HomeMy WebLinkAbout16-17922 /
�; CITY OF ZEPHYRHILLS
5335-8TN STREEf
. r (813}780-0620 17922
BUILDING PERMIT
PERMIT INFORMATIUN � LOCATfON INFORMATION �
Permit Mumber: 17922 Address: 38636 WiNDFLC}UVER AVE �OT 45
Permit Type: ACCESSORY BLDG. ZEPHYRHILLS, FL.
Class of Work: SHED lNSTALLATION Tawnship: Range: Boak:
Propos�d Use: NOT APPLICABLE Lot(s): Biock: Section:
Squau�e Feet: Subdivision: SLEEPY HOLLOW T.T.PK#2
Est. Value: Parcel Number; 02-26-21-0260-40000-0450
Improv. Cost: 1,572.90 OWNER INFORMATION
Date�lsstaed: 1111712016 � Name: SIMMONS FAMILY TRUST SIMM4NS LY
Tatal Fees: 67.50 Address: 9611 S CROSWELL RD
Amount Paid: 67.50 ASH�EY MI 488Q6-9723
Da",te Paid: 11/17I2016 Phone: 989-763-Q929
Wo'r,'k Desc: 8 X10 SHED
�` CONTRACTOR S APPLICATItJN FEES
HOMEOWNER BUILDING FEE 67.50
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; Ins ections Re uired
F ME II
SFtEATHING
FINAL II
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REINS�ECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
loca!government shall impose a fee of four times the amount of the fee imposed for the initiat inspection or
;� first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additianal restrictions applicable to this property that
may be faund in the pu6lic recards of this county, and there may 6e additianal permits required from other governmental
� entities such as water management, state agencies or federal agencies.
"Wa inir�g fio owner: Your faiEure to recard a notice of cammencement may resalt in your paying twice for
impr�vements ta your property. If you intend to abtain financing, consult wifih yaur lender or an attorney
� before recording yaur natice of commencement."
CompOete Plans,Specifications Must Accompany Application. All wark shall be perFarmed in accordance with
l0 City Codes and Ordinances. NO OCCUPANCY BEPORE C.O.
�� NO OCCUPANCY BEFORE C.O.
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,CONTRACTOR SIGNATURE PERMIT OFFI R
� PERMIT EXPIRES IN 6 M{�I�THS 1NITHUUT APPR.C}VED INSPECTION
;a CALL FOR TNSPECTION — 8 HOUR NOTICE REQUIRED
,; PRCITECT CARD FROM WEATHER
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SLEEPY HOLLO'W Mt'3BtLE �STATES� 1NC. � �
38615 LANSiNG AVENUE
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�EPH�(RHiLi.S, FL 33542
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Phone: 813-782•11�11 .
Fax: �13-?83-?681
sleep�thaliowparksGk�rnail,com
� This is a request fo �Ehe Board of Direc�Eors as calied for in fhe �
Prospectus to make the foilowing addi�Eion or improvement to my home
or home site.
1 wish #o« �
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a#�e of Requesf � �,.�,�. � �/.�
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Lot # 7 � :' "
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Street � � -� '
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S�gnature
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O�ate ;
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Approved by Gs � . - -�---'�"
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Date l�f�-�'� `—� . , -
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Comn�ents ��c c ` t�,���'i. �� � � 1' �'�/�' 2 �"� �
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�atio�al ��s6��o and oms��ct6�a� I
�I 501 North Jackson Ave.Suite 2 �
�� Byars Building
; Russellville,AL 35653 i
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�July 25,2015
I�
Mr.Jim Richmond
Florida Department of�usiness and Professional Regulation �
Manufactured Building Program ;
1940 Rlorth Monroe Street
Suite 90A '
Tallahassee, Florida 32399-0772
RE: Pian Approval:6iesidential Lawn Storage Shed
Manufacturer: Bennett Building Systems
Plan Number/IVame:530-021 Gable Shed
Dear Mr. Richmond,
Pursuant to�he requirements of the Florida Depar-tment of Business and Professional
Regulations,the above referenced documen�s have been reviewed for compliance with:
2014 FBC,5�h Edition
These plans comply with Florida Product Approval Rule 61G20-3.006(FAC).Also included in this
approval and atfached to the plans are pre-engineered truss designs P91060�, P911808,
P91�503, and P918603,and, Kingpost,Job#79092.
� A signed and sealed set of plans are main�ained on file in the Third Party Agency office of
National Design and Inspection. �
� P,II mandatory comrnents have been satisfied and plans are app�oved for construc�ion by a
modular building manufacturer�hat is currently approved by the Department of Business and
Professional Regula$ions.
If you have any questions or require my assistance in any uvav, please do not hesitate to contact
me.
