HomeMy WebLinkAbout21-2583City of Zephyrhills
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5335 Eighth Street
Zephyrhills, FIL 33542
BNR-002583-2021
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 08/31/2021
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32 25 21 0050 01600 0170 35968 Morse Willow Ct
41 J11 A
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Name: D R HORTON Permit Type: Building New (Residential)
Contractor: D R HORTON INC
Class of Work: SFR Construct
Address: 12602 Telecom Dr Building Valuation: $140,000.00
TAMPA, FL 33637 Electrical Valuation: $7,000.00
Phone: (813) 549-1968 Mechanical Valuation: $6,000.00
Plumbing Valuation: $8,000.00
41
Total Valuation: $161,000.00
Total Fees: $14,600.69
Amount Paid: $14,600.69
Date Paid: 8/31/2021 2:07:17PM
A,
1CONSTRUCT SINGLE FAMILY 3,160 SO FT
�g
Public Safety Impact Fee -Admin $26-35 Electrical Plan Review Fee $37.50
Plumbing Plan Review Fee $40-00 Transportation Impact Fee - City $36.32
Electrical Permit Fee $75.00 Plumbing Permit Fee $80,00
Building Permit Fee $730.00 Mechanical Permit Fee $70.00
Building Plan Review Fee $365.00 School Impact Fee $8,328.00
Transportation Impact Fee $3,595.68 Mechanical Plan Review Fee $35.00
SIF 1 percent Fee $83,28 Public Safety Impact Fee -Police $254.00
Driveway Fee $45.00 Park Impact Fee - Single Family/Townhome $769.56
,Address Fee $30.00
entities such as water management, state agencies or federal agencies.
1-1 #1 333m=
T93rTMOMMITT-17-WIMM
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accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE
I , N-aaa9w
PEfAIT OFFICEC)
RIFA 4 N&I
Permit No,
Parcel ID No
NOTICE OF COMMENCEMENT
State of Florida County of EaS�O
THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real ro e the following Information Is provided In this Notice of Commencement: p pY and in accordance with Chapter 713, Florida Statutes,
1. Description of Property: Parcel identification No. L !",J�GX°�it
i p
Street Address: 5, " +L, it
z. General Description of Improvement NeW Sin ie Family '@SidOnC@
3. Owner Information or Lessee elotmation if the Lessee contracted for the improvement;
Name
�D
Address
3363i
Interest inProperty: �0 ��tppie
city
state
Name of Fee Simple Titleholder:
(if different from Owner listed above)
Address
4• Contractor: 1i,i� } (QrOp iC
City
State
2602 Teieom Dries_
p _®
`
Address
Trat1 ng 3637
FL
Contractor's Telephone No,:
City
_
State
5. Surety: _ N/A
Name
Address
city
State
Amount of Bond: $ N/A
Telephone No.:
61 Lender. N/A
Name
Address City State
Lender's Telephone No,:
7, Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)(7), Florida.Statutes:�
David �'�Ut�G
Name
A dress T 1PronLJrjy� Tames State 3363i FL
Telephone Number of Designated Person: 813-740-9720 City
g. In addition to himself, the owner designates
�11A of
—to receive a copy of the Lienor`s Notice as provided in Section 713,13(1)(b), Florida Statutes.
Telephone Number of Person or Entity Designated by Owner.
g, Expiration date of Notice 'of Commencement (the expiration date may not be before the completion of construction and final payment to the
contractor, but will be one year from the date of recording unless a different date Is specified);
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713,13, FLORIDA STATUTES, AND CAN
RESULT iN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WiTH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing atioe f commencement and that the facts stated therein are true to the best
of my knowledge and belief,
STATE OF FLORIDA
COUNTY OF PASCO
Sig ature of Owner or Lessee, or Owneds or Lessee's Authorized
Officer/Director/Partner/Manager
-Assistant Sc_cr9tarv/D R Nan, Inc
Signatory's Title/Office
The foregoing Instrument was acknowledged before me this _�_i�day of 20 bye �Y .
as ASS.IStarlt Secyr (type of authority, e.g., officer, trustee rney in fact) for
.�, ITIO3�On, 1nC (name of n2rfv on ehaif of whom instrument was executed).
