HomeMy WebLinkAbout20-22576 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 22576
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
PERMIT INFORMATION LOCATION INFORMATION
Permit#:22576 Issued: 3/04/2020 Address: 8034 BROAD POINTE DR
Permit Type: NEW SINGLE FAMILY DWELLING ZEPHYRHILLS, FL.
Class of Work: 101-NEW CONST/SFR Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 208,177.20 Total Fees: 19,116.25 Subdivision: ZEPHYR LAKES
Amount Paid: 19,116.25 Date Paid: 3/04/2020 Parcel Number: 35-25-21-0140-00800-0040
CONTRACTOR INFORMATION OWNER INFORMATION
Name: DR HORTON INC Name: DR HORTON INC
Addr: 12602 TELECOM DR Address: 12602 TELECOM DR
TAMPA, FL. 33637 TEMPLE TERRACE, FL 33637-0935
Phone: Lic: Phone: 813-549-1968
Work Desc: CONSTRUCT SINGLE FAMILY 1,848 SQ FT
APPLICATION FEES
PLUMBING FEE 162.75 SEWER CONNECTION RESIDEW 2,090.00 ELECTRICAL FEE 244.13
WATER CONNECTION RESIDENT 1,010.00 IRRIGATION METER 473.78 MECHANICAL FEE 113.93
SCHOOL IMPACT FEE-sfr/1% 83.28 SCHOOL IMPACT FEE-sfr/100% 8,328.00 TRAFFIC IMPACT FEE 1% 36.32
TRAFFIC IMPACT FEE 99% 3,595.68 PARK FEES SF 769.56 POLICE IMPACT FEE 254.00
FIRE IMPACT FEE 273.00 PUBLIC SAFETY 5% 26.35 WATER METER RES 3/4" 473.78
BUILDING FEE 1,181.69
0
Inspections Required
FOOTER 2ND ROUGH PLUMB MIS INSULATION CEILING
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
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.REINSPECTION FEES:
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.
"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 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.
CONTRACTORS SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIOlf
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
D.R. Horton-8034 Broad Pointe Dr:1,848 sgft
o umn
SO. FEET PRICE
MAIN OR LIVING: 1,848 $ 112.65
OTHER AREA UNDER ROOF: - $ 88.00
OTHER: - $ -
VALUATION $ 208,177.20
' FEE SHEET $ 1,085.00
ADDRESS $ 30.00
DRIVEWAY $ 45.00
BUILDING: $ 1,181.70
ELECTRICAL: $ 244.13
PLUMBING: $ 162.75
MECHANICAL: $ 113.93
SUB-TOTAL $ 1,702.50
TOTAL $ 1,702.50
SEWER: $ 2,090.00
WATER: $ 1,010.00
IRRIGATION: $ -
TOTAL: $ 3,100.00
WATER METER:1 $ 473.78
IRRIGATION METER $ 473.78
FIRE DEPARTMENT FEES
PLANS TOTAL:
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $ -
PUBLIC SAFETY IMPACT FEES
POLICE $ 254.00
FIRE $ 273.00
5% $ 26.35
TOTAL: $ 553.35
SUB-TOTAL $ 6,303.41
PARK IMPACT FEES $ 769.56
SIF'S: $ 8,328.00
100.0% $ 8,328.00
1.0% $ 83.28
TOTAL: $ 8,411.28
T I F'S: $ 3,632.00
99% $ 3,595.68
1% $ 36.32
TOTAL: $ 19,116.25
35-25-21-0140-00800-0040 1 Pasco County Property Appraiser Page 1 of 1
Parcel ID 35-25-21-0140-00800-0040 (Card: 1 of 1)
Classification 00000-Vacant
Mailing Address Property Value
D R HORTON INC Ag Land $0
12602 TELECOM DR Land $0
TEMPLE TERRACE, FL 33637-0935 Building $0
Extra Features $0
Physical Address
8034 BROAD POINTE DRIVE, Just Value $0
ZEPHYRHILLS, FL 33541
Assessed $0
