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HomeMy WebLinkAbout21-1428 Q _ �!n�r100 City of Zephyrhills PERMIT NUMBER 4t. 5335 Eighth Street Zephyrhills, FL 33542 BGR-001428-2021 Phone: (813)780-0020 • Fax: (813)780-0021 Issue Date: 01/27/2021 Permit Type: Building General (Residential) Property Number Street Address 12 26 21 0030 00300 0130 5309 Beltram Drive Owner Information Permit Information Contractor 1 nformation Name: DAVID HAYES Permit Type:Building General(Residential) Contractor: BAHR'S PROPANE GAS& Class of Work:HVAC Changeout A/C, INC. Address: 5309 Beltram Dr Building Valuation:$0.00 ZEPHYRHILLS,FL 33542-6018 Electrical Valuation:$0.00 Phone: (813)598-6981 Mechanical Valuation:$5,800.00 Plumbing Valuation:$0.00 Total Valuation:$5,800.00 / Total Fees:$69.00 / Amount Paid:$69.00 ��� Date Paid:1/27/2021 9:40:54AM Project Description A/C CHANGE OUT 2.5 TONS Application Fees Mechanical Permit Fee $69.00 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. O ILTR CT RR SIGNATURE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER ge_# JY�Z65 8'13-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permitting (�• ) -J O n T /� ��3'S -Co981 Owner's Name �ff(,}A (5 �V��o/�r,+ham LDq V i Owner Phone Number Ownees Address % 194 1& ► / 5 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 53 j5elfra Dr nulls FL 3�2 LOT# SUBDIVISION PARCEL ID#hai_07 10 07/-0030 OQ3Oo (OBTAINED FROM PROPERTY T=Ttcel WORK PROPOSED e NEW COIVSTR ADD/ALT = SIGN DEMOLISH INSTALL REPAIR PROPOSED USE = SFR Q COMM = OTHER TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL` ^_ DESCRIPTION OF WORK BUILDING SIZE SQ FOOTAGE HEIGHT =BUILDING S VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL S AMP SERVICE = PROGRESS ENERGY Q W.R.E.C. =PLUMBING $ MECHANICAL $�Q�oo, VALUATION OF MECHANICAL INSTALLATION =CAS = ROOFING Q SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE_- REGISTERED I Y/ N FEE CURREN Address I License# ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N FEE CURREN Address I License# PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N FEE CURREK Y/N Address i License# MECHANICAL COMPANY t7L3 Fo ne 6aS it Al C Mi SIGNATURE qq REGISTERED Y/ N FE CURREn Y/N Address / ` 5 License# OTHER COMPANY SIGNATURE REGISTERED I Y/ N FEE CURREA Y/N Addre.s License# Irr � lff � � rrr � � tttlrti � � rr � � � � rr � r � � � � � rrrr � rtrrirr � frr � � � irfti � � rrr 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 subdivisionsllarge 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,Stornwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Pernit'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. 3 :-F�' Directions: Fill otr.application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (AIC 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. ROW'..needs. 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 coritractor(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'constructiori 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. 