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Home My WebLink About16-17627 CITY OF ZEPHYRHILLS �' � 5335-8TH STREET ' �sis��sa-oozo 17�27 PLUMBING PERMIT I PERMIT INFORMATION LOCATION INFORMATION Permit#:1�1627 Issued: 8/03/2016 Address: 5111 6TH ST Permit Type: SEWERLINE REPLACEMENT ZEPHYRHILLS, FL. Class of 1h�lork: SEWERLINE REPLACEMENT Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: Book: Page: Cost: 200.00 Total Fees: 46.00 Subdivision: CITY OF ZEPHYRHILLS Amount Paid: 46.00 Date Paid: 8/03/2016 Parcel Number: 11-26-21-0010-18600-0050 �ONTRACTOR INFORMATION OWNER INFORMATION Name: HOMEOWNER Name: RUSINEK EDWARD & MARIA LIV TR RU Addr: Address: 35549 STATE ROAD 54 ZEPHYRHILLS FL 33541-1947 Phone: Lic: Phone: 813-788-8801 Work Desc: REPLACE SEWER LINE APPLICATION FEE SEWERLINE 46.00 ` � " INSPECTIONS REQ IRE � ' FINAL I �/ ' / � REINS�ECTION 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 impro�rements 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 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 ' s1s-7� �a2o City of Zephyrhills Permit 1�pplication Fax-$13-780-Od21 °' Building Department Date Received ` � � .�� phone Contact for Permitting ,.J �p�Y�� -�t�'-��36�.�"o6 ��Pit�"��fri r " � Owner's Idame ��G!`G�Y ��/y'��=�,. Owner Phone Number r��" r�i'�� Owner"s Address .�lj�` �6� ��`�'�'�L � Owner Phone Number �G"'��361,��6/ � Fee Simpte Tittehblder ldame C- � Owner Phane Number � � Fee Simpie Titteh�tder Address JOBADDRESS �i /,�! -�� .S^ " �Y� ' t'�-� 3�1c(�lfL LOT# SEIBD1VtStQt� � � PARCE�ID# / (OBTAINED FROM PROPERTY TAX NOTICH) WORK PROPOSE� , NEW CONSTR ADQIALT � SIGN � Q DEMOLISH e WSTALL 8 REPAIR PROPOSED USE � SFR Q COMM � QTHER 'fYPE OF COPVSTR� CTION Q BLOCK • Q FRAME � STEEL Q DESCRIPTION OF�IVORK /i��I�RCld�IfZ�i�ll��U��tLL �ZGt�U�'GiI�'-'t�It`/1 �� i C�I�tl�S Cf'Gl �✓I$ .Q BUtLD1NG SIZE �� SQ FOdTAGE �f� HEIGHT I�'� �� OBUIl.DIN � � VALUATION�OFTOTAlCONSTRUC710N QELECTR! �AL � � AMP SERVICE O PFtC7Gf3ES8 ENERGY Q W.R.E.G. OPLUMBlN� $ ��r�� [��12u�'` J �MEGHANI AL �> --� VALUATiON QF{Vi�GNANlCAi.INSi'ALLATION �GAS Q RQOFING Q SPEGIALTY � QTHER FINISHED FLOOR EiEVATIONS �� FLOOD ZQNE AREA DYES NO �UllL1ER . � CO�RPANY SIGNATURE � , ,, REGIS7ERED Y/ N FEE CURRE� Y/N Address � License# �� ELECTRICIAN C4M PANY SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N Addrass � ` ` License# �� ' � PLi1MBER �,11 2�� / �j�l�, COMPANY SIGNATURE G`f�� REGISTERED Y/ N FEE CURRE� Y/N Address �1��-U7�G�ff'< Z?�''��/S'�� License# �� -� 44tECHRAlICAC h COMPAt�tY SIGNATURE' � REGIS7ERED Y/ N FEE CURRE� Y/N Address License# �� OTNER y GOMPANY SIGPIA7URE � REGISTERED Y/ N . FEE CURRE� Y/N Address License# � `� EStDEAiT(AL Atta h{2}Ptat Plans,{2}sets af Bu1lding Ptans;{1)set af Energy Farms;R-O-W Permit for new constrtaction, Mini um.ten�(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence installed, Sani�ary,Facilities&1 dumpster;Site Work Permit for subdivisionsllarge projects OMRf1Ei2CIAL Attach�2}campEete sets of Bu�lding Plans ptus a�ife Safety Page;{1)set of Energy Forms.R-O-W Petmit for new cons#ruction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit foi al!new projects.AU commercia!requiremsnts must meet compiiance tGM PER�IT Aftac�{2}sets of Engineered Pians. '"'"PROPERTY SURVEY required for all NEW cpnstruckion. irecfians: � Fill aut application c,ompletely. Owner&Gontractor�Sign back af apptication,notarized tf ovee$250d,a Mof�ce of Commencement 9s required. (AIC upgrades over$7500) Agent(for the contrali tor)or Power of Attomey(far the owner)would be sameone with natarized letter from owner authorizing same VER THE COUNTER P�RMI'i'TIPfG (capy of cantract required} eroofs if shingles S�wers Service Upgrades A/C Fences(Plat/Survey/Footage) Driveways-Not over Counter if on pubtic roadways..needs ROW -- ��:w.:��:�� MOTICE OF DEEQ RESTRICTIOfdS: The undersigned under.stands that this permit may be subject to"deed" restrictions"� which may be more�cestrictive than Caunty regulations: The�undersigned assumes responsibitity far compliance wi#h any applicable deed restrictions. �� UNLlCENSED CONTRACTORS AND CONTRACTOR RESP�NSIBILITIES: if the�owner�has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance wifh state and iocal ceguiations. If•`the contractor is not licensed as required liy law, both the owner and�contractor may be cited for a misdemeanor violation under state law. 1f#he owner or intended can#ractor are uncertain as to what iicensing requirements.:may;appiy for..