HomeMy WebLinkAbout18-19295 CITY OF ZEPHYRHILLS
5335-8TH STREET
: �• � � ' (813)780-0020 19295
BUILDING PERMIT
P.ERMIT INFORMATION . - LOCATION INFORMATION
Permit Number: 19295 Address: 38218 7TH AVE-STOP WORK
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: q/C CHANGEOUT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-13200-0211
Improv. Cost: 3,000.00 OWfdER INFORMATION
Date Issued: 2/12/2018 Name: ROLLER, MARSHALL �
Total Fees: 55.00 Address: 38218 7TH AVE
Amount Paid: 55.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/12/2018 Phone:
Work Desc: A/C CHANGE OUT 2 TON "
CONTRACTOR S APPLICATION FEES
HOMEOWNER A/C CHANGEOUT 55.00
�
Ins ections Re uired
DUCT INSTALLED
DUCTSINSULATE
FINAL
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications Must Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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CONTRA T R SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTYON — 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHEat
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 �
• Builcling Department 7';�
Date Received .'
� Phone Contact for Permitting �
Owner's Name ,l� Owner Phone Mumber b � ���^ ��"
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Owner's Address ,��b � ' - Owner Phone Number �
Fee Simplei7itleholder Name � � Owner Phone Number �— �
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Fee Simplei fiitlehalder Address
JOB ADDRESS ���I C7 /�'�... LpT# C____�
SUBDiViSiON � � PARCEL 1D#
j (OBTAINED FROM PROPERTY TAX NOTICE)
WQF2K PROPOSED ° e t�EW CONSTR 8 ADD'1A�T � SIGN Q � Q DEMOI.ISH
i INSTALL 'REPAIR
PROP.QSED USE Q SFR Q GOMM 0 4TliER
TYPE"OF CONSTRUCTION C] BLOCK • Q FRAME � STEEL Q
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DESCRIPTI,OTd OF WORK ' / G/ ^
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BUILDING SIZE $Q FOOTAGE�� . HEIGHT �� �
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������t�� � 1'" � VAI.UATtO1V'OF TOTAL COIVSTRtJCTION
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QEE.ECTRICAL $ ANtA SERVICE � PROGRESS ENEt2GY Q W.R.E.C.
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OPI.UMBING �> �
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�MEGHANtGAL $ � � � VP�UATI4N OF MECHANICAL INSTALlfiT10N
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QGAS Q RQQFti�lG Q $PEGIALTY Q QTHER
FINISHED FLOOR EI.EVATIONS ��� FLOOD ZONE AREA QYES NO
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=.BUIl.DER i COMPANY
SIGNATUR� REGISTERED Y/ N FEE CURRE►� Y/N
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Address Llcense# � �
; 'ELEGTRICl�AN �. CdMPAF1Y
SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N.
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- Address � License# �� $ �
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PCUMBER� GOIIAPANY
SIGNATURE REGISTERED Yr/'N. ` FEE CURRE� Y/N
Address
� License# � �
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; MECNANICA[: � COMP.ANY
" SIGNA9'URE"'" � REGISTERED / N -- = FEE CURRE� : Y/N � -
Address" � ' ' License# �! ��
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:"l2ESIDENTI+A1.���_` :Aftach=:2,;Plot�P.lans;;2 k"s`efs�of�Building�Pians;(1,}�set af-E�ergy�Forms;R;O=W Permit.for new.constiuction,. �
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. �y-.-;�;- ;�;,,f-,,;Minimum�:ten;(.1Q).wocking;days.aftersubmittal:tlate.�Required onsite;Gori`strucUon Plans;Stormu'vater Plan"s w/Silt Fence installed,
�;:>. - ` .�'' � Sanit�ry,Fac111ties,8u-1�;dutnpster;ySite;Wor,k Permit forsubdivis{onsilarge''proJects - ' � � . - —
:�-.:GOMIIAERGIAl. A#tach-(2)'�comptete sefs'afBiiiliiirig Ptans ptus a�Life Safety Page;(t}set of Energy Porms.R-O-W Pertnit for new constructian.
• , Minimurti ten(10)working days after submittal date. Required onsite,Canstruction Plans,Storrnwater Plans w/Silt Fence installed,
�:':.;_ Sanitary Fac�llSes&9 dumpster.Site Wotk Pert»it fo��al!-new projeats.Atl commercia!requ�rements.myst meet cotnpliance
�r:„SiGN.PERMtT "Attacfi 2"sets.of_.'En ineered�Plans:-t--� �
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's,:~��°; PROPERTY SURVEY,requir,ed for.all,NEW consUvation:..
