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HomeMy WebLinkAbout17-18583 CITY OF ZEPHYRHILLS , 5335-8TH STREET . ., (813)780-0020 18583 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 18583 Address: 5626 20TH ST Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 12-26-21-0020-00400-0110 Improv. Cost: 12,000.00 ' OWNER INFORMATION Date Issued: 6/19/2017 Name: OUR SAVIOUR LUTHERN CHURCH Total Fees: 95.00 Address: 5626 20TH ST Amount Paid: 95.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/19/2017 Phone: (813)782-1369 Work Desc: CHANGEOU 2 C UNITS 5 TON=�t' CONTRACTOR S APPLICATION FEES CHRIS'A/C COMPANY A/C CHANGEOUT 95.00 � � � � `, �� Ins ections Re uired D CTS IN TALLED DUCTSINSULATED 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 properly 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 pertormed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. � � CONTRACTOR SIGN RE PERMIT OFFI R PERMIT EX RES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER .___. . a�a-�so-oo2o City of Zephyrhills Permit Application Fax 813-780-ao2� Bu!lding Depariment Date ReceOved , � ' �� ' /-� •° Phone�Ganfact for.:Perrrittfln � SaJL� - �/�17��` Owner's Nama .�Gc/f �c v�p,'"' .u�.�1''�,c.'u- ���- Ownee Phone Number /� ' � �'f�K�� Owner's Address o2�U Q '� Owner Phon�Number - �— y� Fee Simple TltteholderName �� � Owner Phone Number �� � ` Fee Simple Tltleholder Addresa JOS ADDRE3S Ga..�vH-"(�'.- LOT# �_,_� - ---- -.._. -- suea�v�siat� , � � �,aRce�rcx� � a �.�v o2 1 _O C3- ---t�—o o � G ._D /� , (OBTAINED FROM PROPERTYTAX NOTICE) WORKPROPt}SED � NEwCONSTR ADDlA�T [� S1GN` Q Q DEMOCISH •e. INSTALL 8 REPAIR • Pl20PQ5EDrUSE , ' Q SFR, Q GOMM ''� ,OT(iEi2 � ' TYPE OF COIVSTi2UCTION` [� BLOCK " Q FRAME � � STEEC Q DESCRIPTION OF WORK' �� !/�v � �.{'/ /�f I'�CI�- � �`— . ��� BtJ1�D1NG SIZ� °` `8Q FOOTAGE�_�;- HEIGHT+�}�� O 0,`.�L� �f��C.. QBElIi.DING ���� VALUATION*tOF`'TOl'AL CONS'FRt1C1'iON . , • QE�ECTRICAI. � � AMP SERVICE Q �P120GRESS'ENERGY Q W.R.E.C: QPLUMBtNG • ,$ ; ` , ; . :.� � �MECHANIGi4l �$ }�� i(i4LUATlON QF:MECHAi�lICAL lNSTALLATION .I__.LF� �' �'"�. �GAS Q RC?OFING .[� SPECiAI.TY �] OTHER ° ` FINISHED FLOOR ELEVATIONS ��� FLOOD 20NE AREA [�]YES NO _ ,.�: -- _.—.. .�. - - -�4lI�t3�e� -- .____________.�_ _ - - CON4P'APt1'� - - — -- - SIGN/�TURE REGISTERED Y/ PI FEE CURRE� Y/.N . Addraas license# i � ELECTRICIAi11. . ' .iCOMPANIt � _ SIGNATURE �` REGI3TERED Y/ N FEE`CURREk� � Y/N ' Attdr��s , . - " � , . ,- License# t . , � j � Pt�t1MBER ,. �� � . GOEVIPANY ; , ` SIGNATURE` � `' � a RE��STERED Y./..N� : ,;EEE CURREP Y/N.- Addre�s � � . .Ucense,# I , - � �n�cr�aa�c�:. . _ � -- -- - - �_ coM�a�r � .�<.�', ,� 7 �.. a��o �c.�r ( SIGNATURE• ' �"'�S`, c"��'" REGISTERED � _..I N. .',- FEE CURREA Y N = j . , , . �� - � , r.A Addres"s°��+� .,�c�� � `' `' �j� � J �� License# ��. `� _ OTHER = . - , ' , `'COIIlIPANX _ � SIGNATURE�- '=�'L'> "' '" �- s ' ' � ' REGIS7ERED ' Y/ Ns..: � FEE CURREP � Y/N Addce� � ., ' ' . � � . -L°EcenSe#� y � . RESIDENTIAI:,,- Atta��(2},p._tot=.P-,la'ris;.(2}�et`s:of'Bu1lding7Fttans;{'1}'setaf"Eoerg}i}Foiii�s;��R�O=WP'srici,ltfarnew�r�struction,, ' . , _ . , •„ ,;�,a�;Minimum;ten;(10)�wori�ing,days,atte.r.;submlttalwdate:�.Requlred onslte;;ConstrucNon=Rlans;Stormwater Plans w%Sllt'Fence installed, "' Sanitary'Facllttles&lydumpster,SlteiWorkrPermitforsubdivislon§Aarge:projeafs,;,:•� ;.;.