HomeMy WebLinkAbout17-18410 CITY OF ZEPHYRHILLS
5335-8TH STREET
r ` (813)780-0020 10
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION-
Permit Number: 18410 Address: 37408 CORNWALL DR
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: WEDGEWOOD MANOR
Est. Value: Parcel Number: 10-26-21-0120-00000-0460
Improv. Cost: 5,493.00 OWNER INFORMATION
Date Issued: 4/26/2017 Name: BROWN, JAMES & SUSAN
Total Fees: 65.00 Address: 37408 CORNWALL DR
Amount Paid: 65.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/26/2017 Phone: (813)778-7798
Work Desc: REROOF SHINGLE
CONTRACTOR S APPLICATION FEES
WIDNER ROOFING INC _ REROOF RESIDENTIAL 65.00
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Ins ections Re uired '
DRY IN R OF INSP
TAPE JOINTS ROOF I � �
FINAL
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
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 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.
NO OCCUPANCY BEFORE C.O.
,�--�-e�(;�J�-�� �
CONTRACTOR SIGNATURE 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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�. CUSTOMER ORDER N0. SOLD BY TERMS F.0.6. � ' DATE � :;w'`
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i 2017062608
, Key No. Permit No. -- -- --- -
. • Rcp4.:1858177 Rec: 10.00
" NC?T1GE OF CC?t1�MENCEMENT Ds: 0.00 iT: �.0e
04I26/2017 J. R. , Qp�y Clerk
� THE UNDERSIGNED hereby gives notice that Improvement will be PRUI.p S 0'NEI�,ph.D PASCO C�ERK & CQMP7RO�LER
i Made to certain,and in accordance with Chapter 793,Florida Sta#e 04126l201 0 0 m 1 of
� Statues,the follawing information is provided in this Nokice of OR BK ��3� PG 2���
� Commencement: �Q — - - -
1, Description of Property: Parcel No.: �2� - �(- o!2 O f" 60 oD4-- p �,�60
{�egat description of the propert�r and s#reet address i#available)
2. General Descripti n of Im�rovement:
.��. � �.! �.. .s�-�
3. Owner Informafion: Name: �a M� �
Address: � � a P�.a� ( e- City State Zip
Interest in Propecty: �3 W,hl� � �:;,.
Name and Address of Fee Simple 1'itieholder(If ather than owner) :
4, Contractor: Name: �< <N"
Address: �-f�`� ' �- ity .�. ` " _State Zip 33 5�--3
Phone No. 3=71 �- b5� Fax Na.
5. Surety: Name Amount af Bond:$ ,
Address: City State_Zip
Phone No. Fax No.
6. Lender:Narr►e;
Address: City State_„Zrp
PhQne No. Fax No. � .
7. Persons within the State of Florida designated by Owner upan whom nafices ar other documents may be
served as provided by Section 713.13(1)(a)(7) Florida Statutes.
Name;
Address: City State_Zip
Phone Na. Fax No. ,
�, tn addition to himself or herseif, Owner designates af ,,
To receive a capy af the Leinor's Natice as pravided in Sectian 713.13{1}{b}, Florida Statutes.
9. Expiration date of Notice of Commencement(the expiratian date is 1 year of recording uniess a different
date is specified.} ,
WARNING 70 OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXP(RATtON QP THE NOTICE OF COMMENCEMENF ARE
CONSIDERED IMPROPER PAYMENTS U¢JDER CHAP7ER T13,PART 1,SEG 773.13,FLORIDA STATU7ES,AND CAN RESULT IN YOUR
PAYiN�TWICE fOR IMPROYEMENTS T4 YOUR FRQPERTY.A NOTICE OF GQMMENCEMENTMUST 8E RECQRDED AND POSTED ON THE
JOB SiTE BEFORE THE FiRST INSPECTiON.IF YflU INTEND TO OBTA{N FINAFlCtHG,CONSULT WITH YOUR LENDER OR AN ATTORHEY
BEFORE GO MENCING WQRK OR RECORDING YOUR NOTICE OF COMMENCEM�NT. •
�,�� ,2'"� ��.� cL t�.0��—
5(gnature of Owner or Owner's Autharized Officer/Director/Partner/Manager SignatorYs TitlelOffice �
•"8ignature Requlred by same below by`X"mark"" -
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State of Counry of
The forgo3ng Instrument was acknawledged bePare me this��'' day of,��J,'20l�by �.��A t�eS �'k,r-�..-` ,
(Prinied name of person acknovAedging}
as � l.Jl.� /J;�"R— �far
{Tjrpe af authorily e.g.,o�c�,trastee,attom ' fac (lVame af party on behait af wl�o ins#rument was eacecuted}
Sf�L-"t2R� y,,) rD��2 �- --" .
