HomeMy WebLinkAbout16-17165 . ,
CITY OF ZEPHYRHILLS
` , �� 5335-8TH SfREET
. (si3)�so-oo20 1 65
PLUMBING PERMIT
- PERMIT INFORMATION _ LOCATION INFORMATION
Permit#:17165 Issued: 3/15/2016 Address: 5429 10TH ST HISTORIC
Permit Type: SEWERLINE REPLACEMENT ZEPHYRHILLS, FL.
Class of Work: SEWERLINE REPLACEMENT Township: Range:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 1,825.00 Total Fees: 46.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 46.00 Date Paid: 3/15/2016 Parcel Number: 11-26-21-0010-13600-0040
CONTRACTOR INFORMATION OWNER INFORMATION
Name: HARRIS SERVICES UNLIMITED Name: PUSKAS, MIKE & DAWN
Addr: 15752 HWY 301 N Address: 5429 10TH ST -HISTORIC
DADE CITY, FL 33526 ZEPHYRHILLS, FL. 33542
Phone: (352)521-0707 Lic: Phone:
Work Desc: SEWER LINE REPLACEMENT
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 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 pertormed 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
a�aaeo-oo2o Gity of Zephyrhills Permit Applica#ion �a�c-s��-7aaoa2�
Building Departmant
, � .
Date Recelved phone Contacf for Permlttln
Owner"s Name Owner Phone Number
Owner's Address '�1� G Si Owner-Phone Number �
Fee Simple�Titleholder Name � � Owner Phone Number �i �
�—
Fee Simple Titleholder Address "
JOB ACIDRESS �� 2 I t/�� J/. �� 6�� �l 1 L07# [�
SUBDtVIS10N �� � PARCEL Iq# �-{� �-t �01 D J�L p t7 (,'7 O�-((,?
(dBTAlNED FROM PROAERTY TAX NOTICE)
WORK PROP{>8ED ° NEW CONSTR ADDlALT �� S1GN Q Q DEMOLISH
� e INSTALL 8 REPAIR
PRQPOSE[!USE Q SFR Q COMM ��� OTNER
TYPE OF CONSTRUCTIOiN Q BLOCK ` Q FF2AME [� STEEI Q
DESCRIP110N OF WO}tK � � G/� sFLti�^� L/N/�•
BtltlD2NG S#ZE •� � SQ FOOTAGE E� HEIGHT ���
QBt}lLQING $ a j}�t�„ � VAI.UATiON�:OF TQ`fAL CONSTRUCT'ION
/[f
QELEGTRlGAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
[�PLUMBING $ �
J��
QMECHANICAL $ VALUATION OF MECHANICA�INSTALLATlClN ; j �!
, �
QGAS �] ROOFING [� SPECIALTY � QTHER � � �7
FINISHED FLOOR ELEVATIONS Fl.00D ZONE AREA QYE3. NQ �
BUILDER COMPANY
SIGNATURE REGIST�RED Y/ N FEE CURREt+ Y/N
Addre$s Ltcense# � ��
E�EGTRICIAN COMPANY
SIGNATURE � REGISTERED Y/ N FEE GURREN Y!N
Address �License# i �
PL.UMBER COMPANY �S,S��Y/C� Gf,�G?X� .T-?�G•
SIGNA7URE REGISTERED Y/ N FEE CURfiE� Y!N
Address ���2^ Ll,f�'o� rY� �'�"�� GI' ) License# I L.�F� 1�.�7'��'/���
MECHANICAL CQMPANY
StGNATURE REGISTERED . Y./ N FEE CURRE� Y/•N , .
At!$C988 LICet1S9# (� `�
OTHER COMPANY
SIGNATl1RE ' REGISTERED Y/ N - FEE CURRE� Y/N
Atldreas License#�� � ��
RESIDENTIAL AtNach(2)PIot:Plans;(2)sets:of�Building;Plans;(1�'set of Energy°Forms;R-O-W Perriiitfar new.,con.stniction,
Minimum.ten:(1.0};worittng;days:after,�submittai'da#e.�Requlted onsite,�Construc�on Plans,�Stormwate�Plans w!Stlt Fence Installed,
Sanftary Fa�tftles&1.dumpste,r,°Sfie�Work:.P.ermit for sutidlvi'slons!lat+r�e proJects �':'
COMMERCIAL Attach(3)`complete sefs of Bulltling'Plans plus a�Ufe Safety_Page;{1)set of Energy Fomts.R-O-W Permit far new constructian,
Minimum ten(10}working day�after submltta�date. Requtred onsite,ConstrucUan Ptans,Stormwater Plans w/811t Fence installed,
Santtary FacfiiUes 8�1 dumpster._Stte,Work�Permit far all new prdjects.AH carnmerdat requir+ements must meet compttence
SIGN PERMIT Attacti(2)"sets of Engineec,red�.Plans':�.: �.~
"'"'PROPERTY SURi/EY reyulred for ali NEW consWctlan.
