HomeMy WebLinkAbout20-1047 813-780-0020 City of Zephyrhills Permit ApplicationO / / Fax-813-780-0021
Building Department
bate Received! / .-, — d d t„ �i �� / Phone Co t ct for Permitting 3
Owner's Name dM C4 J Owner Phone Number
Owner's Addres Sa5a T Owner Phone Number
Fee Simple Titleho�eZrName Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS as aI S LOT#
SUBDIVISION PARCEL ID# �- a` 0 a td —180 0 Q^ o a i.
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT = SIGN Q = DEMOLISH
R INSTALL e REPAIR
PROPOSED USE = SFR Q" COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK Q FRAME j.= STEEL =
DESCRIPTION OF WORK T U a S 7 O ``" vtn Y 1 6' e` 1,l
BUILDING SIZE SQ FOOTAGE .Z 7 HEIGHT
4444444-4
=BUILDING $ 7, � � VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ f' V AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
=PLUMBING $
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION a
�r
=GAS = ROOFING Q SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANYe/jC�° L�•.Z�t_c"
SIGNATURE REGISTERED Y/ N FEE CURREN , Y/N
Address r License#
-------------
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License#
ft
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. (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..needs ROW
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 maybe 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 contactor 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] 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 a
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 rdevelopment regulations in the jurisdiction. I also
certify-that 1.understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility., identify what actions l 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 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 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 promise1n 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 RESIULT-IN YOUR
PAYING TWICE_FOR IMPROVEMENTS-TO YOUR PROPERTY. IF YOU.INTEND-TO OBTAIN FINANCING,--CONSULT
WITKYOUR LENDER OR AN ATTORNEY BEFORE-RECORDING:YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F:S 117-.03)
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to(or affirmed)before me this Subscribed.and sworn to(or affirmed)before me this
by by
Who Ware personally known to me or has/have produced Who is/are personally known to me or has/have produced
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
III li
serving ft d;HWs&era Since
SPECIALIZING IN: "Free Estimates"
* 4122
ALUMINUM.*VINYL *WOOD•--*CHAIN LINK Hillsborough: (863)661-9679
- � -Polk (863)661-9679
863816-3117
LICENSED&INSURED Office:Fa (863)500-6361
Email: ajfencemfg@gmail.com
BUYER: Property Owner N Pro a Owner Website: www.ajfencemfg.com
Name: r. Date: �, l
Address: Phone:
City: Zip Code: Email:
Subdivisi6A, 811#:
Aluniliourn Chain Link Wood
Style Galy ' ed Sto de 4' 6' 8'
Heigh /� �'t Height Board On rd 4' 6' 8'
Color r . 1: J-c Gauge Shadow Box 4' 6' 8
Cap Style: er Black ri Cross
4' 5
#Rails 3 Wire Base Plates r S le:
Size Of Gates: +
Commercial: -7 7 r
HOA Needed: T
Permit Needed: ye C, xa
Total Ft:
Total Ft Remov I:
Concrete All Posts: b X�
Notes:
W6 G � r
4oAA 4
i �
*90 Day Warranty on Labor*
CONTRACT CONDITIONS
Acceptance-The above proposal when accepted by the Company becomes a contract between two parties and is not subject to
cancellation. In the event payment is not made within seven days of billing,the Company reserves the right to place a mechanics lien
on the customer's property and/or repossess all materials used on the job without recourse. PROPERTY OWNER is solely responsible
for locating,staking and clearing the fence lines.Purchaser also agrees that the Company will not be held responsible or liable for any
damage or any nature to underground obstructions,water and sprinkler lines,pool lines,and/or private or public utility lines.
NOTICE:If contract is cancelled a 25%charge of the total contract price will be charged.
*Total Price(including tax)$"7 Z/_A J°k c.c.Fee 25%Deposit$
Authorized Signature Balance$
**Proposal pricing is guaranteed for 30 Days from this date.**
ACCEPTANCE OF PROPOSALICONTRACT
The above prices,specifications and conditions are hereby ACCEPTED.
