HomeMy WebLinkAbout14-15334 CITY OF ZEPHYRHILLS ,/''
' S335-8TH STREET /
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(sis)�so-oo20 15334
BUILDING PERMIT �.
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,.��'•v;�;�;..�;;..s,_.PERMIT INFORMATION LOCATION INFORMATION�::°�v_Y '`.';:.��,�� `�`�...
Permit Number: 15334 Address: 6221 16TH 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: PARK HILL
Est. Value: Parcel Number: 02-26-21-0180-00000-0140
,, �,��� ;.;,,
Improv. Cost: 7,280.00 � . ` .OWNER��INFORMATION� ' T� `. � :=`'°:��.,.,.,_ ._
Date Issued: 5/30/2014 Name: JACKLING BRENDA
Total Fees: 75.00 Address: 11129 COUNTY ROAD 27B
Amount Paid: 75.00 FILLMORE NY 14735-8606
Date Paid: 5/30/2014 Phone:
Work Desc: REROOF SHINGLE
CONTRACTOR S APPLICATION FEES � '
SCOTT BLACKMAN ROOFI G NC REROOF RESIDENTIAL 75.00
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' Ins ections Re uired �
' DRY IN ROOF INSP
TAPE JOINTS ROOF INS
FINAL - --/
REINSPECTION FEES: Reins ection fees will com I with Florida Statute 553.80 2 c when extra ins ection
p P Y � )� ) p
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.
"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 Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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
_._ ...,. ..,,_,. �,��y �i �epnyrnms rerm�t Hpp��cai�on Fax-813-780-0021
Building Departrnent
Date Received 3 S �8 __ —]��3
Phone Contact for Permittin
�
O�nmer's Rlame C�� ('!�� �\Y� Owner Phone Mumber
O�nmer's Alddress � � l Z \ ��l�(n� � a l Owner Phone(dumber
Fee Simple Titleholder Mame ��l�M�'��- � Owner Phone Mumber
Fee Simple Titleholder Address
.DO�r4DDRESS �p �Z� � (Q ��� h r h���J F L•3 gs Z LOT# �
SUBDINISIOM �(�r� ���` PARCEL ID# �Z'Zb Z� � d�80 • Q�QOQ 'Q�y('�
(OBTAINED FROM PROPERTY TAX NOTICE)
WORCG P6tOPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH
INSTALL 8 REPAIR
�ROPOSED USE Q SFR Q COMM � OTHER
Tl(PE OF CO(dSTRUCTlO(d �Q BLOCK Q FRAME 0 STEEL �]
owtn� c o i....y� S
IDESCRIPTIOM OF WORK �UC�`� �� rv�GrS'�p.�� �h�n � �ti�
BUI�DIMG SIZE SQ FOOTAGE�� HEIGHT
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION _ � � Z���Q�
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY �] W.R.E.C.
OPLUMBING $
. /(���
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION `
QGAS Q ROOFING SPECIALTY � OTHER -�°'e`�
�1-�,
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES fV0
B1911LIDER 2 COMPe�NY
SIGtd�1TURIE REGISTERED Y/ N FEE CURRE� Y/IV
����$S License#
ELECTRICIAId COAAPA(dY
SIGMATURE REGISTERED Y/ IV FEE CURRE� Y/N
Address License#
PLUIlA�ER COMPAtdY
SIGR1i4TUIZE REGISTERED Y/ N FEE CURRE� Y/N
e4ddress License#
MECHAIdICAL COINOPANY
51GMQ►TURE REGISTERED Y/ N FEE CURRE� Y/N
Address ' License#
OTHER wL.,,� COAlIPAMY
SIGfdATURE I y�"8n REGISTERED Y/ N FEE CURRE� Y/N
Elddress � � License# CCC��, Q��
R�SIDEtdTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W PeRnit for new construction,
Minimum ten(10)wo�king days aRer submittal date. Requlred onsite,Constructfon Pians,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisions/large projects
COMIME9tC1AL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constriiction.
Minimum ten(10)working days after submfttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8�1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compiiance
SIGfd PERiM1T Attach(2)sets of Engineered Plans. .
"'"'PROPERTY SURVEY required for all NEW construcUon. � -
Direct(ons:
Fill out appl(cation completely.
