HomeMy WebLinkAbout20-1244 ;Q r �
City Of ZephyrhiliS PERMIT NUMBER
5335 Eighth Street
Zephyrhills, FL 33542 BGR-001244-2020
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 12/17/2020
Permit Type_: Building General (Residential)
--Property Number Street Address
14 26 210010 03100 0061 38611 C Avenue
Owner'�Iriformatio ri Permit,lnformation Contractor Information
Name: DAMES PELTO Permit Type:Building General(Residential) Contractor: HOMEOWNER
Class of Work:Electric Service Replacement/
Address: 38611 C Ave Building Valuation:
ZEPHYRHILLS,FL 33542 Electrical Valuation:$700.00
Phone: (508)485-4811 Mechanical Valuation:
Plumbing Valuation:
Total Valuation:$700.00
Total Fees:$45.00
Amount Paid:$45.00
Date Paid:12/17/2020 8:34:38AM
Project Description •1
SERVICE UPGRADE
Application Fees,-74' : -
Electrical Permit Fee $45.00
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.
d-
17'- CONTRACTOR SIGNATURE PEJA IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-7$0•0020' City of Zephyt'ttills Permit Application Fax43-780-0021.
Buildlrtg,Department ,
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=GAS [� ROOFING LI;', PECIAIzTY QTNE
FINiSHELy PLO"OR ELVA 1`IONS '1=LOf�ti ()N1R:'Arz ►' _
BUILDER
SIGNATURE
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ELEtrTRICIAN•-. .. . .. : •: .; ': � :. •::,. ';,.:;,�-,., tCOMt?�ANY;�:`=:..�,....;�'M��s __ �+.: '= e=',
SIGNATURE /
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PLUMBER. :f'c'_:C.gMPANY'.,_ r #
S` NATURE:'>: :n s co''RECi sTE D' `sY :r'':ftl=` : "FED CIJR.Er,'"
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SIGNATURE, REG'srEu:; `Xl;"N;�.. t :ciil3ltEn
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OTHEi� - `COM�Ai�iY', :�#`'�
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IGNATURE" E 'Rt:GISTE El} 'S�J.i'`Y•/a;N=_F ^eFEE'C@RIiEfS'7'' dPi�%L�I:t
Address r z' ;�$:_
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=�'t¢G'u fi. ,r.' :,+rr^..f,.:r v, -':, ,,gs '•Y•� ,,yy',:: �: VV
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�2 of� tl�'spa n'�,�'�:''�'�'€�h �P� ^%� s oFid.�
RESIDENTIAL AttaChci(�`'Pto�l?iartsr.( ;`sets_ I3u)l �r�` a.s� ��.t;0 it ' . ,..� ;�� _h.,fo `eaar, � ,Zv.,,.;%�.�:;.:�'r`.{-;' '�y=:.:;'.r;r,.
Minimum-ton.(10);working'ilays ftec submittal date::.F2i giiired:ogsit ;4brislniciton Plon"s;'Stoi`mwator.Pl rt , I"'Silt: isn i►�'s".t�illetil, '''
Sanitary FacI11ti6641-dumpsW,!Site.:Woik Perim#.for.:subd-,$16fiMl rg8.projects
COMMERCIAL -�'�Attadh-(2'4corhplettsetss6f.B.uitdirtg,�?lans,ptus-a''L�ifo?S�fieiji����;(1.)�etbt•.Ertecgyifibnms.,W=,WPermIt=for;new�olistnrotton
Minimum?ten'`1°0 woiin''1in :eRer' iftiihi�it!3it °f`R' Timh'siteoristncdoriPl o"s`StoVrinia^te1'tlafi'sr %'Silh`'n�cesitst8lledr:r`'''
(I0), a .Ys I3 G
San3 ry Fai iirtles°& I:dumpstei';:`pte;:Wotk peirKi t_o)' rfew:ptxiJects Aii'coneicletdaF.i ui(e�iterlisrmiast:rlieatjcsoin ]tatice''
S.iGNVERMiT Attach(2)sets�ol3Engineered Plafins
"""'PROPERTY:SURvtsY•fegUTred.foralFNEW�oonstr iction. . -
DireCkitinsa. .
