HomeMy WebLinkAbout22-4654ZA;01:11'9117 �
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5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
REINSPECTION FEES- (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the
local government shail impose a fee of four times the amount of the foe 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.
'11911MMEM11
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed ir
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR $IGNATURE
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PROTECT CARD FROM WEATHER
DISCLOSURE BTATE2T FOR OWR
CITY ILLS BUWIRG
have read and fully understand
agree to the provisions of this instrument,
The undersigned states and affirms that he she is desirous of constructing,
renovating, adding to or reroofinghis her own domicile, that be or she
actually occupies, or will occupy said domicile, and same is not for
rent, lease or sale. That be or she shall comply with the following nditio :
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply withall provisions of the City of Zepbyrbills
ordinances and codes pertinent to the building,
3. That in the event various f construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
4. That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrbills Building
Department.
6. That prior to final inspection any additional fees, including reinspection
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, workman's compensation, lien laws, etc., where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9, State law requires construction to be done by licensed contractors. You have
applied for a permit der 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
onsite supervision of the construction yourself. You may build or improve a
one-family or two-family residence or a farm outbuilding. 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 1 year after
the construction is o lets, the law will presume that you builtor
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
make sure that people loyd 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, ,A, and withholding tax
nand provide workers' compensation for that employee, all as prescribed by law.
Your construction must comply with all applicable laws, ordinances, building
codes, and zoning regulations.
DATE
ADDRESS
7PHO _
WITNESS PERMIT
813-780-0020 City of Lephyrhffls Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting
Owners Name ₹ . ;r, 1 17/ Owner Phone Number
Owners Address 4 . ft s` Owner Phone Number LIIIIIIIIIIIIIIIIIIIIIIII
Fee Simple Titleholder Name i� t a� 5 rya Owner Phone Number LIIIIIIIIIIIIIIIIIIIIIIIi
Fee Simple Titleholder Address
JOB ADDRESS LIIIiIiFIEIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1 LOT# Lililill
SUBDIVISIONLililili II 11 PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADDIALT J SIGN EJ LJ DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR El COMM L1 OTHER
TYPE OF CONSTRUCTION LJ BLOCK FRAME J STEEL
DESCRIPTION OF WORK
BUILDING SIZE 1 t } SO FOOTAGE J t? HEIGHT
BUILDING VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE LJ PROGRESS ENERGY EJ W.R,E.C.
fJ PLUMBING Elil C
EElMECHANICAL VALUATION OF MECHANICAL INSTALLATION
GAS EJ ROOFING El SPECIALTY J OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES NO
BUILDER 1 / OMPANY
SIGNATURE REGISTERED Q��FEEURREI Y I N
Address License#
LIIIIIIlIIuIIIIIII
ELECTRICIAN COMPANY
SIGNATURE REGISTERED YIN �FEECURREI ����
Address License# LIIIIIIuIuIIIlIII
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N �FEEREI Y/N
Address License# LIIIIIIIIIIIIIIIIJ
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License# LIIIIIIIIIIIIIIIIIII
OTHER COMPANY
SIGNATURE REGISTERED ;;;;��FEECURRE(' Y I N
Address LIIIIIIIIIIIIIIlIIIIIIII License# LIXIIIIIIIIIIIII
;IIItIIli1IIIIIIIIIIIliIIIRI11I111111I1I11111IIIIIIIli1IiIIIIIIIIIiI
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&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,Stormwater Plans WI 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$25009 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)
Refoofs if shingles Sewers Service Upgrades A/C Fences(Plot/SurveyiFootage)
Driveways-Not over Counter if on public roadways,needs ROW
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 T ACTO AND T CT 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 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/OWNERS AFFI AVIT: 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, zoningand 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 o€ 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, 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 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
WITH YOUR LENDER OR AN ATTORNEY F CO I YOUR T ICE OF COMMENCEMENT.
FLORIDA JURAT(F.S. 117.03)
O NER O EN `° CON r C`ro £
Subscribed and sworn to(or affirmed before me this Subscribed s rn to(or affirmed)before me this
Who is/ re sonally Inown to me or has/have produced Who s are, e onally k wry to me or has/have produced
as identification, 4C ° " _ as Identification.
=.A
Public Notary Public
Comm! ion o. ` ? Commis ' No.
Blame of tam• Name of Nota `t a. Expires I eceober 12,2Q22 4 co mis n 276 57
��: ihruTray Fu u 6nsurun 5 385 7649
.EQ .,.- aQ�ee z� mR °� ��'° Expires Qece�nb�r t2,2022
� F'.� 9nd�d Yhru Trnr F�insurance Siib-365.7039
Otis, .:..... ..