#he� � intended work, they are advised to contact the Pasco County Building Inspection`Division-Licensing Section at 727-847- 8QQ9. Furtherrt�are, if the owner has hired�a contractor or contractors, he is at�vised to =have #he can#ractor{s} sign portions of the "con#ractar Blocic" of this application for which they will be cesponsible. If you, as the owner sign as the contractor, that may be an indication that he is nat properly licensed and is nof entitled to permitting privileges in Pasco ' Caunty. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECCIVERY FEES: The undersigned understands 'j that TranspartatEon Impact Fees and Recourse Recovery Fees may apply to the construcfian of new buildings, change of use in existing buildings, ar expansion of existing buildings, as specified in Pasco County Ordinance number $9-07 and II) 90-07, as arnended. The undersigned also understands, that such fees, as may be due, will be identifieci at�ttie time of permitting. I# is further understood that Transportation Impact Fees and Resource=Recovery Fees must be paid prior to receiving a "certificate of occupancy" o�final power release. If the project does not invalve a certificate af occupancy ar.� final power release, the fees must be paid prior to permit issuance. Fu�thermore, if Pasco Caunty WatertSewer Impact fees are due,they must be paid prior ta permit issuance in accordance with applicable.Pasco Coun#y ordinances. GQNSTRUCTIQN �tEN LAW(Chapter 713, Florida Statutes,as amended}: lf valuatian of work is$2,500.04 or more, t certify that I, the applicant, have been pravided with a copy of the "Florida Cons#ruction Lien Law Homeowner's Protectian Guide" prepared by the Flarida Department of Agriculture and Consumer Aff'airs. !f the appiicant is someane other than the uowner", 1 certify that 1 have abtained a copy of the above described document and pramise in goad faith to deliver it to the"owner" prior to commencement. CONTRACTt?R'S/t?WNER'S AFFIDAVIT: 1 certify thaf aH the infarmatPon in this applrcation is accurate and that atl 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 da wark and instalfatian as indicated. 1 certify thaf no wark or instaftatioh has commenced prior ta issuance af a permit and that all work will be performed to meet standards af all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdic#ion. ! also certify that 1 understand that the regulations af other government agencies may apply fo 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 af EnviranmentaE Pratection-Cyp�ess Bayheads, Wetland Areas and EnvironmentaRy Sensitive Lands,WaterMlastewater Treatment. - 5outhwest Florida Water Management District We!!s, Cyptess Sayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Dacks, Navigable Waterways. - Department of HeaEth & Rehabiiitative ServiceslEnviranmental Hea{th Unit We11s, 1Nastewater 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 allawed in Flaod Zone"V" unEess expressly permitted. - If the fill material is to be used in_ Flood Zone "A", it is understood tha# a drainage plan addressing a "compensating volume° will be submi�ted at titne of permitting which is p�epared by a professional engineer licensed by the State of Flarida. - If the fll materia! is to be used in Flaad Zone "A° in connection with a permitted building using stem wall construction, I certify that filt vuill be used anly to filt the area within the stem wali. - If fill material is to be .used in any area, I certify that use of such fill will not adversely affect adjacent properties. tf use of fi11 is€aund ta adversely affect adjacent praperties, the owner rnay be cited for vialating the conditions of the building permit issued under the attached permit application,.for-lats less than one (1) acre which are elevated by fi!!,an engineered drainage plan is required. tf I am the AGENT FOR THE OWNER, ( promise in good faith to inform the awner of the permitting canditians set forth in this affidavit prior ta commencing constructian. 1 understand that a separate permit may be required for electrica! work, ptumbing, signs, wetls, paols, air conditioning, gas, or other`iristallations nat specifica(1y inciuded in the application. A permit issued shall be construed to be a license to proceed with the work and no# as authority to violate, cancel, alter, ar set aside any provisions of the technical codes, nor shall issuance af a permit prevent the Building Official from thereafter requiring a correctian of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the wark authorized by such permit is eommenced within six months af permit issuance, or if wortc authorized by the permit is suspended or abandoned.for a period..of six(6}manths affer the time the work is'commenced. An e�ctension may be requested, in wri#ing, from the Building Official for a period not to exceed�ninety (90) days and will demonstrate just�able cause far the extenslon. If work ceases for ninety{90}consecutive days,the job is considered abandoned. WARNlNG TO OWNER: YOUR FAl�URE TO REGQRD A NQTfCE OF COMMENCEMENT MAY RESU�T IN YOUR PAYiNG TWICE�OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU�tNTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR MOTICE OF COMMENCEMENT. , FLORtDA JURAT(F.S. .03) .