Legal Description (First 200
characters)ZEPHYR LAKES SUBDIVISION Non-School Taxable Value $0
PHASES 1A 2A 2B &4A BLOCK 8 School District Taxable Value $0
LOT 4
Jurisdiction
CITY OF ZEPHYRHILLS
Land Detail (Card: 1 of 1)
Line Use Code description IZoning Units Type Price Conditio�nalue _
1 1 0000V Unknown Vacant 1 0.00 1 AC $13,190.00, 1.00 1 $0
Additional Land Information
Acres= Tax Area FEMA Code Res Code Com Code Condo Code
0.00 30ZL -- 3ZHN I 3ZHN 3ZHN
Building Information (Card: 1 of 1)
Unimproved Parcel
Extra Features (Card: 1 of 1)
Line Code Description Year Units Value
No Extra Features
Sales History
Previous Owner: DUNE FL LAND I SUB LLC
Month/Year Book/Page Type DOR Code Condition Amount
12/2019 _ 10044 / 2789 Warranty Deed 05 _Vacant_ $589,000
_ 09/2011 8606 / 3376 _ Warranty Deed 05 _ Vacant _ $0
06/2010 8360 / 1872 Certificate of Title 12 Vacant - $0 _
T 06/2006 _ _ 7017 / 0395 _ Quit Claim Deed Improved $0
05/2006 7026 / 0555 _ Warranty Deed Improved $0
05/2006 7002 / 1637 _ Quit Claim Deed Improved $0
https:Hsearch.pascopa.com/parcel.aspx?parcel=2125350140008000040 3/4/2020
OUvApplication Fax-83-780-0021
Building Department
Date Receiv Phone Contact for Permitting
Owner's Name nc- Owner Phone Number QLm (_4
-Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
I (OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR F7 ADD/ALT SIGN DEMOLISH
Ef INSTALL F—] REPAIR
PROPOSED USE SFR COMM OTHER F_
TYPE OF CONSTRUCTION BLOCK FRAME STEEL = —
BUILDING SIZE SQFOOTAGE1Nc` HEIGHT
�--lBU�DNG VALUATION OFTOTAL
F—� G���E�E�� �� W.R.E.C.
[--lELEC��CAL AMP SERVICE PRO .
[--�PLU�B|NG
�—_�
�^ _
[--lMECHAN|cAL MECHANICAL INSTALLATION
=GAS ��l ' 'ROOFING SPECIALTY | | OTHER
FINISHED FLOOR ELEVATIONS ct FLOOD ZONE AREA F--lYES NO
BUILDER COMPANY
ELECTRICIAN COMPANY P.jrc-Me
"LUMBER COMPANY I
wECn*°^.*` ~~~'~^'
Buw/TuRE �om�snso ` L���_� pseounnE^ ° L_Y/N_J .
_
Address uounne
TcnER cuMp*mr
!\oNAJUKE REa/arswso L�LLNL_! ,Ecuvn:c* L� /�L�
Address License#
ZES|DENTI/&' Attach(2) sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(1V)working days after submittal date. Required omsite.Construction Plans,Stonnvater Plans v/Slit Fence installed,
SaoibaryFa�/iUaa81dumpnter;Site VYudkPermit for oubdi�s\on�|onJapn4e�o _�
z]MMERChuL AM�oh(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(1O)working days after submittal date. Required nneite.Conntruutinn Plans,S(onnwater Plans yW Slit Fence installed,
Sanitary Facilities&1dumpstor,S\(eVVorkPennitfnra|\newpn4ects.A||nommencio|noquirbmontomustmeetcnmp|ianma
UGNPERM|T Attach(2)sets of Engineered Plans,
°°^°PROPEFTY SURVEY required for all NEW construction. '
Fill out opp|icatin9completely.
Owner&Contractor sign back of application,notarized
If over$2aoo'a Notice cf Commencement isrequired. (AIC upgrades over$75VV)
^ Agent(for the contractor)or Power of Attorne�(for the owner)would be someone With notarized letter from owner authorizing same..
