HomeMy WebLinkAbout16-17825 i�
CITY OF ZEPHYRHILLS
• � 5335-8TH STREET
(813)78o-oozo �825
BUILDING PERMIT
PERMIT INFORMATION � LOCATION INFORMATION
Permit Number: 17825 Address: 5629 BEECH ST
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: YINGLING ADDITION
Est. Value: Parcel Number: 12-26-21-006B-00000-0040
Improv. Cost: 2,149.00 OWNER INFORMATION
Date�lssued: 10/12/2016 Name: WULFERT, WILLIAM &ANN
Total Fees: 50.00 Address: 5629 BEECH ST
Amou'nt Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/12/2016 Phone: (813)779-7029
Wor,k Desc: REROOF SHINGLE
'� CONTRACTOR S APPLICATION FEES
HOMEOWNER REROOF RESIDENTIAL 50.00
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'' Ins ections Re ' ed
DRY IN RO F INSP
TAPE JOINTS ROOF INSP
FINAL II
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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
II first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe 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.
"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.
I� NQ OCCUPANCY BEFORE C.O.
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'CONTRACTOR SIGN TURE PERMIT OFFI R
�� PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
ii CALL FOR INSPECTION - 8 HOUR WOTICE REQUIRED
�i PROTECT CARD FROM WEATHER
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813-7810-002o City of Zephyrhills Permit Application Fax 813-780-0021
+ � � Building Department
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Date Received I, . _ Phone,Contact for,Permittin —
Owner'�Namell, �v'1 �l r I��1 i � '�a�.. ���'� Owner Phone Number � : ��� ���
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Owner's Address ��� �� `��� �` � �ner Phone Number - �� '
'I ' Owner Phone Number � �
Fee Slmple Titlaholder Name ' ,
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Fee Simple Tit�i holder Address " '
JOB ADDatES� � c�`"! ���� � �i LOT# C�
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SUBDIVISION�� PAItCEL ID# � "
WORK PROPOSED , •��,NEw CONs7R . `. ADD/AI 1' � SIGN NED FR�OM PROPERTYT�rice)DEMOLISH
� 'e. INSTALL B .. ,REPAIR �•
PROPOSED�USE `-y SFR Q 'COMM ` �] OTHER
TYPE OF CONSTRUCTION � ��'' '�BLOCK ' Q FRAME �-� STEEL Q
�escRi�nori oF woRK �e q�'� T�oo� ��nnoV 2 � r ►.iS�ra.c�� ►��e�.•S sh��g S
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BUILDING'SIZE ; ' �" SQ FOOTAGE��, . �.HEIGHT
QBUI�DING $ n ` L1 O� ° VALUATION:OF TOTAL CONSTRUCTION �
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�ELE�TRICAL ,, $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPL��BING $ - ' �
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QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION , I �
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QGA Q RO.OFING .Q �SPECIALTY Q OTHER� �J ���
FINISHED FL�OR ELEVATIONS FLOOD ZONE AREA QYES NO r/
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BUILDER �JV,'� L/�
SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
Addre�s � � Llcense# '
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ELECTRICIAN� � �'COMPAPIY� - �
SIGNATURE ' �` REGISTERED Y/ N FEE'CURRE� ' ` `Y/N
Address � ` : . � �, / License# .�
PLUMBER COMP,,ANY � �
SIGNATURE' , REGISTERED Y/,--N .FEE CURREk Yr/N.
Address' � �Llc:ense# � •
MECHANICAL - , COMPANY
SIGNATURE , �}- ' ' ' � REGISTERED � Y,./ N , FEE CURRE� Y,IrN :
Address ' - � , � �` ` ` `� � ' - � -, � � Cicense# ' .
OTHEIt � . .� � - . , ` �,'COMPANY - .
SIGNATUI2E^'"• � � �- �f ' " ' ' "' `REGI$TERED Y/ N_.� FEE CURRE� Y/N
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Addreas' � -' ��, = '' ,-� . , - � Cicense# .
RESIDENTIAI�,a<. .Atta'ch;''(2)�P:,lot%P:,lans;..;(2)sets�-of=Building Plans;`(1)set of�EnergyaFoRns;�R=O=W'Penrilt for new constructlon,
„ ,,;A.;-MinimumEtep;(1:0)„worliing;days afterrsubmlEtal date.:�;R`equi`retl onsite;<ConsUucdon=Blans;�Stor'mwate��Plans w7 Sflt Fence instelled,
4�SanitaryFacillUes,8r.l�dumpster,�8lte;Work,:P...ermit;forsubdivisions/largeprojects;; •: �• " '" ' � � "�
COMiNERCIA��. Attach(3)complete set's`of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R O-W Permit for new-construc8on.
�' Minfmum ten(10)warking days after submittal date. Required onsite,Con'sUuction Plans,Stormwater Plans w/Silt Fence installed,
I� Sanitary Facilitles&1 durnpster.Site Work Permit for all ne�wprojects:All commercfal requirements,must meet compliance
SIGN PERMI�I Attacfi(2)sets�ofEng,i;rieered�Plans.;::�•��.�-- . : _ �-� .. • ' �
""PROPERTY SURVEY required for all NEW construcUon..
DlrecNons: � .-��.��}°'.` � ,
Flll out applicaUon completely.
Owner BI�Contractor sign back of applfcatlon,notarized
If over 52500,a Notice of Commencement is required. (AIC upgrades over�7500) - �
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Agent(f II the cantractor)or Power ofAttomey:(fo��ttie�owner)would be someone with notarized letter from owner authorizing same
�VER THE CiOUNTER,P.,ERMITTING,..' �-`(Front of Application Only)- t, 4 �`1 , , . ..�_. , ._ .
Reroofs if shi�gies Seweis l � Service Upgrades.A7C ;:�� Fences(Plot/Survey/Footage) _ _ ; ' , ..
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Drivewaya-Not over Counter if on public roadways Yneeds ROVV t. ,, . ,
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NQTtCE t?F DEEQ R�STRICTIANS: The ur�detyslgaect understands;th�t.thi�>p�rmit=.may,Kbe;sub�ect.ta_"deed"wresfricNons"r.. .s� �`:
which may�,be�rr�ore°r.�s#Flctive�-th���CountyFfegulatCons:'The�under�igneid'assumes�resjionsidillty�for campliance v�►ith�any"'�` '�� " '
app!lcable.d�ed restricBiac�s. ;:.�-�.;- �,:.. ,: ` • . .,. ., ., .j
UAfLICENSED�CONTRACTORS AND -Ct3N#RACTOR RESPONSIBILITIES: °if=ttie�owner�hasYfiired��a-`.caintrac#ar or ^
contractors to undertake work,-they m'aay,be�req�rlr;ed:tq.;be;licensed In.accnrdance.vKith:st�#e.and�lacal:t?�gulatlons:,�If the°���'� ��a`��`
contractor�ts nat (lcensed=as�requtred`!iy law, �botirthe owner arid'�contractorz�may�be��cited�for°.a misdemeanor vlalaftan
under state law. If the awner or Intended�contractor;•,ere,uncertaln as t6 what Ilcensing.requlre�nents.;may-,appiyr�for.�the�--, ��-•;����`
fn#ended work�"they are ad`vtseii to+coiitact t�ie.Pasco Cauntyw8uitiiing°lrispe4#ton:Dtvlsta�ty-t:lcensing Sec#fon et 727-847-
8009. Furthermore, tf the vwner�'has�`hired�'a coniracto� iir contractors� he is advlsed ta have �the contractor(s),sign: .
portlons of the."cantractor Block°.of.thls.applicatlon fac.,which they,.wilL.be,resp.onslble.:.-ff:=you,.as:the owner'�'sign`�as'�ttie " � � �
contractor, that�tnay be an Indication that�'he=is not`.prope�iy llcensed�ai�tf`�is'no#ent�led to permlttliig�privlleges in Pasco
County. - ' � - . . __. __ , � �. . ��
TR.ANSPC�RTATIt?N-IMRIo►CT1UTtE:iT1ES 1NlPA6T�ls►1��!�tE3QURCE RECQVERY�fEES;�-The�unde�sigited anders#ands
thatTransportatlan Impact Fees�and.Reca.ur�e RecoveryrvFees may�apply:to�t(�e;constcuctlon of new_buildings�.�change�`of��•"� ���=^`��
use in existing bulidings,�or��.expamsidnrof-3existi�i�'�buildings� as specifled.'in Pascq County Ordlnancs number 89-0? and
90-07� as amended,.;The undersigned atso:understands, that`-such fees;°;as,-mayr�e�:dne;;wiii�be identified at the}time='of`d� .:;.- >.
