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Home My WebLink About11-11686 CITY OF ZEPHYRHILLS � • 5335 - 8TH STREET ' ' �sis)�so-oo20 11686 BUILDING PERMIT Permit Number: 11686 Address: 5442 9TH 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: 11-26-21-0010-11900-0150 Improv. Cost: 4,480.00 Date Issued: 3/24/2011 Name: MOSS, JASON Total Fees: 60.00 Address: 5442 9TH ST Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542 Date Paid: 3/24/2011 Phone: (813)743-8732 Work Desc: REROOF SHINGLE y � V V �r�� i Q � 1' """ C�_ rn TAPE JOINTS F�QOF,I�� ` FINAL �`'[� � � 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 � 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." �' CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER e��eo-oozo City of Zephyrhills Permit Application Fax-813780.0021 Building Department Date Received phone Confact for Pertnittin _�Tt �/� - C, Owrrer's Name � S a N 1 1 �� Owner Phone Number �� 3�� 3� a! 3�- Ownels Address 5�► y a q S t 2e h � � l S Owner Pi�one Number � Pee SYmple Titlaholder Name pwner Phone Number �- � � Fee Simple TiGeholder Add►ess JOBADDRESS y Z q�'' s� e �2 h. I LOT# r�Q= � SUBDIVISION C� � 0' L f //• �) PARCEL IDIf ��'` ot �" � � 0 � �' � � Q �"� � S Q (OBTAINED F(tqi PROPERTY TIU( NOTCEI WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM Q OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q DESCRtPT10N OF WORK e 0.J'� G1 � � S� S r� f 0 l� r� 4 1 r S t /1 C.� �V11 �'l e S BUILDING SIZE � I I� SQ FOOTAGE I/ y � HEIGHT � QBUILDING S" /1 Q� VALUATION OF TOTAL CONSTRUCTION CJ QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. QPLUMBING �� /� �Q� I „ I �'!! QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION QGAS '�[`�/ ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO � SIGNATURE �i� �J�@�(`r ,v` �� M� Y / N CURREn �N � Address 8�) ( lY '�- `(�i S) i✓� ��. e�' L_ 3 7�p 3 �icense # e CC i 3 z 5 sa s � ELECTRICIAN � COMPANY � SIGNATURE REGISTERED Y/ N F� cuRREn Y/ N Address License # PLUMBER COMPANY � SIGNAIURE �cls�D Y! N FEE cure�n Y! N Address License # � MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # OTHER COMPANY SIGNATURE REGISiERED Y/ N � cua�n Y! N Atldress License # �� IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIt1111111111111111111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fortns; R-O-W Permit for new constniction, ' Minimum ten (10) wortcing days after submittal date. Required onsite, Construdion Pla�s, Stortnwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site WoAc Permit for subdivisions/targe projects COMMERCIAL Attach (3) camplete sets M Buildinp Plans plus a LHe Safety Page; (7) set of Energy Forms. R-0-W Pertnit fa new conslructlon. Mlnimum ten (10) wortcing days after submittal dale. Raquired onsite, Construdion Plans, Stormwater Plans w! SiR Fence installed, Sanifary Facilities & 1 dumpster Site WoAc PertnN for all new projects. All commercial requirements must meet compli�ca SIGN PERMIT Attach (2) sets of Enpineered Poans. ""`PROPERTY SURVEY required for all NEW consWction. Directlons: Fill out applicatfon completely OMmer 8 ConVadar sign back of application, nolar¢ed If over s2500, a NoUca of Commencement is req W red. (A/C upgrades over 57500) " Agent (for the coniractor) or Power of Atlamey (for the owne� would be someone witF� �otarized letter from avner authorizing same OVER