HomeMy WebLinkAbout16-18012 CITY OF ZEPHYRHILLS
"� 5335-8TH STREET
(s13)�so-oozo 18012
� PLUMBING PERMIT
' PERMIT INFORMATION LOCATION INFORMATION
Permit�#:18012 Issued: 12/19/2016 Address: 5011 9TH ST HISTORIC
Permit ,�'ype: PLUMBING ZEPHYRHILLS, FL.
Class of Work: PLUMBING/NEW Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Fee�: Est. Value: Book: Page:
Cost: � 100.00 Total Fees: 40.00 Subdivision: CITY OF ZEPHYRHILLS
Amoun� Paid: 40.00 Date Paid: 12/19/2016 Parcel Number: 11-26-21-0010-21100-0100
! CONTRACTOR INFORMATION OWNER INFORMATION
Name: OMEOWNER Name: NAVARRO DANIEL & JENNIFER F
Addr: Address: 5011 9TH ST HISTORIC
ZEPHYRHILLS, FL. 33542
Phone: , Lic: Phone: (813)629-0094
Wo�k Desc: Add Connection to Reclaim Water Meter Install
APPLICATION FEES
� PLUMBING�FEE 40.00
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' INSPECTIONS REQUIRED °
1ST ROUGH PLUMB
2ND ROUG�i PLUMB
SEWER �I
WATER �I , /�
FINAL iI � �,
2 `'
REINS�ECTION FEES:(c)With respect to Reinspection fee ill comply with Florida Statute 553.80 (2)(c)the
local g vernment shall impose a fee of four times the am6 nt of the fee imposed for the initial inspection or
,I first reinspection,whichever is greater,for each such subsequent reinspection.
NOTiCE:I In addition to the requirements of this permit, there may be additional restrictions applicable to this properly that
may be ound 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 ayment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warnong to owner: Your failure to record a notice of commencement.may result in your paying twice for
impro�ements to your property. If you intend to obtain financing,consult with your lender or an attorney
� before recording your notice of commencement."
Complel�e Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
Comple e Plans, S ecifications and Fee Must Accompany Application. All work shall be pertormed in accordance with City
Codes and Ordinances.
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� C TRACTOR PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
i CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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s� '�eo-oo�o City of Zephyrhills Permit Application Fax 813-780-0021
_ . Buiiding Qepartment
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Date Recelv'd t ' .. :.Phone=�ontact far:�Permltt�n f . 2 _ O. -
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Owne�'s Na 'i e •� .���G Owner Phane Number
Owner's Add as� d � �:!. ���• ' Owner Phone Number�
Fee Simple TltleFiolder-Name � � ' � Ownar Phone Number '�� - ' �
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Fee Slmple tleholder Addresa �
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JOB ADORESIS . LOT#
SUBDIVlSION � FARCEL IQ# "
, . (OBTAINEDF.ROM.PROPERTY,TIUC�NOTICE)
WORiC�ROPt?SBD NEW CONSTR ADDlA�T �� SiGN' '[� - Q DEMOLlSH
ji � .e,. "�INSTALL �� r. REPAIR -
PROPOSED;IYS� _ Q : SfiR, [� GOMM� _. Q �CITNER ` .
TYPE OF CO STRUCTION"�� Q� 1'BLOCK " [�' FRAAAE � 'STEEL' `Q
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�i DESCRIPIIO OF WqRK,' � ��' � � C�.C�I ��'t �9 "�
� �UI�DiNG=SIZE � • - �'SQ�FOOTAGE,���: , .HEI,GH�"���;
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� QBUI I�DING � . VALUA'�IOIV�.OF"i'OTI4L COhISFRFICI'IaN - � � '
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i QELEJ�TR1CAi: $ AMP SERttICE. . ✓� Q � "PROGRESS ENERGY Q W:R,E.C. �
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QPLU I` BiNG- $ �� . , Q f �.-
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QMEC� i0.NICAL ,�' �p VA�UATlOIV C?F;tuIECFli41UiCAl:tNSTALLATi<?N.