permitting. It is furtFier understaod that Transportatlon Impact�Fees and°Resource_,RecoVery�Fees:.must be pald pria�to
receEving-a.•certificate�of=occupancy"oc�in�l�power.�elease.• =4��the.proj�ct:cloes:iio#Involve<s`:certific�te of occupatticy�ti���::.} ':_.`:;;
flnal power-release;.the�,fees=mu�t be paid p�lor to;permit is�uance. Fu�thermore;�tf:Pasco;�County"1Nate�/Sewer.�:lmpact , •� ���,°.�<
fess are due�..theyrmust-be-pald:.prtor ta permlt:issuanc+��:ln ai:cordance.wlth:appllcatite-<Pas�co'�County=drillnances. •
CONSTRUCTION'tfEN"LAUV'(Ctiapiter T13�Flor�da State�t�s,as ameededj: if valuaflon af work ts$2,500.00.,or more,.I� :;. =--::
certifiy tfiat I,-�he applicant,. have:.been proylded with -a=capy-of�the�"Florida��Consttuctton� Llen=.Law—Hameowner's
Protectton Gulde" prepared by tlie"Fioi�da Depattment�of Agriculture and Cansum,�r�Aftatrs. If#he applicant 1s someone • •,,�
other than the'owner", 1 certlfy that I have:ob,tained�a'copy;of:the;abave.riescrlbedtloauinent=and:promise�ln,g�od_faith,.to .. ��
deliver It to:the�'owner."=pdor:-��ta�coriamiencemerit:�' ", . , . � - , _ �
CONTRACTOR'S/OWNER'S AFFIDAViT: 1.ce,�klfy.;tti;at�all�the�,lnf.ormaticm:,ln�tht�appltcatlon is ac�urate�nd that all work
will'be done in compl(ance with all.appllcable laws regtilattng oonstructlon, zoning and��land°development. Appllcatlan Is
hereby rnade ta ob#aln..a perm�t�:ta;da, work;;and•-lnstaltatlon as Indt�ated:��-.�1� certifiy"ttiat no wark�or instaltation�Fias
commenced prlor to Issuance oP'a perrriif'and #hat�.all work will be perfarmed�to meet.standards�of all laws regula�ing-
constructlon, Gounty and Clty cades, zvning regulations, and tand de�elopment r.egulations�fn tl�e J�rlsdtction._ !-a1'so .
certlfiy lhat I u�derstand that the regulattons of ather gavernment agencles may�apply�;to the..lntended.work, and that it is
my responstblf#!y to Iden#ify�what.acttons 1 must�kake:to besln:.cotr�p!lance:..S,u�h..agencles-Include�but=are-.nat lfmited to: � -
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- Departmen# of Er�vironmentat��Protection=Cypress.�Bayhead�, WeHand Aress and Erntronmentally Sensittve
Lands�WaterNVastewa#er Treatment. � � '
- Sau#hwsst Flortda W�ter Management�:�C3istrEct:lNells;'��Cypress.�Bay.�eads; Wetiand Areas� Altaring
Watercourses. � . " ' �
- Army Corps of Englneers=Seawalfs�'bocics�Navfgatile Watexways.
- Department of Health,.;.S,.Ret�abilitative;,Servtces/EnvPtonmentai•Nealth Unit Well.s; Wastewater Treatment, - �
Se�tla Tanks:._, : : , . . • , _., �.._ _. .:.
- US Envlranmental Pratection Agency-Asbestos abatement. . � ,
Federal Av.lativn.Autk�orlty=Runways. �
1 understand that the.foltawing:�t�estrictlons apRly to the use of tll1:
- Use of fip Is not a0owed In,Fiood:Zo,ne"V"unless expcessly permitted.
