HomeMy WebLinkAbout18-21124 CITY OF ZEPHYRHILLS
' 5335-8TH STREET
(813)780-0020 21124
PLUMBING PERMIT
PERMIT INFORMATION "LOCATION;' FORMATION'
Permit#:21124 Issued: 4/16/2019 Address: 6015 10TH ST
Permit Type: SEWERLINE REPLACEMENT ZEPHYRHILLS, FL.
Class of Work: SEWERLINE REPLACEMENT Township: Range:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 930.00 Total Fees: 51.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 51.00 Date Paid: 4/16/2019 Parcel Number: 02-26-21-0080-00100-0260
CONTRACTOR INFORMATION. :'. OWNER INFORMATION,
Name: CARR CONTRACTING SVCS INC Name: BINGHAM MATTHEW JAMES
Addr: 3310 DRUM RD Address: 37601 MEADOW OAK WAY
ZEPHYRHILLS, FL. 33541 ZEPHYRHILLS, FL. 33541-4258
Phone: (813)629-4961 Lic: Phone: 813-629-4961
Work Desc: SEWER LINE REPLACEMENT
APPLICATION FEES
SEWERLINE 51.00
INSPECTIONS REQUIRED,
FINAL
1 � 1
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 may be 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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"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 and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
CONTRACTOR PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting O l3 jq
Owner's Name tiPi� IJ'� Owner Phone Number
11f, 3�FK�
Owner's Address 31 0,k W Owner Phone Number
Fee Simple Titleholder Name Irk' tittqkaw, Owner Phone Number
Fee Simple Titleholder Address 3-16 Nk 141 2 141ld 1. ry S Ili
JOB ADDRESS S 13#& ( ��`� 3 Y+ LOT#
SUBDIVISION I S G 4 J PARCEL ID#18�1— 0'SO" D;:' '0 -
(OBTAINED FROM PROPERTY TAXNOTICE)
WORK PROPOSED R
NEW CONSTR 8 ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR = COMM = OTHER lSeWft 9e191&CvTtZ�F
TYPE OF CONSTRUCTION QQ BLOCK Q FRAME Q STEEL =
DESCRIPTION OF WORK �pe Sa kcrvs e Ac,IN
BUILDING SIZE SQ FOOTAGE 1 3'- HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C.
ES2fPLUMBING $ qO-
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING 0 SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N_J FEE CURREN Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
PLUMBER COMPANY rf— 1. h GT A y forV'16-5
SIGNATURE REGISTERED / N FEE CURREN N
Address
3 q33`'� 1/0 ro(0 License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
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 subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plar.is 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: +
Fill 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
y ,
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 andr 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(Chapter713, Florida Statutes, as amended): If valuation of work is$2,500.00 or more, I
certify that 1, 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 1 have obtained a copy of the above described document and promise1n good faith to
deliver it to the"owner' prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I 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:..
DepartmIent of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WaterMastewater 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 filF 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, -1 certify that use of such till 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)consecuttve_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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COPIMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
'44�'����
Subscribed and sworn to(or affirmed)before me this S b crib d and sworn to(or affirmed)before me this
by n-��1-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
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Dear Business Owner:
Your 2019 Pasco County Business Tax Receipt is printed above. Pleased'
lease detach the receipt and display
it in a place that is visible to the public and available for inspection.
The Pasco County Business Tax Receipt is in addition to any other license or certificate that may be required
by law and does not signify compliance with zoning, health, or regulatory requirements.The Pasco County
Business Tax Receipt is non-regulatory and is not meant to be a certification of the holder's ability to
perform the service for which it is registered.
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Business Tax Receipts expire September 30th.Annual renewals are mailed in June to the address of record
at that time. Please contact our office if there are any changes to your business name,ownership, physical
address, or closing of your business.
I
Thank you for allowing us to serve you!
MIKE FASANO
PASCO COUNTY TAX COLLECTOR
EAST PASCO GOVERNMENT CENTER WEST PASCO GOVERNMENT CENTER TAX COLLECTOR BUILDING
DADE CITY NEW PORT RICHEY GULF HARBORS
CENTRAL PASCO GOVERNMENT CENTER COMPARK 75 BUSINESS PARK
LAND O'LAKES WESLEY CHAPEL
CALL CENTER:MONDAY-FRIDAY 8:30 AM-5:00 PM (352)521-4338 • (727)847-8032 • (813)235-6076
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Dear Business Owner:
- I
Your 2019 Pasco County Business Tax Receipt is printed above. Please detach the receipt and display
it in a place that is visible to the public and available for inspection.
The Pasco County Business Tax Receipt is in addition to any other license or certificate that may be required
by law and does not signify compliance with zoning, health, or regulatory requirements.The Pasco County
Business Tax Receipt is non-regulatory and is not meant to be a certification of the holder's ability to
perform the service for which it is registered.
Business Tax Receipts expire September 30th. Annual renewals are mailed in June to the address of record
at that time. Please contact our office if there are any changes to your business name,ownership, physical
address, or closing of your business.
Thank you for allowing us to serve you!
MIKE FASANO
PASCO COUNTY TAX COLLECTOR
I
EAST PASCO GOVERNMENT CENTER WEST PASCO GOVERNMENT CENTER TAX COLLECTOR BUILDING
DADE CITY NEW PORT RICHEY GULF HARBORS
CENTRAL PASCO GOVERNMENT CENTER COMPARK 75 BUSINESS PARK
LAND O'LAKES WESLEY CHAPEL
CALL CENTER:MONDAY-FRIDAY 8:30 AM-5:00 PM (352)521-4338 a (727)847-8032 • (813)235-6076
JIMMY PATRONIS
CHIEF FINANICAL OFFICER STATE OF FLORIDA
DEPARTMENT OF.FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
**CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law.
EFFECTIVE DATE: 3/4/2019 EXPIRATION DATE: 3/3/2021
PERSON: DAVID CARR EMAIL: CARRCONSTRUCTORS AOL.COM
FEIN: 203645197
BUSINESS NAME AND ADDRESS:
CARR CONTRACTING SERVICES INC
I
39334 NORDEL LANE
ZEPHYRHILLS, FL 33542
SCOPE OF BUSINESS OR TRADE:
I
Contractor-Project Manager,
Construction Executive,
Construction Manager or
Construction Superintendent
IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under
this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply
only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be
exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the
person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a
certificate at any time for failure of the person named on the certificate to meet the requirements of this section.
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609