�]GA3� , � , ROOFJNG� ,CI ,- SPECtAL1Y�:.._C'_;],�� t?TFiER=; ,,� . .
FINISHED FLO�I R ELEVATIQNS ��� FLOOD�ONE AREA . L,QY�5. ,NO �
, r,._.,,, n�, ;ck`.
iiV�4iJ.(�i� LVfli�A171'.`. ::<^:�3i:: , : L .. � � .
SIGNATURE REGIS7ERED Y/ N . ���":'�'F.EE"CURRFJ:_' �'' ' Y/N" ' ` �
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SIGNATURE � � . �REGISTERED . Y/ N ��:cu�n4= •:;�;�:Y/:N ` .
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` P�UMBER � � sG.QMP.ANY. ` �4^{,,J'.;# - ;e'i�. - ' �
SIGNA7URE`�',,� ` `REGIS.,T.ERED r�:Y./,.N;; �;. . y, ,,� �.
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MECNANIICAl:` � ,� .; . - ; . � . ` �COMPANY � - _ � , � .� �j fI '
SIGNATURE� " � �� •�- `"' '" i��i"s7E�o Y%,N ~L r�e Curx�En,:. Y. . .
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` . , _ . , ,COMPAia9at - . . .
� SIGNATURE�. J.,, '"� ,` . .'� �' ��. .' �REG157E'ti�o�' Y/'N;..:- ;FEE"CURRE�'' Y/N
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��EtESiDENT1AC."� ..Attaoh:2�;P�ot�Plaris:;2 sefs�ro�`Bu�tdfn";�?lans;'(�)set'of;En'ergy,For�ns;�F2=t}=W�PemiiCfariieyv�c�nstsi�ctlon,
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�• tVlinimumkten,°{1,0)�,wa�ingyde�ys;afte.r�"sabri�ffta7�"defe::<Required oinslfe;:ConstrucUon'Pians;Stortriwater Plan`s w7�Silt Fence ins�lled,
"���"^�Santfary�Fedlitles,&n1.�dury,�.pster-°81te�Worlc;Pertnit�qr.su4divislons/lergetprojects°?;w�;;-,:��y ' - �-..;�}- ' �. , �, ' �'-�: ' � ., .
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GOMNAERCIAi. � Attach{3)�asinpi''sCe'sets'of`Bu1Rdi»g'Plan's ptus a L{fe Satetiy Rage;(�)se!of Enetgy Forms.R-C1 W Petmtt fcr naW�canstruGtton. "� `
Minimum ten(10)working deys af#er submlttai date. Requlred onsite,Gonstruc�tian Plans,Stortnwater Pians w/Silt Fence instalied,
Sanitary Factlitles&1 dumpster.81te Work Permit for ell new:proJects.-All commerotal requlrements_must meet c�mpliance ��' �
� StGN AERMIT Attacti(2)"sefs af'Eng',�e`ei�dyP.lajns:�;.K=;;,.<..�a�, .y-,:� =.:_,;,. : � ._ -.. ° - � _ _
� ••"PROPERTY SURVEY requlred for all NEW construcUan._._. �
Directlan�• " .-.��;.,�:;�,:�;� ;. _ . `
Ftll out appp �tloa compl�kely. �
Owner�Con ctor sign back of appltcatlon,notarized
If aver�50Q a_Notice of;Commencement 1s cequirsd. {AlC upgrades�ve�'�T540) , .
