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HomeMy WebLinkAbout20-100 m ► _�� City of Ze h <. tY p Yrh i I Is XPERMIM NUMBER` 5335 Eighth Street Zephyrhills, FL 33542 BGR-000100-2020 Phone: (813)780-0020 Fax: (813)780-0021 Issue Date:_- fi Permit Type: Building General (Residential) ". Property Number StreetAddress 6" >> 13 26 210140 00000 1080 39588 Meadowood Loop Owner Information' Permit Information Contractor.ln'formation `.•" ", `. Name: MILLER MICHAEL Permit Type:Building General(Residential) Contractor:A-STONE PLUMBING Class of Work:Plumbing COMPANY Address: 39588 Meadowood Loop Building Valuation:$1.00 ZEPHYRHILLS,FL 33542 Electrical Valuation:$1.00 Phone: (813)620-1400 Mechanical Valuation:$1.00 / W11 Plumbing Valuation:$800.00 �®�(9 Total Valuation:$803.00 ® Total Fees:$45.00 Amount Paid:$45.00 Date Paid:5/19/2029/2020 12:57:37PM Project Description REPLACE WATER HEATER Application Fees Plumbing Permit Fee $45.00 Plumbing Plan Review Fee $0.00 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. CONTRACTOR SIGNATURE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Fax-613-780-0021 Building Department Date Received Phone Contact for Permitting - 'i!i!,!!!i p "i&Sl! Owners Name `�Q 1( � Ow{� ner Phone Number 3-,Q 1t7 Owner's Address 500c> PI O'no AD%f) .r Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address , n ,p JOB ADDRESS 3 S eQ c.J LOT# SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED e NEW CONSTR e ADD/ALT = SIGN = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR Q COMM = OTHER TYPE OF CONSTRUCTION Qn BLOCK 0 FRAME _ = STEEL DESCRIPTION OF WORK \�1�+ `a "pgak-e{r BUILDING SIZE SQ FOOTAGE= HEIGHT .;.;.�..�.�.;.X.;..L..CAC.UX X'X i.X R. i.'X.�.X..£.X i:'€"3C.L.'i.3C;.x..R..I.3CXX{I =BUILDING $ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. ESQ LUMBING $ (fXD =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION =GAS = ROOFING 0 SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO BUILDER COMPANY SIGNATURE REGISTERED Y/N I FEE CURREN Y/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/N I FEE CURREN Y/N Address License# /� PLUMBER COMPANY A-C l Ip SIGNATURE REGISTERED /N I FEE CURREN I� Y/N ^� Address 'IBM 9—T L[' C,,License# VA2D # MECHANICAL COMPANY SIGNATURE I Y/N FEE CURREN Y/N Address License# OTHER COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Y/N Address License# Il.l[lIIIII-I"[-3i.'I"IEa!all .III ga11.91225i-$.i#.'EI glitz 1.3.1111 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 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 t ', 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—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 property 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—Homeowners 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 E id 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"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 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 justifi able 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. FLORIDA JURAT(F.S.117.03) OWNER OR AGENT CONTRACTOR�\--,';VC76\-Q-- Subscribed and swom to(or affirmed)before me this Sub!!Mind swomjo_(or affirmed)before me this by \t L by N`q i=25 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 REBECCA E. LAURENDEAU 1P V9�� ';State of Florida-Notary Public ,; Commission # GG 250810 i9p° c.oVP:, My Coml jSSIOn Expires A.igUST 20, 2022 ASTON-1 OP ID: KA DATE(MM/DDIYYYY) �.r CERTIFICATE OF LIABILITY INSURANCE 05/12/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 727-586-1601 CONTACT Jennifer Barjas Brown Insurance and Financial PHONE 727-586-1601 FAX 727-518-0002 A031711 A/C,No,Ext): (Arc,No): 2401 West Bay Drive Suite 603 E-MAIL ertificates rown nsurance ervlces.com Largo,FL 33770 ADDRESS: Chris Bradley INSURERS AFFORDING COVERAGE NAIC# INSURER A:Southern-Owners Insurance Comp 10190 HN�URED INSURER B:FCBI 15764 illsborPlumbing gg uCompany of Auto-Owners Insurance 18988 dba EthicaTAir INSURERC: 245 S 78th Street INSURER D: Tampa,FL 33619 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR 20616566 02/07/2020 02/07/2021 DAMAGE TO RENTED 300,000 PREMISES Ea occurrence) $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑X jE o �X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 F1 OTHER: C AUTOMOBILE LIABILITY Ea BIKED SINGLE LIMIT $ 1,000,000 X ANY AUTO 51-61P-566-00 02/07/2020 02/07/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident HIRED NON-OyyNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ X Hired kx Non Owned A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE 51-616566-01 02/07/2020 02/07/2021 AGGREGATE 1,000,000 DED I X I RETENTION$ 0 B WORKERS COMPENSATIONPER AND EMPLOYERS'LIABILITY YIN X STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE 10661151-2019 02/07/2020 02/0712021 1,000,000 0pFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Zephyrhills ACCORDANCE WITH THE POLICY PROVISIONS. 5335 8th St Zephyrhills,FL 33542 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r STONE LETTER OF AUTHORIZATION I;THE UNDERSIGNED DO HEREBY AUTHORIZE.THE FOLLOWING INDIVIDUALS TQ ACQT to S MY AG IT(S)IN 08TAJNING PERMITS. CIE OF AGENT(S) ec a o =1 THIS LETTER SUPERSEDES ANY PREVIOUSLY NOTARYPUBLIC SUBM LETTER(S)OF AUTHORIZATION.THIS STATE OF LETTER WILL DELETE AND REPLACE ANY I �I ReVICUS AUTHORIZATION LETTER AND THE INFORMAT10N CONTAINED THERE-ON,THIS 1;,,' 1 AUTHORIZATION IS TO REMAIN 1N EFFECT.UNLESS Qn)L CAN ILL UNDERSIONE0. 8 (or affirm! W subscribed before me flip day of by ,3 (Idiot or typed nam of Ucianse Holder) xett r (nature of N Personally Known � OR Produced Idea n (Tyke of Identification Produced) 3`var a�o4 ASHLEY MILLER i Commission II GG SW28 a� ExplrecApd13,2024 o ;-OF FT'O Bon Thm Nft SMv1= aF � 9