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City Of Zephyrhills PERMIT,°'NUMBER
5335 Eighth Street
Zephyrhills, FL 33542 BGR-000794-2020
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 10/08/2020
Permit Type_ : Building General (Residential)
Property Number. V Street Address
1126 210010 11400 0100 138801 7Th Avenue
Owner Information Permit Information Contractor Information'
Name:✓RICHARD WHITE Permit Type:Building General(Residential) Contractor: HOMEOWNER
Class of Work:Reroof
Address: 38801 7Th Ave �otai valuation:$4,000.00
ZEPHYRHILLS,FL 33542 Total Fees:$90.00
Phone: (813)778-8733 Amount Paid:$90.00
Date Paid:10/8/2020 1:00:41 PM
Project Description
REROOF METAL
Application Fees
Building Plan Review Fee ✓$30.00 Building Permit Fee 1�60.00
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 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 permit 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 add fee 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.
1001
CONTRACTOR SIGNATURE PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-78MO20 City"of Zephyrhills Permit,.-Application Fax-813-780-0021
Building,Department
Date Received Phone Contact for P.,ermitting:
Ownef's'Name / ! „s .. OwnerRhori®..Numb'ei•'> : .
Owner's Address V C G V/ ILf�/. Y ::_Owner one Number:
Fee Simple'Titiefiolder Name Owner Phone Nurni orr.
Fee Simple Titleholder Address.
JOB ADDRESS t5 V ! 11 LOT#
SUBDIVISION ..: PARGEL;ID#.
(OBTAINED.FROM,PROPEKTY TAX,NOTI'dEI
WORK PROPOSED NEW:CONSTR ;:..:; . - .;ADD/AST" " SIGN: DEMOLISH
`
e INSTALL.. ".. REPAIR,
PROPOSED USE Q• SW Q COMM "i_ ..OTHER.',: _^A
STEEL•TYPe;OF-CONSTRUCTION Q' BLOCK: FRAME'Q r0 r : ., y: . ..:
DESCRi ,TiON;OFWORK. Cr�.
BUILDING:SiZE i5:V SQ FOOTAGE HEIGHT..L =.
•
=BUILDING-. $
VALUATION:OF.TOTAL.GONSTRUCTION ,
QELECTRiCAL $ AMP SEit=VICE. ".. PROGRESS ENERGY [ .. ° "W:R:E.C.
QRLUMBING $
QMECHANICAL $ VALUATION OF.MECHANICAL IN r
=GAS ROOFING Q :.•,, SPECIALTY:".C] :"::OTHER.
FINISHED FLOOR ELEVATIONS FLOOD ZONE`AREA-_ : -YES, NO.
:1
BUILDER "COMPANY
SIGNATUREWA REGISTERED ::Y%''aN#-• FEECURRE�' Y/=N.'<``.
Address !? r. . {acense#:
ELECTRICIAN• -`.COMPANY
SIGNATUR9 "REGISTSMW ,,`Y,/`aN•. ' ,FEE=C,URREK < :Y/'N;"•_- .,
Address License#,
PLUMBER COMPANY
SIGNATURE REGISTERED - Y./..;N,:,: FEECURREK ":::i:"::Y:/N`:
Address License.
MECHANICAL > :.COMPANY
SIGNATURE REGISTERED YY'N' FEECORREW
Address: . :t lcense.. ;
OTHER ,. .t COMPANY,:
SIGNATURE REGiS7•i3' y/ N;:: FEE cURREh:
Address,
RESIDENTIAL Attach'2".PIot-Plarii'is=""2"sets=cf'Btiiitd[rti v Plafis•:1+ set'ot,Erie` Foans WO',N P rriiiE=l c:newrconstrii ion
Minimum"ten(10)working.days after submittal-.date. Required onsite:'EoristrOction Plans,"Stormwatee Ptans:w1 Silt Fence-installed;°
Sanitary Facilities&1 dumpster,:Site.Work Permit;fo[subdiogl nsfiarge.projects
t COMMERCIAL Attach"(2) omplete sets;of::Building'Plans;piusalite Safety:Page;(1:).setof Energy.Forms.:R-O-W.Permit,fbr new.constt.updbn.,
Minimum ten(10j working days after suhmittai date:'`Requfied:bnsite,.Construction Pans;""StotmVi+afer Plans uirl Silfi:Fencesihstaiied;:
SanitaryFacilities&'1':dumpster:'Slte WorkPerrhit for.all-newprojects.All commercial requlrements must,ineet.compliance
SiGN PERMIT Attach'(2).sets-of.Englneered 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 ls.required.:.(AtC'upgradss: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 required)
Reroofs if shingles 'SeG(i�ris' Sery ceUpgrades`A%C:' .'Fences(Plot/Survey/Footage)
Driveways-Not over Counter if'ori`publid;rdadways..needs ROW
i
NOTICE-OF DEED RESTRICTIONS: The undersigned understands that this permit.maybe subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable,deednstrictions..