1 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 fo 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 N TICE OF COMMENQFMENT. FLORIDA JURAT(F.S.117 03 WNE OR AGENT C NT CTOR b ed and sw o(o of m1 )b this a d swo to r affi ed b is b b Y Y Who i;are persona y mown to me a as/have produced ho is/ a ersanall know o me or h,!Javb produced as identification. identification. c otary Public �UcYi Notary Public Commission No. Commission NoA Oki ame of otary t i rinted.or to ped Nam off ed,Rimmy omm d F .00 �ry Public�rs;ar Florida Tammie M RoprS Tammie M Ropers My Cclmmission 00 913245 My Commission GG 913245 Expires pp115/2023 or Expires 0 9/1 5120 2 3 q ... P ��.111J1 Service:-.Qrder..:/Pronosal = AND'S -INC S' e988 Inva►ice a: 813-7 SALES SERVICE • REPAIR• INSTAL TON WORK QRDER#/SERV ICEMAN 115257. J`AN 4 444-1 A11en�Rd.`�Zephyrhlils, FL DATE/TIME TAKEN 11 11 `1 i i o iS - = TAKElti( -BY �-�; T-AYLt7,1�.,. 04 :PAY ONLINE www.bahrs ro ane "asanlaccom >Y .:; , IJA'fs'1`?I{ Er`l ;R`C1t1'I .E'Lr:} ',/'cry:/:;:>�<< :. ►�: i7i:_: :i ar x , IC3TES�: _ ar - 15T AC4c7' 61PHONE# - 8i,,-598-E81 C P HOB IEc# :Gt El t St/l=ft lD`i'.lY4hl- 11 nor r1� Q0109 3 CONTACT HANDYMAN: CRA I G ROUTE/SEQ J'AN33542 HAYESy DAV I D i=iA1GES=g -D,'V I:D`'' 4824. 1.6TH S-T 5 1Zi9-�BEL'TRAM DR . - r • ZEPHYRHILLS FL. .&3545 ZEPHYRH'ILLS, FL335A.2 CD:, UACC030J'H84 377SM23902500 ESTIMAl%E-=.QN 'MEW UNJ—T' -& =SQI`1E DUCTWORK REPLACED. y 'SS -I+'a`r�,. 41 ,�:�,'tt;F,'.-+s.; _ _-.s..,Y"�+:�.,,�, egg =<°2�k:_;�y"stz.:ei, :ii?"iw'Pn`,uvPnz. -c^ � :.".k%. �-,: ^,. < - ':s-i ik;.sx ..� ..,?S3'3- !'�:.,• .r'. _ = - s::i •'epx ,' - ' a-i'4: '= .ryA. 3 f Vi' i R; =�- Fa S F iP'FION,QCC;UVORK, x -} fr. ;r'^ �, ;_tT3Y K f4 1 1A1;8IMS-R?1lG S. �R�J�.. '! j#tG i' E� •ss� .a:. 7�. n <»S ,,3 h. 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FILTERS x x Changed Monthly I I FILTERS x x Changed Monthly ❑ REGULAR ❑WARRANTY # r eh;r i lafS irtg Whenhere' yYti5 When Away:.__''�T;.Stat$ ❑ MAINTENANCE CONTRACT SERVICE r LIMITED WARRANTY: All materials;parts and equipment are warranted by the manufacldrers'�y "'„`j ONO ,(' T .;; 4`�t CALL I or supptlers'written warranty only.Atiaabor performed by the above named company iswarranted for t' TOTAL 30 days ores otherwise Indicatedan'writing..The above named company makes no otherwaranties dCAS_ _U CK`# express or tmplied,.and its agents or technicians are not-authorized to make any such.:warra fles on' MATERIALS I behalf of abovenamed.company. ❑DEb):61P:CREDIT OOTHER MAINTENANCE . I I have authority to order the work outlined above which-has been satisfactorily completed)agree that Seller PR0G. W I Ci t 1 retains a0e to equipmentrmaledals fumished until final paymentds made.N•payment is not madeas.agreerd, CLAIM# sailer can remove said equipmenVmalerials at Seller's expense,Any damage resulting from said,removal,ehall, not be the responsibility of Seiler.NET 30 DAYS.A 1 12%SERVICE CHARGE-WILL BE ADDED MONTHLY.TO, '}-�+. . '' I ALL UNPAID BALANCES OVER 30 DAYS.NO REFUNDS •LATE'COMPLETED TECH;' TAX lJJ „,,j U�,� T/�T/� ..t CUSTOMER SIGNATURE DATE -- - J7G� _w6a TOTAL IML I 4 1/27/2Q21 12-26-21-0030-00300-0130 1 Pasco County Property Appraiser Parcel ID 12-26-21-0030-00300-0130 (Card: 1 of 1) Classification 00100-Single Family Mailing Address Property Value HAYES JOHN DAVID Ag Land $0 4824 16TH ST Land $12,789 ZEPHYRHILLS, FL 33542-6018 Building $83,657 Extra Features $139 Physical Address 5309 BELTRAM DRIVE, ZEPHYRHILLS, FL 33542 Just Value $96,585 Assessed (Non-School Amendment 1) $96,585 Legal Description (First 200 characters) See Plat for this Subdivision Non-School Taxable Value $96,585 ZEPHYR HEIGHTS PB 5 PG 50 LOT 13 School District Taxable Value $96,585 BLOCK 3 Jurisdiction CITY OF ZEPHYRHILLS Land Detail (Card: 1 of 1) Line .Use Code Description Zoning,Units _ Type _ Price _,Condition Value _ - -- - 2 0100R 1 LP3-2 SFR - r00R1 _-7 000 00 SF _ _ - 1 0100R- LP3-1 1_--_-- SFR _J _.._- "___. _..._.