HomeMy WebLinkAbout20-1013 m
+.J ►i a rue4 City of Zephyrhills F PERMIT N,U.MBER `'a'
E; .,
-= 5335 Eighth Street
Zephyrhills, FL 33542 BGR-001013-2020
Phone: (813)780-0020
Fax: (813)780-0021
Issue Date: 11/13/2020
Permit Type: Building General (Residential) _
Property Number Street Address
1126 210010 03400 0131 38309 12Th Avenue
Owner Information Permit Information Contractor7nformation
Name: JOHN&GLORIA FOSTER Permit Type:Building General(Residential) Contractor: HOMEOWNER
Class of Work:Fence
Address: 19851 Leonard Rd Total Valuation:$1,500.00
LUTZ,FL 33558-5124 Total Fees:$55.00
Phone: (813)477-7038 Amount Paid:$55.00 /]
Date Paid:11/13/2020 1:0 - PM
P oject Description
INSTALLATION 139 FT X 6FT PRIVACY FENCE
Application Fees
Fence Installation Fee $55.00
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.
CONTRACT61R 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 ZephyrhillS Permit Application Fax-813-780-0021
Building Department
Date Received� Phone Contact for Permitting
Owner's Name `�1 O� ✓ �p -I'e f Owner Phone Number —
Owner's Address ���� ��� U Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address //1 zz �r
JOB ADDRESS � �'--! I,a J V LOT#
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR a ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR 0 COMM = .OTHER
TYPE OF CONSTRUCTION BLOCK Q FRAME = STEEL =
DESCRIPTION OF WORK lnce -/- l/ J \ VCC
BUILDING SIZE I I SQ FOOTAGE= HEIGHT
Ex BUILDING $p bn VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $l AMP SERVICE Q PROGRESS ENERGY IQ W R E.C.�U
=PLUMBING $
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING Q SPECIALTY = OTHER C
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES
BUILDER / COMPANY
SIGNATURE ,v / G REGISTERED Y/ N FEE CURREN , Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
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,Stormwatee Plans w/.Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsnarge 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-Attomey.(for, the owner)would be someone with notarized letter,from owner authorizing same .
OVER THE COUNTER PERMITTING". ' (copyof contract required)
Reroofs If shingles Sdwers>, 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
Date Rbceived , 3
Phone Contact for Permitting Y
Owner's Name ~d �x t/ O 7e Owner Phone Number
Owner's Add ess e,_3C?,2 ;.-n, U e Owner Phone Number
Fee Simple Titl older Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS � >C p—l.I�� 30 LOT#
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR 0', COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL =
DESCRIPTION OF WORK
BUILDING SIZE SQ FOOTAGE= HEIGHT
BUILDING $r VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = PROGRESS EN Q R.E.C.
=PLUMBING $ ����
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING Q- SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES3
BUILDER COMPANYHfm v '
SIGNATURE C� REGISTERED Y/ N FEE CURREN
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
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,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 Powerof 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
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit maybe 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 contra.ctor 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: o permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND_RESOURCE RECOVERY FEES: The under6.igned 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 ofoccupancy" 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�mdst 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" PreDared by the Florida Department of Agriculture-and:Consumer Affairs. If the applicant is someone
other than the"owner",
'ow' n'er*, ["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!SIOWNER'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
3
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 J
construction, County and City codes, zoning regulations, and land..development regulations in -the jurisdiction. I also '3
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/Ehvironmental Health 'Unit-Wells, Wastewater Treatment,
SepticTanks. , b
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-RUnways.
(understand that the following restrictions apoly,to the,use of fill:
Use of fill is not allowed in Flood Zone W`uhless: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 tobe used,in Flood Zone "A" in connection With a permitted building using stem wall
construction, I certify that fill.will be',usijd:only to fill the area within thestem Wall.
If fill material is to be used .in any.area, 1-:certify,that use of such fill will, not adversely affect adjacent
properties. If use of fill is found*to,adversaly,,affect:adjacent properties, the owner may:be cited for violating
the conditions of the buildi6g perrhit.issued:.underthe-attached permit application, for lots less than one (1)
acre which are elevated:by-fill,an.engineere&dralnoge.plan"is required.
If I am-the AGENTFOR THE OWNER, I promise in.-good.faith,,to inform:the owner of the permitting conditions set forth in
this affidavit it 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 proceedwith 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 T- O-OWNER: YOUR FAILURE TO:RECORD-A NOTICE OF-COMMENCEMENT-MAY RESULT:.IN YOUR
PAYIN6,TWICE FOR.IMPROVEMENTS TO YOUR PROPERTY. IFXOU•INTEND TO OBTAK FINANC ING,CONSULT
WITH1YOUR LENDER:OR AN ATTORNEY BEFORE:RECORDING,YOUR-NOTICE,OF COMMENCEMENT.
FLORIDXJUR`AT_(F_.S_.1_1%.
TRACTOR
before me his Sqbscribed and sWc. or-am ad)beforen3e this
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OWNER OR A CON
Subscribed and svw
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Who islard personally known to me or has/have produced Who Is/ re pe pna=own to me or has/have produced
as identification. -4.&'CrU_ as identification.
Notary Public Notary Public
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JACQUELINE BODES
Name of Nota 1101". WkI&MI1276457 Name of Notary typ r(mMp�jo#GG 276457
Expires December 12,2022
Expires December 1 2022
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https:Hsearch.pascopa.com/sketch.aspx?pid=272439&bid=272439 11/1/2020
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS— BUILDING DEPARTMENT
I, 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 shall assume full responsibility for the construction and will 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 // / 1 b
ADDRESS 0
PHONE —'
WITNESS PERMIT
I/Masterforms/OwnecsAffidavit/Nov07