Owner 8 Contractor sign back of applicallon,notarized
�• If over s2500,a fdotice of Commencement is required. (A!C upgrades over�7500)
Agent(for the contractor)or Power of Attomey(far the owner)would be someone with notarized letter from ovmer authorizing same
O!/�R TFIE COUNTER PERMIITTIfdG (Front of Applicatlon Only)
Reroofs if shingles Sewers _ Service Upgrades A/C Fences(Plot/Survey/Footage) _
Driveways-Not over Counter,if on'public road'ways.:needs ROW .', �. ;
,: ' , t , , ',
i0'TIGE C1F D�ED RESYRICTlONS: The undersigned understands that this permik may be subject to"deed",,estrictions"
�hich may be more restrictive than Caunty regulations. The undersigned assumes responsibility for compliance with any
pplicable deed restrictions. �;`
iWLiC�IVS�D COW7"F�,CTORS AND CCIW'��tAICYO�E i�iESPOWS1�ILiTiES: if the awner has hiredz a contractor or
antractors ta undertake work, they may be reguired to be licensed in accordance vuith state and loi;a! regulations. lf the
ontractor is not licensed as required by lav�r, both the owner.and;contractor may be cited for a misdemeanar violetion
nder stale law. If the owner or intended contractor are uncertain as to what Iicensing requirements may apply for the
itended work, they are advised to contact the Pasca County Building InspecEion Division—Licensing Section at 727-847-
;009. Furthermore, if the owner has hired a contractor or contractars, he is advised to have the contractor(s} sign
�ortions af the "contractor Block" af this�application far which they wili be responsibte. lf you, as_the awner sign as the
:antractor, that may be an�iridication ttiat he is nat properly l�censed and is not entitlec! to permitting privileges in Pasca
;ounty. .
'1��►INS�OR'TA"�IOFd lilflfP�lCY/UYlL.Y�'I��IflflP�iC'�'AR}D�fE�IDURCI�R�COVfERY�E�S:� The undersigned understands
hat Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buiidings, change af
ise in existing buildings, or expansian of existing buildings, as specified in Pasco County Ordinance number 89-07 and
30-07, as amended. The undersigned a}so understands, fhat such fees, as may be due, vuilE be identified at the time af
�ermitting. It is furfher understoad that Transpartafion impact Fees and Resource Recovery fees must be paid prior to
eceiving a "certificate af occupancy" or final povuer release. tf the project does not involve a certificate of occupancy or
inal pawer release, the.fees must be paid prior to permit issuance. Fu►thermare, if Pasco County VVatedSewer Impact
�ees are due, they rriust be paid prior to permit issuance in accordance with applicable-Pasco.Caun#y ordinances.
;OId5T�3llCYlOPi LI�PI ��►IW(Chap�eP'��J� FioPld�t .°St�tU#�S� �� am�neied): If valuation of work is $2,500,00 or mare, i
�er#ify that I, the applicant, have been provided writh a capy of the "Fiorida Canstruction Lien L.aw—Homeowner's
�ratectio� Gu'rde" prepared by the Florida Department of Agriculture and Consumer Affairs. If ths appiicant is someane
�ther than#he"awner", i certify that E have obtained a copy of the above described document and pram�se in good faith to
deliver it#o the°owner"'priot to comm�ncement.
GOINT�,Cl"Oft'SlOWIN�R'a/1F�IDi11/M'�: ! certify that all the information in this application is accurate and that all work
uvill'be done in compliance with all applicabie iaws regulating construction, xoning and tand developmenf. Applicafion is
hereby made fo obtain a permit to do wark and installation as indicaked. 1 certify that no rnrork or instailatian has
commenced prior to issuance of a permit and that af! work uvill be perfarmed to meet standards af ai! laws �egula#ing
construction, County and Gi#y codes, zoning regulations, and land develaprnent regulations in the jurisdictior�. 1 also
certify khat I understand that the regulations of other gavernment agencies may apply to the intended rrvork, and that it is
my responsibility to identify wrhak aclians I must take to be in campliance. Such agencies Include but are not limited to:
- Department of Environmental Protection-Cypress Bayi�eads, Wetland Areas_and Environmentatly Sensifive
Lands, Water/Wastewater Treatment. ,
- Sou#hwest Fiorida V1later it�anagement District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Arrrty Carps of Engineers-Seawalls, Docks, Navigable Vlfaterways.
- Depaetment of. Health & Rehabilitative Setvices/Environmental Heal#h Uni#-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmentai Pratection Agency-Xsbestos abatement. '
- �ederai Avia#ion Authority-Runuvays.
