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Home My WebLink About11-12168 ✓ CITY OF ZEPHYRHILLS 5335 - 8TH STREET � �si3��so-oozo 12168 BUILDING PERMIT Permit Number: 12168 Address: 38250 A AVE Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(sj: Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 14-26-21-0010-01300-0010 Improv. Cost: 46,076.77 Date Issued: 7/28/2011 Name: S C NURSING HOMES OF ZEPHYRHILLS Total Fees: 270.00 Address: 38250 A AVE Amount Paid: 270.00 ZEPHYRHILLS, FL. 33542 Date Paid: 7/28/2011 Phone: (813)546-7295 Work Desc: REROOF SHINGLE � � � TAPE JOINTS OF I SP. 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 commenceme " CONTRACT SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS , ' S335 - 8TH STREET (si3)�so-oozo 12168 BUILDING PERMIT Permit Number: 12168 Address: 38250 A AVE Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 14-26-21-0010-01300-0010 Improv. Cost: 46,076.77 Date Issued: Name: S C NURSING HOMES OF ZEPHYRHILLS Total Fees: 270.00 Address: 38250 A AVE Amount Paid: ZEPHYRHILLS, FL. 33542 Date Paid: Phone: Work Desc: REROOF SHINGLE �. _ C�%� /� 3 � `� ��-�.� s ��o� � �� -�--��. (� �- � � � �� `"`��' TAPE JOINTS ROOF INSP 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 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 twiae for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commenceme " CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 07/27/2011 16:30 3525674454 MILBAR PAGE 01/05 �l.o`� IIt3•780•0020 City of Zephyrhills Permit Application Fax-01�•78 BuikJing Departmant 4 � �►`� Dam Rccolved -- � PhO� CoMact for PCrmiltin �er's Name U !' OW�1er P1101b Nulllber 1, � 41e. 72. Ownsra Addross vu � Owner PYrono Number Foo Simple Tltbh0lder Name Owner PhOne Numbe� � Fee Simplo Titleholdar Addreas JOB ADDRESS �3S'�e � LOT # � SIJBDIVISION r l�l��hew (�f5� �� __Cl1 � FARCELN� • ' - � (O�TAIN� FROM PROPRRTV TAX NOTICEI WORK pRQPOS6D B NEW CONSTR r� ADDlAI,T Q SIGN Q M01l� Q DEMOLISH INSTALL U REPAIR ' PROPOSEOUSfl � SPR Q COMM � OTHER G- TYpE OF CONSTRUCTIDN � 6�OCK � FRAME Q STEEL Q OtMER DE3CRIP710N OF WORK ! BUILDING 312E 8Q FOOTACiE kEIGHT 1% BUII.D�NG i � VAI.UATION OF 70TAt CONSTRUCTION Q ELEC7RICAL $ AMP SERVICE Q PROGRESS HNERGY Q W,R.E.C. � PLUMBING S , � t Z ( `C � �T ' � MGCHANICAL 5 � VALUATION OF MECHANICAL INSTALLATION Q GAS [� ROOFING Q SPECIALIY � OTHER FINlSMED FLOOR EI.EVATIONS FLOOD XONE AR�A QYES QNO BUILDER COMPANY 1 � 1�1 � � 11k� .l'k�nt�. J 31 �- SIGNATURE REOISTRaED I N PEE CURR Y N I naaress 15AlI 3 3UI 7ade C+ FI 3 uanse# ��,329�^gZ Ei.ECTRICIAN COMpANY SIGNATURE REGIS'rEtt�D Y/ N FF� CURRENT ! Y I N AddreS9 Licen�E # P6UM9ER � COIAPANY 31GNATURE RB016T6RED Y/ N � FEE CURREN7 Y/ N Address �� # MECHANICAI, COINPANY iNATURE R&GISTEREp Y,l N FEE CURREN7 Y/ N Address �� # � OTNHR COMPANY SiGNATURc RECIG'BRfD Y/ N FEE CURRENT Y f N Address Licen�e # � RE5IDENTIAL Attaeh (2) Pbl Plano; (2) 9ets ot BuNdInQ PWna; (1) aef oi Enargy Forms � Minimum fen (1� wOAcin� dsys Af1w eubmMfal delle. Requlled ontNe, Constructbn Plans, Sanitary FBClllties & 1 dumpster COMMERCIAL Alfach (3y sels af BuHdMg Plans; (1) �e! oi Energy Forms. Minimum ten (10) working dAys atter submiltal date• RBquired onsite, Constructbn Plans,�5anitary Facilitks 8 1 dumpster nll commerelal requiremenls must maet compllence. SIGN PERMI7 Aaach (2� eole of Englneered Plans. `""PROPERtY SURVEY requirod for al1 NEW coostructan. rectlons: FYI out eppliption mmploiey. Owner & ControCto� slpn EAdc of appllcatbn, nOtarizEd M over F250D, a Notteo of Commencem•nt Is requlred. (aC upgratJes over �5000) " A9ent (for the cOntracto�) or PoWer of AttomeY (for the OWf�er) WOUId be sOmeone wiM notariZ2d btter irom owner aufhoflzing same OV�R 7HE COUNTER