-I'.c`�:'<,;il;a;��.;�°:'',
"' Agent(far the�c�ntractq�)o�Power of Attom`ey(fo�the ownerj��n'rould be�someone�with notarized letter from owner authorizing same
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01%ER TFiE.CQUF#�, E2�PEE2MITTiNGr...-�-._{Front<of AppllcatiomOn{y} --- _ �` {
Reroofs if shingles� Sewers Service Upgrades A/C Fences(Plat/Survey/Footage)
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Drivswaya taverCounterifonpublicroaduvays'.:rieedsR{}W - :,,.-�::��.=.-.9-�-�:�.•��°<.�:��.u�:s.,°•.�^-r#
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N9T10ECIF.DEEDRE�7RIC'CiO�t�: The.under;slgned;under�tands=�#h�t,t�a1�<�p�rmi€>�rtay.;be,,sub�ect�to-"deed"1res#��tiorts",�.�..:t�,��
f. y;�+ `.>-,,., t� ,�S �'1 'n. ic.. , 1 a r-",.. �'.i",`.P'fti.` a:r�;.4 '.i��.c,s
which may°tie`.mai^e�r�sfrict(ve:tha��Counfy��i�agNilatfcn`_s�.°�Therund`:ers�l�ned��assumes��re�pons�bility'far"cotnpitana�:w,itfi.any
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&pp}IC.�IIlI@'tI@8d=f@$MG1IOt23. =' �:.r;,.�::;•.<,,,` = - `` , .
�INLiC1ENSED�"C+DNTItACTOR$ :AND Ct)NTR�►GTOit�RE�PO�SI�OCi1`i�S:=��if�iie°�atirn�r�°h�s�'"Fii�cl��a":c��tr�'ctat ar
contrr�ctors.to undertake work;:they niay;bs,,=requlre:d:to.;be:llc�nse�i,ltt;accordance:wtth�statea,and�lacalti re ulaNans:��=°if'�the�>•�3`� .-����1
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contractot�ts-not�llcense�'�s=�roquli�iid'tiy law,`tiot#`r�#he nwner arzd coie#FactoTs�iria�y��lie�='�ttei��for'��m1�clerriear�oT vblatlon
under state law. If the owner.or intended};contra,t�tor..rare;`uncertali�.as'to what ttcenaing.cequlrements.;mey=;appily���for�tt�ie��-��;��-=°�
I�� S.:s`....t�.u+_`c�. }..�. A.,
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fntendad"inrork,ttiejr a�e"adviseil��,to contact:tfie�Pas±ca-:County 8ulldtng Inspectl�n�Q1_v,tslon-Lfcensiny�Sectian at.727-847-
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800e. Furthermore, ff the owner'tias'"tiined'a c6inlracto� or contractors, he ts advi�ed to have��the cantr,acta,r(s)�,sign, „ .4,,,.�
portlans of the:°contrectoc:Block' of,this_appilcatian�for�whlch,they:wilt>;be�r,esponsibie:-��If.:you;µ�as�vlhe owo�i�r sign�"a��`�th�'�s""��•."
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contractor; #tia�;ma�rbe an incitc;ation'tiiat`tie�-ls"rioE'p�iie�iy Ilcenset!"�nt3�'1"s riot`ien#�leid"to permltting priulleges 1n Pasa:o..w -�
Counky. ,� ;_. . . ; �:�,r.;E>�f�,,....�w,;,
TR�►NSP0I�TATiON=fMPAGTtUTil41'IESSIMP�G'���ANb�RESO�l�CE RECQVEEtY=fEES:�°The�uride�st�fie�understands
that Transportatton impact Feias:and.Rey%urse.Recovery.Fees ma"y,��apply��to�ti�e�consbuction.of new,buildings;:ch�nge��of�°>=�::':��'��
use in exisNng build(ng�,�or,expar�sturr`�of=�ekiatl��'ikiuil�ings; as specified.in Pasco Cvunty Or�dlnance nur�ber 89-Q7 and;
,�
90-U7, as amend�d,;:;Th�unde�slgned also;�uiiderstands; tti�it"suct�fees;�aas��mayf:;�$��due;,�vltl�6e�dei�t#ffed at the��ime^+a�:�='�:�%x>n�}�'
permltting. It Is further t�nderstood that Transp'orkation Impacf�Fees an:it`��Resource�Redo�sry,`Fees�musC be pald prior to.
