HomeMy WebLinkAbout12-13573 CITY OF ZEPHYRHILLS
5335-8TH STREET
(sis)�so-oozo 13573
BUILDING PERMIT
Permit Number: 13573 Address: 37355 DERBYSHIRE DR
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: WEDGEWOOD MANOR
Est. Value: Parcel Number: 10-26-21-0120-00000-0900
Improv. Cost: 6,500.00
Date Issued: 10/29/2012 Name: GILJAM, JANET
Total Fees: 70.00 Address: 37355 DERBYSHIRE DR
Amount Paid: 70.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/29/2012 Phone:
Work Desc: RE-ROOF WITH GAF SHINGLES
� .
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TAPE JOINTS ROQF I P
FINAL ��'�'( Y
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.
"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."
Complete Plans,Specifications Must Acxompany Application.All work shall be performed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
" � e+�.... �. �.CA�l�M� L�
-'" CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
�,s-reauuzu City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received 1� � Z Phone CoMact for Permittin �S�— .5 Vv .
Owner's Name �GY��� �•- � C� `(`(1 Owner Phone Number
Oumers Addresa �� J-� � � ' �����' p�er Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee 3imple Titieholder Addreas
JOB ADDRESS � �� ����j S C\\C I� r�.1� LOT A �
SUBDIVISION PARCEL ID* / 6 'Z E, - ( - (ZQ _- Q Q 0(,)U — (?�'j�o
(OBTAINED FO pROPERTY TO nce)DEMOLISH
MIORK PROPOSED e NEW CONSTR B ADD/ALT [� SIGN
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME �] STEEL Q
DESCRIPTION OF WORK �YZjU� �j �� ��
BUILDING SIZE SQ FOOTAGE�� HEIGHT
�BUILDING S ��� � -" VALUATION OF TOTAL CONSTRUCTION �4 �5�� U�
[�ELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0�'
QPLUMBING s
QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION l �� � �
.
�
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER "� � COMPANY � , � �
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address � ` cv�c; rf,(� License# �C�j SYj�j �� �
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Addreas License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
OTHER � � COMPANY
SIGNATURE REGISTERED Y! N FEE CURRE� Y/N
Addreas License#
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buiiding Plans;(1)set of Energy Fortns;R-O-W Permit for new construction,
Minimum ten(10)working days aiter submittal date. Requfred onsite,Construction Pians,Stormwater Plans w/Silt Fence installed,
Sanitary FadBdes 8 1 dumpster;Site Work Pertnit for subdivisionsAarge 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 aiter submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Fadlities&1 dumpster.Site Wo►k Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY requlred for all NEW construcUon.
DirocNons:
Fill out applicaHon completely.
Ovmer 8 Contractor sign badc of applicarion,nota►ized
If over S2S00,a Notice of Commencement is roqufred. (AIC upgrades over 57500)
•• Agent(for the contractor)or Power of Attomey(for the owner)vwould be someone with notarfzed letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Applicatlon Only)
Reroofs if shingles 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.
UNUCENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: if the owner has hired a contractor or
contractors to unde�take work, they may be required to be Iicensed 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 vivlation
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 cont�actor 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 T�ansportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buiidi�gs, or expansio� of existing buildings, as spec�ed in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, wiil 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 flnal power release. If the project does not involve a ce�t�cate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, ff 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 vbtain 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 alf 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 Heatth & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understa�d that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
tf 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�II is found to adversely affect adjacent prope�ties, 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 YOUFt
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO 08TAIN FINANCING, CONSUL7
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMEI�CEMENT.
FLORtDA JURAT(F.S. 117.03) � �
OWNER OR AGENT ,° r,.-� � f-�`!'-?� CONTRACTOR �i.-` �o�.— �--- '��° �--'�"��
Subscrlbed and swom to(or affirmed)before me this Sub crlb and swom t�(or affirmed)�re me is
by �p a Z. � .t.�r�S' A.s(�,A,--�—
Who islare personally known►o me or haslhave produced o I personal��y nown to me gr as/havi ced
as Identlficadon. � as idenUBcation.
Notary Public Notary Public
Commissfon Na. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII DSPt01001859 ITeCO 00.00
2012184574 10/29/12 C. Miner, Dpty Clerk
Permit No. Q�',L l!J-- Z
ParcellDNo / �-'��Z�*'���'/G�C���1.-Q��'(�ef
� I � �� NOTICE OF COMMENCEMENT ��S-�a
State of l.��� � -
County of
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,
the following information is provided in this Notice of Commencement:
1. Description of Property: Parcel Identification No._��'°Z ff"2�-f7�L G► .-�J����i � C�C�E��J
Street Address:3 �5 S C.V S�l t �Q Qy� �,� �, �� , " lj �� ��s�
2. General Description of Improvement hc�t 7"' f.✓� qr l'j �j� %��,,,� 6��-/�n t,
3. Owner Information or Lessee information if the Lessee contracted for the improvement:
�f�.�" i �I R-�M
_�'7 �SS a
� r�':S�1i:C �� Z�alty�- /�. ��.5 /�'�
Address City
State
Interest in Property� 3�5 yZ
Name of Fee Simple Ti;leholder:
(If different from Owner listed above)
Address �t /� Ciry State
4.� Contractor: �!OT� ��e�c_k..vKot,.� �y L;-��,,� -=y.e
�� �GX ���� ���/t7 S �-S� S�n /4s��o,►-i . �; �/
Address City State
Contracto�'s Telephone No.. � '�t���/(,r C,+ � 3�s���
5. Surety:
Name
Address City State
Amount of Bond: $ Telephone No.:
6. Lender:
Name
Address City State
Lender's Telephone No..
