HomeMy WebLinkAbout16-17169�I
; -; CITY OF ZEPHYRHILLS ',
5335-8TH STREET
(813)780-0020 17169
BUILDING PERMIT I
PERMIT INFORMATION ` - LOCATION INFORMATION � � I
Permit Number: 17169 Address: 5522 18TH ST ',
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. '
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
� Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-14200-0190
Improv. Cost: 7,175.00 � � OWNER INFORMATION
Date Issued: 3/22/2016 Name: CONNELLY, BRIAN
Total Fees: 112.50 Address: 5522 18TH ST
Amount Paid: 112.50 ZEPHYRHILLS, FL. 33542
Date Paid: 3/22/2016 Phone: (813)454-4993
Work Desc: 21 WINDOW INSTALL S/S
� CONTRACTOR S - - - � � � � APPLICATION�FEES . �
WEST COAST WINDOWS & EXTERIORS I BUILDING FEE 112.50
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' � - Ins ections Re uir.ed �
F TER 2ND ROUGH PL MB MI C IN ULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
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 I,
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the re uirements of this ermit there ma be additional restrictions a licable to this ro e that
Q P � Y PP P P �Y
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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
�
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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. � � 813-780-0020 City of Zephyrhills Permit Application Fax-813-760-0021
Building Department
Date Received
Phone Contact for Permitting -
-1-1-I-1 1 �-�-�- -- - - - --�--�-�-� � - -
Owners Name �C 6�IV� Co h n el I,� Owner Phone Number ���—� �7^ � /
Owner's Address ��«� �v " Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titlehalder Address
JOB ADDRESS s 5aa ���� s�l �e h Q r� rj F� 3 3�y� LOT# �
SUBDIVISION PARCEL ID# p` � vO I�-' C�O^ Q q(7
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONS7R B ADD/ALT � SIGN Q Q DEMOLISH
l INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OFCONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK �I v����OvJ'� S/Zc Or S�2e.
BUILDING SIZE SQ FOOTAGE� HEIGHT �
�r'r'r'rr'r"r"r�r'r�r'r�mm�r'r— rr'r�r'r'r'r�—
�'�UILDING $ � �� �`S.L VALUATION OF TOTAL CONSTRUCTION
r
DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
�PLUMBING $
�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
�GAS Q ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
BUILDER COMPANY C' CO Sr :il� W �f!` ��C Cfi ad�i
SIGNATURE � 0.�-C J REGISTERED Y/ N FEE CURRE� Y/N
Address ���d�0 @kn � �, � ¢ ¢cr 33 b37 License# � c-Ja�S y�a
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 REGISTERED Y! N FEECURRE� Y!N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y! N FEE CURRE� Y/N
Address License#
IIIIIIIIIIIIIIIIIt1111111illllllllllllllllllllitllllllllllllllttlll
RESIDENTIAL Attach(2)Plol Plans;(2)sets o(Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construclion Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities�1 dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safery Page;(1)set of Energy Fortns.R-O-W Pertnit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w!Silt Fence installed,
Sanitary Facilities&1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW conslruction.
Directions:�� ��^ ������^
Fill out application completely
Owner 8 Contractor sign back of application,notarized
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
" Agent(for the conlractor)or Power of Altomey(for the owner)would be someone with notarized lelter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
-- , � 813-780-0020 City of Zephyrhilis Permit Appiication Fax-813-780-0021
� Building DepaAmenl
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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 regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
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 buiidings, 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,will be identified at the time of
permitting It is fuRher 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 wili 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 Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawails,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 fili 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 pe�mit application, for lots less than one (1)
acre which are elevated by fill,an engineered drainage pian 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, wells, 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: 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 TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT � CONTRACTOR �
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or a�rmed)before me this
b�,L I G L/�i�aLir1 by�a�nz [7oCl N3a J�..
Who islare personally known to me or has/have produced Who is/are persona ly known to me or has/have produced
i�tr{1nsaL vn as identification. �'$C,�s L�y Kn n�✓n as identification.
i"
� � � Notary Public �'� Notary Public
Commission No. Commission No.
Nam o a t e , ri e o st e Name of tary,�p�printe�o4a�
:o�''�°� Notary Publ'�c State oi Florida g e� (�c Sfate of Florida
, �`�: Joseph Marc Stapleton �� : Joseph Marc Stapleton
� �a c � My Commission FF 243033 '�c �� My Commfssfon FF 243033
°' ` o� fres 08/22/2019 �'of no Expires 06l2212018
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� 2016038987 �
Permil No, _ Parcel ID No ���a6-���_ c�a�-�c�a oo-c��9b
� � NOTICE OF COMMENCEMENT
Stale of 1 Ir(�T��crl G�t A-- Counly of �a�"C.0 - -� �-
� THE UNDERSIGNED hereb ives not(ce Ihal im rovement will be.matle to.cenain real ro e
Y 9 P p p rty�and in eccordance wifh Chapter.713,Florida Staiuies.
the follovAng inlormalion is provided in this Notice of Commencement:
,• � ,,. .
