HomeMy WebLinkAbout16-17851 . • CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 17$ �
BUILDING PERMIT �
' -� PERMIT INFORMATION LOCATION INFORMATION
Permit f�umber: 17851 Address: 5116 17TH ST
Permit Type: ACCESSORY BLDG. ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Propos�d Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-20200-0140
Improv. Cost: 8,955.60 OWNER INFORMATION
� Date Issued: 10/25/2016 Name: BURDGE, PATRICIA
Total Fees: 120.00 Address: 5116 17TH ST
Amount Paid: 120.00 ZEPHYRHILLS, FL. 33542
Date Paid: 10/25/2016 Phone: (813)319-1000 ,
Work Desc: 612 SQ STEEL GARAGE .� 4.
li CONTRACTOR S APPLICATION FEES
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HOMEOWNER BUILDING FEE 120.00
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� Ins ections Re uired ,
FRAME �
SHEATHING
FINAL I �1
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REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local g'overnment 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 maybe additional restrictions applicable to this property that
may b� 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 pertormed in accordance with
' � City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
j NO OCCUPANCY BEFORE C.O.
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CONTRACTOR SIGNATU 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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City of Zephyrhills
I BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: C( ��C �'�l � J
Date Received: � (�-�- � �—I,�
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Site: , `S 1 �� l',��
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Permit Type: S � �2 S '�_��
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Approved w/no comments:❑ Approved w/the below comments: Denied w/the below comments: ❑
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This comment sheet shall be kept with the permit and/or plans.
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Kal Swit r ans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
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R!•yite3;iN!'A7�D'Y,eruin R�qalctl3`l14gh1Dlff�tente GOIII�AUOUS$�1�0°n�
Requ�t�4'Ilt,yhlDlfftttnt3
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�lorida Pro
duct A roval Codes
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Roll-Up Doors: -
' Janus International Corporation Model 3652: 14425.1
Janus International Corporation Model 1100: 12765.1
' � Janus International Corporation Model 1100: 12765.2
Janus International Corporation Model 750: 12765.5 ,
Janus International Corporation Model 750: 12765.6
Janus International Corporation Model 750: 12765.7
Janus International Corporation Model 750: 12765.8
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Walk-In Door:
� Elixir poor& Metal Company blank (no window): 17996.5 ;
Elixir poor& Metal Company with 12x12 window: 17996.5 �
Elixir poor& Metal Company regular door w/9 light window: 17996.6 �
' Window:
'Pocahontas Aluminum Company Inc.: 12940,2
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Ra.of Deck:
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Capital Metal Supply Inc. Ag Panel: 20147.1 �
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Well Panel:
, Capital Metal Supply Inc. Ag Panel: 20148.1 '
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If you have any questions on concern, please contact Donald Little at ,
38�6-961-0006 or at tubularbuildingsystems@gmail.com. �
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, site�;�ili he free ul heilges;(I84S;048(Iln'ut�Iimcs,spr�nhi�r h�a�:is,ssp;ic tanl:s,dr�.in fi�lds,undar- '
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yr��und E?ipes.�;�alef li��s.utilily iines.gas lines.{!ho�ie lines.12nCes u;olh�r o!�s{�ucii�ms.Tubul:t�
Buildin�Syster�Zs, LLG,an;i its�g��nis aiici arru�lo;'ae,shr,ll nol be res��ansil;le inr any dani:�ga to
tha installation site.Tne[iuyer is sol�ly respun�itde(or obtaining any iequired ga��ernmenl licens•
iny,perniils or apprcvaL Fiorid�inst�ilalions ar�pertorn�ecl Uy Doti Litlle Conslruclio.n F Raufiny
Inc..CBCi260286,CCC1330420
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i DElIVERY:Tutiular Building Systems,LIC,�grees to deliver the purchased merchan�iise to the!o-
cation speciiied atiove.Buyer agrees that no signature is required by Buyer as delivery coniirm�lion
unless:agreetl in advance iri writing by Bu}ier and Selle�.Delivery dates specitieci are desired and '
�not,promi§ed daies,howe'ver,Seller��rill make all reasonable efforts to adhere to lhe delivery dates
furnished by the Buyer.Sellershall not be liable(or any damages,loss'or expense ot the Buyer for ;
� ' i lailure to comply with any stiipping or deliyery dates br any reason tivhatsflever. �
,
PAYfifiENT:8uyer.�agrees to purchase the merchandise described above at the price listed above, '
to aceept d'eiive`ry,,and to make payment ol the'unpaid tialance due as specitied above:�Any deposit •
made by.Buyer shall be applizd against the purch�5e price oi said merchandise,hovrever,should ~ '
� Buye�fail to.accepf,delivery of or pay for merchandise'as provided 2bove,the Seller may relain �
� Buyer's deposit as compensation for expenses incurred in connection v�ith this sale.Buyer agrees
� not to attempt'to stop:payment toTuliular Building.Systems,LLC because o(any shipping problem, !