I understand that the follawing restrictians apply to the use of�II:�
- Use of fi!{ is nat a!lavued in Fiood Zone°V"unless expressly petmitted.
- If the fil! materia! 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 ma#eriai is to be used in Flaod �one "A" in connec#ion with a permitted buifd'rng using stem vvall
constructbn, }eertify that fiil will be used only#o iii!the area within the stem wai}.
- if fili material is ta be used in any area, ! certify that use of such fiii wii! not adversely atfect adjacent
properties. 3f use of fil! fs found to adversely affect adjacent properkiss, 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�1�EWT FOR�fHIiE OWIIV�I�, i promise in gvod faith to inform fhe ovuner of the permitting conditions set forth in
this a€fidavit prior ta commencing construcfion. 1 understand fhat a separate permif may be required for elec#rical wark,
plumbing, signs, wei4s, pools, air conditioning, gas, or other installations not spec�cally inc{uded in the application. A
permit issued shal! be construed ta be a Eicense to proceed with the v�rork and not as authority to violate, cancel, alter, or
set aside any provisians of the technical codes, nor shall issuance of a permit prevent the Buildirig Official from thereafter
requiring a correctian of errars in plans, construction or violations of any codes; Every permit issued shall become invalid
unless the work autF�orized by such permit is commenced within six monttis`ofPperrriit'issuaiice;'�a��if�wark�:authorized by
the permi#'is suspended or abandaned for a period of six(6}months after the time tFie�inrar.k;is:coiitmenced, An exfensian
may be requested, in r�vri#ing, from the �uilding Ctfficial for a period not to ex��e�i',�iinetjr (90}.;days,_and�will demansfrate
justifiable cause for the extensior�. tf waek ceases for ninety(90}consecutive days,the job is considered abandoned.
1�lAf�NIN� 'TO OVNNf�[�: 1fOUR FAIfLUR� YO f�ECO�tD �► Pl0'TICf� OF COflflflflEWCEflflEWT flfl/1Y RESIMLY IFI YOUR
�-��cYIYdG-YIiVICE-�UF3-I�HH�ROV�iWEAIY�-�'O YOUI7 I��O�!�i�'TY, i�YOU IiVYEWD TQ OBTAiN FIPI�►NCIYVC, COPISUL'�'
I�iIYN YOU�t LEiVL1iE�O�i�W AYYOIf�Pi�Y(��FCiif�l� FtIECO��IWt�Yt)t1�2 NO'TiCE C�F COi�i1HENCE�ENT. — _ �
FLflR1DA.lURAT{F:S.117.Q3j
OWVdER OFt AGENT ���^�-�����'— CGPITitACTQPt .%���•..- � �3.��t-�.�«�--
Subscdbed and swom to(ar a�rmed}before me this Subscrlbed and swom to(ar afflrmed)befare me this
by by
Who is/are personally known to me or has/have produced Who is/are personally known to me or hasJhave produced
as Identlficatian. as Iden#Ificatlon.
`�'"��~--� Notary Public �� Notary Public
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Comm sion ••"„�",,,, Commission
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*; ';:: Commission#FE 040�20 ' ,"„. JaCQUEIINE BOGES ,
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i�ame of t�ota �in g�.� ` � � Name of Notaty �8• ri
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:VOTt��OF�UM,V[.�.lCEtivi�iV'�' Rcpt:1609110 Rec: 10.00
Pcrmit Na. . OS: $.@0 I7: 0.00
"""'�"- - ' 06/11/14 b. Bonilla, Opl,y Cl�rk
t'r�gcczy 3�icatiticaunn No. ' "�'�+ � ��'C91�'�t���) — �,'� 1�`tkC7
TWE UND�KSTGT�E�hcrcby gives aotice ihat irnprovcmcnt�will bc mmde tn cercain real properry,and in ac�ardance with 5cction
713.]3�t thc l�tnrida Statutes,t1��fp�lnwiitg i�tfartrtutiott is�rc�vicicd in tho;tit?TY��C1�GU�'t14tETVCEYiE1VYr'.
l. DesczipGon of properry(f�;G+al desrcriptinn:l �' ��'�^1 ��s�^ 'r �O -� - -d l$0-
a} Strcc�Add�ess: '�.-.'�� �'``S ��t.,^,�L��S .� � 5't{�� C�t�ClO � iti{6
2. CroClCCaI fICSCI'Ipt10n�f imprOVCiY1C11Cfi ��,� cca�'r`�� �n^�r.t.'o•rch.�
Sh�n c\[S� ..,�._..... . ..�...._�.,,.. .. .,,,�..__. ..._..