THE COUNTER PERMITTING (Front of Applicalion Ony) Reroofs if shingles Sewers Service Upprades A/C Fences (Pbf/Survey/Footape) Driveways-Not over Couoter'rf on public roatlweys..needs ROW MOTICE OF,DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than Courity regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a conVactor or contractors to undertake work, they may be required to be licensed in acxordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contrador may be cited for a misdemeanor violation under state law. If the owner or intended corrtractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspe�ction Divisior�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 "conVactor Block" of this application for which they will be responsibte. 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 pertnitting privileges in Pasco County TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may appy to the construction of new buildings, change of use in existing buildings, or expansion of existing buiidings, 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 occupanc�' 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, 'rf Pasco Counry WaterlSewer Impact fees are due, they must be paid prior to pertnit issuance in accordance with applicable Pasco CouMy 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 "Fto�da Construction Lien Law—Homeowner's Protection Guide° prepared by the Florida DepartmeM 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 documerrt and promise in good faith to deliver it to the "owne�' prior to commencement. CONTRACTOR'S/OVYNER'S AFFIDAVIT: I certify that all the information in this applicaGon 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 �nrork 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 govemme�t 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 indude but are not timited to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, WeUand Areas, Attering Watercourses. - Army Corps of Engineers-Seawalis, Docks, Navigable Watervways. - Department of Heatth 8 Rehabilitative Services/Environmental Health Unit-Welts, Wastewater Treatment, Septic Tanks. - US Environmerrtal Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. I understand that the folloWing r�estrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone "V" unless e�cpressly 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 aifect adjacent properties. If use of fill is found to adversely affect adjacerrt properties, the owmer may be cited for violating the conditions of the building permit issued under the attadied 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 OVYNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commenang construdion. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specificaly 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, aRer, or set aside arry provisions of the technical codes, nor shall issuance of a pertnit preverrt the Building Oificiai from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the woiic 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 U�e 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 01NNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING T1MCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTA1 ANCING, CONSULT WITH Y R LE DER R AN ATT NEY BEFORE REC IN Y R N Ti F C NT. FLORfDAJURAT(F.S.117.03) � / r �� OWNER OR AGENT CON7RpCTpR Subsaibed an �wom to (or afirmed) before me this Sye 2-/ rd sw�� to (or alfim�ed) before me this ��7 /� �� y / �– Who is/are personaly known to me o� has/have produced Who is/are peisonaly Imavn M me or has/have produced as idendficatlon. P_KS+L, as idendficaUon. Note Pudic � �Y � Notery Public Commissio� No. ,.r ��.u� `� 1M� Name of Notary typed, priMed w stamped Name of N ' 'N : `- ; ;�•�; ��ssio� # � �S � '; "'•'.: : ��., ` �,,,,_E 520 ..,;,�,_.