incident,delay,non-delive,ry or'any other delivery issue,The Buyer further agrees ihat a stop pay- � ;
ment or,der,after;ttie merchandise'has�been ilelivared.by Tubula�Building Syslems,LLC,shall be
considered�prima=(acie evidence bf intenl on the part ot ll�e Buyer to de(raud the Selle�at the timz '
of delivery c?f the check.Buyer ag{ees no!to"cliarge back"any amounts r,harged on a r,redii or debit
card by Tubul�r`Buitding System's,LLC.
1hfARRAfdTY: 30•DAY LL'•.IITEU N10RK�.1AM5NIP Y4ARRAfJT1'8:�20-YEAR:NARRAyTY AGAIi�S7.RUST THROUGN �
ON THE FRAF.I,E,ASSU1.11hG(dORI,1AL_CARE AIdD L;AI�77EtdHI•10E: AODITIONS,I:i001�ICATII�NS AtdD AITcRATIOi•IS �
VOID 11lL INARRl,11•ITIES. aLLUhJITS L0�•1GE,R THAbI�b'Iv:UST�iAVE n�/ERTICAL STYLE ROOF TO H�:VE A,iD•OA'i
� , LIf:fITE�WORKI:IA�JSHIP�G'ARRAPlTY'ALL UN1TS LC1RlGER�HAt�I 3G 1HRT DO f�1JT HAL�G A VER7ICAL STYCE HOOf �
: .8 1Ll=i�DDITI01dS�EXTEtJSI0iJ5 ARE$OLD'AS IS"'THE'PJ.IRPoIPITY PROVIDE-D IS STRICTLY LlilITEQ TO THC-:VAR-
RAt•1TY PflOVIDED BY.TI1E,h�1At•JUFFICTUREFt OE 7HE PRODUCT,Ahl�h.0.OTHER"AJARRAt,1T1ES ARE PROVIDEL�
� � �EY.CEPT.pS SPEGIFICALLY:SET'FOfaTH HEREGJ."SFLCER:DISCL%�L'.�S HNY 7J;D ALL 4dnRRA�TIES. VVHETHER
� E:(PRESS OR;I�.IPUEO.OR G�1 STRICT'l1ABILIT(,IfdCLUDIPIG E3UT h0?LC�.IITED TO TH[fi;tPUCO';:ARRa��JTY O����R-
CHA��lTABIUTY:AtJD THE IdRPUED V1ApRA:'FY QF-FITW£SS.FOA A PARTICULAR PU9PU5E U�J�ER P,D CIRCU::�- ,
STAP•lCES+,'lHATSOEVER SNALL SEILER�E LIABLE EQR C0145EGUEP•lTI�iL DQt,+AGES,L':c:LUDt?�!G GUT��JOT LI�,IITED ,
� �TO LOSS OF,PROFITS�('i�'HEiHER IF!CONTRACT,OR TfJR7j. �, I
, . , ,. ,� �
, AAISCELLAfNE0U5:In Ihe event ot any controvers,.or claim behveen or among the parlies hereto, , �
. . . �
'nc- hi reemsnt. includin �ut not limded to.
, bui nol limited to;ihose�rising oul ol or relati,� io l s ag g.