/VER THE COUNTER PERMITTING (copy ofcontract required)
lemofs if shingles 8moem Service Upgrades A/C Fences '
Driveways-Not over Counter ifon public modvaye.noedoROW
'
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"daed 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 e contractor or
contractors
'tounde�okevvork, they nnayba required tnba licensed in accordance vvithstate and local regulations. If the
contractor is not licensed as.required by |avv, 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. Fudhernnore, if the owner has hired o contractor or contraotnro, he is advised to have the contractor(n) sign
portions of the "contractor Block" of this application for which they will be responsible. |f you, aa the owner sign anthe
contractor, that may baan indication that ho |o notpropedy]ioenaed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IK8PACDOTlLlTlEG IMPACT AND RESOURCE RECOVERY FEES': The undersigned understands
that Transportation Impact Fees and RecourseRecovery Fees may apply to the construction of new buUdingo, change of
use in existing buUdingo, or expansion of existing buildings, as specified in Pasco County Ordinance nurnber8S-D7 and
90-07. as amended. The undersigned also undorsbsnde, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Feea'ond Resource Recovery Fees must be paid prior to
receiving a "certificate ofoccupuncy" or final power na|euae. If the project does not involve o certificate of occupancy or
final povverre|ease. 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, oo amended): If valuation of work io $2.5OO.ODormore, |
certify that |, the applicant, have been provided with e copy of the "Florida Construction Lion Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture ond[|onaunnor Affairs. If the applicant is someoneutherthenthe "ovvner'. \ oart�vthat | haveobtoinedaonpyoftheobovedeocribeddncurnentandpnonniae |ngoodfeithto
deliver itto the"owner" prior tocommencement.
CONTRACT{JFl`SIOVVNER'G AFFIDAVIT: | 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 e permit to do work and installation an 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 laws regulating
construction, County and City codes, 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 work, 'nd that it is
nny responsibility toident�vvvhntaoUons | nnVet take bobeincompliance. Such agencies indudebut are not l}nnitodto:
- Department nfEnvironmental Protect!on-Cypress Bayheada' Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheada' Wetland Areaa, Altering
Watercourses.
- Army Corps ofEngineers-3oavv8Ua. Docks, Navigable Waterways.
' Department of Health & Rehabilitative San/ioeo/Env|ronmenba| Health Unit-We||s, VVmatnvvater Treatment,
Septic Tanks.
- U8 Environmental Protection Agency-Asbestos abatement,
' Federal Aviation Authority-Runvvayn.
| understand that the following Penthctiona'app|ytO the use offill: '
' Use of fill ie not allowed in Flood Zone "VV" unless expressly permitted.
- If the fill material is to be used in Flood Zone 'K, it is understood that a drainage plan addressing a
"compenaat|nQ volume" will be submitted at time of permitting which is prepared by o professional engineer
licensed bv the State ofFlorida.
' 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, | 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 ofthebui|ding permit issued under the attached permit application, for lots |eme than one (1)
acre which are elevated by fill, on engineered drainage plan isrequired.
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. | understand that separate permit may be required for electrical vvorh'
p|umbing, aigOa, vve||n' poo|a, air oonditioning, gas, or Other installations not specifically included in the application. A
permit issued shall be construed to be o license to proceed with the work and not as authority to vio|ata, canne|, a|bar' 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 aix 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 peq000ted, in writing, from the Building Official for a period not to exceed ninety (SO) 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.
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affil ed)b for��me this Subscribed and sworn to(or affirmed)before me this
by MC I y
Who is/are p known to me or has/have produced Who is/are personally kno\�n to me or has/have produced
as identification. as identification.
Notary Public Notary Public
Commission No. Commission No.
d Name of Notary typed,printed or stamped
or
S=Fd -iN a b
ic
State of Florida-Notary Public
hV
INSTR#2020016440 OR BK 10044 PG 3886 Page 1 of 1
01/30/2020 10:52 AM Rcpt 2130554 Rec:.10.00 DS:0.00 IT:0.00
Nikki Alvarez-Sowles, Esq.,Pasco County Clerk&Comptroller
Permit No. Parcel iD No "0 U 140 - MZQ DtLPO
NOTICE OF COMMENCEMENT
State of Florida County of Pasco
THE UNDERSIGNED hereby gives notice that improvement will be made to certain rest property,and in accordance with Chapter 713,Florida Statutes,
the following information Is provided In this Notice of Commencementt� L ,�}
1. Desciption of Property. Parcel Identification No. t �"I -Gt ock- R "10e)TT IL T}kC.s-C coo•
Street ��Address: �� ��l n-�2 �:-' �<<ST} �L :55-40
2. General Description of Improvement Now Single Family Residence
3. Owner Information or Lessee information if the Lessee contracted for the improvement:
n R Horton Inc
Name
19809 Tplprnm I)rivc? Tampa 33637 {�
Address City State
interest in Property: FeeSiniple _
Name of Fee Simple Titleholder.