� • ` t± �, n, r,�,F pt ►�r �2 �1 5 �� . , �� 4 ' "�-� �. . �m�s w�� y �: CCC1�25525 , PH:(813)-983-9099 � � CCC1325526 FX:(813)-983-9588 � oc s� e Roofin lnc. 9� _ www.docksideroofing.com PROPOSAL SUBMITTED TO: ADDRESS: DATE: 5442 9 ST JASON MOSS ZEPHYRHILLS, FL JANUARY 18, 2011 33542 PHONE: 813-743-8732 CONTACT: JOB LOCATION: EMAIL: themosster69@yahoo.com SAME SAME FAX: INCLUDED IN THIS PROPOSAL DOCKSIDE ROOFING, INC. PROPOSES TO PROVIDE AND INSTALL THE FOLLOWING ACCORDING TO FLORIDA BUILDING CODE STANDARDS OR MANUFACTURER'S RECOMMENDATIONS; WHICHEVER SUPERCEDES: 1. RECORD NOTICE OF COMMENCEMENT FOR COMPLETE PROJECT SCOPE OF WORK. 2. OBTAIN PERMIT AND SCHEDULE ALL NECESSARY INSPECTION(S); INCLUDED. 3. PROVIDE CLEAN-UP AND DUMP OF ALL ROOFING MATERIALS. SHINGLE ROOF AREA: 1. TEAR-OFF EXISTING ROOF SYSTEM DOWN TO DECK SUBSTRATE. 2. RENAIL EXISTING DECKING TO MEET FLORIDA BUILDING CODE REQUIREMENTS. 3. ASTM D 226 #30 FELT UNDERLAYMENT INSTALLED TO LOCAL CODE REQUIREMENTS. 4. 2-1/2" HEAVY GAUGE ALUMINUM DRIP EDGE (WCG�.GRAr4P�-FINISH) AROUND ENTIRE PERIMETER; COLOR: G�F'/; ,�' 'A o,{N �, �S 5. GAF PRO-START STARTER STRIP @ ALL EAVE EDGES. 6. GAF TIMBERLINE HIGH OEFINITION DIMENSIONAL SHINGLE; COLOR: f'�'N�f� �� 7. GAF COBRA RIGIDVENT-3 SHINGLE-OVER RIDGE VENTILATION —(50-FT). 8 SEAL-A-RIDGE RIDGE CAP SHINGLES INSTALLED OVER GAF COBRA RIGIDVENT. 9. SEAL-A-RIDGE RIDGE/HIP CAP SHINGLES INSTALLED ON ALL HIPS/RIDGES. 10. 36" WIDE, ASTM D 1970 SELF-ADHERING VALIEY LEAK BARRIER IN ALL VALLEYS. 11. LEAK BARRIER INSTALLED AROUND ALL PLUMBING/HVAC OPENINGS. 12. ALL PLUMBING/HVAC FLASHINGS WILL BE REPLACED WITH NEW. 13. REPAIR DAMAGED TRUSSES, FASCIA, AND PLYWOOD DECKING ASSOCIATED WITH TREE DAMAGE. 14. REMOVE AND DISPOSE OF GUTTERS. � DOCKSIDE ROOFING, INC. � � � � � 8916 MAISLIN DRIVE —TAMPA, FL 33637 �! PG.1 BB�> IMI�� noo•rewn c�7rrnnar..TC,n CCC1325525 PH:(813)-983-9099 �'CCC1325526 FX:(813}-983-9588 � oc si e Roofin Inc. g� - www.docksideroofing.com UNIT PRICING SCHEDULE /(DAMAGE NOT ASSOCIATED WITH TREE): ALL WOOD REPLACEMENT IS PHOTOGRAPHED BEFORE AND AFI'ER REPIACEMENT AND PRESENTED UPON PROJECT CLOSE-OUT. 1. REPLACE ROTTED/DAMAGED PLYWOOD DECK SUBSTRATE WILL BE @$50.00 per 4'X8' sheet. 2. REPLACE ROTTED FASCIA, TRUSSES, 1-BY DECKING, OR PERLINS (IF APPLICABLE) $5.25 / L.F. **FASCIA REPLACED WITH LIKE-KIND MATERIALS. ALL CUTS WILL BE MITERED TO MATCH EXISTING**. 3. STRUCTURAL ROOF-TO-WALL CONNECTIONS: BY OTHERS INCLUDED WARRANTY: "` GAF - W EATHER STOPPER - SYSTEM PLUS *50-YEAR TRANSFERABLE ROOF WARRANN *130-MPH WIND WARRANTY *10-YEAR ALGAE/MOLD STAIN GUARD *2-YEAR WORKMANSHIP TRANSFERABLE WARRANTY DOCKSIDE ROOFING'S COMMITMENT TO YOU: • ROOFING WORK TO BE COMPLETED IN A TIMELY MANNER. WHEN DOCKSIDE ROOFING STARTS YOUR ROOF, OUR COMMITMENT IS TO YOU AND FINISHING YOUR ROOF. • WE DO NOT USE SUB-CONTRACTORS OR LEASED PERSONNEL. ALL EMPLOYEES ARE BACKGROUND CHECKED, DRUG