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HomeMy WebLinkAbout18-19292 CITY OF ZEPHYRHILLS ' ., - • 5335,-8TH STREET (8i�)78o-0020 19292 BUILDING PERMIT PERMIT INFORMATION - = LOCATION INFORMATION Permit Number: 19292 Address: 3839 LAUREL VALLEY BLVD LOT 33 Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Class of Work: 434-ADD/ALT RESIDENTIAL � Township: Range: Book: Proposed Use: MOBILE HOME SUBDIVISION Lot(s): Block: Section: Square Feet: Subdivision: MAJESTIC OAKS Est. Value: Parcel Number: 24-26-21-0000-00100-0330 Improv. Cost: 2,400.00 OWNER INFORMATION Date Issued: 2/14/2018 Name: NHC-FL115 LLC Total Fees: 82.50 Address: 3839 LAUREL VALLEY BLVD LOT 33 Amount Paid: 82.50 ZEPHYRHILLS, FL. 33542 Date Paid: 2/14/2018 Phone: 517-648-6824 Work Desc: EXTENSION TO DECK 12 X 4 FT CONTRACTOR S APPLICATION FEES HOMEOWNER BUILDING FEE 82.50 ��uc-C � � � , �� �� � I - Ins ections Re uire FOOTER 2ND ROUGH PLUMB MISC INSU TION CEILING FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Floriela 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 properly. 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. .�'��.,��z L�� CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED , PROTECT CARD FROM WEATHER a�s-�saoo2o City of Zephyrhills Permit Application Fax-813-780-0021 . Buflding Department '�� Oate Recslved Z_� � :P..hane=Contact far Pemitttln — Owner's Name �'""'� Owner Phane Number Owner's Address �'�3 Y d�"'''�' V � Owner Phone Number -� �� Fee Slmple TItIeHolder.Wame � • � � Owner Phane Number 3j3���?�"z�l � � ; ` � -� Fee Slmple Tltleholder Address ' 3 S 3 � .��t�' 1=""�' �.'� LOT# �33 J08 ADDRE83 SUBDIVIStON �� � PARCEIID# ' f . � , (08TAINED FROM PROPERTY.TAX:NOTICE) WOIiK PRQPQSED _.NEW CONSTR ADDIA�T C�]� SIGN �Q �Q DEMOLtSH I � •�e. INSTALL �� � REPAIR I PROPQSED USE SFR [,� COMfUI � [,,,� QTNEFt 's � TYPE OF CONSTRUCTION = � BLOCK " Q FRAME � STEEG'� Q ,,,� ; Y . DESCRIPTION OF WORK . �� �%j,Z -,� f F� -�"� ,/� �ur�o�N�s�z� 1�F�;',,�°,'1'',a�'f�'�'�"'� sa�oa�rA�E' _ . H�ic�iT ` 3�`�- . �;��P°z`�-'��� �BUlI, � : . . , .DIf�lG $ r�p.� � r/A�UATIOi�1rCfF'TOl'A�COlVSTRt1CT10Ri � ' �„. QE�ECTRtCAL r.� " � AMP SERVICE _�Q °Pl�t?GRESS ENEt2GY Q_ "W:R.E:C. s , QP'L=UMBING J��� ' i fi ��� �� � P� � . � J • �I �]MEGHANICAL $ VALUATION OF;MECFfANiCAL IidSTALLATiOiV_ i ' ' �.../ ����� QGAS Q ROOFING ,Q SPECIALTY �'„_] � OTHER , . ' FINISHED FLOOR ELEVATIQNS F1.00D ZONE AREA YES NO ����Z' - � � � , . � .. • �. •. � > � y /� , `�.�G� _ UILDlER_ ;.. � ' __ �a�c�,niyc►�.°9`:.. _ . ' _ " - ' �G,�TIIRF�„� �r���'�'���� l�*r� REGISTERED Y/ 'FEE CURRE� � Y/'N' �+ � � . �ddress � � - license�# ELECTRiC1AN� COMPAI+tY - , SIGNATURE � REGISTERED Y/ N FEE CURREk ' =Y/N�. :) . - (�� Address � - . . Clsense#�1` . �-.. � � PLUMSER �; , . CQMPANif, , � � � SIGNATi1RE` ° ` _REGIST.ERED Y.L-,N=ti ;_F.EE CURREk Y-/N: - ` ' Addrs�s - � _ � ., . , . Licer„ise# � _� �� ` � , . . .. „ :� _ MECHAAliGAt: � � GOMPANY " � � - .,-. � - :t. SIGNATURE � � ` ' � REGIS7ERED . Y.