HomeMy WebLinkAbout15-16570 i
CITY OF ZEPHYRHILLS
5335-8TH�STREET
j � (813)780�0020 16570
BUILDING PERMIT
PERMIT INFORMATION ' LOCATION INFORMATION �
Permit Number: 16570 Address: 4901 16TH ST
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: �ubdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14-26-21-0010-02000-0010
Improv. Cost: 500.00 OWNER INFORMATION �
Date Issued: 9/08/2015 Name: GRAHAM; ARNOLD
Total Fees: 40.00 Address: 4901 16TH ST
Amount Paid: 40.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/08/2015 Phone: (813)355-4077
Work Desc: REROOF SHINGLE �
CONTRACTOR S APPLICATION FEES
HOMEOWNER REROOF RESIDENT AL 40.00
�V`-�
Ins ections I'Re uired
DRY IN R OF INSP /
TAPE JOINTSI,ftQC}1Fj,�NSpS
FINAL l� ��/`��
REINSPECTION FEES: (c)With respect to Reinspection�fees will comply with Florida Statute 553.80 (2)(c)the
local government shali impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
_ NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may be found in the public records of this county, and there �nay 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 o�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
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATH�R
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� a�saeo-oo2o City of Zephyrhills ermit Application Fax 813-780-0021
Building De artment .
Date Received � -
Phone Contact for Pe mittin —
Owner's Name �GL� Owner Phone Number �0 3 '��Z—�3��
Owner's Addres� '/COl � /�- d� g��s� � �� 7�
! � t� _ d w /�. l �0wner Phone Number
Fee Simple Tltleholder.Name � Owner Phone Numbar
Fee Simple Titleholder Address
JOB ADDRESS U �[2 � � . LOT# �
SUBDIVISION PARCEL ID# '
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED wEW CONSTR . ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL � REPAIR
PROPOSED USE SFR [] COMM OTHER � c,o
TYPE OF CONSTRUCTION Q BLOCK � Q FRAM STEEL Q
DESCRIPTION OF WORK �� 7 � /D � �I /l 1.2 ��C �`j 'S� S/Q�
BUILDING SIZE �"" • � � SQ FOOTAGE HEIGHT
i
QBUILDING $ �' ' VALUATION OF TOTAL CONSTRUCTION
�0�
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ,
QPLUMBING $
G'�.'ra"`�''�
OMECHANICAL $ VALUATION OF ECHANICAL IfVSTALLATION (Q �3_ 2-Z6 _/S j I Z
v v
QGAS Q ROOFING Q SPECIALTY OTHER
FIIVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER � COMPAf�Y
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address Lfcense#
ELECTRICIAN COM PAt�LY
SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
Address Ucense#
PLUM�ER COMP
SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL COMPAI�Y
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N .
Addresa License#
OTHER COMP I Y
SIGNATURE REGISTE�o Y/ N . FEE CURREA Y/N.
i
Address License#
-,RE3IDENTIAL Attach(2)FIot.Plans;.(2)sets of Building'Plans;(1)set of En�rgyForms;R-O-W Pertnit for new construction,
', Minimum.ten(10).worliing days after.subrtiittal date. Requfretl onsite,Construction Plans;Stortnwater Plans w/Silt Fence installed,
' Sani4ary Facilities&1.dumpste.r,Site Work�Permit for subdiVistons/large projects
COfVIMERCIAL Attach(3)complete sets of Buiiding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcUon.
, Minirtium ten(10)wo�lcing days after submittal date. Required onsite,ConstrucUon�Plans,Stortnwater Plans w/Silt Fence tnstalled, � -- '
Santtary FaciliUes 8 1 dumpster.Site Wark Permit for ail new projects.All commerciai requlrements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans..�
""PROPERTY SURVEY required for all NEW construction:
Directlons:
Fill aut applicaUon completely.
Owner&Contractar sign back of applicatfon,notarized .
