel ❑ Long Panel ❑ Flush Panel ❑ Ribbed Panel (Flush and Ribbed panel available in 3000 only) COLOR: 1 e' White ❑ Almond ❑ Sandtone ❑ Brown' ❑ Hunter Green* ❑ Grey ("3000 only) DECORATIVE ❑ NO WINDOWS Glass Type: ❑ Clear ❑ Obscure INSERTS: ❑ Cathedral ❑ Cascade ❑ Prairie Stockton ❑ Sunray full Sunray ❑ Waterford ❑ Wagon Wheel ❑ Moonlite (LP Only) Premier Base n ❑ A ❑ B < ❑ c ❑ D ❑ Ten Lite Square Top Sectio sign ❑ Solid Arch ❑ Solid Square ❑ Double Arch ❑ Diamonds ❑ Quad Arch ❑ Plain ❑ Ten Lite Arch Decor Hardware ❑ Traditional Handles (Included) ❑ Strap Hinges (included) TRACK & l Lift (12" radius) ❑ 15" radius ❑ Low Headroom (6 1/2° ext, 95/8" torsion) HARDWARE: ❑ Low Headroom - Front Torsion ❑ Low Headroom - Rear Torsion 0 Extension Spring LOCK: ❑ No Lock 7Ef Inside Slide Lock (included) ❑ Outside Keyed Lock (Sean Traditional) ❑ Lever Handle Keyed Lock (Sears Premix) GARAGE DOOR OPENERS Craftsman Qty: . - Rail Length: ❑ r ❑ 8' (Extension required) Chain Drive - Model 53985: CJ 1/2 hp Chain Drive - Model 53990: ❑ 3a hp ❑ Customer Furnished Belt Drive - Model 53914: ❑ 1/2 hp nnect existing opener ❑ Emergency Quick Release QTY "SIZE MODE PRICE EACH E T. PRICE Notes & Special Conditions: `n S 1 03ze 9/as 8 0 5 * *Garage to be cleaned out 10' back from opening ** .7„, Kii In 9, ---- i),0 604 i o sei f PAYMENT: Amount $ /Z 7 -' / Subtotal: " ❑ Check ID: ❑ Cash (Please Circle One) Sales Tax e/a f harge: ( SAi/W Visa Amex Discover a p q o 4 Total Project Cost S 4 / 0 9978 �93 s ! a �o � • Account #: _. _ _-__ Exp. date: _ 11 1 Authorization coda: (V a L7 HOW ARE WE DOING? / ' t e _ gbA /.2_74, Date titre - .4( (11 ■�'(!1 U�f'(fr)nl - 4.t nlll 4111 - 1 11' f '�%m- Signature Customer Signature Date THIS MESSAGE APPLIES TO DOOR -TO -DOOR SALES ONLY: YOU 11.18 PURCHASER(S) MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THE TRANSACTION. SEE ACCOMPANYING NOTICE OF CANCELLATION FOR FURTHER EXPLANATION OF 11118 RIGHT. white: corporate file canary: branch file pink: buyer's tile blue: buyers tile Dec -22 -10 01:40P 8509 Sunstate St. 813 886 1134 P.01 MAR -LIN QUALITY FINISHES, INC. 8509 SUNSTATE ST SUITE 202 TAMPA, FL 33634 STATE CERTIFIED CAC 1254953 FACSIMILE TRANSMITTAL SHEET TO: FROM: Permit Department Salvatore J. Basile COMPANY: DATE: City of Zephyrhills DECEMBER 22, 2010 PHONE NUMBER TOTAL NO. OF PAGES INCLUDING COVER: 813- 780 -0020 1+6 FAX NUMBER: SENDER'S REFERENCE NUMBER: 813- 780-0021 RE: YOUR REFERENCE NUMBER: 37405 Teaberry Loop Attached please find the following: = 1 .a • Permit Application to replace a garage door size for size ' • Two sets of approved drawings • Copy of FI. Product Approval Code 5302.3 I appreciate you processing this via fax. If there is something additional you require, please contact me at 813 - 886 -1604. Thank you. Sal Basile PHONE # 813.886.1604 FAX # 813.886.1134