Fill outc8ppiicatlon.completely.. .
Owner&":Contractorsigr,;IJ Ibfapplfcation:rtctaft6d:
'If oirer$;g1gP;.a Notice:of Commencement red required,".,(A1G.,upgredes aver 5.500).
Agent(for the contractor)or Power of Attorney owner):would be someone with'notailzed letter from ownei authopzing.same.
OVERT
COUNTER PERMITTING (Co�jr:of'ogr+tractregyliTiad);. :,.;}+.;,;:,
Reroofs if shingles Sdwers Service Upgrades,A/C Pences'(PlotlSurvey/Footage)'
Driveways-Not over Counter if on public'.roadWays.:needs ROW
:NOTICE'OF,DEEDwRESTRICTIONS: The undersigned anderstaiids•that-th'is:permit.may be.subject to"deed"restrictions"
whicli:rr►ay tte nore';restriptive an Goun#y':reguta respons
#Ions. The undersigned assumes ibility fior'compiiance:wth..any
d s rictions :' ;
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f}wit=. .--^.••-,.
LIC Eli'Cb T11CTOlipo
S»'.,At�IU.:CON� RATOR.RESPOYSIBIITIES if the owner•:has`hiref ya.contraetor':or`
;eontractgis to,;undertake work;«hey?.may.beAarequired�to belicensed-in;accordarice;vlth.:state;andrlocal,regulatio(ie; ?ffg{the
contractor is not licensed as required:bylaw,:both,.the:owner and contraCto"rrrtay be�c"ited-far a"misdemeanor violation
urrder:state°Flaw:-,;lf the owner. or,intetidedantiactor_are:tn,certarn,_aswto what:ttcensing.reguirerrrents.may-applyxford:#he,; ..
u,.;J....
lintendedwirork;they`are;.advisect#o,contact-the--Pasco Count' Building,ylnspection Division-=L ice
nsing-.Section atT27-84Z-'
8Ot39a,;Fuctiierriore:=lf tie ownerasireda:xcontFac#or;or.utxantractors,;he`is::advised;to have'the,contraptorsYsign
po,ions oUthe;°�corit�actQr t310 k"`,of:this:: ppltc000 for;iNhi. they witi LL eeponsibie. If you; as.the.awner..sign as.the
coritractor,.-that.may.be;an indication that he is not'pr' erly•lieensed.:and is not entitled:to•permitting;privileges,in Pasco -
TRANSP-,ORTAXaON.;IMPACT/UtIfLR1ES:IMP#1CT`ANDRESQURC REEOVERYFEES:: The undersigne77
d:undersfands
that Transportation imp ct Feees anl-Recourvb_, ecove l=ees=may=appty t�or ttie construction-:of new:bulldings,change°of"
. _ -
;u0',.in,.existing:.buildings;;or:expansion;:of.'existing`.tiuilding�, as specibed•in'•Pasca County Ordinana®.bomber- 89=Q7-and.
90xt)7;'as amendad The undersigned talso indars#ands;:,that siicFi-fees,,.asrn?.ay be.;due,will ybe;identifi_ed bUthdi#imevof.,"-
permittrng lt;+is furttie�iin`cfertsCood thafi;Transpo�tation.-Impact.fees and Resource Recovery Fees must'be:paid prior to
;receift -"A''certifid o occupancy°wot;-fnal;p'bwer release.: If;7tF a prplect.d es�not in
a:»certificate of,()ccupat wor::_'°
.Anal pauues:release;">the,fees must be paid prldr'to-permit:issua�ice:j Oiirtllei�riore;��=if;Pasco County W-aterlSewer-Impact
fees are tiue�they m6 V6e paid plior�#o peri�iitiis uanae in accordancelwithapplrcabie Pasco.County'ordinances;; ;.x
CQNStUC LONf�iC-i►l C.A1ilfChaptpr�713,; tordi Statutes;,,aeapepded):i,if valuation of wbrit is$2 501).00 Qrmore, l
ppli�antr#lave been,.-O vjded:;.with;a�copy.::of`tFiew"l=torlda or struc#ioh lien•t. Homeowner's
Protectign Guide°;prepared''by'the::Florida:Depart men t`-of'Agricul#ure"and;:Consumer Affairs. if tt e'applic rlt=is:§cq, ,n,.e
o#tier than the"Du ller tertify that l�tta�re�titainer4 a�copy of#1ae=aooVe�descFlbedrdocumen#;antlrpromise iri gaoc'fa h to '
deliver itlo,-.the•"cwner°<prlor,40,commencQmdi t.