- � �
'any claim hased on or arising from an alleged lorl,�Buyer ai�d Seller hereby agree that any action
, , must andsl�all,pe��rought only in th�,-.county and 4ircuit.cour�in,lhe TliiPd Ju�ic�al Circuil,in and
. j
� for Cglumtiia CounCy.'Flo�ida. Tl�e Buyer a�id�Seller he�ehy�riaiv�, and agree not td assert, as �
,. a_defense,i�i any action.suit or proceeding.for the intarpretation or enforceinenl hereo(. thll ha: i
h t s ich ar,ii n s'iit or roc2edina man�nui L�e bn�u h!or is noi
� � �she or it is nol�sut�'eci 1 erato o that.� o , t_ p } g
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iaintainat�le.in said courts o�11ia1 the't�enua tfiereof ma�nat.be a rd�tiatE?ol Ih�1,IfNS a reeme�it
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ma not be,ei�furced in or by said courts.Th�.��arties h�reto e:ait��any artif all rigiits to trial hy itnti� I
Y
. b�•all.legal?nd.equitable issuzs that may arise�ut�f or iri.coiinactic,n e:ith this Rgre�li�ent anil all
cfiscussinns; negotialibns, et�Lnls an�i tran�actions�relat��i thereto. 1n ih:< evznt of any ftiaation �
arisin�Ir�im this agreem�+it,or in ihe e��ant t('�'r;cant«cl is rafeiiecl to an alfo�ii:�y-inr coll�ction,th� i
�.�r���ailing par11�sfi311 E�e enliUeo;in addilion tu such d��mag�s�nt!o1i��r 'reliet as ma,k�s granted to �
. racov�r i�asont ble altarneys fees and c��ts,incluciin�afiorneys ieas incurr�cl on any appeal. ;
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2�16160390
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``Rcptc1807394 Rec: 10.00
� - pS: 0.00 IT: 0.00
10122/2016 J. R. , Dpty Gl�rk
PqULA S 0'NETL,Ph D PASCO CLERK & GOMp7R R
10I12/2026 q09:16am 1 of 1
� N�TT��}E'C+I��NL�MENT OR BK �'T4,� PG ^����
Pecmit No.
Propecty Fdentification No.�I�2�-Z I.�t.�d j 0-2-�G�--D�Y-t)
THE iJND]�2SIGNED hereby givs iaforms you that the impzovemeni will be mede io ceztain reet pmgerty,and'm accordanae with
; 3ecrion 733.13 af the F2orida 3tadrtes,ihe fottowing infrarmahian is prorided'm ttiis IYOfiYCE OF CO�N'CENtE2V'£.
1.Descriptian ofproperty(lega[descrtptlon:)�JaC�-��c7Yt �,, 1�1�Jri.S�t�n 2.-!r�So`k.�lG����LvLy� Z(=�GZS]
+ -z� a}Sh+ae#Address: 1 �^��h , FL - �
� �-�2,Oenelaldescripdanofimprovemenb:���2 , Q--�
;.�3.Owaer information
�a)Nemcandaddross: � rfCiQ(-I•I�ulr.�C1-f .SII(nl��� •2-�P1�h�IIS ��-�.i'`iya--
� b)Name aud addtess of fee simple titleholder('�#' er fl�an owner)
a)Intemst in'P�P�T�Y
.-�l 4.Con�ctbrInformetinn /�� •
a)tlatue amd adaress:l_--G,_"�"/TCi G /-� .��a/G{Q�' S I I �n.►�^I�`�. `Zv��h��( I�FG.. 33�L1 a-
b)Tetcphone Na.: �t,�-')�f�-� ,D� Fan i�io.{Og�}
� S,Suraty Informatian .
� e)2Vatne end'eddresss
� b}.A:nott�tofBond: ,
i � c}Te3ephane No: � ' Fax Na.(dpt.)
' 6.Lander
� a)PTame and address•
, Phone No.
� 7.Identity of person within the State of k7orida�lesignated by awner upon whom norices or other documents may be servecl:
s)Name and address�
, � h}Telephaae Na,: Feac Nci.{Opt.)
8.Tn addiaon to himsel�owne�r designates;he followirig persoa to receiye a cppy of the�,ieaor"s Notice as provided in Section
713.13(1)(b�,Florida Staintas:
! ' a)Name and address: "
b)Telephone No.: � � Fax No.(Opt)
9.ExpiraHon date of Notice of Commencomorit(the expiration date 3s one y8az frbm th�date of recording w►less a diffeient date is
sgoc3fred};
! WAI2PIIN�'I'!?�WAtEYB� �NY�PAXMEl1'PS l�dAID�BY'I`�iE OViR�I�Yi AFPEYt TI�EX'kIItA7CIOTY O�T�i�2O�'ICE 4F
� CCIMMENCEIV�:N'T k:dtE CONSIID�3KED Il9?PRmP�Fd FA719��lVTS 171'd�Ept�CSAPTF'.R 713,PAdtT Y,SECI'IO1V 713.13,
� FI:dRIDR.S'I'ATUT�S;AND CAN RESULT IIV YOUIt PAICIIVG TW14:E FOR INdPR(3VEMENPS TO Yl>TJ12 PROPEYx9C1'.
