HomeMy WebLinkAbout11-11830 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(si3pso-oozo 11830
.
BiJILDING PERMIT
Permit Number: 11830 Address: 6130 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: ZEPHYR BREEZE
Est. Value: Parcel Number: 02-26-21-0190-00000-0200
Improv. Cost: 4,807.00
Date Issued: 4/28/2011 Name: HIRSCHKOWITZ ANTONIA & VERONICA
Total Fees: 60.00 Address: 28817 MIDNIGHT STAR LP
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33543
Date Paid: 4/28/2011 Phone: (813)713-1612
Work Desc: REROOF SHINGLE
t
. �� CiJ �= �r C(
��p � �{"�-�' �r L�
9v`
�
TAPE JOINTS�O�INS��
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
bef re recording your notice of commencement."
�
; �
i
CON RACT R SIGNATURE PERMIT OFFI R
PER IT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
s�aaso-oozo Gity ot Lepnymius Nermit Appucauon raX-u,a-�uu-u�n
� Building Department
Date ReCelved phone f;ontact for Permittin —
Owner's Name b�e�� � �-� ��� �1'a Owner Phone Number �� 3 � � �o / �
Owners Address (X{ �� �3� • �� � � � 5 t'/ 335 z - Owner Phone Number
Fee Simple Titleholder Name � � Owner Phone Number � �
Fee Simple Titleholder Address
JOB ADDRESS � � `7 �' � � � � � � I -3-�� Z LOT # �C1
SUBDIVISION ZP� �'"'�p�' � �P�Ze-.�'`�� , PARCEL ID# � �' °� � °� �I a �� ��� ��
� �'� S a ���'" � � 2 �� / � �� �� �'I�oZ a (OBTAINED FROIiA PROPERTY TAX NOTICE)
WORK PROPOSED � NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
� INSTALL � REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK YE' V OO+J
BUILDING SIZE � SQ FOOTAGE IG�� HEIGHT
�BUILDING $ D d° VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING ��
OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS � ROOFING Q SPECIALTY 0 OTHER
.
FINISHED FLOOR ELEVATIONS FLOOD ZONE AI�EA QYES NO
BUILDER � � ,�� COMPANY il � D� �
SIGNATURE � ���—' REGISTERED Y N FEECURRE� N
Address ' License # � �
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address Lice�se #
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N �
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License #
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address Ucense # r �
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, Co�strucUon Plans, Stormwater Plans w/ Silt Fence installed,
Sanitairy Faalities & 1 dumpster, Site Work Permit for subdivisionsllarge 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) worlcing days after submittal date. Required onsite, Construction Plans, Stonnwater Plans w/ Silt Fence installed,
Sanitary Facllities & 1 dumpster. Site Work Permit for all new projects. Ail commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans. • .
'"'*PRbPERTY SURVEY required for ail NEW construcdon. •
Directions: "
Fill out applicatlon �mpletely.
Owner t�, Confractor sign back of application, notarized
if over �2500, a Netice of Commencement is required. (AIC upgrades over s7500)
"* Agent (for the c�nfrautor) or Power of Attomey (for the owner) would be someone with notarized lette� from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Oniy)
Reroofs if shir.gles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways-Not over Counter iffo� public roadways..needs ROW �
, , L ,� .
, . , , t
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. '
UNLICENS@D 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 violatfon
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 witl 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 specffied 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 ident�ed 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 finai power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prio� 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 ordina�ces.
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: 1 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 ta 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 pertormed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I aiso
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identiTy 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 Serv�ces/Environmental Health Unit-Welis, 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 ticense 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 pe�mit 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, ftom 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 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.
FLORID�4 JURAT (F.S. 17.03) ' �,,,QV�1� e C.
�J VG4an � uL.
OWNFR OR /lG�NT � ri ' '�n�a«.CONTRACTOR ��--- � ��^ - GO,,,� � e Y
S�t+sCrib n swom (or afffrmed) before me this Sub� ed nd swom to (or afflrmed) before me this
� ���f �ioi bv a.✓ n G C. .F'a w 1 e-r<.