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3. Ow�►er�n€ m»tioa
) tvam��n�i uddress: _,,��'C�^'+�e... ��c�<�`^� �1 I�..� C o��..�� r'7 � '7� '�i llntiois;,k N��'-�5-`(�
b2 N�mc and address of f�e simpie tetiehoider(if oth fln owner)� ___,._.�, r. _..__„
r) tnterest in properry C}�'n��
=4. C012L1'ACtQr InfiliYY�LLlfU11 ���g���km
a} N�mc�nd addt'ess' , . __.......__ ,
b) 1'eiephc�ne Nn.;,�,.�.'^�.,-��''�Ibb"'j E��j;$��,��--
S. Suroty tnCurmatioa $El11 ARXQft�p, FL 3�576
a} l+��m��nd�tidres;:._._ _ .. .._ .�--.
bl Amounc of Ban�1: _
C) Tclephu��c No.;„�, Qau�.R s o'NEI l.,Ph•p.RpsCO CLERK & COMPTR4LLER
t4. �.ender 0�I11J14 �1��� p�°f����
a) Nan�c and addtess;_ OR �K ----���-�—. .-•—•- -. '
7, ideniity t�f pc��t►rt within ch4 Statc uCFlnricln tic::i,�i7nted hy c'>wct�r u��on who�n noticc::c�r ather duc:umants ma}be:cc:�Ved:
a) Numa artd addresS:._, . ,. .,_._.......... _.,,...�
i�} Tei�h�ne Na: fr�x t�a.(4p�.)
K, tu acidici�n lo tun�,vcit;owner desi�na�es thc folinwing persd+�to r�reii�r a copy ut'c1�e�ic:ic�r'sNatice��pr'ovidcd in Section
713.13f l)(b).F�nrida StatUkbg:
a} Natnn e»d aciti�zss:�, .
bl '�elephone Nw.: . ..__ F�x Afo.(t�P��)�
9. Exp►ration dace 4YNotice ot Commenccment(chc oxpiration dACe�is one ye�r from the dztc of rccarding unles�a different daie is
SpCCItt��:
1�y4R1�1�yG'['4�pWN�lt;ANY PAYMENTS M4DE BY TMiF:A'VV!VFR A'�T�R T'H�F7tPIYtATiON'UB TH�NO'1'CCE O�'
Ct1MM�NCEM�N9'AItF:Ct3tVS�1��R�D T1M�p�tClE►ER PAYMEN'i'S LTC�DER t',ElAP'Y`ER 723,PAR'�`�,SEC'T`i0(V 7l3.13,
C�'C,ORIUA S'N'A1'UTES AIVA�Al�RESClL7'IlY YUUR PA'Xt\G'T'W'ICE w�UR IYRUVEMEIVTS'Y'O Y4U12 PRUPEi2`TY•A
3Yp�}•j[;g��('f?iV(MFNCFME.NT hXL7ST BE R�EC4RD�Lr AND'hOSTEb ON T�'IF JC1B S'C'N'�BEY C)RE TC�F'1TtS'i'
XNSpE�TYdI`d.i�YUU tl�ix'E1VD�'O OBTA�IV�Y1VA�tCY1�TG,Cp1V�ULT'YUiTFi LFNI�E[t OR AN ATT{}RN�Y�EFQEt�
COlVYME�CINC,�'�'U1ZK Ult 12.ECO1tYlYhC:YO'�hU'C'YGE O�COMMF.IvG�1VlENT.
srnzF a��e.oal�ar ..�._,... . .. ---,�.
�ot'NTY oF PA,SCO Signat �'Ownes or Owner's thurized U�cevlOitCCtod Mcr�anagcr
r"'�� ;
.�7,__'1 P"`R�1��'�� ..�,�� �`7 «
prini N�ntc
'fhc furcgoinb inxuwtlel�t t�•us acA�no�4ViCdgt�d bCfetro me this�r+tssty csf..._._�, 20�,bY.�..._..
as , ,,, __.,, ,-( 'pe of nv�harity.c.g.afticer,trustec,attorney iSt FdCL�PAf
' ° —`.� � j�iame of partY on be6elf df whom insaumCnc �seu ).
Pessanally Y{�own„^„C)R P�'oduccd Idenkificaeon,_ Notary Signaturc '�'
���zt�{prio4� �� � ��
Type of tdancification Prod�tccd .