} l= :ilJkVif .f:Icert' tha#-Oil, he ortnation';i 'ftiis..a ileation is�accuraWandEtha#all work'
Ct?NTRA ,7t>R ST1!1f fF1ER S A; ._ .,k :t.:.�X;.,.:,. j,. I�- PpMahe
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■Arm ._ - ::s -}:. ,.,... °',' ~33,-..i�=s..L�;:>:,:"A
-
. - �!•=- '.5. 1'f'Y`•' ••L - - -,-t •?t'!-}, '9`..`=a:., tin `I riA-�• - y.at
wip.be done'iri`:com l an'66-with;'aii a lddble":laws:'r"e Uldtin �:coristrE ction;,zonmg.and:a"development'. dp��icatlon=.iS`
Hereby made`to-o6i6in a permit to d6,i%Md kj aed►:iristallati'on}'asr Iriidicated:. .t•certify,'that no work�or.iristal6ff -has
commenced: 'rior,to'isstiancea cif;'a„_permit:and:.tl at,all,work,iarlll:be perr&med to meet standards of all laws regulating Jj
'cons�rc O"" 'CQunty and'Clty"goodeVOMdningi:regulations, snit=land develapm:ent regulations"iristhe jurisdiction .; !'also
certfjr tnat:l`iiriderstand<'tttat'the regulatlant of other.government`_agecicies.maYapply..to:'the iitte ided worii,:and:that if is
my.responsibility:to identify what actions 1 must take.to'be in compliance. Such;agencies�lnclude;but are not-iirnitred,#o:
Departrrierit of:Environmental Protection-Cypress.Bayheads; Well Are and Environmentally°Sen'sitive
�Lands;aNater/Wa`s.#ewatet.6T�eatr�nttt.;,«<r; ,. "?"Al"Southwest Tlodda. Water•' Mar a�ge1!n bi`strictmd-,11,` :Cypre's_s Bayheads; Wetland Areas; "Al" ng
Watercourses.
Army::Corpsot Engineers-Seawalls�Dacks;t�4,vigatiie Waterways.
Department of Health 1 ;itai%i!€tative`- ertirices/Enuirorameiital Health unit=VlFells, WastewaterY Treatment;.s,
'Septic�Tanks:
-:LJS En iir him' 'i?Ze1R.r i az l el�Yer �+ k�bstaa'. .batQmpr�try:.: ...
.:federal;Aviatlon'Autl ocity« t iniarays =
understand:thafthe`1'ollowingrestFictiapa,appiy;tothe use dfffllN' .'
UseldfE it is riot allaweo ici Flog #ae: axpcesslygpermi##ed.
'if:~the:#tlt�mateirial~is to':be`>useit' n+'Flaod 2on`e: A ,_.it as=unlefstoaathat'r=a=drainage "tar} addressingy a
wo! m'e will be sutiii�itted'at`tiriie.;ofr rmittin which;-Is, re aced b a. rofessional:-on ineer
n! e Ct lg :�..�-TI n
licensetl'tiy tli State'of Flordda _ - --- - -
If ithe fll mat®rial;`is to'.be::used„irS;:Flood Zoi44AT41-106coniiection•with•'a permitted building,using ste �zwall•_,-
co: '" -t ceit'"tFiat fill i ilE=#a"'' ei I'onl..:toi It ttie+area}uvittain;the..stem:Wall..