- ' - `�� CQMMERCiAl. Attach{3)complete se#s-of Btitldiiig`Plans plus a�Cife Ssf��ty Page;('1}seti of Energy Fatms.R O-W Permtt for neuv canstnsc�on. - Minlmum ten(10)wortcing days after submlttal date. Requlred onsite,Construcklon Plans,'Stortnv✓ater Plans w/811t Fence lnstalled, Sanitary Facllitles&1 dumpster.Site Wark Pertrrit for all new.•proJects.A!I commerGal req�ltements.must meet compflance S1�N PERMFT Attacti{2}'sets"of Engiiieer,ed;Plaris:, ._:;,,°< ,_ . , ' , - - •••"PROPERTY SURVEY requlred.for all NEW con.structlon., � Dlreistlons: _ , '. • . Fill out applicaUon completely. Owner&Canhactor stgn back of applfcaUon,natarized � If aver�2500,a Rlatice of Comm�ncement is requlred. {NC upgrad+�s over 57500) `" Agent(for the`conUractor)'ar"Powe�of Attomey'(for tFie owrner)would be someone with natarized letter from owner authorizing same DVER THE COUP!'FER,�EttMlT[ING- -,-{Front of�Applicatton Onty}- ` �_ , Reroof�If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Foatage) Driveways-Not over Countet if on public roadwiays..deeds ROW , j ,�✓ • - a, �,,- NOTICE�F DEED RESTFtiCT10�i3: The,under�tgned under�tands��th�t:ttal�,.p�rmlt.maybersubJect to.°deed",restrlctioiis"�r �.,M1' :�; which may�be�mo�e�r,est�Ictive-than Cauritjr.a�rgulatrons: "1'he�u�id�rsigned as�umes'�'espc�risifiility for compliance�wlth any�` appllcabfe deed resbrlcttons. -,.,::, � .: � ._ -: ��,�. „ UNLICENSED��CONTRACTORS AND CONTRACTOR�RE�PONS[�ILITI�S: -��tf tlie owner°has��hired=,a"cahtractcr ar contractors ta undertake work, they may�be:required,�to.�be Itcensed In�accardance.wlth_state�.and_local tegulatlons:��If}the��' � ' � contractor ts�na# 1lcensed�as�irequlred`by law,.:bot#� the owr�er an�=:cotitcactor�rnay be�clted for��a�misdemesnor �iolatlan under state law. If the owner ar Intended;contractor�ere,,�uncertain as to what licensing.requiremen�ts,�may�appty:ior.�the- -� -- � intended work,they are advlsed�to`coritact the�Pasce County Bulliifng:`Inspection.Dlvision---l:icens.i'ng 5ection at 727-84?- �00�. Furtt�ermore, If the awrier'f�a�`"tilred a con�racfiir ot coritr�ctoTs, he ts ativ3sed to have�#h� cantractar(s} sign . � . . � r;'� ry,� ,;� pa�tiona of the:.°contractor.Block" of.thls.�application.forWwhich,.theywill;be_r.esponslble.- If;-you;�as,#he,owrier,s(gn�as ttie' � contrac#or, that�rn$y be an in8icatlon�that`he is�not.prope�iy licensed anil-lsrviiot'eritl�ed t�pet�mittUg priiiileges In Pasco _,_ . County. ' 'tR�►NSP�R7ATIdN:.IMPACTtUT1l�ITIES�lMPAC'Y=ANO�tESOUttCE RECOVERY�FEES:The unde�signed"�understands that T�anspo�tatton impact Fees and.Recourse RecaveryµFess msy;apply:ta:the;canstruation,of new_.buiEdtngs�:�change`"af==�''� ` �- use In existing bulldings;�or-.expansi�n�of-existin���6uildings, as specifled.in Pasco County Ordtnance number 89-07 and 90-07, as amended.,r;:The undarslgned also.understaads; tFiat�such fee�;�as�tnay:�e�.due;:wllt,��e Id."e.ntifted aE the��tlme�a#� � � permitting. It Is t�irttier understood that Trensportation Impact Fees and�Regource;Re�very�Fees..mu'st be pafd prlo� to rece�ring�a"certt�caEe=o#�occupancy"or flnal�pawe.r.-:celease:-:lf.E#ie.praject::�loes„rirSf involve<aY.certiflcake of occupancy.•�o��`.._<�<<.;;.:.. finai pawer=release; the#'�es mu�t��a patd,prtor to permft tssuance. F�i�thermore;��if:Pasco��County�iNater/Sewer,�:lmpact ��,.-.