HomeMy WebLinkAbout03-2412
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
DRIVEWAY PERMIT
2412
Permit Number: 2412
Permit Type: DRIVEWAY
Class of Work: DRIVEWAY/NEW
Proposed Use: SINGLE FAMILY RESIDENTIAL
Square Feet:
Est. Value:
Improv. Cost: 2,500.00
Date Issued: 10/13/2003
Total Fees: 45.00
Amount Paid: 45.00
Date Paid: 10/13/2003 I
Work Desc: ASPHALT DRIVEWAY - CIRCULAR
Address: 5225 10TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: - Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-18200-0060
DELGADO GLORIA
5225 10TH ST
ZEPHYRHILLS, FL. 33542
Phone:
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: , I. ._____.___
REINSPECTlON FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-five dollars ($35.00) shall be made for each trip for each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warrnng to owner: Yo':'-rlailLII1!to-recorcfil-notlce -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
before recording your notice of commencement."
-.-------.....----.- Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
MUST BE 6" DEEP WITH WIRE MESH AT RIGHT OF WAY
---~_._-".^...__._--,--._-..,.- -----,-._._----_.__._-~_._--~.
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CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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agree to the provisions of this instrument.
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6 /O/C 1/1
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
C. )ELG-/l-do
have read and fully understand and
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.
2. That the owner will comply'with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of 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 reinspect ion 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 Zephyrhills Building
Department.
6. That prior to final inspection any additional fees, including reinspect ion
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 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
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 $25,000.
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 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
make 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 F.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 re lation~.
OWNER'S
ADDRESS
PHONE
SIGNATURE
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WITNESS
PERMIT #
'BO'UNOARY SURVEY
SCALE: 1" = 20'
REMAINDER
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ADDRESS: 5225 10TH STREET
ZEPHYRH/LLS, FLORiDA.
lP 1"
PLATTED' ALLEY
NORTH 80.00'(P)
N.OO'OO'14''W. 79.90'(M)
150. 00 '(P)
153.32'(M)
~8"
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NOTE:
A-ARC
~ 8IJ - BENCH MARK
~ eRG - 8EARJNG
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..:J cs - C4TCH BASIN
This survey was conducted without the benefit of an abstract of title, therefore there may be othfJr fJasemfJnts, right-of-way,
setback Imes, agreements. reservations, restrictions, or other similar matters of public record, not depicted 011 thifJ survey,
CH8 - CHORD 8CARING D~ - DRAINAGE: E'ASEJ./ENr FH - FlR~ HYOfW{T IJH _ /JANHDLE PP - POWER POLE
CH - CHORD ~OP - E:DGE: OF PAvafENr F1P - FOUND IRON PIP~ OHP .. OVFJ/HFNJ POWEll LINE: R - RAOIUS
eLF - CHAIN UNK FENC~ row - E:DG~ OF WAIDl FIR - FOUND IRON ROD P - PLAT f: -slfk!ROJJo'f,f, G4P I H$5
CONe. - CONCRUTi FCC - FOUND CROSS CI./r FN - FOUND NAIL PC - POINT' OF CURVATUR~ U~" UTI' ~ r..",,,,,,,,,
CSW - CONCRE1E S/DEWAU( FeIJ - FOUND CONCRUTi FPP - FOUND PINCH PIP~ PCP .. PfRIMNE:NT CONTROL PDINT ..., - HI4~ ~.."
D - DEED UOUNUIJOiT" - ItIE:ASlJREJ.tENr PI - POINT' OF INTERSreTION iiF = ..... """
FLOOD /NFORMA nON.'
ZONE: X
NUM8ER: 120235-000S-C
DATE: 12-17-91
LEGAL: SECTION: 11 TOWNSHIP: 26S RANGE: 21E CERTIFIED TO:
LOTS 6, 7 AND 8, LESS THE SOIJTH 10 FEET OF LOT ~ BLOCK 182, CITY GLORIA Co DaGADO
OF IfPHYRHILLS(FORlJfRLY TOWN OF lEPHYRHILLS), AS RECORDBJ IN PlAT BOOK 1, =krt#'tcrr-:- ~1>1JAGE CORP,
PAGE 54, ACCORDING TO THE PUBUC RECORDS OF PASCO COUNTY, FLORIDA. STEWAHf TfTZE GUARANTY COUPANY
FlELD WORK BY:
JB
WB
BW
DRAWN BY:
CERTIFICA TION:
I HIrREBY CERnFY THAT THIS SUIMY WAS /MDE UNDER
MY RF:SPONSIBLE CHARGE AND MEETS THE MINIMUM
TECHNICAL STANDARDS AS SET' FORTH BY THE BDARD OF
PROFESSIONAL LAND SURVEYORS IN CHAPTER 61G17-6 OF
THE FLORIOA ADUINISTRAnvr:: COD~, PURSUANT TO S~CnON
472.027 OF THE FLORIOA STA1UTf:S. NOT VAllO WfTHOur
SIGNATURE AND ~MBOSSED WITH SURVE:YOR SE;4L.
DATE: 12-15-01
REV/SION DA TE:
1:
2:
3:
JOB # 01-5680
PAGE I
. ~ A .~ \{\A ~ _ rz..-Ic;~bl
-d ~ tlA ~ PLS 4-N5 DATE
DATE: 12-17-01
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8th Street, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021 JtJ-9- CJ.3
DATE RECE lVED C. -
PLANS REVIEW FEE
. Gloria Delgado
5225 10th St.
. ..... Zephyrhills, FL 33542-5023
zuo tV<-
PHONE(f/3) &~( .:. S"sl L
OWNER'S NAME
JOB ADDRESS
~.
LEGAL DESCRIPTION: LOT (S) ~ 't- "tI'-? rilES BLOCK /f?:L-
(.'/0 t;~t"711
/ /- ;2(,- ~/- {}tJ t}-lg~{)O-OO&'U
SUBDIVISION
PARCEL 10 #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
~~Q - ~~
. SQUARE OTAGE
HEIGHT
BUILDING SIZE
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. d__.........
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~UILDING
o ELECTRICAL
$
:zrov
VALUATION OF TOTAL CONSTRUCTION
/jjLI!~/..
\ ~/'
'------~'
PERMITS REQUESTED
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLut1BING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES
o NO
BUILDER
SIGNATUREV ~~4d~
I
("-/.
COMPANY '/y ~L-A /
. L/
STATE CERT OR REGIST #
CITY PROCESSING #
********************************************************~*********
ELECTRICIAN
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
********************************************************)~*********
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
********************************************************1~*********
MECHANICAL
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
Cm1PANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. 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
City of Zephyrhills Building Department, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work, If the contractor wishes
you to sign as contractor that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify 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.
E. 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, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental 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 Regulation-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
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance,
A per~it 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 techniā¬al 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 code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A nOTICE OF COMMENCH1ENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COM~1ENCE~1ENT. ,JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
, 20_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
acknol-'Iledged
, 20
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
o,ho is personally known to me, or
Dwho has produced
(type
and whoD did 0 did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and I-'Iho Ddid D:iid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped