HomeMy WebLinkAbout17-18413 CITY OF ZEPHYRHILLS
5335-8TH STREEI�
_ , (813)780-0020 1$413
BUILDING PERMIT
PERMIT INFORMATIC7N LOCATION INFORMATION
Permi# Number: 18493 Address: 6219 11TH STREET
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Ciass of Work: ROOF REP�ACEMENT Towr�ship: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: TYSON
Est.Vaiue: Parcel Number. 02-26-21-0080-00200-0150
Imprav. Cost: 1,004.00 OWNER IPIFORMATION
Date [ssued: 4/2712017 Name: BAKER JAY&TAMI
Tatal Fees: 45.00 Address: 6219 11 TH ST
Amount Paid: 45.00 ZEPNYRHI�LS FL 33542-3551
Date Paid: 4/27/2017 Phone: 813-713-5586
Work Desc: RERC?QF SHlNGLE
CONTRACTOR S APPLICATION FEES
HUMEOWNER REROOF RESlDENTlAL 45.OQ
Ins ections e u d
DR lN R OF!N P
TAPE JdlN-�OFj+'N���_��
FINAL i
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
loca!government shali impase a fee of faur times the amount of the fee imposed far the initial inspectian or
first reinspection,whichever is grea#er,far each such subsequent reinspection.
N4TiCE: In addition to the requirements of this pertnit, there maybe additiona! restrictions applicable to this property that
may be found in the public records of this county, and there may be additianal permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Yoar faiture ta recard a notice af commencement may result in your paying twice far
impravements ta your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice af cornmencement."
Camplete Plans,Specifications Must Accompany Applicafiion.All wark shall be performed in accordance with
Ci Codes and Ordinances. Nt}OCCUPANCY BEFQRE C.O.
NO OCCUPANCY BEFORE C.O.
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CO CTOR SIGNATURE PERMIT OFFI R
ERMIT EXPIRES IN fi MC>NTHS WITHflUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PRC>TECT CARD FROM WEATHER
e��-�eo-ao�o City af Zephyrhills Permit Application Fax-813-780-0021
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Building depattmen#
Qate Recetved P.hane:Contact for�Ferniittin
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Owrter's Alame � - e Owner Phane Number ����,� ��
Owner"s Address Z �� �'c f tc . ��I� •Owner Phone Number �� �
Fee Simple Tltle6older Name � �� Owner Phane Number �� ��
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Fee Stmple Tltleholder Addresa
JOB ADDRESS Z I�1 J�� � f� '2 - (t LOT# C��
SUBDIVtSiON �� � PARCEL ID#
(OBTAINED FR4M PROPERTY TAX NOTICE)
WORK PROPOSED .NEW CBNSTR ADDlALT �,] SIGN' Q Q DEMOI.ISH
e. INSTALL 8 REPi41R
PROPQSEDrUSE •- - � SFI2 Q COMM [� OTHER
TYPE OF CQNSTRUGTION Q` � BLOCK ' [� FRAME [� STEEI. Q �
DESCRIPTION OF WORK-' - ����- S{��,, '
BUtIDING SIZE �� �"SQ FOOTAGE . ,HEIGHfi ,��
�B��Ld»�' � ��� �,,.� VALUATION�4F TOTAL CONSTRUCTION
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C�E�-��T����- , $� - � AMP SER1/ICE Q PRtyGRESB ENERGY Q W:R.E.C.
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OPLUMBlNG $ 1 '
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QMECNANICAL $ VALUATIQN QF MECNANICAC tNSTAl1ATtON'
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QC,AS Q 1200FlNG Q SPEGIAR.TY � O'fHER
FINISHED FLOOR ELEVATIONS ��� FLOOD�QNE AREA QYES. .NO
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BUILDER �,,,./ COMPAI�tYY�• 'R�rizt_ OC�dt � '.,
SIGNATURE REGISTERED Y/ N 'FEE CURRE� Y/N
�ddrass . „ � . ' , .�L'icense#'� y�
ELECTRICIAN: - . � �.COMPANY ' ' ` r � -� ' .
SIGN�ITURE � REGISTERED Y/ N FEE CIJRRE�-' Y/-N .