PERMITI'ING (Front oT A�pliCStton Only) Reroofs Sowers Service Upgredes A!C Fences (Plot/SurvEy/Footage) Drlveways-Not over Countor if on public roadways.,needs ROW 07/27/2011 16:30 3525674454 MILBAR PAGE 02/05 NOTICE OF DEED R�STRICT{ANS: The undereigned understands that this permit may be subject to "deed" restrictions" which may be more restnctive than County regulations. The undersigned assumes responsibility for complience with any appliceble d0ed restriCtlons. UNL.IC�NSED COId'TRACTORS AND CONTRACTOR R�SPQN3191LITIE3: If the owner tt2is hired a conhsctor or contractors to undertake work, they may be required to be licensed in axardanca with state and bcal regulations. If the contractor is not Ilcensed as required by law, both the owner and contrector may be Gted for a misdemeanor violatlon under state law If the owner ar intended contractar are unCeRain as to whet licensing requir'ements may apply for the intended work, they ar� advised to contact the Pasco County Buiiding lnspection Division—Licensing Section ek 727-847- 8009, Furthermore, if the oHmar has hired a contracbor or contractors, he is advised to have the conlractor(s) sign portions of the "contrector Block" of this applicatlon far which they will be responsible. If you, as the owner slgn as the contractor, that may be an indication that he is not properiy licensed and is not entitled to permittit►g privileges in Pasco County. TRANSPORTATION IMPACTIUTILITI�S IMPAC7 AND RESOURC� RECOVERY FEES: The underoigned understands that Transportetion Impact Fees and f2ecourse Reoovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion af existing bulldings, as specifled in Pasco County Ordinance number 88-07 and 90•07, as amendetil. 'fhe undersigned also undersbnds, that such fees, as may be due, will be iden�ed at the time of permikting. It is further understood that Transportation Impact Fees and R�ssource Recovery Fees must be paid prior to receiving a"certificate of occupancy" or final power release. If the projeck does not involve a ae�tificate ot axupancy or final pawer release, the fees must be paid prior to parmit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, th�y must be paid prior to permft iasuance in accordance with applicable Pasco County ordinances, CONSTRUC'I'ION LIEN LAW (Chapber 713, Florlda Statutes, as amended); tf valuetion of work is ffi2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Fbrlda Construction Lien Law—Homeowner's Proteotion Guide" prepared by the Florida Departmenk of Agriculture and Consumer AfFairs. If the applicant is someone other than the °owner", I ce�lfy that 1 have obtained a copy af the above described document and promise in good faith to deliver it to the "owner" prior to commencement. CONTRAC?Olt'SIqWNER'S AFFIDAVI'T: I certify that all the inbrmaQon fn this appliCation is acxurate and that all work will be done in compiiance with ali applicable laws regulating constna�, zonfng and 18nd development. Applicafion is hereby made to obtain e permit to do work and instaltation as indicated. I certafy ihet no work or installation has commenced prlor to issuance of a pertnit and that all work will be performed to meet standards of all laws regulating constructlon, County and City codes, zoning regufations, and �land development regulations in the )urisdiction, I also certfy that I understand that the regulations of other govemment agencles may apply to the intended work, and that it is my responsibility to identify what actfons I must take to be in compliance, Such agencles include but a� not Iimitad to: - pepartment of Environmentai Protection-Cypress 6ayheads, WeUand Areas and Environmentally Sensitive I..ands, WaterlWastewater Treadt�nt - Southwest Florida Waker Management