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Home My WebLink About17-18636 � ' CITY OF ZEPHYRHILLS ��" 5335-8TH STREET �.�'�� (813)780-0020 18,6'36 BUILDING PERMIT � PERMIT INFORMQ►TION LOCATION INFORMATION Permit Number: 18636 Address: 38904 8TH AVE Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-11200-0201 Improv. Cost: 1,336.00 OWNER INFORMATION Date Issued: 7/07/2017 Name: RIVERA GLADYS Total Fees: 187.50 Address: 38904 8TH AVE Amount Paid: 187.50 ZEPHYRHILLS, FL. 33542-4510 Date Paid: 7/07/2017 Phone: (786)942-5089 Work Desc: BATHROOM ADDITION CONTRACTOR S APPLICATION FEES OWNER BUILDING FEE 67.50 OWNER ELECTRICAL FEE 60.00 OWNER PLUMBING FEE 60.00 � � ' � I � �I Ins ections Re uired I FOOTER 2 H PLUMB MISC INSU TION CEILING I FOOTER BOND � NSULATED SEWER MISC. ROUGH ELECTRIC L MISC MISC 1ST ROUGH PLUMB RE-METER INSULATION WALL MISC. DUCTS INSTALLED ATER MISC DRIVEWAY PRE-SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. � 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 pertormed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. . 1 CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER I , t , n=sc�asv� sT�z� FOR awwrrER CIfiY OF Z8PF3YR'fiIT,LS SIIILDIItT� DEPARRT�lBNT I, ha�re read and fu11y understaad aad agree to the pravisioas of this iastrumeat. The undersigaed states and affirms tha� he ot she iB deairous of caaetructiag, reaovetiag, addiag to ar reraofing his ar her owa domicile, that he ar she actually occugies, or wi1Z accap�• by s�id domici3e, aad �ame is aat for reat, lease ar sale. That he or she shall comply s,ritih the fa2lowiag coadition�: 1. Tha� th� owaer aad he or she a7.oae shall ac� as the builder for all phases o� canstruct�.oa. ` 2. That the owa�r vaill comply �rith a�.l provisioas of the City of tiephy=hills ardiaaaces and codes pertineat to the bui.ldiag. 3. That in the event various phases of coa�truction are subaoatracted, he will eagage oalsr properly lioeu�ec3 eubcoatractars a,ad will persaaally �aupervise � euch w�ork. � 4. That in the event the Buildiag Inspector �SaII require aorreations �o be made, �he owaer �aill aeeume full respoasibility to iasure they as�e made, aad upaa compl�etion will call for a reinspec�ioa befoxe proeeediag with the build3.ag. 5. That the owaer shall assume full reepaasibility fos the coaatruction aad will not expect supervision af his wor]c £rom the City of Zephyrhills Buildiag , I7epar�meffit. 6. That prior to final inspection aay additional fe�s, iacludiag reiaspectiaa fees, m�st ]be paid ia ful1.. A wr3tteu r��t,test �rom thi� olEfiae sha11 const3tute a.tb afticxal notice to gay additioxt�l fees. 7. That the owaer shall comply with`all City, S�ate aad Federal laws ia regard to social secura.ty, workman's campensation, lien l�ws, etc. , where applicable. 8. That �he ocvner sha31 campZy.,with �lI th� safety codes issu�d by the Florida Iadustrial Cammi�sian. 9. Stat�e law requires aoastructioa to be dozte by licensed contractors. You h+ave appZi�d �or a. permit uader aa eac�tioa to that law. Th� exemptian allows you, as the awaer of your property, to aat as your own caatraatar with certain res�rictions evea though you do aot have a 3icease. Yau must provide direct ansite su.pervisicai af `th� con�tructioa yourself. Yau may build or improve a oae-fau►�.lg or two-family residenee or a farm outhuildiag. You may a.l�o bttil.�. or 3mprove a comm�rcial buildiagr, prav3c�ed your coets do aot exceed $75,U00, The bu3ldiag or resideuce must be for your owa use or occupaacy. It may ao� be bnilt or aubstsatially improved for sa�e or lease. If yau sell or lease a bui3.diag you hav� built ar substaatia3ly impsaved youzself withia 1 year �f�er the aoastruetian is eomplet�, the law will gresum� thab you built or substantially improved if £ar sal� or Zeas�, tahieh is a violatioa of this eacemptioa. You may aot hire aa ualicensed persoa to act as yaur coatractor or ta supervise people workiag oa your buildiag. It 3s yaur r�sponsibility �o make sure �hat people emp2ayed by you have licenaes r�quired by stat� law and by eounty ar muaicipal Ziceasiag ordinaaees. Yau may nat de3eg�te the responsibility for eupezvisi�g wark to � liceasec3 aoatractox who is aot liceased ta perform the work beiug daae. Any person workiag oa your buildiag who is aat licensed mue�t work uader your dixect sugervisian aad mua� be ------ em loyed by�ou� whic�.meaa�tha�t—yau-must-deduct-I�.�-C:�:�d-xi-th�m-l-ding��c� -------- and prov�.de work.ers' eompensatian far that emp3oyee, ail a� �rescribed by 2aw. Your conatruatian must comp],y with all appl3.cable laws, ordiaauc�s, brailding codes, aad zoniug regu ations. � j�_ -7 OWt3ER'S SIGNAPURE ` 17ATE `��Z ( � ��" �DURESS (� '`�.ff. �3 PHONE_ ��?�r. `�'(1'7 �,,�-��_ '69YTN8S3 PBRMIT # i 1 �,�-�nu-c�ozu , City of Zephyrhills Permit Application Fax-B13-780-0021 Building Deparfinent _ ; Date Recelved .: Phone�Contact for�Permiltin - f; Owner's Name � S \�I�� Owner Phone Number / SC� ��Z 5d�� ` ; Owner's Address �� . �� Owner Phone Number �. Fee Simple Tltleholder.Name �Owner Phone Number ;. Fee Simple Titleholder Address ' JOBADDRESS � , S A��o-t�-e- LOT# � ' SUBDIVISION PARCEL.ID�R � s (OBTpINEO FROM PROPERTY.TAX NOTICE) WORK PROPOSED _�EW CONSTR ADD/AL'f 0` SIGN' `0 -� 0 DEMOLISH i �B. INSTALL ,B REPAIR - PROPOSED�USE Q SFR• C7 COMM • � OTHER � ` TYPE OF CONSTRUCTION �Q � BLOCK " Q FRAME �Q STEEL Q �^� _l�- ti DESCRIPTION OF WORK V n '�Y'UC�"[� V.X.�.T�+,�(0 �M ./j Q ��l�jl IZO IUL/2.C� ' BUILDING SIZE� � � 'SQ FOOTAGE� .,HEIGHT�, � ' 3: QBUILDING $ '� 3 ��-- � VALUATION OF i'OTAL-CONSTRfiCl'ION ��i� �y D(� QELECTRICAL $ - AMP SERVICE � 'Q PROGRESS ENERGY [� W.R.E.C, j QPLOMBING ,$ ' l T�b�(� � � /� � QPAECHANICAL $ VALUATION OF MECHANICAL•INSTALLATION � " �V ' �� QGAS Q ROOFING Q SPECIALTY [� OTHER �� i FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO ./ ,,,J„ � _ _ ��-�J(�"� , � I BUILDER I,Q , COMPANY', � I ilile- 6 l�l �'e� SIGNATURE l\,�/L�- � REGISTERED Y/ fd . -FEE CURRE� ' Y/N Address � - License#' ! . .ibU ; HLE�TRICIAN � � COMPANY � nL°�� ! SIGIdATURE � REGISTERED Y/ N FEE CURRE►:�' �Y/N' �, , I Address , . Ucense=# ` • - � ! PLUMBER _ r ' � ` COMP..ANY � ��— SIGNATURE" °7�,�'zG�-✓�'�`�� ; :REGIS.TERED. � Yl:N. : ;-_�FEE CURREP Y/N � � Address ,License.# �. - MECHANICAL` COMPANY ' � SIGNATURE - ' � � REGISTERED. Y./ N FEE�CURRE� _ Y./N , y � ' Addre�s�`• � . ' . -- ' License# � OTHER ; � - - ,;COMPANY � � $IONATURE =`�'" �- �;�'' ' � • ' REGISTERED` '. Y/'N:.; � FEE CURRE� Y/N I Addres� _ - ' •. - • ' License#�' ' ' RESIDEN7IAL;.- �:Attaofi"(2)„PIot�Plans;.(2)sefs�.:of�Bufltllrig�Plan's;'(1)setof=Enerijy'Foirns;R=a1N Per`rrilf for_new c6nsbvoUon, ` " �Minim . `'' � ' �:_;,�:r_ ,Y_ ,um4ten;(,1:0);uvo,rking.;days;afte�`.subm.ittal'date.?=Required onsite;:Co'n§Uuctlon�Plansr'Storinweter Plans�w/Sllt'Fence installed, SanitaryFaclllUes;&�;1;dumpster_�3ite•�M1forlo;P�erml.ttor4sutidfylslonsAarge}pruJects:;,, _;�:_;;� � • ., COMMERCIAI. Attech(3)�complete s`et's'of'Bullding'Pla s plus a Life Safety Page;�(1)set of Energy Forms.R-O-W Permitfor new constructlon. Minimum ten(10)working days after submittal date. Requtrad onsite,Constructlon Pians,Stortnwater Plans w/Siit Fence instelled, Sanitary Facllides 81 dumpster.Site Work Permit for all new:proJect's:.All commerGal requltements.must meet compllance � 31GN PERMIT Attacfi'(2)sets ofEng,i'nee_r:ed:Plaiis:;, -:� • .� .- - „ •'••PROPERTY SURVEY reyuired for_all NEW constructlon.. Directions: �• . , ' Fill out epplica8on completely. Owner 8 Contractor sign back of appltcaUon,noharized � If over 52500,a Notice of Commencemetet Is requlred. (A!C upgrades over 57500) _ �'idr"'�q:�?d::S? '" ent far the�contractor 'ot Power of�Attome� fo�the owner woul`d be someone with notarized letter from owner authorizfn same A9 � ) Y� _ _�._ ) 9 �VER THE COUN.T,ER�PERMITTING� - (Front of-Appflcation Only)-� - � Reroofs If shingles Sewers Servlce Upgrades A/C Fences(PlodSurvey/Footage) Drivewaya-Not over Counter if an pubifc roadways..needs ROW , ., ._ _, .. , ..�; -, . _.. _....__ �,. ._. � ..,,...>�� _ „ ., ..� : . � ' {' _ .�.} •. ' i , ..,. :li.. . , � � ,_ , ' . +. • ' .., " .t! '" � ' ,, � ' .i . �� -. - — .� -( . ., :2' . - - r • v_�.a.., .r,_.w..._.�.�._........r.�._...a,..-_�.�..,�-.. . �.....:..a.,._.,w�'=:��. �1Ci'T1�E�?�DEE�RESTRiCT6QNS: 'The u�derrrigned.u�d,�t��andsf;th�E.ih,6sup�tntlt m�ysb�e.subjec�,to."deed",:restr�ciDcitis" ` µ. which m�y�tie:,m�re��r�ast��btive�th��Gouniy��+egutations;�"°The�undei�slgn�d��a§sumes�°responsibli'ity�.tor�c�rinpilance v+ritii"any�' appllcable desd:r�strictlons. �. � ,. � • � � UN�.dCEI�tSED�COMT1�►CTORS AND COi+tTttJlC1°�R ��P�PtS1�iCITfEs. 6f�th��wner has�°hlr�d��a�,cvntr�ctc�r �r e�ntractors to undartake work, th�y m�y.b,e:.,r,equir,�d.:to:�be,llcensed In�ccordanc�.wfQh stat��.and�local_regulatl..ons:�,�if�the�� = �� contractor i� not Itcer�sed as�required:=`!iy law,_bo#h#he �r�e��nd'�nt�actot;in�y�t�e:ctQed'for�a'°misct�meanor ulal�tfon under stake law. Bf the owner or intended;;contr�ctor;z�ar�.�uncer�aln a� to wfiak pcenstrog.requireKnents;;may.�,e�rpiy��fair.-�the- �� intended work,they are advlsed to cantact the_Pasco G�unty�uiliding.lnspectlon,pCvlslori--l:Icen�ing Section at 72?