HomeMy WebLinkAbout16-17070 CITY OF ZEPHYRHILLS �
5335-8TH STREET
,, _ c8�3��$o-oozo 17070�•�
PLUMBING PERMIT
PERMIT INFORMATION � - LOCATION INFORMATION
Permit#:17070 Issued: 2/19/2016 Address: 5231 1 ST ST .
Permit Type: SEWERLINE REPLACEMENT ZEPHYRHILLS, FL.
Class of Work: SEWERLINE REPLACEMENT Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 100.00 Total Fees: 46.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 46.00 Date Paid: 2/19/2016 Parcel Number: 10-26-21-0010-09600-0012
CONTRACTOR INFORMATION OWNER INFORMATION
Name: HOMEOWNER Name: JEWELL JOSEPH
Addr: Address: 5231 1 ST ST
ZEPHYRHILLS FL 33542-5404
Phone: Lic: Phone: 813-395-6731
Work Desc: SEWERLINE REPLACE AT TIE IN
APPLICATION FEES .
SEWERLINE 46.00
INSPECTIONS REQUIRED �
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 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.
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
, r
Codes and Ordinances.
�
CONT CTOR PER OFFI
PE MIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
a1�-7aaoo2o City of Zephyrhiiis Permit Appiication Fax 813-784-4021
Building Department -
J . �
Date Recalved Phane-Contact for Permittin t��'J 9�`�O�� �
Owner's Name �'��`e k �" '�'��`-�'e- �� Owner Phone Number �j�'��9`' v��J
Owner'�Address S�� � j � �'�. Ze ti.1'��3 !�'�� Owner Phone Number � �
Fse Slmple Tltieholder Name �� � Owne�Phone Number �—� -..�
Fee Slmple Tftieholder Address a
JOB ADDRESS S- o�� l J � r5 . ��' �J /2J_?,�' /S �( . �OT# �� /
SUBDIVISION �— � PARCEL ID# j� ��"' a' � �'�!O p��,l.}d �3d)�
(OBTAINED FRdM PROPERTY TAX NOTICEf
WORK PROPOSED �NEW CONSTR ADp/ALT �' S1GN Q Q DEMOLISH
' e INSTA�L � REPAlR
PROPOSED.USE _ Q SFR Q CQMM � C�.T#iER
TYPE OF CON8TRUCTlQN , Q BLOCK � Q FRA - STEE� I
DESCRIPTION OF WORK �@'�I d V l.°. �cYa�S' - oEd - !n-c� a2C.'��I �+ � "'�"``-�' l'?.J'!G7U!
BUII.DING SIZE � � SQ FOOTAGE C� WEIGHT �,_-'�
QSUlLDING $ � -���_� ,^x=-_
VALUATION OF TOTAI.CQNS7RUCTION
QEt�ECTRiGAt. �6 _� AMP SERVICE � P120GRESS ENERGY C] W.R.E.C.
�PLUMBJNG $ j' �•' �
� �J
[�MECHANICAL ($ — �, VALUATlON OF{1t1ECHAN{CAI.INSTAI.LATiON l ?� t �
� �� c
QGAS Q ROOFWG. Q SP�ClALTY �� OTH�R
FIMSHED FLOOR E�EVAI"IONS ,.i� FLOQD ZONE AREA QYES NO
Sl3il.DER COMP�WY
SIGNATURE REC�tSTEREO Y t N F'6E GURRER .Y I N .
Address L"icense# r� ��
ElEC7'E21CtRM ry COMPANY
SIGNATURE �GIs7EttEp Y! N FEE CllRi2ER Y f N
Address License# � �
PIUMBER � ' �>„,/J' � „�,,,C��t� CdMPANY ��`e d'�-�'��lt-
SIGNATURE � 4i? �� ��d �• REGISTEREp Y/ N PEE Ct1RREM1 Y/(V
Address license# � �
!llECMAl�!lCAL COMPANY
SIGNATURE RE��S7�r�D Y�! N FEE cu�teE Y L N � �
Address License# � �� I
OTHER COMPANY
SIGNATURE REGISTERED Y/ N , FEE CURRER Y/N.
