HomeMy WebLinkAbout15-16657 CITY OF ZEPHYRHILLS
;�, 5335-8TH STREEf
�� .__ • (813)780-0020 16657
� BUILDING PERMIT
PERMIT INFORMATION � LOCATION INFORMATION
Permit Number: 16657 Address: 5632 5TH 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: 11-26-21-0010-03100-0210
Improv. Cost: 1,200.00 OWNER INFORMATION �
Date Issued: 10/09/2015 Name: ETHERIDGE IRA R JR& MARY B
Total Fees: 67.50 Address: 12230 JOAVAJIN RD
Amount Paid: 67.50 DADE CITY FL 33525-5620
Date Paid: 10/09/2015 Phone: 352-467-0097
Work Desc: REROOF METAL '
CONTRACTOR S APPLICATION FEES �
HOMEOWNER REROO RES DENT AL 67.50
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' Ins ections Re uired
DRY IN ROOF INSP
TAPE JOINTS OOF fNSP
FINAL �L r " 1 �
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 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.
"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 BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CO TRACTOR SIGNA E PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Florida Building Code Online Page 1 of 1
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FL# Tvoe Manufacturer Validated Bv Sta us
FL6508-R2 Revision Metal Systems,Inc. Andrew Lovenstein,P.E. Approved
Historv Category:Roofing (813)251-3301
Subcatepory:Metal Roofing
•Approved by DBPR.Approvals by DBPR shall be revlewed and ratifled by the POC and/or the Commission If necessary.
Con[act Us 1940 North Monroe Street.Tallahassee FL 32399 Phone:B50-487-1824
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http://www.floridabuilding.org/pr/pr_app_lst.aspx 10/9/2015
813-780-0020 City of Zephyrhills Permit Appiication FaX s7saeo-oo2�
Building Department . � -°
Date Received � - -
Phone�.Contactfor Perinittin -
Owner's Name � Owner Phone Number 3 S2 � - c�fl
. ,
Owner's Address ' 122 3 l7 Jo.� 1`d� C, Owner Phone Number ••
Fee Simple Titleholder Name � Owner Phone Number
Fee S(mple Titleholder Address
JOB ADDRESS S 3 2 �j'�� S7: LOT# �
SUBDIVISION PARCEL ID# �1-��'�� -�0/ O ^- U 3/D�D �- a�) -D
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ' ADD/ALT � SIGN ` Q Q DEMOLISH
INSTALL. '�. REPAIR
PROPOSED:USE Q SFR �]� `CONIM � Q OTHER �
TYPE OF CONSTRUCTION [�' BLOCK '` � FRAME � STEEL Q
DESCRIPTION OF WORK �e v O� w,-�-j--��o`�( ��it�c�n�-j� ,���+o.,a 1 (p�� ,a-Ra'
- \ .
BUILDIWG SIZE 3 fl� X o`l9� ' SQ FOOTAGE O� HEIGHT-" S�n .Q ��
QBUILDING $ -�-- ---- VALUATION OF TOTAL CONSTRUCTION
� 2D0 .
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $ � � `�Fp�� ,
1�
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS � ROOFING ..Q SPECIALTY Q OTHER �
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES NO
BUILDER +�
�� l�9✓�,
SIGNATURE REGISTERED Y/ N FEE CURREP Y/N _
Addreaa "' �Lfaense# �
ELECTRICIAPI COMPANY
SIGNATURE �' REGISTERED Y/ N FEE CURREA Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRED Y/N
Address License#
MECHANICAL - COMIPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address � " ' License#
OTHER COMPANY
SIGNATURE ` REGISTERED Y/N . FEE CURRE(� Y/N.
Addre�s � ' License#
RESIDENTIAL•:. Attach(2):PIot.Plaris;,(2)sets.of:Buflding°Rlans;�(1)set of Energy�Form§;'R=0-W Perrnit for new construcUon,
Minimum:.ten(A,0)_working days after,sutimittal date::;Requlred.onsite,�Conshucdon Plans;Stormwater'Plans w/Silt Fence installed,
Sanitery Facilitles,&:7�dumpster_Site>Work�,Perrnit.for.subdfvisi.ons/large•priojects�- ., '
COMMERCIAL Attach(3)oompl'ete sefs of Building'Plans plus a Life Safety Page;�(1)set of Energy Fortns.R-O-1N Permit for new constnicUon.