Addrass ` _ .: Licen e. ��, �
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Pi.UMBER ' COMPANY ., �. ... . '
SIGNATURE " . .Re���T�EREo Y../�,N:�. ;,FEE•,CURRE�_' , Y:/N, - �
1�ldttr@�S l.iCeT1Se#�� - . . � - �.
MECHAMlGAI:' , . � ' COMPI.INY � ` , ' - _
SIGNATURE � � ' REGISTERED _ . , Y,/ N . � FEECURRE�. -. Y./:N- �
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Address � ` -- • - ` � ' License#'�- � I
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O7FlER °' . � , _ _ � •':GOl4F/PANY -
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SIGNATURE �-" _ �.� ".: .' ^� "- " °� ' ' � `REGISTEFtED` ` Y/ N... ' ' .FEE cuwtEn Y/N
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Addres�, , . - " . ` ; � Cicense# � � � ,
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RESIDENTIAI::.;.= Attacti'(2).PfotrPlaiis;::{2}set"s:cf�Biiltding�F'lai�s;{1)"sefof�Energy�Forins;,Ft-0�W=Perrtiltfornewconstructton,
;a Minimum:ten;(�1,0)-worlcing�days after'submittai'date;�Requli�ed onslte;�:ConsUiictlon�Rlans;`Stormwater Plans w/SUt'Fence installed,
^� �Sanitary Facilities;&-:1;;dumpster�3ite:WorlcPermit#or_sutidiVislon§/large;prcijects,:,,-:.;, :.� ' ' '"
CQlHMERC(AL At#ach{3}�coinplete sets"of 8u11iling`Plans plas a l.ife Safelfyi Page;{1}set of Energy Farms.R-O W Pesmit for new cansttuctlon.
Minimum ten(10)working days after submittal date. Required onsite,ConsUuctlon Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary FaclliUes&1 dumpster.Slte Work Permit for ail new:projects:.All commerolal requlrements:must meet compNance
SIGN AERMI7 Attactt{2)sets ofEngliseer,ed;P.,'lans.�:: .;'�, �, �.� �� . .
"`"PROPERTY SURVEY reguired for all NEW construcd'on. .
Dlrectlon�s: � ._ . .
Ffli out applicadon completely.
Ownar 8 Contractor sign back of appifcalion,notatized
If ovar y2500,a No#ce af Corrtmencement 1�required. (A/C apgrades aver�,7800) ,
'" Agent(for the contractor)'or'Power of'Atta'mey'(fcir tlie owner)would be someone with notarized letter from owner authoHzing same
OVERTFiECOl3NTER.PERMi'i'CiNG ._:,.(Frontof-ApplicattamOnty}�- ' _ .. -
Reroofs if shingles Sewers Service Upgrades A/C , Fences(Plot/Survey/Footage)
Drtveways-Nat over Counfec,if_on.public,roadwaqs..needs 120W , � . t , � �., -': .,:,;�:- ;:;, _� :i -- .
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NOT�CE OF DEED RESTRICTIONS: The undersigned,understands;th�t.this;:��rmlt;may,be.SubJecfi to"deed".,restricttons",.�._.,�.:;:`'-.
which may be:�more r.est�:ictiveAth��>Couiity���+eg�ilations:=The`undersigned assurries'�esponsibility''for compllance witlr any��� �`� ��
appNcable deed rest�ictlons. • , , _, �- � -- -�
UNLICENSED'CONTRACTORS:AND CONTRACTOR .RESPQN8181LITIES: ��If��the��ovmer�has-`�hired��a"contractar or
contractors to undertake work, they,may:be.>reiquired�_to..be;licensed In.accordance.with state�.and_�local regulations.::=1f�the�==- ��• '
contractor ts not Iicensed�'as�requlGed.;tiy law, both the owner`and�conV�cto�fmay be�cited for°�a�misilemeanor violatlon
under state law. If the owner or intended:;cont�actor;are:.uncertaln as to what Ilcensing.requtre�nentsl;may:apply���for:�tfie � -�-< �_ =�
Intended work, tliey a�e advised to cont�ct the�-Pasco County Bullding.'Inspection�Dliiision--Licensing Sectton at 727-847-
