HomeMy WebLinkAbout15-16827 r � — � -- -- ----� �
' ' 813-780-0020 City of Zephyrhills Permit Application � Fax-813-786�0021 i
• ` = Bttitding Department
�'/3-���--09a[7
Date Received phone Contact for Permittirt
Ownar's Name \C. r C Owner Phone Number 3 �S(D!%'�d+r"7
—. ... "7
(�',�. ...... ...
pwner's Addrass �(�'�`a" O - �y(j�� � 4wner Phona Number �— �
Fee Simple Titleholder Name A1�� � Owner Phone Number � �
Fee Simple TitieholderAddress
J48 ADDRESS S} �, � ��/LfGd/� LOT# I / i' a-(l
suaaiv�sior� �� � �n�zcEc.i� /t— 3!� t? ' 9!�
(OBTW NEp FROM PROPERTY TAX NOTICE7
WORK PROPOSED e NEW CONSTRB ADD/ALT � SIGN � a DEM�LISH
tNSTALL 12EPAIR
PROPOSED USE � S�R � COMM � i7THER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME C� STEEL �]
DESCRIPTIQN OF WORK � � �1 ' �
BUI1.QlNG S1ZE �� � gC�pOOTAGE� HE1Gtl7 ��
QBUILDING $ ��`�D VAlUATI4N OF TOTAL CONSTRUCTtpN
QELECTRICAL �� AMPSERVICE Q PROGRESSENERGY Q W.R.E•C.
QPl�iJMBtNG ��
QM�CHANlCAL ($ ������� VRLUATfCINOFMC-CHANfCALlNSTAIt.,ATlQN
�_
QGAS Q ROOFINC� Q SPECIALTY � OTHER
FINISHED Fl.00R ELEVATIONS FLOOB ZONE ARF1t QYES NO
BUILDER CQMPANY � ,S�pr' (�L,,,,� ��'
SIGNATURE REc31sT�o Y/ N FEECU Y!N
Address � p License# �C- �56 f.T��
ELECTRIqAN � � CQMPANY —� �
SIGNATURE REGt$TEREp Y J N FEE WRREt+ Y I N
Address License#� ��
PLUNiBER � � CQMPANY �
SIGNATURE REGISTERED Y/ N FEE CURRET Y/N "
Address License#�— �
MECHANICFU. � � CpNlPANY ��
StGNA7URE REGIStERED Y j N FEE CURREA Y I N
Address License# �—� �
OTHER � � COflqPANY �
SIGNATURE RffGISTERED Y/ N FEECURREf� Y/N
Address License#�`� �
IIIIIIIIIi11111L1t111111L11111111i1111111111t1111A1111Blllllllt1111
RESiDENTiAt� Atiach{2}Plot Flans;(2)sets of Buitding Plans;{�)set of Enerc�y Forms;R-O-W Permit tor newcoostruc8an,
Minimum ten{10}urorking days afier su6mittat date. ftequired onsite,Consiruction Plans,Stottrrwater Plans w/Sdt Fence insialted,
� Sanitery Facilities&1 dumpster,Site Work Permit for subdivisionsAarge projects
COMMERLYAI. Attach(2)complete sets of Building Plans plus a Lite Safery Page;(1 J set of Energy Forms.R-O-W Permit far new construction.
Mtnimum ten{10)wortcing days after svbmitta!date. Requ(r�onsRe,Gonshucfion Ptans,Stormwater Ptans wJ S�7f Fence instatted,
, Sanitary Facilities&�dumpster.Site Work Perrnit for ail new projects.Ati commerciai requirements must meet compliance
SIGN PERMIT Attach(2)sets o(Engineered Plans.
""PROPERTY SURVEY required for all NEW construction.
directtons:
Fill out app�ication completely.
awner&Contractor sign back o(application,notarized
IE aver$2500,a Notice af Commencement is required. {A/G vpgrades over$T500}
" Agent(for the contractor)or Power of Aktprney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE CQUNTER PERMITTiNCa (cflpy of contraci req�ir�d)
Reroofs if shingtes Sewers Service Upgrades A!C Fences(PiottSurvaylFoatage}
Driveways-Not over Counter if on public roadways..needs ROW
e � �
. ;
�IOTICE OF DEE� 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.
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 will 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.
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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S. 7.03)
OWNER OR AGENT CONTRACTOR
Subscribe and swom to o 'rmed bef re me this Sub crib d and swom to affirm d before this
l��by � ) � 1��by � �C�''
Who is/are ersonall known to me r has/ha d Who is/are personally known to me or h /have pr
• � ���t�� ' ' ation.
:�'� : ' KATHRIN M ROBINSON
�; MY COMMISSION tl FF236573 '�� �'=
EXPfRES June 02,2919 �� � MY COMMISSION it FF?36573
� 9: •.a,� EXPIRES June 02,2g1g
FwKw.�w:a so•��u+.ca„ N tary Public ..�� Notary Public
, ,� Fk,�idaYua Savr.H.oar
Commission No. Commission No.
