HomeMy WebLinkAbout21-3240City of Zephyrhilis
5335 Eighth Street
Zephyrhills, FL 33542 BGR-003240-2021
Phone: (813) 780-0020 Fax: (813) 780-0021 Issue Date: 11/22/2021
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 initial 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.
* lb ItA 101:1 11-411ft
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
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PEF OFFICEt)
TWOUT APPROVED INSPECTION
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting 0,15 5
Owner's Name J�o n 75 C_ Owner Phone Number 5>/3 -793 q3-75 2�7s C =1 k 'N f - 1,3,3,5 1 --.,3
Dwir�
L cL 0 n r Phone Number Owner's Address q I
- —v, e, ( c=r ""'e 0
Fee Simple Titleholder Name I Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS A -ID LOT #
SUBDIVISION OckV- r-ur) e_ PARCEL ID# ' ;�/ - 0 00 o 0 -
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONITR 8 ADDIALT SIGN DEMOLISH
R INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
TYPE OF CONSTRUCTION BLOCK E::] FRAME STEEL
DESCRIPTION OF WORK 0,5 -Kk It \ 1-.o) ro cl o ve--K
BUILDING SIZE 1 4 9 0 t) 0" 1 SO FOOTAGE[= HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL AMP SERVICE PROGRESS ENERGY 0 W.R.E,C.
=PLUMBING
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
. . .... .... 5 C,
OCAS ROOFING
= ,, SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN L11 N_J
Address I License# I I
ELECTRICIAN COMPANY SIGNATURE REGISTERED FEE CURREN Ly_LN_j
Address License #
PLUMBER COMPANY LC=T
SIGNATURE REGISTERED FEE CURREN Y/N
Address License #
MECHANICAL COMPANY FEECURREN Y/N
SIGNATURE REGISTERED
Address License #
OTHER COMPANY Ci)ris �kr-ite_A� p, 6p-
SIGNATURE
REGISTERED L4�1 N� FEE CUR'REN
Address 7eoklyrAs r"I :53V5,141 License #I CCC- 13 A '7 4 5 0
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/ Silt 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 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. (A/C 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 Zephyrhi|lsPermit 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 Kmmaed in accordance with state and local regulations. If the contractor is not Ummmed 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 theywill 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 mthe construction oYnew buildings, change ofuse inexisting 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 bemaidpMn mreceiving "certificate of final power release.If the not involve ocertificate o[oc* oy 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.
CONTRACTORVOWNER'S AFFID"IT: 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, |certify that nowork o,installation has commenced prior missuance ofapermit and that all work will baperformed mmeet standards ofall
laws regulating construction, County andQ d zoning regulations, and land development regulations inthe jurisdiction, |also certify that
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 unboincompliance. Such agencies include but are not limited to:
- Department ofEnvironmental Protection -Cypress Beyhoada' Wetland Areas and Environmentally Sensitive
Lands. VVetenNVaotevveterTn*mtnl*nt.
- Southwest Florida VVeder Management District-WeUs, Cypress Bayheado, Wetland Araas, Altering
Watercourses.
- Army Corps ofEngineers-SeavvaUs'Docks, Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-WeUs, Wastewater Treatment,
Septic Tanks.
- U8Environmental Protection Agency -Asbestos abatement.
- Federal Aviation Authority- Runways.
| understand that the following restrictions apply mthe use oYfill:
- Use offill ionot allowed inFlood Zone ^V'un|eosexpressly permitted.
- If the DU material is to be used in Flood Zone "A'', it is understood that e drainage plan addressing a
''oonnpenaating vo|unne" will be submitted at time of permitting which is prepared by professional engineer
licensed bythe State ofFlorida.
- If the 0| material is to be used in Flood Zone 'A' in connection with a permitted building using stem vvaU
construction, | certify that fill will beused only tofill the area within the stem wall,
- If fill nnoteha| is to be used in any area, | certify that use of such fill will not adversely affect adjacent
properties. If use of fill in found to adversely affect adjacent pnmporties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots |eaa than one (1)
acre which are elevated byfill, anengineered drainage plan isrequired.
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 inthe 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 (0) 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 FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
OWNER OR AGENT CONTRACTOR
Subscribed and swo i before me this Subscribed and sworn to (or affirmed) before me this
So a
as identification. as identification.
