HomeMy WebLinkAbout21-3159City of Zephyrhilis
5335 Eighth Street
Zephyrhills, FL 33542
BGR-003159-2021
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 11/08/2021
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed ir.
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE
1:14 :4 6 112 *:q:j 10*4 - ' I lot
IJ
PEfIT OFFICEU
ITHOUT APPROVED INSPECTION
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permittin ...
Owner®s Name l Owner Phone Number `='t6 U I �)
7Z . r r
Owner's Address .,� � -„ ._ �=-- m .. Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ....r ,. _.. LOT #
SUBDIVISION PARCEL ID# — Y 1 d O
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADDIALT SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
PE OF CONSTRUCTION BLOCK FRAME STEEL
BUILDING SIZE SO FOOTAGE
BUILDING 1 ,, �-J
VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C.
PLUMBING $
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
GAS ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED YIN FEE CURREN Y I N
Address License #
ELECTRICIAN COMPANY
SIGNATURE, REGISTERED �/N FEE CURREN Y/ N
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED Y I N FEE CURREN Y/ N
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED Y / N FEE CURREN Y ! N
Address License #
OTHER ?} COMP Y `
SIGNATURE REGISTERED Y/ N FEEiRREN` Y I N
Address f � � � �S License #
11Ia1111wI1111111I1lHIIIII�IIIIIIIIIIIIIIIIiN11�111111I11Ilil�l�i11
RESIDENTIAL Aftach (2) Plat 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 wt 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.
.4.41411
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)
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
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.
UNUCENSED CONTRACTORS T CT"OR 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/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 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 NE : YOUR FAILURE TO EC NOTICE OF COMMENCEMENT AY RESULT IN YOUR
PAYING IC FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO TAI FINANCING, CONSULT
IT li Y URLENDERORANATTORNEYBEFORERECORDINGYOURNOTIEOCOMMENEMENT.
FLORIDA JURAT(P.5. 117.03)
OWNER OR AGENT CONTRACTOR t
Subscribed and sworn to(or affirmed)before me this Subscribed and sworn to(or affirmed)before me this
by by
Who is/are personally known to me or has/have produced Who is/are personally known to me or has/have produced
as identification. as identification.
(Votary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
INSTR#2021241538 ORBK10481 PG437 P-,- i of 1
11/0812021 09:11 AM Ropt: 2376012 Rea: 10.00 DS: 0.00 IT: 0.00
S/H Nikki Alvarez-Sowles, Esq,, Pasco County Clerk & Comptroller
Permit No. Parcel 10 NO
NOTICE OF COMMENCEMENT
State Of County of -ra-11
THE UNDERSIGNED hereby gives notice that Improveraftnty4ft be Made to certain real Property. and in accordaT,,:,- *y"n (11-All"i 17r-711"k-�w"V st-hAT--
%1W10
1 General Description of Improvement
UINNIEMy�
If the Lessee oontracted for the improvement
Interesi In Property:
Name of Fee Simple Titleholder.
(It efferent from owner listed above)
4.
eery
Contractor's Telephone No.: state
ite
5. Surety,
Cdh State
Amount of Bond: $, Telephone No.:
6. Lander
Lender's Telephone No.:State
7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 71313(l)(aX7), Florida Statutes:
Name
Address City o State
Telephone Number of DesWudad Parsee:
8. In addition to himself, the owner des4nates Ot—
to recahre a copy of the Uenora Notice as provided In Section 713.13(l )(b), Rodde 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 compleden of construclim and final payment to the
contractor, but wild be one year from the date of recording unless a different deft is specified):
REC 6 AD to AND -P'O'S' T'E"0"-O N* YRE —JO B-'S' 11FT YO e- ` " 11 % � V MU; --R C E 4.AIT AWT BE
EZE BEFORE THE FIF U INTEND TO OBTAIN FINANCING,CONSULT
1:
W1TH YOUR LENDER OR AN ATTORNEY FORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT,
Under penalty of pedury, I declare that I ham read the fo ng notice of commencement and that the stated
Of MY knovilodge and belief. reglal feels therein are due to the beat
STATE OF FLORIDA
COUNTY OF PASCO
SHERRYMONER
•turof Ass", or
C-10113(on # GG 162748 Offlow/DirecelorAlarmselviamager
ExPirOS1OOM1100,2021
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ROOFING INSPECTION AFFIDAVIT
Permit No.:j32L'c)().3
licensed under Chapter 468, Florida Statutes as a(n):
Contractor F Engineer— Architect_ Building Inspector_
License No. C C C - If-- Y--) V -Z-
On or about —LL �q did personally inspect the:
Check: Roof Deck Nailing--L.:L— Dry in Flashing and Drip edge-L--�
Check which was used: 30# felt— Peel and Stick Other (List)
At the following
2eitirp-,r- cz-� f 7,0L, PA
Based upon that examination, I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on Section 553.844, Florida Statutes).
Signature;-142��
STATE OF FLORIDA
COUNTY OF PASCO
Sworn to and subscribed before this day
BY:
Notary Public State of Florida