I � A NOT'IL'L QR COIVIM�IYCEMEP�T MUST BE RECORDED�.IYII POSTED OPI'I'HE JOB SITE�EPt}�tE THE FIRS'd'
INSPECC�ON. �F'XCDU INT'ENY3 Ttb 43BTAi'�T RINt�t!(G'�+1G,�OtVSLiY.T YOUIt bENDER OY�rAN ATTORNEY BEFdR.E
, I �d1VIiVIENCIIYG W411RIC O$12ECiD12DWG XdYJR P7QTICE OF COMMENCEfld[ENT. ,
t STATE OF RLU�A a
courrrY oF rmsco „� � ; - r=c�^ �4'�.�
Si of dwuv or Ovm, 'rt�s Au � Offiacr/DJrect �
, �-#�;c� �. A ,J„� �� �-�
�Print Name
The�'a oing ins ent aclmowledged hefare me this,�4`�day of �� `�� by
� �Q���(":t2 L E1t-r�� as ..�,t e of auth ' ,ag.officer,�ustee,sttomey
, in fact)for (name of pazty on behal of wh m insttumeat,was eneout��.
� Personslly Knozvn�OR Praduced IdentiSsatioa� Notacy Signafure ��� � .
� Type of Fdea#iftca#ion Produced ��-��fl•Q-✓.Si.�''f�k�✓ I�Iame{pr�t) �� it�i�c nf-' P�
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' Yorfficatioa pursvaat to Section 92525,Florida Statutes.Under penshies afpeTjury,I declare that I have resd rhe fa:eegoing und thai
' the facts stated in it are true to the best ofmy Imowledge end belie£
i
s;gnazure otrfaW:al rrnon s;s�+g ntwvo-
FORMuAVOC,rvaC�DOI ;�.=un'�v"Y"e.y'�yt�`ye
� ::�`•�'.°y�',,. JACQUEL��� '
. _*: :� Cammission#8���
FF 160422
''���„�F;40.P� Expires DeCember 12,?p;b
. r���d BondCd7hntTrmFtintnsur:ur.a$DQ-3#5-:'Ai9 '
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� 12evision 2
� flR&A Proicct 1Vo, 160225/x607�S/160933
i REVIEVV D�4�E��/b
CITY
OF ZEPH1fRHIL�S
� PLAN �A+B0�9ER�(f
I'repared for:
; Tubulor Building Systems,LLC
� 631 SE Industrial Circic
, Lake City,Florida 320��
i I A��WORK SHALL
Prepared by: P�EVAILING CODES Mp�Y��TH
FLORIDA BUI,LDIyG C�D�, �
NATIpN ELECTRIC CODE,q►�p
Moore and Associa1009 E�t Avenuend Cons�ttt��€p�Y�H��I-S O�d�p�p�����
I North Augusta,SC 29841
, ��
MOOR� AN� A��OCIATES
� EfVGINBBpING AND CONBIJt,TiNG
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DISCLOSURg STATEMBNT FOR OWNER ;
CITY' OF ZEPFiYRFIILT�S BIIILDIItiTts DEPARTI!'�'NT ` �
I, ��(j C► � � .,�i,t r""�Q-°� have read and fullg e=adersGand aad
agr�e to the provisioas o� th instrumeat. �
The! undersigned states aad affirms that he or she is r2esirous af co�structing, ; ,
reabvatiag, adding to or reroofing his ar her owa domicile, that he or she j ,
actually oeaupie�, os will oecupy by said domicile, aad same 3.s nc� for
reat, lease ar sale. That he ar she sha11 camply with the following couditians:
1. �That the ov�aer anci he or she alaae shall act as the builder £or aIl phases af �
�coastructioa..
2. Tha� the owaer will compZy w�tYi a21 pravi.sions af the City of Zephyshills �
�ordiaaaces aad codes pertiaeat �o the bui.ldiag�.
3. Tha�G ia the event various phases of coastruction are subcontrae�ed, he will!
engage oaly properly liceased subcosltractors aad will persoaa3ly supervise i '
�uch work. '
4. That a.n the event the Suildiag Saspector sha22 reguire correctiaus ta be maiie,
the awae� wil]. aesume full respoasibility to iasure .th�y are mad�, aad upaa� '
eompletion wi11 call for a reiaapect3on befose praareediag with the liuilc3iag:
5. That the owaear shall a�sume-full respoasibitity► for the construction and ivill
aot expect supervisioa of h3s work �rom the City of Zephyrhi.11s Suildiag '
'Department. , ,
6. That priar ta fia�1- ia�pectioa aay additianal �ees, includiag reinspectiaa
fees, must b� paid in fu12._ A wzittea reques� from this af�iee shall� � '
coastitut�e aa offi.cial aotice ta pay additional fees. .
