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HomeMy WebLinkAbout22-5387Mll� M MIM 5335 Eighth Street Zephyrhills, FL 33542 ,*hone: (813) 780-0020 Fax: (813) 780-0021 1111111111IF! lI, I III IIIIIIIjill ili!illiiill 1, il, 11 1 MMIMM LtKk,V,JF,#TV6,* lssu� Date: 01/11/2023 accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.6. NO OCCUPANCY BEFORE C.O. CON CTOR SIGNATURF W1, FkE IT OFFI'E 1:41.-R AAM: *,T,4 -11j*1 lin'' Will 17,01,77, Me" l,"'HIM"alam 813-780-0020 {� City of Zephyrhills Permit Application Fax-813 T80-0021 ` a Building Department Date Received Phone Contact for Permiitin ss�� Owner's Name A l C YYA Owner Phone Number Owner's Address L h . U V U!i Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS}11 ('ei d 2ti} t LOT III SUBDIVISION 1� PARCEL ID# .:ti gr` qp }� (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED I i I NEW CONSTR ADDIALT SIGN DEMOLISH INSTALL REPAIR PROPOSED USE SFR COMM OTHER TYPE OF CONSTRUCTION BLOCK L_._i FRAME STEEL (t EE .. = ax) Sty FOOTAGE HEIGHT r UILDING $ B I VALUATION OF TOTAL CONSTRUCTIO �2 ,r .. =ELECTRICAL $ 8 AMP SERVrE \, PROGRESS ENE Y>, W.R.E.C, t r f ) a , � ot=PLUMBING 0— vA =MEGHANICAL $ VALUATION OF MECHANICAL IN TALUATION =GAS ROOFING E] SPECIALTY = OTHER to FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO BUILDER COMPANY SIGNATURE REGISTERED Y / N FEE cuRREN YIN Address r itt�l,GOii. i�tcj7L r License# � � $ a @ B L t t „� V\(-+ ELECTRICIAN SIGNATURE' "` It COMPANY REGISTERED Y / N FEE CURREN YIN Address. License # PLUMBER i COMPANY INi f . SIGNATURE REGISTERED Y / N FEE CURREN Y I N� Address (o,2D% ` L(;;'( ((AN, (i' ( vlo k ' L( License # MECHANICAL COMPANY SIGNATURE REGISTERED Y / N FEEGURREN YIN Address License # E==== OTHER COMPANY COMPANY E:=== SIGNATURE REGISTERED Y 1 N �.EREN YIN T Address License # E==:= RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-OW 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 subdivisionsAarge projects COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Farms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required costs, 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. (AIC 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 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 contractors) 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'SIOWNER'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, Weiland 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 11 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. It work ceases for ninety (90) consecutive days, the job is considered abandoned. ME= or nafithave pi u identification. Notary Public 'A Notary Public Commission No. Commi ion No. 7 d r Q 2, Cl Name of —Notary typed, piIiited or stamp 14—ameoMotary typed, 4A : , printed or a amped MAILING ADDRESS: P.O. BOX 1038 - PORT RICHEY FL 34673� PHYSICAL LOCATION: 10208 SCENIC DRIVE - PORT RICHEY FL 34668 PHONE: (727) 868-5504 FAX: (727) 863-4119 WEBSITE: WWW.NATIONALPOOLS,NET STATE CERTIFIED: CPC1457034 1, Maurice F. Weisberg Jr., give the following individuals authorization to pick up and sign for permits from the City of Zephyrhills Building Department. - Jenna Wright - Clara Molina -Sanchez - Alex Ceccarelli - Robin Garves Sincerely, 17 isberg Jr. CPC1457034 State of Florida County of __W1 IS -W-,, The foregoing instrument was acknowledged before me on this _J��,kday of 2022, by who is personally known to me, 4 otary��� Notary ignatu e Print Naas N JENMWR*W EXOM &9A 20.21=1 MEMBER UNIT90 POOL a SPA RSSOCIATION U LVLdl I For Private Provider Inspections. FS 553.791(4)(a)(b)(c) 1. FS 553.791(4)(a) Service to be performed: New residential concrete swimming pool Location 2. FS 553.791(4)(b) Private Provider: Rune Lero — BU 1083 Innovative Construction Inspection, Inc 1324 Seven Springs Blvd New Port Richey, Florida, 34655 727-514-5152 Certified Building Code Administrator- BU 1083 Certified Building Plan Examiner- PX 1131 Certified Building Inspector, Bung,1&2 Family Certified Building Contractor- CBC 047789 Certificate of Insurance, Professional Liability Coverage: Barrett Harding Insurance Inc 10014 Grove Drive Ste A Port Richey, Florida, 34668 727-697-3200 Policy Number VNPL02533 1 1111111111111111 , I I � i I ��� IMIAMMIL111 11021104111 - A I - ta a 2 11 I have elected to use one or more private providers to provide building code plans review and/or inspection services on the building or structure that is the subject of the enclosed permit apptication, as authorized by s. 553.791, Florida Statutes. I understand that the local building official may not review the tans submitted or perform the required building inspections to determine compliance with the applicable codes, except to the extent specified in said