HomeMy WebLinkAbout15-16632 CITY OF ZEPHYRHILLS
_ ; 5335-8TH STREET
(sis)�so-oozo 16632
BUILDING PERMIT
I PERMIT INFORMATION � . - LOCATION INFORMATION -
� Permit Number: 16632 Address: 5024 19TH 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: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-21600-0115
Improv. Cost: 7,588.00 ° " OWNER�INFORMATION. - `
Date Issued: 9/29/2015 Name: EPPICH FRANCES
Total Fees: 75.00 Address: 5024 19TH ST
Amount Paid: 75.00 ZEPHYRHILLS, FL 33542
Date Paid: 9/29/2015 Phone: 813-782-0547
Work Desc: REROOF SHINGLE
CONTRACTOR S ° '- ` " APPLICATION FEES � � �
PAR ENT ROOFI C STRUCTIOI REROOF RE IDENTIAL 75.00
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' - � Ins ections Re uired �• � - � � �
DRY IN ROOF INSP
TAPE JOINTS R OF P
FINAL �
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the
local government shall 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 may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
I "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your properly. 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 BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRA R IGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
.- � � � ��i���iiii�i«Illllllllllllllllllllllillllllllliii�i�ii�i���
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. Rcpt:l?16529 Reo: 10.00
Permit Nurnber DS: 0.00 I T: 0.00
Parcel ID Number � � ]� � o�1��' 09/29/2015 J. R. , Dpty Clerk
NOTiCE OF CQNIMENCEMENT
5tate af Florida r�,�;��::�,�����ckUEL�r"CCCLEf;{:�FTNF.CEIJFlYCERi1FIG:,T�c�r�
Caunty of Pinellas � .
THE UNpERSIGNED hereby gives notice that improvements will be made to certain real property, and in accardance with Section 713.13 of the
Flarida Statutes,the foklow'sng information is provided in this NOTICE OF G4MMENCEMENTp.
1�Description of property(legal description);G� .� � j �j'S r GlJ � �1 .� .Uor�J�
a}Street(job)Address: 1., 2
2.General description af improvements:
3.Owner Informatian or Less�e,e informatlon if the tessee contracted forthe im rovement: � � �J� h
a�Narne and address: '� '�D�.. �',..e /
b}Name and address of fee s ple�tleholder(if different than Owner Gsted above}
c)lnterest in property; '�(,�,I�,Q„6�'
Contractor Information .
a)Name and address: �("�t/I�,¢���,�''d-- �+'+5b'k G�� /Z�0/ �l� �T l� 5"r'��'. 1'CL. ��1�
b)Teiephone No.: F�No.:(aptionai)
5.Surery(if appiicable,a copy of the payment bond is attached) �
a)Name and address:
b)Telephone No.:
c)Amount of Bond: $ ' ,
6.Lender
a}Name and address: '
b)Telephone No.:
7.Persons wltfiln ttte State of Fforida designatetf by 4wner ttpon wttom notices or other d�cuments may.be served as pravided by Section
713.13(1}(a)7.,Flarida Statutes:
a}Name and address:
b}Telephone No.: Fax No.:(optional)
8.a,ln addition to hlmself or herself,Owner designates af
to receive a copy of the lieno�'s tVo6ee as prc�vided in Section 713.13(t)(b),Florida Statutes.
b)Phone Number of Person ar entity designated by Owner:
9.�piraiian da#e of notice af commencement(the expiratian daEe may nat be before f�e completion of construction artd fina! payment to the
contractor,but will be 1 ear from the date of recordin unless a different date is s ecified: ,20
VYAR(�ING TO OWNER: ANY PAYMEN7S MADE BY THE OWNER AFTER THE EXPIRATIdN OF THE NQ710E OF COMMENCEMENT,ARE
CQNSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,.SEC7IQN 713,13,FLORIDA STATUTES,AND CAN RESULT IN YOUR •-
PAYlNG TWtCE FQR lMPRQVEMENTS TO YOltR PROPERTY.A NQTIGE OF GOMMENCEMENT Mt�ST 8E RECQRDED AND PQSTED ON
THf JOB SiTE BEFORE THE FlRST INSPECTtdN. tF YOU iRiTEND TO OSTAIN FiNANCENG, CONSULT WiTH YOUR•LENDER OR AN
ATTORNEY BEFORE COMMENCING WQRK OR RECORDING YOUR NOTICE OF GOMMENCEMENT.
Under penalfy af perjury,l decEare that I have read the foregoing notice of commencemen#and that fhe facts stated thereEn are�ue to tt�e best of my
knowledge�a belief. � I �
,f m � ��f�t;nr �t,�, � Gc..c..�1G�o N .
