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FIUI ION City of Zephyrhills PERMIT NUMBER
5335 Eighth Street
Zephyrhills, FL 33542 BGR-000064-2020
Phone: (813)780-0020 Fax: (813)780-0021 Issue Date: 05/12/2020
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Permit Type: Building General (Residential)
Property Number Street Address
12 26 21 0260 02000 1150 5744 Dogwood Street
Owner Information Permit Information Contractor Information
Name: MOLLY SCHEUERMAN BREWER Permit Type:Building General(Residential) Contractor: MOLLY SCHEUERMAN
Class of Work:Shed BREWER
Address: 5744 Dogwood St Building Valuation:$250.00
ZEPHYRHILLS,FL 33542 Electrical Valuation:$0.00
Phone: (727)642-2129 Mechanical Valuation:$0.00
Plumbing Valuation:$0.00
Total Valuation:$250.00
Total Fees:$67.50
Amount Paid:$67.50
Date Paid:5/12/2020 3:48:54PM
Project Description
INSTALLATION 10FT X 1OFT SHED
Application Fees
Building Permit Fee $45.00 Building Plan Review Fee $22.50
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.
/ O RACTOR SIGNATURE PE IT OFFICE
E T EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of ze^rh111s Permit Application Fax-813-780=0021
Building Department n�
cev,
Date Received :j.,Ph6neC,1nIap1fo"
r Permitting.
Owne DID
Owner's Na r
Ouvner Phone Number •, .;- I� �... 'I..IG ',��
Owner's Address Owner Phone.Number
Fee Simple Titleholder Name Owner Phone-Number....
Fee Simpl Titleholder Address
JOB ADDRESS G :LOT# li S
SUBDIVISION. G Itin e PARCEL ID# 2-2(0-Z i<.-02b0--02
(OBTAINED.FROM PROPERTY TAX NOTICE).
WORK PROPOSED ' NEW CONSTR ADD/ALT.. SIGN. 0 Q DEMOLISH
e. INSTALL 8 . REPAIR
PROPOSEDUSE [� SFR []., COMM OTHER
TYPE OPCONSTRUCTION BLOCK FRAME' ". STEEL'
DESCRIPTION OF WORK. i fat
BUILDING-SIZE` V
�1!1 yyiz s h i S,Q FOOTAGE HEIGHi''`
QBUlCDING. $
'r j�• } VALUATION OF TOTAL OONSTRUCTION
=ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY- .:[ W:R:E:C:
=PLUMBING $
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS Q ROOFING 0 SPECIALTYe OTHER b
FINISHED FLOOR-ELEVATIONS -� FLOOD-rZONE-AREA =YES: NO.
:BUILDER COMPANY +4pt4lp, own
1 t
SIGNATURE REGISTERED ''YI'.:N '' TEE'CURREK:
Address License#. .
ELECTRICIAN. FCOMPANY
SiGNATURI: REGisTent a.. Y/-N FEE'CURREn .•:; : Y 1 N.
Address- License#, -
P LUMBER COMPANY
SIGNATURE f2EGi5TEREa Y/ N. FEEcuAktKvv.
Address License#-F 1
MECHANICAL- ' COMPANY
SIGNATURE REGISTERED- I Y/:•N '. :FEE CURREN
Address License:# r -� 1:
OTHER C,OMPAN.,
SIGNATURE REGISTERED Y.�:N .. `FEE:CURRER
Address-, License#.•�_
RE SIDEN TlAL Attach:(2):Plot-Plans;;(2);sets of Building Plans;(•,1;)set;oEEngrgyforms;R=O-W oe rmit fOr�new constructon;. -
Minhi►umten{10}o5rarking`daysafter sti6mit#at�date. Required,onsite;Co"nstruction Plans;'Stormwater-Piaris�wl:Silt Fence.instatled;. ,
Sanitary.Facilities&1.dumpster;•Site Work Permit for subdMsionsAarge projects
COMMERCIAL Attach-(2)complete:sets of:Building':Plans plus a Life:.Safety:Page.',(1)set of Eriergy.FormsrR-O-W.Permit•for new:con§truction.,.:, • _
Minimum:ten'(10)working days after;sutimittai;date:;.RequiKeil=onsite,Constructlori Plans;S#armwater Pans:wl Sltt-Fence'iristallett,::
Sanitary Facilities&A dumpster.Site Work Perrr itforall new projects.All commercial requirements must%'M'ee't compliance
SIGN PERMIT Attach(2)sets of=Englneered.Plans... '
""PROPERTY'SUAVEY.required,for all NEW construction.'
