HomeMy WebLinkAbout21-1318 j i•
f City of Zephyrhills M P.I E-RKM I Md NUMBER
5335 Eighth Street
" Zephyrhills, FL 33542 BGR-001318-2021
Phone: (813)780-0020
Fax: (813)780-0021
Issue Date: 01/06/2021
Permit Type: Building General (Residential)
MENIP00 Number Street Address
02 26 210230 00000 0050 38642 Evelyn Lane
Owner Information Permit Information Contractor Information
Name: JAMES&PHYLLIS WILSON Permit Type:Building General(Residential) Contractor: QUALITY ROOFING
Class of Work:Reroof(Shingle Only)
Address: 38642 Evelyn Ln Building Valuation:$10,200.00
ZEPHYRHILLS,FL 33542 Electrical Valuation:
Phone: (813)997-5337 Mechanical Valuation:
Plumbing Valuation: —
Total Valuation:$10,200.00
Total Fees:$91.00 Il
Amount Paid:$91.00
Date Paid:1/6/2021 1:36:35PM
�Pr.ject Description
REROOF SHINGLE
Application Fees
Building Permit Fee $91.00
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.
(;6NTRXQj2aSIGNAP1RE 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-813-780-0021
Building Department
Date Received Phone Contact for Permitting
Owner's Name S� Ow7ner Phone Number L
Owner's Address I✓ l L O ner FtZ Number
IF
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
at JOB ADDRESS V /V L4MM ! S L / I.OT#
SUBDIVISION
PARCEL ID# -,2 -0.-00_ 0 — 1)
(OBTAINED FROM PROPERTY TAX NOTICE)
Y`
ip.WORK PROPOSED R NEW CONSTR H
ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER O
pA'TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL =
r,DESCRIPTION OF WORK D 0 S �Cd / Ba
OAF
ILDING SIZE SQ FOOTAGE 12 HEIGHT f V
=BUILDING VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE i = PROGRESS ENERGY Q W.R.E.C.
PLUMBING $ l
U" FZ d
=MECHANICAL $ VALUATION OF MECH ICAL INSTALLATI N pr
=GAS Q ROOFING 0 SPECIALTY = OTHER /�///✓�
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY i� ICLr B>f Jrl LLC C !�
SIGNATURE REGISTERED Y/ FEE CURREN
Address License# �0
ELECTRICIAN COMPANY
SIGNATURE• REGISTERED Y/ N_J FEE CURREN Y/N
Address 1 License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N_J FEE CURREt,
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
1111111111111111111111111111111111111111111111111111111111111111111
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 tnrk Permit for subdivisionsflarge projects
COMMERCIAL,; `Attach'(2)'6omplete 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 I I I I I I I I I
. I I I I I I I
. ■ . .
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
l
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 "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 nd 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,,WaterMastewater 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. t
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. i
If fill material is to be used in any area,. I certify that use of such fill will not adversely affect adjacent ;f
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 BEFORE RECORDING YOUR NOTICUE299MMEENCEMENT. J
FLORIDA JURAT(F.S.117.03)
- ti
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or rme e o is �1
by byAol
Who is/are personally known to me or hasthave produced Who is/are personally known to m r has/have p duced
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
INST.R#2021006685. OR BK 1 V25D PG:1613 ;Page 1 of 1
01/121202T 04:01 PM Rcpt:2247073 Reef 16.0.0 DS:0.60 IT:0.00
Nikki Afvarez•$owles,Esq.,Pasco County.Clerk:&Comptroller
' a Of Fiodd!4,Coun#y of.p", o
• is to certify that the foregoing is a
and correct copy Of the dooumer,
� i..r,�rr-yry,�tigr'
or of public record In this ott3oe,
Permit Number 10 1, 1 y hand an';;-cfal seal this
3 .8 a=a.l -A.
Pane{IO Number 0 p ;2/-G? 3t -0�� �f 0. "a . ay of 2_ A-
,,Parcel
O`�'IOE O F CO M ti IEN C ISMEN T ', 188P� , •�, -. i Alvarez-so s,Esq., &cOrnptrpW
��_�. n
State of Florida' •" j�j%. B ,: DeputyCiefk
County of. .......... Fib
THE"UNDERSIGNED hereby gives notice that improvements will be,made to certain real property,and In.accordan tth Section:713:13 of the
Flarida:Statutes,the fiqlloWing information is provided"is NOTICE OFCOMMENCEMENT.
