HomeMy WebLinkAbout15-16817 , �
CITY OF ZEPHYRHILLS
- 5335-8TH STREET
, (sis)�so-oozo 168
PLUMBING PERMIT
PERMIT INFORMATION` = � - - LOCATION INFORMATION �
Permit#:16817 Issued: 12/09/2015 Address: 5018 5TH ST
Permit Type: PLUMBING ZEPHYRHILLS, FL.
Class of Work: PLUMBING/NEW Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 800.00 Total Fees: 40.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 40.00 Date Paid: 12/09/2015 Parcel Number: 11-26-21-0010-19000-0200
� CONTRACTOR INFORMATION. - OWNER INFO.RMATION �
Name: HOMEOWNER Name: BALDREE, JAMES W & CAROL D.
Addr: Address: 5018 5TH ST
ZEPHYRHILLS, FL. 33542
Phone: Lic: Phone: (813)780-8966
Work Desc: CONNECT TO RfEC-�=% :%��''=�=:�
�� - � Gc�a. �- /�
� " - -- APPLICATION FEES. - � -
PLUMBING FEE 40.00
_- � - " INSPECTIONS.REQUIRED - � �
1ST ROUGH PLUMB
2ND ROUGH PLUMB �
SEWER I� I�
WATER
� � V
FINAL I � ' "/�
j2P2 ( -l ��
��
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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 pertormed 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-813-780-0021
., Building Department
Date Recelyed �: Phone Contact for:Permittln — '
Owner's Name � L�/�� �G���r Owrner Phone Number � O � v
Owner's Address � (%� ������� Owner Phone Numiser
Fee Slmple Tltleholder.Name Owner Phone Number � � ��
Fee Simple Titleholder�a►ddress
JOB ADDRESS ✓�/ Q %� C�T ���l� �{l�'� � LOT# ��
SUBDIVISIOId - PARCEL ID# � ' • �
. . � (OBTAINED FROM PROPERTY.TAX NOTICE)
WORK PROPOSED '-NEW.COPIS7R ADD/ALT � SIGN'� Q Q DEMOLISH
B.- INSTALL 8 REPAIR � "
PROPOSED:USE Q SFR Q COMM' - Q •OTHER '
TYPE OF CONSTRUCTION Q BLOCK ` 'Q FRAME � Q STEEL Q
DESCRIPTION OF WORK + C�N/� �C� Q /�.� � %`/� '/✓/� /�(�%Q
BUILDING SIZE � 3Q'FOOTAGE�, : ..HEI,GHT�. .. .
QBUILDING $ , .,,4..:..�-..: . .�.•._. ....� " ,• .
VALUATIOiU,:OF�TOTAL COIySTRUCTION
QELECTRIGAL $ ` AMP SERVICE Q 'PROGRESS ENERGY Q W:R.E.C.
QPLUMBING , _` $ � _� -` b�(1�
1 v
QMECHANICAL $ VALOATION OF;MECHANICAL INSTALLA'1'ION. �
QGAS Q ROOFING .Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD zONE AREA QYES_ ,NO
.,
BUILDER � COMPi4NY� � N(�NI� "` '' L-Y���
SIGNATURE REGISTERED Y/ N 'FEE Curt�� Y/N
Addresa � - - L(cense-# �
ELECTRICIAN � ,=COMPANY ' ' --
SIGNATURE ' REGISTERED Y/ N FEE CURRE�` ' -'�Y/N' '
Address ' - � _ . , � .:� License.#� °
PLUMBER ` . . COMP.ANY -_= �
SIGNATURE' ` � � ; REGI3TERED� .- Y/,.N„ : �,FEE�CURRED; .:.'� Y•/N. _ : ,
Address ' � � License# �
MECHANICAL' ` " ' .� � COBAPANY - -
SIGNATURE t - REGISTERED , Y_/ N._ . � FEE CURRE� Y/-N,
Address-` - ' - ' �� � � License# � .