Personally Known R OR Produced identification M Notary Signature..-O"' ��, .�'` . ��'
Type of Identification Produced Name (Print) /
LY'k . Notary Public State of Florida
f' Michelle Moyes
® My Gommlasion HH 066897
af�d Expires 12/2112024
wpdata/bcs/noticecommencement pc053048
--
City of Zephyrhills Permit Application
Building Department Fax-gl3-Igo-0021
,Date Received
Phone Contact for Permitting 2G11C 5 6� CD C�fr� C)
Owner's Name
�- `
Owner's Address �
Owner Phone Number
�
Fee Simple Titleholder Name
Owner Phone Number
Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS
SUBDIVISION
LOT #
PARCEL ID# aA exo20 / =Od=o/ )
WORK PROPOSED
t (OBTAINED FROM PROPERTY TAX NOTICE)
NEW CONSTR ADD/ALT
L �
INSTALL EREPAIR SIGN [�
PROPOSED USE
._-.1
DEMOLISH
l� �i �
TYPE OF CONSTRUCTION
1 .. OTHER
'�` SFR "OMM
BLOCK ❑ FRAME
STEEL
DESCRIPTION OF WORK
>
�t
BUILDING
SIZE
SQ FOOTAGE
=BUILDING
HEIGHT
$
=ELECTRICAL
VALUATION OF TOTAL CONSTRUCTION �r/'
$
AMP SERVICE
PROGRESS ENERGY W.R.E.C,
=PLUMBING
—
E=MECHANI'CAL
4 '; g
VALUATION OF MECHANICAL INSTALLATION''` '
GAS
r
ROOFING
FINISHED FLOOR ELEVATIONS
!1 � SPECIALTY OTHER
�m g _vmm_..
FLOOD ZONE AREA
® OYES NO
BUILDER
SIGNATURE COMPANY
Address
REGISTERED Y / Ne FE CURREt
p� � Y / N
# 8 co 3 �
ELECTRICIAN � License ;a �
SIGNATURE COMPANY .
REGISTERED Y / N
Address � FEE CURREN Y N
PLUM13ER � � License EEC Is Q-
SIGNATURE COMPANY
REGISTERED Y / N in
Address FEE
MECHANICAL License#
SIGNATURE COMPANY h�p�JP- +�-
REGISTERED g I
Address / N FEE CURREn Y / N
OTHER License #T 3
31GNATURE COMPANY
REGISTERED Y /
Address FEE cuRREn Y / N
II
13
&I<HTIAL AttI1P11111I�IdJI Itl
�ESiDENTIAL License
Attach (2} Plot Plans; (2) sets of Building Plans; 6) set of Energy Forms; R-O-
1C[�I1��1I���I&0►II
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/Silt Fence '
W Permi-t for new construction,
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 Installed,
Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Stormwater Plans w/new Silt F
Sanitary Facilities & 1 Engineered
er, Site Work Permit for all new projects. All commercial requirements must maet compliance
[GN PERMIT Attach (2) sets e Engineered Plans, Fence installed,
****PROPERTY SURVEY required for all NEW construction.
Iirections:
Fill out application completely,
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required, (AtC upgrades over $7500)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with no '
VER THE COUNTER PERMITTING tanned letter from owner authorizing same
ers
eroofs if shingles Sew(copy of contract required)
Service Upgrades A/C Fences (Plot/Survey/Footage), ,.