, Respectfully submitt�d FZEO/oE���T� 1 �J'—_/�.
��OFZLPF���� ` l
s�si�#6��,�
ALL IfVORK SHALL CO P �,��`��
o PREVqILING CODES � Lv lnrir�
i FLORIDA BUILDING CC}GE,
John Farinelli,CBO, MCP,SMP49 . ivATION,q�ELECTRIC COpE,q��
CITy OF ZEPHYRHILLS OROlN,4PVe��
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E.OA�Ii�G(psQ SpACIR1G• 2-0-4 CSI. pEF6.. in (loc) I/de0 Ud 6�LA8�S GRIP
TCLL 20.0 PlaleGtipDOL 7.25 TC Q.23 VetE{LL} O.d2 '12 aggg 240 MT2D 24!l190
TCdt 7.0 LumbetDOL 1.25 BC D.00 Vert{TL) -0.02 1-2 >999 1�U
8CLL 0.0• RepStresslncr YES WB 4.Q0 Hnrt(7i} 6.QQ nla Na
BCQL OA COda FBC201d/TP120D7 (Matlix) Welght:241b FT=0%
L110ABER- � 6RACiCd6.
70P'CHpRD ?x6 SP No.2 TQP CNORO SUuclsua!wucd sfi�atlsing directty appBed ar&0-0 oc purttns. (pj
�C'f10�3. (Iblsizej 1=260t0-3-9(mla 0-t-e},3=264t0-3-8(mfn.O-t-B} BOT CHORD R[gfd ceitfng dfrecUy appqed ar 10�0.0 oc 6radng.
Max Horz1=822(tC 1),3=-622(LC 7)
Mau Upliftt 234(!C 6},3�234(LC 8)
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FO�GES. {lb)-41l�Imum Comp�essioNMattlmum 7ensEon
TOP CHOR u 1-2=661/877,2-3=661/677
CSO4ES- (8)
1)This tsuss�hea hzen checiced tor un!lomt matlive(qad ars4y,axcept as noted.
2y Wind:ASCE 7-70;Vu1t=ldOmph(3-secorM gust)Vasd=tOemph;7CDL=4.2psF BCOL=O.Opsf;h=30fl;Cat.ll;F�cp C;Encl.,GCph-0.18;MWFRS(emelope)gaMe end mne and GC F.nterior(2)mne;C-C
for memle�is and fwces�.Si�WFRS for reacNans shmm;Lumber 001=t.fi4 pfaYa grig OOL=t_60
3j The 6citom chmd dead toad shawn ts suflicleM oniy m covor fhe huss welght ILseN and doas not�1laa Pur any addillonal load to ba added W the bdttom chord.
4)•This hus's Nas�desigrted tot a IHe lcad ot2A.Ops4 on She�ottcm chord In e!!areas vahere s ree3angie 3,6-o talt 6y 2-40 i•rlde wN f�t 6sivreen the battom chatd and arsy aEher membars.
5j Provida mecfianicet connection(9y oihersj af Yruss to 6r2aring plate capahle a1 wflhslanding 234 Ib uplift at Joint 1 end 2341b upfift el Jotn13.
�I Provlde aupp�tl W resls!a hodzonla!foroe ol6221P at joMts 1 and 3.
7)eevcted piat�or shim requinad io pmvtde tuti beadr�g surfaee vrith wss chond et jolnt(s)1,a.
#i}E{4.=_s cn�p�t���w,u�cz:=,�c+casx. E-slgned by Kevia Fraemao
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The pmtassional enginec�dng soal Indicalcis Ihat e Iloensad proP�s�lonef hes revlowad Ihe deslgn undar Ihe stendards re/erenced�aithin lhis documenl, �/20/2075
�eS necossarily tha curront slsto buikllag cade.The engtn¢wima sesl is rsai an ap�avat to usa In�epedFic state.'Ihe itna!datemdrealloa an rrhpther
e Uur.s de�g�is eccepieblo under Ihe Iocelly edoplad bupoing codo ras!vjith Iha bulldfng oRJal or dastgnalad appalnl�.