-847- 8009. Fu�thermore, if the owner Fias�`htred a confcactor or caritractors, he is advls�d to have �the contr�ctor�s), sign . ....,. .. ,. ..,.:..,.. , portions af the "contractor Block" af thla,�application..#'a.r..whlch.they will._be..tesp.onslble.- If�you;-as:#h� awner`�tgn�•'as tlie` c�ntr�cfo�, thst�mary°be an IndEcation tha�'he��8s eict�.proper€y 1le��is�d at�i!"'Is not�nt�� tb par�r"tltting priulleges In Pasca , County. .. ;: 'P�4NSPORTATlON=1MPi4CTNTIL;lTlES"�CMP�►C'1�AN�°RES�OU�GE RE�OVEl�Y�FEE�: The underslgned-understands th�tYranspor#at0an Impact Fees�nd.Re�s�.urse Recav�cy.Fees m�Y}=aPp1��.to�tFre;constructiaan_af new_6uHdings�=ohan�e��f�"� � ,, , use In existing bulldings, or�e�xpar�'sl��r�of��existi�i�g.ibuildings, as �pectfled.in P��cv Caunty Ordinance number 89-07 and �0-07, as amended.�'�'he undec�lgned �Iso:u�derstands, thaE:•such fees,,,�s�cnay��e��d�e;:wlllk�e Idenfi��ad aE the:ti'trie{of. � --�� permi�ting. It Is further understood that'�'ransp'artatlon lmpaat Fees and'�Resource.sR�co�sry�Fees..m�ist be paid priar to rsce4ving��.'certfflc�te.ot�oecupat�cy" orflnat�paw�r;rei�ase. :!�4he.proJ�c�.:does�nm�lnvoiveea;c�ct�icate of oc�upanc�;orr �_-� - . finai powrer�relea�se;:,the=:fees mu�t`be patd.,pr�or to.permit is$uance�. ��#herm�re��if P�scar�County�'Vliater/Sew�r�,impact ,. . . . . fees�re due,..tFrey,:must,b�:pald:.pNor to.permit:lss.a��nc�a;in..��aordance merlQhY��pplta�ble P�sc�o'��County�ortllnances. � �C�NSTRU�T1¢1�4"�:IEN'�W{��pter 7�3, Fbt�r�s�tatut��a�am�e�dedy: If v�tura�ott of waric Is$2,500.00.or mpre,:g . . cerkify that 0, �he. applicant, have beera .provid�d wikh-a-copy-of`the °Florida� Con�tructian: Llen :Law—Homeowne�'s Pcotection Guide" prep�red by Qtie F1o�d€� Departr�enf of Agricuttt�re and Consum�r.��atr�. 1�the appEtcant Is someone . other t6�an#he"owner", i cerfify#h�t I.h�ve�obtainsd`a=`copy;of,the:above.:describ�d�document�and.p.r.oml�e,i�,gaod,,faith,to deliver It t�x the.°ownec"�:prior�to�cornimenca��n�nt:'' � �. � �t)tV�CT�t�°�JQ�1ER'S I��F1d�ilFT: 1.ce�:t#€y.�:fi��t-�1l.the�Inf.oematior��:l��this applicattaro ts�c�ur�te�nd that ati work wi01'be done in aampliance with all appll�ble iavus regul�ti�tg constructior�, zoning and��land°develapmeant. Appltca�lon (s hereby m�de ta obtaln .a.permit,=�ta-do�:woiky�nd instaltatlon �� irtdt�ete�.�=-�I ce�tiFy thaf n� work�or 1nst�ttl�tRcin has commenced p�tar to issuanc�a of�a p�rr�if �nd �hat.all work v�rlll be p��farmed�to m��t st�ndacds-of all laws regul��ing• c�nstructton, County and City codes, zoning regulatians, and land development reguaatians in 4he �urlsdlation: ! also ce�#ify tha�t � ur�derstand #h�t the r�guis�lans�f ot�er�gov�r�rment�g�r�c6�s m�y�appiy�fo the intended work, and that it 1s nny responsibility tm identify,what,�ctions I must,teke:4o bedn:.corrlplla�c�:. �;uch.t�gencles include but•�are.not lim0tec!to: - �?�part�nen� �f iEt�vir�e�rroental=Protection=Cypr�'ss.��jih�ad�� WeN��d Are�s and Envtromrnentatly Sensitive Lands, Wat�rNVastea�ate�Treatment. - South�esQ Florld� lNater M�nagement .D9�#rtct V+telfs; CYPress.'�Bsy�h�ads; We#la�ad� Area�� Alter�rag Watercourses. . • Army Corps of�nglne�rs-Seawalls�I�ocks,Navigable Wate�vvay�. - �epa�tment of.FIe�6��t:�� ft�t��bl�itativ��Servtc�slE�viionmer��1 N�at#h Unit Welfi�,�Wast�wwster�'i'rres#ment, Septtc Tanks:. � . - US�nv#ronm�ntal Prot�ctlon Agency-�1sb��ta�ab�t�men#. - Federel Rviation.At�t�iortty;i.�unways. i understand that the.followang:.re�trictions apply�to the use of flli:• - Use of fltl is not allow�d fn�Flood;Zon�"V"unless expressly per�ltted. - If th� fill mat�rial Is ta be used:,ln.�Flood Zone. "A", Pt. Is undere�v�d th�t a drainage pl�n addr�ss(ng a "compensatit�g volume"wii! be submltted �t time +�f�perr�ttt�ng whlch Is preparecf by a professf�n�l englneer 0(censed by#he Stat�of�fiorida: - !f ih� flA materlal�.ts..�o be tss�d !n Flood �an� "A" 4n�cann��lon�wlth�s permitt+ad bulidt�tg usEng steen walf c�nstr�ctiort, E cerEify that ftll.w�lt;b.e us�d o�iy.to..fill the area within:#he��t�m•wati. • If flli materlal is to be used In .any area, I �certify tfiat .use of such flid wiil not adve�sely �ffect adJacent properfies. 1#use o€filt is four�t�to adver�eEy�,�ffect ad�a��#�•:pr�perlOe��.the awner may be cited f�r vlolating. the co�di�tons.,of th� bullding:permit is"sued�unde� the attach�d permit appl9catlan, for lots less th�n.one (1) s�cre�mvhich are elev�ted�6y f1!!,��t engln��r�ed dr�lnage plan!s re�uired. . df 1 am fh�AGEN'P��R TH��YI�MER, 1�p�°omise 3n good f.at#h t�inform-t6�e��wn�of�-#he penmitting conditions set foMth in this �ffidavik`pnor to cmmmeracin� constructlon. I under�tand thet a��aep�eate permlt may be requlred ior electri�cal�wark, plumbirag, slgns� wellsF.pa�ts;,atr.condi#IaNng�.g��,-or o#��'r: In�tall�#�q�is n��.spec�c�tly included•in.the��ap�lfcation. .A permit 9ssued shall be canstru�d to be'�°Iicense'-to pr'�ice�d with the work and not�as:�uthodiy:to,vl�lat�, cancel, �Iter, or set aslde any provlsions of the.Qechalca!