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' CITY OF ZEPHYRHILLS
�"^�, 5335-8TH STREEf
t (8i3)780-p02d �� $
BUILDING PERM�T
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16058 Address: 3527 A�BASTER DR
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADDIA�T RESIQENTIAl. Tawrtship: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: EMERALD POlNTE RV RESORT
Es#. Value: Parcel Number: 2426-21-0040-00000-1240
Imprav. Cost: 2,400.00 QWNER 1NFORMATlON
Date Issued: 311 012 0 1 5 Name: DRUDI JC1HN & HELEN
Total Fees: 75.00 Address: 3527 ALABASTER DR
Amount Paid: 75.04 ZEPHYRHILLS FL 33540
Date Paid: 3/10/2015 Phane: (607 725-6236
Work Desc: EXTENDED SCREEN RM & PATIC? COVERS 264 SQ FT
CONTRACTQ►R S -� - APPLICATION FEEB
H EO ER B ILDIN FEE 75.00
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Ins ections Re uired
F (5 ER 2ND R U H LU B M1S IN T CEI
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST RQUGH PLUMB PRE-METER iNSULATiON WALL MISC.
DUCTS lNSTALLED WATER MISG DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
Ct3NSTRUCTiON POLE FRAfV1E MISC. IUIISC.
REINSRECTION FEES: Reinspection fees will camply with Florida Statute 553.80 (2)(c)when eactra inspection ;
trips are necessary due to any ane of the failowing reasons: a}wrong address b)candemned worlc resuiting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready far
inspectian when called e) permit nafi posted on job site� plans not at job site g)work not accessible.
NQTICE: In addition to the requirements of this permit, there may be additianal restrictians applicable to this property that
may be found in the public records of this county, and there may be acEditional permits required from ather gavernrrtental
entities such as water management, skate agencies or federal agencies.
"Warning to owner: Your failure to recard a notice af commenc�ment may result in your paying�rnrice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
befare recording yaur notice of commencement."
� Complete Ptans,Specifications Must Accompany Application.All wark shail be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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CONT CTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MCtNTHS 1NITHOUT APPRUVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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Name ,�'r"�'Y��'ry��� �'�;����,�''� Lot# �',:_f�; j�° ,
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LOT IMPROVEMENT �
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EMERALD POINTE BU.ARI� UF D1REC'TORS - �
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APPROVED BY_ _`�1�����>yF=������,��5��+;,�.�-� DATE: �/`� �;'�'��y; ;
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PROPERTY EVALUATI�N COMMITTEE
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A P P Rn V E D B Y: ���� ,�=c � -�.?e ��.�„��-L-,�DATE: .-� — �' —.��-.��' �
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EXPIRATIOI�,� DATE: e:�'����,���;
INSPECT[ON BY: DATE:
FINAL INSPECTION BY: DATE:
PLEASE RETURN TO LOT IMPROVEMENT COMMITTEE
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: N E Lf:Il� O G�J D�
Date Received: � — Z'7 — / S'
Site: 3��,�7 A L1� 3r�STE2 � 2 �OT /Z�f
PermitType: LXTCN� SCREEIU �`M �- � rat�o Cau�R,,s
Approved w/no commentsl Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
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Kalv 'S t —Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
813-780-0020 City of Zephyrhills Permit Application ._. FaX-s�3_7so-ooz�
-- -- ° - -°-•- - , Building Department � ,
Date Recelved ,Phone Contact for Permittin ��, !� - S3.��l .- �
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Owner's Name , �,... ., (� �1 . • Owner Phone Number �(d U ` -7�� -C��- li
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Owner's Address � �� I�CtS 'e Ir �L• 33 �{ � Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS � Sa� �'C�R-l�Q$T PT p , � Y�(�l�S ��-33'� LOT# �a ��
SUBDIVISION 'e R I,�_ OI 1'LT� PARCEL ID# a - (o - - � (�� DD�dC.� " I o� (�
, (OBTAINED FROM PROPERTY TAX N0710E)
WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q � DEMOLISH
INSTALL REPAIR
PROPOSED USE � SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL �
DESCRIPTION OF WORK �x��'1-� SC L°� ��G� � � �t.l f l� C (j V� S
BUILDING SIZE SQ FOOTAGE� HEIGHT
TITrTrTrITTrT
�BUILDING $a fl�� pD VALUATION OF TOTAL CONSTRUCTION
I
DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $ �O�Cr
V
0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '��
OGAS � ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
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BUILDER ��� COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y! N FEE CURREN Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address � License#
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RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large 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 after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requiremenfs must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
"""'PROPERTY SURVEY required for all NEW construction.