,� 1iVAF�NII�G a!l�erl�d�siga�p�ar�m�@��a�d{4��it9��'�� Universal Forest Pmducts,m�. � 2801 EASTBELTLINE Rp,NE ;
7nuushs�ttotbecutormadi'�dwHhwstappmeatol�eWeadaaignw�ginaer. PH4NE{8i6}36A�&96tFAX{616}365-9060 GftAMDl2flPiDS,M(dS525
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torffiting mei!?ads and syaWm deaiga$uYdrat roaponsib8�ltaa ere dafined underTPli.Thb deaign b based aniy opon paramelera ahotm,end Is 1ar ��;���
enlrtsHvMua!b"uwdm"g campenen4 tc 6a h�staCad mW foedad vertIta¢Y APA�"�a�Yof Qesign parrm�stats and pmpartncaryarattan aieomporrent is tesDans�yotbu2d`mg vr
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dc�skjncsr-nat truas doaFgnw:Br�cing nhavm Is for Gateral eupporl of Mdnridual ureb rttemhera an0y.AddiUanel temparay6radng W inoura ntab�ty during caroWdTon ���{-�'��'_1�
fs Q�¢ss�onsf�'Wyefiteasr�etnr.Ad�nslpc3m3anont bmdng oSNe avo�sGuedrro Is the mspona9t�dy W tfie 6uFdtn9deaignar.Fcrganerat gudfanw regaNfrtg �L.._-�
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UnNersel Pomst Roducts Ina,Gmnd Rep'.4s,MI48525,Peggy Beckelt 7.610 o Jan 20 2016 MRok trrdusMos,lnc.Fri Jul 17 09Z8:3q 2p15 Page 7 011
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TCLL 2D.0 Ple(e Grlp DOL 1.25 TC 0.33 Vert(LL) 0.06 2-3 s999 240 AR'f20 244H40
TCDL 7.0 LumbarDOL 7.25 BC 0.00 VeA(TL) -0.05 2-3 >999 1BD
BCLL i0.0 ° Rep Str�s Incr YES WB O.OD Horz(fl) 0.00 Na rJa
BCOL 0.0 CodeF8C3014/fP120D7 (Matritt) WetghL151b FT=096
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TOP CHORD�4 SP No.t TOP CHORD SWcN21 wood shealhirrg directty appCed or 6-�0 oc purlfns. [Pj
�� BOT CHORD Wgtd ce�ing dlraelly appliad or 10-0-0 oc bracing.
PSEAG410R1�. (Ib/stze) 1=260103-8(min.6-1-8).3=260/03-e(mfn.0.7-e)
RAex Horc1=635(LC 1),3=635(LC 1)
Max UpStfl1=234(LC 5),3=234(LC 6)
FO�CES. (Ib)-Mauimum CampresstwdMaxfmum Tension
TOP CHORi 1-2--6731994,2�=-673/894
NOY�S- (B)
1)This Wss has be�n eh3ched foT unHorm rooP Uva Iaad oniy,¢xcept ns rtoted.
2)�ilind:/�SCE 7-00;Vu1t=140mph(3second guaQ Vas�70@mpfr,TCDL�2ps(;BCDL=D.Opsh h=30(1;CaP.II;Exp C;Encl.,GCp1=0.18;A4WFRS(anvaiopa)gahle end:nne and GC Eutedor(2)aane;C-C
far mem�rs and Porces&MWFRS(or reactions shown;Lumber DOL=1.6D plale gdp DOL=1.60
3)Tho 6attom chord deed bad shmm Fs sufiident onty tn eaver the Wss raelght Ilself and daes not allou for any addidonal load to ba edded 90 lhe bottom chord.
4)'Thls Wss has bsan deslgned for a 9ve load oP 20.Ops4 on th�boKom chord fn an areas vfiere a rectangta 3�r0 fa11 by 2-0-0 e�Ide un'A fit betcvean Ihe battom chord and oiry other members.
5)Pmvlda mecheNral connecllan(b}r athers)of truss to hzaring piate capabi3 of wNhslsnding 2341b upfrti al Joint 1 and 234 Ib uplift at joint 3.
8)Pravido suppart tn�esist a hortwrttat forca oY 635fJ et{ohds 1 and 3. E-signed by Kevin Freeman
7)Beveled plate ar shfm required to provide tull bearing surface with Pruss chard et�int(s)1,3.
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The pmfeastonei ongine3ring seol Irtdlcalas lhel e Ilcansed professional has revleu�sd the design undorlhe siandards referencad vrilhin Ihis dowmanl 7/20/2015
nol rt�crossarily Ihe wrrenl slelo 6ulWing oud3.The engirteoring soai Is not an approval lo uso in e s�dfic sinlo.Tho firwl dolemdnation on rhalher
e Wss d3'sign ts exoplahle under Iha locally adopted buiidMg cade msl uilh Ihe 6Wlding oF�idal or dasignated appdnlao.
� �1�����(� -y�viPy d��a�a�paPam�g�r�a�a!R�D i�l��'(�S Unhre�sal Forc�st ProducLs,Inc. 2801 EA5T BELTLINE RD,PIE
Trusa ohaq nai be eut or madN'xd ew'Ihou�approval of Iha truss doctgn engineer.