7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)(7),Florida Statutes:
Name
Address City State
Telephone Number of Designated Person:
8. In addition to himself,the owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
Telephone Number of Person or Entity Designated by Owner•
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the
contractor,but will be one year from the date of recording unless a different date is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE�F COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING 7WICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,COIVSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA �
COUNTY OF PASCO � � �--�
Sig ure of Owner or essee,or s or lr.saee's Authorized
O cer/DirectoNPartneNManager
Signatory's Title/Office
The foregoing instrument was acknowledged before me thi day of�_,2p�y ��j � �(��
as � � (type of authority,e.g.,officer, rustee,attomey in fact)for
(na f party�on half of whom inst u ent was exec ted).
Personally Known Q CLR Produce Identification Q�. Notary Signature ��lf �.1
Type of Identification Produced � Name(Print) (f l ��j
PRULR S 0'NEIL,Ph D PRSCO CLERK & COMPTROLLER
10/29/12 02:32 m 1 of 1 'Y P4j� CORI ANN KEOU�iH
OR BK ���� P� ���5 . • Mfr� EyirK11rY2p.l�� '
s'� Commbtbe I EE tqq
y~� u� �� 8011d�d nM0Y�1 N�y� '
wpdata/bcs/noticecommencement�c053048
�v�! ac
STATE OF FLORIDA,COUNTY OF PASCO .��' • ' • ��
THIS IS TO CER�IFY THAT THE FOREGOING IS A ��"' �G 1
TRUE AND CORRECT COPY OF THE DOCUMENT � � •
ON FILE OR OF FUBLIC RECORD IN THIS OFFICE * � : #
h+yat we'1'rurr
�rdl NESS MY HAND AND OFFICIAL SEA�� * , ._ �, .
._�.DAYOF�O�� ,� o . *
PAU S O'NEIL,CLERK&COMPTROLLER � �887 *
BY � DEPUTY CLERK �f'j•��OF���P
Pasco County Parcel: 10-26-21-0120-00000-0900 001 Page 1 of 2
Data Current as Of: Weekly Archive - Saturday, October 27, 2012
Parcel ID 10-26-21-0120-00000-0900 (Card: 001 of 001)
� Classification 01 - Single Family
Mailing Address Property Value
GIUAM JANET F Ag Land �p
37355 DERBYSHIRE DR Land $17,020
ZEPHYRHILLS FL 33542-7001 Building $66,417
Physical Address Extra Features $773
37355 DERBYSHIRE DR
ZEPHYRHILLS FL 33542-7001 7ust Value ;84,210
Leaal Descri�tion (First 4 Lines) Assessed (Non-School Amendment 1) $84,210
See Plat for this Subdivision
Taxable Value �84,210
WEDGEWOOD MANOR PHASE I &II
PB 27 PG 11-14
LOT 90
OR 8763 PG 643
Land Detail (Card: 001 of 001)
Line Use Description Zoning Units Type Price Condition Value
�1 0100 SFR OOR4 4,500.00 � $4.65 0.80 $16,740
� 0100 SFR OOR4 1,208.27 � $0.29 0.80 $280
Additional Land Information
Acres 0.13 Tax Area OZH FEMA Code X500 Residential Code WDGWLPl
Buildina Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1992 Stories 1.0
Exterior Wall i Above Average Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall i Drywall Interior Wall 2 None
Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet
Fuel Electric Heat Forced Air- Ducted
A/C Central Baths 2.0
Line Description Sq. Feet Repl. Cost New
1 B� 1,302 $69,462
�- 2 EP 132 $3,521
3 FGR 340 $7,256
4 � Q 20 $267
Extra Features (Card: 001 of 001)
�-Line Description Year Units Value
1 DWSWC 1992 444 $666
2 CON PTO��-2009 r 50 r $107
Sales History
Previous Owner MEHRKAM WARD R&GLENNA S TRST
Month/Year � Book/Page I Type Code Condition Amount
09/2012 8763 /0643 Warranty pl Improved �$73,000
Deed
07/2011 8572/ 1114 Warranty 11 Improved $0
Deed
09/1994 3349/ 1351 Warranty � Improved $0
Deed
http://www.appraiser.pascogov.com/search/parcel.aspx?sec=10&twn=26&rng=21&sbb=... 10/29/2012
s��� Proposal/Contract
.Sc��tt � � ' , �I�c.