OTHER = � � ,�tCOMPANY �
SIGNATURE '"- �� '� � " ' � ` REGISTERED Y/ N.,� � FEE CURRE� Y/N
- Address, � - ' . . ' License#� .� ' - I
RESIDENTIAI;,,, ;Atta'ch�(2)APIot�Plans;..(2)set"s�.of�Building Plan's;(1)'set`of�Energy�Fortns;`R=0-W'Permltfo�new construction, �
.;;=w Minimum�ten;(:10)�,u±ro�ing;days;.after,„submittal`date:�.Required onsife,%Constiucdon�Plans;Stormwate�"Plans w/SIIt Fence installed,
;. +.._ �,4, "' ' , y '
��Sanitery Facilifles;8�'�1.;dumpster.Site�Work:P,ermitfor,subdtvisions/large';proJects4,_ .� -�= � �
COfNMERCiAL Altach 3`com lete se4`s"ofsBuildi'n'� Plans "I'us a Ufe Safe �Pa e; 1 set of Ene Forrns.R-O-W Permit for new consUuction.
� ) P 9 P tY 9 � ) r9Y
Minimum ten(10)worktng days'after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed,
Sanitary Facilitles&1 dumpster.Site Work Permit for all new.proJects.All commercial.requlrements_must meet compllance
SIGN PERMIT Attach"(2)'s"efs of"Eriglneer,ed�Plans:, � � _ � � �
••••PROPERTY SURVEY reguired,for al(NEW constructlon.. _. _
DlrecHons: ,. � , �
Fill out applica8on completely.
Owner&Contractor sign back of applicatlon,notarized
If over SZ500,a Notice of Commencement is required. (AIC upgrades over 57500)
;.+��.:�,:�::.:-
" Agent(for the contractor)'or'Power of Attomey(for tFi'e owner)would be someone with notarized letter from owner authorizing same . _
DVER THE COUNTER PERMITIING� --;,(FronCof-ApplicatlonOnly),� r� - � � +'� '''� = ' '• . , .
Reroofs if shingles Sewers Service Upgrades A/C� Fences,(Plot/Survey/Footage) -�� � - �''t'- �� �" -.' ��:' .
... _ -. . , ., , . :�.r;�. i�..,.: ,.:% . ..,
- b . .. , . ;e::� -`' � , ,- . �„ .� � . ,- � ' ' '
Drivewaya-Not over Counter if on publfc roadwiays::need§,ROfN� - � ' ��� � .___.- - .__,_, s-. .�,� - ,,�,.: .,. .-....- ...
, ._.. , �;�-:
�. . ,.� S
NQTICE t3F DEEQ RESTRtCT10NS: The under�lgned unde�tands°�Eh�t:_thls����rmlf�may.be;subJect;to,°deed"res#cictioris"_:s., .`.��:N.
which may�:lieimote=resttictive�tta�n CounEy`�rw�gr�lat(ons. =Ttie underslgned-assurines���e�pansitilliiy-for'compilance with any�`
,�....,.A,
appUc�ble:deed=reaMctlons. ' - .,::, ;., .:`•_.,�,. _ • . , _ .. >. - .�; �� - � '
�._. ..
UNltCENSED`CONTItACTORS�AND C�t�TRACTOR.RE$PONSIBI�IT'IES:-�-If �he�•nwner hasY°hired��� �contiractar or
contraotors to undertake work,-they.may,b.e.r,equire,d,to-bezlicensed�in acc�rdance.wittr state�:and;local:�regulatlans: +If,the= e � - �
contractor is�na# 11cei�ssd�as�tequlEetl`6y lainr, both�the owner a��i:ont�actoT=may be-�clted.for�a�misdemeanor vlolation
�,
under state law. If the owner nr Intended>,contrat�tor�are:uncertain as:to !what Iicenaln�,requtre�nents;'mey�apply-��foruthe'� ��-� �� =
,,:., ...}.
intend�d`wark�they a�e"advlseii fo caintact::the.Paaco,Caiinty 8ullding Inspei;tlon,D(vislrin-Ltcensing Secttan at?'27-647-
8009. Fe�rttiermore, if the owr�er Fias�"+tii�ed`a c+arihactor or aontractors, 1ie is aiivised ta have the contfiactar(s)r.sign , ,,;
. �o,n,r ... � .
