HomeMy WebLinkAbout20-488 ,.( HIM City of Zephyrhills PERMIT',NUR
5335 Eighth StreetT
Zephyrhills, FL 33542 BGR-000 88-2020
Y"+ Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 07/29/2020
Permit Type: Building General (Residential)
Property Number Street Address-'
1126 21 0010 19900 0080 5154 19Th Street
Owner Information Permit Information Contractor-'lnfortnation"-'
Name: MILTON GAUGER Permit Type:Building General(Residential) Contractor: R VANDERHEI CONCRETE
Class of Work:Driveway CORP
Address: 5154 19Th St Building Valuation:
ZEPHYRHILLS,FL 33542 Electrical Valuation:
Phone: (813)782-2773 Mechanical Valuation:
Plumbing Valuation:
Total Valuation:$0.00 V
Total Fees:$45.00
Amount Paid:$45.00 �/l
Date Paid:7/29/2020 3:10:58PM
Project Description
DW37FTX10FT
Application Fees
Driveway Fee $45.00
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
ldty UI Lt:PA lyr I rrlll r'CI I I II6 MPPI1L;HUUII
Building Department
Date Received Phone Contact for Permitting ) y
a!e[!!ea ,/ t[!![ Q
;Owner's Name L Owner Phone Number 90"J�
Owner's Address I Owner Phone Number 13 r r�9
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address 5),5q JOB ADDRESS j LOT#
SUBDIVISION PARCEL ID# 6O"DO
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSfR� ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE .1�0 SFR 0 COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEE`L
DESCRIPTION OF WORK a
BUILDING SIZE J SO FOOTAGE HEIGHT
4T T!'%,dL-t k IL7;7X-1
BUILDING $ V,00,61, VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE PROGRESS ENERGY Q W.R.E.C.
=PLUMBING $ 44 V/1�
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION /
=GAS = ROOFING Q SPECIALTY = OTHER 1
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED q VIN FEE CURREN
2 N
Address 5514L1 `r by- v License# I J
ELECTRICIANF COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN
Address I License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN
Address I License#
OTHER COMPANY
SIGNATURE REGISTERED Y/N I FEE CURREN
Address License#
H[![!!!!![ I[[![!![!!!![.1[[!!t!!!!![ BI![!![!!!!!!! tl![!![[!![[!! !!!!!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 subdivisionsAarge 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
t ity ui Lupi iyilimb rut tint HIIIAIOGItUlI
Building Depprtment
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"cenificate 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 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 a0d 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
"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 TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFQRE RECOR12IN -4-Q-COMMENCEMENT
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn r ff 4
e me t if
by by C
Who is/are personally known to me or hasihave 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
PERMIT-APPUCA'TION
ORMWA, PERMIT:AP.PLI. All- ON
CONSTRUCTION IT.HZN�P.UBL1C=RIGHT.OF-;WAY
Ail information must-befilled=in completely
k0ty>of,Zephythiils
'5335-8'h Street,: phyrhills,-F.L 33542 ,
}wry Telephone:81 .7 0.0000 Fax 813.780.0005 q' y
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"PRU3ECT JOB;SITEc. -PROPERTY OWNER,
Address:. . Name: '. i'1a n 6 o
Unit#• Address: ' 1 Unit: _
Parcel Identification'Number: Citvr.State 21" N
70,
Phone` Fax'
A01' 75(oA
::CONTRACTOR: "
Company:
Name:
Contractor's Ucerise#: 150 E-Mail:
•Phone: —3 "Cell: i 0 Fax: I
;ARCHITECT/ENGINEER.
Name: Fun Name:
.Address City' State: Zip.
State Ucense#: Phone:' Cell: Fax
Description of Proiect
-PE O DRIVEW t�Y, R! LENGTH OF-DRIVEWAY CULVERTS NEEDED '
'RE DENTIAL DRIVEWAY WIDTH OF DRIVEWAY { )REINFORCED CONCRETE.
CbMMERCIALDRIVEWAY `�`TF" pCCAVATION ( )CORRUGATED.MATERIAL
PUBLIC ACCESS DRIVEWAY ,_(�F DEPTH. LINEAR FEET ( )BOX CULVERT.
{ )OTHER(EXPLAIN)
CONSTRUCTION MATERIAL CURB CUT REQUIRED
ASPHALT- YES NO
METE
HEADWAt,L REQUIR ? YES _,A_NO
NOTICE TO-APPLICANT:.If adUal Work exceeds scope of this description,additional permits or drawings
-Will be required.
UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: L800.432.4770.
Page 1 of 3
PERMIT APPLICATION
NEW
UTILITIES LOCATE CONFIRMATION NUMBER:
PROVIDE SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH-TO THIS.
APPLICATION.
ze
q- .-.=�)Coe_OA6aZ
RoAa
AFFIDAVIT: Application is hereby made to obtain a permit to do work and installations as indicated: I certify that all foregoing
information s;accurate and that all work will comply with all.applicable codes. I understand these codes shall take precedence over-all
approved construction documents,,and issuance of this permit is verification that I will notify the property owner of Florida Lien law
reti,F.S.713.
The Issuance of this permit does not ensure compliance with deed restrictions and-1 understand that additional deed
restrictions may apply to this property:
All work.shiall cd.mply with the current Florida Building Code,Public Wdrks Design Manual sand FDOT Design
Standards(it applicable).. (Public Works Design Manual online link:www.ci.zephyrhills.fl.us/publicLworks.asp)
APPLICATION IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT
TECHNICIAN'OR NOTARY PUBLIC.