� `"4-� . !C���1M.9.2g� '"f' Y 1�,c1 n.; ,�!\ � a�..,_
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
; ,
� ,
�
� �I(T ParcellDNu I� 'Z�o'2��0���' ,�O��17' d��17
o Permit No.
i �
a M NOTICE OF COMMENCEMENT
c�i'' �(a 5 CA
Slaleol �� ���D� Counlyol
a8 4-� _
Y � THE UNDERSIGNED hereby gives nolice thel improvement will be mada lo cartain real praperty,antl in accortlance wilh Chapter 713,Florida Slatutes,
w the follawing inlormation is provided in Ihis Notice oi Commenc1ement:
c�i~a 1 �escriptlon ol Property: Parcel Idenlification No. l 1'7�n'ZI- ooi o- 1�Sioo-019 a
� rj222 �� 4ire�+ Z-e.phy�h�lls, 4=� 335'i�
� E Streel Address:
�
a N� 2, General Descrip�ion af Improvement �� •�d�
o ,
L M
a mN;
� 3. Owner inlormalion or Lessee inlormalion if�ne Lessee conlraclea lor Ine improvement:
w.�-��,
z m �Z
��m 5aa� � S-t�� Z�}��.n1�;Ilx .�c, 33s�1a-
� Address Cily Stale
j�� Interesl in PropeAy: �'�"e r
a.+
Name of Fee Simple Tilleholder: A�/�}
(If diff�m Owner listed above) ,
Address City State
4, Contractor• �A.�A.� �G�4l��
Sg�9 "�r� z�l� Z��.�,,,�,: I� S�f� 335�� �
O1 /� �,�
Conlractors Telephone No.• OI�^ /S�'U9�� Y
5. Surety: �� �3 �
I�,i\llme �l� 3�� 5�
C....
AOdress �. City St2le
Amounl of Bond: $ ��Qr Telephone No..
6. Lender: �I�T
Name
Y Address City State
L Lendefs Telephone No..
�
� "'�
B V 7 Persons within the Stale of Ftoritla designaled Dy 1he owner upon whom notices o�olher documenls may De serveU as provided by
��� Section�1a.13(1)(a)(7),florida Statutes: �/�
• a Name
••a O
U
� �� , Address Ciry State
~� Telephone Number of Designated Person:
N Y 8. In adtlition to himsetl,the owner designales ��� oi_
� � lo receive a copy of�he Lienor's Nolice as provided in Seclion 713.13(1)(b),Florida Statules.
� � Telephone Number ol Person or Entily Designaletl by Owner:
f+1�m
r B N
.-� •\ g. Ezpiration date of Notice of Commencement(lhe expireGon date may not be betore the completion ol construction and final pay�nenl to lhe .
..m�
•a N conUactor,hul will he one year Irom lhe dale ol recording unless a diflerenl dale is specified):
�'��� WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRA710N OF THE NOTICE OF COMMENCEMENT
�p� ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING 7WICE FOR IMPROVEMENTS TO YOUR PROPERT/. A NOTICE OF COMMENCEMENT MUST BE ,
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT ,
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT
Under Nenalty of perjury,I declare lhat I have reBd the foregoing nolice ol cammencemenl and Ihal the facts stated therein are true to lhe best �
uf my knowleclge and Deliet. ,
STATE OF FLORIDA �
� COUNTY OF PASCO
Signalure of Owner or Lessee,or Owners or Lessee's Authorized
� OfficedDirectorlPaAnedManager , I
.�
��
i r, Signalory's TiUe/OHice
� ` -'` �
�
The loreyoing inslrument was acknowledged hefore me lhis��y ol�20 Lyby ��`�'�� �1'1
as �►'1j.r (type ol authority,e.g.,off cer,lrustee,altomey in facly lor
I �• (na e o any on behall of whom sw ent was executedJ.
�
Personally Known�OR Produced Identificalion� Notary Signature
� Type of Identifica6on Praduced ��-��lV�s �.IC-• Name(Prim)
�t�1 r--'- - �'-----
�� �o�';:::°�� JUDITH L SCHAPER
—0� * * MY C4MMISSION 1 EE 877261
�� EXPIRES;June 6,2017 �
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wpdatalbcs/nolicecam m e nceme ntyc053048
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,�� , �}, �TATE OF ELO�ODA, COUR�TY OF ��4SC0
� � • THIS IS TO CERTIFY THAT THE FOREGOING IS A
a `' '. .�'
_���� h e � TRUE AND CORRECT COPY OF THE DOCUMENT
� . ���,� �, . � ON FILE OR OF PUBLIC RECORD IN THIS OFFICE
i,. '� i WITN[ Y HAND OFFI AL SEAL THIS
� '.,.. ��y��DAY OF ` 2 � �
�8°.