8009. Furthermore, If the owner h'as hl�ed'a cont�actor o� contractors, he is advtsed to have the contractor(s); sign, .
portions of the "conttactor Block” of thls.appllcation>for whlch:they:will.be,.r.esponslble.-.,If��you;.as.#he owne�`'sign`�as-the �
contractor; that inay tie an indication thaf`Fie'is`not.properiy Ilcensed�and�`is not entiNed to pemiitting privtleges in Pasco ,
County. . ;,.. : . . . ,
Tit�4NSPORTATION-IMPACT/UTILITIES°IMPI4C�'ANb�RE$OURCE RECOVERY�FEES:�The understgned�understands
that Transportation Impact Fees and.Recourse Recove.ry.Fees may:�appiy;�to�tf�e tconstruction.of new..buildtngs;=change'of'�-'f=`�== ''=
use in existing bulidings, or�expansi�n��of;ezisti�i�g..buildings� as specified in Pasco County Ordinance number 89-07 and
90-07, as amended.,,:;The undersigned also:�understands, that�such fees;;;as,tnay:�e:<.due;�..w.iil;-be identified at the':time��of�>�� ��_ '`�'��
permitting. It is furtFier understood that Tra`�spo�tatton impact Fees and�Resource.�Reco�ery�`Fees.mu�t be paid prior to
receiving-a 'certificate=of oxupancy" or flnai-powerrelease. :If�the.p�oj�ct.:does.not involve:a�certiftcafe of occupancy�o���`�����= ���
final powec release;,.the�.fees mu§t;'be paid::prior to,`permit issuance. Ft��thermore;-ff:Pasco,,County�Water/Sewer:;impact ,.-
� fees are due,.they_must.-be:pald:prior to permit:issuance=ln accordance witfi:�appltcabte:.Pasco':County�ortltnances. -
CONSTRUCTION"LIEN LAIIV(Chepter 713� Flortda Statutes�as amended): If valuadon of work is$2,500.00°;or more,:l- � __ ,
' certify that I, #he. applicant;-have�been provtded �wlth-a copy-of:the "Flor(da� Constructton�Llen�.:Law—Homeowner's
Protectfon Gutde" prepared by tFie Flor�da Depertment�of Agric.ulture and Consumer Affairs. If the appitcant is someone ., ,
other than the°owner", I certify�.that.l:h�ve,obtaiined�a`�copy.of..the:abpve.rJescribed document=and:promise��in,good#aith�to. .,
deliver ft to=.the.�'owne�"�:.p�ior'to�commencement:''� ' -� ' � ' .
CONTRACTOR'SIOWNER'S AFFIDAVIT: I cenify.tli;at:all:the.,inform�8on:in�thl� application is accurate.and that all work
will'be done in compliance with all.appltcable laws regulati�g construction, zoning and:land, deyelopment. Application.is
hereby made to obtain.a permit,;Co�:do,�w,o�lc,;�and�installation as indtceted:• �:I cectify that no work>:or (nstaliatton fias
commenced prlo� to issuance of'a�permif""and that.all work will be perforr�ed�to meet standards of.ali laws regula�ing-
const�uction, County and City codes� zoning regulatlons, and tand development tegulaUons•tn the jurisdiction. I�al'so _
certify that I u�derstand that the regulations of other government agencies may�apply�to,the intended work, and that it is
my responsibility to identify�what.actlons I must•take:M bedn:.complia�ce. .S,uch agencles Include but�are.not Iimited to: � -
- Department of Er�vironmental=�Protection=Cypress.Bayhead�, Wefland Areas and Envtronmentally Sensitive
Lands,VHateNVUastewater Treatment.
- Southwest Florida Water Management>.:I�isUlct-Wells;'`�Cypress.c�Bayheads;- Wetland Areas� Altering
Watercourses. ,. •
- Army Corps of Engineers-Seawalls,�Docks, Navigatile Waterways.