-cmde�;�nor sha!!iss�oance�of a.pgrrr�it.pr.event 4h��uildfrig Q�FIcJ�t from therEsa�fer � reguiring a aarrection af errors in�•ptans;-const(ucttan or violation�of�any cmdes. �very��p�ermtt�issued"shail become invalid unless the work auQhorized.by�uch permlt:��.comrnenced�vdlthfn s�t,m.onths of�pertnit Issuanc�, or If work autharized by #he�err�tit-ts susp�nded�ae:sb�r�doned��for:a:pertod._of��C<{8}e�tnnfFis after the:tlr�e the�wat�c��s eanimenc�d. An e3etension may be requested, In writi�ig,�from tFie��uilding,Offici�l for a p�riod:�not to �xceed-nin'ety{90)'�days �nd wilF dernonstrate justlfia�ble cause 4'acQh�extens�an. If w+ork cea��e�.for nlneqr.(90}c�ns.ec�4lve�d�y:sr.the��ob�ls.con�ideted abandoned. - ---- - � - � - -� - •__-__._-: _ _ __ . _ -___ _. WARIMING TO �WNE�t: YO'UR:FAILURE,TQ.�.R�EC:Q�Q;A..,MOTICE•:0�;°�COMMEMC�MEI�tT�MAY-l�ESULT IN YOUR ��a�ttNG TWICEt1=��-1MRR�VENIFNTS�.TO:�X,OUlE�PRC�P��li'Y:�OF°YO.U;1�'�D�'�TQ��T�C'iN=�iNAA1�tNG;'��NSUl.T 11v9�' CI. A '�TO N -. L�,�. ..O � G:3 ,pV ;� : .r . �<.°,:�� FLORIDA JUR/��:(F:5:1.77.03} .. . , . . - , , .._ f � J PJWPIER OR AQENT "�/,�-�-�--�-v-' C�t�'T'�GT�9E3 �T/ � , 8ub bed and�wvm to(or a r�ed)berore rri�!h!s Sab�crlbed and'�wrom�ka(ot a�lrtned)'b ��te'ltii€� _�?��i!,yZ�l�by 11��1�R�t�-1 v 2�rc--- .,��(�.:�y... ��f t/1/�hl -K t i ,�f'�,. Mfio Islare p6rsonally knov+m to.me or has/h�ve prodyc�d Who.ls are p.ersonelty�Cnowm•tp.me;or he�hav�r�produeed � ae Id'entlflc�tlpn. � as Identl�cation. —��Z,�'�'' ` ,��L.�. � �ty Pubitc . ` �` Notary Publia i ��-� Q S� �"f V Commisslon No: � Comr�leslon�No. �`>' ! � .� `�� ' � �. � � . C� �r.�.�... , � Name aI NoPa�e�,or stamped Name af oQary typed,printed or atamped / '�S �,�:_,f6' rr�i.:'= tf �'t�(lflrit�;rj ��l1Y1EY]��LsJ)��4.L.f. , _ ��irr = '. -.... ._ , �t a ��i�" `# 045343 ; ;s°�r;{::y�,,w DEBRA�I�.AI(�jE RUFFELI. ` ar�mi'ssion GG _- c "��' ,:;��`��:�=:is'�s,November7;2Q20 � _�; , �Com��issian:�AQG,Q+#5343 _ ..- . � ��Jt,'v.. :;=;�;r'?�,r�3�oyfaininsurance80D�33r10f9 '� :;,.�P,-�xpires NuvemBer 7,20�Q �ro^�;r..yc4:,Es,` " (s �''�b�;;°.•. �ndedifiruTroy Fain Insurance 600�385�7R(9 � , . .- � ' , } , i ! � Prepared by James W.Elliott BAY AREA LEGAL SER1!lCES ING. 37798 Meridian Avenue.Dade Citv.FL 33525 (352156�-9044 x DURABLE POWER OF ATTORNEY STATE OF FLORlDA COUNTY OF PASCO , KNOW ALL MEN BY THESE PRESENTS: That I, Gladvs Rivera, af� 3134 Great �aks Street, Wesley Chapel, Florida, da hereby constitute and appoint Vivian�Rivera , of the same address, hereinafter re€erred to as my Agent, to be my attarney-in-factJagent and in my name, p(ace arid stead, to ' perform any and every autharized act tfiat I myself cou�d da if personaily present (fo the extent that i am 'I � permitted to act through an Agent), with the understanding that these powers will be used for my benefit ' _ � and on my behalf and will be exercised in a fiduciary capacity. In the event that said Agent is unwilfing or !, unahle to act as rny Agent, I designate , NIA , to serve as my Alternate Agent, with the same powers � I� and responsibifities.: This durable power of attomey is not terminated by subsequent incapacity of the Principal except as '� provided in Chapter 709, Florida Statutes. This instrument was executed in the State of Florida and the �laws of Florida shaJ( gavern af(questions as to its validity and the construction af its provisians. Nawever, it is my intentian that this durable power of attarney sha!! be exercisable in a1f jurisdictions in fhe United -States of America and in a!!fareign nations. ( empower my Agent immediately_upon the execution of this durable power of attor�ey without limitatian or caurt appraval and with respect to all ar any af my property, real (including hamestead property), personal, tangible, intangibEe and mixed, even thaugh my Agent may have personal interest in the matters, to do ths following on my behalf: BANKING AND OTHER FINANCIAL INSTITUTION TRANSACTIONS: --- - �Ta have au#hority#o�onduct bankir�g transactiorts�s-Rrovided7rrs�ction 7U9,7208(1),-FCori�a�Sta�futes:�---- — {a) Establish, continue, modify, or terminate an account ar other banking arrangement with a financial institutian. {b) Contract for servic�s available from a financial institution, incfuding renting a safie-deposif box or space in a vault. (c) Withdraw, by check, order, electronic funds transfer, ar otherwise, maney