� Signature of Notaty Print e 8h$�s�1ty�o fl ary
Petsonally known OR Produced tder�ification � � My Comm�ssiort FF 0751&5 �
Type of Identificatiqn Produced: w� Expires t2/0820�7
Verificafian pursuant to 9ection 92.525,Ftorida Statutes:under Penat#ies of perjury,l decla�e that!have read the foregoirsg aad that the#acts
stated in i true to f my knowledge and belief.
`T'�',==i����G. .:5%�"G�� . �
5ignature of Natural Person 5igning Above
NEWNOCOB.doc Rev-2QDB
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,�po���e . _ .
,�� ° ��� STATE OF FL0�2iDA, COUNTY(�F FAS�t� �
m�� THIS IS TG C�RTIFY THP,7 THE�FOREGOING IS A
��' - �< TRUE AND CORRECT COPY OF THE DOCUMEtJT
� � jnynQ�?n�� a � ON FILE OR OF PUBLIC RECORD IN THIS OFFICE
:`� � WI NES�. Y HAND AND OF�IC L SEAL THIS
.� � `� _ � � �Cr1�AY OF 2 u� �
'x�8� ' o � � PAULA S O'NEIL, CL K&COMPTROLLER
� . �
��.����'�� g DEPUTY CLERK
s�3aso-oozo City of Z�phyrhills Permit Application Fax-813-78p-0021
Building Depa�tr»ent
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Date Received �(� j'T
° Phone�Cantact�fcr Rerm�tttin '
Owaer's 41ame r , , Ownar Phane Numbsr ,
Owner's Address ��'C�� 4�s�rru,U�.��� ��� ' �Owner Phone Numbec � � �
Fee Simple Titlehalder Name � � Owner Phone Wumber � �
z , . .
Fee Simple Titleholder Address ,
J08 ADDY2ESS r.�. `�I'7'�� �o�..�WJi�-YX (Z-- � � 407# ��
SUBDIVISION �! �� PARC�L ID# t�` �� a-� -0(� ����o� p�p ,
� , (OBTAINED FROM PROPERTY 7b91E NOTICE) '
WORK PR4POSEp �NEW�CONSTR ADDtALT �� SIGN 'Q Q DEMOCISH
���, INSTALL � �. REPAIR •
PRQPOS�D;t7$E Q SFR Q GOMM � OT#iER ` '
TY`PE OF CbN3TRUCTIOW Q BLOCK " Q FRAME �]' STEEC �] �
DESCRIP'TION OF WORlC cS 0�_ � �
BUILDINCs StZE ' SQ F04TAGE��, ,HEI,GHT��. �
D����a��C' �� VALUATION��F TOTAL CONSTF2UCl'ION J3
QECECTRICAL. , �� AMP SERViCE Q 'PROGRESS"ENERGY Q W:R.E.C,
�P�UM8ING t �$ '� � ' ' j�,,�jf�
. ��l�;i"�t
QMEGHANICAL $ � VA�UATIQIV OF'iti�EGHANICAL INSTALIATION' �� '
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��,as �oo��� sP�cta�n C] o�HE� -
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FINISHED FLOOR ELEVATIONS FLOOp ZOP1E AREA QYES. NO
BUILDER COMPANY'= . , ' "
SIGNATUI2E REGISTERED Y/ iV FEE CURitE� Y'/fV"`
Addre$s � ��' =t ` �Eicense# � ��
EIECTRICIAN. � GOMPANYt� -� ��` ...- � ,_. � _ .
SIGNATURE � REGISTEREb Y/ N FEE CURR��a�� ` `�rY l N .