„/,.N FEE CURRED?. Y�/=N, - Addr8S8'` r� - _ .. , ;; � . ''1; _ ' '.r;� . . :�"%,'„ .. . , ' � ucense#"�,., : . . , . � - ,: O�NBR �; " , . - �^ � �GOMPANY ' � � � � . - SIGPtATt3RE `_•. � • ' • - ` " ' REGISTERED �' ; Y/ N.,..- FEE CURRE� Y/.N Asldress 4 .. _ - � - �icense#�� ,. t "�` .. . . ,. �..,. ,. :- $t:,,;..�... _ „ . . RESiDENT1AL,r :Attz�cti"(2)u.P-.lofPlatis;..(2}'sets_of<BuilBfng#Ptaris;(1}set of%Energy`>Farii�s;R=O=W Rerinit for new constructlon,,. ` ` �i s,,�,. NiinimumLten;{1.0);yuor{cing;deysvafter�submittai da#e.�=:Requir`ed onsife,:Cbn'strticBon=Rlans;�Stormweter Rlan's�w%Silt'Fence instailed, �. Sanifary Facflities�&1:dumpste,r,�,Sfte Worlc;Pertnit for subdivisions/large._projects�:_,;,;;:.:� - , . .� '- °`• :`� -= CO€�!"JlE�CIAL Attach(3)�ccmpfete'sets�of Buitdiiig Pians plus a�i:lfe Safety Page;{1}set af Enengy Forms.R L1-W PetmRt#or new constiu�ion. Minimum ten(10)working days'after submlttai date. Required onslte,Constructian Plans,Stortnwater Plans w!Siit Fence installed, Sanitary FaciliUes&1 dumpster.$ite Work Permit forall new.:projects..All commercial requl[ements,must meet compllance Sl�N PERMIT AttacFt{2�'s'e�ofEng,t'neered�Rla�is...; _- - �;F : - , - - - � •`«»PROPERTY SURVEY reguirecl,for all NEW constructian., -. � �D1iecNons: , ` � - � " , � ` Fill out appiicadon compietely. � Owner 8 Contrackar sign badc of applfcaUon,notarized ti cves�2500,,a NoEtce of CommencsmeRt ts requtred. {A!C upgrades cvet 57500} , •;-A.�;..,.,,� '" Agent(for#he con'tractor)or"Power of Atkomey�(fa��tFie owner)would be someone with�notarized letter from owner authorizing same-� , , _, OVER THE COISNTER PERMIT'CING - •(Front of,RppllcationyOnly).�__„ � � � .. RerooFs If shingles Sewers Service Upgrades A/C , Fences(Plot/Survey/Footage) � . • Driveways-Nat over Caunter�f an'publlc roadways..needs ROV{t�� ;� , ' ° .� .. .� _ _ , - -� . os� y A � � . � �o . . ' � � .-:_'-�; ;`•.t�a4�L N�T10E AF�EED R��tTRICTIONS: The.under.signed�under�tands;#h.�t�#hls=:p�rmlt.maY:be.,sub�ecfi ta_,.deed,..resfrictions .._ ....,,., ��,�- �.: : x.�,,..> which may�tie=more�-�r.e'sttictiVe`�tti��'County'�negulat(ons.��°THe°�undersigned�assumes're�ponsitiilttji=`forrco`mpliance witl�i��any�' appilcable deed�restrfctlons. .. . , ,. . _. UNLICENSED=.CC3NTRACTCIRS AND CONTRACTOR RESPONSIBtL1TiES: °if�the �owner�has��hired��a"conhac#ar or contractors to undettake work, they,may.be�re�qulred:ta�:�be-�llcensed ln accardance.with sta#e.and_�local,.regulatlon_s.:�°If'the��y � � contractor.ls nat llceriseif-as�frequlEed`6y lavir��tio#ti=#he avwmer anc!'~cciitractot�iriay��behclted�for��=misdemeanor v1alation under state� law. If the owner or Intendedr,con.,tractor,are;uncertaln as to what.licensing.require�nents:may.�-apply���for;`�the'� �-�••-�"� in4ended i�rork,they are`ailvlsed�to criritacE`t.tie;Pasco Coanty�Buitdiiig`Inspecttori.D�rlslori-.-E_tcensing Sectlor�at 727-847- 8008. �urthermore, Ef #he owtier"has`filred`a�con�actor or contractors, he is advised ta have �the contractor(s),�slgn portions of the;_°cantractor Block" of.this�applicatian.for.which.they.will.be�.r.esponslble.