If over�2500,a Notice of Commencement is required. (AIC upgrades ver a7500)
" Agent(for tFie contractor)or Power of Attomey(for the owner)would be someane with notarized letter from owner authorizing same
DVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs lf shingles Sewers Service Upgrades A1C Fences(PIoUSurvey/Footage)
Drlveways-Not over Counter if on public roadways..needs ROW
� ,
NQTICE C1F DE�D RESTRlCTIONS: Tfi�e understgned undetsQands°.that thts.p�rmit may-be.seab�eat to"deed"res#rlc#tons"
wrhich may be more�restftctive�than Counly reguiations.�`The undersigned assumes responsibility for compiiance with any
appllcable desd restrictions. �
!!Nl.tCENSED CUNTRACTQRS 4►MD COIdTRACTOR RESR�NSIBtt�17°IES: If the awner has hired�s contrac#or or
contractors to undertake work, they may be:requ'ired..to be Ilcensed In accardance.v�ith state.and�local regulations. .If the
co�tractor is not IEcensecf as requlred-fiy 1aw, both the owrroer anil:cor�t�actor�may #s�cl#ed foa� a misdemeanor vlaslatlan
under state law. If the awner or fntended°contracto��a�re uncertaln s�s tca what Iicensing.requirements m�y apply�#ar�the
i�tended work, they are advised 4o cantact the.Pasco County BuNding�lnspection Q(visl"an-1:Iaenstng Sectton at 727-847-
aaas. F�ar#hermoa�e, if the awner has hired a cantractar-or confractors, he is advised to have the contractar(s) slgn
porkians of the "contractor Black" of this applicatfon for�nrhich they will be responsible. if you, as.the ovvner sfgn as`the
co�tractor, that may be an Indicatior� that he is not.properly #tc�nsed a�ci Is not entitled t� permitting privlleges In Pas�o
County. ' "
TRAW�PORTATIQN 11�9PAGTIlJT1�.ITlES-CMPAGT�►N�RESQUR�E RECQ4/ERY FEES: The undersigned unde�s#ands
ti�at Transpartation Imp�ct Fees and.R�caurse Recave.ry.F�es may'>apply;to�the construction af new buildings, change ofi
use in existing buildings, or.expansion of existing'�buildings, a�s spealfted in Pascv Caunty Ordinance number 89-07 and
9Q-t#7, as amended. The undetsigned also understands, tha#�such feesw�as may:be�due;.wil!;#ie #dentified at the firroe s�#
permitting. It fs furtfier understood that Transportation Impact Fees and R�source Recovery'Fees mus# be paid primr to
rece�ving a"certlticate of occupancy° or final powec.rele�se. :4f the pro�ect does not Involue-a certiflca#er of occupancy or
final power release, the fees must be paid prior#o permit issuance. Fur�hermore;�lf Pasco County Water/Sewer Impact
fees�re d�e, they must be paid primr to permit-Issuance-In accordance with appitaable Pasco'County oidlnances.
COMSTRU�Tt�N`�.IEN E.A�ifi(Ci�a�t�r 715, FlOtlde StStUt�Se as�menda�j: If valuation ot work is$2,5t30.00 or mpre, i
c�rtify that I, the �pplfcant,. have�been provided with a �opy of the "Florida Co�structian_Lien Lauu�—Homeovbner's
Protection �uide" prepared by the Florlda Department of Agricultur� and Consum�r Affairs. If the appllcant�s someone
other than the°owne�', I certify that I have,c�btained�a copy of the above.described document°and.pcomise In,gaad faith to
dePiver it to the°awner"prior to>commencement:
C9M"TRRAC'TOR'S/011VNER'S AFftDAVIT: 1.certify.that all the 9nformation in this application is accurat� �nd fhat ali work
will'be done in ca�pliance with all a�ppHcable laws regulating constructlon, zoning and land develapment. AppOcation 1s
hereby made to obtafn .a perrrti# Qo da work and ins#allation as Indtcat�d.. ! certify #hat no work.or InstaEtati�n h�s
comm�nced priar to Issuance of a permik and that�all work will be pertortned to meet standard� of all laws regulaking-
canstruction, County and City codes, zoning cegulatfans} and land develapment regula#1ons�in the�jurlsdictton. ( aiso
certify #hat I u�dersfand that the r�g�alations af ather governme�t agencles may�apply�to the lnte�ded work, and thak it is
my respons6bilily tu identify�what actions I must take to be,ln:.cor�lpliance, Su�h agenctes Include but are.nat limited to:
- �epac#men# af Environmental Pratection-Cypress'��yheads, 11Vetland Areas and Environmentatly Sensitive
Lands,WaterMlastewater Treatmenta
- Sauthvue�t Ftorida Water Management �f�Brtct Wells, Cypress.`�Bay.heads; Wetland Areas, Aite�3ng
Wate�cours�s.
