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Home My WebLink About21-3191City of Zephyrhills 5335 Eighth Street Zephyrhills, FL 33542 Phone: (813) 780-0020 Fax: (813) 780-0021 BGR-003191-2021 Issue Date: 11/12/2021 REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the local government shall impose a fee of four times the amount of the fee imposed for the inal inspection or first reinspection, whichever is greater, for each subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. 11110111FIR11 111�11�jpjp 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. 4 CONTRACTOR SIGNATURE AN PEVMIT OFFICE[) ILA I Z 1 1[*4 a _A =b' , I 813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 Building Department M Fee Simple Titleholder Address JOB ADDRESS LOT # SUBDIVISION PARCEL ID# C5 i J Q,() (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONITR ADDIALT SIGN DEMOLISH El INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK FRAME STEEL DESCRIPTION OF WORK r I n-i-d ,u W-;4 BUILDING SIZE 1 —>A-ZZ SO FOOTAGE[= HEIGHT CST -1r'JrKWWX - =BUILDING VALUATION OF TOTAL CONSTRUCTION —z" =ELECTRICAL $\ AMP SERVICE PROGRESS ENERGY 0 W.R.E.C, =PLUMBING $ I-f,/, =MECHANICAL VALUATION OF MECHANICAL INSTALLATION =GAS ROOFING SPECIALTY = OTHER FINISHED FLOOR ELEVATIONS BUILDER SIGNATURE FLOOD ZONE AREA COMPANY REGISTERED =YES NO A-'16 OKI', N FEPCURRE0 LlAi Address ELECTRICIAN SIGNATURE Address License# =5cc- L"967AT i s 4 COMPANY REGISTERED Y/N FEE CURREN License # PLUMBER COMPANY SIGNATURE REGISTERED LE=:T -FEE UR�RENY ( N�� Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/N FEE CURREN Address License # OTHER COMPANY SIGNATURE REGISTEREDY N FEE CUR YtN I Address F1-4T1—ck5—P;;�7U' (rl 3 a 1 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, Stoonwater Plans w/ Silt Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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. 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 Attomey (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 111MOM IN ITIM, NO'nCE OF COMMENCEMENT Permit No: Tax Folio Awli2iiii-W � I 1 11 114pil W416TITM-A-am . #rX*Wn*fr*TEM*fft77*=-.ATi�iri-"F%mw.-w--mwazzy!wjrxwwmmirAmtAfm� . .... ... .. a) Street 6ob) Address: 2, General description of improvement(s): Re -Roof 3. Owner or Lessee information (Lessee as owner only if contracted for Improvements) E( _S6 r4 7k, '31 2 tc4ft �'ADj,,V a. Name and address: 9ELLY Al b. Interest in property: c. Name and address of fee simple titleholder (if other than owner): 4. Contract Information a. Name and addrew, Alin's Roofing, Inc I Alan Field 14498 Ponce Blvd. Brooksvilig-Fl. 34601 CCCD46942 b. Phone number: 352-686-3330 Fax No, (Opt), 1�2-754-8902 S.Surety Information a. Name and address: b. Amount of bond c. Phone number: 6, Lender a. Name and address: b. Phone number: 7. Persons within the State of Florida designated by Owner upon who notices or other documents may be served as provided by Section 713.13(1)(W, Florida Statutes: a. Name and address: b. Phone number: S. In addition to himself, Owner designates the following person(s) to receive a copy of the lienor's Notice as provided in Section 713.13(1)(b), of Florida Statutes; a. Name and address: b. Phone number. Expiration date of notice of commencement (the expiration date Is I year from the date of recording unless a different date is specified) F 0 STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR INPROVEIVIENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT W" YOUR LENDER OR AN ATTORNEY 13EFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. IP41LURAGE, 1*411jt--Tg:zl 121cli4j" lv�avtl 1114-14:19.) Witt, t i ............. State of Florida County of The foregoing instrument was acknowledged before me this talc day of Oct OC-A 20 -AL by who is personally known to me or has produced V) and who did/did not take an oath. it A I (Driver's License #) Signature tary Public tary State of Rol dot Stamp Stamp #41� JOHN M. ACCRETION Notary Public -State of Florida commission# HH 109505 My Comm. expires Aar 24, 2025 Boded OwDugh gational 140tar)i, Milt. 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department 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 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 properly 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 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, Weiland 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 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, after, 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. 1014A 19 1 11IR i! I #J1 AMfl Z:2 F1 I I � 0 2 10 10 Us"M 10 1 0 1 lam I mts Ag Lima'] al 4:4WA I" ; 4 0 FLORIDA JURAT F.S. 117.03) OWNER OR AGENi Subsc dad and sworn to (or affirmed) before me this by— 2OZI-4 Who isIare pers I know r e or has/have prod as identification. Name of Notary typed, printed-6r stamped CHARLES HIG My COMMISSION # HH 156602 WIMS: July 21,2025 SOM Tbfu Nutmy Public UMWMdW CONTRACTOR vk Subscribed and sworn to (or affirmed) before me this b Who is/are personally known to me or hens/have produced t,_4e_as identification. Commission Name of Notary typed, printed or stamped Public 12 Cal City of Zephyrhills 5335 8th St =I#*' 1, U1412040011, WIA 191 licensed under Chapter 468, Florida Statutes as a(n): Contractor I "'Engineer— Architect— Building lnspectorj— License No. On or about did personally inspect the: Check: Roof Deck NallinoL*410-1 Dry In 400C� 3a Flashing and Drip edge Check which was used: 30# felt_ Peel and Stick��—Other 1(t 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: STATE OF FLORIDA te of F rid