__ _ l -""-"--�`— _ _. _ -- - - __ _ ----� r �- _ —. - -- — » _�___ _—_ �� ,� �� ___ - � S bsc 6ed and swom to or affitmed be CONTRACTOR { } fare me this Subscribed and swom to(or a#f'imted)before me this by by Who is/are personally known to me or has/have produced �� Who is/are personally known to me or has/have produced as(denfificaUon. .t=, as identificatlan. Notary Public Notary Public Commiss9on No. Commisslon No. Name of Notary typed,printed or stamped Name of Natary fyped,printed ar s#amped .+ . S 'y , DISCLOSURE STATEI�NT FOR OTa'NER ' CIfiY OF ZBPAYItfIII,LS BiT2LDI2+TG DI:PARTMENT I, � have read aad fu3.1y uaders�and and agree to the provisious of this instrument. The flersigned �tat�s aad affirms that he or sh� is desiraus af canstructing, reao ating, adding to or xeroofing his or h�r owa domicile, that he or she ac�u lly accupie�a, or will occupy by saa.d domici2e, aad �ame is aat for reait� lease or sa1e. Tha� he or she shall comply with the folZowiag couditious: 1. at the owner aad he or she aloae shall act as the buiZder for all phases of oaetruction. 2. hat the owa�r wi1Z camply with all pravisions af the City of Zephyrhills � rdiaaaces aad cades pertineat �o the buildiag. 3. ha� in the event various phases of coasGructioa are subcoatracGed, he wi11 ngage auly propesl.y 2icensed subcoutractors aad will persaaally supervise �ueh work. � 4. T�ha� ia the event the Buildiag �nspector sha21 require carreetiaas to be made, t�e owaex will assume full respaasibility to a,asure �they az�� made, aad upaa completioa wi11 eaZl for a reiaspec�ian before praceeding with �he buildiag. 5. �a� the owaer shall assume full reaponBibility far the coaa�truation aad will aot expect supervisioa of his wark from the C3ty of Zephyrhills Suilding Departmes�st. 6. T a� priar �a fiaal inapection aay addit3anaZ feea, iacludiag reiasp�ctian f es, must be paid ia full. A writtea reguest from this ogfice shall c astitute an official aotice to pay add3tioaal �,f�es. 7. T a� the owaex shall camply with all City, State aad Federal lavas ia regard to s ei.al security, workman's campensation, 2ien laws, ete. , where applieab2e. 8. T at the owaer sha11 comply with all the safety cades issued by the Florida I dustrial Commisa5.oa. 9. S ate law requires coastruction to be doae by liceased coatractors. Xou have a pli�d �or a perm3t under aa e�s,emptioa ta th�t law. The �acemption allows y u, as the owaer of yaur pzopezty, to act as yaur owu coatraetaar with certaia x strictioas even though yau do aot have � licease. You must pravide ditect o site supervisioa af the coastruction yourself. You may build or improve a o�e.�amixy or two-family re�ic�etsce or a E'arm autbuildiag. You may also build a zmprove a commercial builc3ing, provided your casts do not exceed $75,OQ0. T�e building ar residenc� must be for your awa use or occupmacy. It may not b built ar aubstaatially improved for sale or lease. If yau sell or leaee a b i3.diag you have built ar substaatially i.mproved yourself withi�a ]. year after t e coastructioa is complete, the law will presume that you built or s st�atially impxaved if for sale or lease, which is a vialatian of this emption. You may ao� hire an valic�nsed persoa �o act as your coa�ractar or t supervise people workiag on your buildiag. It is your respoasibility to m�ke sure that peapZe e�ployed by yau have I3.censes required by state la�a aad b ' caunty or muaicipal liceasiag ordisaancea. Xou may aot delega�e the r�spoasibility for supexvisiag wark �a a licensed coatraetos krho is aot 1'censed to perform th� work beiag daae. Any persoa workiag oa your buildiag w o is aot liaensed muet wotk underyouur direct supervisioa aad must be ployed bg you, whieh meaas that you must deduct F.I.C.A. and v�ithhoZcliag ta3c ar�d provi.de warker�' compensation for tha�. employee, all as prescribed by 1aw. Yo�ur eoas�ructioa must comply wi�h all app2icable 2aws, ordivaaces, Yiui3diag � c des, aad zoaing regulatioas. � 1s�lU'�� t(�'i''�-- I7ATE ' � ��l j;/ O R'S SSGNATURE AD RESS -` 3�'ZZ P OZdB 'S .3�'-.I�� Tn�2 SS PSRMIT #