•.-If.�you,:as,#he oVimer�stgn�as�the " � - _..a...,J_._. contractor; #ha#�t»ay.,be an Indicatiori that'Fie`Is�noY:properly�Ilceiised�'aiitl�Is�at entltleid ta pertriit#ing privlteges U P�sco County. ' � �� , _ , � ��. ,. . TRANSPOItTATIt}N�IMPACIYU'fILIT1ES'��l�1RAC��ANb�RESCIURCE REC01tERY�FEES:-The�understgned understands thatTranspartatian Impact Fees and.Reca.ucse Recovery�Fe�s m�ay��apply�,;to�t(�e;canstruction;of new.�buiidings,�change�of�=- ��� 's' use In exis8ng tiuildings�or�;ezparisl�rr�of�existin�g.�builtlings, as specffled.in P�sco County O�'dlr�anae number 89-47 and s0-07, as amended,,�rThe undetslgned also;undetstands, fhat:�siich fees;�:as��may_;be��due�:witt;sbe idenfi#fed at fhe<timeiof�. �' ,`' permitt(ng. It Is turtlie�understoad that Tra�isportatlon Imp�ct Fees and;Resource�.:Recovsry�Fees.,must be pald prla� fo recsiving-a"cerf�icate°.of ocsupancy"cr-ftnal��.pawer;release; :If�the.proj�ct.,doesr.not invoive.a.:certificaEe Af occupancy.<o�j,:�;'-:';,; . , _. � . final powec release;.th'e:;fees mu�t"°be'pald�p�for to.;permlt tssuance. Ft��thermare;�If:Pasco;Counly"WatedSewer,�Impact �- :•°; fees are due,.they mustbe=pald:;pNo�to,permlt��;lssua�ice;ln_accordance wltlf�app!laatile�Pasco'.County�ardlnances. � CONSTRt#CTlOPI"L"tEN`i.AVlf'(Cliapte�T13� Flar#da$taterte��as amended}; ff valuatlon of work is�2,500.00�or,more��I� ,;;. cerRifiy ,that I, the. appllcant;--have.,been provlded-�wl#h•-a=capy of the•�"Florida•�Construct(on� L-Ieri�Lavm—Homeowner's Protectlo� G�ulde" prep�red by�tlie Floi�da Qepsrtment�of Agrlauit�re and Consumsr,Affairs. tf#he appClcant 1s someorie; , other.than#he"owner", I certlfy��that I;;have,,abta.lned�a�copy.of..#he;aba�ye.:rlescNbed�tlocu�ent;and.ptomis�'In,good�_falth•fo �, deliver It to:itie.'owner":p'rior`to�commencemerit::�; ` . = ..� . ... , y:�,.r,, . _ f CONTRACTOR'S/OWNER'S AFFIDAViT: l.cer#ity;;tliat,alt"the,inf.ormatlon�,ln�thl� appllcatlon is accurate and that all wotk ��,w„. wlll'be done in campllance with all.appllcable laws regulating constntctlon+ zonfn�and„land'�development. Appllcatlan is hereby made to,obtaln .a.permtt;,#o;do,work;�and iiisfaltatlon as Indt�eted:.i��:1� certit`y #tist rto work=or instaltatid`n fias commenced �prior #o Issuance of'a perinit'"and`that:all work will be pertarmed�to meet standards�of all laws regulating� cons#ructlon� Goun#y and G�ty codes, zoning �egula#�ans, and land developcneri# r.eguta�ons�in #he.Jurlsdlct#an. i also certlfy that I understand'that the regulatlons of other government agencles may�apply�to the lntended work, and that it is my responstbiUty to Identify�what.acttans#�t�tust•take:to be�ln..corr�pllance:_.Such�agencles include but-are.na#llmi#ed to. ; � - Departmen# of Erlvironmentat>'Rrotecttori�Gypress.`Bayheed�; V1le�and Areas and Envtronmentally Sensitive Lands,Water/Wastewate�Treatment. � �_ - Sauthwest Ftor�da Water Management .District V11e11s, Cypress.'