- Army Corp�of Engineers-Se�w�lls, C7ocks,Navfgable Waterways.
- Depar�men# of Heaith�� �et��bltitat€ve Service�/Erniroetmental Heatth Unit 1l�ells� Wastewater ?reatrrsent,
Septic Tanks. _ .
- US Environmentai Pro�ection Age�cy-Asbestos aba�ement.
- Federai Avlation Authority-Runways.
I und�rstand tt�a�the fvllQwing.restrlctions apply to the use of flll;
- Use vf�ili is not allow�d in Fload Zone"V"unless�expressly perrt�itted.
- If the fill rnaterial is to be used,ln :Flood Zone "A", (�. Is understood that a drainage plan addressing a
� "compensating volume" wllt be submOtted at time af permltt{ng wfilch is prepared by a professiona! engineer
Ilcensed by�he State of Florida.
- }f the fll materi�} 6s to be used in Flood Zone °A� Irt�connectf�n w�th`.a permitted buiiding using stem wali
� construcfion, i certi�yy that fiil•wili.b.e used only to#ilt the area vvithin the stem•vvall,
- If fill materlal is to be used tn any arear I cer4lfy that use. of such�fill v�il! not adversely affiect adJacent
propert�es. tf use o#fili is#ound to adversely.affect adJace�t properties, the awner may be`cifed for viala#ing
the conditions of the buiiding,permit issued under the at�ached permit applicatlon, for lots�I�ss than one (1)
acre whtch are elevated by f�ll,an engin�ered dralre�ge pian is r�quired. .
If 1 am the AGENT FOR TH�AWN�R, 1,-promise In good fafth to inform 4he ovvner of#he permitting conditions set forth in
this affidavit prior ta cvmmecacing cor�struction. f understand 4hat a-separ�te permit rr►ay be tequired for eteatrical work,
plumbing, signs, wetls, paats; air condttioning, .gas, or:other Install�itians not spec�tcally included�in the application. A
permit Issued shall b� construed to be a license to p�aceed wlth the work and n�at as.authorlty to,violater�cancel, alter, ar
set aslde any provtslans of#he techn{cal codes; nor shaH issuan�e°of a,permit.pceven4 th��ulldlrig U#�lcial fr�m there�ftee
requiring a correction af enors ln plans, constFuctfon or vlolatlun� of any codes. Every permlk Issued shalF become invalid
' unless the work a�uthorized by such permit•!s-commenced�wlthln sGc month� of permft fss�a�nce, or iF work authorizecf by
the permit is suspended or abanda�ed for a period af six f�}moe�ths.after�he time tfi�e��vark�s commenced. An exfens6on
may be requested, in writing, from the Building.Officla) for � pe�iod not t� exc�ed nin�etyr(90) days and wlll demonstrate
justl�able cause for-the e�enslon: tf work cease�.for nlnety{90}consecutive dayst.the Job i�cansidered aba�done�.
WARld1N� TO OWNfR: YDUR FAIl�URE-TO,REC�E2� A N�TIGE �F�G�MMENGEMENT MAY R�SUl.1 tN YOUR
PAVINt�TWiCE��R iM�ROVEMEMTS Tfl YOL�i�<PRI�PER'i'1P.�IF°YO.U��INTEND�`TQ�OBTAIN•FII�I�NCMNG;�CONSULT
�IVOTH YAUR LENDER OR AM ATTORNEY��PQRE RECOR�f71NG YOUR'NOTICE`Q�CQNIME�ICENlENT
FlORlDA JUFt/tT{F.S. 117,0 � - -
-—n- ,�/ � _.=- - — -�__._ � ------ -
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� OWMEit OEt ACi�NT_1`-�_����!�' y .,,,,� COtdTRACTO
�m�b b d sxro M{ar a�trrnedj bafor e thl S s/�ed 's #a ar aftirmed)�b�fore me 1'
bY� f�z n�a�-,p �2L�i.',��'" _-- "___1�by L
o s/ar ersonally known to me or haslhav�produced Whg,.ls/are ersone y knqw�tttr!!me or ha ave-produced �
(..� 1,�2�� as Identlfic�Uon. �s �},��s"(�t cLL�—"' as IdenH�catlon.
�.�. ' ? Notary Public . ; j n'C'._ -f Motary Publlc
Go mfs ort o. Cam�tls�lo - o. �
Name of tVatary typed,pdnted or stamped Name of�iatary iyped,pdnfsd or stamped
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