HomeMy WebLinkAbout15-16289 CITY OF ZEPHYRHILLS
5335-8TH STREET
�sis��so-oo20 16289 �
� � DRIVEWAY PERMIT �'I
PERMIT INFORMATION LOCATION INFORMATION I
Permit Number: 16289 Address: 39668 MEADOWOOD LOOP
Permit Type: DRIVEWAY ZEPHYRHILLS, FL.
Class of Work: DRIVEWAY/NEW Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: MEADOWOOD ESTATES
Est.Value: Parcel Number: 13-26-21-0140-00000-0300
Improv. Cost: 800.00 OWNER INFORMATION .
Date Issued: 5/21/2015 Name: ROBERTS NATHANIEL & DEBORAH S
Total Fees: 40.00 Address: 39668 MEADOWOOD LOOP
Amount Paid: 40.00 ZEPHYRHILLS FL 33542-6715
� Date Paid: 5/21/2015 Phone: (813)997-1074
Work Desc: DRIVE WAY 36 X 10'4 & 10'9 X 31'9 EXTEND TO EXISTING DW
CONTRACTOR S APPLICATION FEES
HOMEOWNER DRIVEWAY 40.00
r
�
Ins ections Re uired
DRIVEWAY
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 g)work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this properly that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies. �
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
c
,�/��
CONTRACTOR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO .-
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
r .
_`�
Y
{�
. �,
�ERMI'P-APpLICA'1�ON
I�►R=VEWA1t:P.ERMIT:APPL�ICAT:�Ot�
3CC�NSTR1t.CTtON�IA�ITHT(V�PUBL�IC-t�TGHT�CbF�WAY
Atl information must be-filled-in complete(y
� :City.ofaZep�hyrhills
'S335:8�'Street,.2ephyrhills,�FL 33542
Teiephane.813.780AOOQ Fax 813:780.0005
y��G,' :s „ �....r� .., �.,r.9nxuc -41� p'�'-`,''�'•H �'�.`'• .a:' ;�,,,.. .:cW;,r.�� ��L.'t :�Y-�&'itt�> -. A;.'"y,. }
��L�G"� �'�C�l�7ri�,��"k ti��� v,'Y.F'.;��..�F .�1 ���,£-,-s.�r�-�#'�t'S,¢Y,� .r�$:�t','7.''"� :i�'Sz",�"'si°-„'i'e;'�r,, 1pX""�'Yi:d-�,vK"`."ri�r1i��&:,, ��.
::+c s' '�� .t, �"xi s -y .: y�� .�'° ;s �� r.r �cca, � s.g u -r,�sa,�;.�'`����•t "tr•'�Zct,'°a"����,�4„ `� .� '�`
��: .,a�++� ':t' .��:?;�*y�-�`r,�,� B 4��i"a� %�f'.°.� 3, �.y Y:-, .#�� ,r:�.��rf�„Ny �-t:
""'"���' ` �:-,c��;��'f�.� �,-�"w ' ','":t"``�,:��„'(9,r��'��Dn :���� .^r��..r' �; :r-?,.� .3. e, ���;;��;"',�:
,�az����`�. r�- „n � �..' ;�r��•, p. -r� r-..... �"�, r�; -,4> ,.�.,�. �;y;,,�,�.`���",.�r; . M
.��! �' yY. y,�Y',t'`;:i �.i,Z. �,�L..,...jt�,,z y.�. ,ia^t1„ '��`�3��� �rd�� / je3,•:;I•�.1., y'
t;:�'rr'"���.s.�3''i�"`c,"."�,:''�§: s��� ��r,^i+,"t.tFs_�:°�`;3�ri„r�7g�':f:�-_�-a'.`ua�:'s^y.:?h?=t'�sw`i�`�s:�.�.tir. � �'rYa��-1�r7s?��:�'�°s'�ii`nv':�s'�1`�r�,s�E��}�'n3 t=;
x,.
`PR4 ECT .�t�B;SITE: PROPERTY'CtWNER
� Address: D Name: t L.s�' �
UNt#: Address ' nEt:
Parcel Identification Number: � C' State Zi Z,.
Phane: -- � Fax:
I
', �-CONTR.ACTI�R: ���1 ga,Y` '
Comt3any;
' Name.