- If the .fllf materlal=ls to"6�.e usetl:.`In :Flood Zone. "A", It Is understood that a dralnage pl�n address(ng a
"compensating volume°will be submitted a##ime of:permttting wraich ts prepared by a prafessional engineer
Ilcensed by�he State of'Flo�lda: � �
- If the f10-materlal�.ls to be used In Flood �one "A" Itt�connecffon�vfti#h�a.�ermltted builcti�tg using stem wa}I
' oonstruclton, (certify th.a#fill:v��ll.be-used only�to.fll)the area within the�stem�wall: �
- If fflt materlal is to be used In.ariy area, ! cetklfy that .us�t. af such flll wN# n�t adversely affeat adjacent
propertles. If use of fit) is found�.to advers�Fy��fiecf adJaEent�prc�perties�.the owner may be cited for viora#ing
the cond�ions.of the bulld(ng;perrrilt I§suetl�under the.-attacHeid_permlt �ppllcatlon, for.:lots.less,.than.one (1)
acre whlcFi are etevated�liy flli;a�t englneered dralnage ptan is requlred. .
If I am the AGENT FOR THE�OWNER; I;promise In.good falth to Infarrra the owner of-#he permltting condftlons set forth In
thts aff�davit`prlor to coinmer�cing constructlon. 1 undet�tand thst a=s�parate petmlt rnay be requtred for elect�tcaFwork, . .
plumbtng, signs, welis,,poots;, air conditioning,-,.gats;_or other. install'�itions not.spec�tcatly included•in:the�apptication. A .
permft Issued shall be constnued to'b'e�a�Itcens�`ko proceed wtth'tNe.�work and-not�as authority to,vlolate;�'cancel; alter� or
set�side aiiy provistons of#he#echalca#-cod�s;�nor shell issuence�of a.permtt.pr.event the 8u11dlrig O#flctal from Ehe�ea#ter
requlring a.correcNon nf eRors in•plans; con§tFuctlan.or vlolatlons of�any cades. �very pertnlC lssued:sfiall become invalid
un4ess ihe work authortxecf.by such permft:3s-cornmenced�wlthln si�c,months of�permlt fssuance� ar If wark authorized by
the permtt is suspended�or:abandoned-for a;period�of�si�c�t�)monftis,:after.the tlt�te the�wo�k��is commenced. An extension
may be requested� In writing�from#kie:�Bullding,Offlclal for a peNotl��not.to exceed=hinety=(90)��days a�d�virlll`demonstrate
justitiable c�use for-�the extenslon. (f work ceas+�s,for ntr�et�r.(90}cons.ecutive days,_th�f ab�is consfdered aba�doned. .
WARNING TO ClWNfR: YOUl�-FAILURE,T4,.RE,CCt�i�A::N4TIGE:OF=�C4MMEMCEMENT:MAY�RESULT 4N�YOUR
PAYING T1N'ICE;�OR:IMPROV'EMEAt�'S TU.YOUF�<PRLIPERTY:�1�°YOtJ=1N'�E�D:TQ'�G�BTAIN��FIPI�I��1NG;'CONSULT
—_1l11lT _. - U�t- D �Q. �#N_�1�_ O N FC?RE� -OR�@ f=' OUR` �;C "C� '- ,. . E � T• _' _
FZORIOA JURN►;{F.S:1.1 TA3} �- , . - , . , � .
OWNElt OR AOENT , �`���� CONTRAGTO '
Subsalbed and svwm ta(or aifirrr�ed)betore me ts Subscrl6ed and'swom=to(at�af�tm�drbefore e'Uii�;
by W�n c �.0��.F�.cz.� •by 1�1�r(I c�_ u1����,�2:-' .
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W�jp Is/a ersonally,knevm ka�me onhas/have produced Who s/are p r�o alty kn vqn�kn me or haslheve produced :
�!{�t�t.:�S`L�`�ao�i as tden�RcaHP�• � � � ����f lci�.-�1�2_ as ident�€cattan.