Driveways -Not over Counter if on public roadways..needs ROW
NOTICE OFDEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may bamore restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrlobona.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired anontractor or
contractors to undertake work, they may be required to be licensed in accordance with state and |om5| regulations, If the
contractor is not licensed as. required by iovv, both the owner and contractor may be cited for a misdemeanor violation
,under state l8vV. 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-
8809. Furthermore, if the owner has hired @ 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 bean indication that heie not properiy]iceneed and is not entitled to permitting privileges in Pasco
County,
TRANSPORTATION |KNP/\CT UT|L|TkEG 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 furthermnderotood that Transportation Impact Fees'and Resource Recovery Fees must be paid prior to
receiving e "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 CountyVVoter/Sevver Impact
fees are due, they must'be paid prior to permit issuance in accordance with applicable Pasco County ordinances,
CONSTRUCTION LIEN LAW (Chapter713, Florida Statutes, as amended): If valuation ofwork |a $2.500.00 or more. |
certify that |, the appiioant, have been provided with o 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 SO08On8
other than the "owner", \ certify that | have obtained a copy of the above described document and promise in good f8(th to
deliver ittothe "OvVOer"prior tocommencement,
CQNTR\CTOFl`S/OVVWER'B AFFIDAVIT: | certify that all the |nformat|on in this application is accurate and that all work
will be done in compliance with all applicable |avva regulating coDatruct\on, zoning and land development, Application is
hereby made to obtain o permit to do work and installation as indicated, \ certify that no work or iOat8||at|OO has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all \aYVG regulating
construction, County and City Cod8S' zoning rBgU|@t|Ona' and |8Od development regulations in the jurisdiction. | also
certify that ! understand that the regulations of other government agencies may apply to the intended vvork, a,nd that it is
r0yresponsibility toidentify what actions } must take tob8in compliance. Such agencies include but are not limited to:
- DepartmentofEnvironrnenta| Protection -Cypress Bayheada.VVet|andAreas and Environmentally Sensitive
Lando. VVoter8WamtavvaterTraatrnoOt.
- Southwest Florida Water Management District -Wells, Cypress Beyhaoda, Wet] -and Areae, Altering
Watercourses,
- Army Corps ofEng|neero'SeavvaDo.Docks, Navigable VVademVay�.
- Department of Health Q Rehabilitative Services/Environmental Health Unlit -Wells, Wastewater Treatment,
Septic Tanks. � `
- US Environmental Protection Agency -Asbestos abatement.
- Federal Aviation Authodtv-RU0Nayo.
| understand that the following restrictions 'apply tOthe use of fill:
- Use offlUionot allowed |nFlood Zone "V"unless expressly permitted.
' If the fill material is to be used In Flood Zone "A'. it is UOdecoh]Od that 8 drainage p|oD addressing 8
''compensating volume" will be submitted at time of permitting which is prepared by e professional engineer
licensed bythe State of Florida.
- |f the fill, material is to be used in Flood Zone "/Y' in connection with 8 permitted building using ato0 vva\|
construction, | certify that fill will be used only tofill the area within the stern wall,
- If fill material is to be used in any area, | certify that use of Such fill will Oc.t 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 byf|U.mnengineereddrainage plan isrequired,
If | am the AGENT FOR THE OWNER, \ 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,
plU0bing. SigOS, vVel\s, poo|S, air uoDditiOOiOg, g@o. or Other Installations not np8nif}CB||y included in the application. A
permit issued shall be construed to be 8 ||c8Oso to proceed with the work and not as authority to violate, c8noal. a\ter. or
set aside any provisions of the technical codes, DO[ Sh8|| issuance of permit prevent the Building [)ffio|a| 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 OoOOrn8noed within S[X months of permit issuance, Or if work BUthOr|Z8d by
theper0itiSSUep8ndedorBb8ndoDedforoperiodofS|X(8)rDontha8fterth8ti08[hevvorkiooO0OOenoed. An extension
may be requested, in writing, from the Building Official for 8 period not to exceed ninety (9*0) days and will demonstrate
justifiable cause for the extension, If work ceases for ninety (90) consecutive days, the job is considered abandoned,
FLOP DAJU (F£.
OWNER OR AGENT�~~~/ �CONTRACTORSu d nd sworn to (or affir d) b forp rrl� this Subscribed and sworn to (or affirmed) before me this
by
Who is/are p
,�nall �Jaqwr� tpmeL or has/have prodtiaed Who islare personally knov�n to me or has/have produced
as identification. as identification,
^/~ Notary Public
Commission No. Commission No. .
Name ofNotary typed, printed or stamned Name of Notary typed, printed urstamped
����� �m�� `�~° �
PASCO COUNTYy FLORIDA
Permit
Date Permlt`W7���
Control
County Parcel No, �Su!>E
1�=
Rate:— Sq Ft Unit:
Impact Fee Amount Zone No, TAZ:
SCHOOL IMRA i FED
Account (056) single -Family Detached House Amount $
(057) Mobile Home '
(058) Other Residential -------------
23) Collec1lon Fee
Exempt
Yes []No How Determined
IC3EATI FEE
Land Account Land Credit — Land Total
Recreation Account . Recreation Credit
Zone Recreation Total
TOTAL AMOUNT
Exempt LJ Yes El NO
How Determined
LI FEE
Land Account
Land Credit
Land Tote I I
Facility Account _.
