HomeMy WebLinkAbout16-16959 ;- ' CITY OF ZEPHYRHILLS
+ 5335-8TH STREET
(si3)7so-oozo 169
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16959 Address: 36212 SHADY BLUFF LP LT1
Permit Type: IRRIGATION ZEPHYRHILLS, FL.
Class of Work: IRRIGATION Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: SILVERADO
Est. Value: Parcel Number: 04-26-21-0060-00300-0010
Improv. Cost: 900.00 OWNER INFORMATION
Date Issued: Name: HIGHLAND HOLDINGS INC 36212
Total Fees: 40.00 Address: 3020 S FLORIDA AVE STE 101
Amount Paid: LAKELAND FL 33803-4058
Date Paid: Phone:
Work Desc: IRRIGATION CONNECT ONLY**'"****'"'"*****
- CONTRACTOR S - APPLICATION FEES '
JEFF RILEY IRRIGATION IRRIGATION CONNECTION 40.00
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� Ins ections Re uired �
PLUMBING 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 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 Musf 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 T R SIGN URE PERMIT OFFI R
PERMIT EXPIRES IN fi MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
e+y,-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
.. � Building Departrnent
Date Recelved 13 J�� — ���
Phone Contact for Permitting
Owner's Name ��"1 �C ��-�-+ � '�"I"� Owner Phone Number
Owner's Address Owner Phone Number
Fee Slmple Titleholder Name Owner Rhone Number
Fee Simple Titleholder Address -
JOB ADDRESS �� �L � G��, l� � � LOT# �
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL e REPAIR
PROPOSED USE , Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION . Q e BLOCK � Q FRAME � STEEL Q
DESCRIPTION OF WORK ��r� �I O{� CU In����CSj� .
BUILDING SIZE SQ FOOTAGE� HEIGHT
QBUILDING $ •"'�":`".' -';��
, VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. -
�PLUMBING $ C�/�r� ��
��� �UlJ
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
ELECTRICIAN -� COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N "
Address License#
MECHANICAL COMPANY
SIGNATURE . REGIS7ERED Y/ N FEE CURRE� Y/N
Address License#
OTHER COMPANY J��� ��j C� ,!�Y /Q�
SIGNATURE REGISTERED Y/ N . FEE CUR EA Y/
Address �a da . o�� License# S � J��Ja .
RESIDENTIAL Attach(2)Plot Plans;(2)sets=of:Buililing'Plans;(1)set of Energyforms;R-O-W Pertnit for new conshuction,.
,Minimum,ten(10),working;days,after.submittal date. Required onsite,Constructlon Plans,Stortnwater'Plans w/Silt Fence installed,
$anitary Facilities&1 dumpster Site Work:Pertnit for subdivisionsAarge proJects
COMMERCIAL Attach(3)complete sets of Buildirig Plans plus a Life Safety Page;(1)set of Energy.FoRns.R-O-W Permit for new construction.
Minlmum ten(10)working days'after submitNal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facili8es 8�1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance
SIGN PERMIT Attach"(2)sets of Engineered Flans..� � �
"`••PROPERTY SURVEY required for all NEW construction.
Directions:
Ffll out applicaUon completely. ; :, � ` , �, , � , .
Owner&Contractor sign back of applicatlon,-notarized - ;' " _ �
If over 52500,a Notice of Commencement is required. (AIC upgrad`es over 57500) ,
" Agent(for the contractor)or Power of Attori�ey(fo�the'owner)would,;be someone with notarized letter from owner authorizing same
DVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Drivewrays-Not over Counter if on public roadways..needs ROW
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NClTICE QF QEED RIE�STRICTIONS. The underslgr�ed.under�tands:Eh�t,thls.p�rmity.may.be�subjectto,�tleed"res#ricttdns", �"
whlch may be�mor.e��r.est�icttve��the���County:�:regu{atlons. �The�undersigned assurties.respvnslbillty�fior�compitance`witli�-any `
applicable deed restrictlons. , . • _ =
UNk.lCENSED CONTRACTURS AND CONTRACTC�R RESPONSIBI�IT�ES: If the awner-has hired a contractar or
contractors to undertake work, they may be:required,,to be;Ilcensed In accordance.with state.and�local regulatlons. If the-
cartUactor 1s not ltcensed..as cequlred=by law� bath the awner and contractar�inay #e�altsd�for a��misdemeanor viola�ion
under state iaw. if the owner or intended�contractor; are,:wncertatn as ta what Ilceneing.requireGnents;may:,appiy'M°Far�the �
, .. _...