- Department, of;Health;:,&. ReMabllitative .Servtces/Errvironmental.�..Health Unit-Wells� Wastewaterri Treatment, �
Se�tic Tanks: � � - .�
- US EnWronmental�Protectlon Agency-Asbestos abatement.:_: . �- --- -
Federai Aviatlon:Authority-Runways: � . �
-1 understand.that the.following:Festrlctions apply to tFie use of flil: - -
' - Use of flll is not allowed in'Flood-.Zone"V"unless expressly permitted, �
- If the flll` material--is fo 'be used.'In :Flood Zone. "A", it Is understood that a drainage plan addresstng a
"compensating volume"will be submitted at#ime of�:permftttng which is prepared by a professfonal engineer �
Ilcensed by the.State of`Flo�ida: - �= . _ . . . �
- If ih� flIF inateria)�.Is=to be used in Flood Zone 'A° in�connec�lon�viritfi:a�permitted buildir� usin stem wall
9 9
� construction, I certify that flll�:w111=be�used only.to.fill the.area within the�stem=wall: . ,
' - If flll materlal ts to be used In any a�ea; 1��ae�tify that .use. of'{such fill will not adversely affect adjacent
properties. if use of flll is found.to adversely:�ffect ad)aeenf��properties�.the owner may be cited for violating '
the�conditions..of the building-;permit is"sued�'under the`attacFied,�ermit�application;-.for_:lots�:less..than-one (1)
acre which are elevated�by f111;art englneer•ed drainage pla�Is requlred.
If I am the AGENT FOR THE OWNER, I;promise in_good falth to inform the�owner of the perniitting conditfons set forth tn
this affidavtt�prior to commencing constructicn. 1 understand thet a2separate permlt may be requtred for electMcal work, .
plumbing,.signs, weUs,.pools;, alr conditioning,.gas, or.othe'r. Install�tlons not.spec�ically Included�in.the�application. .A .
permit Issued shali be constcued to be��a°license�to�_proceed wlth'the work and not°as:authoNty,to:violate;'cancel, alter, or
set aside any provistons of the teclinical codes;�nor shall issuance•of a.permit.prevent the Bulldirig Official from thereafter
� requiring a conection af enors in„plans, construction.or vlolattons of�any codes. Every�permlt lssued siiall�become invalid
unless the work authortzed by such permit:�ts.commenced•withln sfx.:m.onths of�pertnit Issuance, or if work authorized by
ihe permit is suspended=or:abandoned�for a;period<of�six.(�)montF�s.after the tirne�the�work�ts commenced. An extension
may be requested, In wrifing;.,from.tlie Bullding,Official for a perlod=not to exceed•ninety�(90)�days a�d-will demonstrate
justifiable"cause for:the extension�. If work ceas�e�.for ninety.(90)cons.ecutive�days�..th�Job�is considered aba�doned.
WARNING TO OWNER: YOUR.FAILURE.T�.,R�EC.ORD A,MOTIGE.OF.°COMMENCEMENT:NFAY�RESULT IN��YOUR
'� PAYING TWICE;FOR-IMPROVEM@NTS;TO::YOU�.:PRQPER7Y: IF�YO.UriN�EKID�TO�iOBT�►IN�=FIPtAI�EfNG;'C.ONSULT
__ WITF#YAUR LEND(ER:OR AN ATTORNEI���FOR��RE�AF��71NG��xOI��'�O'FI��"O��AM�l11E�E'�E�'�' -'-- — --- -
FLORIl7liJU�tA�(F.S:1.1T.031 � ` . . . _
OWNER OR AGENT i CONTRACTO � �
Sub cxibed and swam lo or rmed)be re me thls Sub¢crlbe and'swom flirmed)�beiqte me tfil$
bY 1�1�7�/7 ..by- `5G� � .} ..
o p �s IlyI�novm to or:haslha,e produced V�o Is�/a�e�e onallyknown_t_t� or haslhave-produced- � �
/ �-/ a Identlflcatlori. /�Q/V��� /�1��-s'7�.J'� as IdenBflcaflon. •
Notery Public . Nofary Publlc
� �
Commisslan No: Co mission No. "'D S ,
f���.P� �i�/r�/� � ��Z.L , ��z3.2�-- E`.���
Name ol No edFp�'�'��-�:a Name oi Nolery ed rinted or stam�ed
:=�4r;YP�BG.% DEBRAELAINE RUFFELL ;=Q:��ayPqb�c,-DEBRAELAINE RUFFELL
:�: °�__Commission#GG 045343 ' `-� • =Commission#GG 045343
:����ae:Expires November7 2020 ` '� "
;;.F oP•- � ;:=;;,.��;;Expires November 7,2020
�, ••.g„;,.••' Bonded Thru Troy Fain Insurance BDO-385�7019 '•�o�F;RP' f3:Rdsd Tt!ru Troy Fain Insurance 800,985�7019 _
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DISCLOS'�RE ST1�TE�T FOIt OWI�ER ,
CITY OF �BPHYRHIT,LB SIIILDII�fG DEPART�I1tT
I, �., �,�� h�ve read aad fully unc2�rstaad aud
agr�e to the prov3sious of this instrumeat.
