HomeMy WebLinkAbout19-21772 CITY OF ZEPHYRHILLS
- 5335-8TH STREET
(813)780-0020 21772
PLUMBING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit#:21772 Issued: 9/18/2019 Address: 5841 GALL BLVD
Permit Type: SEWERLINE REPLACEMENT ZEPHYRHILLS, FL.
Class of Work: SEWERLINE REPLACEMENT Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 1,500.00 Total Fees: 51.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 51.00 Date Paid: 9/18/2019 Parcel Number: 11-26-21-0010-00900-0130
CONTRACTOR INFORMATION OWNER INFORMATION
Name: JJS PLUMBING CONTRACTOR Name: PROVIDENCE BESA LLC
Addr: 37314 TUCKER RD Address: 9603 ORANGE JASMINE WAY
ZEPHYRHILLS, FL. 33541 TAMPA, FL. 33647-3020
Phone: (813)782-0258 Lic: Phone:
Work Desc: SEWERLINE REPLACEMENT
APPLICATION FEES
SEWERLINE 51.00
IN ECTIO S REQUIRED
FINAL
0
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.
n114A4�a it Aea-
CONTRACT I mom PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - B HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Re;c �it q N
! r � .Phone Contact far Permittin
Owner's Name QO W eOvJ e r Owner Phone Number 13^ 6 O 3^ 7 9
Owner's.Address Owner Phone Number �—
Owner Phone Number
JOB ADDRESS 5 Sal J 61%11 Bid ze&41.jJ :0 94• .3 3 51/2 -LOT#
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED R
NEW CONSTR 8 ADD/ALT EK SIGN [� Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM OTHER
TYPE OF',CONSTRUCTION Q{}- BLOCK 0 FRAME STEEL Q
DESCRIPTION OF WORK µ rti e, (Prv�M . U-acr Me
BUILDING SIZE SQ FOOTAGE= HEIGHT
=BUILDING I$ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = DUKE ENERGY W.R E.C.
PLUMBING $ 5 00 p
17
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS Q ROOFING Q 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
Address License# �—
PLUMBER � -�y COMPANY 'S l itirrl i7 tj rf LC•
SIGNATURE �^ REGISTERED N FEE CURR Y/N
Address 373!`� !tn.&er Z (ff.,�lJS a. 335 ( License# 5!FC 14?'7` J5
MECHANICAL COMPANY
SIGNATURE REGISTERED. LYL N_j FEE CURREN -,Y/.N
Address License# �—
OTHER COMPANY.
SIGNATURE REGISTERED Y/ N FEE CURREN LjjN
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,
Minimur'n'ten(16)working days after sUbmittal date. Required onsit&,Construction Plans;Stormwater Plans w/Silt Fence installed,
Sanitary Faciiities 8,1 dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(2)`•oniplete sets of Building Pans}plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum.tan(10)working days after submitt4date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanita`ry'Facilitib's&1 dumpster.''Site Work Permit foreWriaw,projects.Ail 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 Sewiers .. "Service—Upgrades..A/C.........Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways.:npeds-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 compliane-p i h any
applicable deed restrictions.. , ;
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a�contractor or
contractor's to'undertake work;they may be required to be licensed in accordance with state=-and',locai:regutations. 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`Fe'es may"apply to the`consted ion of niew 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. A 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$2500.00 or more, 1
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 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. 1 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: .•-r
- Department of Environmental Protection-Cypress Bayheads, Wetland`Areas•and?•Environmentally Sensitive'
Lands,WaterMastewater'Treatm ht: .,. 4.,...
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, _Altering
Watercourses.
- Army Corps of Engineers-Seawaifs, Docks, Navigable Wt ierways.
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 maybe cited for violating
the conditions of the buildlt g-�perrhit ti�ssued under.the attached permit application, for lots less than one (1)
acre which,are elevated:;by fill;an:engineered draina9e;plan is required: 5:•.'...'; ._:`_.. .
If I am'the AGENT+.OR THE'OWNER, 1,promige�in.good-faith to-inform•the-owner of the permitting-conditions set forth'in
this:-affidavit prior:,to..,cornmencing construction. i understand;that:.;aseparate permit may be required,for,electrical work,
plurrtbing, 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 code's,,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 YO NOTICE OF COMMEN CENgNT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT`-- -cON`r�tACTOi2 - - - t - --
Subscribed andbyswom to(or affirmed)before me this SOAP d nd by r affi ) efor meetth(s „�r+
Who islare personally known tome or has/have produced re personally known tome or has/have produced C
as identification. Irr I
6a ion.
Notary Public Notary Public
Commission No. Commission No. , ?
d fit V
Name of Notary typed,printed or stamped Name of Notary typ6d, or stamped
E
SMALDONADO
ission#GG346215
s June 1&,2023 70Ttw Troy Fain Insurance 8dd-385-