taw. Instead, plans review and/or required building inspections witt be performed by Licensed or certified personneL identified in the apptication. The taw requires minimum insurance requirements for such personnel, but I understand that I may require more insurance to protect my interests. By executing this form, I acknowledge that I have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance and am satisfied that my interests are adequately protected. I agree to indemnify, defend, and hold harmtess the local government, the local building officiat, and their building code enforcement personnel from any and all claims arising from my use of these licensed or certified personnel to perform building code inspection services with respect to the building or structure that is the subject of the enclosed permit application. S i g n e d Dated: Ron DeSantis, Governor VrAlrr r%z: IN f%Dlr%A Melanie S. Griffin, Secretary a dbor 11=111A D'rKA1:&10r ^C D"ClIkICVC A KI r% n15^CT:CQ1^U A I OCe!"ll If A'rl^kl CONSTRUCTIONLI OARD THE COMMERCIAL POO IFIED UNDER THE PROVIS UTES E Ar EXPI 1, tW 31f 2OU Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. D ATEAC"R" CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lied of such endorsement(s). PRODUCER CONTACT NaE: Insurance by Ken gown, Inc. PwQNE — _ _- _ _-_. __ FAX ___-- 707 Pennsylvania Ave Ste 1300o Ext321-397-3870 �(aic, Nol: 321-397-8888 E-MAIL — Altamonte Springs FL 32701 ADDRESS: certificates insbykenbrown.com INSURERS AFFORDING COVEItACE NAIL # _ __-_---------------------_—_--. _ _._ INSURER A: Amerisure Mutual Insurance Company _.____ 23396 INSURED NATIPOO-03 National Pools of Pasco Inc aNsuREEaB: Pmerisure Insurance Campany _ -- 19488 P O Sox 1038 INSURER c : Port Richey FL 34673 INSURER D INSURER E . INSURER F : _--- � --- - ----- COVERAGES CERTIFICATE NUMBER; 1438261393 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY P -- --- - -- INSR �--�- ADDL SUBR � -_ - � POLICY EFF P CY Ex LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYY IDDIYYYY LINTS A X COMMERCIAL GENERAL LIABILITY GL21138310202 1/1/2 2 1/1/2023 ACH OCCURRENCE $1,000,000 AMAOF TOE iN I ED _ CLAIMS -MADE _ OCCUR PREMISES {E occurrence $ 1,000,000 - - -r-- -- MED EXP (Any one person) $10,000 PERSONAL iI ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $_2,000,000 POLICY (_� JE j LOG PRODUCTS - COMPtOP AGG $ 21000,000 - OTHER: - _ $ . - B AUTOMOBILE LIABILITY CA20051502101 1/1/2022 1/1/2023 COMBINED SINGLE LIMIT $1,000,000 (Ea accident)_ X ANY AUTO BODILY INJURY (Per person) $ OWNER F� SCHEDULED BODILY INJURY (Per accident) $ 1 ! AUTOS ONLY AUTOS PROPERTY DAMAGE X f HIRED NON OWNER $ m AUTOS ONLY AUTOS ONLY (Per accident X PIP-$10,000 -- - A X UMBRELLALIAB �X OCCUR CU20051512002 1/1/2022 1/1/2023 EACH OCCURRENCE-- — $3,000,000 I EXCESS LIAR CLAIMS -MARE I 'AGGREGATE $ 3,DOD,D00 .- --- .- — _.......___ �rDED X I RETENTION $ $ B waRKERSCOMPENSATION WG208077710 1/1t2422 ( 1f1/2023rPER OTH- ARID EMPLOYERS' LIABILITY YIN UTE ER �-- IANYPROPRIETaR/PARTNER/EXECUTIVE ACCIRENT $1,000,000 1OFFICER/MEMBEREXCLUC NIA-'-'-(Mande#dry in NH)..SE-EA EMPLOYEE $1,000,000 If yes, describe under _ _ . . DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 -T" DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Qualifier: Maurice Weisberg SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Zephryhlls ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 5335 8th Street AUTHORIZED REPRES TATIVE Zephyrhills FL 33542 Q 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered Darks of ACORD mIia===llIjiNlWm W, L*]U* anto AC;COUNT#:- 00526 $IC CODE, 1799.03 A . . . . . . . . . . . . . . PE OF BUSINESS RESIDENTIAL POOL & SPA CONSTRUCTION & REJ S I A FE LICENSE# ["IT IW rmM4W%M=- 4M;lWA » «©l DATE RECEIPT AMOUNT 08/22/2022 22-2-010272 31.25 K' jv J*jjL1UjLrd Permit No. Parcel ID NoaL- is--b NOTICE OF COMMENCEMENT [MUSK* 5"W&M- 11 k-j- lex)ylk City A Interest In Property Name of Fee Simple TWelvider. City Telephone No.: 6. Lender. Address city state Lender's Telephone No.; 1115 IMMIM r*MW7**IwTMIRiWk1,%WA V, 111111111,1" Z wpdaUubcslno0comr.mancemnt_pcO53048 DUKE "V!" ENERGY, January 10, 2023 National Pools Subject: 35968 MORSE WILLOW CT Dear Jenna Wright: Thank you for contacting Duke Energy Florida, LLC for a letter of no conflict regarding your pool construction. NO CONFLICT: Duke Energy Florida, LLC has reviewed our existing facilities at the above referenced address and has found no apparent conflict at the proposed pool location. According to the drawing(s) you have provided Duke Energy Florida, LLC has no objection to the proposed construction. mmm Ryan Flaherty Project Coordimator Duke Energy Florida, LLC 4121. Saint Lawrence Dr, Now Port. Richey, FL 346533