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HomeMy WebLinkAbout19-20690 CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 20690 , BUILDING PERMIT \ PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20690 Address: 4510 BLOSSOM BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est. Value: Parcel Number: 15-26-21-0170-00900-OODO Improv. Cost: 14,900.00 OWNER INFORMATION Date Issued: 1/18/2019 Name: GAUDREAU, ROGER & JOAN Total Fees: 115.00 Address: 17 HANSON DR Amount Paid: 115.00 TOPSHAM, ME 04086-1701 Date Paid: 1/18/2019 Phone: Work Desc: REROOF SHINGLE 1 OF 4 CONTRACTORS APPLICATION FEES TLC ROOFING & CONSTRUCTION INC REROOF RESIDENTIAL 115.00 c 1 Vv Ins ections Required DRY IN ROOF INSP TAPE JOINTS ROOF INSP 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 performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR GNATURE PERMIT OFFICZR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 41 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received r Permittigg �D Phone Contact fo ..... .............. KFU a-W .. V --�I S—o Owner's Name Owner Phone Number Owner's Address Owner Phone Number Owner Phone Number F JOB ADDRESS 10,5 so r, lJ 1 LOT# SUBDIVISION PARCEL ID# 00cl 06 (OBTAINED FROM PROPERTY TAX NOTICE) 004-'>0 WORK PROPOSED NEW CONSTR R ADD/ALT SIGN DEMOLISH e INSTALL REPAIR PROPOSED USE Q SFR Q COMM C= OTHER TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL DESCRIPTION OF WORK 0 6614 W UA rug.J-0 C)kg 14 r"Q4 BUILDING SIZE SO FOOTAGE= HEIGHT 1 7 0 111111111114 =BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL 1$ AMP SERVICE DUKE ENERGY = W.R.E.C. =PLUMBING =MECHANICAL VALUATION OF MECHANICAL INSTALLATION =GAS Q ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN LL/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address License# F_ PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Ly LIN J Address F_ License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN L)LLN� Address License# I I OTHER COMPANY I L?_ (YNSI SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# c 17, om 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 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 wl 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 rota fted letter from'owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Fo6tage), Driveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may benub|oot0o"deed^rmo��Uohs" vvhichmay be more reo�ic(�ethan County regulations. Thounderoignedoosumes -responsibilityfor compliance with any applicable deed restrictions.. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: |f the owner has hired o 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 o misdemeanor violation under state |ovv. 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. Furthermona, if the owner has hired e contractor or contnaotorn, 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 'm the oontractor, that may bman 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 tm the construction of new bui|dinga, change of use in existing buildings, or expansion of existing bui|d|ngo, as specified in Pasco County Ordinance oumberD9-07 and 90-07. as amended. The undersigned also underotando, that such feea, as may be due' will be identified ot the time of permitting. |tie further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving e "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power re|mmam, the foes must be paid prior to permit issuance. Furthermore, if Pasco County VVabar/Smvxmr Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW(Chaphmr713. Florida Statutes, as amended): If valuation of work is$2.500.00 or more, | certify that |' 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"mvvner^prior bocommencement. CONTRACTOR'S/OWN ER'S AFFIDAVIT: | certify that all the information in this application is accurate and that all work will be done in compliance with all applicable }axvo regulating oonotruotion, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. | 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 |avvo regulating oonmtruotion. County and City codeo, zoning regulations, and land development regulations in the jurisdiction. | also certify that | understand that the regulations of other government agencies may apply to the intended xvorh, 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 ofEnvironmental Protection-Cypress Bayhoade, Wetland Areas and Environmentally Sensitive Lands,Water/Wastewater Treatment. � ' Southwest Florida VVoher Management District-Wells, Cypress Boyheado, Wetland Areao, Altering Watercourses. - Army Corps ofEngineero-8eammUo. Docks, Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health UnitVVeUs, VVaotavvoter Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Authohty+Runvmmyo. l understand that the following restrictions apply to the use offill: ' Use of fill in not allowed in Flood Zone^V^unless expressly permitted. - If the 0| 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 professional engineer licensed bv the State ofFlorida. ' If the fill material is to be