or property of the principa! � deposited with or left in the custody of a financial institution. jd} Receive statements afi account, vouchers, nofices, and simiiar documents from a�nancial institutian and act with respect to them. � ' �i (e} Purchase cashier"s checks, a�ficia!checks, counter checks, bank dra�ts, money arders, and similar instruments. (t� Endorse and negotiate checks, cashier's checks, afficial checks, drafts, and other negotiabfe paper of the principa(ar payable to the Principal or the Principal's arder, transfer money, receive the cash or other praceeds of those fransactions, and accept a draft drawn by a person upon the Principal and pay it when due. (g} Appty f�r, receive, and use debit cards, e(ectronic transaction authorizations, and traveler's checks from a financia! institution. (h) Use, charge, or draw upon any line of credit, credit card, or other credit estabiished by the Principal with a financial institution. (i} Consent to an extension af the time of payment with respect to commercial paper or a financial transactian with a financiai institution. !n addition, to borrow any sum or sums of money for rrty benefit on such ferms and with such security, whether real or psrsona! praperty or otherwise, as my Agen# may think fit, and far that purpase to make, execute, deliver and acknowledge all promissory notes, mortgages, instruments of guaranty or indemnit}r, contracfs, affidavits, receipts, agreements, or other instruments as may be necessary or required or as my Agent sha(i deem fit. DOCUMENTS; To take custody of and retain any of my Isga! docurrtents or other valuable papers, including, but not limited to, deeds, wills, trust documents, insurance policies, securities, title certifieates, account passbooks, certificates, and statements. tNSURANCE: To purct�ase, madi€y, rescind, terminate, exert any rights ar options concerning, pay premiums on, fake � loans on, surrender and receive the cash surrender value of for my benefit, fife and process clairris an, � receive information from the insurer regarding, and submit claims, execute releases, litiga#e concernirag, or take similar actions regarding insurance of any type. Principal's initiais: y � � lNVESTMENTS. To have autharity ta conduct investment transactions as provided in section 709.2248{2), Florida Statutes: (a} Buy, sell, and exchange investment instruments. (b} Estab(ish, continue, modify, ar terminate an account with respect to investment instruments. (c) Pledge investment instruments as security ta borraw, pay, renew, ar extend the time of paymenf ofi a debt of the Principal. (d� Receive certificates and ather evidences of ownership with respect to investment instruments. (e) Exercise voting rights with respect ta investment instruments in person or by proxy, enter into voting trusts, and consent to limitatians on the right to vote. (fi� Sell cammodi�y fufures cantracts and cal(and put options on stocks and stock indexes. For purposes of this subsectian, the term "investment instruments" means stocks, bonds, mutual funds, and ail ather types of securities and financia( instruments, whether held directly, indirectly, or in any other manner, including shares ar interests in a prtvate investment fund, inc(uding, but not(imited to, a private investment fund or�anized as a limited partnership_a limited IiabiLty_company,_a_statutory a�common-law----------- ---- � � business trust, a statutary trust, or a rea!estate investmertt trust,joint venture, ar any ather genera!ar limifed partnership; derivatives or other interests af any nature in securifies such as options, options on futures, and variable forward contracts; mutual funds; cammon trust funds; money market funds, hedge funds; private equity or ven#ure capita(funds; insurance confracts; and other entities or vehicles investing in securities or interests in securities whether registered or atherwise, except commodity futures contracts and call and put options an stocks and stock indexes. LEGAL ISSUES: � � , � ) � . ! ,� ,� ' (a) To take any action on my behalf my Agent may deem �t regarding causes of or choses in action, claims, litigation, administrative actions, arbitra#ions, mediations, negotia#ions, bankruptcy acfians, insolvency proceedings, reorganizations, assignments, receiverships, and all other cont�actual and statutory rights and elections ! might have, including but not limited to any actions my Agent may deem fit far asserting, fi(ing, prosecuting, defending, and sett(ing such mafters, accepting service of process upon me, executing and enfarcing judgments, collecting sums or property on my behalf, and claiming or waiving