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Home My WebLink About19-21530 f CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 21530 t DRIVEWAY PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 21530 Address: 5837 14TH ST Permit Type: DRIVEWAY ZEPHYRHILLS, FL. Class of Work: DRIVEWAY/NEW Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-05100-0040 Improv. Cost: 400.00 OWNER INFORMATION Date Issued: 7/18/2019 Name: THRELKELD, MARY&VIRGINIA Total Fees: 45.00 Address: PO BOX 1538 Amount Paid: 45.00 ZEPHYRHILLS, FL. 33539 Date Paid: 7/18/2019 Phone: (813)782-3468 Work Desc: EXTEND DRIVEWAY 8 FT X 22.1/2 FT CONTRACTORS APPLICATION FEES HOMEOWNER DRIVEWAY 45.00 J Ins ections Required DRIVEWAY 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 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 CONTRACTOR PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIOlf 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 Received1 • Phone Contact for Permitting V Owner's Name Owner Phone Number Owner's Addresslo3� / tL , Owner Phone Number a—Lf Owner Phone Number JOB ADDRESS LOT# SUBDIVISION PARCEL ID# H-9 0 0 1 6 0 5-1 Z)D — 0 Q (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR F__1 ADD/ALT SIGN DEMOLISH e INSTALL REPAIR PROPOSED USE Q SFR Q COMM OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL DESCRIPTION OF WORK BUILDING SIZE I SC FOOTAGEL� 1AP'(HEIGHT =BUILDING -C) VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL AMP SERVICE Q DUKE ENERGY 0 W.R.E.C. =PLUMBING 1$ =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION =GAS 0 ROOFING 0 SPECIALTY OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO I BUILDER COMPANY ttj SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address 9 —1 License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN LYLN J Address I License# PLUMBER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN LYLN J Address License# MECHANICAL COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN N Address License# OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Address License# F 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/Slit 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 newconstruction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, San itary*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. (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-Nat over Counter if 66public;roadways..hdedsROW % 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/EnviLonmental 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-AGENT - - Subscribeda dswornt r ffi e befsre meSbi � L\ �rill and byo 0 or affi a ore rye this ,L, f-Who, / r@-perso ally known to me or has/have produced Wh is/ar eon_a�l y f mown to me or as/have produced J L�UAW— as identification. �L� ��'� 4 ce-r'15 _as identification. n Notary Public Notary Public Co mi ion o. Commissi n o. Name of t ": �f, lion Name of Notary typed,printed or s %Comm' 202'l JACQUELINE SOLES pecember 1 Wince aoo-3ss lots s"•ArV,f�:% ,: Commisskn#GG 276457 gp�eETw Troy Fain �; :•: 1-,,,y,,,p%7j !f: Expires •F 1�1 Yam""•^I' �, W"rYT OWW ERMIT APPLICATION DRIVEWAY PERMIT APPLICATION fi elffil�k_ CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY All information must be filled-in completely City of Zephyrhills 5335 e Street, Zephyrhills, FL 33542 Telephone 813.786.0000 Fax 813.780.0005 Date rt �,6nv L V VNFAURI W. 2,11 112q1z -fMac, ' V 6,466 _603ECT/30113 SITE: PROPERTY OWNER Address: A 77-77-1 -rk C--9 Name: P, Z_A L,7 -Unit#: Address: R,31 Wk&:& Unit: Parcel Identification Number: Citv, State,Zip 5 rz_ -.6 D b5l 6 Phone:F/,3_?F;?_:7,Lkb-9ax: CONTRACTOR: -Company: Name: -Contractor's License #: E-Mail: Phone: Cell: Fax: ARCHITECT/ENGINEER: --Narne: Firm Name: Address: City: State: Zip: State License #: Phone: Cell: Fax: Description of Project TYPE OF DRIVEWAY ENGTH OF DRIVEWAY CULVERTS NEEDED X, RESIDENTIAL DRIVEWAY WIDTH OF DRIVEVVAY 81 REINFORCED CONCRETE —COMMERCIAL DRIVEWAY R.O.W. XCAVATION,�,2 YE' CORRUGATED MATERIAL PUBLIC ACCESS DRIVEWAY /-�DEPTH `LINEAR FEET BOX CULVERT OTHER(EXPLAIN) CONSTRUCTION MATERIAL CURB CUT Rvoulm ASPHALT YES NO 2CCONCRETE X- HEADWALL REQUIRED? —YES NO NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings will be required. UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 Page 1 of 3 4.4ERI4IT APPLICATION UTILITIES LOCATE CONFIRMATION NUMBER: PROVIDE SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS APPLICATION. AFFIDAVIT: Application is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing information is accurate and that all work will comply with all applicable codes. I understand these codes shall take precedence over all approved construction documents,and issuance of this permit is verification that I will notify the property owner of Florida Lien Law req.,F.S. 713. The issuance of this permit does not ensure compliance with deed restrictions and I understand that additional deed restrictions may apply to this property. All work shall comply with the current Florida Building Code,Public Works Design Manual and FDOT Design Standards(if applicable). (Public Works Design Manual online link:www.ci.zephyrhills.fl.us/public—works.asp) APPLICATION IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT . TECHNICIAN OR NOTARY PUBLIC. NOTE: The City of Zephyrhills is not responsible for maintenance or repairs of driveways. Driveways shall not alter/ interfere with existing stormwater treatment and/or conveyance. PROPERTY OWNERS: By signing this application: I certify that I have read and understand the owner/builder disclosure statement. (please initial) -7 Ll 7 119 Appli rint ame Applicant Si tore Date of PermVnt hnician Si ature (or) Notary Signature Date Applis( )personally known to me or produced as identification. (type of identification) Page 2 of 3 1 # , PER*MIT APPLICATION OFFICE USE ONLY _ _ _ PUBLICt WORKS:USE ONLY Concrete (min. 6') Y N Asphalt Base(min. 6'1 Y N Asphalt(min. 1112'� Y N Length (min. 19D Y N Width (10'min—20'max) Y N Existing sidewalk. Y N New sidewalk. Y N ADA compliant. Y N Expansion material required. Y N Contiguous parking pad. Y N Triangular flare(31N x 71) Y N Visibility triangle o.k.? Y N Side set back(3'min. R.O.W.) Y N Plan Review Fee Additi®nal.descii on of viiork:as defined b ,Pu61ic=1Norks Director and or desi nee: Permit application approved by: Date: Page 3 of 3 DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT have read and fully understand and A agree to t1ff-j provisions of this instrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is not for rent, lease or sale. That he or she shall comply with the following conditions: 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 provisions of the City of Zephyrhills ordinances and codes pertinent. to the building. 3. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector shall require corrections to be made, the owner will assume full responsibility to insure they are made, and upon completion will call for a reinspection before proceeding with the building. 5. That the owner shall assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office shall -constitute an official notice to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc. , where applicable. 8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial building, provided your costs do not exceed $75,000. The building or residence must be for your own use or occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved yourself within I year after the construction is complete, the law will presume that you built or substantially improved if for sale or lease, which is a violation of this exemption., . You may not hire an unlicensed person to act as your contractor or to supervise-,people working on your building. it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility foi-.supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers" compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. OWNER S GNATURE ATE 7 112 ': Y - ADDRES � (Y 0 7 '?,35 PHONE L4- WITNESS PERMIT #