7. That the a�,mer sha11 comply with all City, Sta�e aad Federal la�,rs ia regardito-
,sacial seaurity, workman's aampensatian, lien laws, etc. , where appliaable. +
8. That the owaer shall comply with all the safety codes issued by �he FZorida�
'InduatriaZ Commisaian. ,
9. �State law requires coastruction to be doae by 1ice,nsed aontractoss. Yau have
'applied for a perrnit uader aa eacemptioa to that law. The eacemptiaa a].lows ��
,you, as t�he awaer af yaur praperty, to act as yaur own contractoz with certaia
�restrictiaas even though you do aot have a liaense. Yau must provide direct i
'onsi�e supervision of the constructiou yourse2f. You may buiZd oz improve a
�ane-family or two-�amily residence or a farm outbuildiag. You may also build
�or improve a cammercial building, provided youx costs do no� easceed $75,000. ;
,�The buildiag ar resideace must be £or youx owa use or accupaacy. It may aat ,
be built ar substantially improved far sale or lease. If you se11 or lease �a
buiZdiag yau have built or svbstaatially improved yourself w3.thin 1 year a£ter �
ithe aonstructioa is complete, the lava will presume that you buil� or � ,
subs�satial3y improved i� foz sale or lease, which is a violation af �his � �
ye3cemptioa. You may aot hire an ualiceased persoa �o ac� as your coatsactor or �
to supervi�se people workiag an yaur build3ug. It is your .resQonsibility to '
�ake sure that peop2e emp3cyed by yau have liceases required by state law ancl �
by covaty or muaic3pal licensiag ordiaances. You may aat deZega�� th� � i
z�espoasib3lity far sugarvisiag work ta a liceased eontractor �.►ho is uat , �
liceased to perform the work beiag doae. Aay persaa working on your buildiag i
dvho i� naG liceased muaG work. uuder your direct supervision aad must ba ; �
employed by you, which meaus tha� you must deduct F.I.C.A. az�d withhol8ing tax �
��nd provide workers' compensation for tha�, employee, all as pxescribed by law. i
Your construetioa must comply wi�h a3I. applicable I.aws, ordiaanees, buildirig; ,
�odes, aad zosxiag regulationa. ! '
oc�Rj s s�crrx�v� �� �, ` ��a� 1 Q I!a �
�a� l�n �
ADDRESS �1 ! (v -rh r -�- ti r ; � � y a �
�saNs r�1 � -''? x 2--���`i t�`7 �
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WTTNBSS PERMI'T' # ' I
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a�3-isaoozo City of Zephyrhills Permi4 Application Fax 813-780-0021 '
� � � . Buflding Department
Date Recelved �� 2 "� phone�Contact•for�Pernilttin �
: ,
Owner'a Name (1' i � r -� Owner Phone Number �I 3 "� t���?J �� �►�1.
Owner's Address S� ���h S�". Z�P h (h i 11S .�S�I a- Owner Phone Numb �� )J� �1 ��� 1 �'�-r(
�' � -- ;�_j �.',,��'�
Fee Simple Tltlefiolder Name Owner Phone Number �i ���O"
; !, - " � �
Fee Stmple Ti4leholder Address � .
JOB ADDRES � � m
� � LOT# � i
SUBDIVISION PARCEL ID# l� a�v a I d D t � ���-� o O l `{c7 ,
I , - ,, (OBTAINED FROM PROPERTY TAX NOTICE) �
WORK PROPOSED • NEW CONSTR ADD/ALT Q SIGN� Q �Q DEMOLISH
s e INSTALL B/ REPAIR � ,
PROPOSED�USE Q , SFR Q COMM Q -OTHER
TYPE OF CONSTRUCTION Q� �' BLOCK " Q FRAME � � ,STEEI Q�
^�` . +� \ G��a �--e Z '
ESCRIPTION OF WORK
� J l f / - /
BUILDING SIZf_____.I__�_____. 3�1 SQ POOTAGE �� a' . .,HEIGHT � l I
i . . `.
(OBU11 DING $ � ��� �O VALUATION�OF'TOTAL'CONSTRUCTION , ♦ � ,
QELECTRICAL - $ N� � ; AMP SERVICE Q -PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ N - '
i I�
QME�GHANICAL $ � � VACUATIQN OF'MECHANICA�INSTALLATION, � � ���
� l
OGAS Q ROOFING .Q SPECIALTY � OTHER�
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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�u��.���- �; ` �Q - �.� •Qcr,�r�a��(` ---f-7 a�,-, - p�„� --��- - - -- -- - � - - -
SIGNATURE �✓1 G �� � � REGISTERED Y/ N FEE CURREA ' Y/N .