Minimum ten(10)wo�lcing days after submittal date. Requfred onsite,ConstrucUon Plans,Stormwater Plans wl Silt Fence installed,
SaNtary Facilitles 8 1 dumpster.Site Work Permit for all new proJects:°All commercial requlrements must meet compllance
SIGN PERMIT Attacti(2)sets of Engineered�P.lans:.; � . � �. ' •
""PROPERTY SUR1/EY requfred for_all NEW constructlon.
Directlons: _ _._
Fill out applica8on completely. � I � ', ,
Ouvner 8 Contractor sign back of appl(catlon,notarized � .
If over 52500.a Notice-of�ommencement i�requirad. (AIC upgrades over 57500) �j � -`• �o `� ' ���o`; --
" Agent(for the contractor)or PoVirer of Attomey(fo�the�owner)would be someone with notarized letter from ovmer authorizing same � � ' ~ 1 i,,
DVER THE COUNTER PERMITTING (Front of Application Only) ' �, �� „ .,-. v.��9�.'�°: ,`" • "._7 , �
Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) ;f" `''��,t.'' , '=':,` ;,e �
_ � -�,ti�; � ,;,�., ,. „ , ;{c; � '-1
Driveways-Not over Counter if on public roadways..needs ROW � �i�:= -••• ° � - �
�..�z�.,.r_n A..�,•o..,.-.,,�..��,-,�..._.�_ . ��,�.,�. ...
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NOT1C@ OF DEED RESTRICTIONS: The underslgned.undergtands�;th�#=this.�pprmif.mayrbe.sub ect to_".deed"restrictlons" �� � ;
which may be�more'�rest�ictive�th�n,C.ounty��+ag�lations:�THe�tindei�signed��assumes�responsfbllttyfor�compiiance"'witFi�any "
appNcable deed restrictions. :, ., � .�,,,,.,,,:;. -::;,, • . _ - ' �
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: --�f the owner�has���hired� a �contractor or
cont�actors to undertake work,.they may.bie,requlred..�totie;licensed In.accordance.with_state.�nd:local regulattons:��Ifthe
contractor is not itcensed as re�qulred';by law; botlr the.owner and'contractor-may beycited�for-�°misiiemeanor violation
under state law. If the owner or Intended;;contractv�,are:,uncertaln as to what Iicensing.requlreRnents.�'may�apply��for',the �- �
>...., ,.,.,�, .,
intended work,.they are advised b coritact tfie_Pasco County,.Building;lnsPection fl�hilsion_--l:icensing�Section at 727-847-
8009. Fu�thermore, tf the owner has Fil�ed a contractor or contractors, he�is advised to have'the contractor(s)._sign
portfons of the "contractor Block".of tlils application.for.which.they..will..be,.responsible.._.If.you�-as-.the owner"stgn'as`tfie
contractor, that�may be an indication�that�he ts not.properiy flcensed and'is not �n8tled�to permitting p�ivlleges in Pasco
County. ' ` '
TRANSPORTATION:IMPACTIUTILITIES IMPAC7�ANb RESOUItCE RECOVERY FEES:�The undersigned understands
that Trensportation Impact Fees�and.Reco.urse Recove.ry.Fees may.�appiy.to the�.constructlon of new bulldings,,�changexof�- '
use in existing buildings, or:.expansi�i��.of<<ezistin�`�buildings, as spectfied in Pasco County Ordinance number 89-07 and
90-07, as amended. .,The undersigned alsa�understands� thait`�such fees,:;as�rnayr:�e:��due„�will:�be identified at the'time°'of�' -
permitt(ng. It Is fuither understood that Tra�sportation Impact Fees and�Resource_:Recovery"Fees:.must be pald prior to
recelving�a 'certi�cate�of-occupancy" or flnal.powec,:release. :I���the proj9ct:.does not involve�;a,certificate of occupancy�or'�
flnai power release; the.fees must be paid prior to permit Issuance. Ft��thermore;�if Pasco:CounljrVllatedSewer. Impact
fees are due, they�must be-paid prior to,permit-Issuance�in accordance with applic�ble Pasco�County��or`ilinances.