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Addressa - � , ;-- 4tcense.#-,�:__���.Y� �
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P4.UM6�R ' GONiPANY • .:, _ , �+: _ ": . :
SIGNATURE' ` � ,REGISTERED, Y.L�.N :FEE CURR��-; �Y/N. - �
Address , .,t.icens.e,# �, :. . ' ' �,-
nn�crt�w�ca:� � , , , coM�i►�nr ` , , . . _.: ,.
S1C3WATURE " � � REGI§TERED , Y,/:N FEE�CURREP< Y./^N�
aad��$-� � � � � � � , �w �� . _ . - �.ice�se#��u.�.. _' � �
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o�+��� � � _ - - `;co�u��nr _
SIONATURE:. ;: , , �� -R�cisTe�o ' '1f/ N_..' F��cuR�n /N
�� E �`:, � � ,._ � . . - , ,. , .,.�._ ,. _. ..
Address �:.. ;:�?w, . � .t..�C- ' License#_ 'C-'CC_°=�S 1� ``�Z- 1 � ,
..�. ,-,:..« ,._ �., ,. ,•_.- ._:: .. �
RE8IDEN'T1A1:�=� 'AtNaoh"{2},,P.,.lo#��P•,lans:.,{2}sets�;of,BuiCiling�Plans;(1)set aF:Energy>Forms;TMR=t'?-ti'N`Peimitfor'new canstruc�on,
•� �..Minimum;ten;(,1,0):wprking;days::aiter„'subiniftal'date.�:Requi�ecl onsite;:ConstruoBon�Rlans;`SMrtnwater Plans w/SIIt Fence installed,
"•����.,<�����- �- � , . ..
Sanikar`yFaciltUesc8�;l;dumpste�Site�Work:Permit#or.subdivisions/large.pr,oJects,;,_,,,� u;t ' � � "° - _-.
GOMMERClAL Attach(3}corriptete"sefs of 8uittling�Plans plus a Life Safety Page;(1}set of Eaergy Farms.R-O-W Petmit for new construction.
Minimum ten(10)warking days after submltMal date. Required onsike,ConstrucHon Pians,Stortnwater Plans w/Silt Fence installed,
San(taty FadliBes�1 dumpster.Slte Work Pertnit frar all new pmjects:_All commercial requl�emenGs.must meet compliance �
.-51GN PERMlT Attaeh(2)set's'of Eng"ineered;Pians..,�� .�--=-:,..�: _. - � "
'•"•PROPERTY SURVEY required,far all fVEW conshuctlon., . � - � ,, - •
Direction�s: • .r. : .. _ . ,
FIII aut applicaUon campletely.
Owner 8 Conbac�ar stgn back a#applicaUan,.notarized
If.over 52500,a Nottce,of Commencement fs requlred. (AIC upgradea aver�7500}
.. �.:m�,�,�.�;.., .
Agent(for ttie ccntraator)or"Powet of Attoii►ey'(fo�`e ow�er)would b.e someone virith notarized lekker from owner authorizin�same
DVER TH�COUNTER RERMi7TiNG -. •(Fronk ofiAjaplicatiomOnly) �� � � " � }
Reroofs if shingles Sewers � 3enrice Upgrades A/C.. . Fences`(PIaUSurvey/Footage)
Driv�ways-Not over Counter if on putilfc roadways::�;eeds,ROW �,.
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P00'9"iCE AP DEED RE�T�ICTION�: The ur�decsigned undergtands:th�t:thi�.�permif:may,be,subJect_to_"deed".restrictlons" - '
, . . . _ ..