Address ' L'icense# � ��
RESIQENTIAL: Attach(2).Plot P.lans;-{2)set&of Building`�Pians;(1}set of Eriergy�Forms;R-O-W Perrriit foi new„constntction,
.Minimum�,ten°(1,0):woricing�day"s after..submittal date. Requfred onsite,Construadon Plans;�Storinwater`Plans w/Silk Fence lnstalled,
� Sanitary Facitittes&�1.,dumpste,r,.8ite Work;Rermit far su6diW'sfon§flarge projects . • �
COMMERClAL Attach{3)corriplete sets of Builiflrig�Plans plus a Life Safety Page;(1}set of Ertergy Fortns.RA W Patmit fo�new cansWctian.
Minimum ten(10)warking days after submfttal date. Requlred onsite,ConstrucHon Plans,Stormwater Plans w!SAt Fence fnsta4led,
Sanitary FaclliHes&1 dumpster.Site Work Permit far all new projects.AI�commercial.requirements must meet compilance
SlGN PERMlT Attacti(2)�sets af EngEiieer.ed Plans.i,:, ,� _ -
`""PROPERTY SUR1/EY required for all NEW construatlon.
Dlreations:
Fill out applicatlon campletely.
Owner&Contractor sign back of applicadon,natadzed
If over y2540,a Motice.af Commsncement is requlred. (A!C upgrades over 5T500}
" Agent(for ttie contraetor)or Fav+ier 6fAttamey(for the awner}wauld be someone with notarized lefter from owner authorizing same
CiVER 7HE COUNTER.PERMlTT1FlG (Front of Application Oniy}
Reroofs if shingles Sewers Service Upgrades A!G Fences(PfatlSurveylFootage}
Drivewaya-Not avar Caunter if an pubiic roadways..needs ROW
i � �
NO'T10E�E�DEED RESTRIC3'IONS: Th��tnderslg�ed unclers�tands��th�t.thls:;p�tmi�-.mayybe.rsubject to"deed"restrlctions° �
which may�.berimore�>r.estr(ctive�than•County-�re�gulations:=TFie�undersigned�assur`ries'responsitillity�far=compliarice witli�"any
appllcable.deed restrtctbns. - _ _
UNIiC�NSED�CONTRACTORS AND CtiNTRACTOR RESPONSIBILITiES: - If the owner has hired �a contractor or
contractors ta undertake work, #hey.may.be:cequi.r:ed<:to.be;licensed in accardance.writh state.�nd•lacal regulatiqns. �If�the
contractor�ts:�not:ltcensecl�as�requlred�tiy law� botEi tha owner and i:ontractiir��nay be-atted #or a-misdemeanar vlala#ion
under state law. If the owner ar Intended contrac,tor.�are,�uncertaln as to what Iicensing.requlrements;may>-apply.��for<the � �
intended work,they are advtsed ta con#ac#the Pasao County Bufiding:lrispection Dlvlslon-Llcensing Secttan at 727-847- '
8009. Furthermare, if the-owner has�hlred a conhacto�o� corifractors, he is advised to have the cantractar(s), slgn ;
portlons of the "conhacto� Block" of this appllcation for which they wlll be r,esponsible. If.your.as--.khe owner`s(gn�as�`rhe ;
contracfor, that may•be an indication fhat°he is nat.properiy licensed and-(s not entttlea to permltting pr€ulleges in Pasca �
County. � _ .. � � �
TRANSPQRTATlON..iMPAGTtUTiUTiES=1MPAG�'ANb RES�1U�t�E RECt'�VERY�FEES.J The underslgned understands �
#hat Trenspor#ation impact Fees and.Recourse Recove.ry.Fee� may��appty.ta�the construation.af new,bulidings,tchange of � �
use in existing buildings;�or:expansion�of�ezisting�6uildin�s, as spectfled-in Pasco County Ordlnance number 89-47 and �
90-07, as amended,;.�;he underslgned also�undetstands, #ha�t�such fees�;as Tmay��e�-due;:w,iEi�,be identified at the�tirrie af` i
permitking. It is furtfier understaod that Transportatlon Impact Fees and�Resource Recove"-"ry`x Fees.rrwst be paid prior to ;
receiving a °cerfi#icate..of occupar�cy"ar#inat-power.�-�elease, :i#�the praject does.not Invotve-a..cert#�cate af occupancY oT' ;
final pawer•release;;;the�.fees mu�t�be paid prior ta permik issuan`ce. F��tk�ermore;-if Pasco;:County�Water/Sewe� Impact -
fees are due�.they,must.be�pald..prior to permlt�lssuance-!n accordance wftfi�pptfcabis Pasco�Caunty�orcllnances, '
CONSTRUCTtON �IEN`L.AW(�t�apte�713�F1orlda Statutes�as amer�ded): if valuatian of work is$2,500.00.ar more, I �
oertify that I, the applicant, have�been provided w�ith a copy� of Qhe "Flarida Constructton Lien_Law.:.-Homeowner's �
Proteatian Guide" prepared by the Flntida Department of Agriculture and ConsumerAfifairs. Ef the appllcant�s someone
other than the"owner", I certify#hat l have.obtained`a copy.of the•above..des.cribed document�and.p.r.omise��in,good fat#h to
deliver!t to.the='ownec"�prior.�to�cotnmencement; ��� ' ,
CONTRACT�R'S/qWNER'S A�FIDAViT: i.ceitifyc#hat:ali the inf.ormation ln�thts appltcatlon is accurate and that ali wark
will'be done in compliance with all appUcable laws regulating constnactton� zoning and:�land development. Appitc�tion Is
hereby made to obfaln .a permit to do. wot'k.and Insts�llatian as Indfcafed:�:; °I certlfyt #hat no work�ar instaflation hes
commenced prior to issuance of�a permtt and that all work will be pertormed�to meet standards of all laws regulating�
construction, Caunty and City cades, aonfng regula#i�ns, and iand devetopmen# r,egulationsy in the jucisdlctian. ! al'so
certify that 1 unders#and that the regulatlons of other government agencles may�apply#a the intended work, and #hat ik is ;
my responsibility to identify�what,acttons!must take ta be,tn:.comp!lance. S.uch agencles include but-are,not Ifmiked ta: �
- Department af E�rvironmenta!�ProtectEon-Cypress.�Bayheads; Wetland Areas and Environmentatty Sensitive
Lands, WateNWastewater Treatment. �
- Southwest Florida iNater Management- .�7is#�c#-Wetls, Cy{aress. Bayheads; VYeftand Areas, Attering =
Watercaurses. ��
- Army Corps of Engineers-SeawaHs,Docks�Navlgable Waterways. ;:
- Department of Heaith- 8 Rehabititativ.e Servtces/Environmenfai Health Uhit Weli.s, Wastewater Treatment,
SeptlaTanks: , ,
- US Enviranmental Protection Agency-Asbestas abatement.
- Federal Avlatton:Authority-Runways.
i ur�derstar�d that the following�resUictions appiy to the use of flii:•
- U,se af fllt is no#altowed in Fiood Zone°V"unless expressly permitted.
- If the flq material is to be used��in Flood Zane. °A", (t. ls understood that•a d�ainage plan addressing a
°compensating volume"wi11 be submttted a#time af permifting whlch (s prepared by a profess3onal engineer
Ilcensed=by, the State-of Flortda.
- !f the fl!# materlal-_is.:to be used in Fbod �ane 'A" In�connecEion�wtth.a�ermitted bu11d3ng astng stem waH -
� aonstruction, I ce�tify that flil:wlll:be-used oniy.to fill the area withln.the•stem�wall.
- If flll material Is �to"6e used In any area� 1 asnlfy that .use af�sucti�flll wll! not adversely affect adjacent
properties. if use of fltl is t'ot�nd to adverseEy,�ffect adjaeent�properties�,the owner may be aited for vioCating '
the conditions of the"building;perm(t Issued�under the attactied permit.application, for lats less than.one (1) �
acre which are etevated by flit;a�t engineered dralnage plan 3s required. ``
ff 1 am the AGENT FOR THE OWNER;I,-�promise In good fatth ta inform the awner of-the permltttng condftlans set forth in
this affidavlt�prlor to comrner�cing construction: l�understand that a�separate permlt may be required for eleatrlca# work, ;�
plumbing, signs, welis,,paats; air candltioning,.ga:s, o�`other.insfailatlons na�,spec�ica0y included in.the apptication. .A ��
permit Issued shall be construed to be°a'Iicense,to'p�oceed with tNe work and nok as:authority to.vialate; cancel; aiter, or ,
set aside arty prov�slons of tlte technlcat-c�des;�nor sha113ssuance�of a.permtt.pcevent fhe Bulldlrig Q#filclal from thereafter ;_
requiring a correction.af errors In.plans,-cons#ructian or violaQons of any codes. Every p�armit Issued shall become invalid ��
unless the work autnorized by such permf#=�ls.�aommenced�wtthln sUc�nonths of�permlt issuance� or t!'work autharized by }.