-.1__.____.___. $1 8� _i _ 1.00 i $12,600 -_ 00R1 } 700.00 SF $l).27 j - 1.00 - ' -$189- _ Additional Lan_d I_n_fo_r_ma_tion _- -Acre_s Tax Area FEMA Code �- Neighborhood Code(s)- -- 0.18 �yj 30ZH ZHLG`-View Sketch Sketch Building Information - Use 0100-Single Family Residential (Card: 1 of 1) ear Built 1961 Stories 1.0 xterior Wall 1 Concrete or Cinder Block Exterior Wall 2 Above Average oof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle nterior Wall 1 Drywall Interior Wall 2 None looring 1 Terrazzo Monolithic Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted /C Central Baths 1.5 Line_ ;Code bescription Sq. Feet Value 1 �_ _BAS01_ LIVING AREA_MV!�--- 932 "-- - - $59,427 -4 2 ? _FE_P01_ I FINISHED ENCL PORCH 192----"-"T" `r -- -------- $8,544 FGR - 3 ----f-_ 01-� FINISHED GARAGE�"��__------ ------252 '__.-___ $6,440___-"---- --- FGR 4 UDyni UNFINISHED DET UTILITY - - --144- -- $2,742_ -4 - 5 _i FCA_01 FINISHED ALUM CARPORT 168 $2,678 - - 6 USTCd j V_UNFINISHED_ST_ORAGE^_ i _ _ 84_ _ $2,168_ _ 7 _ UOP01 ; UNFINISHED OPEN PORCH -; - 172 - $1,658 -- Extra Features (Card: 1 of 1) Line ,Code _IDescription JYear Units _ _ Value 1 RDWSWC j DRVWAY/SIDEWALK CONC j 1973 234 - $i39.___� Sales History Previous Owner: HATHAWAY ANTHONY S Month/Year jBook/Page -------------,Type-- --___------------ DOR Code---- --------__----------- -- Condition Amount 10/2020 10209 / 3637 Warranty Deed _ 01 Improved 1 $65,000 �08/2013 8934 / 0622 -' -_Warranty Deed - -- -11 - - Improved- J!---$0 _- -'--- 04/2008_ - ' 7801 / 1709 - Quit Claim Deed - ; Improved $0 12/2001 j - 4818 / 1444- _- -'__ Warranty Deed - j - - _ Improved ! $68,000 09/2000 j 4450 / 0008 _Warranty Deed -�i — `- Improved t $65,000J 07/1996 �f 3600 / 1642 _ Warranty Deed Improved } $58,500- https://search.pascopa.com/parcel.aspx?parcel=2126120030003000130 1/1 INSTR/t 2021032021 OR BK 10281 PG 1297 Peg.1 of 1 02/17/2021 11:25 AM Rcpt:2262169 Rec:10.00 DS:0.00 IT:0.00 Nikki AlvarezSowles,Esq.,Pasco County Clerk&Comptroller Permit No. �' Parcel ID No 3,"�'S"'Z"1-bC(S'0-0 UU 0 "0 f 3 p NOTICE OF COMMENCEMENT Stets of r 1 County of Piz.S W THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property,and in amordance with Chapter 713,Florida Statutes, the following Information is provided in this Notice of Commencement: i. Description of properly:Parcel Identification No.33=Zr-Z(-O 0S'0 -000 a O -d 13 O Street Address; .1.3 r ft Aa 1 t-'41.A c ?� ( Y b -14r P-j 3 2. General Description of Improvement rr 0 0 3. Owner Information or Lessee Information If the Lessee contracted for the Improvement: /Vdv'wiQvt LJE7.1 f,1S'n Name AddreseZ 3y }� city I State Interest In Property: Name of Fee Simple Titleholder y,�. t (if different from Owner listed above) a. contrarian: _ C0r 1 iS)4 c k"-e. P, ��yCr[�S Lrc city state % 6a-)' er SGk Address city 3 7 6 Contractor's Telephone•No.: S. Surety: Name Address city State Amount of Bond: Telephone No.: 6. Landa Name Address city state Lender's Telephone No.: 7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by Section 713.13(1)(ax7),Florida Statutes: Name Address city State Telephone Number of Designated Person: 8. In addition to himself,the owner designates —of— to ,_ to receive a copy of the Llenors Notice as provided In Section 713.13(1)(b),Florida Statutes. Telephone Number of Person or Entity Designated by Owner. 