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Directions:
Fill out application completely
Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
•* Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE�F DEED RESTRICTIONS: The undersigned undees#ands that this permit may be subject to"deed"res#rictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictians.
UNL.ICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES� If the awner has hired a confractor or
contractars ta undertake work, they may be reguired to be licensed in accordance with state and local regulations. If the
contractor is naf licensed as required by 1aw, both the owner and contractor may be cited for a misdemeanor viofation
� under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended wark, they are advised ta contact the Pasco County Build9ng lnspectian Divisian—Licensing �ection at 727-847-
8009. Furthermore, if the awner has hired a contractor or confractors, he is advised to have fhe contractor(s) sign
partions af the "contractor Block° of this applica#ion for which they wil! be responsible. If you, as the owner sign as the
cc�ntractor, that may be an indication that he is not proper(y licensed and is not entitled to permitting priviEeges in Pasco
County.
TRANSPORTA7lON IMPAGTIU3'IL.tT[ES tMPAGT AND REStaURCE 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 F'asco Coun#y Ordinance number 89-07 and
90-07, as amended. The undersigned alsa understands, that such fees, as may be due, wi[I 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 fina! pawer release. !f the project dass not involve a certificate af occupancy or
final power release; tlie fees must be paitl�prior to permit issuance. Farthermore, if Pasco County-Water/Sewer impact
fee�s are due,they must be paid prior to permit issuance in accardance with applicable Pasco Caunty ardinances.
CC?NSTRUCT[O3� LIEN LAW{Ghapter 713, Fiorida Statutes, as amended}� If valuatian af wark is$2,504.00 or more, ]
cerkify that I, the applicant, have been provided with a copy of the "Flarida Construction Lien Law—Homeawner's
Protection Guide" prepared by the Ffarida Repartment of Agriculture and Consumer Affairs. !f the applicant is someone
other than the"awner", i certify that i have abtained a eopy of the above described document and promise in good faith ta
deliver it to the"owner"prior to commencement.
GONTRACTdR'SlOWNER'S AFF[DAV[T: I certify that all ths information in this application is accurate and that all work
will be dane in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit ta do work artd installatiart as indicated. ! certify that no work or installatian has
cammenced prior to issuance af a permit and that a11 wark wi11 be perfarmed fa meet standards of alI laws reguiating
construction, Caunty and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
cerfify that 1 understand #hat the regulations af other government agencies may apply to the intended work, and#hat it is
my responsibility to identify what actions I must take to be in compliance. Such agencies inciude but are not limifed to:
- Department of Enviranmenta! Pratection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Vltatercourses.
- 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 filf:
- Use of fi!! is not allowed in Flaod Zone"V" unless expressly permitted.
- If the fill material is ta be used in Flood Zane "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
3icensed by the State of Florida.
- If the fill material is ta be used in Flood Zone "A" in connecfion with a permitfed buiiding using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
- lf fll material is to be used in any area, I certifiy that use af such fil( 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 af the building permit issued under the attached permit application, for lots less than one {1}
acre which are elevated by fill, an engineered drainage p(an is required.
If I am the AGENT FOR TME OWNER, I promise in good faith to infarm the owner of the permitting conditions set forth in
this affdavit prior to commencing canstrucfion. l uncierstand that a separate permit may be required for electrical warlc,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in #he app►ication. A
permit issued sha(l be construed ta be a lieense to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisians of the technicai codes, nor shali issuance of a permit prevent the Building O�cial fram thereaf#er
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorEzed by such permit is commenced within six months af permit issuance, or if vuark authorized by
the permit is suspended or abandaned for a periad of six(6) months after the time the work is cnmmenced. An extension
may be reguested, in writsng, from the Bui(ding Officia! for a period not to exceed ninety (90) days and wi!! demonstrate
justifiabie cause for the extension (f work ceases for ninefy(90}cansecutive days,the jab is considared abandoned.
WARNING TO OWNER. YC}UR FAtLllRE TO REGORD A NQTtCE OF COMMENCENiENT MAY RESULT IN YOUR
PAYING'fWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSUL7
WITH YOUR LENDER OR AN ATTORNEY BEF(JRE RECORDWG YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.d } �,,,,
OWNER OR AGEMT CONTRACTOR _____�y�!1 i /�,!�-�G- •
Subscribed and ywom ta. or a�rmed}bef r��t is� 8ubscribec3 and by ort�#o{or ff��le Nfor tr}s,this � .