used in Flood Zone ^A" in connection with o permitted building using stem mm|| 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. | certify that use of such fill will not adversely affect adiocord properties. If use of fill is found to adversely effect adjacent propartiea, 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 imrequired. |f/ amthe 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. ( understand that a separate permit may be required for electrical xvorh' p|umbing, signs, vm»Us, poo|e, air condit|mning, gao, 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, after, or set aside any provisions of the technical codes' nor shall issuance of 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 requooted, in writing, from the Building [)ffiuio| for e 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 UR FAKL0R �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. OWNER OR AGE CONTRAC R 1 V Who is/are personally known to me or has/have produced Who is/are personall n to md—or has/have produced as identification. as identification. Public Notarypvmw CITY OF ZEPHYRHILLS 5335-8TH STREET 20691 (813)780-0020 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20691 Address: 4506 BLOSSOM BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est. Value: Parcel Number: 15-26-21-0170-00900-0000 Improv. Cost: OWNER INFORMATION Date Issued: 1/18/2019 Name: HARDY, VIRGINIA ESTATE OF Total Fees: Address: 4506 BLOSSOM BLVD Amount Paid: ZEPHYRHILL FL 33542-5629 Date Paid: Phone: Work Desc: REROOF SHINGLE 2 OF 4 CONTRACTOR(S) APPLICATION FEES TLC ROOFING & CONSTRUCTION INC RrEOOF RkSIDENTIAL 0.00 DRY IN ROOF IN Ins pectio s'Required TAPE JOINTS ROOF INSP FINAL REINSPECTION FEES: (c)With respect to Relnspection 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. I "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 performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR S&rONATURE PERMIT OFFIVR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION 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 rr11_rTTT1Mrrrrr= Owner's Name [/�,��Dwner Phone Number U�T- -71�5 o 55sl V . / 1 Owner's Address Owner Phone Number Owner Phone Number F__7 JOB ADDRESS 05 3 O-J-I(A UZ—_C-QS LOT# %J SUBDIVISION PARCELID#1 I 5_<3LQ —� -0 1-7 b-00 q0D (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTRR ADD/ALT SIGN DEMOLISH e INSTALL REPAIR PROPOSED USE Q SFR Q COMM OTHER TYPE OF CONSTRUCTION BLOCK 0 FRAME STEEL DESCRIPTION OF WORK 0-- Ck_ Lwat_v RQkJJ BUILDING SIZE SO FOOTAGE= HEIGHT =BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL 1$ AMP SERVICE DUKE ENERGY Q W.R.E.C. =PLUMBING 1$ =MECHANICAL 1$ 1 VALUATION OF MECHANICAL INSTALLATION =GAS Q ROOFING Q SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address I License# 'PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN LXIN_j Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# I OTHER COMPANY T=LQ__R 06;-t r\23 Q- ( 6 s SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# 1�3 0 8,t HHHHH+ HII Ilif HHHHHHHHHHH!it 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 wl Silt Fence installed, Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large 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. "4 Directions: ................ ......... HsiIIHHH"H4 Fill out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (AIC 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 I_ocal 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: 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: - 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. understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone W" 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03)r _ OWNER OR AG T — CONTRAC R Subscribed and sworn to ffiJT` dj before me this Subscribed and sw rn to(or affi d)before me this by or by /are Who is personal) n 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 5335-8TH STREET (813)780-0020 20692 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20692 Address: 4508 BLOSSOM BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est. Value: Parcel Number: 15-26-21-0170-00900-00130 Improv. Cost: OWNER INFORMATION Date Issued: 1/18/2019 Name: GROVE, JULIE A&WINKLE PHILIP R Total Fees: Address: 905 WORNALL LN Amount Paid: CYNTHIANA, KY 41031-4424 Date Paid: Phone: Work Desc: REROOF SHINGLE 3 OF 4 CONTRACTORS APPLICATION FEES TLC ROOFING & CONSTRUCTION INC REROOF RESIDENTIAL 0.00 V Ins ections Required DRY IN ROOF INSP TAPE JOINTS ROOF INSP 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 performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR S GNA URE PERMIT OFFICkR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION 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 V — ; Owner's Name r ca-1/KU 5 Owner Phone Number Owner's Address 1 V Owner Phone Number Owner Phone Number JOB ADDRESS L4c S S14D, OT# Pin SUBDIVISION PARCEL ID# D a-1'O I )— coo®-'00 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED R NEW CONSTR R ADD/ALT = SIGN = = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR 0 