which may be::mor��r.est�lcttve�th�n Courity-regulations: The`undersig�ie�t��ssumes responsiblitty'for"co�ipliance witfi any ,
applicable deed-resMctions. .... � . . : - . �
UNLICENSED CONTRACTOItS AND CONTtgACTOR RE�PONSI�ILITIES: �1� the-�owmer has��htred'-a contractor or
contractors to undertake work, they may.be;r�qtaired:_to;be•)(censed In ac�ordance.with state�.and�local regulatlons:�if the � �
contractor ts�not Iicensed_as�req�alred=by law, both the ovimer and=cont�actor�may-be��cited for a•mi�demeanor violatlon
undar state law. If the own�r or InQended�contra�tor,are,.uncertain as to what Iicensing-requirements;may•�apply.�.�for:the`= � �
intended uvork, 4hey are advised to coritact the Pasco Couetfy Building.'In�pectlon Dlvlsion-Llcensing Section at 727-847-
� 8009. Furthermore, If the own�r tias fii�ed a conUacfor or contractors, he is advised to have �the contractor(s),,sign ,„
portions of the "contractor �lock" of thls.appllcation for which.ihey,will.be.-responsible: If youu, as..xhe owner`sign'�as'tlie
, contractor, that may tie an Indication that'Fie Is not.properly 9lcensed and is�not entitled to permitting privileges in Pasco
County. �
'f�1NSPORTATIAN-,IMPAGTIUTILITIE�`INIPAC'�`Af��ttE�OIIRCE ItECONERY FE��: The undersigned understands
that Tr�nspo�t�tfon Impact Fees and.Fteco.ur�e Recove.ry.Fees may�,apply�to the;construction of new_buildings,change of>-'' " -
use in existing buildings, or:expansi�n�of�existi�ig,.bulldings, as speclfled.in Pasco County Ordinance number 89-07 and
90-07, as amended._ The under�igned also;und�rstands, thaQ:�such fe.es�-.as��may_;�e�due;:will�jbe Identified at the time'�of.� �- �
per�itting. It Is furt6ier understood that Transportation Impact Fees and°Resource Recovery'Fees.must be paid prior to
� re�eiving � °certiflcate=of occupancy" or flnal��powerrelease. :If�Ehe.proJ�ct does�not.Involve:a:.certificate of occupancy.o��"�'�'
final powec r�lease,•4he-.fees must'be paid prior to.permit Issuarice. Ft��therrr�ore;if P�scv:,.C.ounly VNater/Sewer��lmpact � . � '
fees are due,they�.must be�pald pNor#o.permit�-Issuance�ln accordance wltFi applic�ble Pasco�-.County orclinances. j
CONSTEtUCT10tV'LIEN LAW"(Cli�pter 713� Florlda Statutes,as amend�d): If v�luat�on of.work is$2,500.00.or more, I� _ ��,� ,I
c�rtify 4hat I, #he applicant,--h�ve-been provided wlth�a copy of the uFlorida� Constro�tctlon_Llen .Law—Homeowner's
Protectfo� Gutde" prepared by the Flo"rida Depa�tcnent�of Agriculture and Consumer Affairs. 6f the app9icant is someone . �
other than the°ow�er", I certtfy that.l h�ve.obtained�a eopy.of the�above..r�escribed docu�ent�and.p.r.omise in,good faithto �,
deliver It to the`owne�'�.prior:to�ciommencement:' _ - i
COMTRACTOR'S10WNER'3 AFFIDAVIT: I.certify.,that all th�:.information.l�•thi� applicatlon is accurate �nd that all work
will�be done in compliance with all applicable I�ws regulating construction, zoning and�l�nd development. Application is
hereby made.to obtain .a permit.�to _do. work:.and�-lnstallatlon as IndicaQed:� °I certffy that no work:or Instailation tias '
commenced prior to issuance o��a permit"and that.all v�ork will be performed�to meet standard� of all laws regulating- ,
construction, Gounty and City codes, zoning regulations, and land d�velopment regulatlons�ln the jurisdiction. I al'so
certlfy that I uad�rs4and 4hat the regulations of other government agencies may�apply�to the_intended work, and that it is
my responsibilityAto identify.w6�at.act(ons I must take to be.in:.corrlpliance. Such.agencies include but are.not Iimited to:
- Depaetment of E�lvironmental'�Protea#ion-Cyptess.Bayheads, VNetland Areas and Envtronmentally Sensitive
L�nds,VNaterMlastew�t�r Treatment.
- Southwest Florida 1Mater Management:- C�istrlct-Vllells; Cypress.��Bay_Meads; Wetland Areas, Altering
V1latercourses.
- Army Corps of Engineers-Seawalls, Docks, IVavigable Waterways.