CONSTRUCTION'LIEN'-LAW(Chapter 713� Florlda Statutes,as armended): If valuatlon of work is$2,500.00.�or more, I
certify that I, the appltbant, have�been�provi.ded `with a copy of the•.°Fiorida• Constructlon� Llen:Law—Homeowner's
Protection Guide" prepared by the Florida Departmenf of Agric.ulture and Consumer.Rffairs. If the applicant Is someone
other than the°owner", I certif�r that.,l have,obtained�a�copy.of.the above..rlescribed tlocti�ent�and.promise:in,good=iaith�to
deliver it to the-`owner":p�ior�to�commencement:'" � � ' ` '
CONTRACTOR'S/OW�IER'S AFFIDAVIT: I certity:that�ail the.information-in thi� application is accurate and that all work
will'be done in compliance wlth all.appiicable laws regulating construction� zoning and:land�development. Appltcation is
hereby made to obtain .a.permit.to:do,,,work,,,and�insCallatlon as Indtcafed:.� `I �:eNify that no work�or Installatton ha5
commenced p�tor to Issuance of a permit"and thaY.all woric wlll be perFormed to meet.standards of all laws regula�ing-
construction, County and City codes, zoning regulatrans, and land development cegulaUons�in the Jurisdlctton:. •l �al'so
certify that I understand that the regulations of other government agencies may apply to the lntended work, and that it is
my responsibilily to identify�what,actions I must take:to be�ln:.corrtpliance..,Such agencles Include but are.not Ilmlted to:
- Department of Et�vironmentai�Protection=Cypress°`Bayhead�, Wetland Areas and Environmentally Sensitive
Lands,WatedWastewater Treatment.
- Southwest Florida Water Management-.District Welis, Cypress.F�Bay.heads; Wetland Areas, Altering
Watercourses. �
- Army Corps of Engineers�eawalls,=Docks, Navig�ble Waterways.
- Department of Health�'8 ReMabllitative,Servlces/Environmental Health Unit.Wells� Wastewater�-Treatment,
Septic Tanks. � �- ' , _
;
- US Environmental ProtecBon Agency-Asbestos abatement. �� �',..�
- Federal Avlattvn-Authorlty--Runweys. � , ,
I understand that the fvllowing.restrictions apply to the use of flil:�
- Use of flll is not ailowed in'Fiood_Zone"V"unless�expressly permltted.
- If the flll material is to �be used::In.:Flood:Zone °A", it. is underefood that a drainage plan addressing a
°compensating volume"wil) be submitted at time of permifting which (s prepared by a professfonal engineer
Iicensed by the.�tate of Flowida.
- If th� fill material is to be used in Flood Zone 'A" irr connectlon�with'a �pecmitted building using stem waii
� conatruction, I certify that flll:wall=be-used only.to#111 the area within 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
' properties. If use of flll Is found to adversely:�ffect adJ�eent�propertles;.the owner may be'cited for viofating
the conditlons of.fhe building•:permit Issued�-.under tha"attacNed permit application, for lots less than one (1)
acre whtcfi-are elevated�by flll�aR engineered drainage plan fs requlred. . .
If I am the AGENT FOR THE OVYNER, It.promise In good faith to tnform the�owner�of the permitttng conditlons set forth in
this affidavlt�prior to commenoing construction. 1 understand thata:separate permit may be requlred for electrical work,
plumbing, signs, wells,.pools; alr,conditioning,.gas,:or otMer install�tlons not�spec�fically Inclu�led�in.the application. .A
permit issued shall be canstrued to be a°license to�proceed with tNe wo�k and•not as.authority to.violate,�cancel, aiter, or
set aside any provisions of the technical.codes; nor shall issuance�of a.permit.prevent the Buildirig O�icfal from thereafter
requiring a conection nf errors in.plans, corisfruction or vlolat(ons of any codes. .Errery permit issued shall-become invalid
unless the_work authorized:by such permlt:is.commenced�within six.months of�p�rmlt Issuance, or If work authorized by
, the permit is suspended or.abandoned for a:period,of�six(6)monti�s:aRer the tirne the�work�is commenced. An extenslon
____may_be_requested� In writing,_from_the_Building.Official for a perlod:not-to_excee�_.ninety_(90)_days.and_wiU-demonstrate___ ____
justifiable cause for.the extenslor�. If work ceas�es:for ninety(90)consecutive:day.s...ih�)ob�is�cansidered abandoned.