Facility Credit
Facility Total
Exempt El Yes [] No
How Determined
Total Amou
TOTAL AMOUNT
ERLI -------------
WE=
N=
Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of.a copy of this form, placing
the building Permit owner on notice Of this assessment and the conditions of payment for same,
DATE
RECEIVED} §Y_-
RECEIPT NO, --.DATE
BY
Single Family Dwellini4
I. ERE, shall be as triinitnum of'(S" above the road elevation and an engineered site plat],
2- Lots shall be graded to coniply avith R4013 of the RB,C.
4 3
.1, Coarpaction test reqr:rired if 24" or more of Fill dirt is brought in, at any one place,
41"ie in survey required before pouring concrete,
5n Driveways require as R,O,W, use permit, All 4 sides of"driveway thru the sidewalk shall have
expansion material,
6, All setbacks shall be met,
T All property markers shall be Uncovered and niarked at time of first inspection,
All A,D,A. requirements stratll be inet,
9, No electnic, plumbing, mechanical, or fraining shall be covered withOLIt an inspection and
approval first,
10, All Garages shall cornpiv with section R302,6 ofthe F.B,C, (Fire Separation),
11, Appliances stiall not be installed in as location where sulnject to n-rechanical darriage unless
protected by approved farriers, M303A of the F,B,C
12, Water heaters shall comply with sectio.ij P6073) of the F,B,(',
13, Foundation supports Im A/C units shall be raised at least 3" above finished grade. M 1308.1
14, Return air in all bedroorns. f`,B,C', N41620A
15_ Smoke detectors are to be installed in accordance with R3 I 3A of tiara f<,B,C,
16, All glazing reqUiren-ients are to be in accordance with R308A of the FRC
17, All rneans ofegress are to be in accordance with R311 of the
18 "Cireen gypsum board" shall not be used as a backer in showers or tubs, R702A,2 F,C,
19, Conibination-type, AR breakers are required at all locations requiring an AFCI type brrxaaker,
20, Carbon rnonoxide alarnis will be required in rim construction that LISeS fossil -burning heating
or appliances or an attached garage, "I"hey, shall be In in accordance with the FRC,
21, All plurribing, mechanical, and electrical shall be separate from unit to unit, This includes all
undergrotind plunibing and electric,
22, All 2016 N,F,C, Codes will be enf6rced,
23 . Tamper- Resistant Receptacles in accordance with 406, 11 of the 2016 N,pilaf:"
24, In accordance with the Land Development Code, lots shal I be sodded befibre final at least 10
feet arOUnd the structure,
25, R403.5.3Hot water, pipe insulation
Insulationfor hot water pipe with a minimurn thermal resistance (R-valUe) of R-3 shall be applied to the
following:
Piping -,/, inch (19.1 mm) and larcger in nominal diameter
Piping serving more, than one dwelling unit,
Piping located outside the conditioned space,
Piping from the water heater to a distribution manifold,
Piping located Linder a floor slab.
Buried in piping,
Supply and return piping in recirculation systems other than demand recirculation systems,
25. Blower door test shall be provided before C.O.
2& A coL)IL2'the engjcysbivith !ertnifat ltirWies.
27 ' . i erinhit be I, re 'taL
28�, kj`q 'trice )001 Or Screen enclosure is issued wit/ th-is L)e
-t —,L — -Enfif.
F.F.E.-Finished Floor Elevation
F.B.C® Florida Building Code 6" Edition
R.O.W.-Right of Way
A.D.A.- Americans with Disabilities Act N.E.C.- National Electric Code (2016)
PLOT PLAN
DESCRIPTION:(AS FURNISHED)
LOT 17, BLOCK 16, SILVERADO RANCH SUBDIVISION PHASES 10B AND 11C
AS RECORDED IN PLAT BOOK 82, PAGE(S) 72 - 75, OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA.