Vncifrcation rarsuant sn Scc�i�,n$2,525,f lUrida Sl�iutes.Undcr fiCnwlli�s of parjury.I declart that f 2�:tr�c ro8d il�c fbrdgoinq t�nd thxl lhe liuta sia�tcd
in it s�e kruc ro the hcst c�t my knnwlccige anc4 helief. ������ �,1 .�Le�.�'=•=••C..+�.
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Nf1WAS�N('1C.rrW2tlA7 � �iGr.NUisAf\uWm�'WnSi�� '
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, NO.OI V06i C1749
QuCptled In 1UlegGrlY C un C
My Cammission�tpi�es
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V'.O. Box 1188 • 33010 SR 52
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San Antanio, FL 33576 �de����d,
v _ 4352} ���-��0� ��663) � �813) 752-�330 �ei�e� �
���66-40�-0559 � �a�t (352) 5��-9763 �,��u���
�rv�nrvu.scot�black�nanroof�ng.codn . ,
�°°��.� emaiBe f�8ac��nroofing@aof.cor� Date o► �9 20 �
G�GG�057957
PROPOSAL SUBMITTED TO WORKED TO BE PERFQRMED AT
Name�,C'C'(lC�C'A. � C..��\Yl.' Street
Street ��� � 9 ���
City, �-F'��� {-�+\�,�S State Zp
State ��--- � Zip � Owner of Properfy
Phone.Number���J°�� � — �� I Phone Number Fax
�0.�.��1 Y-1� �� � y Q:�O d.�.0 .
We hereby propase to furnish ail the materials and perform al�the labor necessa�or the completion of:
�3emove existing shingle roof �teplace bad fascia boards at$ �.��? pecfoot
❑Remove existing built-up roof 0 Replace ix decking at$ perfoot
�d'Dry-in with ❑ 15 Ib. ��b_ �instal! feet of ridge vents
1�6ry-in with a fulty adhered underlayment$ �+�BQ;� ❑)nstal!modified bitimen(granulated)torch down roofing
�stail new galvanized valley metal Bdd"'°°�
�� � biack,wtiite or other color.
�'(nstail new lead boots Install 2 ' - ' Ies�e.SS �--��(
�nstall new roofi jacks 1"�'fi e`A' �` ����,^�—
� �1lnstaA-�fungus resistanfdimensionai shingles� �a��Q.
�'{nstall newdrip edge, �AJ���+�. color ��
. ❑Shingle manufacturer o W E N S �C}c�rt�
❑Install new flastiing as needed Cv��`�` -
,lnstall TPO,white rubberized roofing membrane
�eplace plywood at$ ��s o� per sheet �her: � .S��e�5 .���WUc�� t�'le,�GQ�(�t
�epair rotten trusses at$ �.Q� perfoot ' ' `
"`Woodwork is an-add'itional charge,see pricing above
�- � •., �AY- !e �-�`G'�Y^r� �C�Q�D���'t)C" ' Cac� s
AII materia�is guaranteed to be as specified,and the above work is to be performed is accordance with the dra ings and specifica-
tians submittad for above work and completed in a substantial workmanlike manner for the sum of� �ti�.�Q.a�
with payments to be made as follows: P� t�te�lt tl�� er�ful9 ote com oletiOP1,.�s�less otF�et'vvise rtOted.'Thclr�{�Yo` �
�� c�-e � ('`n� ��'��`��Credit cards accepted, ditional 3%charge.
`Not responsible for sateflite signal when satelite is reinstalled *Not responsible for A/C &electrica lines too close tb roof decking
Any alteration or deviation from above.speciftcaEions involving extra costs�vill
be executed only upon-wriuen orders,and wiil become an extra charge over and ���•-�--�.
abova the estlmate.Au agreertients contingent upon strikes,acciden�or delays QfficedA ent Scott Blackman Raofin
beyond our control.Owner to carty fire,tomado and other necessary insurance � g
uponaboVework=lNorkeis'CompensationandPublicLiahUiryinsuranceanabove Note: This proposal may be withdrawn by us if not accepte
work to be taken out by Roofing Contractor Extreme caution sBould be
used during and after construction for debrls and naits missed during within �_days.
cleanup.
ACCEPTANCE OF PROPOSAL
The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do tlie work as
specified.I have read the back of this ProposaVContract,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. s
Accepted Signature � ' i L�
, _ .. , � ,