Address� Llcense#
ELECTRICI�41�. . `�COMPANY �'
SIGNATURE � � REGISTERED Y/ N FEE CURRE� �Y/N
Addresai • � , License# _ •
I . .
PLUMBER i COMP;ANY .�; : � '
SIGNATURE`� � , : ,REGIST,ERED Y/,-N.. - ` ,FEE CURRE� Y/N. •�
Address , License,# �
MECHANICAL ' ' ' � ., ' ' C.OMPANY, .
SIGNATURE � � ' � , REGISTERED Y./ N FEE CURRE� Y/�N �
Addres��:� - � • . . . , , _ , , ., . i
_ . License# ,
OTHER � ' -- ' ` � " �;COM PANY �
SIGNATURE � •- ^ "" - � ' �� � ' ` 'REGISTERED
' Y/ N�_ FEE CURRE� Y/N
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Address, �, ,,.,° � "� ; �; ,7'- . ,. . :Li'cense# ' �
RESIDENTIAL f: .�Atfacfi`(2),Plot�P..laris;:(2)sefs•of�Building'Flans;'(1)sef of'Energy>Fo'rms;`R=O=W�Perrrilt for new construcUon,
- :,�Minimum;ten�(4.0)workfng;days after:submiftal`date:;R'equlreiJ onsite,:ConstruoBon�Plans;Stormwater`Plans w/SIIt Fence�installed,
� �Sanitery Facflttles:�c�lr,dumpste_r,;SIt��Work,Permit forsubdivisions/large_prcjects., , `:,:. ' •' ` ' -
COMMERCb4L Attach(3)�compl'ete sets'of Building Plans�plus a�Ltfe S�afety Page;(1)set of Energy Fortns.R-O-W Pertntt for new construction.
Minimum ten(10)worktng days after submittal data. Required onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed,
, Sanitary Facflides&1 dumpster.Site Work Permit for all new:projects.All commercial requlrements..must meet compllance
SIGN PERMIY ALtacFi"(2)sets of"Engineered;Plans:, :,:c^�- , �.; ,.._�. � .
'! ""PROPERTY SURVEY required for_all.NEW construction.
Directions: , ., ;- �.,�.. , �
Fill out applicaUon wmpletely.
Owner 8�Contractar sign back of applfcaUon,notarized
If over 53500,a Notice of Commencement i�required. (AIC upgrades over ST500)
" Agent(for the conVactor)tor'Power of.Attomey:(for the rtowner)would be someone with notarized letter from owner authorizing same
, .� ... .. .
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DVERTHECOUNTER.PERMITTING�-- --:�(Frontof�Application,Only);� ,;; � � ="-'�-`'=-"'°•_-�-"•��--�-•- °-�-•-����--_ _>_-�
Reroofs if shingles Sewers ;Service�Upgrades NC�,; Fences(PlodSurvey/Footage) - • ' ' � � . , ';
. ..�__ _. '__. ._ , ,;. . - • , . ,
Drivewaya-Not over Counter if on.public roadways:.neeil`s'ROW-�;� � • ' � ' �'�`'•��� ��'�' • �
I .�-.n,... ,n..�... . <.�.,.. .. r<.. - . 4..<....:. �.J...�-.. I...r ............ ... ....� ..
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NOTICE OF DEED RESTRICTIONS: The undersigned undergtands:th�ttthis;p�rm,if�may.be:subJ�cfi.to"deed"�restrictions° `._._,;,::`.,
which may�tie_more%r.est�ictive=th���County���iegulatlons. �The underslgned a§gumes��resp�nsibillty�for'compilance=:with any� " "
applicable.deed_restrictions. - � � . „_ . _' ;�'��� • � �� �
UNLICENSED� CONTRACTORS AND CONTRACTOR�RESPONSIBILITIES: =YIf-tlie�ownerhas`fiire�i��a�`cbntractor or `
contractors to undertake work, they may�b.e�requlred_to�be,ltcensed•in..accordance.with.state.and_localTregulatlons:��:If'the� - �� �
contractor is-not'Ncensed'as�requlred."tiy law, botti�the owner and'°conVactor��may�be°°cited•.for°a�misdemeanor�violatton
under state law. If the owner ar intended.;.contractors are;.uncertaln as to what Ilcensing.requlremenfs..;may-�apply�:�for=the' �� �°�:��a '
.. ... .. :....... .. . . . , __...�.. �,_..,;. :. .. , .._
intended'inrork,they are advised to coritact`the Pas`co�County Bulldin,g;lnspection_Dlvision�-l:icenstng$ection at 727:.-94T-
.. .__. � .,._..-.. _"'_4._._..�....