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':Directions: r .. , „ - r. ,
�Fill out,application completely. ,
Owner'&Contractar sigt�back of application,notarized
, lf over:$2500,a Notice af:Commencement is required. (A/C upgrades over$750p)
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.�`"'' Agent(fo�'tfi's''�contractor)�or°Power of`Attomey{for"tkie dwner)would tie someone with no#arized letter from owner authorizing same
;;;�OVER;THE COUNTER�PERMIITINCa> ,(copy_of contract-required) "
;-°Reroof's if sFiingles � Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-NotaverCounterifonpublicroadvirays..neecisROW: - ,,.,. ,,_,u,,�:-3�.__:,:n,.. --��• �-••_;,°
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NOTtCE OF DEED RESTRICTIONS: The undersigned understands that,this;permit may b,e su,bj�ct.to".deed°µrestriction�s"�'i;': ;
which,,may.rbe;more.restrictive;than:County regulations:-°'The�undersigned��assumes responsibility�'�fo�.campliance with any ' ,k
applica�le deed restrictions. ..:,,�,;� ,.,-.,.+,a� �;t
UNLICENSED:CONTRACTORS AND CONTRACT4R RESP.ONSIBILITIES:-- If-tfie�>owrier=hasr iiired`•��a�-=contractor or '
contractors to undertake work, they may�be required.to be licensed in accordance with state and�Ioeah cegulatians:.�-:If.tiie=:��� �f;
contractor is not licensed:as rEquired�bjr`law; botfi the owner:an+d:eontraafor-may�be�cifed}�for=a:iriisderrieanor vicilation, >;;?
under sfate law. If the owner or intended:contFactor are.uncectain as to what licensing requicements;�may,apply=for��tlie`k��';`���
�d�h�;p •. .:,.:,v...<
intended work,.#hey_are=advised to�confact ffie'Pasco County Bailding lnspection°Division-=Licensing Sec#ion at 727-847- ' :'I
8009. Fur-therrnore, if the owner has hirec7Ya� contrac#or ar cont�acto�s, he is advised #o�have the contractar,.(s.);-sign...r;; ;�
portions of the "contractor Bfack°of this ap{�lication.#or which tFtey vtri(t.be responsible. :If,you, as°'tFie`owner$sign as�ttie�'� '�;;�
contractor., that may tie an indication=thaf he-is nat properly licensed�and is not eri#itled to permit#ing�privileges,iri,Pasco:„_:;�`
County. � __ , ._.-_:.,. �,t;
TRANSPORTATION IMPAC7/.UTILITIES�IMPACT AND RESOURCE RECOVERY FEES:� The undersigned under.stands '�
that Transportatian impact Fees and Recourse Recovery Fees,�may:apply to:the constructian of new.buildings, chan�ge-°of�s��":;�;
... .�_. ;.
use in existing build�ngs,,or;exp.ans'ron:of.:existing buildings, as specified in Fasco County Ordinance number 89=07:an;d �;,
9Q-07, as amended, `fhe,undersignee! also.ur►derstancls,�that such.:fees, as_may,be.due, will�be identified��at�the;tiirrie�of���°='f
permitting. `It is further�understood that Transpartation Impact Fees��and ResourcerRecovery.Fees rnus# be paid;pcior to
receiving.a "certificate-of�occupanc�'or.final.power release. If the.project does not involve a'ceitificate of oc:cupaiisy';o�+tk-> �+}
final power release,_the fees°:must be..paid prior_to permit issuance. ;Furthermore, if Pasco-County WateclSewer�-lmPact�,-�-- X
fees are due,.they:,must 6e paid priorto permit:issuan�ae in accordance with�applicable.P�asco Cou.nty ordinances. � �
C�NSTRUCTfON=i�IEN-LA1tV{Chapter 713;Florida Statutes,as amended): If valuation af work is$2,500.O,Q.or;mor:e,�(:-�,;- ;
ce�tify that 1, the_applicant, .haVe .been�rvprovided with a copy-of #he °Fiorida Construetian::Lien .Law--Flameawnes's
protection Guide" prepared�by tt"ie Florida Department of Agriculture and Gonsumer Affairs. ff the applicant is someone„ _
ather than the"awner",:l certify.that L�have obtained a copy of the above'd'e'scribed tlocument and promise•�n good4faith`to,'; �
deliver it.to.the-?�awner":pr.ior:to coinmencement. � � � �
CONTRACTOR'S/4WNER'S AFFIDAV.(T:�;I:certify that all the inforrnation in this application is accurate and that alf work
wi11 be dane in comp('rance with alt�appl'icable'laws regu(ating constructian, zoning and land�development. Application,is