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Who is/aGe personalJy known o mg,or has/have produced Who is/ erson Ily knQ�n}a me or has/have produced
f-,�.t}r1�f`�- �las identifica6an. ��}rlL��-L�. as identification.
��T"� 11z'�"Y J Notary Pu61ic ' / Notary Public
Gammission Na. Gommission No.
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N rYieTof fa't�jf ty s KS Name of No#ary typed, in „..... n'���
� =`MY COTAfu1iSSION#FF09,3699 =a°`�YpUB{n=: ~NANCY J BROt�KS
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'••'.F`oF.F;;q?:••` �JEPtRES Febru�ry 1g �p�g =� ' MYCOMMISSIQN#FFp93699
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{aa7}ssa•o�ss� FtorldallotacyService.com y9�'�oF'fl.�Q� ���RES February 18.2018
(ao�)399�0153 FloridallotaryService,com
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DISGLOSDRS STATS�N'r FOR OWNSR
CITY OF ZSPBYRHILLS BIIII,DING DBPARTI�NT
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T, �_ •2_° l�Ll �✓�vt.Cb � have read aad fully understaad aad
agree to the provisioas of this iastrument_ -
The uadersigned states aad affi.rme that he or she is desirous of constructing,
I renovatiag, addirig to or reroofiag his or her owa domicile, that he or she
actually occupies, or will occupy by sa3d domicile, and same is not for
rent, lease os sale. That he or ahe shall compiy with the folloariug concla.tions:
1. That the oovaer aad he or she alone shall act as the bni.lder for a11 phases of
constructioa.
� 2. That the owner ovill comply w3th all provisions of the City of Zephyrhi].ls
' ora�*+p*+�es and codea pertineat to th� buildi_ng.
3. That in the eveat various phases of coastruction ase subcontracted, he �v3.11
engage only properly licensed subcoatractors aad mill parsonaliy superviae
such work_- '
4. That ia the event the Building Inapector shall require Corrections to be made,
the owaer will asaume full respoasibility fio insnre they, are made, and upon
completioa arill call for a reiaspeation before proceediag with the buiiding.
5. That the owne� shall assnme fuZl responaib3lity for the construction and. mill
aot expect supervision of his work from the City of �ephyrhills Hnildi.ng
Departmeat.
6. That prioi to final i.nspection aay additional fees, including reinspection
fees, muat be paid ia fiil.l_ A �vritten reqnest from this atfice shall
constitute aa official notice to pay additional fees.
7. That the vamer shall comply wi.th al]. City,� 3tate aad Federal laa�s in regard to
social aecurity, wor3�an's compeasation, lien lar�s, eto., where applicable_
8. Tha� the owner shall comp�.y with all the safety codes iasued by the Florida
IndustriaZ CommiBSioa.
9. 3tate law requ3.res construct3aa to be done try licensed coatractors. You have
applied for a pexmi.t uader an exemption to �hat law. The exemption allows
you, as the owaer of your property, to act as yonr own coa�sa�ctor mith certain
restrictioais even though you do not have a liaense. You must provide direct
onsite supervisioa of the coastruction yonraelf. You may build or i.mprave a
one-family or two-family ress.deace or a farm outbuildiag. You may also build
, or i.mprove a commerci.al bui.ldiag, provi.ded yonr costs do not exceed $25,0�0.
The building or resideace mnst be for your owa use or occupaacy. St taay aot
be built or su'bstantially improved for sale or lease. If you sel]. or ].ease a
_bvilding you have I�uilt or substaatially improved yonrself within I, year after
the coastructioa is complete, .the law w311 pres�e that you huilt or
anbataatially improved 3f �cr sale or lease, whi.ch is a violatioa of this
exemption_ � Yon may aot hire aa Zmlicenaed persoa to act as yonr contractor or
to superviee people working on yonr bnilding_ It is your responsibility to
make snre that people employed by you have licenses sez+77red by s�ate la� and
by couaty or muaicipal licensiag Otdinan_n_e8. You may not deZegate tlie
responsibility £os s�exvising work to a licensed coatsactor who is not
licensed to pertorm the avork being done. Any persoa working oa youx buildiag
�vho is aot licensed muat work uader yanr disect supervisioa aad mnst be
employed by yau, which meaas that yon must dednct F.I.C.A. and ari�hholding tax
and psovide workers' compensation for that emplayee, a11 as preacribed by 1a�v.
Your aonstxuction. must comply wi.th a7.1 applicable lama, ordiaaaces, bnil.ding
codes, aad zoaiag regula ' .
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