8009. Furtfiermore, If the owner'Fias'Filred�a contractoF"vr contractors, he Is advised to have �the contracto�(s),;sign_, r _
�---.•, •.- - . :„�
portions of the "contractor Block°.of this_application.for'which.they-will...be..r.esponsible.-.-1f you,:as�.fhe ownec.s(gn'as��tlie" -
contractor, that��may be an indication that`fie'is�not-:properly'licensed antl`�is�nof entitled�to permittfng priiiileges In Pasco
County. ' •- � • _ _ . _ -, _ _. ..,_.._ ;�_ r
TRANSPORTATION..IMPACTIUTILITIE$=rMPAC'��ANb RESOURCE RECOVERY�FEES:�The undersigned understands '�
lhat Transportatlon Impact Fees�and.Recourse.Recove.ry.Fees may�zapplyuto�the,constcuctton,of new�b.uildings,�change-of����`�";�'��'"
_ �.
use In existing buildings; or�.expansi�nrof�ezistin�g�,buildings; a§ specifled.In Pasco County Ordinance number 89-07 and,
90-07� as amended.,�,,:.�he undersigned also:understands, thait�such fees;�;as:�may�be�:due;;wlll::�be identi�ed at the='time�of`��• ����'� ��`
permitting. It is ftirtHer unde�stood that Transportatlon Impacf Fees and,ftesource.�Reco�ery=Fees,.must be paid prtor to
receiving a 'certi�cate-of-ocxupancy" orflnal�powerrelease.��:If�the.proj�ck.daes.not involve:�a�certfficete of occupancy�or��<�' �'f�:�°
final power release;���the=#ees=mu�t.�tie paid:,prior to:permit�issuance. F.u�tkiermore;If:Pascc,_County"Water/Sewer-.Impact� �� �;;��•��
fees are due,.they.must,be=pald-,prior#o.permit�,issyance=in accordance,witff;appiicatife_Pasco�.County=o�tlinances. •
CONSTRUCTION"LIEN�LAW(Cliapter 713�Elor�da Statutes�as amend�d): If valuaHon of work is$2,500.00-or:more,_I �-.. � ,..
certify that I, the. applicant, have;been provided �with=-a��copy of, the�"Florida-Constructton� Lten;Law—liomeowner's
Protection Gutde" prepared by,the Flo�ida Departme�t�of Agriculture and Consumer:Aifairs. If the applicant is someone: .. :. _.
other than the'owner", I certffy�-that I.h�ve,obtained�'"arcopy.of the;above-.des.cribed'iiocuii�ent;and�.promise�:in,good'.faith..to ,*f
deliver it to:the.'ownee"�p�ioc.toYciomntencement:'�• ' ' � ��� '�� -..� "� �-- ' � . �
CONTRACTOR'SIOWNER'S AFFIDAVIT: I.cert,Ify.�:tiiat�ail�.th��{Inf.ormatlon:;in�thi�applicatlon is accurate and that all work
will'be done in compltance w(th all applicable�laws regulating construction� zoning and��land`deyetvpment. Applicatlon is
hereby made to obtain_a .permit;.Co do_-wo�::,and �Installation as IndlCafed:��.•�I. certi�i that no work�°or Installation fias
commenced prior to issuance of�.a permit`'and that�.all work will be pertormed�to meet�standards-of all laws regula�ing�
construction, County and City codes, zoning regulafians� and land development regulations��in the.Jurisdiction.= 1�also- _
certify that I understand that the regulations of other government agencies m�y�apply:to the.intended.work, and that it(s
my responsibil(ty to identlfy�what,act(ons I must�take:to berin:,compllance....S.uch agencles Include but=are.not Ifmited to: :: -
- Department of Environmentai>�Protectton=Cypress.'Bayheads, WeN'and Areas and Ern(ronmentally Sensttive
Lands,WaterlVllastewater Treatment. � - �
- Southwest Florlda Water Management:`�.District-Wells,` �Cypress.r�Bayheads;- Wetland' Areas� Altering
Watercourses. � � • �
- Army Corps of Engtneers-Seawalls, Docks,NavlAatile Waterways.
- Department of_,Health:'B,.Rehabllitativ.e..,Servtces/Ertvtronmental:VF�ealth�Unit-Welis,:Wastewater-Treatment, �
�. ... � :: , . .
Septic Tanfis:_ . _ .. ,.__. � - -- - .-
- US tnviranm��i�l Fro4ec4i�n Ag�ncy-Rsbegto�abat�rrenl.