�8ay.heads; Vlletland` Ateas� AI#ering Watercourses. � � - Army Corps of Englneers-�eawa!!s, Doaks,IVavlgatite Watennrays. � - Depa�tment of.Health:�,8. Retiabilitafive.;.Services/.Envitanmental;.Nealth Unit Well.s; �Wastewater�Treatment; Septtc Tanks: � � _ � � ' . ' � ' , --- � . ' �� t.*. '. .r ,, - - - - - - E�S��,�3;ssr�s���.��s-�����������r�, F��b����������n�i�i.-:- - - - - - Fedet�alAvlaltvn.Authoeity=:Runways;�4 ^ � � l understand.tnat.the.foltauvlrig>restrlctlons appiy`ta tfie use of fll�: . ___. � : - Use of fllt is not allowed In fFloo.d,�;Zone"V"unless expressly,permttted. ; - If the:1�11'mate�lal�-`Is=to�`b:e useil_�'In.:flood-Zone. °A", Ik.�Is underst6od-that a dralnage plan addressing a "compe�sa#ing vofume"witl be submttted a##ime of,permifting wfiich is prepared by a professionai engineer Ifcensed by'�he�StaCe�of'F�o�tda.. � -� � � . � . . _ , ' - i# th� flll materlal�.�s=fo:be�used tn Flood 2one 'A" In=connec�ion�w3th�a'��ermltted building using stem wa€! � construction, I certify.;that,fll(>v�all=b.e used only.to.flll the area wtthln�the�stem-walL � - !f flll materlal Is��to"be tised lii anjr area; I certlfy that .use of such fll! w111 not adveesely affect adjacent propertles., If use:af fill,.is,#ound:.to advers�ty:�ffec#adjacent�properties,.the owner may be'cited tor�lolating the condltions.of,the bulldtng':permlt Issued�under the�attached�permtt�applicatlan,_foc:lots�_less�than.one (1?) acre wfi3cfi�re elevated`by flll,�ct engMeer�ad dralnags plan is requlred. '. If I am the-AGENT FOR.THE OWNEit; l;.promise In good fatth to I�form the owner of-the permltttng condft#ans set forth In this ati#daVit`prlor to commer�cing conatructtan. 1 understana that a�separate permlt may be requfred far elect�lcaf wark, plumbMg;.signs�,wells,,.paots;. air,conditioning,.ga.s,or otheT Insfail�itions not�spec�icatt�y inciuded•in.the application. .A permit Issued shall be.aonsfiue,d to''6e�a�Ilce�nse'•to��proceed wlth tFte work.and nok�as:authoNty�,to.vlalate,�cancel, alter, o:r set aside etty'provlsions of tFte tec.�i�ilcat.,cc�d�s;�nor shalt issuance�of a.permit.prevent the Bulldirig C�tcial from thereafte� � requlring a correctian df eRo�s,ln:plans; cons#ructlan.or vlolaUans of any cades:� Every�p�armik lssned"sFiall become invalid unless the work author'lied_by such permlt:•Is.commenced�withfn s�t.�nonths of�permit Issuance, or If work author�zed by the pernnit is suspended-or:abandoned-for.-a;period;of�s�C{8}montiis,:afitec:the;ttme fhe�work�ts aommenaed. An extenslon may be requested� In wrtting;_ftom.fhie,�Bullding,Off1c(al for a parlod.nat.#o.exceed•nlnety�(90)days and��wlll demo�strake just�iable caase for.the e�ttensio�: tf wor:k cease�:for nine#y.{90}consecutive day.s,..the)ob�is.consldeted abandoned. i i . ,. , „ - � � � - 4 lAfARNfNG Tt�OWNEI�; YOU�..�AIR.URE,�Tt?.,RE..C.Q�tQ,i�1sMQTICE::OF,vGQMMENCEMEMT•.�fI1AY-RESU�T IN YC�U�3 PAYING TWiCE:.FOR iMPROVEMEN�'S�Tfl:Y0U1'�:PR�PERTY:�-�IF�.YO.U�INTENCl:'TO'M�BTAIN'fINAwEtNG;'CONSUl.T ` WIT_.. _�_ � _� A�_�, � F�A. ��,�E�O �:•. �U � � ,G >p ��_. :,, . � , . ._ _._ :_.� ,_.__ __ .— Fl.ORIDA JUi�A�",(F:S.:1.7:03} ��"' � • � � : ,.- � <�' . . ,. 