-V fees are.due,they�,-mustbe;paid=.p�lor�o_perrtdt�Isst�anca�:in accordanc�wlth:�appllcable Pesco�-County��ortlinances, • CONSTRUCTtON'CIEN-I.AW'(CHapter 713�Elortda S#a�t�#es,as arnendedj: If v�alua�on of wark ls�2,50Q.00;or more+!� °� =�ti� cerlify tfiat -I, the •applicent,_ have.been pro�ided �wtth�a�copy� of�the�"Florida� �onstruct(on: Llen .Law—Homeowner's Protectton GuEde" prepared by'tlie Fio�l�a Deparfinent�of Agrtcutture and Consumsr;:Afiatrs. If'the appilcant fs someonei, .. -� ather than the`owne�", I certify�that i;.have..ab#ainad�a=eapy;of.the:abova.des.crlbed�locur�entvand�:pr�mise�:in,good::faithto . �, deliver It ta:the.'owner:"=prior_�:to•commencement:' � � ° �� . ` �ONTRACTOR'SJOWNER°�aP�lDAYR: i.ce�ti�y<ttiat.all�.the;informatl�nin�thi�applicatian is accurate.and tha#all�work will'be done in comptiance with all applicable'laws regulating construction, xontng and:land=development. AppUcatlon is hereby rr�ade to abtain .a.pertn�t�.to dc�wark�;.and�=I�istallation as 1ndt�atec�:•�.-t. certifjt that no work:or tnstallatlon t�as commenced prio� to I'ssuance of:a permit`arid that�:all work will be perFormed to meet standards-of all laws regulaxing- canstructlon, Gounty and Gity codes, zoning regulatlnns, and land devefopment r.egutatlons�In the f urtsdtotion.�� ! al'so .. certify that i uaderstand that the regulations of other government agencies may�appiy�to the intended work, and#hat it is my responslbility to ldentlfy•what.acNons 1 must take;to,be�in.carrlpliar�ce..S.uch.agencies include but�are.not Ilmited to: � - Department of Et�vironmental}�Pirote�tion=Cypte"ss.B�yli�ad�;��!le�snd Areas and Environmentally Sensitive Lands,WaterlWastewater Treatment. - Southwest Ftor�da iNater Management-:C?istric#,:Vllells; `Cypress.,.Bay�ead"s; Wetland Areas� A1ter�ng Watervcaurses, - " - Army Corps of Englneers=Seawalls,�t�ocks,hlavlgable Waterways, - Depart,ment of_.Heatth;:�.,Refiabllitative SerYiceslEnvironmentai...F#e$Ith Unit Wetts� Waste�rater�Treatment, Septic'Tanks:., _ ' _ .. - ~ � - - US Env�ronmei�tal F�rotec#lan Agency-�sbes#o�sbatemen�. Federal.Avtallon�Authority.=Runuuu�ays. � � 1 undetstand that.the following.:reslrlctlons aPply to the use of flll:� . - Use of�ill is no#allawed in,Flood;:Zona�"V"unless expressly_permitted, - 14' the,=fill mateNalw`is �fo� b:e useid.�In.�Flood Zone. °A", It. is understood tht�t a drafnage pl2�n addressing a pcompe�sating volume"wi11 be submltted at time o#'.permitttng w�ilch is prepared by a professtonai englneer . licensed by the-StaCe�of�lorida. � ' �- �� � - . - EF th� #iii materlal�_ls to ba used�!n Flood �one 'A" in�connectlon�wiEh�a��erm#tted bultding a�sing stem wafl � construction., t certify that fiil;wlii:b.e used only.to.fill the area�withtn�the�•stem waii: " , - If flll materlal is�ta be used in any area, 1�c�rtify that .use. of;such fllt��will �ok adversely affect adjacent properties. If use af filt,is found�to adversety,�#�ect adja�enfi�praperties�,th�awner may be ctted far violating, the�conditions_:of the builiding;permit is"sued:under#he�attachedr�ermit applicatlon�-for.:lots�.less than�one (1) acre wlilch are elevated�tiy flll;an engineer�ed drainage plai�is requlred. � . If I am the AGENT�OR THE OWNER; I;.promise tn gogd fatth#a(nfarm-the owner of•the permttting condi#tans set forth (n this affidavlt`prlor ta�commeacing construction. "1 understand that s=s�perate permlt may be requtred for elect�ical