hereby made to-abtain;,a�„permit to do. work and installatian as indicated. I�certify that no�wrork or.insfaiiation= has
commenced priar.-tci issuance of a permi# and that a!1 wark will be performed ta meet standards of afl laws regulating
constructian, Caunty and City codes, zoning regulations, and land develaprnen# regulations in,the jurisdiction. ; !.also� -
certify that I understand that the regulations of other goverr�ment agencies may apply ta th� intended work, and that it is �
my responsibility to identify what actions I must take to be in compliance. Such agencies include:but are not�limited,,ta:
- ,Depactmen# of Environmental;"Rrotectian-Cypress Sayfieads; Wetland Areas and Environmentally Sensitive '
i.ands,WaterNllastewa,ter Treatmen#. � �
- Southwest Florida Water Manag�ment District 1Ne!!s, Gypress .8ayheads, Weiland Areas, Alterirrg �
Watercourses, t -
- Army Corps of Engineers-Seawalls, Docks, Navigable 1Naterways, '
- Departmen# of Health �& Rehabilitative Services/Environmental Health Wnit-Wells, Wastewat�:r.Treatment,
Sep#ie:Tanks. !
- US Enviranmental Protection Agency-Asbestos abatement. ,
- Federa!Aviation Au#hority-Runways. `
I understand that�the following restrictians apply ta the use of fill: �
- Use of fill is not allowed in Flood Zone"V" unless expressly permitted. �
- . if the fiii material: is to be used in. Flood Zone "A", it is understood that a drainage plan addressing a
"compensa#ing va(ume"will be submitted at time af permitting which is prepared by a professional engineer "
licensed°by the State of Fforida. - � �
- If the fll material is to be used in Flood 2one "A" in cannection with a permitted building using stein wall
canstruction, I certifythat-fill�will be used only to f!l.the area.within the stem wall. �
- If fill� material is-to•:be used in .any area, I certify that use of such�fill will not adversely a�fect adjacent
prope�ties. If use of filt is found to adversely affect adjacent properties, the awner may be cited for violating
the condifions of;#Fie bailding;permit`issued under the attached permit.appiication, for Iots less than one (1) `
acre which aTe elevated by fll, an engineered drainage plan is required.
If! am the AGENT FOR THE QWNER;:1�promise i�good faith ta inform the�owner af-the permitfing conditians set forth in
this affidavit prior�to cammencing coriskniction. �! understand that a separate permi# may be required €or electricai�work, `
plumbing, signs, wells, poals,,,air,conditioning, gas,.or othe� installations not specifically included in the application. A , �
permit issued shall-:be eonstrued�to=6e a license-to proceed with the work and not as authority.to violate, cancel, alter, or
set aside any provisions of"the technical codes, nor shatl issuance of a permif prevent the Buiiding Official from the�eafter
requiring a correction of.errors�in�ptaris;construction or vialations af any codes. Every permi#issued shali became invatid
unless #he work authorized by such permit is commenced within six months af perrttiE issuance, or if work authoriied by
the permit is suspended.or abandoned#or a•periad,of-six(6�monfhs after the time the wark i�`commenced. An extens4on
may 6e requested, in writing, from the Building�Offlcial for a period nat ta-exceed ninety(90�tlays and will demonstrate
justifiable cause for#he extension. lf wark ceases for ninety(90)consecu#ive days, the job is considered abandoned`
, ;
WARNlNG TQ OWNER:. YOUR.FAILURE TO REC..4,,RD.A.Nf3TIC� OF GOMMENCEMENT MAY�RESULT IN Yt3UR
PAYING TWlCE`FOR lMPRQYEMENTS�TO YOUR:�PRQRERTY...!�YQU';.INTEND=TC1 OBTAIN FtNANCING,CONSULT
WITH Y�DUR'LENDER C!R AN ATTQRN�V��FORE_R�r�RnQ�l�-Y�?��?=!�Q'fil�l����y�QORla�#E�:�L�llt��Y1MP:-.--_�`- - -- - -
� FLi3FtiDA 3URAT(F.S.'117.03) • ' `
OWNER OR AGEN�����y�yC G� C.ONTRACTO�"�ClG�(� G'v_�, �--
Subscribe�i and swom to or affirmed befare me s Subscribed and swom to or affirmed before e this H .
