HomeMy WebLinkAbout21-3175City of Zephyrhills��
5335 Eighth Streety�,
Zephyrhills, FL 33542 BG -0031 i5"2021
Phone: (813) 780-0020
Fax: (813) 780-0021 Issue Date: 1111212021
Permit e: Building General (Residential)
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02 26 21 021A 001<00 0040 38341 Ironwood Place
Name: CAROLE THOMPSON & LORI Permit Type: Building General (Residential) Contractor: SCOTT BLACKMAN
FORSHAW Class of Work: Reroof (Shingle Only) ROOFING INC
Address: 38341 Cottonwood Place
ZEPHYRHILLS, FLORIDA 33542
Phone:
Building Valuation:
Electrical Valuation:
Mechanical Valuation:
Plumbing Valuation:
Total Valuation: $0.00
Total Fees:
Amount Paid:
Date Paid:
REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) .
localgovernment shall•• of •ur times the amount of • imposed for the initial inspectionor
first reinspection,greater,• each • -•uent reinspection.
I
®® CONTRACTOR SIGNATURE
Fill out application completely.
owner W66ntrioto slgnbaa_of appllcatlona.notalrzed ..
If'over $2500} a Notice of Coster ncoment is required. (AIC upgrades over $1500)
•" Agent (for ties contractor) or Power of Attorney (fdr"the'own r) ociid be sdrn ne With notarro�ed:il�tter from owner r authorizing arrre
OVER THE'OUNT PER I_ = NG (copy of ntract r ., uir )
Rerooft if shingles Sewers Service races°`A+l ' F'erideSIPIOUSurveffootage)
Driveways -riot over Counter if on Oublic roodwaysa.needs ROW
NOTICE OF DEED.RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictlk is'
which may be more restrictive than County re dletiohso The undersigned assumes responsi6liiiy for cord liande with ay:..
appIlcebe $ded to trictipaS w .UNUVCENSED CONTRACTORS lAND CONTRACTORi tC "Ti If the owner.,h i hued a'7d ntractor or
contractors to undedsKwQrK,they ayA e re ;irbd t be licensed In a . rdance with state an, ocal r Motions:,)'llf the
contractor is not licensed,as required by law, both the owner and contract6r may be cited foe a misderneanbr violation
unddrx tate.:Eaw. If the TMowner or. inter` e` cbrltrector re uncertainaasJo what J1 nsin, regiuir marts..- as l ,0," he°°
intended work, they are dvis d tb contact the Pasco County Building Inspection i l ion—LJcensihg Section at 727-847
8009 Furthentmrev-If-the-,owner hhIred* aCOfltlCtor or c ntrp t .rep .he is,advised.t ,ha t e dhtr tdr( ) slgn
portions of the="contraCtor Block!;of. is-applicatlonfor which they xiwill.a v espon ibl if you as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to perittlngpYJlgeLiflP=P, q .
County
; ., o
T T TI NoIMPAC JTILITI IMPACT AND RESOURCE RECOVERY FEES The undersigned under t nds
that Transportation Impact,.Feesd rid: arse. e y ry b s may #h ch rage bf
use In existing buildings, or expansion of existing buildings, a� spepife in Pasco County Ordnance number 89m07 and
9007q as amended The undersi Q d; is j et rfands; that sudh'fddsa as •ay beduerwilibeidefltified:at the tl l `of`
permitting. It is further unérstood thtiransPOrtatiOn Impactif e a d eso r tRe I covera Feetsrf.musticate� paid
prior
to or
receiving a TMcertifcote of Occupancy or final po er release¢ pf 3 ,r
final rpower releases the must*bexpai prier to,permit issuance. Further Ore IVPO County Water/Sewer Impact
fees. re dti .they.. last bex a% , rior,to-perm ltl `seance in accordaneth appii able Pasco County ordinances
CONSTRUCTION LIENLAWChaPtW7l$ Florida Statutes,as.amended), 'If vatuabo of work i1 2, QQ QQ r more I.