4WNER OR Af3ENT ,� ���tii�`""" �"�"�� . GONITRACTO ���' /�✓�Lt'L� �� • � Subscrtbed a�d swo ta{or �f ed)before me Urts bs be `snd'swo �{�.afRrmed}• efore m 't#il� . 2�r-1f� by '�1�1;1 �'� Co,s.,ye(r ����bv .�j'vlll-7°a� �rU�G�' o Is/a �persana�l y-known to.me or has/have produced le/ re er�on Ilyk�owmb,me.oc haslhave�produced • � as Idend�c:�8pn. �f�',�-�L �,.L as tdenBAcation. _ . � C !° - Notery Pubtic , Notary Publlc Com ! y.1 .�� . E 8 ES Comr�� n. =� ',�: Commission#F '�s::i;"- JACQUELINEBOGES =* cember 12,2018 $�� �. x Name.a w ; „� e�,��lnle�et�st�rtt Name of Nota ' #�pqg�9@81�f�er 12,2018 ' �',j�f„°�S'� 8ontlad Thm Troy FaID Insurenca 90p•385-7019 �4 l ,: . � • ' ,��'' �' ' ' ;; , " � -., . . . . .. ,. . . . . � , �' , EXTERIOR IMPROVEMENT REQUEST � � . . �. ��,. -���y � -�_� /� ���g - �- ,� l. ;'.,r-r,-- i _.�'r�� �. •.' (..,`x .�; S./� !i!,f'.,:•�r.cs �..��.'✓!N�/ 4 FIESIDENT NAME COMMUNITY NAME� '� ,' - %' ;�-��,��.,,7,::f t%,�.?,,-� ';,!4 -�� � ��' ,0,./' �y- i:.�,!'l ADDRESS ' DATE OF REQUEST ?; ?' '?'','' y/� 11 � G . � TELEPHONE NUMBER PROPOSED COMPLEfION DATE ,,, _ The above named Resident requests approvai to build, add-on, or otherwise alter his/her manufactured home, its associated structures, or site. Approval by the Community Management does not waive Resident's responsibility to secure any and all permits required by the governing municipality whose name and telephone number is: 4 Description of Alteration �.�r��,�--�� �. � ��. ��s . � , ' ' p�a � �� .�e r - • � ��� � �� /� t.�y �FZ����l �i� VP�r?.��.d .� .�a� �� 2�✓`�� � ,kn��ra � ��,�+ �r�t� .r� 1�'�. � - � B' ' Upon review of the above request, we find it is within our guidelines. ,Resident will obtain any and all permats necessary to construct improvemen#. If Resident hires an independent contractor, it is recommended that they be licensecl and insured. ` Upon review o.f the above�equest, we:��nd it os no#within�ur guide�ines. � . ___� _ i° - _--- - . `��:; - - --- . , ' . �����_� � � �`�� ��.��� � '�, Cb MUNITY MANAGER DATE USE SPACE BELOW TO SKETCH THE ALTERATIONS AND LOCATION ON YOUR HOME SITE. � ' (ATTACH SEPARATE SHEET IF NECESSARI� _ �., , FOLLOW-UP INSPECTION I Management reserves the right to inspect the alterations described above upon completiori. ' � � COMMUNITY MANAGER DATE WHITE-Community Files YELLOW-Resident SUN 045 EIR 7/O6 - _� _ ;� R: Ii � � 7��1G- 1� l�'`":rl� �'�i� �`-�'f� ��"4�5� �P� ' � ' ° �� • ��t��z;� f rt c�'-�J�� f�,�c� c��"�t$ � !� ���� �`�- l� ` . i. : . , . � -�-�- -�, - .���i�4-6?� -�ud�trdC�-._�o"s��=- � � - - — , __ . _... - . 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ALI.UI(C�RK SHALL C�it�PLY VV9�'f� P�EVAILIRiG - ---- ,:_= �,___=s: -_--�.__�:: � - , ;�. - - �----`--- ,--- - — ------ - - -- - ___. ,.� —------- ------- � ' � � � NATIOfVAL E E YRIC ,.___ __ - . -�.—:-_,-.� ---- -- - -- --- �' -- -- ---=-=Ca�.-C_-�� :, AfVD TkiE CIl`Y�F ZEPF�YRFiIL�� 4 :__------- --- ----�- '-- ___�.__-_ __.___.._�_._-� ----- --- • - �_y..�_ -�-_ --- ----- -- � - ----- __ . .. _�._._ . � ii _... — _" _—�;_ -— — --- — --- —------�..