The uadessigaed sta�ea aac� affirms tha� he or she is desiraue of constructiag,
renavatiag, addiag �o or rercofiag his ox Yier own domicile, that he ar she
aatually oceupie�, ox will aec�p�► by said domicil�, aad same ss not for
reat, lease or sal�. That he or she shaZ]. comply with th+� followiug conditi.ons:
3. That th� owner and he ar �h� aloae shall act as the builder for all pha�es oiE
eoastruction. �
2. That the ox*a�r will campZy �v:ith aZ2. provisioas of the Cit�r of Zephyrhills
ordinsaces �ad cod�s pertiaestt to �he build3.ag.
3. That ia the eveat various phases of coast�cuctioa are subcoatracted, he will
engagre oaly properly lioeased subcontractar� aad will persoaal].y supervise
suah work.
4. That ia th� eveat the Buildiag Iuspeator sha1l require corrections to b� made,
�he o�,raer will assvme full respaasibiZity to iasure they are made, �and upoa
complet3on will ca].l fax a reiasp�atiaa b�foxe proaeeding with the bui.ldiag.
5. That th� owaer s�all assume full respaaeibil.ity far the cosistxuct3on a.ad w311
xxot e:�cpect supervisioa af his work �rom th�e City of Zephyrhills Suildi.ag
Departm�nt.
6. 3'hat pria� to giaal iaspeetion aay �adclitioaal fees, iacludiag reiaspection
£eesj mus� Tae ,paid ia full. A writteu request from this office $hal.3
coastitut� an offi�ial notice to pay adc4itionaZ fees.
7. That �h� owner sh�11 comply with �1]. City, S�ate aad Federal latvs iri r�gard to
soca.aZ security, workman's compensa�ian, la.en laws, etc. , where applicable.
8. That the owaer shall camply aaaith all the s�fety cade� issued by the Florid�
Indus�rial Commission.
9. State law reguires �onstxuction to be done by liceased coatractars. Ycu have
applied fcir � permit uader aa eacemp�ioa to that l�w. �h� exemp�ion allows
you, �.s the awaes of yrour praperty, to act as your a^wa cantractar with certaia
restrictious ev�a though yau do aat have a licease. Yau must provid�: direct
i oasite supervisiou of the coastruCtioa your�elf. You may build or improve a
oae-f�mily or two-f�amily resideace as � farm outbuildiag. Yau may also build
or 3mprove a cammercial buildiag, provicied yaur cost� do not exceed $75,OQ0,
The building or reaideace muat be for your owa use or acaupaacy. Zt may ao�
be built or substaatially improved for sale oac Zease. If you sell or lease a
bui3diag you have built ar svbstaatial.ly improved yourael� wi�hia 1 year aftes
the eoastruetioa ss eamgZet�, the law wi11 presume that yau built or
sub�taat3a11y iaiproved iE for sal� or lease, which is a viola�ioa of this
exemption. You may aot hire aa ualicexased persoa to act as yaur coatraator or
to sup�ervioe people workiag ou your buildiag. zt is yaur reapoasibility to
make sure that peaple employed by you have Iicenses required by stat� law aad
'b�r couaty or a►uaicipal Iiceasiag ardinances. Yau may aot de3egat� the
r�aponeibilitg foz supervising work to a liceased.acs�traetor �ho is aot
liceased ta perfozxn the work being daae. Aay persoa working oa your buildiag
who is aot liceased must work uader your direct supervision aad must be
----- --�ployed b�you�rhi�ILmeans-that___.y.ou-must-deduct-I�.-I-.-C:34:—aad-withho-l-ding-tmx----------------
and provide workers' eompensa�Gion far that emplayee, ai2 as prescribeci by Iaw.
Yaur caastruatiaa must aomgly Fri.th all app3fcabl� 3aws, ordinances, buildix�.g
codes, aad zox►ing sec,�ulat3ons.
dWNER'S STGNAfiURE �,J"' DATE
ann�ss �zE� tJ��- �czF-�
PHONS�
V�IITATE;SS PRRPdIT #
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