TESTED, AND PROPERLY TRAINED ANO CERTIFIED TO INSTALL YOUR ROOF SYSTEM. • ALL ROOFING WORK IS SUPERVISED FULL TIME BY HIGHLY QUAIIFIED AND TRAINED SUPERVISORS. THEY ARE WELL TRAINED WITH A WRITTEN PROTOCOL FOR INSTALLATION, SUPERVISION, SAFETY AND CODE COMPLIANCE. • THE GROUNDS ADJACENTTO WORK AREA ARE TARPED FOR PROTECTION OF PLANTS AND SHRUBBERY. • THE 10B-SITE WtLL BE KEPT FREE OF ROOFING DEBRIS THROUGHOUT THE DURATION OF THE PROJECT AND A THOROUGH CLEAN-UP COMPLETED UPON COMPLETION OF THE PROIECT, INCLUDING SWEEPING GROUNDS WITH MAGNETS TO PICK-UP ANY LOOSE DEBRIS. PROPOSED TOTAL: $4,480.00 FINAL TOTAL: $ � °� .00 *PRICE GOOD FOR 30-DAYS* PAYMENT SCHEDULE: 25% DEPOSIT 25% DUE DELIVERY OF MATERIALS (MATERIALS NOT DELIVERED UNTIL COMMENCEMENT OF WORK) 50% DUE UPON PROJECT COMPLETION *PROVIDE WAIVER OF LIEN UPON FINAL PAYMENT *COMPLETE HURRI NE IGATION FORM PROVIDED BY YOUR INSURANCE CARRIER SIGNATURE: DATE OF ACCEPTANCE: �'��'� c:_---� �� DOCKSIDE ROOFING, INC.: ''�� DANIEL BONEBRAKE *WITH ACCEPTANCE OF PROPOSALYOU ARE AGREEING WITH THE ABOVE PRICE, PROPOSED SCOPE Of WORK, AND AGREE CONDITIONS ARE SATISFACTORY AND HEREBY ACCEPTED. PAYMENT WILL BE MADE AS OUTLINED. � DOCKSIDE ROOFING, INC. � � . � � 8916 MAISLIN DRiVE — TAMPA, FL 33637 PG.2 BBB�� T / 90 NUOfIH[l GCYNfFlACY01� CCC13255�5 PH:(813)-983-9099 �'CC1325526 FX:(813)-983-9588 � oc s� e Roa�fin Inc. J� www.docksideroofing.com PROPOSAL SUBMITfED TO: ADDRESS: DATE: 5442 9 ST 1ANUARY 18, 2011 JASON MOSS ZEPHYRHILLS, FL 33542 PHONE: 813-743-8732 CONTACT: JOB LOCATION: EMAIL: themosster69�«�vah�c�,com SAME SAME FAX: ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES,) THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAIL TO PAY SUBCONTRACTORS OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A"NOTICE TO OWNER". FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX AND IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY. SIGNATURE: DATE OF ACCEPTANCE: �"�� ,�` �� DOCKSIDE RO ING, INC.: �� °"�� DANIEL BONEBRAKE '"WITH ACCEPTANCE OF PROPOSALYOU ARE AGREEING WITH THE ABOVE PRICE, PROPOSEO SCOPE OF WORK, AND AGREE CONDITIONS ARE SATISFACTORY AND HEREBY ACCEPTED. PAYMENT WILL BE MADE AS OUTLINED. � DOCKSIDE ROOFING, INC. � � � � � 8916 MAISLIN DRIVE—TAMPA, FL 33637 PG.3 BB� • �est w « � nons�NCa cor�t��ncran --- - -- - --------� � IIIIII IIIII IIIII IIIII IIIII IIIII (IIII (III) IIIII IIIII IIII IIII ' 2011044727 Rcpt:1358164 Ree: 10.00 � DS: 0.00 IT: 0.00 • 03124/il C._ Cook Dpty Clerk __ _ NOTICE OF COMMENCEMENT pAULq 5 0'NEII,Ph D PRSCO CLERK 8 COMPTROLLEF2 P�,�tNo. 03/24/11 1 of 1 PropertyldentificationNo./I-.?fi'�/-00%-//900 OR BK �� PG _2 59--_ THE UNDERSIGNED heroby gives notica that improvemerts will be made to cartain roal property, and in accordance with Section ' 713. ] 3 of the Florida 5tatutes, the following information is providcd in this NOTICE OF COMMENCEMENT t Description of ProP�►Y ��5� dv�&on :) N'a4 •/•Uaio • • a/to �C I'� e'� 2 f �'1 @' Os 1 P y' � 7 a) Strcet Address: S4VZ 9 JT. itlS f �,�- S/ S1� �6 2. General descripdon of improvements: p� E.tiST,ub /Jfuo /?«�iCE c��i _,vf`. �SiX�PIT __ __ .S/li,ve� ,Q�a�` - - 3. Owner Infortnation � � � �� 9 a) Namc and address: ,�� -� /11.rr Su�i2 tiT� ST ZEOn/kP�ills ti 33TS/Z b) Name and eddress of fee simple titleholder (if other than awner) .el,G! o r�f 3Z G� r4l c) Interest in property n� � 4 Contractor Information a) Name and address: �r/�AE ,Pooi•cc�'a� T.