__.` .�—.�—•-----.�_.._:_.��_�___._ _ ._�__.x__�_— :___. �i 3�"_ _'_'___'__._—_'_' _T � '__ -_' ' - _,�. � _� __ .,__�.�.__"__"_�.�_. _.._.�..�.�.____._' __�_____-_'��___'__. _""'___.___'__ _..____ _ . : !; �-.. _. .� � -'--- •__—.-...-- !t � '_�,�� --__r_�..._ -— — — -—-— - ----- - — —--- — — -- — ---— — — . __.. ._._ _._._�._._;:� _�._..._...�_----- — --------_ __���..,..�___—� — -- .� _ .—:. — — .�yj��— _ _— — —— — — — i --i---�----- ----- — -- — —__--»�_—_ = , � _..�.._ _._ � .�_ _ L..� ._..__._� _. �{ _ __ ---.. �_��-5.-_�-�.-�J- - p 2_���C -- - � -- --_I;k-=--- -- - - --- --- -- _�___.-�- - - -- ---_�____�-�_ -- =_1:��'��.�-_-. , � 6 � ��._-- -----�---.- -_- .�--- -- ---�--- --_-= - _�_�.� -- -- __��`---�--- --- -_-..__---_--- - .��___--_---- _ ____ _ . .. ;, � ._._ �� .. , _ ,, .. 4' � " �`��_�_:�_" _-...�._. �....-.._ _._�....' '_'_' `�_��"�_..____�._'_.:.�.'__"_____•�_ -�_-,_"'___ __ _'__` ' __ '__._.-_ ����.�... _ '_ '__ _ _' " '_._.-� . . _._. -.� __.:_..—_�___� - `�... . li •' y� t ..."""_".. .- .: :...�,_.;. ""'____._ _�_.- _�- _ �_. ___ '_ _ _ '__ ___ _ _ _ _ _ _ __ _ __ _ _ _ _ . . ._' " '"_ . .... .. . _.. .. _.. _ .. _ . .�.�_._..�.__� y_"__._w�_.._.._..�.-�.__.._._�"___ . . .� .. . .. . _. ._ .. .�_.._�__. - _'�__' ' ii ..�»__`_'__�___�"_.___.'""_.._..'_'_.___�__ 1� i7 .. '� ..-_�._� __ _-�.. _ _�"_-_`_____._-_�_____-___'..-_-�..--1.�_-_._-"-_.._`-.._.' —____.____-_ _...._"__.....__.-.____.._.__"_e_ __-"_.� __. '_`.'___' „" .._____.��_._....::._.f_ ( . " _.� i � ' � , "_ _. ' � -.. _ _ r - . .�i ! ..�... .._ - � _ -_ dte __..�.�—�_ -��._:_....=��ti.=' �_�___—__".�_._"_'"__.^__.___.�.._�._._....._____._,:�"._'._��..�.._.__�`_.____-_,.i._..�_c..=.._____ ._� _`___f _ _. _.�._ _ _�_.._'___._ w_.,�e __� . ,` _ � �_�.;. _�n ,; „ --,-------._�--- ;-,;_�----_._��-_-��-�--�-----__�;_--�_�_--.-_- .___-�___ - _-_���.(�n:.. _--- -�_---�_----= -- ;. ; , - - s -- - - -- -- -- - --�� - �- - w --_._. . ._.._.__ ---=.-_------�-�-__-�_ . . . _ -� ....�__------___ _---�.-- �._--- .----- ., ,: _-._. -�--------------- - - __- - -- _- --._. ,__ - -- _. ._ .: - -- -� ��� �� , �: DISCLOSURS STATffi�NT FOR OWNER CITY OF ZEPHYRHILLS BIIILDING DEPARTMENT _~F `�I, __ have read aad fully understand and agree to the provisions of this iastrumeat. The undersigned states and affirms that he or she is desirous of coastructing, renovating, adding to or reroofing his or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is not for rent, lease or sale. That he or she shall comply with the following coaditioas: 1. That the owner and he or she alone shall act as the builder for all phases of construction. 2. That the owner will comply with all provisioas of the City of Zephyrhills ordinances and codes pertiaent to the buildiag. 3. That ia the event various phases of coastructioa are subcontracted, he will eagage oaly properly licensed subcontractors aad will persoaally supervise , such work. , 4. That in the eveat the Buildiag Inspector shall require corrections to be made, the owaer will assume full respoasibility to iasure they are made, and upoa completiou will call for a reinspection before proceeding with the building. � 5. That the owner shall assume full respoasibility for the constructioa aad will I aot e ect su ervisioa of his work xp p from the City of Zephyrhills Buildiag � Departmeat. 