PI
— - — - — - — - — - — -
N89*58'58*W CENTERUNE 01 156.30,
RIGHT—OF—WAY
ON LOT CALCULATIONS I
LOT
= 7,800
SQ, FT.
LIVING AREA
= 2,372
SQ. FT.
GARAGE
= 538
SQ. FT,
ENTRY
= 50
SQ, FT.
LANAI
= 207
SQ. FT.
PATIO
= 0
SQ, FT.
DRIVEWAY
= 591
SQ. FT,
A/C PAD
= 9
SO. FT.
WALKWAY
= 26
SO. FT.
IMPERVIOUS
= 49%
3793
SQ. FT.
SOD
= 4,007
SQ. FT.
OFF LOT CALCULATIONS
RIGHT OF WAY
= 1138
SO. FT.
DRIVE APRON
345
SQ. FT.
PUBLIC S/W
= 325
SQ. FT.
SOD
= 468
SQ. FT.
TOTALS
AREA
= 8,938
SO. FT.
DRIVEWAY
= 936
SO. FT.
SIDEWALK
= 351
SQ. FT.
SOD
= 4,475
SQ. FT.
40?,
&4 0eh 76
76
PREPARED FOR:
BUILDING SETBACKS
FRONT: 22'
REAR: 13'
SIDE: 5' (50' LOTS)
7.5' (55' & 60' WIDTH LOTS)
SIDE STREET; 15'
NOW
Pc� iRR
01
1. ELEVATIONS SHOWN ARE PER LOT GRADING
PLANS PROVIDED BY THE CLIENT.
2. ELEVATIONS ARE BASED ON NAVD 1988
DATUM.
THIS PLOT PLAN IS INTENDED FOR PERMITTING PURPOSES
ONLY. THIS IS NOT INTENDED FOR THE CONSTRUCTION OF
THE PROPOSED HOUSE. REFER TO HOUSE PLAN AND
OPTION LIST FOR CONSTRUCTION. ALL BUILDING SET BACK
LINES SHOWN HEREON IS PER DATA FURNISHED BY CLIENT
AND IS FOR INFORMATIONAL PURPOSES ONLY.
THIS IS NOT A SURVEY
THIS IS A PLOT PLAN ONLY
I HAVE EXAMINED THE F.I.R.M. MAP NO. 12101CO2118F,
DATED SEPTEMBER 26, 2014, AND FOUND THE SUBJECT PROPERTY
APPEARS TO UE IN ZONE *X*, AREAS DETERMINED TO BE OUTSIDE THE
0.2% ANNUAL CHANCE FLOODPLAIN. THE SURVEYOR MAKES NO
GUARANTEES AS TO THE ABOVE INFORMATION. PLEASE CONTACT THE
LOCAL F.E.M.A. AGENT FOR VERIFICATION.
BEARING BASIS:
BEARINGS SHOWN HEREON ARE BASED ON THE SOUTHWESTERLY RIGHT
OF WAY LINE OF MORSE WILLOW COURT BEING N65'08'43"W, PER PLAT.
(FIELD DATE:I
SCALE: 1' = 30 FEET
APPROVED BY JB
200648 LOT 17, BLOCK 16
JOB NO.
DRAWN BY: DSB
M
0
A/C
S/W
SWLY
4
OF 07-
CO( J
Wipe T
on, 76
76
(IV
Ck
.0
BUILDING SETBACK LINE
CENTERLINE
RIGHT OF WAY LINE
PROPOSED ELEVATION
PROPOSED DRAINAGE FLOW
CONCRETE
AIR CONDITIONER
SIDEWALK
SOUTHWESTERLY
PI
PC
PT
RP
PRC
PCC
TYP
CS
(P)
(C)
PB
PGS
SQ. FT.
F.E.M.A.
F.I.R.M.