NOTE; The City of Zephyrhills is not responsible for maintenance or repairs of drivewaeya. Driveways shall not alter
interfere with existing stormWater treatment and!or wnveyanae.
PROPERTY OWNERS: By signing this application: I certify that I have read and understand the owner/builder disclosure
statement. (please initial)
Applicant Print Name- Applicant Signature Date
.Permit Technician Signature (or)Notary Signature -Date
Applicant is( )personally known to me or produced as identification.
(type of identification)
Page 2.of 3
'i PERMIT APPLICATION
OFFICE USE ONLY
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....,R!.al..w..-t,.o,..., ..:A.
Contrete (min. 6'1 Y N
Asphalt Base(min.Vj Y, N
Asphalt(min.. 11/i 1 Y N
Length(min. 191 Y N
Width(W min_20'max) Y, N
Existing sidewalk. Y N.
New sldewalk. Y N
'ADA compliant. Y N
Expansion material required. Y N yi
Contiguous parking pad. Y N
Triangular flare(3'W x TL) N,
Visibility triangle 6.10 Y N
Side set back'(Y mini. R.O.W.) Y N
Plan Review Fee
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Permit appiication,.approved by: Date:
Page 3 of 3
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INSTR#2020129196 OR BK 10153 PG 3051 Page 1 of 1
08/10/2020 09:22 AM Rcpt:2191075 Rec: 10.00 IDS:0.00 IT:0.00
Nikki Alvarez-Sowles,Esq.,Pasco County Clerk&Comptroller
NOTICE OF.COMIVIENCEMUff
do
Permit
.Property ldentificatiou No. o b ems'a
1TiE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property,and.m accordance with
Section 713.13 of the Florida Statutes,the follOwing information is provided in this NOTICE OF COMMENCEMENT.
1.Descripfionofpmperty(legaldes don.) 6oZ- p4/ ,�� a /O• oG/c%Se-i
a)Street Address: Sy
2.0eneral description of improvements: i
.3.0wnef Information !/
a)Name and address:,o /lly.d. to tf.{�Y'.2. S/S Yjet,¢y /,F 15 /- zely t wtis
b)Name and address offee:supple Mich0 ldfir(ff other tllaa'ow#er)
C)Interest is piopeiry .
4'.Contractor Iiifarmatioa pp //,,
4)Name and address: huo x 44 .,�! 3�y 1 ��•a.�'�e ,d e- g,.�y,�,�i//del s�!?
b)Telephtana No.: Fax:No.(Opt)
5:5tutty.hiformati6n
a)Neme.end address: .. . -
b)Am6tuit ofBond-
e)Telephone No.: FaitNb.(Opt)
6.Lender`
a)Name and address:
PioniNe...
7.Identity of parson within the 5 e of.Flo da 8esf by bwhei•tipop whorh niitiCOS of othei doctmreMs may be':served:
a)Nam and address:
b)Telephone No.: L; Fax No; Opt):
B,In addition fo•himself,.owner esWhrtes the fello, p_ '.n to mcgive®"copy of the Lienoi s Notice es provided m 5tcfiaa
713.13(Ift F169&Statutes:
a).Name and address:
•b)Telephono No.: c .Fax No.'(OpQ
9.Expiration date of.Notice of Coh3menti'emeut:(the expiration Sate is one year from the date of recording tmless a different date is
specified):
WARNING TO OWNER. ANY PAYMENTS MADE BY THE OWNER AFTER THE MIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED I11VROPER,PAYMENTS UNDER CHAPTER.7.13;PART I.SF;CTIOI!i 713.13;.
FLORIDA STATUTES,AND CAN RESULT IN YOUR PA:*WG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED ANI)•POSTED ON THE JOB.STTE.BEFORE THB FIRST
(INSPECTION: IF YO MM. ND TO OBTAIN FINANCING.CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCINGW.ORK OR RECORDINd YOUR NOTICE:OF N EMENT.
STATE OF n0filMi
doumiv OF PAsdo
siM gfoww acowricei °j /D!_ft1dPdrtoa U_w
Nome
11 t6 i m was ac(mowledged bef me this- day gf
132�1 (y(giOdE.�ie.as' ': :_,. r:.;• (tYPe f :e.g.ofHimr;trustee,attornay
'iu fad)for (narae'ofparty'on btihalf of I etit was
Personally Khown_OR Produced Ideut(fiistio�/�, Notary Sigoattue _
%
Type ofIdeatificationProdtieeil �, 6�L C 44('a..,(priat)
Verification pursuant-to Section 9:4425,Florida Statutes.Under penalties,ofpd*jury,I declare that I bave read:9.foregoing and that
the facts staid-lb it and(tire to the best'of my lmowledge eud belief'
909are:0fNewil Pam Sty 46ovo;:
R4� F:JACQUELINEBOGES
Commission#GG276457
i g Expires December 12,2022
' y'+'}',or i;o�' gy��11ru Tray Fa1n insurance 8003SS7019
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t
�� .�1 Lt?► Mete Of Florida,County Of Pasco
3 4 This is to certify that the foregoing is a
true and correct copy of the document
on file or of public record in this office,
`Y��c�,�e f ,y •,. Witne�,s�m_y hand d official seal this
day of T 2Qa-b
sbr Nikki tar �P�les,'ES .,Clerk&Comptroller
PascoutyFlorida
® �� By Deputy Clerk