HomeMy WebLinkAbout15-16695 CITY OF ZEPHYRHILLS
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� PLUMBING PERMIT
PERMIT INFORMATION � LOCATION INFORMATION � � -
Permit#:16695 Issued: 10/29/2015 Address: 38544 5TH AVE
Permit Type: PLUMBING � ZEPHYRHILLS, FL.
Class of Work: PLUMBING/NEW Township: Range:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 7,500.00 Total Fees: 40.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 40.00 Date Paid: 10/29/2015 Parcel Number: 11-26-21-0010-16900-0080
� CONTRACTOR INFORMATION- - - OWNER�INFORMATION
Name: DJ PLUMBING INC Name: JAPAGE PART C/O 7/11
Addr: 41414 MARQUETTE RD Address: P.O. BOX 711
UMATILLA FL 32784 DALLAS, TX 75221
Phone: (352 242-1224 Lic: Phone:
Work Desc: INSTALL GREASE TRAP @ 7/ELEVEN STORE
� ' � - � ,APPLICATION FE S - - "
PLUMBING FEE 40.00
Na �
' � INSPECTIONS REQUIRED
1ST ROUGH PLUMB n -•
2ND ROUGH PLUMB ROa°'��-Y '�rr°�'y� 1rA��`Y
SEWER ��E Olc cau i QI���
WATER � `2_ �—f� � [1:33 �`�
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 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."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
_
CONTRACTOR PER OFFI
PERMIT EXPIRES IN 6�MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER �
813-780-0020 City of Zephyrhills Permit Application Fax-a�a-�saoo2�
, Building Department
Date Received Phone Confact for Pertnitting
Ownefs Name l Owner Phone Number
Owners Address � �� Owner Phone Numher
Fee Simple Tiqeholder Name Owner Phone Number
Fee Simple TitleholderAddress
JOB ADDRESS iJ Q �� � r� l LOT# �
SUBDIVISION PARCEL ID# 'a 'VV�O� D �K/
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW coNSra e ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK � GLO� I C U 1
BUILDING SIZE SQ FOOTAGE� HEIGHT �
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�PLUMBING $�S�(,J
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY 0 OTHER
� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N F�curu�n Y/N
' Address License#
PLUMBER COMPANY � J U� �
SIGNATURE r�cis�aEO Y N �cuw�n Y N
Address ,w T License# l! ' !p
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N F�cuw�n Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N F�cuw�n Y/N
Address License#
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RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new consWc[ion,
Minimum ten(10)woricing days after submittal date. Required onsite,ConsVuction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilides 8 1 dumpster,Site Work Pertnit for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction.
� Minimum ten(10)working days after submittal date. Requi2d onsde,ConsWction Plans,Stormwater Plans w/Silt Fence installed, �
Sanitary Facilities 8 1 dumpster Site Work Pertnit for all new projects.All wmmercial requirements must meet compiiance �
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW construction.
Directions:•
Fill out application completely.
Owner&CoNractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over a7500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner aulhorizing same
OVER THE COUNTER PERMITTING (copy of conVact required)
Reroofs if shingles Sewers Senrice Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
� NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local reguiations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor vioiation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE 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 Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands,that such fees, as may be due,wiil 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 final power release. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be perFormed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentaliy Sensitive
Lands,WatedWastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- 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 fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fill material is to be used in Flood Zone "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
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill 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 of the building permit issued under the attached permit application, for lots less than one(1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, weils, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel,alter,or
set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
WARNING TO OWNER: YO R FAIL RE C
U U TO RE ORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LE DER OR AN ATT R Y BEF E RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F. . 17.03)
OWNER OR AGENT CONT CT R
Subs be and swo t�-(or affirtne f re me this S bsc ed nd s o_(aF rtne )be,��me this
by I/���� ��PU��c� .� / / by
Wh is/a e�����wn i e oY�ies/have produced Who is/a a y cno e r has/han produced
as identfication. as identification.
Notary Public `.e/ Notary Public
Commiss'on No. —� / Com ' ion No.