portions of the "c,ontractar..Block".of thls appilcatton,for.which.they, will:.be:,ce�ponsible.- .If.you, as,thea,ovimer°`sign"2'as'''the � � -"` �
cont�actorE that�may,be an indicatlon'#ha#'iie`'is`noY:properlj►Ilc�iised'and�is'"nat entlfled to permltting pri�lleges tn Pasco ,, . �
Counly. � , ::��>.. :
TitANSPORTATION:-IMPACTlUTILITlES`�MPAC7=ANb l�ESOURCE RECCJVEEtY�FEES;The underslgned�utiderstands �
thatTransportation Impact Fees and.Recoutse RecoverymFees may`�apply�to�t�e:canstruction,of new_bultdings,.change�of�'°'� '-� �
90-�7, as�mended tn�e undexsl ned'alsoxu8nd� ', � ' :
. . .._. --w --
� ' � :�buildings� as specffied.In Pasc� County O�dinance number 89-07 and ;
g etstands, th�t:such fees.-,as��may��s::due;�w11�:�ibe iden�ed,a#fhe�time�;of`���� ��-;h .�'
permitki�g. It Is fu'rtlier understood that T�aiitispottatlon Impact"Fees an.d�Resoucce,Recor:eryraFees,must be pald prlar to ,
�ace�ving a"cer#tficate of�nccupancy",ar final�powet;celease: :If�Ehe pro�ect..does}:riot lnvolve&a.cert�Eiqate of occupancy or;:--�:��;;-:t:• ;
final powec release;�the:fees mu�t be`paid,pilor#o,�permft issuan'ce. F��thermore,�1f.Pasco,C,ounty'Water/Sewer��lmpact - � ����.,�� ;
fees.are due�Ihey.must.,be-pald:prlor!o.p..ermit�.lss�ance=ln,.accordanc�a wlth'�rppllcabte.Pasco'County ordlnances. �
CONSTRUCTiON`CIEN'kAW(Chepte�713�F1or�cla Statut�a�as amend�d): if valuatlon of work 1s$2,500.00}oc;more,,i�� �. � _::.: •
certify that I, !he appllcant,. have�been ,provldetl=vvfth-a-copy-of t0�e�"Florida•��onsttictlon� Llen.:Law--Homeowner's
Pratectlon Gutde" prepared by the Flot�da Depa�rtmetit�of Agrlcutt�re and Gonsumer-.A�aics. If the appllcant Is someone- :-•-�
other than th�a"owner", I certify that I:,have;,obtalnetl�a�aapy.of.#t�e�above:des.crlbed;document�.and-.pramise::in,goad:-faith.to
deliver It to:the.�?owaec";p�ior�toacommencem�int:°�.. � . . . , _
CONTRACTt3R'STOWNER'S AFFIDAViT: I.ceiti�'y<:ttia#-atl�the,4ir�formatlonrin•thi�applicattan is accurate.�nd that afl wark
wlll'be done in compliance with all.applicable�laws regulating constructlon, zoning and:�land develapment. Appllcatlon is
hereby made to obtaln .a.permit{.#�.;do=w+�tk.�.and i�lristallaflon �� Ind[�sfedr-..�;1. t�rtif�i that no work=or tnstattat(on fias
commenced prto� to Issuance of'a perm(t"and that`.all�work wlll be pertormed #o meet.standards•of all laws regulating�
constructlort, Gounty and City�cQdes, zontng regulatlQns, and land devetopt�ent regalatlons�fn thie.�ur�sdlctlon:� !�al'sa ;
certlfy that 1 uaderstand that`tFi�,re�ulations af other godemment agencles may�apply ta the.lntended work� and that it is
my responstbility to lden#ify•what.acttona!must•take:to.bertn�c:orrlpllance:. S.uch.agencles�lnclude bu#�are.not limtted to: �� � ,
- Departmen# af Er�vironmental°Protectton`=CypTess:°Bayhead�, VfteHand Areas and Ernrironmentally Sensitive ;
Lands�WaterNVaskewater Treatment. w „ �
- Southwest Ftorlda Water IUlanagement: .C7ts#rtct�We11S� -Gyptess. 88y#t88d�;- WBtl�ttd ATe�s� A1#ering i
V1latercaurses. . � ° •
- Army Corps of Englneers�5eawalls�Docks,Navlga�le.Waten�vays.