PHOPIE(69S}364-6151 FNC(Bt6}3650060 GRAND RAPIDS,MI 49525
Thh eompaneni has anty bsfan dasigned farlhe Iasda rroled on ihb draKing.ConstneWnn artd fi(iFng forcea have nnl6eon eonslde�cd.The Wn�der is�espons�b �
torGfitng mathotla end s�1em des[ga 9u's�ormapunuEMSTten arodefu�sd under7P11.Thlsdealgn Lv hased anlyupan paramotara eharm,and Is Wr
an 6�d"roPdunl �
huCQ'veg amponont to bo[n3t�.'ad mrtd Iaaded vartira4y.lippEeahdEi y oPdesFgn pammotore and proparinwrpara6ion of mmponent b reaponai6Fty of bu26mg �
dasigrtnr-rtet Ws9 doslgner.Bradng charm Is fwlniaral suppoR of h�i2Qua1 c3b membaru anly.Addt�onal lempararyMadng lo tnaure aFa6�ity during oonsW Wnn ��1r •-_^"�-9y
!s fhe rtsspcnsl6L�ty oPiha csr�e4ar.AddAional parmertart!hradng af f0m avmra0 stnte�n�i31ho reaponutbc7dy ottha 6ui�(ng dealgnor.Forgeneral gufdanta ragerding /
Fa�iffiCmR qssc�Y Ws�imJ'.starega.QzGreR',aeeciton artd bradng,wt�u2 @CSI i-0&(rom ffia Wnud Yn�ss Caut�af Nner�ca and Ttuss Wato IrcsUiuto Recemma�aFian avadabte �
ham�AltC{�IXiQ9 Enaerpeiae LN,Rladkon,VBI b3719 JA4uRPa�PP���P�tF�
' � DISCLOSIIRE STATEN�NT FOR OWNER '
I CITY OF Z?3PFIXRFIILLS SU2LDING DBPARTN.�NT
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I, ' have rsad and fulZg uad�rstaad aad
agree to the provisioxis of this ins�rumeat.
The, uadersiga�,ed states aud affizms �hat he ox she is desirous af constructing,
reaiavatiug, addirig to or reroofiag his or her owa domicile, tha� he ar she
act9a.a31y oceupies, or will occupy by sa3.d domic3.le, aud sa:ne i.s aot for
reat, lease or sale. That he or she shall camply with the followiag coaditioas:
I. i'Tha� the ov�ner and he ar ehe alaa� eha1Z aet as the bua.2der for all phases of
�coaotruc�ion.
2. Tha� the awner arill comply with aII provisioas of the City of Zeghprhi3.2s
' ordivaaces aad codes pertinent �o the buildiag.
3. ,That in the eveat various phases of cons�ructioa axe subcoatracted, he will
eagage only proper�.y Iicensed subcontrac�ars and will persaaa3ly eupervise
such work.
4_. Tha� ia �h� event th� Buildiag Iasp�etor shall require correetians to be made,
the awaer will assume full xespoasibility to a.asure th�y are made, and upoa
eompletioa will call for a xeinspection befare praaeediag with the building.
5. That the owaex shall at�sume full re�ponsibili�y far the coastructioa and will
- aot expect supervisioa of his wark fxom the City of Zephyrhills Suildiag
Departmesit.
6. '�That priar to �iaa1 iaapection aay additiox�al fees, includiag reiasp�ctioa
� jfees, mu�t be p�id in �1711. A writtea request from this offic� shaZl
"coastiEut�e an official aotiae ta pay addstional fees. _
7. Thati the awaear shall comply with all City, State aad 8ederal laws in regard to
soc3.al security, workman's campensation, Zien laws, etc. , where applicable.
8. That the awner shall camply with all the safety codes issued by the Florida
+Iadu�trial Commisaioa.
9. State law requires coastruction to be doae by Ziceased contxactoss. Yau have
applied for a germit uader an e�cemptioa to that law. , The eacempGion allows
you, as the o`vaer of yaur proper�y, to ac� as your owa cantractor with certain
�zestrictiaus evea though you do aot have a licease. Yau mus� provide direat
onsite superv3.sion of the caastructioa yourself. You sn�y build or improve a
�oae-family or two-£amily res3deaae ox a farm autbuildiag. You may also build
�or improve a commexcial buil8iag, provided your coets do not exceed $?5,040.