Distric4+We11s, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Se&walls, Docks, Navigable Waterways. - Department of Health 8� Rehabilitative Services/Environmental Heafth Unit-Welis, Wastewater Treatment, Septic Tanks. - US Environmental ProteGtion Agancy-Asbestos abaCement. - Federal Aviation Authority-Runways. I understand that t�e following restrictions apply to the usa of nll: - Use of fill is not allowed in Flood Zone "V" unless expressly permitted, - If the fill material is to be used in Fbbd Zone "A", it is Lndersbooc4 that a drainage plan addressing a "compensating volume" will be submitted at time of permitdng which is prepared by a professional engineer licensed by the State of Florida. - If the fill materlal IS to be used in Flood Zane "A" in conn�ctton with a permitted building using gtem wall construadon, I certlfy thAt fill wlll be used only to fill kAe area within the stem wall. - If fill material is to be used in any area, i certify that use of such fitl will not adversely affect adjacent properties. If use of fiU is found to adversely affect adjacent properties, the owner may be cited for violating the condlUons of the buliding permit issued under the attached pertnit application, for lots less than one (1) acre which are elevated by fill, an engineered dreinalge plan is required. If I am the AG�NT FOR THE OWNER, I promise in good faith to inform the oumer of the pemlitGng canditions set fonh in this affidavit prior to commencing construction. I undersWnd that a separate permit may be required br electrical work, plumbing, signs, wells, pools, alr conditioning, gas, or other installatlons not speat�Cally included in the application, A pertnit issued shall be construed to be a I'�cense to proceed wikh the work and not as authvrity to violate, cancel, alter, or set aside any provisians of the technical codes, nor shall issuance of a permit prevsnt the Building Qfficial from thercaiter � equiring a correction of errors in plans, construcction or violations of any codes. �vory pertnit 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 permft is suspended or absndoned tor a per.iod of six (8} months after the time the wolic ia comm�nced. An extension may be requested, in vv�iting, trom the Building Offlclal for a p�riod not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) conseCUti�e daye, the }oy Is cc�sidered abar,doned. WARNING TO OWNER; YOUR FAILURE TO RECORD A NOTICE O� COMMENCEMENT MAX RESULT IN YOUR PAYING'MIICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT�ND TO OBtAIN FINANCING, CONSUI.7 Wlt U I EN �! Q�� ' �CR 11 �IJ Na G O Ca � ENC E T. FLORIbA JURAT (F.S. 117,03) OWNER OR AGENT CONTRACTO &ubsulbed and a �o (or rtne� re ma ib Subac�ibbd and t0 (o� )��° ro me this 'i � by �_��sx� u '" � � J.ZI'1�L�._.. who Israre peraona naarr smave produced who IsMte paso�aly know�tFrlR�b haslhave produced as Identificatlon, C� , j-� as IdeM'd'icaUon, fy Publlc Notsry Publlc Cammissi A. �OVE� Commission N �hA A. (py� �,p �f7�P1AESJU�29I0i2 � as �JIA.2a2074 Name of pHn ��; Narr�a of Nota ��' 07/27 /2011 16:30 3525674454 MI�BAR PAGE 03/05 � ��I�ar �taof�� , 159N-11.5. 301, Dade City, FI, 3�523 Stete Cert �OaFer #CCC13Z909x � ph: 8Q�/5�2��3�� Fax: 35�/567�b4�54 RCI Reg Raef Conx�dtent #01�9 milbarl�earthlink.n�t ROOF PROPOSAL a e 1 ot 2 DATE; 06/28/11 TQ; SE,AIAND�R CONTRACTOR SERVIC�S, INC. F��" $ti3 88�4028 ATTN: ED SEALANDER 5305 CAMB�RL�A DRIVE Z�i�HYRMII.LS, FL 33541 Q �� '• ti z �`�� y��" �' "„�� JOB; ZEPHYR HA1J�N NURSING H�ME - MA1N BLDG 38250 "A" AVENUE Z�PHYRWILLS, FL 33&�42 - -- --- --- - �_..__-_�__�:...._�__�..., __ ======= ===�===��=�� ___�_ $�I��E RE-ROO� ONLY (aoes not include Flat Roo� As per atlached dra�ring 1, Tear nff and haui away existing �ne-layer shingle roo��nc1 system. 