✓G. �.PeE�GL�I �0/�� 4/4 M.AiS/i✓ �•. l��iit 33637 b) Telephone No. �/3 •�l�d • 40? 9 Fex No. (Op�) yi3 •4f 3• s'�F 5. Surety Information a) Name and address: b) Amount of Bond: c) Telephone No. Fax No. (Opc.) 6. Lender a) Name and address: Phone No. 7 ldentity of person wiffiin the State of Florid designated by owner upon whom notices or other documents may be served: a) Neme and address: D6o�si6E �� xs..T.� �9/(� /lf4iS�N+ �1P. .�M�f�4 i iL 33�+37 b) Telephone No.. ftl3 • 4P3• 9o9�I � Fax No.'(Opt.) �i3 • 41r3 • q�'�i S. 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 Statutcs: a) Name and address: /�^-��/�u.''s,, T�/ �fdYv MA�a�.v AQ, Tqpt�_a 33�037 b) Telephone No. Pi3 • 9&3• 9094 Fax No. (Opt) f�3• 4p3 • fe?& 9 Expiration dete ofNotice of Commencement (the expiration date is one year Erom the date of recording unless a different date is Specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFPER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAP'fER 713, PART 1, SECTION 713.13, FLORIDA STATUTES AND CAN RESULT IN YOUR PAYiNG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A IYOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN F[NANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF CO NT. STATE OF FLORIDA COUNTY OF PASCO DANIEL RAY BONEBRAKE. JR �� y �� p� Si a o a Authori O�c /DireetodPa�trier/Mmmger My ��istlon F.xpires June 1 � S`d/ ., •� r S`• apmr�leebn NO. �pq6 d m rt� r The foregoing instrument was acknowle beforo me this Z; day of �� . 20_ FI • by T'�"✓ h� � yq !y Y/� 6 0�✓✓4I�- (typC o ity, e. ffiCtT, trU51CC, BttDmey in fact) for NE'✓ �' r (name of party on behalf of who ' n xceuted). Personally Known k OR Produced ldentificarion , Noffiry Signadue Type of IdentificaYion Produced Name (print) Di�i✓/F� I�?'!' OuvLtj/,ors�c�- .yrl Verification pursuant to Section 92.525, Florida Stahrtes. Under penatties of pe ' , decl that I have read the foregoing and tliat the facts stated in it aze true to the bestofmy knowledge and belief. �TATE �7F FLORIDA, COUN'fY �F PASCO T _ 71FY THAT THE FC?REGOING IS A s� �oe .w�.ir�,s� OF THE DOCUMENT Fo��+�,^�Z�� ON FILE OR OF PUBLIC RECORD IN TFlIS OFFICE JJITNES MY HAND AND OFFICIAL SEAL THI � � DAY 0 �'n � 1 Q�� - PAUL. O'NEIL, CLE & COMPTROLLER BY � � �)EPt�TY CLERK � � Dockside Roofing, Inc. 1 /20/2011 To: City of Zephyrhills Fr: Robert Mariull RE: Authorization I, Robert Mattull, President of Dockside Roofing, Inc., give Sandra Mattull and Kyle Swonger of Dockside Roofing permission and authority to sign and pick up permits on our behalf. My license number is CCC1325525. If you should require additional information, please ca11 me at the above phone number or my cell phone number (813) 477-1182. Thank you. � Z/t �//( Robert Mattull, Presi ent Date T— State of Florida County of Hillsborough -l�- The foregoing instrument was acknowledged before t�s--�-.�._ day of F�� , 2011, by � uh� �-�- ��, L � i � , who is rson � known to m or produced a s i d e n t i f i c a t i o n, w h o d i d l d i d n o t t a k e an o a t h. � �'` � j ��t��u�ut�� S' ature of Nota.ry Public \�� p, A MqTT� ,,�� .••....�� 0.��,N,\SSIONF�.�� i i ? � �o � 4, 2p � � � i � N i � =* • •*� • �� • � • • '� �� ;� #DD 655947 �� Q ` O� � q '.� T �ded 1�iN� : pQ� i 9 •� .