CUSTOMER SIGNATURE DATE
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P
A
813-780.0020 City of Zephyrhills Permit Application Fax-813-780-0021
Budding 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 wilt be responsible.If you,as the owner sign as the contractor,that may be an indication that he is not property 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 1,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 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 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 shad 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 CONTRACTOR Zju
Subscribed and swum to(or affirmed)before me this Subscribed and swom to( affirmed)before m is
by by
Who is/are personally known to me or haslhave produced Who islaTTonabicrrpwn to me or hasfhave produced
as identification. 4 as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped dw
CARLOS MALDONADO
.; COMMISS10n#GG 348275
'�`.•` Expires June 18,2023
8ondedThru Troy Fain Insurance800,M&7019
f
STOP WO,RK
By order of the Building Official: William A. ourgess
All Building, plumbing, electrical and mechanical work
shall cease at the below mentioned property.
Address: � % 4-c' �r��
Date: 10 -
Code Enforcement Officer: 134 C C)6U
Contact.the
Zephyrhills Building Department
5335 - Sth Street
513-750-0020
10/22/2020 11-26-21-0010-18000-0010 1 Pasco County Property Appraiser
A
Parcel ID 11-26-21-0010-18000-0010 (Card: 1 of 1)
Classification 00100-Single Family
Mailing Address Property Value
THOMAS EDWARD W ]R& Ag Land $0
GILL JENNIFER L Land $4,139
5252 11TH ST Building $91,294
ZEPHYRHILLS, FL 33542-5030 Extra Features $245
Physical Address
5252 11TH STREET, Just Value $95,678
ZEPHYRHILLS, T ET, Assessed (Non-School Amendment 1) $47,460
Homestead -$25,000
Legal Description (First 200 characters) Additional Homestead -$0
See Plat for this Subdivision
TOWN OF ZEPHYRHILLS PB 1 PG 54 Non-School Taxable Value $22,460
BLOCK 180 LESS SLY 170.30 FT School District Taxable Value $22,460
THEREOF AND LESS NLY 60 FT Warning: A significant taxable value increase may occur when
THEREOF DESC AS FOLL:COM AT NW sold.
COR OF SAID BLOCK 180 TH S25DG 00' Click here for details and info. regarding the posting of
OWE ALG WEST BDY OF SAID BLOCK 60 exemptions.
11 FT FOR POB T[...]
Jurisdiction
CITY OF ZEPHYRHILLS
Land Detail (Card: 1 of 1)
Line Use Code Description Zoning Units Type ;Price Condition Value
1 010OR , 1_132-1 SFR 00114 2,956.21 SF $2.00 0.70 $4,139
Additional Land Information
Acres Tax Area FEMA Code Neighborhood Code(s)
0.07 30ZC X ZHLH
View Sketch Building Information - Use 0100-Single Family Residential (Card: 1 of 1)
Year Built 1951 Stories 1.0
Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Plastered Interior Wall 2 None
Flooring 1 Hardwood Flooring 2 Parquet
Fuel Electric Heat Forced Air - Ducted
/C Central Baths 1.0
Line Code Description Sq. Feet Value
1 BAS01 LIVING AREA 1,509 $84,673
2 FCA01 FINISHED ALUM CARPORT 372 $5,218
3 FST01 FINISHED STORAGE 42 $1,178
4 FOP01 FINISHED OPEN PORCH 15 $224
Extra Features (Card: 1 of 1)
Line Code Description Year Units Value
1 RUDU-M UNFIN DETACH UTIL MT 1986 1 $245
Sales History
Previous Owner: RICKEY KATHI A & RICKEY MICHAEL N
Month/Year Book/Page Type DOR Code Condition Amount
05/2009 8089 / 1298 Warranty Deed 01 Improved $95,000
04/1995 3423 / 0221 Warranty Deed Improved $48,500
05/1993 3148 / 1432 Warranty Deed Improved $45,000
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