2, provide and install �new 15 Ib. saturated felt paper in accnrdance with the 2007 Florida Building Codes. 3. Provide and ins#all new CERTAIidTE�D "Landmark" laminated dimensional shingles with streak-fighter (algae- resist�nt) �berglass shingles; 4wner to select shingle Colorfram CERTAINT��D's standart! colo�s. Provide C�RTAINT�ED'S Limited Lifetime shingle warranty. � 4, Cricket at 20 ft wid� biock wall cu�reniiy has shingles; remov� shingle roofing and install Firestone APP-180 white granular surf�ced modified bitumen. ��Z ...,` 5. Replace all valley flashing an gooseheok vents as ne�cied. 6 Provide and install new lead boo .�g v�nts. 7, Ridg� Vent. "remove the 2 exis�ting turbines and the 6 power attic e�haust ventilatars; piywood aver op�nings. "provid� and install 300 I.f. of new pre-finished aluminum ridge vent *electrical disconnect of the 6 power atfiio exhaust ventil�tors is fio be by others and is not irlcluded in cantract sum, C�:.. R • r1n�\ 8. Provide and install new pre-finishe�d aluminum eavedrip,�`white r brown}. 9. Repair/Replacement of any rotten dr damaged wood (dieck, fascia, trim, framing, etc.) vr r�-fastening of the existing deck wiil be completect an a cost-plus basls above and beyond the cantraot price, We will cut out rotl�n/damaged plywood as needed and repair/replace Full, '/, or 1/4 sheets as needed. Labor & Material for Full Sheet 5/8"x4'x8' CD exterinr plywood repair/replacement �$65.00; '/: Sheet = $32.50; 1/4 Sheet = $16.25 10. MilBar Roofing, In¢. to provide a 5�year warkmanship ;varranty to the original purahaser that covers shingle roof lesks; excluslons: stonr► damage, woHc done or damage by others, tree damage, andlor stivcturai damage to roof deck. 11, Qwner to provide access to roof for delivery #ruck fvr laading/unloading of roofing materials, 07/27/2011 16:30 3525674454 MILBAR PAGE 94/05 � .�� 1�ilBar Ro�fi Inc 1591) I1.S. 301, Oade City, FL 335�3 3tete Cert RneFc�� CCCI3�o92 Ph:8Q0/'�i6Z-z�'�� Fax:35x/567-�4a4 RCI Rag RooF Cnns�c #p14,q m�fbarC�ear��lfik.n�t ROO��ROP03AL �aae x of,�?, DATE; 06/28/'! 1 Y0: S�ALANDER CONTRACTOR SEI�VIGE5, INC. C�LI.; $13M29-4981 ATTN: ED S�ALANDER FAX: 813/780-1689 5514 CAMB�RI.�A DRNE ZEPMYRHILLS, F� 335�1 �dg: ��PHYR HAVEN NURSING HOME - MAIN BLDG 38250 "A" �4V�NU� xEPHYRHILLS, Fl. 335�42 ---�-�--__---�---_�__-------_'___�--�-==----..�_..�__..=-----�_=----�_�--,=-_,_�=�==_=-�_=-_--=-__ - 12. Raisin ofA.C, unitsand/o ' ^w � � � _ ��if required, is to be by others and is. not included in contract sum. Flat and/or Metal RooHng not included in the contract sum. MaintenanceiLaundry Bldg and/or Pump House Bldg not in�cluded in cantract sum. 13 MilBar Rooflng, lnc. td �provide General �iabilfty and Worker's Compensation Insurance ($Z,000,000 timit) and re- roofing permlt. We propose to fumish mateN�l and labar, abrn 1Me in acc � � ^^T=y � ==^T==W � -^ � -- � -^ � - � '"-_�__`--^�_�_-^=-_ FIFi'YANE THbUS p ordanCe wilh abovp Sp��C�tlons, for ttte sum of: ^ `^ Y �^ � _ AND �ive kUNDR�o FrFTY-THREE AND 21/�100 DOLI,ARS-----_.�,..�..r.,_�.....�,.,�.....,�,,.,� �_xe,..___�........�.._�_ ��.»..,�e�_�.^„�e= �—,-e.. e=.�� ^�o� ��' :�rc�_`a��C�xe�..�—=ae�.-��a_,: Paym�r�t to i�p made as follows': pue qg Par Drdw SChodule. OPTION. ^�-�---_--_--==---_.��=`=W_=_�,___��__,==-_-�-�___--_,.._==___..�_��=-_�=�===_=�_====;��==�= �(e�t�i�l� (� 2tl5pw. Ld. �-Me�t..x ,., , ., . A. 1"��I�y: . `�UI�� r''�'II�1 `H�`�C �� Ft,M - . _.._.__ .. �,,,. ° . , .�� t Y�,�.' p�,� t �±.: �.� �, �. i ,., � Hi.� ��„�. , s • ;,. �,: � � �., � ts �wna��. L, ,., :� ' � �,y ' �'�ri'tivv.t::�r� ,� ,.; l I; x � ��i� �; I', �:r� � .;,; = . , �,.,..'