The lauildiag or reaideaae must be for your owa use or occupancy. =t may aot
be built os substantially improved for sale or lease. sf you sell or lease a
building you have built ar eubstaatially improved yourseZf withia i year after
�he constxuction ig complete, the law will presume that you buil� or
suhstantia2ly impzcved if fox sa1� or �ease, whieh 3s a vialatioa a€ �his
�c�.xemption. Yau may aot hire aa ualiceased person ta act� as your aontractar or
�o superv3se people workiag an yaur buildiag. Tt is your responeibility to
inake sure that peaple ea�ployed by yau have licenses required by state 2aw aad
�y couaty or municipal liceasiag ordisaancea. You may aot delegate the
xespousibility for supervising work to a lieeased coatractor who is aot
�.iceaa.�aed to perform the work being daae. Any persoa workiag oa your building
�vho is ao� liceased must work uader your dfrect supervisioa a,ad muat be
einpZoyed by you, whieh meaas that you mus� deduct F.I.C.A. aad wi�hhoSdiag ta�c
and psovide warkers' compensation for that employee, all as pxescaribed by law.
Your cons�ruet3aa must comply wi�h al2 agpi.icable 2aws, ordi�naaces, building
codes, aad zoaiag regulatioas. ,
p � �
OWNER'S 3IGAZATURE . DATE 1
ADDRESS � "cZi'.3 d ;
��iONF � �'� "�L� '"— ��?' � !
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w12TNESS PI3RMIT #
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� CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
Owner: ' `� v� ��i L,» �n� U rl_S
Job Location/Address: :� �� '.,� d �J i����-�' )��.J P/� i� �
Parcel I.D. #:
SHOW ALL EXISTII�TG&PROPOSED STRUCTURES GIVING DIMENSIONS&SETBACKS
UTILITY BITILDINGS NIUST SHOW SIZE&FOUNDATION INFORMATION
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FRONT PROPERT3� LI1�TE
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— � — STREET — — — — — — — — — — —
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(NO'�'���ANdPLES 1&B)..
Example 1. Setbacks for Rl &R2 Zoning Example 2. Setbacks for R3 Zoning
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I) 70'
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' 0 I 10 F�QSII'ING 10'
10' � T IQ 14�'
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PROP05FD
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�� FRONT PROPERTY LINE }RONT PROPER'fY LIHE
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- - - StREET - - - - - - - - - - - - -- 5lREPf -- - - - - - - - - -
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813I��ao-oazo City of Zephyrhills Permit Application Fax 813-780-002�
�� 8uliding Department
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Date Recetv�d ��. 7, t . Phon�<Contact far�Permlttin "
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Owner's Nartie �� � ' � "rVf t� DY S Owner Phone Narnbe� — G� � � /Cl
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Owner's Ad�ess � �����. �� , �+ �� �U' Owner Phane Flumber
Fee 5lmple 7ltleholder Name � Owner Phone Number
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Fee Simple q tleholder Address Y
JOBADDRE�SS � �✓� 4 �� �'t� LOT# �,�
SUBDIVISiO� � � PARCEI.ID#
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--� WORK PRO�OSED --- NEw CANSTR . _'_,._.AD4IALT.- � SiGN - [�- �[�- DEiUlOL18H -.
I J� I INSTAI,L 8 . REPAIR �
PR4PQ3ED�USE [,� SFR Q GOMM � OTHER
TYPE OF CO�NSTRUCTION Q " BLOCK '' Q FRAME [,� STEEL �] t
DESCRiPT10N OF WORK ' - � � (' ' f� f'' v�':
BUII.pING S�Zf- � �'SQ FOCITAGE��: , HEIGHT .0,,,, �
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��������`' � �"` 7 �� VALUATION'�t3F'1'C►TAL CONST'RUCTION � "
QEL.ECTRICAL $ - ' AMP SEf2V10E. PROGRESS ERtERG'l W.R.E.C.
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�PLUMB[NC3 $ .
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Q �CktA{V1CAl $ VAl:UATtON QF'MECHAI+lICAI INSTA�CATIQN
QGAS Q ROOFING .Q SPECiALTY [� OTFtER
FINISHED FLOOR ELEVA710NS �� FLOOD 20NE AREA QYES NO
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BU1I.DER � � C{�MPAt�iY� V C�,�"�`LP-�
SIGNATURE REGISTERED Y/ N �FeE cuRrtEn ,Y/N
Addre�� ' , ,. ' .Ltcense# l._ �
ELEC7lttCl�!!V . ,:COFRPANY�
SIGNpTURE ''' REGISTERED Y/ N FEE CURRE� �Y/•N
Addre�� � , , `
� License#
PLUMBER CQMRANY �
SIGNATURE � � , REGfSTEREQ Y L N Fee cURtte� Y/N -
Address , � , �License.# ��- � �
MECHAAtFGA�L „ ` ' -" � ' C{1MPANY
SiGNATURE l� � � � REGISTERED Y.,/ N ; FEE CURREn Y/=N
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Addre�s � " • � � �� ' � License# � �
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OTNER Ii. � _ � . . , - -
+:COMPANY
SIGNATURE� ' - � '" � " ' ' 'REGISTERED~ Y/ N:.. FEE CURREh Y/N ,
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Address ':; � - . • - .. Uceiise#�� � �
RESIDENTIAl:;� •Attacli{2},Rldt�Plans;:�.(2}"sets:of:8u1lding�Plar�s;{1}set`of'Energy>Forrns;�R-0-W Peririi#tor new t�nshuation,
- , Minimum.teny(1.0);y+%rking;days_after,submittal�date:-Requlred onsite;eConstiucdan�Rlans`,•�Stormwater'Plans w/Stlt Fence installed,
I;���� �Sanitary Facill8as:&;1z�,dumpsterrSite-Work.Permit[ar subdiVisionsJlarge:projects - ` � '
_- _COhtMERClFlL Attach{3)complete sets ot Bultilirig Ptans pla`s a'I.Ife Safety Page;{'I}se#af E[iergy Forms.R-Q-W Permtt Eo�new constructicn.
