HomeMy WebLinkAbout20-845 ED
F URtUfl City of Zephyrhills PERMIT dNW.M9ER
. ._ .. _ 5335 Eighth Street
Zephyrhills, FL 33542 BNR-000845-2020
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 10/29/2020
Permit Type: Building New (Residential)
Wd N.• ,=��" St er eta` ess '
Property Number a„ �_; addr
04 26 21 0120 00000 0540 1 6479 Bradford Woods Drive
Owner Information _. fiAV101 Contractor Information
,Permitlnformation c� ,
Name: PULTE HOME COMPANY LLC Permit Type:Building New(Residential) Contractor: PULTE HOME COMPANY
Class of Work:SFR Construct LLC
Address: 2662 Falkenburg S Rd Building Valuation:$114,122.00
RIVERVIEW,FL 33578 Electrical Valuation:$4,971.00
Phone: (813)964-5182 Mechanical Valuation:$4,402.00
Plumbing Valuation:$5,147.00
Total Valuation:$128,642.00 /)
Total Fees:$13,723.66 �'
Amount Paid:$13,723.66
Date Paid:10/29/2020 9:08:04AM
11.,roject D,,esc�ription
CONSTRUCT SINGLE FAMILY 2,469 SID FT
�Ap 1plp icat'ion F' x
Mechanical Permit Fee $62.01 SIF 1 percent Fee $83.28
Electrical Plan Review Fee $32.43 Building Permit Fee $600.61
Mechanical Plan Review Fee $31.00 Address Fee $30.00
Plumbing Plan Review Fee $32.87 314 Water Meter Fee(Calc) $473.78
Water Connection Residential Fee $1,010.00 Building Plan Review Fee $300.30
Driveway Fee $45.00 Irrigation 3/4 Meter(Calc) $473.78
Plumbing Permit Fee $65.74 Sewer Connection Residential Fee $2,090.00
School Impact Fee $8,328.00 Electrical Permit Fee $64.86
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.
NTRA R SIGNATURE PE r
IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
PASCO C:OUNTY9 FLORIDA
AzPermit No.
Date Permitted
'Builder Name/Owner Name l Ste- Control#'
County Parcel No. Zf 61/e0- SubDly:
Address/Locatlon
" c
Classification/Type of Usq
I TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit:
Exempt' M Yes •[]No How Determined
Impact Fee Amount $.'4 -__-- Zone No. TAZ:
r .
SCHOOL:IMPACT FEE
Account (056) Slh&wFamlly Detached House Amount $ Z
(ov) Mollie home
(058) OtherResldentlal
d23)
Collection Fee
Exempt Yes . Q No How Determined
PARKS AND-RECREATION TEE-
Land Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone TOTAL AMOUNT
Exempt [Q Yes No How Determined.
LIBRARY FEE
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt ❑Yes ❑ No How Determined Total Amour .!
RESOURCE FEE ERU
TOTAL AMOUNT
Prepared By t Checked By
NO CERTIFICATE OF OCCUPANCY WILL 13E ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE:TOTAL AMOI.JNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE-OF PASCO COUNTY
Acknowledgement below does not Imply acceptance of concurrence,but simply ieceipS of a ropg of this form,placing
the building permit owner.on nodes of this assessment and the condhions of payment forsame.