`[lirectlons:
Fill out application completely.
Owner:&:Contractor;sign''back of application,notarized
If oveu$ifift a Notice of Commencement'Is required. (AfC upgrades over$7500)
•" Agent.(for the contractor)or Power of Attorney(for the owner)would be someone'with notarized letter from owner,authorlAng same
OVER THE COUNTER PERMITTING- (copy of contract.required)
Reroofs if shingles Sewers Service-Upgrades•A/C Fences(Ptot1Survey/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 maybe more restrictive 1han County regulations. The undersign.ed assumes responsibility for comp�ance with any
applicabi.e-.de.e.d.,re.stric.ti.ons.
UNLICENSED"CONTRACT-ORS'-AND-CONTRACTOR RESPONSIBILITIES: If the -owner has- hired a contractor or
contractors to,widertakework, they may bwrequ"ired,to-be licensed in accordance with state.and-locifregulations. IfAhe.
contractor is not licensed as required by law,
both the-owner and contractor may-be'cited,for a misdemeanor Violation
under,._stateJaw,--lf the,.,ow.ner-or,Jntended:contr�actor are uncertain-as-to what licensing-requirements may apply-for the
intended work,they are advised twcontact the Pasco County Building Inspection'Division—Licensing Section at 727-847-
8009. Furthermore,:If the owner has-:hired!4"contractor or-contractors, he is.advised to have the-,contractor(s)�sign
portions of the "contractor Block" of this.applicg'ition4br-which-they.will-be.-responsible; .-ify.oui..as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitfing,,pri.vileges.in,1?asco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation,:Impact-Fees land-Recourse=Recovery.:Fees,may.apply to the-.:construction of new buildings, change of
use in existing' buildings, or expansion of existing bull I dings, as•specified.in Pasco County Ordinance number 89-07-and
90-07 as.amended. The,undersigpipo,,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-166tinvolve 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 areAue,they:mustte-'paid'-priorto.per-mit issuance in accordance with applicable Pasco County-ordinances. -
CONSTRUCT.ION"LIEN.LA',W-*(f,hapt-or 71'3I `'Flo eida Statutes,as amended), lfvaluation,of work-is$2,500.00�or.�more,�I
!
certify-that-1; the-applicant;-:have.-been-,-provided,with,a copy of Ahe.-"Florida:-.Construction-Lien, Law—Homeowner's
Protection Guidif prepared by-the.Florida Department of Agriculture and Consumer Affairs. If the applicant,istsomeone
other than the'"owner", certify.-that4.have obtained a copy of the:aboveAescribed,documerit and promiswin good faith,to
deliver it to the"owner"prior.to.commencement.
CONTR.ACTOR?.S/O,W,NERIS,:A,FFIDAVIT: 1,odrtify that-alVtheinformatiipn 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 i ,-is.
hereby made to obtain a permit to do work jand- installation as indicated.' l,certify that no work.or installation has
commenced prior to,-Issuance of, a.pe-rmitend,that all work will be performed to,,,meet.standards,of all-laws regulating
construction, County,.and City=des, zoning regulations, and land-development regulations in the jurisdiction. I also
certify that I understand that the regulations ofother government agencies may apply*-to-the,intended work, and that it is
my responsibility to identify what-actions I musitake to be in compliance. Such agencies include butare not limited;,to?:-
- Department of'Environmental Protection-Cypress Bayheads, Wetland,Areas and Environmentally Sensitive
Lands,:WaterMastewater Treatment:
- Southwest Florida Water Management District-Wells, Cypress; Blayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks, Navigable Waterways.