UNLICENSED CONTRACTORS:`AND"CONTRACTOR RESPONSIBlLlTIES: If the:owner-host hired 'a acontractar ar
contractors_-to.undertake work;they may-be.,requiredtfo be:licensed in:accordance with state and local regulations.. lf.<the.
contractor is not licensed as required.by law, bath the•owner,and-contractor-may-be'eited for a-misdemeanor violation
under-state.law. If.the-owner or,intended;contractor are uncertain.as to what•licensing requirements may apply Ifort 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,,hiredl a-contractor or contractors, he is advised to have.-the contractor(s),sign
portions-of the."contractor.:Block°:of.this-.applica#ion for. which they will be responsible. If-you, as:the owner sign as the
contractor, that may bean 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•:Reeovery--Fees:may apply to..the:.construction..of new buildings, change.1of
use'in existing..buildings, or expansion of existing.buildings,:asspecified In+Pasco'County Ordinance number 89-07 and
90-07;-as amended. TMeundersigned..aiso..understands,.that�bu&,fses,.as may be.due, will be identified at the.time,of
permitting. It is further uncles•stood'th it'Transportation.:impact Fees and Resource Recovery:Fees must be paid prior to
receiving a'"certlficate of:occupancy"or.final,pointer release. If the project does�!ncit::involve a certificate of occupancy-or,
final,power release; the•fees,must be paid prior to permit issuance: -Furtheirmore,.4fiPasco County.Water/Sewer Impact
fees,are-due,_theymustbe paid:.prtor to permit•issuance in accordance7with applicable'Pasco County ordinances.,,
CONSTRUCTION-LIEN-'LA ,(Chapter-713;Florida Statutes,as.4amende4) -If valuation of work Is$2,$00.00.or more, 1.
certify-that l, the applicant;have--been-provided-with -a.:copy=of.:the_."Flor.ida.:,Constructiom:Lien Law—Homeowner's
Protection Guide" prepared by the`Florda Department of Agriculture and.Consumer-Affairs. If the applicant is someone
other than the"owner";1 certify that.l have obtained a copyof the above described doeumentNand-promis01n'good'faith'#o
deliver it to the"awner":prior-to commencement. .
CONTRACTOR'S/OWNER':S>AFFID!AVT :I:.certify that alt:the':information.in:this Tapplication•is-accurate and that-att,work
will be done'in compliance with all appticalile.aaws regulating construction;zoning':and"land:;development. Application is
hereby made to obtain a permit to do wwork larid-�in§tatlatlo&.as-ihdicEited, ! certify that ,no.,W9rk or installation :has
commenced.prior.to'issuance.of a permit and.that all work will be performed-to-meet-standards of all laws regulating
construe#ion, County and'Cif codes; zidn'ing regulations, andAihd='development regulations"ins`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.l'must take to be in compliance. Such'agencies-include-but are not limited to:
Department of Environmental .Protection-Cypress Bayheads, Wetland 'Areas and'Environmentaily'Sens!ttve'
...Lands,WaterMastewater Treatment. . . < _.. •_._ �,
Southwest Florida Wa#er Management Distrlct-llllells,' Cypress Bayheads, Wetland Areas; •Altering
Watercourses.
Army Corps of Engineers-Seawalls;'Docks;Navigsitile Waterways. .
Department of Health & Rehabilitative•S,epvices/Environmental Wastewater.Treatment,
Septic Tanks.
US rivironrmentakProtectiolt/ geragyAsb;estos,abatement..
FederahAviat!on Authoriti-RU6'way`s "
I understand,that the-following;restrictions apply,#o'the-use of fill-,-:,
Use of fill is n'ot.allavued ir�ii bdd.:Zane U°unless explessly permitted.
