HomeMy WebLinkAbout21-3276City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
RNM%F !
Issue Date: 11/30/2021
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,
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice fig
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.
SIGNATURE
PE IT OFFICE
104 111
III Kof 1-1 0.1 !1 a 1071 J, RTMA I M 14 za
City of Zephyrhd(s Permit Applicaton
Date RaceiWed
Ownees Name
Owntes Address
Address
ShMW TfthQWrLL=
JOB ..
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SU FO#S
WORK PROPOSED
M WCtffe'SrR ADDI,L I
STALL PAt
[ t P�tyrs
PROPOSED u3E
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TYPE F CONSTRUCTION
BLOCK � FR.AMSTEEL
DESCRIPTION OF WORK
45
is �t
S aT "RIGHT
BUILDING
7
VALUAT?C ON OF TOTAL S (2a ?3 ON
[=)CLECTRICAI,
'"" AMP SE ":CE mm] PROGRESS ENERGY
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COMPANY
SIGNATURE REGISTERED Y i N R`�'F.. Gt3RR....
Address
IELECTRICIAN
Si# 4AiTtt ft STcitED Y 1 sFf CURREN Y 1
Addiviss L Es
PLUMBER
SIGNATURP
.Ma+TM" COMPANY
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SOKATURN COMPANY !
Ltea r
OTHER
58COMPANY�
t3 f as ED' Y t N FEE CURR#r V i N
Address
KONVENTIAL AnlrC q (4 Hot N-ians, {,q semis G'r t$wlaing Hlans, (I 7 set 0, t. np,'"�}t tk:YV Sfi Sri, ntr dvn ter,(S } rig days afte s ,f FtaE late Reo r cns e, E's�nstructf"' PlOns, ftrmv her w IORS M 9f# Fence installed,
Sanitary FIrall+tres & I dun"FWer, StPa WON Pewit ter sub4livisionwierge projects
COMMERCIAL Attac# (2) comoota sets of BurtdIng isns ptus a Lite $afi ty Page. ('?) t of Energy Fom% R-O-VV PerrthE friP now Oonstructmn.
Mtm11011. Fen (10) Mrk ng days after c etam;tt of data rRertut e 3 rlsLt , < ast t c P , StO"Ivwls MRTIS Nor Slit �eoce installej,
santaty, Fa'- fps & I corrpster !fe +r OFs Pet -nit fOl ai! lew, p' )eac%, All cv,rme-vial �t a e ms ust n i camp once
I FS PERMIT Attach (2) sets of Engineered Bans.
.. max --PROPER Ty SURVEY requked for ail , b corjstMCtjrs
If over $2M, a e of Commeotgnngt €s aadrad, (AjCupqr* OVOr $7500)
Agent (fie Ihe a n ra Vic.) nr Pu * cat Arnri 0Y {per tPe Amer) mvId be sni ,a0nea 41th ntotacaea latter fawn, ,- ar auihc rid ing same
OVER T O AP M#TTt (cc)tgOfscs"(1 in )
Ramok if .f ngle s �,°eA"t''s , nice Up9te es A,`F titS { !pt Sa£k`a yfF a tt€ i
0NV#wa -N tt Over Counter tf on put'#Ic runs ays neem ht:`W
W
NOMCE OF DEED RESTRICTIONS- The undersigned understands that this pernift may bet sutqt to "deed' re ictiosrxs
ma's uxal# ��xar iucra3�.arcc aae rc.arv� iir�tr � ,a„€ r aax�#.a�cdr, +, w gee s��i�e�p +emu rt'as+xax+; zs�a+�vF,ror�.�az`a:�- ,e+, +:�a�.ga,=am. ce;� r,.,x iai x�`
applicable deett'restfl0ons,
UN410ENSED CONTRACTORS AND CONTRACTOR RESPO I IL,ITIES; It the owner has hired a contractor or
contractors to undertake 4vork. y be required to be licensed in accordance with state srtd local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be c#ed for a inkidernesnor violation
under state law, 1f the owner or intended oontractor ars uncedain as eta what ficensing requirintferft may a PIY fur the
intended work, they are advised to contact the Pasco County Building Inspection Division —Licensing Section at 7 7M 4 -
. FurtherMore, it the owner has hired a contractor or contriactors, he is advised to have the contractortsj sign
portions of the 'contractor 5laawlc' of this application for which they will be responsible, it you, as the owner sign as the
contraottir, . t nmy tre an indication that tie is not property licensed and is not entitled to permitting privit in P
County,
1 KAN F OR I A`t its I Atttb I tt3 t IU i I iMPAt; t xu tt tf fit $,iUVt C T : InOunitter"nockInGloWas
that Tranaportston imlomn Fees and Retourse Recovery Fees may apply to the cOnSbU00M of new Wildings, change of
use in existft buildings, or expansion of existing buildings, as Specified in Pasco County Ina= rater W07 and
7. as apienaled, The undersigned also understands, that such fees, as may be due, voll De tdentftd at the tune of
permitting. It is turftr understood that Transportation JropacFees and Resource Recovery Fees must be POld Prior to
receiving a 'oeditioete of ocoupene or final power retease. it tiv project does not involve a certificate of occutrairloy or
final power red . se. the fees must be paid prior to permit issuance, Furtherrwre, if Pasco County WaterlSewor impact
fees are due, they must be paid prior to pernlit issuance in 8ccordance vuth applicable Pasco County odnarroes,
CONSTRUCTION LIEN LA (Chapter 713. Florida Statutes, as amended}: if vale€story of work is, $2,12W,00 or more, t
cortiiy that 1, the applicant, have been provided with a copy of the "Florlda Construction Lien Lai Homertwner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. It the applicant is someone
^:°r than ;hc "dv ., i a= z that I ho,o ^Nl of^o d n "ory of the obc tc deccribcd loots,,, ^t',d f rorrrlasa In gelid faith to
deliver it to the 'owner' prior to commencement.
