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Home My WebLink About21-3179M fy-o- f Ze-p- 5335 Eighth Street Zephyrhills, FL 33542 Phone: (813) 780-0020 Fax: (813) 780-0021 4 MEN BGR-003179-2021 Issue Date: 11/12/2021 11i 111117111,1151111119111T 111911TITylip a # •1 i •-I•1111=3= 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. CONTRACTOR SIGNATURE PEV OFFICEU �WTATNIKTSI-:l I ki Ri U I. W 813-780-0020 Date Received Owner's Name Ownses AddressE Foe Simple Titleholder Name Fee Simple Titleholder Address JOB ADDRESS SUBDIVISION WORK PROPOSED PAOPOSED USE UTd2SdrA&#_A1S�_1_1y 01 =BUILDING =ELECTRICAL =PLUMBING =MECHANICAL V NEW CONSTR INSTALL SFR BLOCK Building Department I M I M I Ki 954-M Owner Phone Number LOT # [::= 11✓F 1111111111111111111111111111 (OBTAINED FROM PROPERTY T NOTICE) ADD/ALT SIGN DEMOLISH REPAIR Comm OTHER FRAME STEEL VALUATION OF TOTAL CONSTRUCTION r-L— 0 16 -0 '3 a9f,�'_? AMP SERVICE PROGRESS ENERGY = W,R.E.C. VALUATION OF MECHANICAL INSTALLATION (47- =GAS ROOFING SPECIALTY OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE REGISTERED L7== FEE CURREI\ Address License # ELECTRICIAN COMPANY FEE CU�RRE�� SIGNATURE REGISTERED YIN Address License # PLUMBER COMPANY E SIGNATURE REGISTERED ;;N: FEE CU�RREII Address License #E===== MECHANICAL COMPANY E SIGNATURE E=== REGISTERED YIN FEE C�URRMI Address License #E==== r-------------------------------------------- OTHER COMPANY [��FEE �CURREI�,�� SIGNATURE REGISTERED Address License 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/ $01: Fence installed, Sanitary Facilities & I 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 SURVEYirequired for all NEW construction. 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 T CTOR 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 IMPACTIUTILITIES IMPACT AND RESOURCERECOVERY 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 69-07 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 withapplicable Pasco County ordinances. CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is$2,50000 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' 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 zWater Management DistrictmWells, Cypress Bayheads, Wetland Areas, Altering Watercourses. Army Corps of Engineers- eawalls, 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 , 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 OWNER: YOUR ILU E TO C NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR . IF YOU INTEND TO T 1 FINANCING, CONSULT ITFt YOUR LIEN DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CO M NC M NT, OWN R OR AGENT t CT d �u on and sworn (or affi rem this Subscribed and sworn to(or affirmed)before me this b by Who is/ar rsonally know me or has/have produced Who is/are personally known to me or has/have produced as identifi tion. as identification. Notary Public Notary Public commission No. commission No. Name of Notary typed,printed or stamped Name of Notary typed printed or stamped hA o va MICI AELREVELL MY COMMISSION#CC 1$4920 EXPIRES:February 12,2022 Bonded Thru Notary Public Underwriters