•' � i �� '+ � ; �� ` � ` �w 8916 Maislin Drive, Tampa, F133637 Ph# (813) 983-9099 Fx# (813) 983-9588 CCC 1325525 CCC1325526 STATE OF FLORiDA � DBPARTI�NT OF BIISINL33 AND PROFS83IONAL REGULATION . CON3TRIICTIDN INDU3TRY LIC�IiTSING H�ARD (850) 487-1395 ' 1940 NORTS MONRO$ 3TR$ET `�*R TALLAHA338L FL 32399-0783 ffiATT[�LL, ROHERT i�ILLIAM DOC�3ID$ ROOFINC3 INC 8916 MAI3LIN DR T�A FL 33637 c.�a,�i wan tt� � «� o� �'. , � - �C# ��► boense �►«i the n�ly one rr�ion '.:� si"�°��- - ... :��_x::.;_Jy F�lai� lic�er�sed by the Departrr�nt of Bt� �uM P�nfessionai Regtdation. l � � - - � -� =., . �`" . .: .� ! � Professionais and b�s range i�tn ard�ec� to yadrt brokers, fr�nm �,:.- _- �- -- --- � �- baacers to _ i= =�_- - � :4 - �-Y �, and they keep ' �,_ - ' .�'_ °_. =:� � - -- � � `' { ■��p�/�{�/y �.,,r�= -�=� v �� :° :� �;-�; '��"��1�� S VNAR/��IySYN�� '•"y^��• Y: ti _ r .'� .'��!� - r�fi13 - ...t: Every d�y we work to frt�pr+ove the w a y we do 6� in ortier t� serv�e b e fi�.. - .��..�..�� =� - = Fa� a�fc�rmsdion abouc a,r �ervioes, v+�se bs o� tirwM►�ayno�da� c«n. ` "°"� c� � ��r � - ' - - ''- "� �:';' �l � 7'here you c�i fuM mor+e ir�orrnation abv�� flur ''' �c! the r�bons #�at (� t '- �� - =, : `i�` - ''� � I�, �e �o d�ment �s and leam rnone aboutthe g"�' - � - - - '��yr � '}`�"''� ?' . .Depertrrtent'$ s'atiHtiVe.S. 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' _ � Kia+` �: �, ',1 " ...'� xr ' t'. ' ' _'_" _ .__ _ - '_ _ "'- '' _ '-..+�:,r•�. _ _ .it_, - = � - ' °-''�-� ' -- :�� - '-- ' - _--- _ - - - • c ± s-" ti., - _ � - i{.� i �"T 1 � ' ♦ �� : - " _ :1.n ' - - - _ �'�.� - '��• Y-'4 � _ - = �-,�, --•r -:� �',t� -_ �;: _ _ _ _- _ - - - _ �-- _- - _ _ '_�i' - _ '�'sY+=" _ �'�l�i.r� -_ ' - _ < ' ___ _ _ ' �,.:•_. '- ' - - ' _ � '..- ' . ._ . -.�. -.. '- a " _ �'�`-.._ '_ _' _ ' ' - - :' 1 ��:`�=:"�.. l?,�.°_. - �- : av�'�°`- j-= - - : = = � - _ - 1..^._.- ,� - - -_�� -- 02/11/2p11 16 '2 FAX 407671252p FRSA SELF INSURERS fUND l�001/401 Issue Date� 2l11l2011 RORIDA fqOFING, SHEET METAL b AIR CpNqfflQNfNG CpNTHAC�'ORS AS$OCIATION, INC. � RSa - - r 1-800-767-3772 • FAX (40� 671-�520 CERTIFICATE OF INSURANCE ISSUED TO: COPY PROVIDED Tp: City of Zephyrhills Building DepaRment Dockside Roofing, Inc. 5335 eth 5treet 9916 Maislin Drive Zephyfiills, Fl 335a2 Tampa, FL 33637 AttenUon. Dodcside Roofing, Inc. This is to Ce►tify that: 8916 Maislin brive Tampa, FL 33837 being subjeCl co the provisions of the Flonda Workers' Compensation ACt, h85 SeCUred the paymCnt Of Cpmpensation by insuring their risk with the FLORIDA ROOFING, SHEET METAL � AIR CONDITIQNING CONTRACTQRS ASSOCIATION SELF INSURERS FUND, P.O. eox 4907, Wlnter Park, FL 32793. COVERAGE NUMBER� 870-0331 LIMITS Workers' Compensation� Statutory - State of Florida EFFECTIVE DATE� 1/7/201 Employers' Liability: $100,000.00 Each Accident EXPIRATION DATE: 1l1/20 $100,000.00 Disease, Each Employee �500,000.00 Disease, Policy Limit REMARKS Non-cancelable, without 30 days prior written notice, except for non-payment of premium which will be a 10 day wntten nOtiCe. No Exemptions. Robe�t Mattull as Qualifier, Li�ense #CCC1325525 This certificate is issued as a matter of information only, is not a policy and of itself dces not attord any insurance. Nothing contained in this certificate shall be constructed as extending coverage not afforded by the policy(ies) shown above o� as affording insurance to any insured not named above. This provides cover'�ge for Florida policyholders and Florida domiciled empbyees only. c BY= By: Brett Stiegel, Adrtanistrafor Debra Guidry, CPCU, Un erwri0ng Manager FRSA-S1F FRSA-S I F 2010 ZE111 HILLSBOR�UGH COUNTY BUSINE�S TAX RECEiPT EXpIRES 9-�0-ZO'11 wuo No: � � Q Q 14 R� 974i4 �1000 occ.COnE �g�� oso.o�a �, R�ul� s�r �ru. �'�"`�'� . 