HomeMy WebLinkAbout23-5656City of Zephyrhills
5335 Eighth Street
oZephyrhills, FL 33542
Phne: (813) 780-0020
Fax: (813) 780-0021
BAR-005656-2023
Issue Date: 02/24/2023
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,
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
. .. . ..... ........ ...
CONTRACTOR SIGNATURE PE IT OFFICE RA V
---e--�70
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER i
%.,ity of i,epr''yurim5 rrerrnit /Application
Building Department
f� F`,iSiTFt71'+STIIfft<l+il
Date Received
Phone Contact for Permi
Owner's Name
Fee Simple Titleholder Address„
JOB ADDRESS I LOT #
SUBDIVISION AJ14 I PARCEL ID# LL-f (� ._ G' /
(OBTAINED FROM PROPERTY TAX NOTICE)
WORD PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH
9 INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
PE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK
BUILDING SIZE a SQ FOOTAGE HEIGHT
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
GAS
«
1
IOt,'\._
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED E;��FEECU�RREN Y I N
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRER Y I N
e
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED Y / N FEE CURRER Y / N
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED E;;;;;
FEE CURRER
Address License #
OTHER COMPANY t
SIGNATURE REGISTERED YIN �FEERRER Y / N
Address License #
1l1111l/111/Ilfllllllflllllllllllllllfl/11l/1111111111/1111111111/1
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 wl 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, (AIC upgrades over 7500)
d 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
NOTICE F 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 T CTOR 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 RESOURCEEC V Y 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'S/OWNER'S AFFi ViT: 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 , 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 C NOTICE F COMMENCEMENT MAY RESULT IN YOUR
PAYING iC IMPROVEMENTS TO YOUR P . IF YOU INTEND TO T I FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINGYOUR NOTICEOF COMMENCEMENT.
FLORIDA JU T(F.S. 117.03)
OWNER OR AGENT CONTRACTOR_
Subscribed and sworn t6"(o affirmed)before me this Subscribed and s om to r affirmed)before me this
L` 2- byX
Wh,0 Isla e p;rso sally no to me or has/have produced Who i re ersopaiiy kn w to me or has/have produced
as identification. T tda r s as identification.
ry Notary Public
Comrr si Commission
a°`PRA A c"': JACQUELINE BOGES q' Y,pU°,
<� JACQUELINE DOGES
Name of N L,�aF4 1p�ee �r sttamr e 0 � Name of Nota :t
F`; ;,�w xpires IJecember 12,2026
have read and fully understand and agree to the
provisions OtiS 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 occup� byygdjj,;��71 said
Iomicile, and same is not for rent, lease or sale. That he or she shall comply with the following
conditions:
OWNER'S SIGNATURE,"'.- DATE /14 �b
ADDRESS I -f
thilk L 3Z')l
PHONE
IMSM1111
I/Masteifonns/OwnersAffidavit!NovO7
M,
m
900-1 900-1
900-1 900-
900-1
1000
700-1 400-1 300-1
1400-1 1400-1 600-1
MM
Permit No,
Property Identification No.__, C)DI, 0 oo- 61
61
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain =1 property, and in accordance with
Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
I.Description ofpropary (tegal daertpdon.)
a) Sheet Address: . A
2.0eneral description of improvements:
3.Owner Information I I j, 6! i 4
a) Name and address: '� 'I ! ` j11f " 11 1 "i A ��,
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4,Contractor Information
a) Name and address: 62 6
b) Telephone No.: . .. . ......... .
5.Surety information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fox No. (Opt.)
6,Lmder
a) Name and address: Phone No.
7. Identityithinth address: Of Persou�N State of Florida des' by owner upon whom notices or other doctrmetrts may be sarved:
a) Name a b) Telephone
8.1D addition to himself otter designates the following person W rcive a copy of the Lianor's Nokia es provided in Section
713.13(lXb), Florida Statutes:
a) Name and address* A
b) Telephone No.: IF;!: No. Q
92xpiration date of Notice of Commencement e expirationdideisOne year from the date of recording unless a different date is
specified):
•. Vk? THE EXPIRATION OF THE NOTIC-L"U
461
Al #004. 14191`041NA . ' 1040*1141111
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wild, is
F Oil WN192411,11,11 11 IND F
INSPECTION. IF YO11 III-MA41 F- MWW, MIM],
COMMENCING wORK OR RECORDING YOUR NOTICE OF COMMENCEMENT -
STATE OF MORWA
COUNTY OF PASCO
The f gg instrument was acknowledged before
C, as
in fact) or
o Owner or Owner's Authod UA' OffiW/D4cW&PW#W"WM-
Pri aroe
this day 1_Jff. �f 20 2-by
(type, fauthority, e.g. officer, trustee, Woraq
(name of party on
Personally Known OR Produced IdentificatiWNotary Signature 9—/
K
jj
Type I of Identification Produced-�E -bgt�6C�0'tame(wint)
Verification pursuant to Section 92,525, Florida Statutes. Under penalties of pedury, I declare that I have read the foregoing and OW
the facts stated in it are true to the best of my knowledge and belief.
Signature ofN pmm Siping Abaft
F0RMSWQCrWV=
jACQUEUNEIIOGES
Crninissjon #NW 32B52
12, 2ON
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