�'1 G�Dn t'�ct n� �rr,�
Whcs IsJaP rso kno o me or has/have produced Who is/are ers all kno to me or has/have produced
as IdenBflcaBon. as identlficaHon.
otary Public Notary Public
Commission No._ Commissfon No._� V - I�R (� q S� �--_
� '� -
Name Name of Notary typed, p , �
' EVA M MARSHALL ;�.�;; EVA M MARSHALL
:�+�'`�' -�• 8 : MY COMM18SiON # D0960950
;•;, �z MY COMMI9SION # DO9�096� " �,� � EXPIRES Aprf111. 2014
'�� • EXPIRE3 April 11. 2014 ' ' , ' F �� .,,,,,
�07 �N• ' r � . � (1071996-0183
. a
' • �
PTOTICE OF COMMENCEMENT
Pemut No.
?roperty Identification Na d�t �( � 1 !� 1 �/d � D �OO v 3 c ts
THE tJNDERSIGNED hereby give informs you that the improvement wiII be made to certain real property, anc3 in accordance with
Secrion 713.13 of the Florida Staiutes, the following informarion is provided in this NOTICE 4F COMMENCEMENT.
�� l08'`�
1.Description of propertY (legal descri�tion:} l �r� e zE 5 b N(� 1`I Oa � ���• 14 Z� �.�o �,'�', °ir2d
a) Street Address: Co ) 3 e� t�i � C�-r P-F' �- 7�� ,��.�r,�ill�_F" � 3 3 s� � T
2.General clescription of improvements: �f �Y ��
3.Owner Informarion
a� Name and address: QO _[�► t�c z � n� RrC� o� SZ' � i� J in� . I (Lc� l.e __-#- �-�-r ; ,�� � �,.,` '� � p� C �-,ct �
b Name and address of fee simple titleholder {if ot�cer than owner) ��-Y\ ��— ,�' j_ 3 3 S ��
c} Interest in property
�.Contractor Information
a) Name and address: "'��� E . y �,s}y� �,�„ � „. ��
b) Telephone No.: g 13 `� �p `°7 -� � U (�j � � � � g� Fax t o. (Opt.) � l � �7 � p ' ) � b'7 C3
S.Surety Taformarion p�3 S
a) Name and address:
b) Amozmt of Bond: __
c) Telephone No.: • Fax No. (Opt.)
b.Lender .
a) Name and address: At �,� '
_ � Phnne No.
7. Identity of person within the State of Floxida designated by owner upon whom notices or other do�uments may be served:
a) Name and address:
b) Telephone No.: Fax No. (Og#.)
8.Fn addition to himseIf, awner designates the foIlowing gerson to receive a copy of the Lienar's Notice as provided in Sectian
�13.13(1)(b), Florida Statutes:
a) Natne and adc2ress: ___h � �
b) Telepl�one No.: —� Fax No. (Opt)
9.Expiratio� date of Notice of Commencament (the expiration date is onc year from the date of mcording unless a differen# date is
�����): 41 z s�l j �.
WARNING TO OWNER: ANY PAYMENTS MADE BY T`HE OWNER AF'TLR THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CEAPTER 7I3, PART I, SECTION 1i3.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPRUVEMENTS TU YUUR PROPERTY.
A NOTICE UF CUMMENCEMENT MUST BE RECORDED AND POSTED OAF THE dOB SITE SEFURE THE FIRST
Ii�iSPECTiON. IF YOU iNTEND TO OBTAIN FIlYANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDIlYG YOUR NOTiCE OF CONIlI�NCEMENT.
5TATE OF FLORIDA ` O
COUiYTY OF PASCO � e
Signatare of Owner ar Owner's Auth�ized OfficerlDirector/PannedManager
�_� Y1 1 G ���� 1''4.
Pnn� Name �
I1-
Th� IC OIII instxument was aclaiowledged before me tlus � day of 20�, by�l� � C.�.
g
--- �1.1-��r $s O �.� r��� (type af authority, e.g. officer, trustce, attorney
m fact) for {name of party an behalf of hom inshument was e�cecuted),
Personally Known 4�R Produced Identification Notary Signature
Type ofIdeutifcation Produced I�Iame (prini) _ �VGL, � " 1 � [;� � �
Verification pursuant to Section 92.525, Fiorida Statutas. Undcr penalties of perj�y, I declare that I have r�ad ffie fvregoimg and that
the faccs statcd i�i zt axc rose to the best of my lrnowiedge and belief.