.;:::' •'" ' ...1 • y ' ��, ,., „�, .,,.. . . ,, ., „�• ; :� Provide and install new ATLAS "Pinnacle" laminated dimer�sidna! shingl�s (algae with �LIMITED �IFETIME WARRANTY FROM ATL�AB in lieu of CERTAiNYE�D "XT 25" 25-year 3�tab with streak-fighter (algae- resistant) �iberglass shingles. a.15�,i �a atit*� � ---�_---,�.�o=��_=__..-===_am__,_..�____=—_��__=�_—�--=--�—__^�__��__..�__�_;��_,-=ox_GtJ1�ue t' a..2.�_� � R... a.4t7G.Ati+.�' � C'- HAt..` AUTHORIZED SIGNATURE; IJQG'�� pCQ DATE: 06/28/11 DAVID R. ABLA, pRES ACCEPTANCE OF PROPbSAL: Signature; �c,[� ,�� The nbovg prknx, ap�lfbollom nndenndlHoneareeeuHnberylmdhaiebyaeeeptn�( Printed: , Yeu,�re aul�alY9tl to do Mn wel'k na fiedflbd. Reymenl wlll 4H mede ea oWlna! aEOvc.,. � Inwalced amei� � pqd In neeerdPnce wllh Me pnyroeM tnn�a a►�II be coneltleroa Date �_ "'� p� '-^l` tln�h�q�rem and t�r Inte�eM et Me m1n of 114'A px moMh. Owner npre�p ro pay en �.�....�__..� casl� Inourred, oueh ae qltomey feee� eeun eeAM, Ma� for aollet:Uan ot tle11n4i+an1 Imdces Inctutlinp Ir.le�ea� Owner le earry fire, larnetlo er14 olher nxeaaqry Inwmnea. Our wo�kero nre fut�y covtrnad bY �Norkmm�'� Comperoelbh Ma� Knnce. MIIBn Roenng, Ine,1a not ranponelble fa Mmagaa r,�ueed by o41�v,a, vendellem, nagligran�+, Rtorme. 7nie qopoanl mqy tia wlihdravrn yy ue N not ncoy�ted py OC t t 07/27/2011 16:30 3525674454 MILBAR PAGE 05/05 . � 1lllllllflll�lllllllll11111111�1111111111111111111111lllllll 203I116QIi9 Rept : ],380137 Ftec : 10. 00 p5: 0.00 IT: 0.00 NOTICE OF COMMENCEMENT 07/27/�1 K GarcAa, Dp1.y Clerk MRI#43bY1 Permft No. Tax Fo1io No. i4-26-21-OQ10-01300-0010: THE UNDERSIGIVED hereby gives not;ce that improvements w(If be Inade to cert�in rea! property, and in• a�ordance wlth 3echqn 713.13 aF the Flprid2i Statutes, the folbuvfng inform�tion is prdvided in triis NOTICE OF �OMMENC�M�NT. 9•C?escrip#ion of properly (I�gal dpscripfio,�): N�OpRES �IRST ADDITIbN pB 1 I�G 57 PORTION OF BLOCIrS 9Z 13 & 14 & VACATED ALLEY 8, VACA7ED A AVE ��4� S7R�ET D�SC AS; 38250 A AV�, 7.E!'HYRHiLCS, FL 33542_5758 �� 2.Generaf descrlption of improvements; ROOFlNG �� 3.Own�r InfqrmaUon � �, a)N�me and address: SOUi'H CENTRAL NURSING Ho11�S OF Z�PMYRHIR.LS INC. � M; 602 COURTCAND ST, STE 200, ORf.ANb�� FI. 32gp4.T840 p� p}Name and addrass of fee simple ti�e holder (if other tttan alnmer): N/q �� ~ c)InterESt In property: OWN�R (�. � 4.CbnMactor Informadon � � a)Name a»d address: _MILBAR ROO�'ING. INC. . 1591 ��1 g HWY 309 DADE CITY FL 33823 � 9 b)TetephoneNo.: 352! Fax �Uo,(Opt.) �+ 5.Surety Information ,�. S � � a) Name and address: c� o � b) Amount of �lond: .,,, � c) Telephono No,: ��x No. (Opt.) �.. a. 6.Lendor a a) Name and add�ss: � � Phahe Ne. o 7. Identity of person within the State of Fbrida designated by ovuner upion vrhom notices pr other doauments may be senred; � a) N�me and address: � b) Telephpng Np,; �2at No. (Opt.)� B.In addibon tt► himself, awner designates the following person to receq�e a capy of the Lierwr•s Notics as prov;d�d in Sectlon 713.13(1)(b), FloMda Stah�tes: a) Name and address: bj Telephone No.: Faat No. (Opt.) 9.�xpiretlon dat� pf Nptice ot Commencement (the expire�tion date is pne year from the ►i2�te ef recortling unless a differ+ent date is specified}: WARNIIdG TO OWNER: ANY PaYM�NTS MADE BY TH� OWNER A�TER THE �XPiRATION OF TFI� NOTICE OF COMMENCEM�NT ARE CONSIbEREd IMPROPEIi PAYMENTS UN�ER CHAPT�12 713, PART I, SL'CTIQN 773.13, FLORIDA STATUT�S ANO C� R�su�.r iN YauR PArN� �rwrCE IMPROV�MENTS TO YOUR PROP�Fi7Y. A NOTIC� O� COMMENC�MEN'i' MUST BE RECORD�p AND POSTED ON THE JOB SiT� B�FORE 1'H� FIRST INSP�CTION. IF YOU INTEPIp TO OB7AIN FINANGING, CONSUIT'�OUR L�NDER pR AN ATTORNEY BEFORE COMM�NCING WORK OFt �tECORDING YOUR NQTI E OF COMM�NC�M�NT. STA7'� OF ` � „ CO�iNTY OF 10 : �r 3�9 ture of er or 's NfartnpyMar�agor / +C � r l ' 7 /'�,� y -- PNn Neme and �for�g0ing instru nt was ack a w1 g d betore �.th' � deSr of �. ', 20 /(, by �� In fact) (name of p�rty en behalf of ` �� a c '` Personatly Known OR ProduCed Identificatlen Notary Signat Type pf Identlflcation Produced Name(prl g �� , 2015 � � C01a�Mssbe rIF �E 59010 """ �� "' � � Ilfllon�l Nol�ry Asfn. Verific��on pursuaM to Section 92,525, PloNda Statutes. Un[� r pena e iotegoing . antl that the facts st�ttod in it are lrue to the best of my knowled a , li . � ' • � � 31g f I Person SiAnlnq (In Ilna #.) Above FCR�grtJOC,ivStilpp7 �' 813-'780-0020 City of Zephyrhills Permit Application Fax-813-78 Building Department � 3 ��l Date Received �•� Phone Contact for Permitting -- � (� U ' � �er's Name J� l� Owner Phone Number L Ouvner's Address C t. Jt� � 3 �Owner Phone Number � Fee Simple Titleholder Name J>r Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 1 '�35 `rZ LOT # �� SUBDIVISION (� PARCEL ID# �- J- � - � (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR � ADD/ALT Q SIGN Q MOVE CJ DEMOLISH INSTALL REPAIR PROPOSED VJSE Q SFR 0 COMM � OTHER G�4 TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q OTHER �— � DESCRIPTION OF WORK �� ''n'n �-�L BUILDING SIZE �� SQ FOOTAGE HEIGHT �� BUILDING $ VALUATION OF TOTAL CONSTRUCTION � � � EL.ECTRICAL �$ �I AMP SERVICE � PROGRESS ENERGY � W.R.E.0 � � � PLUMBING �$ � � � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � GAS Q� ROOFING � SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES ONO BUILDER COMPANY 1� 1�� U� � U��_ � L1 �. SIGNATURE REGISTERED � / N FEE CURR T Y N � Address � �`1 � � ug �� e �� ) 3 3 License # �. ( 3�,'jv� G.+ —J ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N Address License # � � PLUMBER COMPANY SIGNATUR'E REGISTERED Y/ N FEE CURRENT Y/ N Address License # �— � MECHANICAL COMPANY �NATURE REGISTERED Y/ N FEE CURRENT Y! N Address License # � � OTHER COMPANY Siui�filTUR� ^cC�C'''ER�D Y; P! F�E CUP.R�NT Y/ N Address License # � � RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of �nergy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (7) set of Energy Forms. Minimum ten (10) working days after submittal date Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. ***"PROPERTY SURVEY required for all NEW construction. ""'V rections: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A1C 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 A�plication Only) Reroofs Sewers Service Upgrades A/C Fences (PIoUSurvey/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 TRAN5PORTATION 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 ce�tify 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 P�otection-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 , 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 justiflable cause for the extension. If work ceases for ninety (901 conser,utiti�e da�s, the;oh ;s ce^�idered abardoned. 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 I.END�ER OR P.�! A'!'T�iRT±�Y BE��RE Rc^..^,�:v;;o;, Y3i�r't hOTiCE �F Ct3�riiNiciVCEiViENT. FLORIUA JUF�AT (F S'I 17 03) OWNER OR AGENT_ � CONTRACTOR � Subscribed and swa�n to (or� �rmed) , efore me is Subscribed and swo n to (or affirmed) before me this L'i � by .1.�01.V1 � L�k�1Ci _ u�azz� by �n.�c�r,l P�htct Who is/are personal�ckn�cni as/have produced Who is/are personally know has/have produced as ident�cation. as identification. Public � Notary Public Commissi . �q A. IOVE�_ Commission N �«��A A. ��7 co►�uss�oN a � �Du� se 20� s ru�auc EXPIRES JUL 28 2012 �• Name of N a printe Y ° � Name of Nota ��eNr - -�'�t l�il�ar RoafinQ, Inc. �.-�� 15H1! U.$. 