(Signature of Owner or Lessee,or ers or Lossee's(Authorized(5(ficerlDirectoriPartrieNManager) � (Print Name and Provide Signatary's TitlelOffice) `
The f regoing instrume}n1t�w�s acknowledged before me#his 2�'� day of .5��"„�+�?.r9�z, ,20 �/�
by ri ��d�C�[Li'� 8S E'j�f F,�'� {type of authorit}r,e.g.of6cer,firstee,attamey in fiad}"
for = tc.�—�- ct ;as t�W+'�
(Name of Person} {type af authorify,...e.g.afficer,Vustee,attamey in fad}
for (name of party an behalf of whom insVument was executed).
PersQnaNy Knawn Praduced!D ' ' . '
Type of ID ''�� �'�� �'J°, ��/��� Notary Signature � .-- �
�] 'z�'O YS63� 6p - Z./r.�/_� Print name oW
. +Ytu.6BC.,Statt.etFieiii},e :,,LL..,
PRULA S 0'NEIL,Ph.D PHSCO CLERK & COMPTROLLEi �.�m'�fo�y� � •-
09/29/201 12:S1 m 1 F 1 N°����
�R �� �2�� P� �612 e=�. �a9�b . . ,,
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STATE OF FLORlDA,�OUN�'Y 0� ���C�
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THIS IS T0 CER7IFY THAT THE FOR�GOING ISA ��. ��
TRUE AND CORRECT COPY OF THE QOCUMENT
ON FILE OR OF PUBLIC RECORQ IN THIS OFFICE � • �G��er�r ; �
WITNE S MY HAND AND OFFICIAL SEAL THIS � ' , I _�e',•, '
2 � 5 O.
DAY OF �— � , �
PAULA S O'NEIL,CLE K&COMPTROLLER � a38' r�
B�, � DEPUTY CLERK ' ��Q'� ° e ���
�F�LO�
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813-�ao-oo2a City af Zephyrhills Permit Application Fax 813-780-0021
�U��t�ItSt,��8�1t'�i't18lit
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Qate Rece[ved Phane�Contact for Permittin � 7�-7 f — ��
I_ r r,� c►�
Owner's Name /'" ' � �� QIV�'� Ow»er Phone Number � �tr?�/ ��
Owner's Address �.�—y � �� ���I .Z Owner Phone Number �� 7� �..Z���
Fee 3lmple Titleholder.Name � � Owner Phone Number � �
Fee Simple Titleholder Address
JOB ADDRESS � Z.(' ►��t �,,,� �7 Z LOT# I� �'I�-
SUBDiViS10N � . � PARCEL ID# � �-- 2.
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � e NEW CoN5TR 8 ADQ/AlT � SIGN Q Q DEMO�tSH
INSTALI. REPAIR
PROP05ED USE � SFR Q GOMM � OTHEi2
TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME �� STEEI. Q
DESCRIPTION OF WORK � j � (,� �� '� �►
BUILDING St2E �- � SQ FOOTAGE �� HEIGHT �_�
�����j��' � ,� �� VALUATION OF TOTAL CONSTRUCTION
QE�ECTRiCAt � � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBiNG (�y� � j �,v�
L �� Q
�]MECHANlCA! $ VAf.UAT10N OF MECHANICAt IF�STA�CATION
QGAS Q F20QFIiVG � SPECIAI.'fY C� QTHER � ����
FINISHED FLOOR ELEVATIQNS ��� FLOOD ZONE AREA [�YES NO
BUILpER COMPANY (/' ld �"(9� � „/�
SIGNATURE REGISTERED / N FEE CURRE� Y/N
Address -f �- -'"� License# � 1�j„�.9 7„���
33 7�
EIEGTRICIAN COMPANY
SIGNATURE � REGIS7ERED Y/ N FEE CURRE� Y/N
Address Llcense# �� ��
PLUMBER COMPANY
SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �� �
MECMANICAt. GOMPANY
SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N
Address License# �� �
UTNER COMPANY
StGNATURE REGIS'TERED Y/ N FEE CURRE� Y/N
Addres� License# �� —�
EtES1DENTiAL. �Attach{2}Pict P,lans;(2}sets af Builtlirtg'Pians;(1}set of Energy�Forms;R-O-V1t Pennit for new construct�an,
Minimum ken(10)worki�g days aftec.submittal date. Requlred onsite,Constructian Plans;Stormwater Plans wl Sflt Fence installed,
SaNtary Facilides&7 dumpster,Site Work Permit for subdivislonsAarge projects
- COA+ItYlERCIAi. Atfach{3}camplete sets af Saildiri,g Plans plus a Ufe Safety Page;{1}set af Energy Fflrms.R U-W Permit for new cons�vc�an.