Directlonss
Fiil out appilcatlon completely. , '
Owner&Contractor sign back of applicatlon,natarized �
!f av�r 52500,a Natice of Commencestent ia requtred. (AtC upgrades over S7S40) :� ,
" Agent(for the contractor)or Power of Attamey(for tha owner}would be someone with notadzed letter from owner sutho�izing same
DYER THE COUNTER PERMITTING- � (Front of App!lcation'Only) -
Reroois If shtngles Sewers ; Senrice.Upgrades'A/C , Fences(PlodSurvey/Footage)
Drlveways-Not aver Caunier if on pubEfc roadways..needs ROW
r
� � ,
NOT9CE OF DEED RESTRICTIONS: The unde�signed under�tand5.:that:this,p�rmit.may_.be.sub)ect tg"deed"restrictions°
which may be�more��rest�ictive=tFial�-Gounty�regulatlons. The'�u�dersigned`�assur"ries�respon'sibiltfji for�compiiance wi'th any
applic�ble deed restrictions.
UNL.ICENSED C:ONTRACTOItS -AND CON'fRACTOR RESPONSI�ILITeES: If th� owner has -hired a contr�ctor or
cont�actors to undertake work, they may.be:r.�,quired..to::be.;llcensed In aceordance.�rith state.and�Iocal regula4lons. I�the
contractor is not Iicensed as requlred'=by law, both the owner and�contracto�•may be-clted�for�a misdemeanor vtolatlon
under st�te law. If the owner or Intended>:contr,aetor,:�re uncertaln �s to what Iicensing.requlrements:may>apply�ior•.the
intended work, they are advised 2o contact the Pasco County Building lnspectton Divislon—Licensing Sectiore at 727-847-
8009. Fu�thermore, tf the owner has hlred a contracfor or contractors, he Is advis�d to have the contractor(s) sign
portions of the "contractor Block" of this application for which they rrvill be tesponslble. If you,-as.the owrier sign�as the
contrac#or, that�may be an Indication that he�is not.properly Eicensed and is noY entitled to perrriitting prlvileges in Pasco
County. -
TRAN�PORTATION IMPACTIUTILITiES=IMRACT,ANb-RESOURCE RECOVEEtY�FEES; �The�undersigned�understands
that Transportation Impact Fees.�nd.Recourse Recove.ry.F�es rr�ay��apply��to:the constructton of new_bulldings;.change�of
use in existing bulldings; o�:expansion:•.of�ezistin,g'�buildings, as specifled in Pasco County Ordlnance number 89-07 and
90-07, as amended..,_.The undersigned also,understands, that�such fees,-.as;may�be•:due;,;will:be identified at the�-time�of
permiQting. It Is fid�her understood that Tr�nsportatlon Impact Fees and�Resource Recovery�'Fees must be pald prior to
recefving a "certiflcate..of occupancy" or flnal.paw►er•rele�,se. :I€the project does.not Involve-.a certific�te of occupancy or
final powrer release; the fees must�be paid prior to permR Issuance. Fwthermore,-�ff:Pasco County Water/Se.wer�Impact
fees are due, they�must be:paid.prlo�to permlt•Issuance°On accordance wr(th�appllcabie Pascv�.County ordinances.
COOVSTRUCTION LIEN LAW(Chapter 713, Elor�da S'tatu4�a,a��mended): if valuation of work is$2,500.00.or more, I
certify that I, the applicant, have�been provlded with a copy- of the "Florida��Constructlon� Lien Law—Homeowner's
Protection Guide� prepared by the Fiorida Departmenf of Agric.ulture and ConsumerAffairs. 6f the applicant is someone
other than the°owner", I certify that I�have.obtained>a copy,of.the above.ries.cribed dbcui�ent�and.p.r.omi,se�in,good faith to
deliver it to the'owne�"�prlor.�to�cornmencement:
CONTFtP►CTOR'S/OVIIPI@R'S A�FIDAVIT: I.ce�tlfy..tti�t�II the,information In�thi.s application is accurate �nd that all work
will�be done in compliance with �li applicable I�ws regulating construcflon, zoning and:land�development. Appllcation (s
hereby made to obta(n .a permit to .do work..and Installation as Indlcefed::• i certffj+ 4hat no work=or installat(on has
commenced prior to Issuance of a permit"and that.all work will be perFormed to me�t standards of all laws regulating�
construction, County and City codes, zoning regulatians, and land development regulations-in the jurisdlction. I �Iso
certlfy that i uaderstand that the regulations of other government agencies may�apply�to the intended work, and that it is
my responsibElity to identify.what.�ct(ons I mu�t t�ke:to be�ln�.compllancs. Such agencles include but are.not Iimtted to:
- Department o� Er�vironmentai Protection'-Cypress. Bayhead�; WeUand Areas and Ern(ronmentaily Sensitive
Lands,WatedWastewater Treatment.