certify that I this applirtt; have eenw°prayided-with a copy of the «Floridaronstrctin ien La o e®wrier&s
Protection_ aide" prepared by the Florida Department of Agriculture and Consumer Affairs if the
other than the owner", i rtify'that l hav gbtained a copy of the.above*Scribéd doc4r '�' nt nd ise n�� nod faith to
deliver it to the"owners prier to. menpemerlt '
CNfi 'C°IrRt % NE12I ,'.RFtiAtIrtitlatiallthe.iafdratdlrithiapltcttop $ ra„tat� Ftat� ior =
will be done In compliance with all a plica e laps re@'pulatiI1g nstruction, onirr and l nd developr tent App t tlbrPis
o, x k
hereby made to obtain a permit to do work a i,.thy ad styli tlbri as°hidi".Q"tede It certify that no work or instellatiOn has
co once r prior to:`issuance of a permit and that all work will.,be performed to x meet,s nd rd A of all laws regulating,
construction, County and City codes, zoning regulations and land dove dpmePt regulations In the jurisdictions °1 also.
certify that I understand that the regulations of otherto be in compliance h a enciets in�iud but are notellmatediti ,P and that it is
my responsibility to identify what actions I must take p Wetland... �eas.and..Envieonrnentali Sensitive
Department of Environmental Protection-Cypress ayheads,
Lands,WaterMa5tewatereatmeflt.
® Southwest Florida Water Management District-Wells, Cypress BayheadS, Wetland Aras, Altering
WatercourSes.
® Army Corps of Engineers-seawallst Docks,Engineers-seawall Navigable Wafeays
Department of Health & Rethbllitative er ices hvtir A. . taliHeâlth*hJhitWCll1 Watewater Tr t . ern
Septic Tanks,
m t1�� i yirort .rat i t=btectiet� agency Asbestosiabatement, .
Federal AvistlenAuthoritYRuflw8Y5.
i understand thatsthe folio to r trlctl aPt Y to the ue of 1111
Use rof ILi not allowed n a d ` ear unless expressly permitt
If the fill material is to k used in Flood Zone= „As, it is understood that a'd ins a plan ddressing a
® "compensating voltarnes: ill be submitted at time of Fpermltting which is.prepared by a_prdfesslonat engineer*
licensed by theState of Florida
® tfth =fill ati3Ciatito ..bus pan Flood:Zone "Ainsti inn s tion with a permitted building using ter wall
onstructiog� I rtify that fill will b • sod•bnly to fill the rea within.tbe$temWaIl.
if fill material is to be ueed,in any area, I certify that use of such fill will not adversely affe t adjacent
properties :If use of 1111 is found to adversely ec#adjacent rgp rt�e�t the q nor.:ma b cited fo#vie etln
the,conditions of the building permit issued under the atfach'ed permit application, for lots lessthan one (1)
acrey hic;0`4re ele�r tedA iIA a piginoered draanag 1pn is₹requir
et
if I am the; "TFi R, 1 promise in' nod faith to diteg s het forth in
this affidavit prior to commencing conStEUCtiOfle I understand that a installs s me ecit may Il ibe requlredfOr eIu n the electricaltonork,
plumbing;0s! ns,-wells,-pools, `air-conditioning; as,aorpthe
rpermit issued shall be construed to be a license to proceed
the worand
not rot as the authority
welding violate,
fro here after'.,u
set aside any.provisions."of the`#echdi I�co es, o :Thal ssuanc permit.,
requiring'a correction-of errorsiln'plans,construction or violations•of any codetve
tissuance, or i worLk adthori Invalid
by
dnless a or §,authori ; .. . y auc� frrtit is commenced within six months of rrei
the permit is suspended or abandoned for a periodof
siL(6)months
may be:reqtest : , i rata �frp t al for or bd notetb exceed itnine (90)days and will demonstrate
., , , uildi_ pl....
r tepb.lsorisldere abandoned. _
e days,
justifable, use..for,the extension 111- drk cease or ninety( d)censecutiv�
I t! .`T RD NOTICE OECD NC ENT A T.i. YOU )
WARNl tN s Y, I R a a ti" ® °ANY" ` T tN tNAN tNt �
owFl o X l� Subs k0ttd sworn10 o ram e r e I ',.
Salbscribad� ndts�r�t�t���r�a �d�r � .���ti � . ,h •-
by a�s/ara rsnnaly no rt►e& rt►d tamed
Who islare personally known to me or has/hava produ Minna
as Identification.
N ryii' w
Notary Public
mmission No
Commission No
Name of Notary typed,printed ar stamped Name tsf Pl !p P`Rrirlt 6�. t lmPad
Y u" t icHA L REVELL
{ ; MV MMiSSiON ft 00184920
ry 12 2022
- xPii S,FabrtbaP
Then No Public undo wgitsrs