(if different from Owner listed above)
Address City State
4. contractor, D.R. Horton Inc
Name
FL
12602 Telecom Drive Tampa 33637
Address City State
Contractors Telephone No.:
5. Surety: NIA
Name
Address City State
Amount of Bond: $ NIA Telephone No.;
B. Lender, A
Name
Address
City State
Lender's Telephone No.:
7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)M,Florida Statutes:
David Gude
Name
12fiQ2 Telecom Thrive Tampa _ '33637 FL
Address City _State
Telephone Number of Designated Person: • 813-740-9720
a. In addition to himself,the owner designates _N/A of
to receive a copy of the Lienoi's Notice as provided In Section 713.13(1.)(b),Florida Statutes.
Telephone Number of Person or Entity Designated by Owner:
8. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the
contractor,but will be one year from the data of recording unless a different date Is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713 PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SiTE BEFORE THE FIRST INSPECTION. iF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Udder penalty of perjury,I declare that I have read the foregoing notice Qf commencement and that the facts stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA
COUNTY OF PASCO
Signature of Owner or Lessee,or Owner's or Lessee's Authorized
Officer/Dlrector/Partner/Manager
Asa!,
tant Sedreta R. Horton, Inc
�}y :9;�
' e/Offloe
The foregoing instrument was acknowledged before me ails�day 20 by
as Assl:taut Secretary (ty)e of authority,e.g.,officer,trustee,attorney In fact)for
D.R. Horton, Inc ( e of party on behalf of wh�Imentas executed).
Personally Known OR Produced identification[INotary Signature""
Type of Identification Produced Name(Print)
• ,tUtt1lq,
E\a_
OANA ANNE NAGHTIN
' Notary Public-State of Florida
Commission t#GG 010660
�' My Comm.Expires Jul 12,2020
wpdatalbes/noticeeommencement-Pc853048
813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
Building Department
c
Date Received Phone Contact for Permitting 17
e
Owner`s Name Owner Phone Number
(. Owner's Address Owner Phone Number
Owner Phone Number
JOB ADDRESS' LOT#
SUBDIVISION PARCEL ID#
�(OSTAINED,FROM PROPERTYTAX,NOTICE) .
WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISHE3 '
INSTALL 8 REPAIR
PROPOSED USE = SFR COMM OTHER
TYPE OF CONSTRUCTION = BLOCK = FRAME STEEL =
DESCRIPTION OF WORK
0 C
BUILDING SIZE E SQ FOOTAGE_ HEIGHT.
=BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL 1$ � AMP'SERVICE 0 DUKE ENERGY` 0 W.R.E.C.
=PLUMBING �-7
=MECHANICAL VALUATION OF MECHANICAL INSTALLATION
=GAS Q ROOFING = SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS' FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y I N FEE CURREN . Y I N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED' Y t"N FEE CURREN
Address License# j
PLUMBER COMPANY
SIGNATURE ( REGISTERED E;W
FEE CURREN "Y 1 N ``
Address License#
MECHANICAL ;, COMPANY
SIGNATURE• REGISTERED YIN FEE CURREN Y t N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED 'Y I N,.-;- .. FEE,CURREF LYJ:N.•:.
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 submittai'date. Required onsite,Construction Plans,Stormwater Plans wt Silt Fence installed,
Sanitary Facilities&1_dumpster;.Site Work-Permit for subdivisions/large projects"
COMMERCIAL Attach(2)complete sets of Building Plans,plus a1lfe 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 Pians;.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. (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 (eopyof contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit,may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance With any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a.contractor or
contractors to undertake work, they may be required to be licensed in-accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the,Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the.construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands,,that.such fees,-as may be-due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final,power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if-Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable,P6'sco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, 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 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,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 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 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
WITKYOUR LENDER OR AN ATTORNEY BEFORE*RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this
by by,
Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification. as identification.
Notary Public —Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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1_
Single Family Dwelling
Plan Review Comments
1. F.F.E..shall be a minimum of 8" above the road elevation and an engineered site plan.
2: Lots shall be graded to coriiply with R401.3 of the E.-B.C.