DATE RECEIVED BY
RECEIPT NO. DATE BY
INVOICE (INV-00001693)
FOR CITY OF ZEPHYRHILLS
BILLING CONTACT
JODY SALTER
PULTE HOME COMPANY LLC
2662 FALKENBURG S RD
RIVERVIEW, FL 33578
INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION
INV-00001693 10/24/2020 10/24/2020 Invoiced, Past Due NONE
REFERENCE NUMBER FEE NAME TOTAL
BNR-000845-2020 3/4 Water Meter Fee(Calc) $473.78
Address Fee $30.00
Building Permit Fee $600.61
Building Plan Review Fee $300.30
Driveway Fee $45.00
Electrical Permit Fee Z $64.86
Electrical Plan Review Fee $32.43
Irrigation 3/4 Meter(Calc) $473.78
Mechanical Permit Fee � 3 $62.01
Mechanical Plan Review Fee $31.00
Plumbing Permit Fee cT9-b( $65.74
Plumbing Plan Review Fee $32.87
School Impact Fee $8,328.00
Sewer Connection Residential Fee $2,090.00
SIF 1 percent Fee $83.28
Water Connection Residential Fee $1,010.00
6479 Bradford Woods Drive Zephyrhills, FLORIDA 33542 SUB TOTAL $13,723.66
REMITTANCE INFORMATION TOTAL $13,723.66
City of Zephyrhills
5335 8th Street
Zephyrhills,FL 33542
October 26,2020 5335 8th Street,Zephyrhills,Fl-33542 Page 1 of 1
ups-ruu-uuzu Ulry OT Lepnyrnnis rermit Hpplication rax-Clb-rcu-uuZ'I
Building Department
)ate.Received Phone Contact for Permitting �� . ) C1
/�
Jwner's Name Pal ke li o ni C Cu rA )G{O c, Owner Phone Number
Jwner's Address 2U�2 5• t'a,x i1 t`�ui C �V G��I f Q(� L Owner Phone Number
Fee Simple Titleholder.Name / r Owner Phone Number
Fee Simple Titleholder Address !A
JOB ADDRESS -( Vdd -,c `// i li ZM,r &,S , 3 LOT#
r
SUBDIVISION 00,ILS �5c� PARCEL
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED M
NEW CONSTR 8 ADD/ALT n SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE 0 SFR = COMM OTHER
TYPE OF CONSTRUCTION II 11 BLOCK Q FRAME �' STEEL Q
DESCRIPTION:OF WORK 4GCJ 610 n's fi �J�n 16 Fa-,m 1 /
BUILDING SIZE - JL I l SQ FOOTAGE� HEIGHT
.=BUILDING $ ���-J VALUATION OF TOTAL CONSTRUCTION
F `TT 1,��;�D
=ELECTRICAL $ AMP SERVICE PROGRESS ENERGY = W.R.E.C.
5-a'-pu-ve.
=PLUMBING $ �/ #64too ` ��
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING Q SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS I
■�/�/ FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREI< LZ/N
Address �Olafl�S-. _ � G° �(l�i U/elG)l ,33T ` License# �/a 1., .Dl i
ELECTRICIAN COMPANY
SIGNATURE REGISTERED YIN FEE CURRE1% LILN
Address 1 License# C6
PLUMBER COMPANY v � �
SIGNATURE Ai REGISTERED Y/ N FEE CURREr,
Address 3r33/j/,3-?tb 01,,A)f Fz--3 785' License# �2 C/LMTa _7-
MECHANICAL COMPANY �CGrJ�S lliY /(/�I//1C(I II
SIGNATURE REGISTERED Y/ N FEE CURREK LYj N
i7Gn ( GtSw1,FL 3 q fPLO� License# 3 20
Address
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address 1030m,n) %G/7 11 R13 y License# �1,eu
111111 .1111I11111111I111I11111111111111111111 Bill 11.IIAIIII..111111I111
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.
■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ i ■ ■ ■ ■ ■ ■ ■ r ■_■-■ ■ r ■ ■ ■_■-■�_■�■ ■ ■ ■ r ■ ■ ■ ■ ■ ■ ■ ■ ■_ ■-■
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
D
Q
w
r..
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 comply with R401.3 of the F.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.W. use permit, All 4 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).
11.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 cogiply 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 requirements are to be in accordance with R308:4 of the F:B:C:
. -
17. All means of egress are to be in accordance with R311 of the F.B.C:
18. "Green'gypsum.board" shall not be used as a backer in showers or tubs:R702.4.2 F.B.C.
10. Combination-type AM breakers are required at all locations requiring an AM type breaker.
20. Carbon monoxide alarms will be required in new construction that uses fossil-burning Beating
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.