3�1, I]ade City, FL 33523 State Cert Roofer #CCCI32909Y Ph: 8U�/5fi2-Z�93 Fax: 35Z/567-4454 RCI Reg Roof Consultant #0149 milbarLearthlink.net ROOF PROPOSAL, paae 1 of 2 DATE 06/28/11 TO SEALANDER CONTRACTOR SERVICES, INC. CELL: 813/546-7295 ATTN. ED SEALANDER FAX: 813/788-4028 5305 CAMBERLEA DRIVE ZEPHYRHILLS, FL 33541 � � `� (, � � � �� r �' �E a d, �.� < <�- � JOB ZEPHYR HAVEN NURSING HOME - MAIN BLDG 38250 "A" AVENUE ZEPHYRHILLS, FL 33542 SHINGLE RE-ROOF ONLY (boes not inciude Flat Roofl As per attached drawing 1 Tear off and haul away existing one-layer shingle roo��ng system 2 Provide and install new 15 Ib. saturated felt paper in accordance with the 2007 Florida Building Codes. 3 Provide and install new CERTAINTEED "Landmark" laminated dimensional shingles with streak-fighter (algae- resistant) fiberglass shingles; Owner to select shingle color from CERTAINTEED's standard colors. Provide CERTAINTEED'S Limited Lifetime shingle warranty. 4. Cricket at 20 ft wide block wall currently has shingles; remove shingle roofing and install Firestone APP-18� white granular surfaced modified bitum ��--- -.. 5 Replace all valley flashing an gooseneck vents as necded. 6. Provide and install new lead boo ta.e.-�al�rrr°rbing vents. 7 Ridge Vent. '`remove the 2 existing turbines and the 6 power attic exhaust ventilators; plywood over openings. "provide and install 300 I.f. of new pre-finished aluminum ridge vent. *electrical disconnect of the 6 power attic exhaust ventilators is to be by others and is not included in contract sum .__ t - ,� 8 Provide and install new pre-finished aluminum eavedrip (white r brown). 9 Repair/Replacement of any rotten or damaged wood (deck, fascia, trim, framing, etc.) or re-fastening of the existing deck will be completed on a cost-plus basis above and beyond the contract price. We will cut out rotten/damaged plywood as needed and repair/replace Full,'/2, or 1/4 sheets as needed. Labor & Material for Full Sheet 5/8"x4'x8' CD exterior plywood repaiNreplacement =$65.00; '/2 Sheet = $32.50; 1/4 Sheet = $16.25 10 MilBar Roofing, Inc. to provide a 5-year workmanship �.varranty to the original purchaser that covers shingle roof leaks; exclusions: storm damage, work done or damage by others, tree damage, and/or structural damage to roof deck. 11. Owner to provide access to roof for delivery truck for loading/unloading of roofing materials. � . �IiiBar Roofina, Inc. 15911 IJ.S. 301, Dade City, FI. 335Z3 Stete Cert Ruafer #CCC1329092 Ph: S00/562-2393 Fax: 352/567-4454 RCI Reg Roof Consultant #0149 milbarLearthlink.net ROOF PROPOSAL, aage 2 of 2 DATE. 06/28/11 TO� SEALANDER CONTRACTOR SERVICES, INC CELL: 813/629-4961 ATTN� ED SEALANDER FAX. 813/780-1689 5514 CAMBERLEA DRIVE ZEPHYRHILLS, FL 33541 JOB ZEPHYR HAVEN NURSING HOME - MAIN BLDG 38250 "A" AVENUE ZEPHYRHILLS, FL 33542 12. Raising of A.C. units and/or� . • ts, if rPquired, is to be by others and is not included in contract sum Flat and/or Metal Roofing not included in the contract sum. Maintenance/Laundry Bldg and/or Pump House Bldg not included in contract sum. 13 MilBar Roofing, Inc. to provide General Liability and Worker's Compensation Insurance ($2,000,000 limit) and re- roofing permit. ----------------------------------------------- We propose to furnish material and labor, complete in accordance with above specifications, for the sum of: FIFTY-ONE THOUSAND FIVE HUNDRED FIFTY-THREE AND 21/100 DOLLARS-----------------------------______________________._$51,553.21 -------------------------------------=----------- ----------- Payment to be made as follows: Due As Per Draw Schedule. ---------------------------------------------------- OPTION ��2�J►� @ 2�lSpr.. l',1 �o�Az,,,.t,_r.,- 1�,�.n.ka �hmn A. Option: Shinqle Up�tr�de to ATLAS "Pinnacle" dimensional shingles �,,�- h�c�-��, �� in ��1ran Mist" col�r ............................................................... New Contract Sum $46,076 77 Provide and install new ATLAS "Pinnacle" laminated dimensional shingles (algae-resistant) with LIMITED LIFETIME WARRANTY FROM ATLAS in lieu of CERTAINTEED "XT 25" 25-year 3-tab with streak-fighter (algae- resistant) fiberglass shingles. 