work, . plumbing,_signs, wells, pools;. alr�canditioning�-:g$s��_or ott�ec Ens#all�itlons nat.speclf�calCy included�in the apptication. .A permit issued shall be construed to'be��a�lic�inse to��p�oceed with'tFie�viiork and not�as;autho�iqr to..violate;�"cancel; alter, or se#�slde any provislons o1'tlie#echntcal,c�des;�nar shall lssuance�af a.permlt.pcevent th�Buildirig CNflc�a!from theteafter requlring a aorrection af errors ln.plans; constructlon or violattons of any codes. .Every.p'ermlt�tssued"stiail become�invalid unless the work auEhar#zetl.by such pe�mi#:-1s-cammenced�wlthtn stx.months of per►n!t issuance, or!f work authorized by the permif is suspendad or:abandona�d:for-a�;period af si�r,�)monfiis;:after,the.ti�e the�watk�is commenced. An extensian may be requested� In writing;�from the.Buflding,Offlcial for a period�not_to.�xceed'=nineiy�(90)�days and°wilf demionstrate �u�#i�able cause for.�the extensiort., If work ceases:for nlnety{90�c�ns.ecuthre�days...th\�ab�ts.aonsidered aba�daned, UI4tARNtNG T4 OWN�R; YOUR...;�AIl.URE.T4,.REC.OEiQ_A:.MOTIGE_gF;-COMMENC�lVlEI�T.MAYrRESULT fN �YOUR PdAYtNG TVVtCE,FOR IMPROYEMEN�'S_Tfl.YE3UR°:PRDPERTY. -i��.YO.U=IN"FEND�i'�'�CiBTA1N�FiNi�11��tNG;�C.ONSUL.T IMIT U D �O: A i� O FOREi � OR� G:; pU �.� � - :p f �..� E , — FCORIClA JtlRAR°{F.Si 1:'t "03_ _� _ _�_. �_._�-___ _.r. , . . .:..,� � :__� .-- ::. -:-_.; . =--�—___ -------- _-----_,- OWNEIt OR AGiENT C�PITRACTO �� Su6s«ibed aMl swam �cr afiinned)b me thls Subscrlbed'snd'swram'to(ot ai�rmedj-6 ' e ttil�.; by •by ` ' Who Is/are persanally knawn to.me or haslhave produced Who:ls/ere p.ersonallyJcnovm�ta me.or#►a�lhave�produced as{deritl�i:a8o». as tdenHficafto�. Notary Public . Notary Pub11c. Gammission No': ComRtission-�to. Name ol'Natary typed,ptinted or stamped Name of Notary typed,p�tnted a�atamped ; � i � �� � ��-��� � �.v�. i� � <---.--� . ,..�� �� .� `�,�/'��J � �t�-�e� o��• Gt�... ' ����� �:�� r ;� �__ . V1-1-��� ; . �' � `.��-� �� p� ��► .,l�:; Y' : PRfl�'�SAL CIACCiS$�75 42�532 Mi{fiilf 30� D�IEl�CI'fY {352)52�i�77 DADE CITY,F�33525 " �P#lYRHE�LS(813}779'�5'i5 ���L'�,,.,XA'4,�,�.,.�- " l�A�E: Our Savuyr Luthem Chwch Date: - 07/15/45 s� XK t�ur �1'A Si.�3�t�.S[f7i�: � 'E� ' _ X 5626 2flfh St . .:_ ,_.�.. ..... _ . _ h i�s zt�cc�: 4i����:3': - _ .. i�: s13-7s2�1369 vu�sc: F��: TE�U�At3C$�}��2) �: �:�TUTB�kY#-i�'R�v'##}�8.2 '��: Chr�s. . �llEi�#CA#�i.STA�l�J4�t7 -.. ��a: 'i� : : �.�� � _�_._ ....� .._.. _._ . ,r.,__.. .... . .. . . . . . . . .. . . . . . - 2�t�;wwat��rr . �►'T'�: �:�#: : HOi�YV�tQL PRO 80W THERMOSTATS f Wf-Fi t 7 QAY ' ` ' . � .. , O�L . . ._ . ... Tt2ANE:EQilNAI.ERFT A!G Sl(S7EMS i�R�Y": P/�RTS: '�YEAiR_ � - ' I , _ _ ' . . CEiUtt CANt�Et3SEF2 `.��Y���I:S $EAL,E7l�CTWL?RKTO Ct)DE , •— -<._,;__:-;->;.._._ ..�.�._ _,�._.. ..._.�..;,._. r... -- ��, t2ELOCATE AtR NANQtERS TO ACCES$ ' i�LYW WOD:PLATFE�RM,S FQR A!R HANDlER SERVIC!!�.PER COQE tiAt�i.EfZ � �G�iGLi-' FiBVifOYE:fltD�EQUIPMENf ,TER: � CTED Tti D4lS17NG'DUCTS A[�!C?Ei_EC1'R!C . t.A�tOR Ai�tO FERMtf iNGLUDED E�4T'Ft+IG: ��t" � - _.. � e��wvnrrei�Arsce o�r��nr tiu�rs�R a�� t��'�Z;�'�' �A. ,,,���: - � � .: .: : .. , - ;� : . �� �r�,�rtar�c��t2�sr�r�5 rot���rs�r�.«a�sr,r� ��t�i�r: PA��f's; � �.,��' � rr�wir�c��oR�.t.a ur�rrs ar�rAUY ss4o.00 ��:A�.�.... . ._:,..:.e-..�.�....:.. ......�.._._..,�__..._._..... .._. . ............