1.Description of property(legal descripilon): 7 -;24�- 1"- 7,2 _—
a}:Street{joliaAddress; $ c�_ . 1/_2 c1 r7_ t!n' 2
ents:..__,_
2.General:descri tion.of Im-rovem •- . ..___. .- .. .-
- p p
V0. .lt.�- �- ram'-::.... -
- _ ,-
3.'Owner lnformation;or Lessee inf atip if the'Lessee..contraeted fort improvement»
a)Name and'.address: 1vv ., }1 ._ tJ�Q
ti)Name and address of feesimpie titlelioider(ifdiffierent.than Owner listed above)'_ _ _ _ _ _ 3 •���!
c}Inteiiestaii property:_ (;)W-'MR.T-7__
4,Contracforfnforniatidn ---•"-` µ�� -_�: .._:.._. .� �-,__,:�
b)Tea bond address: S/ 1 er_. o_of C c G uaf 7�yRo1��rlj_3- o73_r
.. p ._..eNo:.-.__,• _ rlol _=.. ._.___. Fax (options)
J.
$.Surety(if appticable,.a copyof t4'p payment_bond Is'attached)
a)Name:andoddress: -• _ _
b)�TelephoneNo.: .._._._.._. .,.
c)AmatmtofBond:S..
f),Lender
b)Telephone No::
T.Persons within the State of Florida designated by Owner upon whom notices or ather:documents in be served as provlded:oy:Section
713.13(1)(a)7.,�FlorideSttttuies:
a}Nameandaddtess: --
b)Telephone No.:.
8.a)In addition to,himself or herself,Ownerdesignstes , _•, — of _ •.
to receive a copy of the lienots Notice as providedJn Section 713.13{1)(b),Florida Statutes.. -
6).Phone Number of.Person or entity designated by Owner:
9.Expiration date of notice of commencement(!he expiration date may not be before the completion of construction and final payment to the
contractor,but will ba 1 year from,the date of recording unless a different date is specified).:,_.-• -: :, ••, __,.20___.
WARNING TO OWNER:i4MY;PAYMENTS MADE BY THE OWNER.AFTER THE EXPiRATl01d OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER-CHAPTER 713,PART I,S CTION1713A3,FLORIDA.STATUTES,AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST HE RECORDED AND POSTED ON
THE JOB SITE BEFORE THE FIRST INSPECTION: IP YOU INTEND TO OBTAIN FINANCiNq, CONSULT VIFITH YOUR LENDER OR AN !
.ATTORNEY SEFORE:COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENi:. _.__._.. !
Under penalty of,pejury,I d lara that I have read'tha foregoing notice of:6o iii ncement and that tha facts stated therein are im to the hest of my
knowledge and belief:
CSignatutsofQrmeror ar•Ovmefsarl`esseeStAuthoritedOfficedi?irectcrlParinerlManager) PttntNameandProvide.SignatcysTi.CeJ ,
Th foregoing in$. M .t=was acicnowiedged before"rrte p,means of""-U physicai.presence or ari-line'i►otariiation;tttfis . - day
of Or: as authority,:e.g.otficeri trustee,allomey in fact)
for St,Y.. �i,sa-tin._ . .._ ___.._.._ as O ►.Jn.iz 9" _
(!+lame of poison) �-(type ofau6wriiy,e.g.officer,trbstee,attorney in facq
for Ina oI artyan behalf orwhomIrMmentwasexewled).
Personally Known ❑ Produced ID
Type of IDrLl Notary Signature_ �i- Notary
name ------- r �,_..- GIN-IA A-DORR-
_ .._..._ _.M__.-.� gState of-Florida:hlotaiy.P-ubiiC
�+ *; Commission ri % 17050
My Commission
F,eb"ruary 0 8 t202ap,ros
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City of Zephyrhills
Zephyrhills FL 33542
(813)780-0020
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ROOFING INSPECTION AFFIDAVIT
Permit No.: bj�K'_ 00131$`,A0p_ '
1, T11 r 1
--� / / F
H M//I licensed under Chapter 468,Florida Statutes as a(n):
it
ContractorZE�n�g+ineer Architect Building Inspector
License No.
On or about �202/did personally inspect the:
. / a
Check: Roof Deck Nailing Dry in Flashing and Drip edge Y
1
Check which was used: 30##felt_Peel and Stick "Other(List)
At the following J
address: D Q 0102- Evd m LGt-j'e—
Based upon that examination,I have determined the installation was done according to the Hurricane ='
Mitigation Retrofit Manual(Based on Section 553.844,Florida Statutes). fr;
Signature:
i,
STATE OF FL
COUNTY OF PASCO
wol� to and ;ubscri fare this day a Q
Cr:
Notary Public ate of Florida `
s
" VIRGINIA A DORR !'f
l��Y PUgAi
-State of Florida-Notary Public
_* Commission # GG 176650
My Commission Expires
February 06, 2022 !
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