recei�ring.a"cec#t�ca#e:,af�occupa�cj�'-or`flna��.power.�eleas�:�..i��Ehe.proj�ck;doesr:no��lnvoive.a�.ce�t�icate of occap��icy°o��'�=�`a���k��
final power�releas�►�;_iF:�e'�:fees-mu�.t`tie patd:;p�lo'.r#o;permft Issu�ince. F��#t�►er�rnare;�If:Pasco��County°'1NaterlSewer;lmpact� :�>.,�>4��
fees are due,;.they must.be=:pald:prtor.ta,.permit.lssyance��n_accorclance_�+rlth�:appltcat�le�PascotCountj`r��aidlnances. •
C�tdSTRUCTION�RlEN"GA1ti�(Ciiepter 713�FlorXda�tatc�tes�as ar>n�ndeat�: if vaiva�on of work is�2,500 OO�oc�more;�l� ts, :�•y r
certify tHat .I, lhe..�:applicent;:-have-.been provid�tl°�wlth;�a�•-copy-�.of-�the.��"Flo�ida����onstivction�=Llen�:.Law-Homeowner's
Protectlon Gulde*prepared by'the F16iida D�pertmer3t;of Ag�lculhtr� and Cons�tm�r�A�Falrs. If#he appllcant Is,sameat�e�:;....:�..�-.<�
other than#h�`owner", I certify th�t-1,.h�ve,o��ineitl"a��icopy.of..#he�aba�e:rfes.cri�ed;tl�ocu'�e ; pirar�is�-:In,gootl'faith�:to . ,. ,.,
C�, nt;and�
deHver It`to:.tlie`own�e�':`piior=to�cai�iriier►cement;": ., . , - ,.: .� . _ :. " . _ ._,
CONTRACTOR'S/OVYNER'S AFFIDAViT: 1.ce�tt'y:;Ni;at::all,�thec�lnf�rmatlon;,l��thi�appltcatlon is accurat��nd thatall wark
will'be done in camplianae wfth all.appltcable laws regulati�g construation�zoning�nd:�land�`devetopm�nt. App!lcatlon.ls
hereby made.,to obt�in.:s permi��#o,,fido�wa,V�aand�:lhst�lla�an as indt�ated:M1}���lY certify 'that no wark'�or tnstaltation Fias -
aommenced p�lo� ta Issuance of a�perr�if and that�:all work wlll be pertormed�to meet=st�ndards-of:all laws �egula�ng:
constructlon, Go�nty and Glty ccdes, zoning �gialaticans, and land developmettt regiila#to�s�tn #iie Jurisdlcttari:`r��'°i�-�i'so
certiFy that I uader�tand that the regulatlons of ather�government agencies may�apply�,ta the,:intended work, and that It ts
my responsibqity to iden#Ity,whet.actions l.mu,st_t�ke;to be.�ln�cantp!lat�ce.:.�Suc1,�.aget�cfes�lnclude=bu�are;nat tlmitec!#o: � •
- Department af Er�vironmentai$�ProtecNon=Cyp"ress"8ayiiiesd�, V�le�and Areas and Environmentally Sensttive
l.ands,WateNVUastewater Treatment. . -- " " � " �
- Sout��west Flar�da 1lV�ter Managetrtent-:'�I�is#r1�t-lNetls;'='`Cyptes.s.'.�8ay.�eail�;� �Wetlar�d ,�reas, Aitertng
Watercaurses. _,.�- y: � . , : - •:>r:., : - � . . ,
;;.,., . .: ; ..;.._� ;•, , .
- Army Carps af Englneer's�=Seawaqs,'Docks,Navigatite Waterwaiys. � :
- Depar#ment<<at_,Heaith�,B,�Rehabilitafhie�Sen+ices/�nvironmen#aix.F�ealthi�Unit Welts;YlAt�stewater�Tre�tment; �
Septic`1'anks:Y.�. ._ ,. � . . . � - .. �
- US Envlronmental Protection Agency-Asbestos�bafemen� �
- Federal Avlalloq:Autho�ity,=,Runways:M, .
� w•.�
t�nderstand.that:the:.follow#rig:=i�e�tr.lctlons appiy Ca the use of flli.�
- �Use offiti is nat aliowed in,iFlood�Zone'"V"untess expressly permltted.
- If the:<<flll�m�ite�ial��>Is�=to��b.e used_`In.:flood Zone. "A". tt !s understood tfiaf�a dratnage plan addre�sing a ,
"compe�tsating votume*vvi1) be submttted at Ume of:pemtift)ng whlch is prepared by a professtanal engineer} �
Ilcensed.by�the;�tate�of�Flatida � " ��� •� � .