Contractor's License#: E-Mail:
�Phone: �C�II: °- d Fax:
ARCliYTECT/ENGINEER: . I
Name• Frrn iVeme:
Address: City: State: Zip:
State�cense#: Phone. Cell: Fa�c:
i Descriptiora af Proiect
TYPE G1F DRIVEWAY l�j'��j!� �LENGTH OF DRNEWAY CULVERTS'NEEDED
�_RESIDEMIAC AittVEWAY ��}',.�„��WIDTH OF DRIVEWAY ( )REINFORCED CONCRETE
CCIMMERQAL DRNEWAY • R.t'l.W, ,�7CCAVATI0IU ( )CORRlJt"sA'fED MATERtA1.
PUBLIC ACCESS DRIVEWAY DEPTki LiNEAR FEEr ( )BOX CULVERT
( )OTHER(IXPIAIIV)
CONS1'RUCTION MATERIAL CURB CU7 REQUIRED
ASPHALT YES �X_NO
�CONCRE fE
HEADWALL REOUIR�D�' YES NO
NOTiC�TO kPPLICANT: If actua�worlc exceeds scope af this descriptian,additional permits ar dravuings
�wilt be required.
U7TLITY LOCATIONS REOd1IREDt CALL BEFORE YOU DIG: 1.800.432.4770
,
Page 1 af 3
����ce�������t�� /1?��}DoWODO Co�P �.D�U1. �S � �
� , , � _.�,.�
�H.��:��.00�TE CON€��E�'�4.'P����RR�9[��ERo
�I�&��S�E SKET��4 3E� '��1�5,AF�IEA, E!����E�°T��1,�1������ I�;� �EC�B�YI���� �'�'AC� `P�'�8���
�B�F��IIC�a'�B�A�.
f -
__..._�-�r�,i .
J
�,s/,a�,!�-...f L��, ) �l
�J �7 ���� f4��
_ 1� �`f^ '.f
j���r ���__�.�1 Y '�� � �d� / , �+�lQ�l1U� C�� �•
}
� ` . �a� �E du P2�Y�l�
� . , -�� (�f��
wI �
s ! � ! i�
�Y1; S --s
'}; `�_�-T , 5,,�i `.
! � c'�� ;�I f�-T "�'
� � � �
j + EXEST�riC7
f j ���•������;�
�
,. ,
�
; �tIDT�= f���',t'`/� Ps�,.l3
;
� .��f GG t�� /h/f!///�lU(�'P D�
:���. � ^_._�rt3�D ��Dyl ��icr',�'�' �F !�!�'�'� -�_---�'__��. —'
�� �`��' � �Of�15 �_.� � �����,
o � -�° � ! • j ��°-� �^
� - o
i
AFFIDAVIT: Application is hereby made to obtain a permit to do work and installatians as indicated. I certifjr that all foregoing
information is ac�urate and that atl work witl comply with ail applicabte codes. I understand these codes shall take precedence over all
approved construction documents,_and�ssuance of th(s permit is veriticatian that I wii!notify the properiy owner oP Flarida t3en l.aw
req., F.S. �13. .
`fhe issuance of#t�is permit does not ensure compliance with deed restrictions and I understand that additiana(deed
restrictions may apply to this property.
���w��sh�88 ccs�p9y�wot�s�h���t�rrent Fl��ic���a�i�c�i��C�d�,���9ic W�r��e�����+I�e�aa�0�r�d FDt�'�'t����r�
�rt��rd�(if��pli�bl��. (Public 1�larks Design Manuat online link:www,cl.zephyrh,��s.#�.usJpubtic works.asp)
APP�IC�4TION IS VOID C�NLESS SIGNE�1NiTF4 PROPER IDE(VTIFICATION AND WITIVESSED BY A PERM9IY
�"ECHNICiAa(�OR h1�DTARY PUBLIC.
,
�P�`�: 4he�ity of�ephyrhitl�is nat e�spora�Hbl�f�e�rroa�enb�n�wa;��e�r��ics a�f�r�v�w�y��. Drivewr�ys�i��16 w�at a����/
ee�t�r�v�6ti�eKi�en���eo�u�raC�r����nt a�na�J��we�vey�nceo
PROPERTY 01�It�ERS: 8y signing this appiication: I certify that I have read and underst�nd the ov�rner/builder disclosure
5�atement. {please initial)
Appficant Pr3nt Name Applicant Signature Aate
Permit Technician Signature {or)�lotary Signature page
Ap�licant is{ )personal(y known to me or produced as identiFication.
(type of identifcation)
���� ����
�• �'��6�'��'����'�Y��B
,
�...��...�.+������..�.� �� .�,.��.�.