E u, m vai Notary Public
Notary Public JU—_
Commission No, Commission No, C0�4c)
9—ame of Notary typed, printed or stamped Ra—me of Notary typed, printed or stamped
P Notary Public State of Flond
> 1,4* Eva Marie Marshall
My Commission GG 2(0*6557
Expires 04111/2022
EKigEl
`
plkk� Notary Public State of Fk)nda
Eva Marie Marshall
MY Commission GG 206557
I MTmr
5335 81h St
Zejh�rhills F
mt:.Ir*l
"n
Permit No.:_---,
J= cvv oi e-- C
licensed under Chapter 468, Florida Statutes as a(n):
Contractor V-'Engineer— Architect— Building Inspector_
License No, �1 �75 0
On or about —*24aj— did personally inspect the:
Check: Roof Deck Nailing--__�� Dry in Flashing and Drip edge
Check which was used: 30# felt �Peel and Stick— Other (List)
91111113rou M# T, I.
Based upon that examinatifit, d .............
'trill]
Signature:
X��W
w r 0 and su scri ed before this day
BY:
Notary Public State of Florida
YROW ""� Notary Public State of Honda
If Eva Marie Marshall
MY Commission GG 206567
Nof Expires 04111/2022
EE]
INSTR4 2021251545 OR BK10490 PG 42 Page 1 of 1
11/22/2021 10:22 AM Rcpt: 2381401 Rec: 10.00 DS: 0.00 IT: 0.00
Nikki AlvarezSowles, Esq., Pasco County Clerk & Comptroller
Permit No. Parcel ID No � ! "a f'1 " � 1 l 3ci ' cy,'o 0 re C�
NOTICE OF COMMENCEMrNT
State of Cl County of 'a
THE UNDERSIGNED hereby gNes notice that improvement will be made to certain raw property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided In this Notice of Commencement M t l-
1. Description of Property: Parcel identification No. (%
r r1 1
Street Address: =� F {` ('
2. General Description of improvement
Owner Information or Lessee information if the Lessee contracted for the Improvement
Name
Linn I
h wtr yt ��S
a{
Address
v
city
_ay�i5'o
state
+
interest in Property:
Name of Foe Simple Titleholder.
(If dlPFerent from Owner listed above)
Address l>
•
s
by
State
4. Contractor,ttT'
�._,-� a n t r2 i i A
pr /
City
State
Address
S _
�f ��
_
j�. ��c} }"7' :�
Conteactor'sTelephone No.:
-✓!�'
5. Surety:
Address
Amount
8. Lender.f
No.:
city State
Telephone No.:
CRY state
e
T Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(9)(7), Florida Statutes:
r
City state
Telephone Number of Designated Person:
8. In addition to himself, the owner designates Of-
- to receive a copy of the Lienor's Notice as provided in Section 713.130 Xb), Florida Statutes.
Telephone Number of Person or Entity Designated by Owner.
9. Expiration date of Notice of Commencement (the expiration data may not be before the completion of construction and final payment to the
contractor, but will be one year from the date of recording unless a different date Is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT" MUST BE
SULT
RECORDED
AND
OR AN ATTORNEY BITE EFOREORE THE FIRS INSPECTION. IF YOU COMMENCING WORK OR RECORDINGNTEND To YOUR NOTICE OBTAIN COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are We to the best
of my knowledge and belief.
STATE OF FLORIDA
COUNTY OF PASCO"�
Signature dtrOwner or Lessee, or Owns e s or Leasee's Authorized
Officer/Dir octor/PartnaNManeger
S nato s TiBelO _
/ t Kit ga °°1Ce........,
The foregoing instrument was acknowledged before me this -day of �> 202L by � i) c' i 1 � (.� S i �-; ?�• Pp �j''t
as ( ^ ' ✓ (type of authority, e.g., offlcar. trustee, av , .ih for
< < { of party on behalf of whom Instrument Wei
Personally Known 9B Produced identification Q Notary Signature '� rf�-� ` .mil n
;tee` t
Type of Identification Produced Name {Prim} • t®®...�' r�+, •, ��'•- e„�. •° y,
•°°aranspweUeaa,`°``•
Notary PIAW Of fends
Eva Mane fi
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