_ . � E DCfES NOT tNCL#119E ftLTERS,BELTS,PARTS OR REPAiRS. • � �}' • � �U��: � � � #�UA , <, €��: .�#/A , ��'t'�: °' .. _ ��# ...,. .: ,. .: . ...._.,. ......, ..._. _. ..,.: ..... , . .. . _ � . t�axE n�au�^irv Tq o�s�wauc aur�o a�. �a�ii�d�'�i,.�r � ' .�{�.. n�rs t�n��a��u�rrar�s�a�tncs tsxsn.r-u�ac�nn�r�s e�.�Fa�xr ��i:RAi+�#'Y: P�kRTS: � . s ffor�tis ar,a�n.sr�cr�r��saa��ua�eeaJr at+�+�v,�s as L�R: � . , , �.�var anr,�s�tn.��c�s sa��nrAt.�t.t�'r'a� . . � FHE RESi�'OF SH.kER. tlYA7 ED VY,4�lNTY:EQU�I�NT�PARTS A!�klASERlAL WRfi'!`EN�ACIZlR�SWIWRAAfiYONIY. :. ... .... .._. _,. ......, .,,. ..... ..:. .... .....��..�.:f.:.:..: - l**��� TCI�AER Sl�1KA�FURE DAl'E: t37:i'(t3U-U{)2U City of Zephyrhills Permifi Appiication Fax-813-7$0-0021 � Building Department � Date R�celve� "' l % �l�" ��a 5--�f - � �. � �' Phone�Ccnt�at for��rmittl» a. f3wner's Plareie tL✓/'� 0�,,�,�.�� Own�r Rhone IVumb�r ��3 ' �t�a ' �.� �'7' ' Owner's�►ddress , �+r�� � 0 � �Ue.,-�—G Own�r P'hone Wumb�r � � � ' , � � Fee Slmple T1�1�ltofd�c F1ame � Owrrier Phon�Nucnber �! � F�e Slenpte Titl�holder�ddr�ss ; JOS ADDFtE�3 �'�' i.OT# � . sueoiv�sooc� ��c����� a t� � t o a a D �o oZ� Q I�t� (OBTAIPdED FROM PROPERTY?AX•N017CE) WC�RK PEB��OSEp .idEl�t COt�STR' AQDlALT [� SIGN' Q- Q DEMQLISH e. INSTALI 8 REPAtR - . PROP�SED+U3E Q SFF2, [� COMM � OTMER TYPE OP C�WST�2�lCT60Td Q ° BLOCEC " Q FRAME � � STEEL Q . ��sc��������woR�c , /�t/.�L- .,.�C,. � ` s�'-�''�-�, � � � �� � BUILDlPIC'a SlZE �� � .�]: ` � O���e� f �v � SQ FOt9TAGE � H�IGHT .. �,�^f; [��UILpING �� VP.R.tltiTlOiJ�OF't'QT,4L CONS'1'1tl?CTIOht � � CJELECTRICAL �___,� ANflP SERVICE [� PROGRESS EIdERGY Q . 1 ; QPLUfUBING (g,_—_—^� ' � Q� , � � �� .� �MECHANICAL $ " VAI.UATI4N OF MECHANICAL INSTALI:ATIOId �{�.- , �� �� � � QGAS Q ROOFING Q SPECIr4LTY C] OTMER v�j,,� � FINISFiED F�04R E�EVATIOMS � � FlC10D ZONE AREA QVE$. h!O �r � - � , ( BUILDEFt �ONiPi�P6Y � � SIGt�0AT13Rl� REGtSTEREd Y I ft1 . -.FEE CURRET Y/Ft) AddrB�s ' - � � Llcense#'r EI.�CTRICO�V= . � Y i Gl`�MPAE+IY i SiGP�ATtlRE � REGSSTERED Y 1 � �E Gutt�aEh 'Y 1 PV �'` � Addeg�s , . l.Icense# ( � PLURABER ` �OMPMlY - . SICaN�TUP2E' � ` , _REGlS.TERED. - Y�I�{�1.. . FEE GURREh Y 143 Addre�s I,l�nse,# (�. �. � MECHANICAL'. � � � COMPANY, C �1 ''�.� � ,� � �� ` SIC31��tT�R� ,.� REG.ISTEF2ED ./ N FEE GURRER GN - AddfA�S' ' ' � � f�' �� �J O/ (.►C8itS9# ,J"'t"Ci J ,�. Oi"9'WE18 ' � - ;C�IMP��iNY � ��GNfiITE?f2E `-j . � - . ` REGISTERED ' Y/'N .; FEE Gt1RREt� Y 1#U Addc��s , ' - - Llcense# � �. � . RESIDEMTIiAL,: Attachi"(2)„Plat;Plans;;'(�)sets;of.%Builtlfng�l?lens;(1)set of�Energy�Farrns;,,R-0=1A1`Per`rrilt f6r new constructlon, ' " _.<;:Mtnimum�ten;(�0);,woticing�day,s,atte�,�subi�ilttaf'date:Y;Fiequlcet�onstte;'Gonstruc�cnjPlans;=Stortnwater Plans�wl SEIt Fence Installeii, �� � Santtary`Factitties,&��1:,dumps@er.�Site�Work:;Permit#orsubdivl�Ionsllarge�proJects�: � ,. � COMMER�CIAI. Attech(3)`eomplefe'sets oF B'ullding Plans~"plus�a`Ufe'Safety Pege;(1)set of Energy Forms.l2-O-W Permlk far new constructlon. iVlinimam ten('#0)wrorking dsys after st��mittal da�e. r�equlred onsite,Consttvctlan Plans,Stormwater PEans w!SII#Fence 3nsfatled; - --- - Sanitary Facllitles 81 dumpster.Slte Work Pemnit for atl new:�pro)ects.All commerclal requlrements must meet compllance SIGtd PEitMIT Attadh'(2)sets`ofEnglrieer.edrPlans:;� � • �. , . :°'°PROPER7Y SURVEY required far,atl NEW can.s..