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City Of Zephyrhills PERMIT NUMBER
r` ; t 5335 Eighth Street
Zephyrhills, FL 33542 BGR-001482-2021
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 02/08/2021
Permit Type: Building General (Residential)
Property Number Street Address
35 25 21 0050 00000 0130 7234 Applegate Drive
Owner Information Permit Information Contractor Information
Name: NORMAN JOHNSON Permit Type:Building General(Residential) Contractor: SCOTT BLACKMAN
Class of Work:Reroof(Shingle Only) ROOFING INC
Address: 7234 Applegate Dr Building Valuation:$6,400.00
ZEPHYRHILLS,FL 33542 Electrical Valuation:
Phone: Mechanical Valuation:
Plumbing Valuation:
Total Valuation:'$6,400.00
Total Fees:$72.00
Amount Paid:$72.00
Date Paid:2/8/2021 9:39:22AM l
Project Description
REROOF SHINGLE
Application Fees
Building Permit Fee $72.00
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.
cti � t 6
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 Zephyrhil)s Perniit•Application Fax-813-780.0021
Bu0jo'g_Department
Date Received Phone Contact for Permitting-
q: 1 d1
Owner's Name r vy\ Owner Phone-Number
Owner's Address � j! Ir` Owner Phone Number
� .•C
Owner Phone Number
JOB ADDRESS' 'S c- LOT# .
SUBDIVISION s101 t�� �. PARCEL ID# �`��'�•i ' 61)So "4 a 0.0 °" to 1 .3
(OBTAINED'FROM-PROPERTY TAX NOTICE)
WORK PROPOSE.0 Ej NEW CONSTRR ADD/ALT �� SIGN Q 0 DEMOLISH
e INSTALL REPAIR
PROPOSED USE Q SFR COMM OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL
DESCRIPTION OF WORK �� �;n- cr.t t Cl sq. t i-11 t IDN,
.BUILDING.SIZE SO FOOTAGE-= HEIGHT
t
=BUILDING L.._ VALUATION OF TOTRL CONSTRUCTION'
{
=ELECTRICAL AMP'SERVICE 0 DUKE ENERGY' Q W.R.E.C.
=PLUMBING
[MECHANICAL $ VALUATION OF MECHANICAL INSTALLATIOA ?0 r
=GAS Q ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN .
Address' License# F
ELECTRICIAN', COMPANY
SIGNATURE REGISTERED` YY'N FEE CURREN Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/-N FEE CURREN
Address License# F
MECHANICAL . . COMPANY
SIGNATURE' REGISTERED Y/ N FEE CURREN Y/N
Address Licen$e# �
OTHER COMPANYj�
SIGNATURE REGISTERED Y/ N,..; FEE CURREA - I YIN)
t^
'Address P(� v�i vc: � ,� License#. CU-6s .�,
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building'Plans;(1)set of Energy Forms;R- -W Permit for new construction,
Minimum ten(10)working days after submittai'date. Reou-!red onsite,Cons Plans;St6rmw1ater Plans w/Slit Fence Installed,
Sanitary,Facilities&1..dumpster,:Site Work Permit*for subdivisionsAarge-projebts-
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.submlttal date:.Requiredtonsit%Construction Plans,.Stormwater Plansw/811t Fence installed,
Sanitary Facilities&1 dumpsteE 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.
Rollo
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 fetter from owner authorizing same
OVER..THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers.. Service*Upgrades A/C.. Fences(PlottSurvey/Footage)
Driveways-Not over Counter if on public roadways,.needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit inlay 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 whatAdensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspe tion Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has, hired a contractor or contractors7e is advised to have the contractor(s) sign.
portions of the "contractor Block" of this application for which they wi�Lie responsible. If you, as the owner sign as the
Contractor, that may be an indication that he is not properly license 'and is not entitled to permitting.privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND-RES. URCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery.Fe s.may apply to the:construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specked 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$2,5.00.00 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 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 applyto 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 maybe 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 —
WITFL-YO.UR-LENDER-OR-AN-ATTORNEY BEFORE-RECORDING-YOUR NOTICE-OF-COMMENCEMENT.--
FLORIDA JURAT(F.S.117.03)
OWNER O AGENTj *-n`1L CONTRACTO a.,
Subscribed an�m to(or affirmed)before me this Subscribed an o(or affirmed)before me this
by
Who is/are personally known to me or has/have produced Who i r personal) nown to me or has/have produced
as idenfification. as identification.
Notary Public Notary Public
Commission No. JCoonTNo. !
Name of Notary typed,printed or stamped Name of Njpytary;tyed, i�ted -�•�,,..M
,�C�,amiS:on#GG2764{?
ThWTMY Fain
�;;�r,F. ,`�"�?�ftres U2ce►r►6er 1� �r•.
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City of Zephyrhills
5335 811 St
Zephyrhills FL.33542
(813)780-0020
ROOFING INSPECTION AFFIDAVIT
N — 1
. Permit o.•
1
licensed under Chapter 468, Florida Statutes as a(n):
Contractor✓gineer Architect Building Inspector
License No.
On or about a- ,:�� �-I did personally inspect the:
Check: Roof Deck Nailing t/ Dry'in y: Flashing.and Drip edge ✓.
Check whch.was used:.: 30#felt Peel and.Stick Other(List)
At the following,
address: a •
Based upon that examination,1.have determined:the installation was done according to the Hurricane
Mitigation_Retrofit Manual.(Based on Section'553.844, Florida:Statutes):
Signature: , ��
STATE OF FLORIDA
COUNTY OF PASCO
MICHAEIREVELL' .
. ,,,; W COMMISSION#GG t849Q0 '
Sworn to and subscribed,before this day '�} ZI EXPIfiES�FeImisly12,
,o ;R"Bonded lhru Notary Public UndOlm t'
BY: C�Q9-P Q.S,t,P Q D
77
Notary Public State of Florida
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