WARNING TO OWNER: YOUR;FAILURE�TO.,:REC.ORD.A.NOTIGE OF�COMMENCEMENT��MAY�RESUlT IN YOUR
PAYING TWICE.FOR IMPROVEMEN�S-TO.YOUR:=.PROPERTY. -IF�YO.U�IN�E�ID:TOzDBTA1N��FIPFAMEING;'CONSULT
W17H YOUR LEND�R OR AM ATTORNEX�EFORE��R-ECORDIN��YOUft'NO'FI�F'OF�C�MII11lENCE�IENT'
FLORIDA JURA�•(F.S.117.03} ' � � �'"
OWNER OR A(iENT CONTRACTOR ' '
Subscrfbed and swom to(or afli ed)betore me this Subscribed and'suuom�to(ot aflirtned)�b�fore me thl9
by •by•�
Who Is/are personaliy k�ovm to.me ar has/haye produced Who Is/are personallyknown•to-me or has/have-produced •
ae IdentlBcetlqn. as idendRcaUon.
Notery Publlc Notary Publlc
Com s n Commisalon�No.
, ;�ti�"�'Y,�c: JOELE.BACON
Na e o(Nota : � 73 Name of Notary typed,printed or atamped
;, o: pires un 9 2018
"s� � oac �
P,�„Z.` Bonded Thru Troy Frn Insureon BOp.385•7019 � '
'� DISCLOSUR$ STATEMENT FOR OWNER
�: � CITY OF ZEPHYRHILLS BUILDING D}3PARTMENT
I, �a �-�1-���� have read aad fully understand and
agree to he provisioas of this instrument.
The undersigned states aad affirms that he or she is desirous of constructing,
reaovatiag, adding to or reroofiag his or her own domicile, that he or she
actually occupies, or will occupy by / said domicile, and same is not for
rent, lease or sale. That he or she sh 11 comply with the followiag coaditions:
1. That the owner and he or she aloae shall act as the builder for all phases of
constructioa. •
2. That the owaer will comply with all provisioas of the City of Zephyrhills
ordiaances and codes pertinent to the building. �
3. That in the event various phases of coastructioa are subcoatracted, he will
eagage only properly liceased' subcoatractors and will persoaally supervise
such work.
4. That in the eveat the Building Iaspector shall require corrections to be made,
the owner will assume full responsibility to iasure they are made, aad upon
completion will call for a reinspection before proceediag with the building.
5. That the owaer shall assume full respoasibility for the coastruction and will
not expect supervisioa of his work from the City of Zephyrhills Building
Department.
6. That prior to fiaal iaspectioa any additioaal fees, iacluding reinspectioa
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owaer shall comply with all City, State aad Federal laws in regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires constructioa to be doae by liceased coatractors. You have
applied for a permit under an exemptioa to that law. The exemptioa allows
you, as the owner of your property, to act as your own coatractor with certaia
restrictioas evea though you do aot have a license. You must provide direct
onsite supervisioa of the construction yourself. You may build or improve a
one-family or two-family resideace or a farm outbuildiag. You may also build
or improve a commercial building, provided your costs do not exceed $75,000.
The buildiag or residence must be for your own use or occupancy. It may aot
be built or substaatially improved for sale or lease. If you sell or lease a
buildiag you have built or substaatially improved yourself withia 1 year after
the constructioa is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violatioa of this
exemption. You may aot hire an unlicensed person to act as your contractor or
to supervise people workiag on your building. It is your respoasibility to
make sure that people employed by you have licenses required by state law and
by couaty or muaicipal licensing ordinances. You may aot delegate the
responsibility for supervising work to a licensed contractor who is aot
licensed to perform the work being doae. Any person working on your building
who is aot liceased must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholdiag tax
and provide workers' compensation for that employee, all as prescribed by law.
Your constructioa must comply with all applicable laws, ordinances, building
codes, and zoniug regulatioas.
OWNER'S SIGNATURE DATE 9 - 3 t7- /��
ADDRESS 6 i� +� S' �.EE
PHONE �SZ - ''�6�� - �OQ7
WITNESS � PERMIT # 1 10�S�
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: �TH�R� ��� ��.a R + �l A�Y �
Date Received: � " 3 O ^ �5
site: 5 6 3 � �S'+'L cS TRi.F T
Pernut Type: REROOr M E 7'A �
,
Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
; � t���/C� , �'a� � -� _
: �� � �ti� � 6� �
This comment she t , all be kept wi e 't and/or plans.
������
Kalvin Swit —P1ans Ex Date Contracto d/or o eowner
` (Req ' when comments aze present) �