� • ���'�''i o ��� PAULA S O'NEIL, CLER COMPTROL
� •. �
� ����� BY _ � DEPUTY CLERK
�
� '
'A_
�
Closing Affidavit
(Buyer) '
Before me, the undersigned authority, personally appeared Richard P. Lynch and Gayle A. Lynch, husband and wife
("Affiant"),who being by me first duly sworn,on oath, depose(s)and say(s)that:
1. Richard P. Lynch and Gayle A. Lynch, husband and wife ("Buyer"), is purchasing the following described property
from JOHN ALLEN ROMAN AND MARY ELAINE ROMAN, AS CO-TRUSTEES OF THE 8th STREET
TRUST AGREEMENT DATED DECEMBER 1,2010("Seller"),to wit:
Lots 19 and 20, Block 168, A MAP OF THE TOWN OF ZEPHYRHILLS, according to the map or
plat thereof as recorded in Plat Book 1,Page 54, Public Records of Pasco County, Florida, LESS the
East 47.00 feet thereof.
2. Buyer's marital status as reflected in this a�davit and the other closing documents is true and correct. The Buyer is of
legal age and has never been adjudged incompetent. There are no matters pending against the Buyer that could give rise
to a lien that would attach to the property prior to the recording of the interests to be insured, and Buyer has not and will
not execute any instrument (nor permit any action to be taken) that would adversely affect the title or interests to be
insured.There are no judgments or liens against Buyer and no bankruptcy proceedings are currently pending with respect
to Buyer.
3. To the best of Buyer's knowledge, information, and belief: (a)within the past 90 days there have been no improvements,
alterations, or repairs to the above described property for which the costs thereof remain unpaid, and that within the past
90 days there have been no claims for labor or material furnished for repairing or improving the same, which remain
unpaid; (b)there are no actual or potential mechanic's, materialmen's, or laborer's liens against the property; (c)there are
no tenancies, leases or other occupancies (oral or written) affecting the property; (d) no other person or entity has any
contract to purchase,option to purchase, right of first refusal, or other potential claim of rigtit to purchase the property.
4. Buyer knows of no violations of municipal ordinances pertaining to the property, or any action or proceeding relating to
the property which is pending in any court, nor does the Buyer know of any judgment, tax lien, or matter of any nature
whatsoever which could create a lien or charge upon the�firoperiy. Buyer has no knowledge of any matters that could or
does create a cloud on the title to the subject property.
5. There are no matters pending against the Buyer that could give rise to a lien that would attach to the property between the
effective date of commitment and the recording of the interest to be insured. Borrower has not and will not execute any
instruments that would adversely affect the interest to be insured.
6. There are no actions or proceedings now pending in any State or Federal Court to which the Buyer is a party, including
but not limited to,proceedings in bankruptcy, receivership or insolvency,nor are there any judgments, bankruptcies, liens
or executions of any nature which constitute or could constitute a charge or lien upon said property.
7. This affidavit is given for the purpose of clearing any possible question or objection to the title to the above referenced �
property and, for the purpose of inducing Meridian Title Company, Inc. and Old Republic National Title Insurance
Company to issue title insurance on the subject property, with the knowledge that said title companies are relying upon
the statements set forth herein.
8. Buyer hereby holds Meridian Title Company, Inc. and Old Republic National Title Insurance Company harmless
and fully indemnifies same(including but not limited to attorneys'fees,whether suit be brought or not,and at trial and all
appellate levels, and court costs and other litigation expenses) with respect to the matters set forth herein. "Affiant",
"Seller" and "Buyer" include singular or plural as context so reGuires or admits. Buyer is familiar with the nature of an
oath and with the penalties as provided by the laws of the United States and the State of Florida for falsely swearing to
statements made in an instrument of this nature. Buyer has read, or heard read, the full facts of this Affidavit and
understands its context.
Pile Number:15-10-22JL DoubleTimem
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� , -- _ .. � , ., � . . : .- . = �� - -
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7`tt�ut�dln$nsd'hefWy csni'�s that.they�have caroWfiy rC�+e�xs!thm C�asing 0`scia�4;er or U.ts�r sc,^:rr.�^�s�r..er:�-z'�.--�;r��.t.-.�p recc;'���^.�a�i;- ; ,
• to ths psyrrunf at s11 i�ts,coat�,a�uutn�aa ana disbursem�ni as�eflareied an 1h�e Cacatng Oacscsara�c.eG^ar�;�ar.-�e�.aza�zr��'-w,�s tv'��.,c�c.::+�:-�� t� - '
t,ti�hslt,l'lfir SurthAr'cs�tityr J�sat us iuqv�recaf�ed a es>py otihc CSasirog Oactosure cs asts�s se��enartt s�*r�.-� . - " . � '
- . • � . . - _ '�; .
"�jLsty� `�t �- ��--^.�� • <�' � ` . _ � � , �
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- .in•th�P�ynn%n!a!ati t�ss.casts,expenses gnd dtsburoemeot as ror�oac�ed on the Clas:ng E�sc�crssue m-�:��sc�ez�=e�c s�'�--a�:,t..�.:�,a;.aac�..n'»�r i. ,
b�,f�alt;W�ftuthtr Ctrfiilt thst we A��e race�+ed�copy�t ttze Ckasirg E}isCiosssrC ck o�F�n3eG�zfcer�s•.a��^.:tr.',: ,,'. .
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