3. Compaction test required if 24"or more of fill dirt is brought in at any one place.
4. Tie in survey required before pouring concrete.
5. Driveways require a R.O.M. use permit. A114 sides of driveway thru the sidewalk shall have
expansion material.
6. All setbacks shall be met.
7. All property markers shall be uncovered and marked at time of first inspection.
8: All A.D.A.requirements shall be met:
9. No electric,.plumbing;mechanical,or framing shall.be covered without an inspection and
approval first.
10:All Garages shall comply with section R302.6 of the F.B.C. (Fire Separation).
1.1. Appliances shall not be installed in a location where-subject.to mechanical damage unless
protected by approved barriers. M303.4 of the F.B.0
12.Water heaters shall comply with section P607.3 of the F.B.C.
13. Foundation supports for A/C units shall be raised at least 3" above finished grade. M1308.1
14. Return air in all bedrooms. F.B.C.- M1620.4
1.5. Smoke detectors are to be installed_ in accordance with R313:1 of the F.B.C.
16:All glazing requirerr�ents are to b.e in accordance with R308.4.of the EB.C:
17. All means of egress are to be in accordance with R3I I of the F.B.C.
18. "Green gypsum,board" shall riot be used as a backer in showers or tubs.R702:4.2 F.B.C.
10. Combination type AFCI breakers are required at all locations requiring an AFCI type breaker.
20. Carbon monoxide alarms will be required in new construction that uses fossil-burning heating
or appliances or an attached garage. They shall be installed in accordance with the F.B.C:
21. All plumbing,mechanical, and electrical shall be separate from unit to unit: This includes all
underground plumbing and electric.
22. All 2016 N.E.C. Codes will be enforced.
' 23. Tamper- Resistant Receptacles in accordance with 406.11 of the 2016 N.E.0
24. In accordance with the Land Develop_merit Code,lots shall.be sodded before final at least.10
feet around the structure.
25. R403.5.3Hot water pipe insulation
Insulation for hot.Water pipe With a"minimum thermal resistance (R-value) of R-3 shall be applied to the
following:
Piping 31.inch (19.1 mm) and larger in.nominal diameter:
Piping serving more than one dwelling unit.
Piping located outside the conditioned space:
Piping from the Water heater to.a-distribution manifold..
Piping located under a floor slab.
Buried in piping.
Supply and return piping in recirculation systems other than demand recirculation systems.
25. Blower door test shall be provided before C.O.
26.A cony ofthe-enemy cacls shall be with permit at all times
27.. Cony of final insulation report shall be provided with permit before fnai'
28. No fence,pool or screen'enclosure :is issued with:thispermit:
F.F.E.-Finished Floor Elevation
F.B.C- Florida Building Code 6th Edition
R.O.W-Right of Way-
A.D.A.-Americans with Disabilities Act , N.E.C.-National Electric Code(2016)
PASCO COUNTY, FLORIDA
Permit No:
`'_ Date Permitted �_�� _
Builder Name/Owner Name c (1#G f Control#'
County Parcel No. c —Z 5�- o1 7a^ t�- SubDiv:
t f Address/Location &ock m
Classlticationtrype of Usq t _
TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: 2 3&L
Exempt ❑ 'es ❑ No How Determined
Impact Fee Amount b 3a+ Zone No. TAz:
SCHOOL IMPACT FEE
Account 058 Single-Family.Detached House Amount $ 1. 243
(057) Mobile Home
(058) Other Residential
123) Collection Fee
Exempt Yes 0 No How Determined
PARKS AND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone TOTAL AMOUNT $ 76 9• S1
'+ Exempt ❑Yes ❑ No How Determined
4 LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
rarw:. tv fy .
IN'
r Exempt ❑Yes No How.Determined Total Amount
RESOURCE FEE' ERU
TOTAL AMOUNT
Prepared By Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
{ PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
x,. RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE.OF PASCO COUNTY
ks
Acknowledgement below does not Imply acceptance of concurrence,but simply recelpt ofa copy of thle form,placing
the bullding permit owner,on notice of this assessment and the conditiona of payment for some.
t: '
DATE RECEIVED BY
RECEIPT NO. DATE BY