�EIF��E �IP����BL.�
... . . . , . _ .. ., . . . . . . ., .. . .. . ,
.... . .. ... .. .._ .._.....:. -, __. ,
;.._._ ..
, :���LCII�C�61�5:_k�'�ar�:.:_.�1::� -�
Goncrete (m€n. 6"� Y N
Asphalt Base{min. 6'� Y �
Asphalt(min. l�h'� Y 1�
t.ength(min. 19� Y }� °
Width{10'mrn—20'max} Y N
�isting s4dewalk. Y N
�IBW SICI�W�I�C. Y �
ADA compliant. Y N
Facpansion materia] required. Y �1
Can�lguous parking pad. Y N
, Triangular flare(3'W x 7'�) Y N �
�
i Visibility triangle o.k.? Y N
SEde set back(3'min. R.O.W.} Y �
( Plan Review Fee
�
-:-�-. ,.¢ - - .. ,... . .
:_�,+��i�io:�ai.�fi+a�i' �i�:o�;�o�k:����fi�ie�:f� �li�iclAliiai�l3�r.ecbi+raeti�p�rdesi"`ei � `. - --
�e.`.b°
� t
/
Permit application approved by: Date:
������ff�
���' �
PascoView
' � � � � � � � Q �i � '� � � �� �' � »���l�dt�� �
� �II I " d� ,�'.� � � rw.....:i t __, �� �, ' , .. 1: . � •i",^F, ky r«y{
; I., Y� 'r '.� k w'' �fl {�,.��'a "'.�� �'.�'.:i � I'k� :A.
"- $ � � 'S �tr� F.
�..� � M , i�� � � � yd ��... � ., � 4.y.e'6'�NT �..��,.
' 3 { . � r��. �,.,�
�ra +�� 'M i; �' . si t +tr .,}��F�.r '1�.;i, 4k:l� py�;
�,...� , ry� ti � ,� � t'X.��ry��, , M.,R� �;��� +., .���_ ��
, � j.'•�. � .�_f ���,` .. �:� e���{,;,�, p3y, 1'r� N �. .,, ., �
. �µ �' .'+ � � .t: -.t. . , .� . _ �,—.k.`. .� ;�,�� . . � �.,�';'��.
r � �� t S"l M �� .• .. � �! , t . .�. 7r�. ��'4# ,. �i,i '.
. } u � '�. ' f � �� , �,a� , X 4 �"� 3 ,f ���� .�
�ir*i" .s�� ,.+ �^ 3.t s�(, � .�c'' i . - � ..H��^�� `� '.�y �y.a .
le�i"... .'.. �'(��.'k''� ,� 'i'�'.+t t,f;�i , • , '.�T ���'.w'� � ,�,�.' � ,,1 �t
i! �, �� ,r V' " i {, _ � ,��+al, �� � fi . � . �Tif'� ��;�'� �, e 7
c_ � . o .a� � �, '�`',�`rz� �_„_ ,+[i • _
�� � .�r y� •(rd,� 5�;;�,�4 t� �'�, w.-.,,r r!
�� _ ° y � �"'� � � �� �
� ' * ; t ���# ��� �1`� x ,.
' �;�, �_ � �� � ,
F ,,� P �:t " .!��yyi' Y`. ,�,; 4
,y% �`��.� �` � �'� f•� . . . `} ,�,'�
,„�y+'�,.^�� +� �; �' + � „ �, + u� ,t�' i�� � �r
,� ••t• ��''���.,� .�r +��� # � +fC � ,}, ���- ��}y��i'# �
1N�i. 1' � f �"`*A't P
.�, . !y:, r: �.:' .� r j'p I;.. . . , �?. �!� „
�!"k ,,{ ��Y}.�. � "���} ��. � �,`' � �f'�� �•�+ �1��.
�;.. y i *� �� `��� �'"� N$ � . �. � � 'q� � >y,,.
.y� . � Y �� �� � .. �,• ��.
� r� � ��
.� � � } t ., ��. �„�� " . t � ' . . �,;�
, �,.'..�. 4 � ,� ,,�� ��. I � .,! ,y��
� x:.�. f.
� ,
.
; .
,,t,+t, . ..j -r .�` �r; . � .� � x.
,.
� , �
, . t � _. w ,i - . . ,� ... . .
,
.
� t � �1
� fl w
;�� '3"`� � '�,�;� � �.�; �' °'��+�' ,
r i ,{ c' f t���C. �I ��
t_
��;� � a �� I ��" � �t "�-��� '� ��r n�S r r�.t{�; .~�b� . . . . a� zi. nr �i'� n�,�.