P.O. Box 1188 • 33010��
•
San Antonio, FL 33576 .��ec�dee�,
� (352) 588-ROOF (7663) • (813) 782-1330 �sK�c� �r
1-866-407-0559 • Fax (352) 588-9763 9�d�c�c,d
www.scottblackmanroofing.com
�°°���� email: blackmanroofing@aol.com Date . '� � ` LL
>> OST95T
PROPOSAL SUBMITTED TO WORKED TO BE PERFORMED AT
Name ���:a�°� Street
Street _ 3 �l�S� �e r �S�it r-e 1�- Ciry
City �.=.-P�t'� � � � State Zip
State . L Zip Owner of Property
Phone Number Fax Phone Number Fax
We hereby propose to furnish all the materials and perform all the labor necessary for the completion of:
O Remove existing shingle roof r�Replace b�d fascia boards at$ � �6�0 per foot
❑Remove existing built-up roo# ❑Replace 1 x decking at$ per foot
0 Dry-in with ❑ 15 Ib. �0 tb. �7 Install feet of ridge vents
❑Dry-in with a fully adhered underlayment$ p Install modified bitimen(granulatedj torch down roofing
❑Install new galvanized valley metal edditional
black, white or other color
0 Install new lead boots ❑ Install 25 yr.fungus resistant 3-tab shingles
❑Install new roof jacks p Install��rr.fungus resistant dimensional shingles��`^^`�
O Install new drip edge, �� : ��.color p Shingle manufacturer color ��1 �{ l�
O Install new flashing as needed ❑ Install TPO,white rubberized roofing membrane
O Replace plywood at$ �'1r��G per sheet
L�Other:�`�'N cT-�-C�1��.��� h��e��.+�-. �' ✓�
f]Repair rotten trusses at$ "�. � per foot ��
f7 1A� f,s�v:� n� , �.rn � .� '. " �.��
'Woodwork is an additional charge,see pricing above �(�S.f�h� �. iA Ct' � { ���� (� �' ��(,.rr�y
All material is guaranteed to be as specified,and the above work is to be pertormed is accordance with the drawings and specifica-
tions submitted for above work and completed in a substantial workmanlike manner for the sum of$ (�SQQ'"�,��
with payments to be made as follows: Payment due in full on completion, unless otherwise noted. Thank You.
Credit cards accepted,additional 3%charge.
'Not responsible for satellite signal when satelite is reinstalled 'Not responsible for A/C & electrical lines too close to roof decking
Any alteration or deviation from above specifications involving extra costs will
be executed only upon written orders,and witl become an extra charge over and
above the estimate.All agreements contingent upon strikes,accidents or delays Officer/A ent Scott Blackman Roofin
beyond our control.Owner to carry fire,tornado and other necessary insurance 9 g
upon above work.Workers'Compensation and Public Liability insurance an above Note: This proposal may be withdrawn by us if not accepted
work to be taken out by Roofing Contractor. Extreme caution should be
used durtng and aiter constructlon for debris and nails missed during within days.
cleanu .
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as
specified.I have read the back of this ProposaUContract,which contains Florida Statues 713.001-713.37. Payment will be made as
outlined above. Client gives permission to drive on driveway to deliver materials. �
Accepted Signature _ ; '
�
Date Signature �
APPLICATION FOR WEDGEWOOD ARCHITECTURqI, ACI.IVI
Date Received -- � - /�
Before making any alterations, additions, or improvements to the ex enor of a res d n
o r l o t b y re p a i ri n g, r e c o n s t r u c ting, re btu l d i ng, or improving after the house is built, the e
HOMEOWNER MUST SUBMIT AN AppLICAT I ON TO THE
ARCHITECTUR.AL CpMT�IITTEE FOR APPROVAL. AppROVED REQUESTS
WILL EXPIRE SIX (� MONTHS AFTER DATE OF APPROVAL.
A�.�'IVITY INTEND •
e � e_ o -�" ��"1;� �S ✓ ' �
- S� -- � L �'
i,
.
State what you wish to do. Perinits are required to meet all current state, county, and city
building requirements. All direct and indirect costs associated with the project are the
homeowner's responsibility. Sketch a drawing of your proposal on the back of this
application if needed.
�
Applicant � �.�J �� �,- , L �A Lot Number � �
Address � `7 3�� .e2/.3�S � �,2
,L�.�.�.�_ Phone No._�i���. L,3S9
Signature of Applicant � /�
J ,
ARCHITEC'I'UR.AL COMMITTEE
APPRQVED PROJECT-DATE DEI�IIED PROJECT-DATE
' . �o-.S-i2
�C ' .5 /.2 y
���5" �i2
'�' " = 1 1
COMMITTEE MEM$ER ASSIGNED TO PROJECT � �,� r r
1�'L�s /;.S�
APPROVED COMPLETED PROJECT DATE COMMENTS � �� � � �3
, .
:- ,
,
- _ Signature of inspecting committee member
HA.RMOIVIOUS----WORK�BLE--__NEIGHBOR FRIENDLy
Revised 3/29/2011