Federal Avlativn�Aul�ori,tjc-Runways:� • - �
I understand.that the,following.restrlctions apply to the use of flIL••
- Use of ftll is not allowed in;Flood,Zo,ne"V"unless exptessly permitted.
- if the:flll materfa4-is �to b.e used.'In.�Flood Zone. "A", Ik. is understood that a drainage plan addres�ing a
"compensating volume"wlll be submltted at time of permftting which is prepared by a profess(onal engineer
Iicensed by`�Iie State of`FloNda. � - . __ .
- If ihe flll material�.is to be used In Flood Zone 'A" in�connec#ion�with�a�permitted buflding using stem wall
� construction, I certify that fiil:virlll:be�used only.to#ill the area within�the�stem�wali.
- If flll material Is to be used In any erea; I �certify that .use of such flll will not adversely affect ad)acent
� properties. If use of flll Is found:,to adversely.�ffect adJaEent��pra�perties,.the owner may be cited for violating, '
the condi#Ions.of the bi�ilding:permit Issued�u�der the.'`atEached.permit appllcation;�for.lots�.less.than.one (1)
acre whicFi ere elevated�tiy f111,aR engineered dralnage plan Is requlred.
If I am the AGENT FOR THE OVYNER,_I�.promise In good;falth to inform the owner of•the permitting conditions set forth in
this affidavtt�prtor to commer�oing constructlon. I understand thet aTseparete permlt may be requlred for electrical work. . �
plumbtng,..signs, wells,,pools;, alr condttioning,,.gas, or otMer Installatlons noE�spec�laally included-in.the�application. .A _
permit Issued shall be constiued to;be'a'license`�,to�'proceed wlth'"ttie work and not�as:authoNly to:violate�'cancel; alter, or
set aside any provislons of the technical.codes;�nor shall issuance of a.permlt.prevent the Bulldirig O#ficial from thereafter �
requiring a correction af�ercors in.plans; constiuction orviolattons of any codes. Every permlt�issued=sfiall�become�invalid
uniess the work autho�ized by such permlt:�Is-commenced•within sUc_,m�nths of�permit lssuance, or if work authorized by
the permit is suspended or.abandoned-for.a;period:of�six fB)�montfis:aRerthe tir�ae�the�work�is commenced. An extension
may be requested, in writing, from tNe.�Bullding,Offlcial�for a perlod:.not to_exceed�nlnety�(90)�days a�d-virill`demonstrate
justifiable cause tor.the extenslon�. If work.ceases.for ninety.(90)cons.ecutive days�..the job�is considered aba�doned. " �
WARNING TO OWNER: YOUR.FAILURE�T4.R�E�.OttD_A::NOTIGE:OF.�COMMEMCEMEI�tT:NFAY-RESULT IN YOUR ^ �
PAYING TWICE;FOR�IMPROVEMENTS�TO.XOUEt:�.PRt�PER7Y:��IF°YO.U=IN�'�EWD:�T��OBTAIN•-FINAI�EING;'CONSULT
WITH YOUR LENDER OR AN ATTORNEI��EFOREiRE�OR�II���'YOUR'NO'T-I�E�'OF"C�IIAl111ENC�E�IIENT' �
... . _- -- � ... . . .. -
FLORIDAJURA��(F.S:11 •.03) '- ' ' ' � - � �
OWNER OR AOENT Q oI CONTRACTOR�C� � � � Q ��., , rAa
Subscrlbed and swo s n or aNflrtned)befo e me l hls Stibscrlbed'and'swom� ( flirmed)�befote m 'tlii�-�i
�0-�b-/(o b C rrcr�./-}• .l ��ro(�-� /0-/a-/,( �b �,l �-f�tci� -A-: . c�raf�-�
Y� Y
Whg,.)g/a�q personall known to.me ar haa%have.pro. .ced Who.ls/are pep�onal cnqvKn•to me-or has/have:produced •
T•�G�G2:5G��- ae IdenU8ca8pn. FG � 1"J,ZrL�erS U�'.t.s.eo as identlflcadon.
—�
�. Not� Pubifc . �- �_ Nota Publlc
ry ry
Com Is on N�"• Comrl�is fon�
'�*':�;a• JACQUELINEBOGES :q�'r'' "'-
.��'�� 4••. =; I;:: Commission#FF 150422
:..
Name ot ta P ,2018 Name of Not �rin �
:�' 'd`r ' �'a,F'FF.q`' gondadThN7roYF nnsivanco800;485•7019
'�PF�?p�� 8onded Ttvu Troy Fain Insuranco 800�385•7019 P��" '