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HomeMy WebLinkAbout18-19917 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received 1 f O Phone Contact for Permitting G� �1 y��,,n� 1 T Owner's Name Z 4 I IS L e{/ 1 i t 11 t 1 Owner Phone Number Owner's Address PO �Y 3 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address R t JOB ADDRESS Cv `r QI�{ly t�� LOT# SUBDIVISION V I�` PARCEL ID# IN-&�Q—a W 1 U'05 3YJ— \J W�v� (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR e ADD/ALT �.J SIGN = = DEMOLISH INSTALL REPAIR PROPOSED USE SFR 0 COMM = OTHER TYPE OF CONSTRUCTION BLOCK Q FRAME = STEEL t� = DESCRIPTION OF WORK t�IC t �t BUILDING SIZE SO FOOTAGE HEIGHT BUILDING tn —7a$O VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. =.PLUMBING $ =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION / /J (7 =GAS = ROOFING 0 SPECIALTY = OTHER l r FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE t Q REGISTERED IGN FEE CURREN N Address 1 v License# ELECTRICIAN COMPANY SIGNATURE F7 REGISTERED Y/ N FEE CURREN Address License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N I FEE CURREN I Y/N Address License# MECHANICAL COMPANY SIGNATURE F REGISTERED Y/ N FEE CURREt Y/N Address License# OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE< Y/N Address License# IIIIIIIIIIIIIIIIIIIIIIIIIItllllllllllllllillllllllllllllllllllllllt RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsf arge projects COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construction. Directions: FIII out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement Is required. (A/C upgrades over$7500) '• Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND.RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees,as may be due,will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a"certificate of occupancy"or final power release. If the project does not involve a certificate of occupancy or final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I certify that I, the applicant, have been provided with a copy of the. "Florida Construction Lien Law—Homeowner's Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the"owner',I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the"owner'prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: 1 certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the 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 to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone"V"unless expressly permitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume"will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" In connection with a permitted building using stem wall construction,I certify that fill will be used only to fill 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 affect adjacent properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating the conditions of the building permit Issued under the attached permit application,for lots less than one (1) acre which are elevated by fill,an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be 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 shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance,or if work authorized by the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension may be requested, in writing,from the.Building Official for a period not to exceed ninety(90)days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned. 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 ORAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S..1 ) pnln OWNER OR AGENT CONTRACTOR Subscribed and sworn to(cT a efore me this Subscribed and sworn to( r i )befor a this by by Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced as identification. as identification. Notary Public Notary Public Commission No, Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped City of Zephyrhills 5335 811 St Zephyrhills FL 33542 (813)780-0020 q1 � ROOFING INSPECTION AFFIDAVIT Permit No.: jCaiq 1-1 i, V 1 Q licensed under Chapter 468, Florida Statutes as a(n): Contractor Engineer Architect Building Inspector License No. - ©L`j t' y On or about 2OkA 20L9 did personally inspect the: Check: Roof Deck Nailing_(C Dry in Flashing and Drip edge Check which was used: 30#felt_)QPeel and Stick_Other(List) At the following address: Based upon that ex in tion, I have determined the installation was done according to the Hurricane Mitigation Retrofit It nu I(Based on Section 553.844, Florida Statutes). Signature: STATE.OF FLORIDA COUNTY OF PASCO Sworn to and bed te BY: 71 Notary Public State of Flor a a4�r Notary Public State of Florida Alicia Herweh-Cannon ` e Ally Commission GG 218378 Expires 05/10/2022 R P.00fa ig� irde.. ji :A:k- (E-11,71 TE ( E.T1Fi0 Lj-j,TA : U ,-SE �wvl Dzuet rs m< ciry r Vi.r f b L,,, zip To 1. F C,r fl)e 1,-lin-je."!-,porn c-,j,,s4 of the-h-,myi e..f em,-we-c,I(I r,ofin 2 n.)-at en at t;,dry-I:rl-.!w"Jul C,pre-calum,on ici Protect the buildiria and the %fid,-;zc-apWp-. (I-ooi'n &,i�.nec--R iiho 1-,�L;a the.ex-Htffiq d.-t-e-Kiffl-L. rizils. Rephic,?bad othe,-than berem vreed to, at at a all ed insta dylp "p, d p aFt 4. Insfall C�� Z,-fs whefic 3:.4 1 a1u;h-ingle.SV I Ph - -a -7 ' jvr P�aJ fo , ' . V vIIe5. 11.1t-lj ajjej%1ai , feengb �Mfvva b o 5- BISM01 13 e.W I ei-ld bOOL',OWY VeTil Pjpe,C;Qrj(I fjj e.1 a v1vj 7. IMe-4 sdiall be. zqjwk tcl a1r11-Jjfe-pf,%Pe.-:Awipge expZ,r;11-re. --eay Manufacturer C-14-f— CL 9. 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'Description of property(legal description}: 4 C. CA 0 -� -- "a CD Co LaV& Pe) -lPi 65 - c)V� TR 5-�) Exc For 9,D R/vV to oV, ZDZ-6 PG e3*A Street Address q ii Z.5, �0—�[r q Ijocg�Z)r-. ()n �-t—, 2. General,Description of Imploftment: r'C(-00 5htn 0_ 3.0t,%inerinformation: a)Name and address-. b)Name and address of fee simple tit?e r(If oath nE r�):N 2/A' -0 c) Interest in property: Owner 4.Contractor: Paul Schaper,8949 Gall Blvd.,Zephyrhills,FL 33541 —Ph:(813)782-0920, Fax:(813)715-4875 5. Surety: Bauer&Associates, 122 V0 Highway 301 N-., Dade City, FL 33525-$5,000 bond X 6. Lender: Name/Address: NIA 7. Identity of person within the State of Florida designated by owner upon whom.notices or other documents may be served: N/A Name and % address: b) Telephone No.: Fax No, CArm (a13t) (000 8. in addition to himself,owner designates the following person to receive a copy of the Lienor*s Notice as provided in Section 713.13(1)(b),Florida Statutes: Paul Schaper, 8949 Gall Blvd,'Zephyrhills,FL 33541 —Ph:-(813)782-0920—Fax:(813)715-4875 3 9. Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a M different date is specified): -409,QD WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTERTRE EX.PIRATION OF THE NOTICE OF COMMENCEMENT ARr)CONSIbIRED IMPROPER PAYMENTS UNDER CHAPTER 713,PART"I,SECTION 713.13.FLORIDA "E stAxirms,AND CAN RESULT IN YO(IR PAYING-i'Nvtcc FORiviPRovErviEN'rs'ro YOUR PROPERTY.A NOTIC W COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU rn INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF Hiltsborough 3iinature of Owner or Owner's Authorized 01*ri�L)'itectur/Partil4gim� Print Name The foregoing instrument was acknowledged before me this_ 2day of, 20 by -b as Mrj AQ 32 A' (type of authority,e.g.officer,trustee, dhorney in fact) for (name of party on behalf of whom instrument was executed). Personally Known 4 OR Produced Identification NoiliDisit atur 'Type of ldentiticati�(—)n—Produced* JONES COLAMISSto IO #Fr-2364"7 02.2019 xPIPES Jljrl 53