Minimum ten(10)working days'afke�subml�Pdake. Required onsite,ConstrucUan Plans,Stortnwater Plans w/Spt Fence installed,
Sanitary FaoiliUes&1 dumpster:$ite VVork Pemiit for all new proJects.All commercial rec}uirements must meet corripliance
StGN PERMIT Attacti{2)sets af Englnee`r,ed Plans. i, '
•••`PROPERTY SURVEY required�,for aII;NEW�construcUon.
Dlrectlons:
� Ftll out applicatlon completely.
Owner 8�Contractor sign back of applicadan,nota�ized
'� tf over S25d0,a Nottce of Commancement is.required..-,jAtC ypgr8des over 57500)
' '" Agent(for the contractor)or Power of Attomey(for the awnerj would be someone with natarized letter from owner authorizing same
OVER THE CQUN'fER PERMITFiNG ';(Front af A�spllc�tipn On{y}; :. , �
Reroofs if shingles Sewers Service Upgrades A/C, Fences(Piot/Survey/Footage)
Drtveways-Not over Counter tf on public roadways..naeds ROW
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NOTICE OF DEED RESTRICTiONS: �he understgned.undergtands�th�t-this.p�rmit.may.be.,subJect to"d,e.ed" restrictions"
which may be�more=rest�ictive-thart County��egulatlons. �The undersigned assumes•resp�nsitiilitji-for�compliance'with any -
applicable deed reshicttons: . • ".' ' . • '. . . ` � - , -
UNLICENSED CONTRACTORS�AND �CONTRACTOR RESPONSIBILITI�S: if the owner has hired a contractar or
contractors to unde�take wor�C,�they,tnay be tequi�ed�,to�be;Ilcensed.ln:ac.cordance�witfi�state�.and•.local regulations. If the
contractor ts not'Itcensed as requlred'`by law, both the owner and=conUaator may be clted�for a-misdemeanor violation
under state law. If the owner or intended_contractor-�are_unce�tain as to what Iicensing.requirements;may apply�or�the
intended work, they are advised to contact the Pasco County Bullding inspection Dlvision-Licensing Sectlon at 727-847-
8009. Furthermore, tf the owner has hired a contractor o� contractors, he is advised to have the contractor(s) sign
portions of the "contrector Block° of this applicatlon for whtch they will be respo�sible.-.If you,_as..fhe owner slgn as the
contractor, that rnay be an indication that he;is not.properl.y licensed.and is not entitled to:permittfng;privil�ges in Pasco
County. . � ' , • .' � � � . .. . ?`, - • . . . . . . . .
TRANSPORTATION.:IMPACTIUTILITIES�rMPAC7 AND-RESOURCE RECOVERY�FEE3:-The underslgned understands �
that Transportatfon;Impact'Fees and:Recour,�e.Recove.ry.Fees may��apply to the construction of new buildings, change of
use in existing buildings, o� expansion•of�-existiri�,`�buildings, as speclfied-in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that:such fees�-:.as;may�be�dne;:wlll..be identified at the time of
permitting. It is further understood that Tra�sportation Impact Fees artd Resource Recovery�'Fees must be pafd prior to
receiving a °certificate-of occupancy"or final:power. release. .If•the project.does not involve:a certfficate of occupancy o�
final power release;the fees mu�t be paid prior to permft issuance. Farthermore;�if Pasco County Water/Sewer-Impact
fees are due, they.must.be�pald prior to permit�=lssuance�ln accordance witFi applicable,Pasco�County ordinances.
CONSTRUCTION LIEN LAW(Chapter T13�aFlorlda Statu�effi�as amended); If valuation of.work'is,$2,500.00 or more, i
certify that I, the applicant, fiave.been' provided wlth"� co�y of the °Florida� Construction.Lien Lav�—Homeowne�'s
Protection Guide" prepared by the Florida Department of Agric.ulture and ConsumerAffairs. If the appllcant is someone
other than the°owner", I certify.that I have.obtalned�a copy.of the abov�.des�cribeddocurr�ent�and.pJOmise ln,good faith to
deliver It to the°ownec"prio�to•commencement: ;
CONTRACTOR'S/OWNER'3 AFFIDAVIT: I certify that ail_th�Information In this appl(cataon (s-accurate and that all work
will�be done in compiiance with all.appl(cable laws regulating construction, zoning and larid developrrient. Appitcation (s
hereby made to obtatn .a permit to do, work and installation as indioated.. :I�certify that no work or Installat{on has
commenced prior to Issuance of a permtt and that.all work will be pertormed to meet standards of all laws regulating-
construction, County and City codes, zvning regulatio.ns, and land development tegulatlons�in the jurisd(ctton. I aiso
certify that I understand�that the regulations of other government agencies may apply�to the intended work, and that it is
my responsibilily to identlfy�what.act(ons I must take.to be�in:.cottlpllance. Such agencies.include but�are.not Ilmlted to:
- Department of Er�vironmental�'Protection-Cypress.�Baylieads, Wetland Areas and Envtronmentaliy Sensittve
Lands,WaterlWastewater Treatment. ,
- Southwest 'Florida' Water Management .District Wells, Cypress. Bayheads�, Wetland Areas, Altering
Watercourses. •
- Army Corps of Engineers-Seawalls, Docks, Navigatile Waterways.