Minfmum ten(10j wo�lcing days after submittal date. Required onsite,CanstrucHon Plans,Stormwater Plans w/Silt Fence installed,
� Sanitary Facilitles&1 dumpster.Sfte Work Permlt for all new�projecfs..All commerciaf reqWrements_must meet compifance
SIGN PERMI'F Attacli{2)sets of Engliieer,ed�Plans:.,-'-.� - ,. � . �
; .«.«PROPERTY SURVEY r „uired for all NEW cansWc.tlan.
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Dlrectlons; � . .,;_,.;} ,. . , ,
FIII out appNcaUon completely.
Owner B��Contractor.sign back of applicaUort,notarized
� !f over��2500,a Natice of Cammencement is required. (AIC upgrade�over 57500)
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" Agent(for the contractor)'or Power of Attomey�(for tFie owner)would be someone with notarized letter from owner authorizing same
OVER'TWEGOUFtTERP.ERMiTTlNG.. :::.�..(FrontofiAPPIlcaNari-Only}� ' , • _I__�. , . , - , _- . .. . .
Reroois If shingles Sewers $ervlce Upgrades:A/C ' �,Ren�es(PIoNSurvey/Footage) ,� � �., , � �,
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Drtvewaya-Not over Counter if on pubiEc rosdways..need's ROVV� i , � � � � � �
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NQTICF Q�DEED RESTRICTIONS: The under�lgn�d,under�tands:th�t,#h�s:p�,rmlf:may,be.,sub)ect;.to,"deed":restrictlon`s°� ,. - ,,;:.�
which may de�more.resthlcti4e`=tha���Gountyar+agr�latfons::�•�The uinderslgned�as`'sumes��esprinsltill(ty'for compllance�wlth any `' �
applicable�deed��restrtcttons. � -,_�-��_�,,-:,� .-.,�,.�. . � �� _ _ .-_,,_. ,_<: ���_.__ _ ,_�._=�w�
U(VLICENSE��'CONTRACT{aRS AND CONTR��ICTOR RESPONS181L1TtE�S: �ff' #he�4oin►ner=has°fiired'��a"conMactar or
contractors to�ndertake work,they m�y:be;.r,squtSred-.ta.,be�Ilce�sed�In:accaPdance.wlth state,and�lacal�re�gulatlons:.�:�lfA-the�-= � �
contracto� is-ndt llceri'seid-.as`r+�qulred=6y tew,':tiotti-°#he ovrmer:and�•contfactcr�rrtay:�be,:cited�for��a�mtsifemeanar vlolation
under state law. If the awner or Intended>,contr;a�tor:are�unce�tatn as to what llcensing.requlrements�,may��apply'�ior`tfie'• •-°�-�-� �'
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intended wortc,'they��e$dvisei!to c�iritact�t�e�;Pasca Coutity,Bulldlrtg`Inspectivri.,D�viston--l�.ir�nsftig Section at 727-847
8009. FurtFiermore, lf #he owner'has-hli�id a cont�actor or contracto's, fie ls advlsed to have ;the contractar(s),,sfgn. ., ,,.. .
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portlans of the "contractor Black".,of thls�appllcatlon�for:uvhlch they wDlbe,responslble.: !f=youu,��as-�he oViinersign'°as`the 'f" "
contractor, that�may�be an Indica�on'that'Fie`-is not`:prcpeiijr=llcensed'and`is no#"en#itiiaii'to perinitting p�'iulleges M Pasco .