'TI TOP
E ENGINEER çJLLC.
to
STRUCTUFt et ENGINEERS
February 12, 2021
Mr, Thomas Campbell
Florida Department of Business and Professional Regulation ALL WORK SHALL COMPLY WITH PRVILI
2601 Blair Stone Road, Bu lding T NAT FLORIDA BUILDING CODE,
NG
,
Tallahassee, Florida 323996563 AND ItL ELECTRIC C0DE`TH CITY OF PHYRFIILL
ORDINAS
RE: Pion Approval
Robin Builders
Plan#PBC2020ACP
l
Dear Mr.Carnpbell. pZEPH
Pursuant to the requirements of the Department of Business & Professional anal Regulation e x'
referenced documents have been reviewed for compliance with:
2020 Florid Floridø BuildingCode, 7►r, Edition
2017 National Electrical Code( A70)
Florida Product Approval Rule 61 2 -3,006 (FA C)
All mandatory comments have been satisfied and plans are approved for construction by a currently
approved modular building manufacturer, t'
These documents were reviewed for only what is to be constructed in the factory. Any work
performed at the site, such as the foundation, is under the authority and jurisdiction of the local
Building Official,
Third Party Agency approval in no way alleviates the builder/manufacturer from complying with all
the applicable codes, which may or may not be identified in this review. Approval also does not
preclude the local building official from requiring work be performed that was not previously
reviewed, approved, and constructed under the State of Florida's Manufactured (Modular)
Building Program to make the building, code compliant, for the intended use.
)
A signed and sealed set of plans are maintained on file with Top Line Engineering, LL .
If you require my assistance in any way, please do not hesitate to contact me.
Thank you,
Respectfully,
illiarn E. N ary,alt
Business Partner
Top Line Engineering, LLC
lull rai oot art
**Please notes Any questions regarding local permitting hld be directed to the Manufacturer
The Manufacturer's contact information con be found in the title block of the plans,
106 t9 Ookview Poi to Terrcac:.e *C, othca o Flori llc 3 f Phi ne 2 resler s, _ : yea r c�.carra
FL Certificate of Authorization 31 785
ItSTR#2022I83652 OR(3K1 0675 PG1414 Page 1 of 1
08/18/2022 01:55 PM Rcpt:2493735 Rec: 10.00 DS:0.00 IT:0.00
Nikki Alvarez-Sowles,Esq., Pasco County Clerk&Comptroller
Permit
Prer Identicstlon No.Jt - ZI /Q' 5&Q -t✓ �
THE UNDERSIGNEDy giv®informs yon that the improvement will be made to rertein real property,endin aceerdance with
Scebon 713.13 of the Florida Ststntes the following aion is provided in this NOTICE OP COMMIN
2.General deicrtption of° ts:
b)Nne and d&ess of simple titleholder(If other then )
o)I in property
{. )to eon No.: P Na.(Opt,)___________________
S.Smety information
a)Name sad
b) of d:°
c)Telephone No.: Fix No.(opt.)
6.Lender
e)
No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other'doctmrents may be served:
a)Name and
°b)Telephone No.: Fax No.(Opt)
3.1n to himself,lf,o designates the following on to receive a copy of the Li s Notice as provided in Section
7l3.13(1)(b)y Florida S :
a)Ai
b)Telephone No.: ' Fax No.(Opt)______________________
f Notice of Commencement(the expiration one year of a di ,
9. ira ot date is
epecl5ed):
WARNING TO OWNER: ANYPAYMENTS MADE BY TRY o EXPIRATION OF TEE NOTICE OP
COMMERCEMINT ABA CONSIDERED RO. ..R PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,
FLORIDA STATtYFES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED ANt)POSTED ON THE JOB SITE BEFORE'IRE FIRST
LNSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT Yonk LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OP COMMENCEMENT.
Slteraf Owen w
s r
min ac w a this day of �,20
fk @ as ( of ,ego
in )for { of If o e
Personally wn C fld Notary Signature
of Identification , t}
Ver1cation pursuant to SectIon 92.525,FlorIda Statutes,Underpenalties of perjury,I declare that!have
the facts stated in it are tune to the best of my knowledge and belief.
27
. '•:� s;Q"°' trop 9p
State Of Florida,County Of Pasco
This is to certify that the foregoing is a
true and correct copy of the document
t on file or of public record in this office,
wVV' my I�artd d official se 1 this
j�� dayo
Rlikki�Ivarez- wies sq., lark&Comptroller
(; ;' Pasco Count rich
DY Deputy Cleric