#ructlon.. - - ,. Dlrectlons: • - - � F�II aut agplicatlon comptefiely. Owner 8 Canhactor slgn back of appllcaUon,notarized � If ov�r 52500.a Notlee of Cammencem�n�ts nQuBr��. {IQJC wpgirades av�r�Ta00j " Agent{for the contractacj'ot�Povue�qf�Attoriiey(for tiie ownet}wouli!be sameone with notariz�d letter from owner authortzing same DVERTHE COUN7ER.PERMITflNG- -- �{Frontof•A�pllcation Only)� - Reroafs EF shingtes Sewers Servic�Upgrades AlC Fences{PlottSurveylFootage) Drlvewraya-Not over Counter(f on public roadways..needs ROW �.... _ . . . _.. _._. ._, . _ �: ,. -- - - 'a _,_ .�. : ; , � � _ . ,. � : � � -- ` � , ,. ' "� ,. ,�„. _ r. . ; , _. „ ,. -. ..., , .,. ��. .... � �--�^_.__._.�...�_.:_�..mw.._,.�...�: _�.-__ �,�_.�r._.,...�._.....,a_..,_.,,.._ __�,,._�__._.__ �_�.._�,.�..�.w._.. ....��,___.... _. _ Nt?'�'1GE @F DEED R�STRICT���d$: The u�de��si�n�d��der•�t��ds�:th�tt;th�s����tmlt:m�y:b,e.s�b��ct;to:"deed":restrict3ons" . whlch m�y�ba�more°res��aotive�t6�a�r`County�r+e��lattons:��The°undersigned°k�ssumes'responslbllity°for'"c�rnpllance with �ny appAcable deed-restrictfons. �. �.- • _ . . UNILBCENSE�-COMTRACTt�R� ��kN� ��id�'RACT+�R �t��PC1NSIBIC:1'�iE�: If��fhe�owner has°��hir�d�.a.;c�hactor or cont�actor� to undertake work, they may;b.�,�requir�d:to�be:rlicensed I��ccordance.vuith_state�.and•IocalxegulaQl..o,ns:.,�lf°the�• ��' � _� � �on#ractor Is n�t llcea�s�d�-as�required=6y tai�t, bath-'#he owner and�coiit�acfor-�•�ay be�°�t#ed�f�r�a'°�rrfl��emeanar ulot�flon under state law. If the owner or intended;;contractor;;are.,�uncertaln as �o wh�t Ilcen�ing;,requirements;may�:afpplys�fcir:�the� � fntended work, they are advised t�caritact ttie Pasco��C�uotty��Ili9ing'In�pectldn.Dfvlslon--!�.{censtng Sectfor�at?2?-847- 8v09. Furthermore, if the owner'tias�'hitred�"a canttact�r o� corttractors, he is advi��d ta have �the contractor�sj, sign portlons of the °�ontractor �lock" of.thle..application..for.,which.th�y wrill:�.be�...r.esp.onsible.-,�.If:.you,=as�,#he,aviirier°stgn~as'the �- , �vn#ractor, that�may be an indica#it�n th�#�'he°1s nat:properiy ilcenses! ��i�"l� nat enti�ed�to pen�tltting�pr�uileges It� Pasco , County. . : .;-:- . 46tANSPORTA`[ION-!NlPACT/U-T#{:ITlES°�IMPAC't�AND-1���0�lRGE R�COVERY�FEES: Th�underslgned�tindersk�nd� thaQ Yr�nsport�#lon impact Fe�$and.R�ca.urse.Ftecove.ry.Fees r��ty=apply�;t��t�te_con�tcuctiean;af new.buildings.,:s�han�e��of':.. ,, . us� in exi�Nng buildings, or�exparisiorrtof�+ezf�#i�r,g��buildings, as sp�clfled.in P�sco Caunty Ordinance number 89-07 and, �0-07, as amended.,,�..T;,he �ndec�l�ned aiso;unders#ands, #ha�:•such f�es;�,��tr�ay_b��,dt�e„�witl;#be ide�it�ted at the'timerof�' _ permOtting� It is �rther und�r�tood that Transp'o�ta�lon Impact'Fee� and��Resoueca;Reco�ery�Fees,.mu�t be paid pNar to rece{ving��."cet�lflcate.of�oscupa�tcy" o��4naF-power�.�'ele�se►: :i��tha.pr�ject:.��es�:not invotve�a:-cert�i�ite of occupancy�or��'.•_. , finai power�release; tiie-,fees must"tie paid,pc�oo�to,perrnit Is�u�nce. F�k#k�ermore,•if:Pasco,�Coun�y�lNaterlS�wer,�.impact -� � fees are du��..th�y�.,must�b�-pald:.pclor to.pePr�it��is�4�i�e�:�n.