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Home My WebLink About22-4359�.f IS 5335 Eighth Street Phone: r 0-0020 Issue Cate: 06127/2022 REINSPECTION respecto. ;1 imposelocal government shall of four times the amountf+. it or greater,first reinspoction, whichever is ♦subsequent Notice: In addition to the requirementspermit,"e may be additionalt .• .. may be • ♦ in the public recordss may be additional permit required from other governmental entities such as water management, state agencies or leagencies. ►, � �i+l' i s s�+1Y .� r r 'i" E 4 •' . Y, A � . * - .I '� :i: 4 ♦ � '',! � � �i' .�' +. 'R b ;R 1 'wit accordance with City Codesand OCCUPANCY OCCUPANCYNO BEFORE :. d CONTRACT SIGNATURE 4PEOFFICE INSPECTIONPERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received 1 I" 611 (.11 FZMrMME= Owner's Address I k 5,,7-2 IMMTMPEN� NTINMX" Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS LOT # SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTRF--] ADD/ALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK E] FRAME STEEL DESCRIPTION OF WORK BUILDING SIZE [�SO FOOTAGE HEIGHT -rTlrlr =BUILDING VALUATION OF TOTAL CONSTRUCTION TELECTRICAL AMP SERVICE PROGRESS ENERGY W.R,E.C, =PLUMBING =MECHANICAL VALUATION OF MECHANICAL INSTALLATION =GAS ROOFING SPECIALTY OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO t�ro BUILDER r COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# ELECTRICIAN COMPANY �FE SIGNATURE REGISTERED E CURRENY / N�� Address License # PLUMBER COMPANY E SIGNATURE REGISTERED �� / N�FEE CURREN Address License# MECHANICAL COMPANY E;;;�: SIGNATURE REGISTERED FEE CU�RREN Address License # OTHER COMPANY E�;� �FEECUR�REN�� 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/ Silt Fence installed, Sanitary Facilities & I dumpster; Site Work Permit for subdivisionsliarge 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 & I 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 (PlottSurvey/Footage) IMIMERM33MMEEM NOTICE OF DEED TRICTI® : 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/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 I, 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, 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"'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 E , 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 U FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE ICE FOR IMPROVEMENTS TO YOUR P . IF YOU INTEND TO T I FINANCING, C LT IT" YOUR LEN AN ATTORNEY B EF O E C I Y U NOT OF COMMENCEMENT . Fl ORIDA JURAT(F. 7.M3'i OWNER OR AGENT CONTRACTOR Subscribed and sw n r cif Subscribed and swo o or b e t is Who is/are personally known t me or has/ ve reduced Who is/are personally known o me or has/have p ced as identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped � DNA T�� / /./ 120 Rcsiden�a||commenla| Warranty Standards Performer 310DcLa CrUz Blvd.. 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Cell Tvp, GO,, J.2mm, I? an-;ir�svion, low iro:,i, imi)ci, d Mile Anoxlized Alurwrtan Allov limcKn Box 1756 X W9 X 30w1 Oil, " put Cable 4mm2 (EU)12AWG,39.37in.i'-200i�ii�„ Woo -it, 4119%A20 51,I�) We Length 1200mri I v tntertek UMMLUIMM-2 BILLING CONTACT GARY COOPER 38522 PIEDMONT AVE ZEPHYRHILLS, FIL 33540 INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION INV-00007120 06/27/2022 07/27/2022 Due NONE REFERENCE NUMBER FEE NAME TOTAL ELCMISC-004359-2022 Electrical Permit Fee $86.25 38522 Piedmont Avenue Zephyrhills, FLORIDA 33540 SUB TOTAL REMITTANCE INFORMATION TOTAL June 27, 2022 5335 8th Street, Zephyrhills, FL 33542 Page 1 of 1 r 0M 4Re 0 0 r 0.IT: O00 . Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller pmhNo. Pro" Idandfication po �� Streetr } r* ti,10 .. 2.0werW descroon of kYA A fi _ A � 3DWsw1 .tiro and address: e r Y A Y w. and address } N,. } . 1 "Y Y . 4 tl .n YI .,! a" l 1'fi luio a6 .k# f ii a) Nam and addressi hIL * Tallophone No.: fox No. a) Nam *ad address: Awant 1 Bond: *iXY Y it) Nwo Yaddress- 7. of M"�}k kk s u e:n } . ,t +1 .e. Y Y ( a i} !}. 1k' i f 4..•.} i .'.." 1 saved: r: Y } r , . Y ,�. ;. t} Y e s NoticepoOded in SoWon 9SVItstim date Y -dde b t k + i rf r rtl #.ell= .!� ► �� ,� � � ., �: .. �* Y rt '1 tt 'Y.. a +1t X.'r ♦��A 1., i' ti Y.. X #. r ..R*!, a .�"#�. } •t «a r t 1:.. Y < yY. i k'd.«R"..V �aJ+�MMY�_ �I �r x M' Y! Y I Y� i e . u! x f a.. ♦ irk �. ti. t L' � S f . Y! f i ,• Y} ..{j i"r: it i � it � ii � 1t *X• x ~ t' State Of FIorIda County Of Pasco This is to certify that the foregoing is a true and correct copy of the document on file or of public record in this office. wit ess my hand r d off clal seal this m� day of J Nikki Alvarez s,Es lerk Comptroller i8 Pasco Count ride Cy � , Deputy Clerk DISCLOSURE STATM42NT FOR OWNER CITY OF ZBPHYRHXLLS BUILDING have read and fully understand and agree to the provisions of the.s instrument. The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domicile, that he or she actually occupies, or will occupy by said domicile, and same is not for rent, lease or sale. That he or she shall comply with the following conditions: 1® That the owner and he or she alone shall'',act as the builder for all phases of construction. 2s That the owner will comply with all provisions of the City of Zephyrhills ordinances and codas pertinent to the building. e That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work, a That in the event the Building inspector hall require corrections to be made, the owner will assume full responsibility to insure they are made, and upon completion will call for a rein pection before proceeding with the building. S. That the owner shall assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhills Building Depar ment . a That prior to final inspection any additional fees, including r inspection fees, must be paid in full® A written request from this office shall constitute an official notice to pay additional fees. 7< That the owner shall comply with all City, State and Federal laws in regard to social security, wor ,s compensation, ''lien laws, etc., where applicable. S. That the owner shall comply with all the 'safety codes issued by the Florida industrial Commission. a State law requires construction to be done by licensed contractors® you have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a license® You must provide direct ousite supervision of the construction yourself® You may build or improve one -family or two-family residence or a farm outbuildings You may also build or improve a commercial building, provided your costs do not exceed $75,000. The 'building or residence must be for your own use or occupancy. it may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved yourself within I year after the construction is complete, the law will presume that you built or substantially improved if for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building. it is your responsibility to rake sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. you may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done, Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct .I.C.A. and withholding tax and provide workers, compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes, and zoning r ations® OWNER,OWNEROS i T E DATE ADDRESS PHONE WITNESS PERMIT