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� '�- No Publlc . "' '''"�-� Nofa Y PubUc
� �Zt,,, tary �Y ,
Cn Sss n Com ss .No � .- '�.. M
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,.�;�i�'eG�f�, JACQUELINE BOGES �,,� R= Commission#FF 150422
Name of NotarY tYP € � :�` Name af Riotary type _ ,.," �
t��, �_ � ecem6er 12�2d�$ � '.n; .. tuu Tm,i�ain insu.anca 800-385-7019
�,�,�rq,�� Bonded Thru Troy Fein Insuranca ED0�385•7019
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�' DISCLOSURE STATEMENT FOR QWNER
� CITY OF Z�PIiYRHSLLS BIIILDSN� DEPAR.Ti�`N'.P
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z� � have r�ad aad fu21y uaderstaad aad
agree ta the provisioas of this instrument.
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The uxzdersigned sta�es aad affirnts that he or she is desiraus of constructiag,
reaovating, addiag �o ox reraofiag his or her owa domicile, that he or she
actiia3ly occupies, or wi21 oecupy by �said domicile, aad same is uot for
reat, lease or sale. That he or �he shall comply with the followiag coadita.ons:
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l. E'That the awaer and l�e or she alane shall aat as the builder fax a12 phaees af
��caastructiaa.
2. lTk�at the owaer will eomply with all provisiaus af the City of Zephyrhill.s
ordiaances aad codes pertiaen� to the build3.ag.
3. That in the evexst va.rious phaaes of construatioa are subcontraeted, he wi].1
eagage anly praperZy lie�ansed subcontractors and will pereoaally supervise
such work.
4. That ia the evettt the Bui2diag Iaspectar shall zequire carr�etiaas to be made,
th� owaer will assume full respoasi.bili�y to insure they are made, aad upon
comple�3on w311 aall for a reiuspectian befare praeeed3.ng with the building.
5. That the owaer .shall assvme full respousibility �or �he coastructioa and will
' no� expect supervisiaa of his work from the City of Zephyrhills 8uilding .
Departmt=at. `
6. That prior �a fi,aal iaspectioa aay additioaa7, fees, iacludiag reiaspectian .
feesr snust be pa3d ita full. A writtea xequest from this affice shall
coao,stitute aa official notice �o pay additiaaal fees.
7. That the owner shall compl� wi�h a11 City, State aad Fecieral laws ia rsga�d ta
social seeurs.ty, workman's compensatian, Iien Iaws, etc. , where applicable.
8. That the owaer shall comply wi�h all the safety codes issued by the Florida
Iadustrial Commiasian.
9. State law requires coastructioa to be doae by licensed coa�ractars. You have
�applied for a permit under aa exemption to th�t law. The exemptioa allows
�you, �s the owaer af your property, ta act as your owa coatractor with certaia
restric�iona even though you do aot have a licease. Yau must provide direct
aas3.te supervisioa of the coaetruetion yourself. Yau may build ar improve a
oae-fam3ly or twa-fam3,ly residet�,ce ar a £arm outbuild3ag. Xou may also build
or improve a commercial buildiag, pravided your costs do aot �acceed $75,OQQ.
The buildiag or residenc� must be far yaur owa us� or occupancy. I� may aot
be built or substaatially improved �'or sale cr lease. =f`yau sell ar lea�se a
bui3diag you h�ve bui2t or substantially .imgzaved youreeZf within.l year aftet
�the construction is cample�e, the lav�r wi11 presume that you built or
substanbatally imgraved if for sale or lease, whieh is a vialation o� this
exemptian. Yau may no� hire an ualicensed persoa to aat as your coatractar or
�to superviae peop].e working on your building. It is your reapoaaib3.lity to
make sure that peaple emgI.oyed by yau have liceases required by state la�r and �
by aounty or muaicipal liceasiag ordinaaces. You may aot delegate the
sespaasibility for supervisiag wark ta a liceased contractor who is x�ot
�liceased to perfarm the work being doae. Any pereoa worki»,g on yous buildiag
��who ia aot liaeased muat woxk under your direct supervisios: and must be
employed by you, which meaas tliat you must deduct F.I.C.A. and withholdiag tau
�and provide workexs' compensation far that employee, all as prescribed by law, ,
Youx constructioa must comgly wath a1Z apgliaab2e laws, ordiaaaec�s, bui3diag
- codes, and zoaaing r atioas
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Oii1ATERj S STGNATURE DATE � �►�t�Z.( ZO��A
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iADDR8S5 "Z„ . �a �
�� HONS �� '�7��""'t. ^� �+�e� �� .. .
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