1. Descriplion'ofPiopert'y:.Parce,lldentificallon,No.�-c�(0--c�I^��(�-_�.y'�'00-.,0,(�/O.
StreefAddress:�S��. �.d "' Yh .Z2��jv�.,��l, FL, ;�y-�j5/„Z
2. General'Desuiptlon of tmprov_ement �f W� ����'� S�Z�'-�FD�. 'r(2� ,
3. Owner Inlormation or Lessee informallon If the lessee contractetl for the improvemer.t:
�� r ;�A/V ��o n a�L l v ,'.
ssaa ,��+`� s� � �,r �II� �� -
Addresa' n (� _ .� .,Cit� - - -�-- - - - Sl" a�e
Inlerest In Property: fCe 5/cJ�C h LP •
_ Name of Fee Simple TlUeholder•
„ 1 , , . (II different from Owner listed abovej ,- - --_�W
W Atldress A
�. � �..: � �'�^�..r.'r ./ � � i �, l tCItY State
(:ontractor: ��•rc-T y�" v�J l a�7i if: �'�r i c: S�Lhr' - - - - - - -
f�-�:_
�a0'(GmvxP�c. ^��C C'C QC.G. 1-�cl�y � I C{M Ln �'2('r Ci L.0 �
Address � Cit� - -- - State
Conlraciors Telephone Na.•�I��9�5�3���
5. Surety:
Neme-- - - -- - ., — _ , .. —
Atldress , - - � City��� �- ulale
Amounl of Bond: $ TetepHone No.•
, _ , ., ..
6. Lender:
Name
Atldress � '— .--Cit�=— � State
Lenders Telephona No.� ' __ _ �� ', _ _ „
7. Parsona vAthin.the,$txte of Florida designaled by the o+.u�ier upon whom noUccs%`or=o;her-documen;s rnay be�,3rved as proviaetl-by
Section�713.13(1)(a)(7).Floritla Statutes• " • . � �. �
, t^ , : _ � _ �
,, Neme - ' .. . _ . ... , _ . . . . _ . . _ .. _ _ ,
Address ' . Cl:y_.-• State
Telephone Number of Destgnated Person: � � -
8. In additlon!o himself,the ovmer designates _ a�
_to recelve a copy ol lhe Llenols Nolice aa providetl in Seclion 713.13(t)(b),Floride Slatutes.
Telephone Number of Person or Entity Designated by Owner: � •
9. Explralion tlate of NoUce ol Commencement(the expiration date may nol be before the cample:ion of consWction antl final paymenl to lhe �'
contractor,but vAll be one year irom the date of recording unless a alfferenl dal�Is sptcirieC): _
WARNING TO OWNER: ANY?AYMENTS MADE BY THE OWNER AFTEQ THE f='!PIR4TIbN OF THE PiOTICF OF COMMENCEMENT �
ARE CONSIDERED IMPh'OPER PAYMENTS UNDER CNAPTER 7??, FFJ2T 1 SECTIOM 71J.i3, r�URIDA STATUTES, AND CAN �
RESULT IN YOUH PAYING TW�CE FOR IMPRUVEMENTS TO YOUP. PROf'ER?v, A NOTICE OE COMMENCEMENT MUSi BE
RECORDED AND POSTED ON THE JOB SIl'E BEFORE THE F(RS i:NSPECTICN. E=VC�Ii INTEtJ�%T.i�OETP.i�:�;!'.;�:�I7+Ct.t.'�id:�;:��
WITHYOURLENDERORANATTQR'7F.Y9EFORF!:CL73!F.P:�:In.a�'�/C:��_,r.;5Y'-.-:;:�;�_^;;C�iGt�.ir�uMM=NCEPiF,JT.
Under penalty of perjury,I tleclare thal I t�ave7ead Ihe forego ot( of commencemPnl er�d th�t the � ted therein are lrue ro lhe�est
of my knovAedge and belief.
\ fA
STATE OF fLORIDA ' � C c�
COUN7Y OF PASCO �Q`i �o�
Sigr�ature of pwner or Lessee,or Ov+ner's or Lessee's Aulhorize
d aa
OKcerlDire^_tor/?zMerlManager u ��,o�
� ���Signalory's TillelOffice ;�'�
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The loregoing instrument was ackno�vledged before me this P day af Feb ,2D_,by �C 1 IP4 1^ GUY1/�Q L L� a a�
��j a a es D W II Q(" __(type of au�hority,e.g.,aNcer,lruslce,ettomey in fac()for �O T�
�� S� (nam2 of party gn hehe�of vrtium'in rum n was ezecuted). �-'��
Personally Known�g�y Producetl ItlenUllc tlon� Nolary Signature�.l�.��-'+ � - �'►'4r�
1 �L — .�/
Type of Identlficalion Produco� �'� L' Name(Print)�✓i� /t?�?/%J.�t�N ' � �
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Sl'ATE OF FLORIDA,COUNTY OF PA��� � • �
THIS IS l'G CERTIFY THAT TH F HEEDOCUMENT �'�� � �G�`'�
T R U E A N D C O R R E C T C O P Y 0. � , 4 . � ,' �
ON FILE OR�HAND AN OFFOIC AL SEAL�ISI C E �'
WITN�Sy��l �¢ °' zn G���ve�rust o
S�DAY OF 2� ��°,•"'� �
PAULA S. ' EIL,CLERK&COMPTROLLE � .�,,�� ; '
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BY DEPUTY CLERK •. .
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Florida Building Code Online ,. . � � Page 1 of 1
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Historv Model:Series 1441 Non-Impact Vinyl SH (804)684-5124
Flange
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Subcategory:Single Hung
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: �`���CC�� //�
1� � ��%lyU
Date Received: 3—l ����
Site: �c5 �� f U� � ,
�j ��l � �C � � �
Permit Type: /it� G� � L� /J 'I
Approved w/no comments�l Approved w/the below comments: ❑ Denied w/the below comments: ❑ �
�
This comment sheet shall be kept w' h the pernut and/or plans.
�
Kalvi Switz " ans Examiner Date Contractor and/or Homeowner
(Required when comments are present)