If the fill materiat isi to`be used.in Flood;Zor►d•I -it is-understood- h*6 -;a-_dralnage::plan addressing a
"compensating:votu rie �wilVbe�.submitted at titnb..of.permitting which'is. prepared by a pro#esslonal'engirtser
licensed by tile"State of"Flafida, _
- lf..the fill:material,is-to be,-used tin..Flood.Zon64X,jnt.connectlon with a permitted building using stem .wall..
construction,'I certifyttl a 01wiill;t e:used:only to�U44e area•within the stem:wail
If fill material Is-to. be used':in any-area, 1 certify h6t, use=of`-such--flll,�will-�not='adversely-affect adjacent
properties:-df-use.'of=fill ls..foundao.,-adverselyaffect_adjacent properties,,.the.,owner..may be:cited for violating
the condltions:of the buifdirig permit lsstaetj: tiler the attached permit application;for lots-less-than one (1)
acre which.areLLeievated byflll,an engisteered•dra ria`ge,blanlis required.
If I am.the AGENT-FOR-THE-0_ ItR, I p'iot�iise:ln good-t !ittttotinforms:the owner.of.3he=permitting:conditions set fotth)in
this affidavit.prior to-commencing'constructlon. t understandaharar separate permit:-may`bekrequired�for•electrical work,
plumbing,.signs,....wellspoots',::air',c ondit oning,.,_gas, or other,instaltations-not:..speoocally�inciuded in.the:applications-,A
permit;issued shall be construed to be a license to-proceed.with.ther.woik and sofas authority to.•violate, cancel; alter, or
set aside any provis.!Qns-of-the:--tect nical-codes;nor shalt.issuance•o#a permit;prevent the Building Official from-thereafter::
requiring•a-correction.of:errors.:in plans, construction or violat'icrns of any-codes �Every.permit issued shall.:.become!nvalid-',
unless the work authorized by such.:permit is commenced within six months-of.permit issuance;-or if work authorized by
the permit-Is suspended•orabaiidoned for--a period ofsix(6)`months-after:the>.time=thexworkLis commenced: An-extension
may be requested,'in-writing, from the Building Official for•a;perlrod notf to exceed ninety:(90) days and will demonstrate
justifiable cause for�fhe extension."If:work'ceases#gr ninety:(9�j consecutive days,the job is considered abandoned.
WARNING TO_.QWNER: YOUR FAILURE T0`:RECORD.A:NQTlCE`OF_COMMENCEMENT.MAY RESULT IN YOUR
PAYING-tTWICE•�FOR41MR120YEMENT�S-TQrYO.U:R}:PROPER7Xl*. IF YOUli-I A�D TQ OBTAIN`.FINANCING CONSULT
WFTH YOUR LENDE O..,, i+ TT NEY-BEIF-ORE,R*ECORDING.YO.URq bT! 'E: F-.COM '
FL0R1D'AvJURAT,(F.S:.
OWNER.ORAGENT CONTRACTOR _
Subscribed andswo ..to(or:affirmed);bef6re.me,thts S;ubscfitied:anct:sl"'rra; .,0
oraff1ime4bef6re`rri'e-tfiis
Who are pe orally known tome or has/have produced Who lstare-pe n I i nown to'me'or has/have,priiduced
]=NotaryPublic
. —r_r as EdentiBcation.
NotaryrFublic.-
Commission No. "CommisslomNo.." Q
dJi �, Vt�lr
Name of Name of otary- ed,print ped
CARLOS MALDONADO.
CARLOS MALDONADO
h; Commission#GG 346275 ;:Commission#GG 346275
o°Expires dune 18,2023 c Ex it
;�F-....a,• ., a p'os June 18,2023
„►!t.• Bonded Thru Troy Fein Insuraneo 8004W7019 Eon o
tR••' Bonded Thro Troy fain Insurance
800-385-7019
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS-BUILDING DEPARTMENT
have read and fully understand and agree to the
provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing, renova i g, dd'�pg�o or
reroofing his or her own domicile, that he or she actually occupies, or will occupy by dog said
domicile, and same is not for rent, lease or,sale. That he or she shall comply i 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 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 for 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 worker's compensation for that employee, all
as prescribed by law. Your construction must comply with all applicable laws, ordinances,
building codWandzegulat' sOWNER'S SIGNATUR DATE
ADDRESS
PHONE
WITNESS PERMIT
I/Masterforms/OwnersAffidavit/Nov07
t ,I
red
City of Zephrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: c C ke- (,j
Date Received:
Site: ll v
Permit,Type: O L
Ir2 j
Approved w/no comments: Approved w/the below comments: O Denied w/the below comments: ❑
This comment sheets a e kept with the permit and/or plans.
OCT 0 7 2020
Kalvm t — Tans Examiner Date Contractor and/or Homeowner
(Required when comments are present)