9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of mnslnsction and final payment to the contractor,but will be one year from the date of recording unless a different date Is spedfied): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of pedury,I declare that I have read the foregoing notice of commencement and the fads stated therein are true to the best of my knowledge and belief. STATE OF FLORIDA COUNTY OF PASCO I nature o er or Lessee,or Owners or Lessee's Authorized OfflcerlDl tor/Partnar/Manager Signatory's Tttla/Office ` 1 The torego ng instrument was acknowledged before me this�day of �0.,N ,20_,by ht b r"i" &�k p� es I sJ vLL s' (type of authority,e.g.,officer,trustee,attorney In fad)for (name of party on behalf of whom Instrument was executed). ._� Personally Known 0 t,7$Produced Identification Notary Signature Type of Identification Produced I P L- Name(Print) . ♦sue" sco C BLACNMAN . � Nfttarq Pu411c-State st Florida fAtI' tan N GG 236T76 M1 My Gomm.Erp res Jun 20,1022 ^Bonded lhrouph National Notary Assn. wpdat3lbmfnoticemmmencemen(,pc053048 State Of Florida,County Of Pasco ss This is to certify that the foregoing is a m true and correct copy of the document on file or of public record in this office. Witne s y hand and official seal this x(I day of — �� Nikki Aluare wle ,Esci..C�s k&Comptroller $ ,® Pasco u y,�8 da ,� gy ,Deputy Clerk � � B13-780-0020 city of Zephyrhilis Permit Application Building Department :pamittin 5�10) Phone,C"ftd for Pef,d Date ltemqi�ed Phone C"A3d for r ownees Name ljo Number 590 ownees Add qjU4+sS+ Omer Phone Number Fed Simple Titleholder Nam Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS LOT#5 SUBDIVISION PARCEL io#F (OBTAINED FROM PROPERTYTAX NOTICE) WORK PROPOSED R INSTALL NEWCDNM� ADDIALT = SIGN [--j DEMOLISH REPAIR PROPOSED USE SFR M Comm r--j OTHER I TYPE OF CONSTRUCTION = BLOCK [D FRAME STEEL ED r_— OF-SCRIPT-'ON OF WORK ph S-TON P+--- arne,oul-, I coor -n+, BUILDING SIZE So FOOTAGE HEIGHT E= =BUILDING VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL is AMP SERVICE PROGRESS ENERGY Q W.R.E.C, =FLUMBING 15 �-'ECHANICAL jsZjqq5,a3j VALUATION.OF MECHANICAL INSTALLATION =c.ks r7 ROOFING rl SPECIALTY OTHER FINISHED rLOOR ELEVATIONS FLOOD ZONE AREA =YES NO . . . . . . . . . . . It It It II BUILDER i COMPANY I SIGNATUF1'.- REGISTERED I YIN FEE CURREN Address License#F ELECMCrAA1 COMPANY I SIGNATURE REGISTERED I YIN FEE CURREN i YIN Address I License# PLUMBER COMPANY I SIGNATURE REGISTERED I Y/N FEECUPREN L_XLN J Add. License#F— MECHANIC -Wo-F COPANY SIGNATU AL REGISTEREDM I Y/N FEEtURREN I YIN Address MI-71 A W"qd Zi 1/6 ticehse#1 efi e-5-013q q9 OTHER COMPANY SIGNATURE REGISTERED I YIN I FEE CURREN LILN J Address License#F- 111i I 111111111 1161111111 11111 111 if 11111111 RESID9NTiAL Attach'(2)Plot Plans;(2)sets of Building Plarvi:(1)set of Energy Forms;R-O-W Permit