. �,��. �
Na �3p�p Name of otary typed,printed or stamped
' ,?��'"��"!��= DEBORAH ANN WARD •'"«�P'
° :='o�' "B<;'°� DEBORAH ANN WARD
' �" '' MY COMMISSION#fFF069375 '_ °=
`.�'... �a�= " '= MY COMMISSION#FF069375
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Permit No. PercPJ ID No �' �"'
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IdOTiCE OF COMMENCEMENT N�p
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THE UNDERSIGNED hereby g'rves notice Ihat trnprovementwl�be made to ceAein reel property,end in eccnrdance wllh Chaptrt713,Florida Stahries.
the fo�awing infartnetlon is provided in this Notice af Commencem�k���D �����0 ���n„� �1,�'�\ ���
1. Desaiption of Property: Parrel Identifiratian No. l "lU U�6 ) 3 " n
StreetAddres.: "US�� � Z l� h �l1 �35��— ; �"
2. General Deuription of Imorovement '�`� (.(.ill U ��ISIL/.l�(.C��SY 1 �O O m
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�. Owner IMOrtnaUo or LeSsee ircfortnetlon if Iha Lessee conVaded for the impmvement: Cf
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Addre s I�O 1/O Ciy Slate
Interest in Property:
Name df Fee Simple Titlehdder.
- (If ditferent from Owner fisled above)
Address � .,l O �1 urn�(`Q` � C-- C�O�11 lUll.l1 S�� �
� 4. ContreCor.
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Addrass� Ciry Stele
Contrectors TdephonG N�
5. Surety: N 1 • �ti
Name ' m�
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Address City State �N a
Amaunl of Bond: S Telephone No.. �\v'
6. Lender:
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Neme `�~m
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Address Cily State NN�
Lenders Telephane No.• ��o
• 7. Persans within the State of Flmida desiBnated by the owner upon wfiom notices w other doaments may ba served as provided by �µD
Section 713.13(7)(e)(1),Florida Statutes: 3 0
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Neme �� �r�
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Addres9 Cily State ,v��
Telephone Number of Designated Person: �..►
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8. In addillon to himself,tha ovmer designales � � �1 of_ W �
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W recelve a copy of the lienofs NoUce as provided in Section 713.13(1)(b),Florida Statutes. �
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Tdephone Number af Person or Entity Designated by Ovmer. �
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9. E�iration date of Noti�ol Commencemenl(lhe e�iration date may not be hetore the compledon aT construcUon and final paymeM to the �
cantrerlor,6ut will be ane year from Ihe dele of reeording urdess a drtferent date is spedfied):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AF1ER THE EXPIRA'f10N OF THE N0710E OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UN�ER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES. AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRS7INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LEN�ER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING VOUR NOTICE OF COMMENCEMENT.
Under penally of perjury,I dedare that I have read the foregoing notice of commencement Ihat the fads stated therein are We lo the besl '
oi my knovYledge end beGef.
STATE OF FLORIDA
COUNTY OF PASCO
Sig re aT or Lessee,or Ownels w Lessee's AuthwQed
Offi lDireUOr rtnedManaBer
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$�gflH�Ofy6�@/QIfICC
The foregoing instrumen[was acknowledged tore me lhis� of � 2o�ny D o� ���e v�e
� S (� ol,authnriry, . ,afficer,Wstee,attomey in f )tor '
m Ip behelf who m i e twa exeart� ).
II Personely Knovm Produced Identifiratian Q Notary Signawre
Type nf Identificaean ProdurPd Name(Print)_
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;,�- �;:DEBORAFF ANN WARD
'; MY COMMl.SSION#FF069�75':
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• '•,?oF,�d±;.� •EXPIRES January 5,2Uj� ,,
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STATC C3F �Lf��f��, G�?U�1TY 4�� P�SCO ���a��"���
THIS IS i�U CERTIFY THAT THE FOREGOING IS A �,`� ° � 0 ��°�
TRUE AND CORRECT COPY OF THE DOCUMENT �
ON FILE OR OF PUBLIC RtCORD IN THIS OFFICE � ' �
WITNESS MY HAND AND FFICIAL EAL THIS � ' . �, �
�AY OF n 'Z� � ]tt C�3�i�1YC'7Ytt5� o
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P ULA S�. O%�IEIL, CLERK&COMPTROLLER � � � ` O ,
BY� DEPUTY CLERK � ` x887 �
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Oct 271511:42a Rob's Septic Tanks, Inc 3523943124 p.3
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October 27, za15
I,Jerry Rogers, owner of D J Plumbing Inc authorize Charlie Sm th and/or Katie
Peterson to act as my agent and sign on my behalf in order to ull �ermits under
my license.
License#CFC0�7981
Signed: �p
C�~r d'
��'e�i�c eYl"�'
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�ynww4
?_�','•"Y�"°,t�`.a:DEBORAH ANN WARD ��
"� = MY COMPdISSIpN#FFa69375 !1 �.�
E�i'.• / 1 '�V/
�.;���;�� EXPIHES January 5.2018 C/� a � �" p�Q r
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