- Department of Health: & Rehabilitative Services/Environmental :Health Llnit-Wells,, Wastewater Treatment,.
Septic Tanks
.
.--US-1:ENit,.onm.ental�P-tot6otiomA,.gene ; sbestos_,a4atemer[t-._.
Federal Aviation Authority-Runways.
I understand thatth0ollovft rest'ctions,.apply n to-th .e
use of fill:
Use-offill`ls:,not.allowed.:in Flood-26he:V" unless expressly permitted.
If 1he:fill .material is to be used"in Flood Zone "A", it is understood that a drainage plan addressing a
"c ',p -prepared by a professional engineer
om 'ensating yolUme�',wlll"be-.submitted at time of-permitting,�w.hich,-is
licens.dd.`by the State of Florida.
If.the.fill-m.,4tedaI-_Js.,to._be.-used.'in-,,FIood-_Zone "A":in connection with a permitted building using stem-wall
conr;trOcti.'e,n.'-,.t certify,,that fill will be'7used-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 .
propertiesr 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),,
acr.e.w.b'io"h,ar)e bl6!vat!pd;b fillamengineered drainage9lan is required.
Y
OW to-iriform-the::owner-rof.-the�permiffingconditions.setfo h in
If I am1he-.-AG. NT:1 NER, I promise-in good faith forth
this affiday.1t,.,Pribr-ito.-com*menclhg construction. I understand:that a separate permit may be required for electrical work,
plumbing,4..Sjg,p,"s,--wdli's.i-pools, -air_conditlonlngj-gas;-or other installations not specifically-:,included.-in4he-application. A
permft..i$.ski.ibd•thalLbe.icons,trued to be a..Iicense to proceed wlth.%the,-workr and not as authority to violate, cancel, alteri,or
�a permit prevent. thereafter
set asidw h.y-proVisions,..of the.tiD.chnical;codes---nor,shall'issuance..Of,
I A -the Building.Official from
requiring:-6-correction-of-.errors.-in plans,,construction or violations of-any codes-.-. Every permit issued-shall become invalid
unless,the',work,authorized bysuch permit is;commenced within,six months-of,permit issuance,.or if work authorized-by,
thii pern1it-.,,ia-suspended or abandoned for a p6tiod of six-(6)months after the time tho-work is commenced. An-extension
may berre.quested.-in-writingi-from-the-,Buildin �perl ,not to exceed ninety 9 I Building:; a;period ( 0) days and will demonstrate
justifiable cause for,'theext6rision...-If work ceases.-for ninety(90)*tonsecutive.da. S,-.thejob,,is.co
-Y nsidered,abandoned.
WARNINGTO.OWNER:�,Y UR,-,FAILURE,,T.( RECORD A NOT-ICE:IOF�:�COMMENCEMEN-T,MAY RESULT IN YOUR
,V -.,
P-PAYINe�rwic"OR,IMP'RPVEI,MENTS.-T-0'�� OURI ROPEkTY, YOU11K END'-,TO"-OB-TAIN"-F-INANC-INP,,taONS L
WIT- H-YOUR,LEN t-AN-A T;T-ORNE-Y:,BEFORE-4--FtEC-ORDING_-YOUIZ-�NOTIC-e',OF.;COMMENCEMENT.
FLORIDA'JURAT(F.
OWNER-OR'AGENT ZONT R
Subscribed d,an swo i�i Far Subscribed,and s rn, r�ffl-edyb me this
by rnt a,61
I me or hasthave produced Who Is/are personally known to m&br:hAe1hav&produced
by V
Who Is/are personally*known
as identification. as identification.
Notary Public Notary,Public
Commission No Commission No.
Name of Notary typed,printed or stamped Name ofiNotary-typ ad,printed or.stamped,.
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, 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 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 codes/And zoning regulations.
OWNER'S SIGNATURE DATE
ADDRESS
PHONE
WITNESS PERMIT
I/Masterforms/OwnersAfffidaviVNov07
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