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Home My WebLink About21-3189City,of Zephyrhills 5335 Eighth Street Zephyrhills, FL 33542 Phone: (813) 780-0020 Fax: (813) 780-0021 0 -------------- --------- ----------- BGR-003189-2021 Issue Date: 11/12/2021 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 I III PEfIT OFFICE ITHOUT APPROVED INSPECTION All 813-780.0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Pennittln °' S " -7 r pp + _ v rt B tit a j 'yr - 1 A' l2 Owners Name d4 .". .t Owner Phone Number l l Owner's Address t i t Owner Phone Number —� Fee simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS t r �j LOT # SUBDIVISION oe -olll ef PARCELI C '� (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED Nd W CONSTR ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK FRAME STEEL DESCRIPTION OF WORK BUILDINGS SIZE SQ FOOTAGE HEIGHT BUILDING VALUATION OF TOTAL CONSTRUCTION T =ELEGTRIGAL 1$� PLUMBING $ =MECHANICAL $ ,......__.. _ GAS ROOFING AMP SERVICE PROGRESS ENERGY W.R.E.C. . i . / , VALUATION OF MECHANICAL INSTALLATIO SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE REr;ISTrRED LY/ N FEE cuRREN Address License #P ELECTRICIAN COMPANY SIGNATURE REGISTERED Y 1 N__j FEE CURREN Address License # 1.._._.__ PLUMBER COMPANY SIGNATURE REGISTERED Y! N FEE cuRREN Y 1 N Address License# MECHANICAL COMPANY SIGNATURE EE CURREN Y t N Address —� License #R�� OTHER COMPANY ( ' SIGNATURE REGISTERED YfN FEECt1RRE Y!N ram^ -�*- Address �� G C%e. a° A?) - J &V 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/ Sift 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, Stoanwater Plans w/ Slit Fence installed, Sanitary Facilities & 1 dumpster. Site Wait 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, Directions: 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 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department NOTICE OF DEED RESTRICTIONS: The undersigned understands thatthis 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 AND CONTRACTOR 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 property licensed and is not entitled to permitting privileges in Pasco County, TRANSPORTATION 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 WateriSewer 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 tile "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 lam 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 W" 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 licensed by the State of Florida. If the fill material is to be user construction, I certify that fill will If fill material is to be used it submitted at time of permitting which is prepared by a professional engineer in Flood Zone "A" in connection with a permitted building using stem wall be used only to fill the area within the stem wall, 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 pert -nit 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. OWNER OR AGENT Sub -scribed and sworn to (or affirmed) before me this by Who Were personally known to me or has/have produced as identification. Public, Commission Who islare personally known to me or hasihave produced ---------- as identification, AdJ LJ Notary Public, Commission No. Naive of Notary typed, printed or stamped Name `61"Notery typed,(printed oFstamped INSTR#2021243650OR BK10483 PG36 Pepe ifi 11 tl 0/2021 10:00 AM Rept: 2377113 Rec: 10.00 DS: 0,00 IT: O.00 Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller PnwPcrtY I&Milication Ni), THE UNDERMNED hcreby givcs noI dW improv=M$ will be '44 lip ion of property f 41d d&uv*w4x:) a) Strect Addrcss: K 1244� Gcnml deNL iiptinn of improvI . ....... ... .... .. .. . . . ....... LI " i"N"IIIIA"C J, A Mugu, '07 -J, ow , C. NOTICE OF COMMENCEMENT bKW ISE RECOgM &No p0M=r'0fZW-1'W-*,( ff*—K4WT0Y0tJRPR0PUW.A INSPEC"17ION. IF YOV JOB SMSEFMTMEMST MT"D To (*TAM M"C'NG- CONSMT YOUR LENDER ORAN ATrORNEY BMRE COMMENCING WORK Oft REL-ORM(; NO17CR OF COMXMCXMwsT. STATE Of FWIUDA LAURENCE WO C401',!IIII Of PAl'I My Cot),mjIiW�KSII Z j! C(PII�E$ JUL 09,2923 Sili;li,!!!Illti!:tC'�'�4'�hvemciI PVI www 'Pic fom'90",V Inwwm011 ---v% acknowkdged berom rw jh t'y (rmd Y. C-411. ofter. "I S[wr'x7' in f2a) rtm (naze or Party an beharror k*r,,wrjJJv Krmtwn OR Pd Identirtz". Notary Sivuwm Raw (PriAt? WnG"fim pumtont tosection, 110I Staws, Unda pmaltka of perjwy. I &cWt *011 h. if' i I arr Inic to the bc-4 of iny knjwj-,ko-,,,e WAM ve fad the 0I City of Zephyrhills 5335 8th St Eejh�rhillj F MG11,1911 Permit No. - licensed under Chapter 468, Florida Statutes as a(n): ContractorA. Engineer_ Architect_ Building Inspector_ License No. 2�-3, On or about --'�,'�" did personally inspect the: Check: Roof Deck Nailing----L�"Dry in L-' Flashing and Drip edge Check which was used: 30# felt— Peel and Stick-�Other (List)- WE�=-' used upon that examination, I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on S ction 553,844, Florida Statutes). Signature:-- NEEMy= Sworn' BY. 4 Notary Public State of Florida ptkt' 13EVE4LY LEFAN 'OP 4P Cormissloo # KH 053064 Exores November 30,2024 %F� Vor"le, ewdedrhru Budpfttm S61191111