M. All 2016 N:E.C. Codes will be enforced.
21 Tamper- Resistant Receptacles in accordance with 406.11 of the 2016 ME.-(24. 1 n accordance with the Land Development 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 3/. inch (1.9.1 mm) and larger_in..nominal diame_ter._
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 copy of the enerpm cacls shall be with perinit at all times
27. Copy of fnalinsulation report shall be provided with peen:it before fnaL
28:No fence,pool or enclosure :is issued with:this permit
F.F.E.-Finished Floor Elevation
F.B.C- Florida Building Code 6"'Edition
R.O.W.-Right of Way
A.D.A.-Americans with Disabilities Act N.E.C.-National Electric Code(2016)
PASCO CGUNTYj FLORIDA
Permit No.
Date Permitted Zp�—6
Builder NamelOwner Name ;_ �e.. Control#'
County Parcel No. O.Z/,7—/, 2/ /Zd" � SubDIv: --)x1� A e3
Address/Location cllgg
Classification/Type of Us@
TRANSPORTATION IMPACT FEE Rate: Sq.Ft Unit: .2, �
Exempt' []Yes -[] No How Determined
Impact Fee Amount , _ Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House Amount
(057) Mobile,Home
(058) Other Residential
23) Collectlon Fee
` Exempt dyes . Q No How Determined
PARKS AND RECREATION FEE-
Lind Account Land Credit Land Total
Recreation Account Recreation Credit Recreation Total
Zone TOTAL AMOUNT
Exempt ❑Yes 4❑No How Determined'
LIBRARY•FEE
" Land Accounf Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt ❑Yes ❑ No How Determined Total Amour
RESOURCE FEE ERU
TOTAL AMOUNT
Prepared By t. Checked By
i
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION ,
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE,OF PASCO COUNTY
I
Ackm Wedgement below does not imply acceptance of concurrence,but simply recelpt of a copy of this form,placing
the building permit owner.on nonce of this assessment and the conditions of payment for same.
DATE
RECEIVED BY �
RECEIPT NO. DATE BY
� 82
87 85 85 84
88 _ _ •f
bo
69
i FF=91.40 ! iFF=91.4(3! iFF= 1:2:1 ,1FF:9'.)t?9- .IFF-91:�Sl �! `
Ja—as ! 1 4 1 —2x f ``=1y I ___ 4 0-32 "`'�( 'J
le
- - - - - 20* P 2oT
y
90
49 1 1 j{ 5-07 1 ! 51 ! 1 JAL'?
` ; nAM
�
PLOT PLAN
DESCRIPTION;(AS FURNISHED)
LOT 54, OAKS OF PASCO
AS .RECORDED IN PLAT BOOK 80, PAGE(S) 113-118, OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA.
FLOOD ZONE "AE" '
.. .. ... -
. _ _FLOOD ZCNE "X°
r .
0
ApPROXIMATF 'DEL FEhkA MAP. UhE�
Un SCALED FI'
.. ... CA ..
0
I I:: 10 z
I
i o� aye. l I N8542'ts'E GRAPHIC SCALE
z0.00__4
�' 6k 85'42'16"E — o.. 15 30
115.00'
D� J yo $ � m v f'1 N =�Ln
o�
I—I oo z�m t N . .::. ADD
m� ITj CD ,�I� s.0' o oo^ � 7.B' Ay.' �20.5' Ul N
I CA / O < i0
v� I l :,r .'o ,. 1
w.•..a
O a;; -^� 49.0' 23.T O
o �m I u ITT
L27.3' . 1n �+z
0 CL
115.0b' s96, I o y
a �9 S854216"W e2JZ.
�m
moo'
ROOD ZONE "X '
I FLOOD ZONE "AE"
- - ..
0I
ul
ON LOT CALCULATIONS
LOT 5,750 SQ. FT.
LIVING AREA = 1,696 SQ. FT.
GARAGE = 549 SQ. FT. '
ENTRY = 25 SQ. FT.
LANAI = 199 SQ. FT.
PATIO 0 SQ. FT.
DRIVEWAY = -347 SQ. FT.
A/C PAD 9 SQ. FT.
WALKWAY = :35 SQ:'FT.