�c�ord�nce wlth�appllcable:Rasco'��County�ordlnances. • �0►N�TRUCTiOtd�C1EN'LAtOt1�{Cfi�p#er 713� �tar�da�tattatea��a amend�d�: if vatua�an ot work is�2,500.00:ar more� { . c�r�ify that I, #he. �pplicant;-have�been .provided:with a copy of`the �"Florid�� �onstructibn� l:len:L'aw—Hameow�rer's �ra��oQlon Gutdo" prepa�d by tFie F1�iid� DeparEment o�Agc0��lture �rtd Cos�sum�er.:Afi#airs. if�hs �pplicant 3� someone other ihan the"owner", i c�rtlfy,th�t 1.have,ob.taOned`a°copy;af:the:abpve...descri�ed doicuii�ent°and.promi�e�„in<good:faith.to deliver it to the"owne�:�p�iorA#o�comm�ncement:" . - �{11dTR�1CTOR'�lOWNER'S A��IDAViT: i.cc�rtiiiy:�#h�t-all..the,lnf�rm�tl±m.ln°thi��ppticstion is�cc�r�t�,and#hat eii work �►ill'be dor�e in c�mpliance with �II.applic�ble 9aws regulating constructian, zoning and��land deve�lopment. Appl(ca#ion is hereby made to obtaln .� per�ni@�,ta_d�:w.o�`,lc.a.artd Ihst��t�tion a� Indi�t�d:� �1-ceetifjr #hat n� war��or install�ttbn �ias comm�nced priar to issuance of a permlf and #hat.all wo�lc wiil be perFormed to me�et skandards•of all laws regulating• conslru�tian, C�unty and Clty codes, zoning regc�latlnns, and land devafopment r�gulatton� In the Jurlsdiction: 1•also. ce�tify th�t 1 und�rsf�nd that fhe re�gul��ians of other gov�rnm�nt agencie� may�appiy�tm the.int�nded w��k, artd that it is my r�esp�nsibility to I�entE�r.what.��4(ons I must•t�ke:t�o be.in:.compliar�ce,. 5.uch:ag�ncle�Includ�but�are.not llmfted ta: - D�partr�ent af E�1vEronmetital-�Protect#on=Cypie'ss.�Bay�i�ad�; V11e�end Are�� and Environmentatly Set�sittve Land�, WeterMlaste�rater Tr�atment. � - SoutF�v+r�st �lorida lflYater Ma��gePnent� :D��trfct We!!s, Cy'press.' �ayheads;� W�t#and Areas, Atter3ng V1o�tercmurses. . - Army Corps of Engin�ers-Seawalls,C)ocks�Navigatil�Watervvay�. - Dep�rtment of_H�a�th:'.&. ReF�abilttaativ��Secvtc�slEr�v6to�me�tai N�alth Unit We0[si W�st�v�ter Tr�atr�nent, Septtc Tanks.. _ - US�nuironm�ntai Proteatton Agency-Asbestos�batement. FederaB Av��tivn.Au��iorily-Runyu�ys. I understand that the fallowing.restri�tions apply'tb the use of flA:• - Use of fflf Is no#allerwred 3n�Flood,Zone N"unless expressly pr�rmitted. - if the fill materia�l is to be used;,ire �Fload Zone. "A", It !s understaod thaQ a drain�ge plan addr��stng a °compensaEing vofume"wlll be subm6tted a#�ime of pertnit#[r�g wlilch is prep�red by � prafessian�� er►gln�er Ilcen��d by#he State of�fioNda�: - , - !f thd fl!I matersal�is`��be used In Flood Zbn� "Aw ira�conn��llon�v�l�h�a•��rmitted bulfd#r�g �sing stem wati . con�tructian, l certify that f�1:�ir�tl=b.e u��d�nty.to fi11 th�area within:the�stern v�rali. _ - If flit maQerial is to be used In .any erea� I �c�rtifjr th�t .u�e. of such flll wlll not adversely affect adJacent pr�pertles, @f use o�fill fs foc�nd to a�rersia�y,a�ffect ad�a�ent��propeatle�,.th�owner may be cited for vlotating the condi#ions..of the buildtng;permit is�ued under th�attached�ermit appl(catla�, far:lots less than.one (1) �are whlch are etev�ted�by t11d,��t englneer�ed dr�lnage pian fs required. tf 6 am the AGENT.FOR.THE:t�31P�N�R, 9,.�romise in gaod fal�h to Inform#he�owner of��#he permitting condftlons set forth In this aftidavtt�pN�r to cmmmencing cpnstruction. 1 under�t�nd th�t�a=separate permit may be requlred for elecMcal�work, �:..-��. plucnbing..s�gns� w�tlsF.poots;. alr condit�a�ning,-.g�s, .