COMM = OTHER ` TYPE OF CONSTRUCTION = BLOCK Q nFRAME = STEEL = DESCRIPTION OF WORK UL Gam. © LJ+�' a' Wes' r&j BUILDING SIZE SQ FOOTAGE HEIGHT =BUILDING $ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ AMP SERVICE = DUKE ENERGY = W.R.E.C. =PLUMBING $ =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION =GAS = ROOFING 0 SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address I License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# I OTHER /� COMPANY IT Ll_ c&_- 1'1 d' �6A5t SIGNATURE v' REGISTERED Y/ N FEE 6URREN Address License# (3 6`d -' toollessommossmossmoiaiiiisoNsommosessmemossseI 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 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: 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 NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restricti�J-_ns"� 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: 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: - 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"W 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S.117.03) OWNER OR AGEN CONTRACT Subscribed and swor to(or a rmed b fore me this Subscribed an swor o r affirmed) efore me this by by Who is/are personally kn n to me or has/have produced Who is/are personally own 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 5335-8TH STREET (813)780-0020 20693 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 20693 Address: 4512 BLOSSOM BLVD Permit Type: RE-ROOF ZEPHYRHILLS, FL. Class of Work: ROOF REPLACEMENT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: 'Square Feet: Subdivision: ORANGE BLOSSOM RANCH Est.Value: Parcel Number: 15-26-21-0170-00900-00A0 Improv. Cost: OWNERINFORMATION - Date Issued: 1/18/2019 Name: POST, MARION B Total Fees: Address: 4512 BLOSSOM BLVD Amount Paid: ZEPHYRHILLS, FL 33542-5629 Date Paid-:- Phone: 813-715-0555 Work Dese: REROOF SHINGLE 4 OF 4 CONTRACTOR(S) APPLICATION FEES TLC ROOFING & CONSTRUCTION INC REROOF RESIDENTIAL 0.00 Ins pectio s Required DRY IN ROOF INSP TAPE JOINTS ROOF INSP 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 performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGNATURE — PERMIT OFFIC9R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION 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 -3 Loso o ........-I I I MTTr ...... a- -, I Owner's Name Cl'\ PC,S Owner Phone Number Owner's Address FL T'S cl 10 S5 6-r" CA_ Owner Phone Number C _ Owner Phone Number F JOB ADDRESS (4 c5 ossoy�--, G\v L LOT# SUBDIVISION PARCEL ID# 1 S-010 -CD1 0 0 -C0900 -OD PC (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR e ADD/ALT SIGN DEMOLISH e INSTALL REPAIR PROPOSED USE 0 SFR F__1 COMM OTHER I TYPE OF CONSTRUCTION BLOCK FRAME 0 STEEL = I DESCRIPTION OF WORK 0 tj GAA_C� L�W(Cxta vLR I J StAulo[j BUILDING SIZE SO FOOTAGE= HEIGHT r =BUILDING VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL 1$ AMP SERVICE 0 DUKE ENERGY W.R.E.C. =PLUMBING V_ =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION =GAS Q ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ YES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN LXLN_J Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED L_YI_N J FEE CURREN Y/N Address :1 License# PLUMBER COMPANY L_ SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address —1 License# I OTHER COMPANY 1�ooS:A"$.4- SIGNATURE REGISTERED YVN FEE CURREN LZI_N J Address License# (n HHHHi I f I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 2 11 i I m I H I I I I I I I HHHHHHHH 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 wl Silt Fence installed, Sanitary Facilities&1 d'umpster;Site Work Permit for subdivisions/large 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. g!""Hiiiiiii!.......... ........... .. 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/Fo6tage) 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: 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: - 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. 7 understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone W" 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF.COMMENCEMENT. FLORIDA JURAT(F.S. 117.03) ZE� OWNER OR AGEN ,U r 1 CONTRACT Subscribed and sworn t (or a irmqo before me this Subscribed and swor to( r affirme before me this by by Who is/are personally known to me or has/have produced Who is/are personally nown 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 ' 63358mSt Zephvrhi|bFL33S42 (813)780-0020 ROOFING INSPECTION AFFIDAVIT Permit No.: ~ ����� ^ Chapter 468,Florida Statutes asahA: Contractor I,".'Een g I n e e r Architect Building Inspector License No. CAX ~�» Onor about did personally inspect the: . ~~~, ^ ~~~. Check: Roof Deck NaiU ___x~'__n� Dry in �- Flashing and Drip edge �~- Check which was used: 30#felt Peel and Stick VOther(List At the following — Based upon that examination, I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on Section 553.D44` Florida Statutes). Signature: STATE OFFLORIDA COUNTY OFPASCO . to and subscribedbefore this day ary�PuWicStateofF|ohda ' � . - — ' ' . ' ' '