NAVD
NGVD
D&UE
D&AE
PDE
PUE
z
I' = 30'
GRAPHIC SCALE
0 15 30
RR/i
11
RPj
POINT OF INTERSECTION
POINT OF CURVATURE
PONT OF TANGENCY
RADIUS POINT
POINT OF REVERSE CURVATURE
POINT OF COMPOUND CURVATURE
TYPICAL
CONCRETE SLAB
PER PLAT
CALCULATED
PLAT BOOK
PAGES
SQUARE FEET
FEDERAL EMERGENCY MANAGEMENT AGENCY
FLOOD INSURANCE RATE MAP
NORTH AMERICAN VERTICAL DATUM
NATIONAL GEODETIC VERTICAL DATUM
DRAINAGE & UTILITY EASEMENT
DRAINAGE & ACCESS EASEMENT
PRIVATE DRAINAGE EASEMENT
PUBLIC UTILITY EASEMENT
—1sc. r -1 r— I ...
1. THE SURVEYOR HAS NOT ABSTRACTED THE
LAND SHOWN HEREON FOR EASEMENTS, RIGHT
OF WAY, RESTRICTIONS OF RECORD WHICH
MAY AFFECT THE TITLE OR USE OF THE LAND.
2. NO UNDERGROUND IMPROVEMENTS HAVE BEEN
LOCATED EXCEPT AS SHOWN.
3. NOT VALID WITHOUT THE AUTHENTIC
A5hA ELECTRONIC SIGNATURE AND THE AUTHENTIC
ELECTROC SEAL OF A FLORIDA LICENSED
S
M E-- FR I C:� ,n,, NJ SURVEYONIR AND MAPPER.
L-J FR V E "T"I N 0 Digitally signed by James W So —on
,�c %
44- DN: -US, st=lrorldd, ND
A P P I N G I N C. —AMERICAN SURVEYING & MAPP!NG,
INC., cri-Jm., W i3i,le—n,
CERTIFICATION OF AUTHORIZATION NUMBER LB#6393 emall=jboleman@asmcorpo,ate.com FOR
3191 MAGUIRE BOULEVARD, SUITE 200 Da e, 2021.07.26 10:41:22 0400' THE
ORLANDO, FLORIDA 32803 . . . . . . . . . . Adobe Acrobat version: 110.23 FIRM
(407) 426-7979
WWW.AMERICANSURVEYINGANDMAPPING.COM JAMES A BOLEMAN PSM# 6485 DATE
&i 7.:r rqr,City of Zephyrhills Permit Application Fax-613-7,032t
Oe's Namet om Number
OW"Oes Adiftess' _ Owner Phone Number
Fee Simple 1 illett ld r Nun der ne a b
Fe* Simple ThWhold*f Addmrs
J
ORTARRO FROM PROPERTY TAX WWI)
WORK PROE NEW erRSIRj NQQAALT 4v� NI Ls H+
ST.At to ] REPAM
PROPOSED use 17-1 l ^e case R ,
TYPE OF CONSTRUCTION SLOOK FRAME S;E ;
uaLracs 81Zf SQ+a7 �iEt�iT
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AMP SERVCF, PROGRESS ENERGY ,�E �
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FUr, U ZONE AREA YES,
1
SIGNATURE OOP Y
RFOIST ED v f N v G(1RRFra } ,
dress
ELECTRICIAN� Y �.
SIGNATURE ftE l3TFC1 Y ? ]N� FED RRFR Y /#
Address
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it$Z Fa „
SIGNATURE COMPANY
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at Corr{€aMr sign £same or appt cat,—, nreo
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OVER THEE COUNTER P i0ITTING (Coon of Contract T±¢aun ati)
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NOTICE OF DEED RESTRICTIONS: The ur em% Ma be su 0 to "deed' rthlitrial na'
voeraigned understands that this P Y b dt
q—,
applicable deed restftbOnS,
UNLICENSED CONTRACTORS AND CONoR RF-SPONSIBIU'r)ES: lf the owner has hired a contractor or
contractors to ubdertake work, they rimy be required to be licensed in accordance voth state and local regulations, If the
contractor is not licensed as required by low, both the owner and contractor may be cited for a riasdanxesnor violation
under state law, if the owner or intended contractor are, uncertain as to what licensing requirements may apply for the
intended wark, they are advised to contact ft Pasco County Building inspection Division —Licensing Section at 727-847-
8009. Furthertnore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Bic ear this application for which they will be responsible. it you, as the owner sign as the
contractor, that rnay be an tndicirtion that he is not property licensed and is not entitled to permitting privitoges, in Pasco
County,
'I RANSFURIX110N IMPAU 111.1 [ILI Itb IMPAL; I AMU KtbUUKI,;t MtkiVVtKT rr=*: Ing Wvertligneit once nos
that Transpridelton impact Fees and Recourw Recovery Fees may apply to the constntireon Of new bultdings, change of
use in exialft buildings, or expansion of existing buildings, as specified in Pam County orotrance number 89-07 and
W-07, as amended, The undersigned also understands, that such fees, as may Ite diLls, salt be rdardifiad at the time of
It 'din 810 pFlor to
emil 9, it is funhor understood that Transprirtation Impact Fees and Resource Recovery Fees must be P