- Department of,Health;:& Ref�abilitative.ServtcesJEnvitanmentat�Nealfh U'rtit Well.s; Wastewater�Treatment,
Septic Tanks: ' . � - � . �
- US Envlranmen#al Protscttan Agency-Asbestos ab�tement. . � _
Federa)Avlatton Authorlty-Runways: , �
t understand that.the�follow�iig•.restrlctlons appty"to tfie use of flA:•
- Use of filf is not afiawed ln�Flood;Zane�VV"unless expres�iy permitt�d.
- If'the--fi11 mate�laf�ls ta;be�used�ln.-:Flood Zone. °A"� It Is understood that a dralnage plan addressing a '
"compensattng volume"wi11 be subrnitted at time ofk•permift€ng w61clt is prepared by a profe�s�onal engineer �
Ilcensed by the State of Florld'a.:, r; � • � � " . �
- Of th� flll material !s�to ba:used In Flood Zone "A" in�connection�wlth�a�,.}�ermi#ted buitding usfng stem wali
� constnaction, tcertify.thatfUl�:wlll.b.e•usedonly.toflllthe,areawithln�the�stem�wall.
- It fill materla! Is to be used-ln any ares; I�ce�tNy that .use of'such flll wlll not adversely afFect adJacent
properties. If use of fill is found:ta edaetsely,�f�ect ad)a�er�t��pmperties,.the owne�may be cifad far viorating � �
#he condltions of the'bullding.permlt-I�'"sued under tNe�att�cFied;pecmlt appticatlon, for:lotsrles��than.one (1)
ac�e wiilcF�are elevated�tiy fllt;an englneer�ed dratnage�plan ts requlrad. � .
If I am the AGENT FOR.7HE OWNER,,I�pramTse In.good.fatth to 1�form�the�owner of•the�permltttng aonditians set forth In
� this affidadlt`prtor to commer�cing conshuctlon. ! ur�derstan�that a:separate permlt may be requtred for elecMcal wark. ..
� �m r,�•
ptumbing, signs, wells, pools;.alr condttioning�-.ga�s,_or.oti�ei instailStions na�.spea�tcsatly indu�ed�in.the application. .A
permit Issued"shall be co"rtstrued tabe a�license'ta�proceed wlth`tlie work end:not�as:authoNly to,vlolate;.cancel, alter,,ar
set aside an}+�ptavisians of the.#echnlcal cod�s:�nor shalt tssuance°of a.permit.pcevent fhe Bulldlrig Ofl3cial from therea#ter
requlring a coRectlon af ercors In�plans; cons#Fuctlan or vlolatlons of-any codes, �very-�p�ermtt-I.ssued sfiall become invalid
unless the work authorized.by such permlt�ls.commencec��wlthln,s;Uc�months of permlt IssUanae. or It wark authnrized by
the permit.is suspended or..sbandoned-for.e:period.of�i�c�)�montfis.efter the#ime the�vvork�is commenced. An extension
may be requested, In wrltltig;,,from tFie Bullding,Offlclal f6r a perlod:nnt.to exceed'°nlnety(90) days a�d-virill demonstrate
_ _ ____ .._____
—�us#�fa�bte catise fior":��he extensio�;�1f inrork:ceas�es for nlneiy.�90}cons.ecut v�e day.s,..the j��is cons�dered abac�doned:
WARNlNG TO OWNER; YQUI�..f.A1LtJRE.Tt?.RECQtt[�A.,NOT�GE QF�CQMM4MCEMEte4T:NrAY�RESULT fN YOUR
pAY1NG TWICE:.F�lR_-iMQitOVEMENTS�TO YDUR�.PRCC�PERTY. �i��YA.U�ii�i'�END`T�'�OBT`AIN�•FINAt�E1NG;�C.ONSULT
WIT U . D AN O NEY FO. '1 °O �'M �.� OU ''• • � °� -'' ��•' E �E � '
FI.ORIOA JUi4A'�(F.S:.217.03) - � . .. ' . . _ - ..
