HomeMy WebLinkAbout23-6219 (2)City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
ELCMISC-006219-2023
Issue Date: 10/19/2023
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.
before recording your notice of commencement."
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CC . TRACTOR SIGNATURE PE IT OFFICE
PEW IT EXPIRES tft 6 M0A,;,TVITAOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
313-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department JA
Date Received
Phone Contact for Pe mittin -351-3430 M!
A I a * * X 0 LJLI-JLK I a 1 0
Owner's Name Jason Wagner O er Rhone Numberu 13) 360-5495651 nth 2
Owner's Address Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS LOT #
SUBDIVISION PARCEL I D#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONITR ADDIALT SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK ROOF MOUNTED SOLAR PANEL INSTALL
BUILDING SIZE SO FOOTAGE HEIGHT
BUILDING VALUATION OF TOTAL CONSTRUCTION
L 04,
SIELECTRICAL
=PLUMBING
=MECHANICAL
=GAS ROOFING =
FINISHED FLOOR ELEVATIONS E=
BUILDER
SIGNATURE
12ram•
AMP SERVICE PROGRESS ENERGY
014
VALUATION OF MECHANICAL INSTALLATIOW1,""'
OF :-4 07 MIA�__
0 ............ I I I -11,
LOMMI.--f
SPECIALTY = OTHER
FLOOD ZONE AREA =YES NO
COMPANY
REGISTERED
License #
PLUMBER COMPANY
SIGNATURE REGISTERED VE_E_CURRF`N -------
Address F_ License #
MECHANICAL COMPANY �
SIGNATURE E=== REGISTERED FIE CU�RREI
Address License #
OTHER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address License #E=:=:=
2#11t# Is It Isis it#* #I*##2#11#111#1## 111# 1 #it I *I at
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 w/ Silt Fence installed,
Sanitary Facilities & 1 clumpster, 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)
11
— 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 Solar
* Local Experts who Care
PERMIT NUMBER:
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Florida Statutes, the following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY (Legal description of the property & street address, if available) TAX FOLIO NO.: 11 -26-21 -0010-03100-0010
SUDDIVISIONZH PQ 1 PQ 54 BLOCK31 TRACT LOT1 2 3 BLDG UNIT
5651 6th SL2p"h rhLiI1.sFlQri0a_33542
2. GENERAL D"CR'PT'ONOF'MPROVFMENT: Roof Mounted Solar Panel Install
3, OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
a. Name and address: Jason Wagner 5651 6th St Zephyrhills FL 33542
b, Interest in property: 100%
c. Name and address offec simple titleholder (if different from Owner listed above):
4. a. CONTRACTOR'S NAYS: US Solar
Contractor's address: 2732 Broadwa -n Center -BIvd Brand b, Phone number: 35
y� --Ft-�3510 00-1-- -a-- --Z43XQ--
5. SURETY (if applicable, a copy of the payment bond is attached):
a. Name and address:
b, Phone number
6, a, LENDER'S NAME:
Lender's address:
c. mount of bond: S—
Phone number:
7. Persons within the State of Florida designated by Owner upon whore notices or other documents may be served as provided by
Section 713 13 (1) (a) T. Florida Statutes:
a. Name and address:
b. Phone numbers of designated persons:
8. a, In addition to himself or herself, Owner designates ------ -- of —
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b). Florida Statutes.
b. Phone number of person or entity, designated by Owner:
9. Expiration date of notice of commencement (the expiration date will be I year front the date of recording unless a different date is
specified): , 20_
WARNING
ARE CON IDERED IMPROPER PAYMENTS I rNDER CHAPTER ?1.3 PART i SECTION ? 13 13 FLORIDA STA TES ND CAN
RESULT IN, YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPE"i- licil, IF YOU INTEND TO OBTAIN Fli, AI i iCING —CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT,
Jaw47, Waq4�
13235dfb393,b8Oc,ba30c96efdbac8acOlbbdfo205dO9c2d6c2,
(Signature of Owner or Lessee, or Owner's or Lessee's
Authorized Officei-/Directoi-/Partner/Manager)
State of Florida
County of Pasco
Jason Wagner
(Print Name and Provide Signatory's Title/Office)
The foregoing instrument was acknowledged before nic by nicaris of [a, physical presence or 0 online notarization.
this 22nd day of DM _A 20 23
by Jason Wagner as Homeowner
__--
(name oftlerson) (type of authority_.e.g. officer, trustee, attorney in fact)
for Self
(name of party on behalf of whom instrument was executed)
Personally Known or Produced Identification / Type of Identification Produced DL
-e
MILKALYS ROAGUE2
hotary Public - StatE of FlorWa
(-ignatureof otaryPublic)
(Print. T-
ype. or Stamp Commissioned Name of Notary Public)
Ay"toMm . E-Vites . all 3, 1026
Rev- 10-15-12
Solar
Local Experts who Care
• We will design, install, and maintain the
System .
• The solar panel manufacturer provides
warranties with registration regarding
panel performance. Visit your panel
manufacturer's website for details.
• The inverter manufacturer offers a
workmanship warranty. Visit the
manufacturer's website for details about
your specific warranty and any exclusions
that may apply,
• We will fix or pay for any damage We may
cause to Your Property or belongings
during the time of installation.
w To pay the Contract Price for the
System.
° Ensure that Your Property and
roof are ingood condition,
w Respond toOur sales and
support teams when scheduling and
completing paperwork,
w Tbcomply with the
terms ofthis Agreement.
0 To maintain the System,
ADMINISTRATIVE AND WARRANTY SUPPORT SERVICES, AND MAINTENANCE
SERVICES:
* Subject to the hanns of this Agreement, We will provide warranty and customer support
for your System for up to 10 years.
In addition to any manufacturer warranties, We will provide Our Workmanship Warranty
for your System for up to 10 years, subject to the terms of this Agreement.
Primary Phone: Alt. Phone:
PdrnaryErnai|:
Property Address:
City: :FL Zip: 33542
Estimated Installation Start Date: 08/06/2028
Estimated Completion Date: 07/21/2023
Installation Notes:
***4J| dates set forth above are estimates only and may be subject to change based on
availability and other factors.
Sales Price: $39,35000
OtherInrentive(a) or Discount(s)
(if applicable):
Total:
In witness whereof, the Parties hereto have executed this Services Agreement on the date set
forth below
31111�1110
Jawn, Whj".w
By: 13235dfb393b80cba30c96efdbac3acOlbbdfe205d09e2d6c2�
Name: Jason Wagner
Title: Homeowner
Date: April 22, 2023
By:
07d82b480887c8f2663bee4482b94f6b8527d243cd0395c3bE
Name
Seann Gates
Title:
Installer
Date:
04/22/2023