- , if th� fiN��materlal�.ts`to-�a�used 1n Fldod �one 'A" In.4 connec�ion�vv�Eh�a�ermltted bultding using s#ern walt., _.
_ canstruction,_I.cemfy,:that:flll:iNlll;be:.used only.to.flll the are.a wtthin�the•stem�wall: _
- If flll material��is��to be used-In�.any ar�a� f �a�nlfy lhat .use af�.such flti wiii.nat adversety aftect ad�acent _
prapertle�., It use:.of fill.is�fauncF.to.$d.v,ers�ty:v�fiect ad)a�nt�;pcdpertte�,.the o�vner may be ctted for a�torating,
the condi#lons.:of�the.bulidt�ig��perrriit fssued:�under the�at�acfied;��pecmit��applicatlon��for:lats�.le"ss�t6an`one (1}
acre wtirch ere eleviated��6y fl1G.,��t engCneer�ed draEnage ptari i�requlred. �
If i�m the AQENT FOR_TH�.OWNER,.�I;promise In good,._f.aith to infortn�the��owner of�the permitttng canditlnns set forth In
thls aHidavtt prlor to commeracing constructton. i unilerstai�i�thet;a�s±�parat��permlt may be teqult�ec!for etectrlcr�l:.vvc►rk. . _-
ptumbtng, signs� welts,.:poots,.ait�,condi8oning;<:ga�s,�,vc•other Insfaft�i�ns nak spe�a�iaally included�in.the�application. .A .
permit issued'"shall be aonstcued talie a°Iicense'�to�proceed wtth'tfte;virork and�:not-as.authoNiy�,�b:.violate;��a�ncel� alter� or
set aside�ny provlsions oft�e.technlcal:cod��;:rtor shslt Issu�nce�of a.permit.pcevent the Bulldtrig O�ttcial from theresfter �
requirin,g a cort�ctian M;emo.re•in�;;plans;.con��cuctlon.or.violatlons of-any�cod�s:���Eve•ry-�pt�rmtt=l.ssued"sfialf become•�invaNd
unless the work aulho�ized�by such permlt:is.commenEe�within.sF�c.,�tto�ttts of-petmit Issuance, ar iF work autho�lzed by
the pennit is suspended�-or.ebandoned:for a;period;,of:;�im:{�)�monfiis;:after:the ttrne�ths�wo�rk��s commenced.. M e�ctensian
may be �equested�,ln.writiiiag,:from�tfie.;Building,bfflclal�for a perlod��not.to exceed'�ninet�r�(90)"days e�id�-viilll�demongtrate
�u�tl�abte`cause for:�the e�ttenslon: If work ceas.es.for nMe#y.(90)cans.ecutive�day:s,..the job�ts considered aba�doned. �
WARNING TO O1fVNE1�: YQUR�,FAil.fJRE:,;Tt�1„l��.�QltD,A:��4T�GE�:Q���CGMME���ME�i�f:.AItAYrRESU1:T 1RM�Y0UR �
PAYiNt3 TWtCE;;FOR��iMF'RQ �' ��N�'$�,T�J,fY�.WR�;�:P��ER��T1f:':1��YO.tJ�1llF'�'E�1D4�TQs�BT'IRIN=fINi1�►NE1N!6;�O�ISULT
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FRORIOAJUR+4'�(FS:�1x: : ., . „ .-.� � ,..:. . : � . _ , _ -- :.. -. ..�, -_ _ • . __ . - ____ —
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qY1MER OR AO�NT ••, � C�(��,�p� : - �
IS�d artd awem to(or_�tElrmed� fore q,. t� Seibacrlbsd'srxi'awom ta(ot aflinnedj�b�fors me�ftit� .
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`�:a*"s?'y�� DEBI2AELAINERUFFELL .. .
�Y'��q<'Commission#GG 4453�3 .