V �r ;
+ I � �^'�µ'��' .y��:� �. �jr�<.'_ . . A.��4
.�! � , _��. �':!k�
}
,
, .i 4
- ` �; ..s.�'x �;�'�'�' ,.. � � '►.�' �f.ry:
'*'� :.; 1 ya.� .�;� . . ��:,: ' . � � �} I :
.Y .,1 �'"! � SI � (�f.f N L, . ,'Y' 't,.�, . . . f J
�� "� y„� ' :� 4r �, � ����� � �3`�, :��`1�,.�y�'� �` � .,
,.
� . �
.
r z , .
e .�. '. . . . .i ��� . , � .� �F7.
; n .. �. t , . ,:
, . ��. �Y� , � ''r . 1 r �� ..,.�t y f .. i ,. A tr�s�. �
.
, .-" -� .. �a
, e
, :: ..� � �� �}
� ` , ' �_
�r rr .€.� s }F ss� ,t�
'�« , a '�fir:,�t, �wAP� � •y� � "'A.. � � ,t'�
. .
.
�r ..�:._
,
,. � � �� x� '
�` ,�� , � a
,
.
�.r"ti�k . '� �,, d .� .s� *
r . ..... . . . 1�4 ...
i�'44i � a�F ;,�'`':. ,�' �'` ' �, t��l, t 5.�,�-,�. �..�
�
,v- ,,. . .-� �. � � _,. .
„ .� a� —
� i.
���
""r1,:_,.,Ai��.lY+ ;�O�AWf�'� '�".a.>. , ,.�.T, � . a ....�..�.*i.�^�Ine.Z� . � -:L"t^�� . 1�z�� � . . . _.„. .. „_,____ .. _.
�.Y...>.i-
2oam ta:��� � + Print Map �Cport Ma�
r � • •. • • ' • • 1
• DISCLOSDRE STATII��NT FOR OWNER
; � CITY OF ZBPHYRHILLS BIIILDING DEPARTMENT
' 2, ���S���v�� � 'n�1�D��} �Q�� have read aad fully understand and
agree to the provisions of this iastrument.
The undersigaed states and affirms that he or she is desirous of constructing,
renovatiag, addiag to or reroofiag his or her owa domicile, that he or she
actually occupies, or will occupy by said domicile, aad same is aot for
rent, lease or sale. That he or she sha 1 comply with the following conditions:
1. That the owner and he or she aloae shall act as the builder for all phases of
coastructioa.
2. That the owaer will comply with all provisioas of the City of Zephyrhills
ordinaaces and codes pertinent to the building.
3. That in the event various phases of coastruction are aubcoatracted•, he� will
engage oaly properly liceased subcontractors aad will personally aupervise
such work.
, 4. That in the event the Building Inapector shall require correctioas to be made,
� the owner will assume full respoasibility to iasure they are made, and upon
completion will call for a reiaspection before proceediag with the building.
5. That the owaer shall assume full respoasibility for the constructioa and will
not expect supervisioa of his work from the City of Zephyrhills Suildiag
Departmeat.
6. That prior to fiaal inspectioa aay additional fees, includiag reinspectioa
fees, must be paid ia full. A written request from this office shall
constitute an official aotice to pay additioaal fees.
7. That the owner shall comply with all City, State and Federal laws ia regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owaer shall comply with all the safety codes issued by the Florida
Iadustrial Commissioa.
9. State law requires construction to be doae by liceased contractors. You have
applied for a permit under an exemptioa to that law. The exemptioa allows
you, as the owaer of your property, to act as your owa contractor with certaia
restrictions evea though you do aot have a license. You must provide direct
onsite supervision of the coastructioa yourself. You may build or improve a
oae-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial buildiag, provided your costs do aot exceed $75,000.
The buildiag or residence must be for your owa use or occupaacy. It may not
be built or substaatially improved for sale or lease. If you sell or lease a
buildiag you have built or substaatially improved youraelf withia 1 year after
the constructioa is complete, the law will presume that you built or
substaatially improved if for sale or lease, which is a violation of this
exemption. You may not hire aa unlicensed person to act as your coatractor or
to supervise people working on your buildiag. It is your responsibility to
make sure that people employed by you have liceases required by state law and
by county or muaicipal licensiag ordinances. You may aot delegate the
responsibility for supervisiag work to a liceased coatractor who is aot
liceased to perform the work beiag doae. Any persoa workiag on your buildiag
who is aot licensed must work under your direct supervision aad must be
employed by you, which meaas that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your constructioa must comply with all applicable laws, ordinances, buildiag
codes, and zoaiag regulatioas.