rights and elections. PrincipaPs initials:,�,L�' a Z. (b) To exercise the following powers with regard to filing bankruptcy on my behalf, with the specifrc undersfanding that these powers wil( be used for my benefit and will be exercised in a fiduciary capacity: to file a petition on my behalf under Chapters 7, 11, 12 or 13 of the Federal Bankruptcy Code or under any future laws that provide bankruptcy relief for an individual consumer debfar, to take at( acfians that I could take with regard ta any bankruptcy action filed on my behaff, including but not limited to, executing schedules, statements of affairs, repayment plans, and attending all bankruptcy-related praceedfngs that my Agent deems advisable, inciuding creditors' meetings and confirmation hearings, filing abjections to claims and filing and prosecuting adversary proceedings. {c} To fiEe ctaims on my behatf in any bankruptcy proceeding, and to take any necsssary actions to collect an those claims. I hereby autharize my Agent, acting as claimant on my behalf, with full power of substitution, to vote art any question that may be lavv#uJly submitted to creditars, to vote far a trustee and far a committee of creditars, to receive dividends, and in general to perform any act nat constituting the practice of law. Principal's initials:��,_ (d) Ta enter into modify, reform, rescind, renegatiate, execute, acknowledge, and deliver any and all contracts, deeds, certificates of title, mortgages, obligations, instrumertts of indemnity or guarar�ty, leases, ' bills of sale, re(eases, receipts, affidavits, pledges, agreements, or other instruments ar papers of any kind or character whatsoever and to draw, accept, rnake, sign, seal, execute, deliver, endorse, discount, or othetwise deal with any bi!!s af exchange, promissory nates, ar otfier commercial or mercanti(e instruments. � Principal's initials: � � - MAiL AND CCiRRESPONDENGE: To receive, open, read, and respond to my mail and electronic or telephonic correspandence, and to change the address to which mail ar correspondence wi[i be sent. Pt1BLlG AND GQVERNMENTAL BENEFlTS AND QUALtF1ED INGOME TRUSTS: (a) To prepare, sign, file, pursue, prosecute, and appeal any clairri or application for a benefit or assis#ance, financial ar otherwise, to which I may be entitled under a statu#e or governmenta!regulation. , (b} To prosecute, defend, appeai, submit fo arbitration, setfie and prapose or accept a campramise with respect to any benefits L may be entitled to receive ar repayments I may be requested to make. �� Principa�'s initials:_�� ------�---(�}�—fio�re�eiv�and��n�l6rse cfi��ks whicfi�epresent�he"fiinancial p�acee�s ofi a claim o� fhis type and--��- ---LL -- ---�� use them for my benefit. � {d} Ta arrange for direct deposit of payrnents, income ar benefits, inc{uding but not (imited to Social Security, SSI, VA, and pensian checks ar bene�ts, to my bank or other financial accaunt. {e) If necessary for eligibility for pubJic benefits arad if lawfu! as exempt transfers under then-existing public benefits laws�and regulations and the transfers would not result in a period af ineligibility for such benefits, to make exempt gifts or transfers from my estate, Pncluding of assets ! may have in a revocabie � trusf, but an(y fo my spouse andlar to a special needs type trust currentiy exisfing ar that my Agent may � create in rny name for the benefit of my blind or disabled dependent child, if any, and/or to other parties to '� � � ,� li � , i whom then-existing public benefits laws allow me to make such exempt transfers. Such gifts or transfers may be matie 9n amounts up to the tirrtits under fhen-existing laws and regula#ions regarding exempt transfers. Principat's initiais:_1�, a� . {� To esta6lish, fund, and maintain a qualified income trust such as a Miller Trust. PrincipaPs initials:�� (g) 7o make such modifications ta a qualified income trust as may be required from time to time to maintain my eligibility for Medicaid and ather public benefit and entit(errrent programs. Principal's initials:,�� {h} !n general, to exercise a!I powers with respect to governmenta! benefits that i could exercise if present and under no disabiiity. REA�.AND PERSONA� PROPERTY: (a) Ta recaver, enter upan, take possession of, arrange for#he safekeeping of, contract for alterations or repairs upon, arrarage for shippingr {�£'IIV$�l, or receipt of {including the signing of necessary papers}, obtain licenses and registration for, manage or conserve (including via court or bankruptcy filings or proceedings), insure, demalish, rehuild, improve, sell, transfer, exchange, lease, or otherwise canvey or dispase