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Home My WebLink About21-1685 ' 6 City .of Zephyrhills >PERMITNUMBER': - � 5335 Eighth Street - Zephyrhills, FL 33542 BGR-001685-2021 `` .. Phone: (813)780-0020 Issue Date: 03/11/2021 V, . Fax: (813)780-0021 Permit Type: Building General (Residential) Property`Number. Street Address 12 26 21 0030 00600 0170 1 5337 23Rd Street Owner Information ' Permit Information Contractorinformation Name: LANCE SMITH Permit Type:Building General(Residential) Contractor: HO OWNER Class of Work:Reroof(Shingle Only) Address: 5337 23Rd St Building Valuation:$1,500.00 ZEPHYRHILLS,FL 33542 Electrical Valuation: Phone: (813)997-3981 Mechanical Valuation: Plumbing Valuation: Total Valuation:$1,500.00 Total Fees:$47.50 Amount Paid:$47.50 Date Paid:3/11/2021 4:29:43PM Project Description REROOF SHINGLE Application Fees Building Permit Fee $47.50 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 intendsto 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. y1Q9L*—)Lurn COWfZACTOR SIGNATURE PE IT OFFICE ERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER - City ofZephyrhills 5335 81'St Zephyrhills.FL 33542 (813)780-0020 . ROOFING INSPECTION AFFIDAVIT J . Permit No.: /'- W S I, - licensed under Chapter 468, FloridAtatutes as'a(n): . ContractFEngineer_Architect Building Inspector_ License On or about 3 did personally inspect the: Check: Roof Deck Nailing Dry in Flashing and Drip edge . Check which Was used: 30#felt Peel and Stick=Other(List) 6 C At the following 2 address: �J� �.. J' t Based upon that.examination, I.have determined the installation was done according to the Hurricane . Mitigation Retrofit IVlanual(Based on Section'S53:844,Florida Statutes).- Sig ure: . STATE OF ORIDA COUNTY OF PAS Sworn to d b re t BY: Notary Public State of,Florida -_ �{ ?i ,,•, DENNIS S,MOSES. ----- • MY COMMISSION#HH 11154 EXPIRES:June 18 2026 Y • 1 - - --- Bonded Thru NowN Public Under riftW ---- — -- - - 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 ��-J�,*s Building Department Nl-* Date Received Phone Contact for Permitting ( ) — ittitE�t �E[itt Owner's Name Lance Smith-Three Corners Investments Owner Phone Number $13-997-39$1 Owner's Address I Owner Phone Number Fee Simple Titleholder Name I Three Corners Investments LLP i Owner Phone Number Fee Simple Titleholder Address I PO Box 1536 -6272 Abbott Station Dr.Unit 102 Zephyrhills FL 33542 JOB ADDRESS 1 5337 23rd St.Zephyrhills F1L 33542 1 LOT# SUBDIVISION ephyrh Heights PARCEL ID# 12-26-21-003o-oo6OO-017o (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSfR B ADD/ALT = SIGN = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR 0 COMM = OTHER TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL = DESCRIPTION OF WORK Remove old shingles and Re-roof house with asphalt shingles BUILDING SIZE I SQ FOOTAGE 728 HEIGHT 8 =BUILDING $ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. =PLUMBING $ =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION =GAS = ROOFING Q SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE REGISTERED I Y/N I FEE CURREN Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Y/N Address License# PLUMBER COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Y/N Address I License# MECHANICAL COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN I Y/N Address Licensee## OTHER COMPANY Y SIGNATUR ,REGISTERED Y/N FEE CURREN Y/N Address 6426 Huntington Dr.Zephyrhills FL 33542 License# _WALL[-i 1 i .i.i.l.i.i.i i,Li-i i-Li-i i-!i i.i i-i.i.Li i i_i.i!L■i.i.i.i.i.i-i.Li.i-!.i i l.i i.i-[i i i#i-i i i.i i.l 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,Stornwater 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. + a ••"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 Attomey(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 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 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—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 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 1 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 1-6nds,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 6 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 r' 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 BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT, FLORIDA JURAT(F.S.117.03) OWNER OR AGENT Lance Smith CONTRACTOR Subscribed and bsworn to(or affirmed) of rem thj, Subscribed and sworn to(or affirmed)before me this C b Who is/are personally nown to me or shave produced Who is/are personally known to me or has/have produced identification. as identification. V , r otary Public Notary Public Cam fission No. aJ V Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped 40 Notary rid Public State of Floa Nancy J Brooks y My Commission GG 178530 Ezpires0211E12022 I; Y� III , Jy� I DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS- BUILDING DEPARTMENT have read and fully understand and agree to the provisions of this instrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is not for rent, lease or sale. That he or she shall comply with the following conditions: 1. That the owner and he or she alone shall act as the builder for all phases of construction. 2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector shall require corrections to be made, the owner will assume full responsibility to insure they are made, and upon completion will call for a reinspection before proceeding with the building. ------ — — —5- — That the owner sh—all assume -full responsi6li y�i for th construcwn and wild-not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office shall constitute an official notice to pay additional fees. 7. That the owner shall comply with;all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc.,where applicable. 8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial building, provided your costs do not exceed $75,000. The building or residence must be for your own use or occupancy. It may not be built or substantially improved if for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on-your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide worker's compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. OWNER'S SIGNATURE DATE ADDRESS PHONE �' 7 WITNESS PERMIT L Masterforms/ownersAffi aavit/NovO7