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TR�P1S�oRTAT�ON-IMPACTJUTI�lTIESxl�V1RAG'C��AN�?RE9�C�U�tGE ltECO1fERY�PEEs; �The i�nderslgr�ed~understands
thatTranspartatlon Impact Fees and.Reco.utse RecoVe.ry:Fees may:aapp1y��#o�tfie;ir,.o.nstructton�of new buildings.ichange�''of'�� `���� �-�
use In exisNng buildings} or�.expansltin.�of��eiiistin�:�buildtngs, a� speaffted.tn Pasc;o Caunty O'rdlnance number 89-UT and
90-07� as amended...;�'he.undarstgned aigo.a�ndetstands, th�t such f�e�;:as tnay=�e�::d�e;;�will:�6e i�entified at the�°time�of��= -� - .,
perrt�itting. It Is furtFier understood that Tra�isportatlon Impect'Fees and'Resource;Recodery�`Fees:must be pald prlo�to
recs�ving-a"c+e��fiFica#e.of-accupancy"�ar f{nal��pawe,;r,�lease:- :4f��he.pro]�t:t:.�Ioes:not Iravolve<a�cert�icafe of accupan�ayxor�:'�;�'-;,":
flnal powec release; the..fees mu�t''be pald.p�lor#a;permtt Issuance. Ft��thermare;�If PascoY County`1Nater/Sewer-�lmpact �� :4•.���
fees are due,;they�must:�e,patd.prior to_permlt::Isse�anca:In.accar.dance.witt�.appltcabte.Pasc�.Caunty onlinances. -
CONSTRUCTi�N'C1EN"t.�►V11 iCti�pter 713�Flar�da�tatutea��amend�d); If vatuation of'work ls$2,500.OQ>oc��more.•:I� � .:t-
certify that I, the. appllcant��hav,e been provlded �wlth�a-copy�:of:.the. ."_Elorida°�Constnictton� Lten.:Law--Homeowner's
Protectlan Gulde" prepared by,tl�e Flni�da Depacfinent:of Ag�iculh�re and Cansumer,Atfairs. 1f#he applicant is someone. .. , ,
other than the"owner", I oertffy.that,l„h��e.obtained#a�capy,of.the?abova:desc�lti�d:docui�ent;and'.pmr�itse;(n,good;:�falth�to _._ :x
deliver it to:the�'ovuner.*�:prior,=to�cornr"nenceti�ierit:��'� ,. . . _ � .. , � �__. __ _ -
CONTRACTOR'SIOWNER'S AFFIDAVIT: I.cei#i[y,�:tti;at:.atl.:the�,lnf.ormatlon�;ln:thl� appllaatlon is accurate�nd that all work �
wil!�be done in campliance with aIL appllcable lainrs reg�ilating constructlon; zoning and��lartd`develapment. Appltaatlan fs
hereby made ta obtatn .a.permit�,to,:do,�wori�;a=and�installatian as indi�sted:�,t.:�t certity that no workr�or tnstaltation iias�
commenced p�lor to Issuance of'a permft"'and #hat�all��vork wlll be� pertormed�#a meet_standards of all laws regula�ing-_ A
constructton, County and Ci#y aodes, zoning regulatiQnst and land development regtalations=ln the ju�isdlctlan.= 1 �al'sa�� :
certlfy that I understand that the regulations of other gavemment agencies may�apply�#o the,lntended work, and that it is
my responslblllty to fde�tlty�what.acttons i must t�ke,:to be�fn:_corr�pliance.- Suc#�:agencfes-Incl�tde but�are.nct tlm3ted to: �-
- Depar'tmen# of Er�vironmental��Protect6on=Gyp�ess.@ayhead�; Vlletiand Areas and Envlronmentally Senstttve
Lands�Water/Wastewater Treatment, r,
- Southwest Ftarlda Water Management:".District-.ltVetts;'°Cypress.--Bay.heads,- Wetland Ateas, Attaring
Watercaurses. � � � � - '� '
- Rrmy Corps nf Englneers-Seawalls.Doc�s,Nav(gable Waferw�ys.
- Department_of:Heaith,:,& ;ReF�ablllta#ive�,.Servtces/Envitonmen#al�-Health-Uhit:Weil.s� Wastev�ater-Treafinent; � `
Septic Tanks� _ _�. , , . . " , � . �. �� � � , �
- US Envlronmentai Pratection Agertcy-Asbestos abatement.._. - x
Federal Avlatlon.Authorlty-Runways.� _
t unders#and that the.fottou��ag<�est�ctions applynto tFie use o#ffll:� �
- Use of flll ls not allowed 1n;Flood:Zone"V"unless expre�sly permlttgd. .
- !f the :fill cnate�fal�=ls to�'be usecl�In �Flood Zone. "l4"� tt. Is iarideratood th�t a dralr�age plan addressing a
"campensa4ing vatume�uvitl be s�bmitted �t tisne�e�f:�em�r3ifing which�i� ptr�pare� by � prmf�ssionai engin�er
Ilcensed by"�he�tate`of'��o�lda: � �-• - �=� �
- tf fh� flll matertal�.ts.to�be:used in Ffood �otte "A" tn}'connec�ion�in�th�a�-permlttied buitdlrtg using s#em walf .