3 �lS� �N t•tt5 ------------------------------------- �t+�lue P z✓c�1��p � � �� a,�Td..A�-ti -- � 1�� c4\ AUTHORIZED SIGNATURE: !/Q�i'Gl IC, �DCQ DATE: 06/28/11 DAVID R. ABLA, PRES ACCEPTANCE OF PROPOSAL: Signature: '�� The above prices, specifications end conditions are satisfadory and hereby accepted. PrII1t2C� � � /,Z ,( �� You are authorized to do the work as specified. Payment will be made as outlined above � �� Invoiced amounls nol paid in accordance with the payment tertns shall be considered Date: dalinquent and bear interesl at the rate of 1'r4 % per month. Ownar agrees to pay all costs mcurred, such as attomey fees, couR costs, etc., for collection of delinquent invoices mcluding irlerest. Owner to carry fire, tomado and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurancs. MilBar Roofing, Inc. is not responsible for damages caused by others, vandalism, negligence, storms. This proposal may be withdrawn by us if not accepted by 06/29/11 i i��ii� ii�� i �� i�� ►�� iii , 2011116019 Rcpt:1380137 Re�: 10.00 D5: 0.00 IT: 0.00 NOTICE OF COMMENCEMENT 07/27/11 K. Garcia Dpty Clerk MRI#4360 Permit No. Tax Folio No. 14-26-21-0010-01300-0010; THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and :n accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal description): MOORES FIRST ADDtTION PB 1 PG 57 PORTION OF BLOCICS 12 13 & 14 8� a VACATED ALLEY & VACATED A AVE 8� 4 STREET DESC AS; 38250 A AVE, ZEPHYRHIL_t_�, FL 33542-5759 0 � � 2.General description of improvements: ROOFING �� D 3.Owner Information W � `� a)Name and address: SOUTH CENTRAL NURSING HOMES OF ZEPHYRHILLS INC. � t ` + .. Z 602 COURTLAND ST, STE 200, ORLANDO, FL 32804-1340 m b)Name and address of fee simple title holder (if other than owner): N/A �N � c)Interest in property: OWNER �� T 4 Contractor Information � ° a)Name and address: MILBAR ROOFING INC. 15911 U_S. HWY 301 DADE CITY FL 33523 � (� D b)TelephoneNo.: 352/567-6047 Fax No.(Opt.) � 5.Surety Information � " � a) Name and address: � o A b) Amount of Bond: ~' � c) Telephone No.: Fax No. (Opt.) �'-' °° 6.Lender � 3 a) Name and address: � Phone No. o 7. Identity of person within the State of Florida designated by owner upon whom notices or other documPnts may be served: m a) Name and address: A 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 TY,� NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, S�CTION 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 i FIE 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 FLO D � � , �� COUNTY OF 'I O. Sign ture of er or 's Au o' ed ice i todPartner/Manager C'r"� �' � � � t 5 i�ii'fr> 1�' rin Name and Titl T foregoing instru ent was acknowl g before thys �_ day of � � , 20 /�, by t _ ass�� . �� (type a thffriry f. o ic y in fact) for (name of party on behalf of . � � � - Personally Known_ OR Produced Identification Notary Signat � Type of Identification Produced Name(prin = an 2fi, 2015 ��.,y . Commission A� EE 59070 —�� --- '•'.,?;o� �� .�,, 8 rntpuqh National Notary Assn. Verification pursuant to Section 92.525, Fforida Statutes. Unc{ r pena e e t e foregoing and that the facts stated in it are true to the best of my knowled e a elie . � f t./ Signa f tural Person Signing (in li�e # 1 ) Above FORMSINOC,rvsd2007 l� � STATE OF FLOR�DA, �QUNTY �� 4�'�� THIS IS TO CERTi�Y THAT TH� FA��Q�� IS A TRUE AND CORRECT CC.)PY UF TH� DOCUMENT ON FILE OR Q� PUBL�IC.R�GQRD IN THIS 4FFICE WIT�ESS MY HAN�AND; OFF�CIAL:�EAL �� DAY OF 2 G � PAULA S'N �, CLE & OMP ROL� � � DEPUTY CLERK