ofi all or any part af my reai estate ar persona( property (including hamesfead praperty and � I property held in any type of sole or joint tenancy, although homestead property may only be mortgaged or sold with jainder af my spause, if any, or my spause's guardian ar ag�nt under a power of attorney, if ' any), and any interest therein (including mineral, oil, gas, or other rights) for such consideratian and upon ' such terms as my Agent shalf.de�m fit. (b) To mortgage or encumber rny property for my benefit, I (c) 7o purchase property for my benefit. {d} To make, execute, acknowiedge, and deiiver gaod and su�cie�t deeds, leases, contracts, affidavits (except as to my personal knowledge), closing statements, certificates, titles, notes, or other instruments in connecfion therewith, with such covenanfs of warranty or otherwise as rny Agent shatt see ft, and to � give goad and effectual receipts far all or any part of the price or other consideration. {e} These powers specifically include, but are not limited to, rr�y personal properky, and my rea! property � (acated in County, Florida, cammaNy known as (address) ' and more particularly described as (legal description below). �� My Agent sFra(i have the pawers listed in this section regardiess af the Agent's rela#ianship to me. ( Principai's initiats:l� J�_ . RE7IREMENT ACCQUNT$: � — --- --�c�rnaic�zi�m��n�i�rp�n,-�xe7ci��ny7ighfof-witfidr�wal frc�m,-�eii�ves��z��t�ake otfier acfion�regar�ing,-an�-�----�----^ otherwise deal in my place and stead in any quali�ed profit sharing plan, refirement plan, 401k benefits � program, TDA, tRA, annuity, or similar#ype pian or program. '� To execute a consent ar waiver with regard to such plan or prograrri, other than wa'tver of a right to be a �� beneficiary. � � � ° �� PrincipaPs initials: ,��', i , . , TAXES: � i � � �D To make, verify, sign, execute and file tax returns in my name and collect and endorse refund payments, Ta represerrf ine before the Department of the Treasury, fhe Praperty Appraiser, or any other taxing body in an}!tax matter ta which I am a party, including, but nat limited to, audits, hearings, and litigation. Ta make and execute waivers, c(aims, requests for exfensian, petitions, or other documents. To pay, compramise, or contest assessments. Principal's initials:,��, i �. TRUSTS: To add assets to a revocable trust previously established by me as my Agent sha!! deem advisable for my benefit, or to wi#hdraw assets for my benefit. Ta exercise ar allow to lapse any powers which I have as a non-fiduciary under any trust. To receive infarmation or property from trustees and bene�ciaries. For powers regarding incame trusts, see "PUBLIC AND GOVERNMENTAL BENEFITS AND QUALIFIED 1NCOME TRUSTS,"above. IN GENERAL: (a) Ta carry an, rrianage and canduct my business and affairs, including af( such which my Agent and I are or may be jointly interested ar engaged in, including, but not limited to agreements to pravide far my support, medicat care, and maintenance. (b) To hire, discharge, and replace accountants, attorneys, domestic warkers, health care workers, personal care providers (includ�ng my Agent� under personal care cantracts, brokers, appraisers, workmen, laborers, and other profess'tana(s or contractors as my Agent deems to best meet my needs, � and to pay them reasonable compensation. {c) To conctar with ather persans, including said Agent, jointly interested with myself, in doing all acfs, 'i deeds, matters and things either particularly ar generally described herein as fully, and effectually to all � intents and purposes as f cauld do in my own praper person if personally present. IVatwifhsfanding the above, my Agent may not perfarm duties under a contract fhat requires my personal services, make any affidavit as to my persanal knowledge, vote in any public election on my behalf, �i execute or revoke any will ar codicil af mine, or exercise powers and authority granted to me as trusfee ar caurt-appointed fiduciary. I My Agent is entitled to reirnbursement of expenses reasonably incurred on my behalf. Florida law pravides that I may choose whether or nat a"qualified agent" may receive compensation. Agents who are ; not within the "qualified agentu category are nof entitled ta compensation. Per Florida Statu#es I 709.2112(4), "qualified agent" means an agent who is my spause, my heir within the meaning of s. 732.403, a financial institution that.l�as trust powers and a place of business in this state, an attorney ar certified public accountant who is licensed in this state, or a natural person who is a resident of this state and who has never been an agent for more than three principals at the same time. � [initial one] If my Agent is a "qualified agent" per Florida Statutes section 709.2112(4), then I authorize my ' Agent to receive reasonabis compensation fortime spent acting as my Ageni. _ - --__—_ _--____---_------- - - --- -_—� _—� .