�
-nRMr�RfpC Signatute of TlsturaI Person Si iu A
;� ' . EVA M MARSHALL
.•; :'= MY COMMIS810N �k DD�d0�6�
F''.PIRE8 Apri111, 2014
• �' • „ F oeT
. �p �9{�O�`+:
Apr 29 11 04'06p Eva Marshall 813-780-7470 p.1
� NOR7H �QINTE INSURANCE CO C�MERCIAL SUMMARY DEC
i079950UTHSIDE f30ULEVARD.#200 �"�Of�
JACKSONVILLE FL 3225fi . �
N{JRTH . �
POI NTE ______--
POLlCY NUMBE POLI(:Y PERIUO 12�tw.1l�SSSrida�dTi�ne
i FRONE TO P�� ��med insuied.
2094123055 I 4l01 /11 4l01 /12
.
.. � :_. _.. _.
N�1ME�::iNSU . .. . kf�0�_AD�RE:�� � :. .... .. ` - : - - -; - -_ - - - - -- _ - - _ _ - -�
. .. .. - --. . ... . . . ... . .
° - -. A(�`��'3-:11�t�N�.SS: :.
... -..: � __:- . . ... _:.�.
_ . -.. . -..:. -- _ _.
:. . .. _ ... .. ... .... :.. ::.. -
4�04 -.. . .
A KIlBRIDE INSURANCE 1NC
TKJ CONSTRUCTlON INC 4501 NEBRASKA AYE
376Q6 AAARCLIFF TERRACE TAMPA F1336pg
ZEPHYRHIL.LS F� 33541
(813j 238-7467
Business Descript�on• ROOFENG � Fonn of Busi�; CORPORATION
����
tFi�s policy, PaY �� � pnemaim an S rms �s qr. w�e agree l►� b .muranae as n
THiS POLICY CONSISTS OF THE FO;LLOWING COVERAGE PARTS FOR WHICH A Pi�iEMlU�A IS lNOICATEO.
THIS PREMIUM MAY BE SUBJECT T� AD.JUS7MENT'S.
COMMERCIAL GENERAL LfAB. CCIVERAGE PART ��
� i,5os.00
FEDERAL 7ERRORISM ACT $ 15 _ 00
$
$
$
$
$
$
$
FL INSURANCE PREMIUM SURCH4RGE $ 33.8�
$
$
Emaigency bTanagement Preparedness and Assistanca Trust vnd Fee:
Ci6zens RecoupmorG Fee:
Fbrfda Hunicang Cat2sUaphe Fund q5ses5�nert• ; i9 �1
�oraa�nsuranceG�aranryASSOeiaGonAssessment; S ia ia
CAizens' 2005 Emergency AsSe8SrnenL•
TOTAL ADVANCE PREMIUM $ 1 549 _ 81
�n ��� ANNUAL
Coinsurdnce ontract; the rate charged in this pol cy is based upon the coinsurance ciause attached to this
poi�cy with the conserrt of the insured.
Form(s) and Endoraement(s) made part of lhis polic,y st lime pf is��e:
' ACfiOUS{Q2/08) CG2i70(01/08) fL0UC�3(09/08) fL0017(11/98) IL0021(09108)
IL0932(07!02) NPQ194(OSi70} NP037!1(05/05) NP0381(01/01) N�0382(10/Q8)
�IP0385(01/0Y) NP2001(09/10)
Countersigned g
04/19,�11
�� In Witnes..� YJhErEOf. the �Ompany hgs c2u5ed 7hi8 (7o'iLy W 7C+ exB�f9tl a�ld dR8928d. bU�lh15 PDIiCy SFIa'I fqf b2 Y8110 Uflk55 I '
��unlersigired by a tluly aunorized repr�sentaUve of the oonpany, �
CP°SUMDEC(7 t-p8)
COAIfjBL Ff/