for now construction, Minimum ten(10)worldng days after submittal date. Required make,ODns6xUon Plans,Stonewater Plans wl Sift Fence installed, Sanitary Facilities&I dumpster,Site Work Permit for subdivislorwlarge projects COMMERCIAL Attach(2)complete sets of Building Plans plus a We Sofory Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)vvq%ng days after submixtal dote..Requited onzite.Construction Plans,Stormwater Plans W Sift Fonco Installed, Sanitary Facilities&1'dumpster.,SfI67Work permit for all new projects.Ali commercial requirements must meet compliance. SIGN PERMIT Attach(2)sets of Engineered Plans. 1 '4 . - . . .1. 'PROPERTY SURVEY required for all NEW construction. 4 . . . . . . . . . 11all 01=4 oft Fill ou,application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice or 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 PERMUTING (copy-of 99npat required Reroofs if s.-iingles Sewers Seivicm Upgrades A/C �fot/Survey/Footage) Driveways-Not over Counter it.06 public roadways:.needs'ROW NOTICE OF DEED I RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions" which may be more restrictive than u Co ' 'rbguIati66&*The undersigned assumes responsibility for compliance with any nty 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 iiccdn:16rice,vwth,state.and local regulations. If the contractor Is not licensed as required by law,both the owner and contractor may be cited a.misdemeanor for I violation under state law. If the owner or I.ntended 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—Licer sing Section it-727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the cofitractor(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/Unii-mis IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transpdrtatlo'n'Iffip6ct Fees and Recourse Recovery Fees may apply't6 the construction of new builditigs,change of use in existing buildings;or expansion of e)d§biig 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 tion 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 applicirit, have been,provided with a copy, of the 'Florida Construction Lien Law—Homeowner's Protection Guide"prepared by the Floridd,Departmerit 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 descri6eddodurneInt 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 'Bagh6ads, -Weiland 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'T 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"K 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 car* 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'aUth6rity to violate,cancel,alter,or set aside any provisions of the technical codes,nor shail Issuance of 6 flermll-prevent the Building Official from thereafter requiring 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 ATTORNEYBEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S. OVVNER,OR AGENT. 900*1ka d two (Or a sworn r affi edd)be Is Twlkie rsonally known t(5 me Or"8/yaV6 produced I Personally own-jo me orhaVUve-produced ,as 4iotllic=ation. as identification: ,2A Notary�.b)h Sad. Public otary Public Commission Na. Commission No. Na Notary Pc State of Fjold, .0",p W NO- Notary PAwic Su Tommie M Rogers f&J% Tommie MR C . Rogan My Commission GG 913245 %1�1, My Commission GG 911324111, Expires 0911512023 V Expires(111111`13/20"