C NT A TC ° f ' AFFIDAVIT: I certify that all the informetior, in this application is accurate and that all wore
will be dorm in omplisrice with all applicable tows ro uli Ping construction, zoning and land development. Application is
hereby made to obtain d permit to do woek and installation as indicated i oertify that no work or installation has
commenced pr$ ar to issuance of a permit and that aft work will be perforitied to meet standar a of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certfy that t lends nd that the regulations of rather government agencies may apply to the intended work, and that it Is
my responsibiltry to identify what dons I must take to be in cornphance, Such ageagemies Include are not limited W
Departrners of Environnirsal r . gyp ds, ~and Areas and Environowntally Sensitive
I Phrig WatprMardev".terTr tment
a inth sf Florida Water Management isisict_ f4s. Cyril° oyneads, #bared Am s, Altering
ercourses,
Army Corps of Engineers -Seawalls, locks. Navigable Waterways,
0oportirent of tie Pth & Rehabilitative Services/Environmental Health Unit -Wells, Wastewater Treatment,
Septic Tanks,
US Environ nto,= Protection Age - . bestos abaternertt-
Federal Aviation Authorits-Runways,
I understand that the following restrictions apply to this use of frli.
UsO of ill is not allowed In Flood Zone W' unless expressly periodted.
If the ill material Is to be used In Flood Zone 'A', ff is understood that a drainage plan addressing a
o' n t t v t 3i4 d P time .,f per!n tt e Hrh i � , m 'e,i 1— as 15rn aaoas(nre€,}k aaersrvir2 *r
licori :d cy the Statc of Flor;da..
If the fill material is to be used in Rood Zone „A' in connection with a permitted building using stern wait
construction, I certify that ill will be used only to ill the area within in the sterna wall,
if Ell material is to be used in any area, d certify that use of such Pied will not advemely affect adjacent
properbos, If use of ill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the builollnpermit issueo under the attached p rrrift application, for lots toss than one (1)
acres which are elevated ray fill, an engineered otr inage plan is mquirea,
It I am the AGENT FOR THE OWNERA I proin good faith to inform the owner of the pwmittinq conditions set farts in
this affidavit prior to wrelermiIng construction. i understand that a Warete permit may be requiredfor eleddital
plumbing, signet, wells, pools, air conditioning, gas, or ot€ r installations t o fly i ed in the application, A
m ��m t tzt a
},+caxaa,r ia4n�cr �i uxr+ e�c x„ia, a�eiw�.-w iv +rs+;+z ee,.aza r. c: eax prx+ew-a:+.0 aye p
set aside any prcivIltlona of the technical codes, ter shall issuam of a Perm# prevent to Buddina Oftel him thereafter
requiring a initraction of errors its plans, co ruction or violations of any codes, Every p d shall beonrite invalid
unless the work authonsed by such permit is commenced withar six monthis of permit Issuance, or it work authorized b
the parrritt is shapended or abandoned for a period of six (6) rotas after the time the vmrk is commenced. An extension
may be requested, in writing, from the Building Off; loan a , read not to exceed ninety (l) days and will demonstrate
justifiable cause for the extension, If work ceases fair ninety () co ecutive days, the Job is considered abandoned,
WARNING T OWNER* YOUR FAILURETO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU
PAYING FOR IMPROVEMENTS NT TO YOUR PROPERTY. IF YOU INTENO TO OBTAIN FINANCING, CONSULT
ULT
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Pon NP
Fe€sled 1'ru Notary Pwbdic Underwriters �j ua� lr�fi A ;tC -- i RStTAI
MY COMMISSION # GU 925496
v" EXPIRES: Febma
.,,' Sondcd i. r? 23, 2924
hru P�ofaey public Underwriters