- Department of .Heaith"& Rehabllitative Services/Environmental..Health Unit-Well.s, Wastewater Treatrrient,
Septla Tanks. � _
- US Environmental Protection Agency-Asbestos abatement. .
- Federal Avtatlon�Authortty-Runways.
- I understand that the following.:restrictlons apply to the use of flll:
- Use offill is not allowed in Flood:Zone"V"unless expressly permttted.
- If the fill material�Is to�be used_in �Flood Zone. "A", It. is understood that a dra(nage plan addressing a
°compensat(ng volume" will be submitted at�ime of�.permifting which is prepared by a professional engineer
Iicensed by the State of Florida. � �
- If ih� flll materlal�is to be used in Flood �ane "A� in�connec�ion�with�a permltted building using stem wali
� construction, i certify that flll�:wlll-be used only.to.flil the area wttB�in the�stem�wall:
- If flll materlal is 4o be used in any area; i ce�tlfy #hat use. of such flil will not adversely affect ad)acent
propenies. If use of fill is found to adversely:�ffect adJaeent�proper4ies,.the owner may be cited for violating
the condl#(ons of the b�9lding:permit I§sued under tha at�ached permlt appllcation, for lots less than one (1)
acre whlch ar�elevated�by flll,an engineered dralnage plan is required.
If I am the AGEN'T FOR THE�O1fVNER, I,�promise In good falth to inform th�ovvner of the perrriitting condit(ons set forth In
this affidavtt�prior to commer�cing construction. I undersfand that a=aeparate permit may be requlred for electncal work,
plumbing, signs, weU�,.pools,_ alr conditioning,.gas, or.other instail�ttons nal,spec�ically included-tn.the application. .A
permit Issued shall be construed to be-a�Itcense to p�oceed with the work and not as.authority.to.violate;'caricel, alter, or
set aside any provisions of the techn(cal c+odes;�nor shall is§uance�of a.permlt pcevent the Bulldirig O#fictal from thereafter
requir6ng a correction af errors in.plans; const�etion or violatlons of-any cod�s. Every piermlt"Issued�sFiall become invalid
unless the work authorized.by such permit.•Is.coFnmenced�within sGc_m.onth� of permit lssuance, or if work authorized by
the permit is suspended or.abandoned�for a;perfod of six(�)montfis.after the titne the�work��s"commenced. An extension
may be requested, in writing,..from tHe �ullding,Offlcial for a per(od=not to �xceed ninety(90)�days a�d will demonstrate
� jusdii�ble cause for.the extension�. ff uvork ceases:for ninety(90)cons.ecutiv�days�..th�)ob�is considered aba�doned.
U4le4RMING TO OVIFNER: YOUR:FAILURE�TO..REC.OR�!A.NOTIGE OF��AMWIENCEMEMT�MAY�RESIIL:T IN�YOUF3
PAYING 11NICE.FAR�IMPROVEMENTS T0 YOUE�:::PR�PER7Y. IF°YO.U�I�l�END4T0'O�TAIM•�FIN�t�E1NG;�CONSULT _
NI�ITH_V_OU13-LE,. � -QR-A!�e'�2��l:EY~B�{FSo°:�'E'�n^�e�3$� Cro:'- ��"„ ;��,�._.-. ,r _ � .�.. ---- - - —- -
FLORIDA JURA�(F.S:t97. ) , �� ' ' ' -
�
OWNER OR AtiENT GOf�iTR/SCTOR �-��ti.�� �
Subsarlbed and swom to(or aRirmed)before me 7his Subscrlbed and'subom to(or'afflrmed)�before me thi§
by- '�-�1�'
VVho Is/are personally knowm to.me or has/haae produced Who Is/are petsbnally� own•ta me or has/have produced •
es Idendflcatlon. � as IdentlBcadon. •
__._ �
Notery Public . l,i� �� , Notary Public
Commisslon No: Com Issl .No. ,.�"�Y"'�-.
'�; �i:= Commission#FF 150422
Name ot Notary lyped,printed or stamped Neme of Nolery � ,,;�„� c AST,�Upp� ein Inwranco 800385.7p1g