OWNER'S SIGNATURE ��,!_!�`.�� DATE
ADDRESS� � ,�� t7 I
PHONE g (�j Q���If��T
WITNESS PERMIT #
� � `�,�'ir' ��'�G�
8�s-�so-ooao City of Zephyrhills Permit Application --_.� FaX$�a-7eaaazl �
Builc3ing Department
�
Da#e Fiecetved Phone Contact for Parmitting
� _
' �l.Owner'�Name ��/ = e- Owner Phone Number
Owner's Address 6 � � �k�Q U Owner Phone Atumber �— �
i
Fee Simple Titleholder Name r— � Owner Phone Number � �
Fee Simple Titleholder Address
JOB ADDRESS ��-��"'� LOY# ��
SUBDIVISIdN �— �� pARCEL ID#
(OSTAINED EROM PROPERTY TAX NQTICE}
WORK PROpOSfD , e NEW CONSTR 8 ADD/ALT 0 SIGN [� Q pEMQLISH
INSTALL REPAIF2
� PROPOSED USE Q SFR Q COMM � OTHEFt
TYP�OF CdNSTRUCTION [� BLOCK Q PRAME �'] STEEI, Q
DESCRIPTIQN OF WORK ^�-a ��C� �Y �f�r .� � r �C ,e. � ,�}"��,h/
BUILDiNG 81ZE � � SQ FOOTAGE�� HEIGHT C��
��U���»�`'� $ � G' VALUATION OF TOTAL CONSTRUCTION
��Q�
0 � � AMP SERViCE Q PROGRESS ENERGY Q W.R.E.C.
EI.ECTRICAI $
,,.._,
QPLUMBtNG (;s � �
L �`7 l�� �
QMECHANICAI. $ VAL.UATION OF MECHANfCAL INSTALLATION
QGAS [� E204FING Q SPEClAt�TY C� OTF4ER
FINISHED FL.00R ELEVATIONS � � FLOOb ZONE AREA QYES NO
BUI�DER � �p�P�qpJy
SIGNATURE ,�,/1� REGISTERED Y/ N FEE CURRE� Y/N
Address License# �— �
EIECTRICIAN CQMPANY
SIGNATURE REGISTEREd Y/ N FEE CURRE� Y/N
Address Ucense# �— �
PCUMBER � �O�pqNy .
SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N
�d�� License# �� �
MECHAEtICAL CQMFANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �_ —�
OTNER CONIPANY
SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N
Ada�e�$ Ucense# � �
, RESIDENTiAI, Attach{2}Pla#P1ans;(2}sets af Bu3lding Plans;(1}set af Energy Farms;R-O-W Permi#for new construction,
' Minimum ten(1Q)working days after submittal date. Requlred onsite,Gonstruction Plans,Stormwater Plans w/Sift Fence installed,
Sanitary FacillUes&1 dumpster;31te Work Permit for subdivisionsAarge projeats
COMMEl2CtRL Attach{3)comptete sets af Builditig Plans plus a Ltfe Safety Page;{9)set of Enargy Fotms.R O-W Permit for new canstniction. � -
-- - - - MlNmurri"ten(1Q)working days after submlttal date. Required anslte,CansUuckion Plaris,Stormwater Plans w/Silt F�nce Instelled,
Sanitary Facilities&1 dumpster.�tte Work Parmtt tor all new proJects.All commercial requtrements must mest compllance
SIGN PEt4MiT Attach{2)sets of Engineered Ptans.
««..PROPERTY SURVEY required for all NEW construcUon.
Dlrecttons:
FIII out application completely.
Owner&Contractur slgn back of applicatlon,notarized
iE over�250d,a Notice of Commencement is requlred. (A/C upgrades over S75d0)
'" Agent(for the cantractor)or Power of Attomey(for the awner)would be someone with notarized lekter from owner auUiorizing sarrie ` ;",� '�'
OVER TtiE COUNTER PERMI'iTING (Front of AppNcation Only} s
Reroofs if shingles Sewers Service Upgrades AJC Fences(PIoUSurvey/Footage) , , `'
Oriveways-Not over Caunter if on public roadways..needs ROW - � ' - -� �� ' � " "'