6. That prior to fiaal inspectioa any additional fees, includiag reinspectioa fees, must be paid ia full. A written request from this office shall , coastitute aa official aotice to pay additioaal fees. ' 7. That the owaer shall comply with all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc. , where applicable. 8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. � 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemptioa to that law. The exemptioa allows � you, as the owner of your property, to act as your own contractor with certaia restrictions evea though you do aot have a licease. You must provide direct oasite supervssioa of• the constructioa yourself. You may build or improve a , oae-family or two-family resideace or a farm outbuilding. You may also build or improve a commercial building, provided your costs do aot exceed $75,000. The buildiag or residence must be for your own use or occupaacy. It may not be b��ilt cr st:bstantially impr�ved for sale or lease. If you seil or lease a building you have built or substantially improved yourself within 1 year after the coastructioa is complete, the law will presume that you built or substaatially improved if for sale or lease, which is a violation of this exemptioa. You may aot hire an unlicensed persoa to act as your contractor or to supervise people working on your buildiag. It is your respoasibility to make sure that people employed by you have liceases required by state law aad by county or municipal liceasing ordiaaaces. You may aot delegate the respoasibility for supervisiag work to a licensed contractor who is aot liceased to perform the work beiag doae. Any person workiag on your buildiag who is aot liceased must work under your direct supervisiou and must be employed by you, which means that you must deduct F.I.C.A. aad withholding tax , and provide workers' compensation for that employee, all as prescribed by law. Your coastructioa must comply with all applicable laws, ordiaances, buildiag codes, and zoaing regulations. OWNER'S SIGNATURE �"��/�'t-�/t/ DATE Z,-J I� ADDRESS 3�J (� F ,j�� ' PHONE jI - 7 7� WITNESS PERMIT # ✓ �� ~ I ' ^ ^ ' F .O''`3� ,,.,��� _ �_ - .';�;. _ s,�t ;.,�,�,.a>,rr �.3;,�'ah�'� >sC..+,y�,,." p�' . iF� �'^y�"'�G. 1• F'' ft.. ._ Czty of Zephyrhills � BUILDING PLAN RE'V�W COMMENTS ' � �ar �y� ConiractorlHomeawner: Date�Zeceived: �J � 1�.J Site: �� `�� �.t�.t�l�✓c.f !� X-�G'��� Permit Type. ^d���'�Z.�-- ���k�?`� 1 � x ��C�"1► � Approved wlno comme;ats:O Appraved w/the belaw comrnents: �- Denied wlthe below comments: ❑ ��i.--�- �S�"��-S � ���'�.9 � � . � his camment sheet sha11 be kept with the permit and/or plans. ' �. �' ��.,,�.�' ���' � Plans Examiner Date Contractor andlar Homeowner \ (l�equired when comments are present}