receiving a certificate of occupancy' or post power release. If the project, does not Involve a certiftWe of occuparr-Y Or
final power release, the fees must be paid prior tea permit issuarce. Further rmire, if Pasco County Water/Sewer Irate
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco Caunty ordinances,
cONSTRUCTION UEN LAW (Chapter 713, Florida Statutes, as amendedy if valuation of work is $2,M0,00 or more, I
certify that 1, 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. It the applicant Is someone
.-*hc, 'hor, in. "b"N'rIct", th-31 I havc- obtztrcd -- --opy of the abovc dca-cribcd docu=rIt P,10miso In good faith to
deliver it to the "ownor" prior to commencement,
CONTRACTOWS/oWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in,complianee vAth all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indioated. I oerfiN, that no work or installation has
cort mencer! prior to issuance of a permit and that all work will be performed to meet standards of all Isets regulating
construction, Ciounty 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 resporisibifity to identify what actions I must take to be in corrIpliance, such agencies indude W are not limited to�
Department of Environmental Prc4ecTxx,,-Cyprem Bayheads, Welland Areas and EnvironnIeritally Sensitive
I alms Wiupriltif;mlewater Treatmert
Sou thwL at Florida Water Maragpmenr Doyfiet-Wells, Cypress Boyhoads, Mttand Areas, Attering
,
watercourses,
Amoy Corps of Engineers-Seewags, Do0s, Navigable Water"I's,
Department of Hearth & Rehabilitative Services/Environmental Hearth Unft-Wells, Wastewater Treatment,
Septic Tanks,
US EnvironmentM Protaction Attency-Asbestos abatement,
Fe0eral Aviation Authorityr Runways.
I understand river the folloWng restrictions apply to the use of filt
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', a is understood that a drainage plan addressing a
tIubmitted 2t ti!re :,! penri !nI; fes,�k —?! er-i—
ficore acd by the Statc of Florida, u if the fill material is to be ''sed in Rood Zone 'A' in connection vdth a permitted building using stem It
corlstaiction, I certify that fill will be used only to flil the area within the stem wall,
If Oil material is to be used in any area, I certify that use of such fill Wit not adversely affect adjacent
properties. if use of MI is kund to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached pwrrilt application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
It I am the AGENT r-OR THE OWNER, I prowfte in goof faith to into ft owner of the perftitfing oanditions set fact h In
this at devit prior to commencing constructon. I understand that a separate permit rmy be required for efectricei work,
plumbing, signs, wells, pools, air conditioning, gas, or other In Ilan not spocitioally juetuded in the application- A
ycm'�k *")' , " '- , --- ` tom, — I - --- a, ---- �-
wt aside any ord"fans of the teetiffin) codes, rw shail i"witce of a pertrift prevent the Buddirq; Mal from thereafter
requiring a irottection of errors in mans, conStruction or violations of any codes. Every pennit issued shall timme Invalid
unless the work authorized by such permit is commenced within six MrIths of permit issuance, or if work authorized by
the perrnit is sUsPend or abandoned for a penod of six (6) rmnithe after the firne the wcRk is corronenood, An extension
may be reque.0ed, in writft, from the Building Offictai for a period not to exceetl ninety (90) days and will demonstrate
Justifiable cause for the extension, if work ceases for ninety (90) consecutive days, the job is considered atrandoned,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT iN YOUR
PAYING TWOt FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
MEM
E
4"bfret,on --- I I --/ as i�*Itlt"ton
AMANDA ACKER80N
f""Y # CG 925,49C)
EXPIRES: Fobwary 23,2024
EX,P,'RES: Februlry 231, 26 24
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