lntended work,they are advised to co�tactthe.Pasco C�unty Building"Inspectlon Divislorr-l:lcensl�g Sectton at 727-847-
8009. Furthermore, if the owner has filrecl'a contracto� oT contractors, he is advised fa have the canUactar(s), sign
portions af the "contr�ctor Block" af this application for whia�h they will be.responsible. If you, as.fhe owner'slgn"as the '
contrac#or, that�i�y be an Indica#ion that fie Is not property ilcensed and ts riot enti#leii to per�riitting privileges in Pasco
County. '
TRANSPORTATION-MMPAC7/UTIl:lTIE3�IMPAG't�-AND�RESOURCE R�COaERY��EE3: The underslgned understands
tha#Transpo�ta#ian Impact Fees and.Recourse Recove.ry.Fees may'-appty.to�the construa#ian of new bulldings,�change-of � ' �'
use in existing buildings, or:expanslon>of�:eziskiri,g'�buildings; as speclfled.in Pasco Caunty Ordinance number 89-07 and
90-07, as amended. The undetstgned also;urtderstands, fha�E-such fees.;as�may�be�d�e,,wilt:�be Identlfied at the=`time��of .
permittfng. It Is furtlier understood that Transpa�tatlon impact Fees and Resource Recovery�Fees mu�t be paid prior to
rece�ving a°certiticate-o#�occupan�y" ar ftttal power=release. :If the project doea not lnvoive:a certi�icate of ocaupancy ot-�
finat power release;,the-fees�.mu�t bs paid prior to permit lssuance. Ful�thermare;if Pasco County INater/Sewer lmpact
fees are due,they�must.be-paid prlor to permit-Issuance�in accordance with�applicable Pasco'County ordinances.
CONSTRUCTIt�N'LIEN t:AW�Chapter 713� Elorlda Statutes�as amended}: if valuation o#work is 52�500.00-or more, L - .
certify that I, lhe. applicant,. have•been provlded with- a copy of the "Florida Constructlon� Lien Law Homeowner's
Protectton Guide" prepared by tfie Fiortda Qepartmer�t of Agricu[ture and Gonsumer Affatrs. If th� applicant ts someone ,
other than the"awne�', I certlfy that I have_obta.i�ed a-copy,of the.above..�iescrlbed.document-and.promise in,good faith to ,
deliver It to.the"awner"�pdor:to>commencement: ' ' ' .
CONTRACTOR'SIOWt�ER'S AFFIDAYIT: 1 cei�fify fhat atl the informatton In�thi�applicatlon is accuratte and that ali work
will'be done in comptlance with all.applicable laws regulating constructlon, zoning and land development. Application is
hereby made to obtaln..a permit.to do wor'k:.,and installatlon as EndEcefed.� °t certify that no work .or Inst�tla#[on has
commenced prior to issuance of a permit and that.all work will be performed to meet standards of all laws regulating-
constructlon, Caunty and City codes, zaning regulations, and land development r.egulatlons-in the jarlsdictlon. ! aiso
certify that 1 undarsfand that the regutations of o#her government agencies may�apply�to the int�nded work, and that it is
my�e§ponsibility to identify�what.actions I must take to beJn:.compUar�ce. S.uch agencles include but�are.not limited to: �
- Dep�rtmeni of Er�v€ronmental RroEection-Cypre�s.'Bayheads; V1►etland Areas and Ec�vtronmentally Sensttive
Lands, WatedWastewater Treatment.
• Soutnwest Fiorida Water ItAanagement .C�isUict WellsF Cypres5. 8ay_heads; Wetiand Areas, Aitering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navlgable Waterways.
- Department of Health�& ReF�abiEtta#ive ServlceslEnv3ronmental Neatth Unit Wells, Wastewa#er�Trea#menf,
Septic Tanlis. .
- US Environmenta#Proteo�on Agency-Asbestos aba#ement�
- Federal Aviation.Authority-Rur�ways.