� construction,, I.ce�ti.fy,that,fill�:iArall.b.eused only to.ffll the ar�aa-wlthln�the stem�walL �
- If f�ll mater4al Is to be used In any area; 1 �certify Ehat .use of such fl11 wl11 not adversefy affect adjacent
propertles. tf use_of fill 1s,found�to advetseFy,.�ffect adja�ent��prctperties�.the owner may be cited for violaling,
the cond�ions.of.the bullrlinge;perrn(t Jssyed�under tlie at�ached,permlt�ppllcatlon;.fo�lots�.less:than.one (1)
acre whicti�are elevated'by fll#,a�engtneered dral�tage ptan is required. ..
If I am the AGENT FOR.THE OYYNER;_I;promise In good_falth to Inform�the�owner of�ther permltting condl#lons=set forth In
this a#fidavft'p�or to comtner�cing constructton: �1 untlersfend tha#aRseparate�permtt rrtay be requlred#or etectrlcal work. . � ,.
piumbing, signs, welis�, pools;,alr..conditioning,..ga�s, or.otheT Instali�tlons no��spec�lcally lnctuded�tn.the applicatlon. �A
permlt Issued shaQ be con�t�ued to'be��a�llcense�to'=proceed wlth the work and•�not•as:.authoclty-to.vlalate�.°cancel; alter, or
se#aside sny provEsions of the.techniii�l.cades;�nor sha11 issu�r►ceaof a.permit:pr.event the�uitdirig t�icial from thereafter
requlring a coReckion af eRors;,ln,ptans;-consfnictlon.or,vlolatlons of•any codes: -�very p'ermlt=l.ssued sfiall become invalld
uniess the work suthorized:by such perrnli:�ls-co�men�ed�wlihin sf�c,months of�p�rmtt Issuance, or!F watk suthocized by
#he permtt is suspended�or.abandoned;,for.a,period;ofis�C:�8)�inonfiisi,�afte"r the;tlme the�work�ls commenced» An extenston
may be requesked, In wcltltig,:,from tlie_Bullding,Offlcle! f6r a-pertod:not to.exceed�nln�ty(90)"iiays and•virill demonstrate
just�iable'cause for.�the ex#ension. tf w�rlc ceasea.for ninefy{90)cons.ecutive d�y.s,-the)ab�is cansidered abac�doned. -
WAR�SIIV� TO OWNfR: YOUR.FA11.lJRE�,T�1.RE.�OEtD;A::NOTIGE�OF,�COMMENGCME�tT�MAY RESU[:T�IN�YUUR '
PAYINC TWI.CE:FOR.�IMPROVEMEfdTS�Tfl,YOUR�:PRC�PER-TY, tIF�YO.U{II!F'FEIVD:TG�qBTA1N�FINAMEtNG,�ONSU4T
_aAI�T �. _ 1� ��r. .�A _ TTA 1� . � ���.� -AR� �=t �E� �' �=�� =� .:< �..�� �.�� : � . .s•��.
F�.ORIDA dURA�,{F.S:1:17.03) _" . , .. , ,� - ` . ,; _
OWNER OR At3lEt@T 5����r.: y�'�"-l?`'Q �ONTRAGTO
Subsaibed anc!s M ar afl#rmed re� Siibscrtbed an�suwm- (of a�tms�dpb° _ .me flitg .
by�.k4.�w1 �E UYI Vl'l O N_�„ .by S,�j a�� ����Z�
Who I a ers nauy,f�n,oam to.me or haslhave.produced Wdo.lsla . ene Ay ki�own:to:ms or has/have�produced� � �
a t{ �as IdentlflcaNOn. ��S�:` ident�catton.
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t ry Publlc . � ��- Notary Publlc_
Commiss n ` � Com s n.N .,,,F,���•,. .
O1��Y o��,= ' .��;„ � ;'#R� '�` Commission#FF 150422 %
:;' �: Commission#FF 150422 =
Name of Notary a �cem er , � Nsme of NatarY�YA� ,,.� tltr�Troy Faln{nsurance BODaBS-7at9
�•�„�����°.•" gondad ThrU 7roy Fein Insurance E00•385�7019
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� Cit. ~of Z h '.hills '
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BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: 5���(�n S� �1(�Qns
Date Rec�eived: � � . r] . f(.p
Site: �g�J�lO �-il 1/JCl��/� GcJe� f�l/�
Pernut Type: ��h� — /��� ��
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Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
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This co�nent sheet shall ept with the permit and/or plans. �
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Kalvin S �' er. a s Examiner • Date Contractor and/or Homeowner
� (Required when comments are present)
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