IMPERVIOUS .. = 50% .. '
= 2860 SQ. FT.
SOD = 2,890. SQ. FT.
OFF LOT CALCULATIONS
PREPARED FOR: RIGHT OF WAY = 400 SQ. FT.
DRIVE = 57 SQ FT APRON
PUBLIC.S/W = .250 SQ. FT.
SOD = 93 SQ.:FT.
TOTALS
pyppi
AREA = 6.150 SQ. FT.
IC/'l-� DRIVEWAY = 404 SQ. FT.
BUILDING SETBACKS SIDEWALK = 285 SQ. FT.
SOD = 2,983 SQ. FT.
FRONT: 20'
REAR:. 10'
SIDE: 5'
SIDE STREET: 15'
LEGEND:
NOTES: — -— •— BUILDING SETBACK LINE. PI POINT OF INTERSECTION
PC POINT OF CURVATURE -
1. PROPOSED.ELEVATIONS SHOWN HEREON ARE BASED — — CENTERLINE pT POINT OF TANGENCY
ON THE APPROVED ENGINEERING PLANS PREPARED _ _ RIGHT of WAY LINE RP RADIUS POINT
BY CORNELISON ENGINEERING &-DESIGN INC. " PRC POINT OF REVERSE'CURVATURE
2. ELEVATIONS ARE BASED ON NAVD 1988 - PROPOSED ELEVATION PCP PERMANENT CONTROL POINT
DATUM. TYP TYPICAL
PROPOSED DRAINAGE FLOW CS CONCRETE SLAB
THIS PLOT PLAN IS INTENDED FOR-PERMITTING PURPOSES :.,-;- �: CONCRETE (P). PER
CAL PLAT
ED "
ONLY. THIS IS NOT INTENDED FOR THE CONSTRUCTION OF (C PUT BODE
THE_PROPOSED STRUCTURE. THE CONTRACTOR AND/OR A/C AIR CONDITIONER PGs PAGES
OWNER ARE REQUIRED TO VERIFY ALL SETBACKS, BUILDING s/W SIDEWALK SQ. FT. SQUARE FEET
DIMENSIONS,-AND LAYOUT SHOWN HEREON.PRIOR TO ANY F.E.M.A. FEDERAL EMERGENCY'MANAGEMENT AGENCY
CONSTRUCTION. F.I.R.M. FLOOD INSURANCE RATE MAP
NAVD NORTH AMERICAN VERTICAL DATUM '
THIS IS NOT A SURVEY SEE DRAINAGE SAS�ERE EASEMENT
THIS,IS A PLOT PLAN ONLY UE UTILITY EASEMENT
FLOOD NOTE: I HAVE'EXAMINED THE F.I.R.M. MAP NO. 12101CO2B9F SURVEYOR NOTES:
DATED 09/26/2014 AND FOUND THE SUBJECT PROPERTY-APPEARS TO LIEPAR7 1. .THE SURVEYOR HAS NOT ABSTRACTED THE
OUTSIDE T E ZONE N A'AEA ZONE OXO, AREAS DETERMINED EA BE LAND SHOWN HEREON FOR EASEMENTS, RIGHT
OUTSIDE
TO BE SPECIAL FLOOD HAZARD!ARREASZSUBJECT•TO��s OF WAY, RESTRICTIONS OF RECORD WHICH
INUNDATION BY THE 1X ANNUAL CHANCE FLOOD EVENT,BASE FLOOD MAY AFFECT THE TITLE OR USE OF THE LAND.
ELEVATIONS DETERMINED TO BE 88.5'. THE SURVEYOR MAKES NO
GUARANTEES As TO THE ABOVE INFORMATION.PLEASE CONTACT THE 2. NO UNDERGROUND IMPROVEMENTS HAVE BEEN
LOCAL F.E.M.A. AGENT FOR VERIFICATION. LOCATED EXCEPT AS SHOWN.