n Qn..._ _.>fy; a. .Y
- if fill-rr aiteTiat:is.'-t�`>t%e seid..ii :::any;-atea, J :cettilj%tFiat`u a of"such fit wi1t'.:not"adverse)y°affect:adjacent`
xo'ernes:: if usemof filE`isstaidxor{aversely; iffept:adjacent:l�rQpiiets�the.owner::may._.k�e;;cltedfor�iolating
the co%iditions of'the builiiing perritit issut3 iutiiter#fie vattaiahed{iermit'appiic, ition fot dots°less-than one(1)
acrswhjol :are elo�raten `'e ngin eretl:tlraii# ierplan"iS rrequired.
h -�;p e_:; 9
If'lkam the AGE[ T E3R !'H Q IfNER;'1:p Ilse<ln.good aitt e r t rit Xtba:owner;of tho:,perm#Ling;:conditions setforth?in -
s»
this.;affldavitprior:to:commencing;;cons#rue#ion:: I understandttiat:.a seacte;pe�mIt:`me�i'be:reiquired:for.'electrical,work,
pIuKS, ="ii`.,.': slias";swells:= "aols air''con'ditioni»' s.:o others:il stAla#iai svnot:s .eclfica!!' included in:the a licatio6'°.A
»,rnbI.,g,,...=9l-_.... _._P ,.: .._.';...._ _,.i�-l .,i.:=. :. p _ y.:... _,., -.._..,. . Pp. . .
permit issued shall:be:construed to be`a license to.proceed.with,:th&.v obi .ano not•as.authority to:viotate, cancel,:alter, or
setaaside`:an rovi io s,of tf etechnical=codes;wnor-shall lsstlarlce'_of:a,perml#prevent-the•Building`Official:from:tl ereafter'�
r Uiri , ,,a:: otrectjoci-af:.errr rs in,:plans;constructtori orviolatioi s.of anj_codes: :€vety�perMiOssued siial become.mvalld'r
. ....
unli6ss,the,work authorized by such; , linitls:commenced within sIz months of::permit issuance, or`if,work:authorized by
this eti lit-ts`:susperidecfio abandoned,for=a=psraod of six{8}rridriths after the tlrnethe::worlcas_cornet@aced,—An•exterisstin.
m'aycae;,requested ih„writing;.;from`the Cuitdiitg Official'fort;a.period not">to'exceed ninety.(90),days and-wiiC:demonstrate
justable cause for the extension itworcea•ses fortninety;( )consecutive days;the job:is considered abandoned;
WARN NG=.TG::QViINER :2::Y0Ul ?F;AI,I U�tE:T4;'REGORR:A'rvNOTfCE OI=.; OAAMENCFMENT.:Ma►Y<RES.U�' IN YOUR
t?A�1� fixl�lf�(�tt�. � �R{�if111A�tiI �'f �ltt�U,.�SPttt�ft!EttT�f,-r�tt#'Yt�'4t '`1'�Rp�TQROBT'1,l!1[!txl�1[�`- �tf±tts,}� .U.SU�:T.
IAl'1 'F!°YG1UR:1Ef1tl)ERORs#AWK'A7TORILYaB:EQ1tt2EiCOttD NG�YbU121NOt:E:OFCOMNIE;CEIIII T:
FLORtI�A?':l.C�.FiHTz�FS y7TQ33.. —
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OWNERiQR;�1GlENT G7E1 >: C.QNTRAT
etia r'e`mea_Ss,_;.Subscaparid: vamto.(o�fl+rmel¢stgr ,m�rtk► - bsori oi:RQ'(.. - .-rm, .). :
r:
Who Is/are`pe�sonally'kriown.td,rite or"heslltave;prodec�ci"' iNiio-ts/are p'ersorially kriown'to`.me or°hes/fiaye produced`.
a'sadentiflcadon; ``as�idenUfic�tion-,
Notary Public Notary=i?ubiic
Commission No. Corn sio0 No.;
Name.of.Notary typed,'pdntedor:stamped .Name ofNotary..0"W- ;:pAh'ted.orstamped
e►
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS-BUILDING DEPARTMENT
Y 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 Zephyrhiils Building Department.
8. That prior to final inspection any additionai 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. 1t 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 DXn ^/7—,.�
DRESS V
HONE - l
WITNESS PERMIT
VMwterformsr0wnasAffidavivrtov07