- Southwr�st Florida Water W9anagement: .:District-Wells, Cypress.��Bay.heads; Wetland Are�s, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigabla Waterways.
- Depa�tment of Heaith� � ReY�abllitative ServOces/fEnvironments,l Healt� Uhit:Wells,..Wastewater Treatment,
Septtc Tanks. _
- US Environnnental Protection Agency-Asbe�tos abatement.
- Federal Avlatlorr Authority-Runway�.
I understand that the following;restrlctions applyto the t�se of flll:•
- Use of fill is not allowed in Fiood Zone"V"unless expressly permitted.
- If the ffll materlal fs to be used�In Flood Zone. "A", It. (s understood that a drainage plan addressing a
°compensating volume" wlll be submitted at#ime of permitting whlch Is prepared by a professfonal engineer
Iicensed by�he State-of Florida:
- Of the flll materlal .i's to be us�d in Flood Zone "A" ins connection�wlth:a��p�rmitted buflding using stem wall
construction� I certify that fill:wlll�b.e used only.to.fill the area�n►lthin�the stem�wall.
- if flll material Is to be�used in any area, I ce�tify that .use. of such flll wlll not adversely affec@ ad)acent
propertles. If use of fiiil Is found to �dvers�ly.�ffect adJacent��properties,.th�owner may be cited for violating
the condi#ions of the�b�iid(ng-;permit issued under tha attacfied p�rmit applicatlon, for:loQs less ihan one (1)
acre which are elevated�by flll, art engineered dralnage plan is required. .
If 9 am the AGENT�OR TH�OIWNER, I;promise In good falth to inform the�owner of�the permitting conditions set forth in
� this aPfidavit�prior fo comrriencing construction. 0 understand that �;separate permit may be requtred for elecMcal work,
' plumbing, signs, wells, pools; air conditioning,.gas, or othec Installations not•spec�ficaily included�in the application. A
permit Issued shall be constcued to be a�Ilcense.Qo�proceed with the work and not as:authoNty to.violate,cancel, alte�, or
set aside any provisions of the technical.codes;�nor shail issuance�of a.permlt.prevent the Bullding Officl�l from thereafter �
requirin.g a correction af er�ors in.plans, construction or violatlons of any codes. Every permit issued shall become invalid
unless the work authorized.by such permit.•ls.co�nmenc�d•withtn sUc months of permit issuance, or if work authorfzed by
the permtt is suspended or abandoned#or a:period of�six�8)�months..after the time the�work fs commenced. An extension
may be requested, In writ(ng,.from the Building;Officlal•for a perlod.:not to.exceed ninety�(90) days and will'demonstrate
justifiable cause for.the extension. If work ceas�s.for ninety(90)cons.ecutive:day.s�..the Job�is�considered aba�doned.
WARNING TO OWRIER: YOUi�..FAILURE TO..R�EC.ORD.A �IOTIGE OF•COMMENCEMENT:MI01Y RESU�T IM�YOIJR
PAVINC TWICE;FOR�IMPROVEMEN.TS�TO.YOU��:PR�OPERTY. IF�YO.t1;IR�'�EWD'�T��OBTAIN��FIPtl�1�E1NG;�C.OIdSfllLT
�lIITH YOU D API ATfO N .�B FO'REt ECO D G:YO � -C :� ' °' E C� N
FL�JRlDA JI��RA'�(F.�.-1.7 � _ --- -- - – —
OWPOER OR AOEN CONTRACTO '
Subscrlbed and m to(or aHi ed efore m is Subscribed. m to(or dpbefore me thi5
by _�
WFio is/are personally knovm to.me or hasla�ave prqduced VNho ls/are p:et onallykno w�`►•to me�or has/heve•produced •
as IdenUflcatlon. - � / as Identlflcatlon.
r ; n 'n//�
Not�ry Public �--' �'�X ��� � Notary Publlc
Commisslon�tdo. Com � sion No
�qiiRY.?Y,e�, .
=':• �°k= Commission#FF 150422
Name oi Plotary typed,printed or stamped Name of Notary " �• �0 8Ce �
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