BEARING BASIS:
BEARINGS SHOWN HEREON ARE BASED ON THE CENTERUNE OF 3. NOT VALID WITHOUT THE AUTHENTIC
BRADFORD WOODS DRIVE BEING N04.17'44'W, PER PUT. ELECTRONIC SIGNATURE'AND THE.AUTHENTIC
ELECTRONIC SEAL OF A FLORIDA LICENSED
(FIELD DATE:) REVISED: M E FR I'CAN SURVEYOR.AND MAPPER.
SU RVEYI N.G �����AN� rI Digitally signed by James W Boleman
SCALE: 1* = 30 FEET Q� `^l,o.:.�e's%ry, DN:c=US,st=Florida,l=Orlando,
L7C MAPPING INC'. 1, o=AMERICAN SURVEYING&MAPPING,
APPROVED BY: J9 INC m=lamesW eoleman, ;
j _
CERTIFICATION.OF AUTHORIZATION NUMBER LB#6393 3:i rrre�'a�. e mail=Jboleman@asmcorporate.com.FOR
3191 MAGUIRE BOULEVARD, SUITE-200 ......fY -"-Datei2020A9.02123123-04'00 THE
JOB NO. 191105 LOT 54 ORLANDO, FLORIDA 32803 �°m ~? Adobe Acrobat version: FIR
... , .0ronunmm�nmro" ''f'� _ FIRM
(407) 426-7979 DRAWN BY: DSB DATEpLOT PLAN OB 31 2020 G0. WWW.AMERICANSURVEYINGANDMAPPING.COM JAMES'W. BOLEMAN P.SM# 6485
ts�3-iao-oozo City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received.
Phone Contact for Permitting
€€-Ca911aa lax € € €
Owner's Name ' ' ' �. . GU�7� ' /— Owner Phone Number ,q-i
7
Owner's Address ���1 '- , j'' " G� Owner Phone Number
Fee Simple Titleholder Name F Owner Phone Number
Fee Simple Titleholder Address /
JOB ADDRESS
Z�/ ✓` ,� Q�J G� - � ���//� �L J LOT#
SUBDIVISION / � PARCEL ID# O � (�-��^ !�0'AW40-1)5 �
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR a ADD/ALT SIGN 0 DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR Q COMM �� OTHER _ lj
TYPE OF CONSTRUCTION . BLOCK Q� }FRAME /�y� STEEL
DESCRIPTION OF WORK �� �/ �C�vV �y��� "L/ G' ✓ /��(�
BUILDING SIZE X -?i�f SQ FOOTAGE HEIGHT
=BUILDING $/141 VALUATION OF TOTAL CONSTRUCTION
i
ELECTRICAL $ ��O� AMP SERVICE PROGRESS ENERGY Q W.R.E.C.
=PLUMBING $
=MECHANICAL $ c 00 VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY +i
SIGNATURE REGISTERED Y/N FEE CURREN
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address 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#
OTHERAN COMPANY V'/ ``G/ i L Q f �G1_6
SIGNATURE REGISTERED Y/N FEE CURREN �Y/N
/�
Address ��/ / � License# �(/!
soft 11.1flif � [.fQlgi $ Itf1�If$ f91allll . g Itlllf1V1131v all lHl@IEI€ 1t t � tfi � il61f1lEi€t� € ilEl 1
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
- -- ---- VILy LJI L_VF1 Iy1111110 1 V1 I I11L r-%F 11UCXL1U1 I ton-u 1J-/VV-wl1
Building Department
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—Licbensing 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
.1 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 TOO IN FINANCING, CONSULT
WITIJ YOUR LEND K�L-A=-,rORNEv BEFORE RECORDING Rfick'QcMENT.
FLORIDA JURAT(F.S. 117.03)
OWNER OR AGENT CONTRACTOR
ubscri ed and sworn (or d " (ed)bef re me this / S cribed and sworn t or affirmed)befQre me this
Xe
Wf�q s/are personally known to me or has/have produced Who is/a personally known to me or has/have produced
as identification. as identification.
otary Public ::�1117 Notary Public
Co i sion No. 6 /7/ Commissi o.
r
Name of Notary typed,15r-irited or stamped Name of o ary typed,printed o stamped