OWNER OR AO�NT 9 ' ������,,,� CONTRACTO ,. �L � —
Subscrlbed and M(or a e bsforra me Ihlr s�---- Subscribed m= (�af�nned}�betore me'ttii�.
by � .by... .
Who Is/are personally knavm to.me or haelhave produced Who.ts/are p.ersanallyknown�M.me,or hes/have•�roduced • �
' as td`enUficatl4n. ' ss[detlB�caUOn.
� Note Pubitc . � �� Nota Publlc
ry ry .
CommissR � Ccm�lss2cn N ,
-`'�� y��°" Commission#FF 137073 �`�'�"'�`�`.." ,
-A. .kn dpNY a�i. _
Name oi ,, Nsms of N _, �►�}�itt3;��P�?r.'.;
r�;� BondedTh�uTroyFainlcspur�ce8d0�S5dOt9
i�`"p���.�' :�;: � Expires June 29,�?D 18
;,�.
. '��ffrd��,.�.�`� Brn�ded Thm Troy Fain Iriswa.xa c0U38�Y019 ,
t
% DISCLOSURE STATEMENT FOR OWN�R
CITY OF ZEPHYRHILLS BIIILDING DBPARTMEN'P
I, have read and fully uaderstand aad
a e o the provisioas of this instrument.
The uadersigned states aad affirms that he or she is de8irous of constructiag,
renovatiag, adding to or reroofing his r her own domicile, that he or ahe
actually occupies, or will occupy by said domicile, aad same is not for
reat, lease or sale. That he or sh hal comply with the followiag conditioas:
1. That the owaer and he or she aloae shall act as the builder for all phases of
construction.
2. That the owaer will comply with all provisiona of the City of Zephyrhills
ordinaaces and codes pertinent to the buildiag.
3. That ia the event various phases of coastructioa are subcontracted, he will
engage only properly liceased subcontractors aad will personally aupervise
such work.
4. That ia the eveat the Buildiag Iaspector shall require corrections to be made,
the owner will assume full responsibility to iasure they are made, and upoa
completioa will call for a reinspection before proceeding with the buildiag.
5. That the owaer shall assume full responsibility for the coastruction aad will
aot expect supervision of his work from the City of Zephyrhills Suildiag
Departmeat.
6. That prior to final iaspectioa aay additioaal feea, includiag reiaspectioa
fees, must be paid in full. A writtea request from thia office shall
coastitute an official notice to pay additional fees.
7. That the owaer shall comply with all City, State aad Federal laws in 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
Iaduatrial Commiasioa. -
9. State law requires constructioa to be doae by.licensed coatractors. You have
applied for a permit under an exemptioa to that law. The exemptioa allows
� you, as the owaer of your property, to act as your owa contractor with certain
reatrictioas evea though you do not have a license. You must provide direct
oasite supervision of the constructioa yourself. You may build or improve a
one-family or two-family resideace or a farm outbuildiag. You may also build
or improve a commercial buildiag, provided your costs do aot exceed $75,000.
The buildiag or reaidence must be for your own use or occupancy. It may not
be built or aubatantially improved for sale or lease. If you sell or lease a
buildiag you have built or subatantially improved yourself withia 1 year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violatioa of this
exemption. You may aot hire an ualicensed persoa to act as your coatractor or
to supervise people workiag on your buildiag. It is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinaaces. You may aot delegate the
responsibility for supervisiag work to a liceased contractor who is not
licensed to perform the work beiag .doae. Any person working on your building
who ia aot licensed must work under your direct supervision and must be
employed by you, which meaas that you must deduct F.I.C.A. and withholdiag tax
and provide workers' compensation for that employee, all as prescribed by law.
Your coastructioa must comply with all applicable lawa, ordinaaces, building . ,
codes, and zoniag regulations. � -
OWNER�S SIGNATURE / DATE /�i "/ ���J�
ADDRESS
PHONS
WITNESS �✓l� PERMIT # /b ���