the permit is suspended or.abandoned for:a.period.of�six(8)mantiis:aftec the time the�wokk is commenced..An extensian '�
may be requested� In writing� from the Building,Offlolal far a perlod:not to exceed ninety�(90) days and wrrill�demonstrate `�
�ustl�abie cause foc the e�ension: If work ceases:for nlnety{90}cons.ecutive daysk..th\�ob�s.constdered abafldoned.� �k
WARNING TO OWNfR: YQUR.FAIl.URE�7t�.tREGQRt?_A NQTIGE OF•Ci�MMENGEMEMT N1AY=RESUET IN YOUR �`
PAY(NC TWiCE-.FOR iMPROVEMENTS�T�_YO.UR�:PR�PERTY. IF°YOU�It�'FE1�(D".TD�tJBTA1N��FINANCING,�CONSUI.T �
WITH YC1UR l�END�R OR AN Aa;TTORNEY��EFOt.�E�-RECOR�'ll��,�QUR:'�dDTI��'QF-CAIiA ' ENCE'�flEM"�'�; - -- '
��o�icaA,�uRn�tF,s.117.03} "
DWNER QR AdEN7. CONTRAC70R
3ubscrlbed and swom to(ar affltmed}before ma lhts S6bscrlbed snd'swom=ta{at aflinned)�befoFe'me Uti�
bY '�►Y
Nho Is/are persanally known to.me or haslhave produced Who.ls/are personelly kt�nwn•to me•or#iaslhave�produced •
es tden��ce�on. as Identi�cation.
Y,
Notery Pubitc _ Notary Public
3ommisskon No. �- ' ' Commisslon No,
dame ot Notaty iyped,pti�ted ar stamped Name of Natary typed,printed or stamped
� � � • DISCLOSIIRE STATII�NT FOR OWNER
CITY OF ZEPHYRHILLS BIIILDING DSPARTNII�NT
I, �����n L" ' � E'w� � ` have read aad fully understand and
agree to the provisions of this instrument.
The undersigned states and affirms that he or she is desirous of conatructing,
reaovatiag, addiag to or reroofiag his or her owa domicile, that he or she
actually occupies, or will occupy by said domicile, aad same is not for
reat, lease or sale. That he or she ahall comply with the followiag coaditioas:
1. That the owner and he or she aloae shall act as the builder for all phases of '
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordiaances and codes pertinent to the buildiag. �
3. That ia the event various phases of constructioa are subcontracted, he will
engage only properly liceased subcontractors aad will personally aupervise
such work.
4. That ia the eveat the Building Inspector shall require correctioas to be made,
the owaer will assume full responsibility to iasure they are made, aad upoa
completioa will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
aot expect supervision of his �vork from the City of Zephyrhills Building
Departmeat.
6. That prior to fiaal iaspection aay additioaal fees, ineluding reiaspection
fees, must be paid in full. A written request from this office shall
coastitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws ia regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owaer shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be doae by licensed contractors. You have
applied for a permit under aa exemption to that law. The exemptioa allows
you, as the owaer of your property, to act as your owa coatractor with certain
restrictions evea though you do not have a licease. You must provide direct
onsite supervision of the coastructioa yourself. You may build or improve a
oae-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial buildiag, provided your costs do aot exceed $75,000.
The building or residence must be for your owa use or occupaacy. It may not
be built or subatantially improved for sale or lease. If you sell or lease a
buildiag you have built or substaatially improved yourself withia 1 year after
the conatruction is complete, the law will presume that you built or
substaatially improved if for sale or lease, which is a violatioa of this
exemption. You may not hire aa unlicensed persoa to act as your coatractor or
to aupervise people workiag oa your buildiag. It is your respoasibility to
make sure that people employed by you have liceases required by state law aad
by county or municipal licensiag ordiaances. You may aot delegate the
responsibility for aupervising work to a liceased coatractor who is aot
licensed to perform the work beiag done. Any person workiag on your building
who is aot licensed must work under your direct supervision aad must be
employed by you, which meaas that you must deduct F.I.C.A. aad withholdiag tax
and provide workers' compensation for that employee, all as prescribed by law.
Your coastruction must comply with all applicable laws, ordiaauces, building
codes, and zoaiag regulations.
OWNER'S SIGNATURE � • DATE ������
ADDRESS SdZ�1 �? �2 � S L
PxorrE �I 3= 3 5,�— � 7 3 1
in1ITNESS PERMIT #