!understand that the following.�restrictlons apply to the use of flll:�
- Use affiH is not alloweci in Flciad Zpne"V"unless expressly permitted.
- If the flil material-Is to be used``in :Flood Zone. "A", (t. Is understood #hat-a dreinage plan addresstng a
°compensating votume"will be submltted �t tfine af perm[fting whlch is prepared by a prafesslonal engfneer
Iicensed by�he State af Florida.
- !f th� fiA materia).(s to be used in Fload Zone "A" in�connectfon�wi#h,a permitted building using stem wali
� construction, i certify that filt:wlil:b.e;used only.to fill the area withtn the�stem vva1L
- If fill material is to be used in any area, f certify that.use. of such fill will not adversely affect adjacenk
propertles. If use of fill is fot�nd to advetse�jr.�ffifect adja�er�#��propertfesr.the owner may be cited for violating
the condilions af the"buiiding:permit Issued under the.attached permit appl(catlon, far lots less than ane (1)
acre which ars elevated�by f!t!,aR engineer�ed drainage pfan is cequired. •
If I am the AGENT FOR THE OWNER, I;:promise in good faith to irrform the owner af-the permitting conditlons set farth in
this affidavlt�prior to cammencing canshuction. 1 understand thak a=separate permit may be requlred far electrical work,-
plumbing, s�gi�s, we#Is,.PvaSs;, alr canditionin9� ,9as;`ar other Ins#altations no��spec�tically incfuded-in.the application. .A
permit Issued shall be constcued ta be a Iicense to-praceed with tiie work and not as:authority ta.violate,cancel, alter, or ,
set aslde any provisions of the techn�cai codes; nor shaii issuancejof a.permft.pr.event fhe 8ultdtrig Q#�Iclal from fherea€ter
requi�ing a correction af errors 1n�pians; constructlon or vtolattons af any codes. Every permit lssued shalF became invaiid
unless the wo�k authorized.by such perm(t�ls.cotnmenced�w(thin sGc manths of permit lssuance, or if wark authorixed by
#he permt#is suspended ar.abandar�ed far a:perlad af�six{8)manths-a�er the time the�wark�s camrnenced. An e�ctension
may be requested, in writing, from the Bullding,Offlcial for a perlod not to exceed nlnety�(90)�days and will demonstrate. ,__ __
--�u�#N��b#e-c�u�s-f�r th��ht��ts3�t�:-li�r�c�ease�:�or ninety-�90}-conseciixtve�iays`r..the�a��s con`stde€ed abandoned.
WARNING TO QWNER; YOUt� FAILURE�TCI.,RECQltD.A..NQTlGE:OF COMMENGEME�tT il!lAY�RESUlT !N YC?UR
PAYING TWtCE.FOR,IMPRC3VEMENTS TO,YCIUR�.PROPERTY.�IF°YO.U�IN'€END`TQ'08TA1N��FtNA�CiNG;�CONSULT
WITH YOUR LEI�DER OR AN ATTORNEY�B,�OR��RECQR��ING�YOUR'NOTICE"CIF'COMMENCENlENT'
FLORtDA JUi2A�-{F.S.1.17:Q3)3 � —� ' 1���
OWNER OR'AOEN
+ CONTRAC70 � �
Sabscrfbed and (or a�lrmedj efore thts Subscrfbed and'swom�{or aflirmedpbe me�8it�
by •�y
Who Is/are personally known to.me or has/F�ave produced �Who is/are personally known to me•ar has/have•produced �
as tdenBQcaBgn. as Iden�tication.
�,w�a+rwosar�
"„ � _;�41�y.i�B:�,,, JOEL E.BACON '
,?oti�"Y�!�'•., JOEL E.BACON • `
:• R�= Camm�ssPoR#FF 13707 +; �P= COTittitisSiOii#FF 137073.
- - i�ote Pubtic . =�. _ S Notary Publla
: . , oe:
•,o���;°`'� 8pmled Thru Troy Insurenca 8WJ85d019 ''��i,�a�k dad Tluu roy Fein I�s ce 85- 19
Commts on Commtsslon. ""�'
tVame ot No ed,p ted or stamped Name of Notary!yp d, nted ar atatmped