— — � My Agent 'is to serve withaut compensation. �i . , This instrument i� non-delegable, �xcept as provided in Florida Statutes section 518.112. � If any section of this dacument is deemed to be invalid or unenforceable under current law, the invalidity of that section shal! nat affect the validity of the remaining sections. � , � � � ' � � , , I y " ♦ j A photocopy ar electronically transmitted yersion of this document shall have the same farce and effect as the original. My Agent is not fiable for any acts or decisions made by the Agent in gaad faith while acting in my best interests as my fiduciary urader the ferms of this durable power of attorney. If an exercise of pawer is improper, my Agent is liable to interested persons as described in Florida Statutes for damage or loss resulting from a breach af fiduciary duty. My Agent must keep ful! and accurate accounts of all transactions made as my Agent, and of the inventory af my safe deposit boxes each time they are accessed. Such accaunts and inventories wi(( be made availabie for inspection upon request by me, my guardiatt, anather fiduciary acting far me, a caurt order, a governmenta( agency having aufhority fo protect me, or, upon my death, by the personal representative or successor in interest of my estafe. My agent must attempt to foDow my reasonabfe expectations and preserve my known estate pfan, to the extent it is in my best interests. My agent must cooperate with my health-care decision-maker in arder ta carry out my reasanable expectations, or if not known, my best interests. Third parties who act in reliance upon the authority granted to my Agent hereunder and in accordance , with the instructions af my Agent wil!be held harmless by me from any lass suffered or(iability incurred as I a resulf af actians taken prior to receipt by the third party of a written notice, as described in F(arida Statutes section 709.2121, of revacation, partial ar camplete termination by adjudication of incapacity, my � '�� death, or suspension by initiation of praceedings to determine capacity ar appoint a guardian. A third person who ac#s in good faith upon any representation, directian, decisian, or act of my Agent is not liable to me or my estate, beneftciaries, or joint owners for those acts. In any proceeding cornmenced by filing a petitian under this section, including, but not 1Emited ta, the unreasonable refusal of a third persan to allow an agent to act pursuant-to the power of attorney, and in , challenges ta the proper exercise of authority by the agent, the court shall award reasonable attorney's fees and costs. � IN WiTNESS THERE4F, ! have hereunta p(aced my Mand and affixed my seal this �day af i ' _Mav, 2o1s, J X �f�/�4a' .l Principal{Sign ure} Date signed Gladvs Rivera Printed name of Principal 3134 Great flaks Street Address Weslev Chaqel, FL 33543 � City, State, Zip Cade Signed by the P 'ncipa! in. p ence of: ..,._ . x 1St Wi�s igna rej G 2� s (signature} �� ' l,� � �� j I �� --�. ._J- .�1h2�$� Printed name af 1St Witness Printed name of 2"d Witness ; � � �--- — . � > { ✓�� + � �j I t�� ' �� /1 D ��.2 r�i h/� f-i t! � Address Address � � �J��' _�.JA�� 1...-.t�.,, ��- '��J S~,�� ity, 5tate, Zip Cade City, State, Zip Cod� ?)5�� '7'�i��f'� • �5a , � �7 9�x'S� rea Code and Telephone Number Area Gode and Telephone Number STATE 0�FLC3R(DA COUNTY OF PASCO xr� The foregoing durable power of attorney document was acknowledged and subscribed before me this 4J day of NI�Y. 2018 by�ladys Rivera,wha decfared his or her identify and who has produced_�L I�r"j u�,�,`��S� _ 1�� d -'3,��7a�{-D as personal i�entification. Notary Signature:�� l�G, � Printed Name: ,,'�r:"" .' Notary Public,Sfate of F! "" '= GOmmission#EE 849525 -�= Expires November B,2016 My cammission expires: `� ,� a�am � , � � � � 4 ! � � � I � � � o O . �I,OHiIIA�., - n�'„i'�`: �� __`. �p^_ �; _ . s ,r,!' . � _ �`: City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: /�/`��(�J Date Received: _ � :=-- • � Site: ��j�� O��— /rJ'i�- • Pernut Type: ��,� � /Q �� B�-��OQ/� ( , Approved w/no comments:❑ Approved w/the below comments: � Denied w/the below comments: ❑ �� ,� �� n �. �� " ��e � � f� � .:� �c v�e$.� � `+° vi 0 r `�' �/J This comm nt she t hall be kept with the permit and/or plans. �� _/� � �� . , c Ge Officer Date Contractor and/or Homeowner (Required when comments are present)