40�0 3s.ou s � e�s �siar oR uu�cirtpr� TAMPA 3363T . � � MA't'it1LL RUBCRT MIN.L.IA1A � DIBIA DOCIG�DE ROOFlNG It4C ��s �1611AISt.�1 pR TAMPA FL 33�iT B#�SINESS TAX REGEiPT ��.�,.r,��,� P,�-;�, -� w��ror�owwwa��cioawaE 813.g�.� 07r2?12010 "' T6.00 •+et��o�ssoN.aaooa�sweq9os��nt TI�S 06C0�6 w TAX NBClP[NI#fY/{L�Yl7EQ �`` °RO� � 'CERTIFICATE OF LIABILITY INSURANCE ° ��' M � °° """"' 2/11/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTiFICATE HOLDER. THIS CER7IFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMENO, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUtNG INSURER(S), AUTHORIZED REPRESENTA7IVE OR PRODUCER, AND THE CER7IFICATE HOLDER. IMPORTANT: If the certificabe holder is an ADDITIONAL INSURED, tlie policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsemerrt. A stabemerrt on th� certificabe does not co�er rights to the certificate holder in lieu of such sndorsemerK(s). PRODUCER �� Rebecca Sengaroun Comegys Insurance Corner � . (727) 521-2100 � �: (727)528 Florida Contractor Insurance A��,rebeccas@co�egys.com One Beach Drive S. E. Ste. 230 � D0028624 3aint Petersbur FL 33701 INSURER�S AfFORqNG COVERAGE NAIC # INSURED INSURERA�`TO=tYl Pointe C3311a1. INSURERB�SSe]C Insurance CO Dockside Roofing Inc INSURERC: 8916 Maislin Drive INSURERD: INSURER E : Tampa FL 33637 INSURER F: COVERAGES CERTIFICATE NUMBER:10/li GL/Dl+� 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 NOIlMTHSTANDING 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. � TYPE OF INSURANCE POLICY EFF POLICY EXP U � S LTR IN POLICY NUMBER GENERAL LIA&LITY EACH OCCURRENCE S 1� OOO � OOO X COMMERCIAL GENERAL LIABILITY PR MISES Ea ocwrtence 5 lOO � OOO A CLAIMS-MADE � OCCUR 094119817 0/14/2010 0/14/2011 MED EXP (My one person) $ 5� 000 a�RSOru� a Aov INJURY S 1, OOO , OOO GENERAL AGGREGATE $ Z� OOO � OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Z� OOO � OOO X POLICY PR a LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a (Ea xatleM) ANY AUTO BODILY INJURY (Per person) S AlL OUVNED AUTOS BODILY INJURY (Per acadent) 3 SCHEDULED AUTOS PROPERTY DAMAGE a HIRED AUTOS �P� ��) NON-0WNED AUT0.S $ $ X UMBRELLA LIAB p�CUR EACH OCCURRENCE S 1� OOO � OOO EXCESS LIAB CLAIMS-MADE AGGREGATE S 1� OOO � OOO DEDUCTIBLE 3 B RETENTION E OM1/A312510 0/14/2010 0/14/2011 E WORKERS COMPENSATION VYC STATU- OTH- AND EMPLOYERS' UA&LJTY Y � N R ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT 3 OFFlCER/MEMBER EXCIUDED? � NfA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE E I( yes describe urWer DES�RIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (Atlach ACORD 101, Addkb�al RemaAca Schedule, H more space is rnquired) CERTIFICATE HOLDER CANCELLATION ( 813 ) 780-0021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WI7H THE POLICY PROVISIONS. City of Zephyrhills - Building Department 5335 8th Street Zephryhills, E'L 33542 AUTHORQEDREPRESENTATNE M Mercurio/JESSIC ACORD 25 (2009/09) OO 1988-2009 ACORD CORPORATION. All rights reserved. INS025 �zoosos� The ACORD name and logo are registered marks of ACORD