�Expires November T,2020
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DISCLOSURE STATEMENT FOR OWN�R
j CITY OF Z�PHYRFIILT.�S SIIZLDING DEPART�2E�T
I., t,� ��'L(/`'j f f� have reac� aad fu21g uaderstaad a�d
ag ee to t he provisione o f t his iaa�rumets t.
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Th� uadersigaed statas aad affirms �hat he oz she is desirous of co�nstructing,
re� ovatiag, addiug to or reroofi.ag his or her owa domivile, that he or ehe
ac ually accupies, ar will oceupy by said damicile, a�nd same is not for
rent, lease ar sale. That he ar she sha11 camply witla the followiag coaditions:
1. Tha� the owner and he ar sh� alaae shall act as the builder for aIl phase� of
� coastructiioa.
2. That the owaer c�ill comgly with ali prcvisioae of �he C3ty of Ze,phyrhi3.ls '
ordivaaces aad codes pertineat ta the building.
3. That ia �he eveat var3.ous phases of cons�ruction axe subcontraated, he wi.Zl
eagage oaly propexly lioeas�d subcoatxactors aud will p�rsoaally supervise
such work.
4. , That ia the event the Suilding I�spector shall require aorrectio�s to be made,
the awner will aesume full respaasibaility to iasure they are made, aad upan
aompletiaa wi21 c�21 for a r�inspection before praaeediag arith the buiidiag.
5. That the awaer �hall assume �ull respoasibili�y for the coas�ruc�fon aad will
,uot �xpect supervieion of his work fsom the C3ty oE Zephyrhills Suildiag
Depastmeat.
6. ,'Z'hat priax to �iaal iaepection aay adc3itioaal fees, includisxg re3anspectioa
fees, must b� paid in fulZ. A wx�itten request fram this affsce shall
aons�itute aa official aotic�e to pay additional fees.
7. That the o�raer shall comply �aith a21 City, State aad Federal Iaws ia zegard ta
'social security, warkman's compensation, lien laws, etc. , whete appliaable.
8. That the o�vaer sha11 comply with all the s�fety codes issued by the Florida
`ZadustriaZ Ccmmissian.
9. State law requires coastruct3oa �o be doae by licensed caatractors. Yau have
��ppl3ed �or a perm3.t uader aa e�cemptioa ta that law. T2ze e�cemption allaws
; ou, ms the owuer a£ your proper�y, ta act as your ov�a coatractor with certaia
estr3ctioas even tk►ough you do aot have a licease. You must pravide direat
� asite supervisian of the eoastructiaz� ycurs�lf. Yau m�y 'buiZd or impzove a
' ae-f�nily or two-family resideace or � fa�rm outbuildiag. You may also build
r improve a commexca.al buildiag, Prova.ded yaur cos�s da aot +e�caeed $75,000.
he buildiag or res3.deaae must be for your owa use or occup�cy. It m�y nat
�e built ar svbstaatially improved fo� sal� or lease. If you sell or lease a
uiltti,ag you have �,►uilt or stYbstaatially impsoved yourself w3.thia 1 y�ar after
he coastzuctioan is comp].ete, the law will presume �hat you built or
�ubstaat3ally impraved if fo� sale ar 1�ase, which is a viclatiaa of this
emptioa. You may aot hire aa unliceased person to act as yaur coatractox or
�o superviee people workiag oa your bu,ildixig, St is your respoasibility to
�ke sure that peaple emplay�d by you have liceases required by s�ate 1aw asxd
]ay county or muuicipal liceasiag ordivancea. You may aot delegate the
�espoasib3.lity far �supervisiag vaark ta a I.icensed eontractor who is aat
�icensed to perform the work beiag doue. Aay persoa workiag oa your buildiag
�,r o is not lice�ns�d mu�t work undez yaur direct supervisiaa a,nd mtast be
� Zoyed by you, which means that you must deduct F.2.C.A. and withholding �ax
a d provide woxlcers' compensation for that emplayee, all �6 prescribed by lmw.
Your eanstzuctiou must 3�► wzth all applic � s, crdiiias�ces, buildiag
c'Ides, aad zoniag regu a� s.
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