- Department of Health�8 Rehabllitativ.e Services/Environmental Health Unit WeIIs,:,Wastewater�Treatment, �
S'eptic Tanks. � ,
- � .US Environrree�tal Prote�tion Agency-Asbestos abatement. .
- �� -'Federal�Avlatlon.Autho�ity-Runways. � � - - - •. � �
I understand that the following restrictions apply to the use of flll:• . ,
- Use of.fill Is�ot allowed,in Flood�Zone"V"unless expressly permitted•°.°-. -�� . = • -� , � - .
- If the'f�ill rriaterfai is to be used_in �Flood Zone. �A°;,�if i5�':understood that a drainage plan addressing a
"compensating volume" will be submitted at#ime of permitting which (s prepared by a professional engineer
Iicensed by the State-of Flor(da:
- If th� fill material.is to be used in Flood Zone "A° in�connection�wlth.a��permitted building using stem wall
construction., I certify that fill�:will-be�used oniy.to.flll the area wtthln�the stem wall.
- If flll material is to be used in any area, I certify that use. of such flll�will not adversely affect adjacent
p�operties. If use of flll Is found to adversely:�_ffect adJaEent�properties,.the owner may be cited for violating•
the condifions of the buiiding;permit issued�under the attached permit application, for�lots less ihan.one (1)
acre which are elevated by flll, an englneered drainage plan is required. .
If I am the AGENT FOR THE OWNER, I;:promise in good faith to inform the owner of-the permitttng conditlons set forth In
this affidavit prior to commer�cing construction. 1�undersfand thafi a=separate permtt may be requtred for elecMcal work,
plumbing, signs, wells,.pools; afr conditioning, .gas, or other install�tions not.spec,�cally included�in.the application. .A '
permit issued shall be conshued to be a Iicense to;;p�oceed wfth the'work�nd not as.authorily to.violate,�cancel; alter, or '
set aside any provis(ons of the technical.cod�s;�nor shall issuance�of a.permlt.prevent the Bulidirig Oi�icial f�om thereafter
requlring a correction nf errors In�plans, constniction or violatlons of any codes. Every permit Issued shall become invalid
unless the work authorized.by such permik�ls.commenced•withfn six months of permlt issuance, or tf work authorized by �
the permit is suspended or.abandoned for a.period of six�f 8)montf�s.-after the time_the�work Is commenced.. An extension
may be requested, in writing, from the Buildtng,Officfal for a perlod not to exceed ninety(90) days and will demonstrate
�ustifiable cause for:the extension. If work ceases for ninety(90)cons.ecutive day.s...th�Job is.considered abandoned.�
WARNING TO OWNER: YOUR.FAILURE�TO.,REC.ORD.A NOTIGE OF-COMMENCEMEMT MAY RESULT IN YOUR
PAYING TINICE.FOR iMPROVEMEN.T3-TO YOUR�.PROPERTY. IF�YO.0�INTEMD:'TD�OBTAIN��FIPtANCING;'CONSULT
WI7H Y UR��NDE .O -AN ATf RN�YP B FORE� ECOR�QS G�YOU � � �CE'01�= °' E�7�� �E 4=- --- -- - -
FLORIDA JURA�(F.S.1.1T.03) � -
DWNER OR AGENT � CONTRACTO �
5ubscrtbed and swom to(or afflrtne before me this Su6scribed and'sw�e to ot fflrtne b" �me i�
by 9�.�s .by. � q
JVho Is/are pe►sonally known to.me or haslhave produced Who.ls/are .erson ly own to me or has/heve produced
as Identlflcatlon. � as IdenBflcaOon.
Notery Publlc ' Notary Public
3ommisslon No. Commis lo �=R �f �= Commission#FF 422
-,,:. ;; . � .
���t�A,,,,yQ�� BondadThruTroyFetn�ineivancaB00•3B5d019
Vame of Notary lyped,printed ar stamped Neme of No ary pe ,printed or stamped
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