�r o#I��r. Install�tlons nol.sp�c�cally lrtcluded�in.the appttcation. .A permit Issued shall be canstrued to be a°Iicense�to`-proceed with ti�e wiork and nat•�s.authority to vlolate� cancel, �It�r, or set a�slde any pr�v4§fon�of the.technlcal.cz�de�s;�nor sh�il issuance��g a.permit.pc�vent tha Buitdirig U�fcial from thereafter requiring s correction af errars in..ptans;-aan�friiction.or vioiatimns of-any cadea. �very��piermit lssued shail become invalld unless the vrrork authorized.by such permlkis.co�menced�within s�c montha �f�permlt Issuanoe+ or !f w�rk a�th�rized by fhe per�4t d�suspended oc�:�bandorted-for:a.pertod�of�sGt.{�}�montiis.after the:tlme-the�wsrk��s canim�nc+�d. An extension may be r�qu�sted� In writirtg,;from the,BuildOng,C3fficial for a period:not.to exceed�ninaty(90)�d�ys ��d-will demonstrate � �ust�iable-cause for.the extensfo�: !f wrork c�as��:for nlne�t.{90}cot�s.ecuQ9ve�day.�...theti�ob�ls.cun�idered aba�tdoned. �IIARNING TO OWNER: YQIJR.�AILiJRE,�TO.,.R�ECQEtQ A,,.MQTICE�:OIF�-COMM�MCCMEP�T,MAY-REv�i!!T IN�YOUR ��Y1NG T1/�t10E.;t=tbR IMP1�t1V�lJEsN��'5�.1"�=Y{4llEt��.P.,RQ�ER'iY:�1��Y0U�1�'�t}��TQ%�C��AiN•'=FiNiI�M�'tt�IG;'CON3ULT Y�i�T V '' �f �{J � �.��,, �O �� ��+i ,Au a. , r -_ � �. �F `,.' ' ' C , .. - l� . . ....: . . . , _. . .,, , � ,.,. .., .-_. .. , FLORlClA JURA�;{P.S:_4.17.�03). " ' , - - _ __ - - -- - - . , OWF9ER OQt AQIENT 1 CO�"1'62ACT0 3ubsalhad�nd swrom, (or aflirmed)beto, „th�{ - Sub� dbed and's�' {ow a nnedpb re ' �1� . Vl��fbY Gt'l� ,c�� N7� Jvt-' �j�/�by-� , �i��;l�� � � L�i11� - o i,/are personelly kttown to.me or haslhave produced Who.ls/are p.ersonelly known ta.rroe:orhes/heve.•prvduced � e�ia��ne�evn. _ as tdenBflcaUon. �� , '� , ` - ,_j2 t.t .�G�1' 17. ��ofary Pabi�c . C� '' . Notary P'ubtrc Commisslon No.; � 4'— (r.7 � � � �Commisaton No. � U �: � � �l�;�it �/�a �� ;��w.�ll �i.�..b;��_ �-1�..�.i�-� �v��.�/ . � Name o'�Nola ed n tT'�"' ""'' Name oi Nolary�ped,pdnt�d ar�tamped � ��'*,�'s*' � �t�iA�t�ili+t��RUFFELt� ,,,�„�„i � •'°O• =�' ' ��C'��"s��^�G�'045343„ � , �•��,a,�':¢�,�;_�D6�A�L.I�II�E RUFFELL ��= �`�=��t��`�v�mb'er'7,242Q;,��� `' . ==:� .,�. •._Commisston#GG Q45343 �'� a+�°��'S�T;:rutre?fa;��:s�}anee800�385-78i9� : :;�'�"'" ��,�b,=Ex ires Nov . ��N'NN�� ._ ,4'4 iL.ti.,� ♦ P. P em6erl,2020 }. . � . '' .:1���; �o�d�q`'� BoMied lhru Troy Fafn In�y�ance 800�85�7018 � � l ' ' � t s , �. . . - =� �s► � ,� � _ ..� �,. _ i _ � � - . � � � �, e : : yx =i t.•.s� i e i. � - z ' � s _ �p ;, ._ _ r ti,;:^"!'��':�: � '�'�i::�`.�:��� ��..� 'r�' _ �`�,`�'"�� �`,��e. � t•s:-� ^�. e•� :F '• i+ti ix" .i�f. 't�:,zk:�;ti.,,^,' •� "��.�:�,. _ +Ti �� .e•� .d :s'-� - •:a• �- - 6° .� f - - a : -- ! i,,,,,d.vY .:. .4.' "' . '� ♦ '�.� "� r '{� ae�.��: '"�� i�4i " ;���i^�.�. �� �,��Y.a-.�� � - :z- -t-• # �'�_,�i�.'��=`:ZI��'��.�.�� s $er.ai�■�.i.,�1 �..; a -o :rar :'...s a• -r - - �$��#Y����-� � - w� � `c_ y O.�' t�: iC`.7 �-�r' ; ,.3%�n:'�a`,�y"''.'�.$_s "E� ,� "r - 31� . .��-'t ! Mi 3 � `�" • ' i!' 3- • r .i.Y;�',�.�.7"„' / / �I t- e e - s.-e �. •- !� - ..- +�e:i -, _s; � ^�.�.�. •t e� i s� }',-, i - - +' : F �s i ^..� :. t' � .! _ _ ,?3 :3!{ a :��•' tA "7'r it�7i ��_.,rs ��,�'�,'�!�� Llss"��•"•�3Y i°� ''��'��<�_.�,' �♦ �f1 � !� � ' i1 d � � :S ia�sn9a �_ �.�f� �����`,�����:�•�� •r o- 7E�. :. a , _ �: s- - - :�'�.- - ).: e� - : F �c � e� -:�;' ' �. � !i• �• 16� �' _ ♦_ ' _. 1 w .iS,,,:i;C�'�"+:i ' ii, ' � !� S�i" • �} f�lY ��� �:��. ' _5i� :���". s n' ���y� '�'"���#�'s���i�':1`�<� ���y1:'�J�;�=�-���� '�.^i • �':>_' ���' •� e3s :•i •.C-._ _ ""-0R� �� t i � .,J _' .) .�3.. _at: _� • �t"-�.� - -.-*.. a' �:ar� "' :.-3 -- �<' ' - ' �s �v • - '.7:r v: r - - - - s: :M � p. ' ' ��'