�f/�/j�S'by �L���jt��,1 �6��.'...�' ��:�t,�,�,_by �f�.l�i'}�.�� ����
Who is/are personally known#o me or has/have produced Who t lare personally knawn to me or has/have.produced •
;,�,_(C'Q/��-, as identification. � . �;�C.Q el:�___._+ as identification. `
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_ .� �"����,,� otary Pablic h Notary Pubtic
Co mission No.__i� t%� c1..� Commissian o.��� �j//,r,,.7�(�.�
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Name f Rlota ped,printed or stamped Name of Notary typed,printed.or stamped
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:a���'::�o�`==DEBRA ELAINE RUFFELt � DEBRA ELAfNE RtlFF�C�,
��Gommissian#GG 045343 �,+ �Cammfsslpn#GG Q���
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' ' ' ' DISCLOSIIRS STATII�NT FOR OWt�TE�R
CITY OF ZEPHYRHILLS BUILDING DFPARTMENT
I, 1 �c�,f� /:C.l.l � I J"'e� have read and fully understand and
agree to the provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, addiag to or reroofiag his or her own domicile, that he or she
actually occupies, or will occupy by said domicile, and same is aot for
rent, lease or sale. That he or she shall comply with the followiag coaditions:
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 pertinent to the buildiag.
3. That in the eveat various phases of coastruction are subcontracted, he will
engage oaly properly liceased subcontractors aad will persoaally supervise
such work.
4. That ia the event the Buildiag Inspector shall require corrections to be made,
the owaer will assume full responsibility to insure they are made, aad upoa
completioa will call for a reiaspection before proceeding with the buildiag.
5. That the owner shall assume full responsibility for the construction and will
aot expect supervisioa of his work from the City of Zephyrhills Building
Department.
6. That prior to fiaal iaspectioa any additional fees, iacluding reiaspection
fees, must be paid ia full. A written request from this office shall
constitute aa. official aotice to pay additional fees.
7. That the owaer shall comply with all City, State and Federal laws ia regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owaer shall comply with all the safety codes issued by the Florida
Iadustrial Commissioa.
9. State law requires coastruction to be doae by. licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions evea though you do aot have a license. You must provide direct
onsite supervisioa of the coastructioa yourself. You may build or improve a
oae-family or two-family residence or a farm outbuildiag. You may also build
or improve a commercial building, provided your costs do aot exceed $75,000.
The building or residence must be for your own use or occupaucy. It may not
be built or substantially improved for sale or lease. If you sell or lease a
buildiag you have built or subataatially improved yourself withia 1 year after
the coastruction is complete, the law will presume that you built or
substaatially improved if for sale or lease, which is a violation of this
exemption. You may not hire aa unliceased persoa to act as your coatractor or
to supervise people working on your buildiag. It is your responsibility to
make sure that people employed by you have liceases required by state law and
by couaty or municipal licensiag ordiaaaces. You may aot delegate the
respoasibility for supervisiag work to a licensed contractor who is not
licensed to perform the work beiag done. Any person workiag on your building
who is not licensed must work under your direct supervisioa aad must be
employed by you, which means that you must deduct F.I.C.A: and withholdiag tax
and provide workers' compensation for that employee, all as prescribed by law.
Your coastruction must comply with all applicable laws, ordiaaaces, buildiag
codes, aad zoaiag regulations.
OWNER'S SIGNATURE _ / )LNl/!�-� DATE oc� � �� � �
ADDRSSS ��dZ.I '?� ���D
PHONE
WITNESS PFsRMIT #
By ord�r of i�he �uilcling Official: �ViCI'xam.,�. �urgess �
Ali �ui�d�ng, plumbi�g, �I�ctr�c�i a�ntf �ecl�anicat work
shall c�ase at the belo�n► m+en�i�ned prc�p��. �
Address: �
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D�t�: � �- � �'
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Code Enfercem�nt t�ffic�r: !,� �� �` �--� ��
Contact the
Z�phyrhills �uildin� �epar�trr��r�t
5�35 - 8th Street
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