HomeMy WebLinkAbout03-2467
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
2467
Permit Number: 2467
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 1,000.00
Date Issued: 10/31/2003
Total Fees: 35.00
Amount Paid: 35.00
Date Paid: 10/31/2003
Work Desc: RE-ROOF
Address: 39320 6TH AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: ROSA MACIAS
Address: 39320 6TH AVE
ZEPHYRHILLS, FL. 33542
Phone:
- .. 1_- t !
REINSPECTION 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
uJbe pay'!!ent of inspection fees shall be made before any further permits will be issued to the person owning same
"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
before recording your notice of commencement."
-'----' 'Complete Plans, Specifications and Fee Must Accompany Application.
_______ ______ _ ____ AUvlfork shall be performed in accordance with City Cod~s and Ordi':lt:inces _n ___ n____
NO OCCUPANCY BEFORE C.O.
'~ ~~-iio~ s,~;iSJ:? S. ~MIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
fJ QQ~
CENTRAL PERMlmNG OFFICES:
· Dade City: (352) 521-5144 FAX (352) 521-5149
13852 17th St.. Dade City
· New Port Richey: (72n 847-8126 FAX (727) 847-8901
7530 Uttle Rd., Rm. 210 New Port Richey
· Land O'Lakes: (813) 929-1266 FAX (813) 929-1307
4111 Land O'Lakes Blvd. (US 41), Land O'Lakes
THIS APPLICATION MUST BE TYPED OR PRINTED IN INK
AND IS VOID IF NOT PERMITIED WITHIN 6 MONTHS
PASCO COUNTY BUILDING PERMIT APPLICATION
SHADED AREAs FOR OFFICE USE ONLY
OCCUPANCY: SEQ#:
NO. OF UNITS:
RRE DISTRiCT:
TYPE CONSTRUCTION:
DATE RECEIVED:
II
PERMIT#:
m N
BY:
VI
v
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IS THIS APPLlC.ATlON THE RESULT OF A~S OP W~R.K ORDER OR NOTICE. OF VIOLATION? Y _ N_
G OWNER'SNAME:, '~f1,-~B - .CUi.S. ,"t1-~HONE# (~) lR~ _ j(QC, /
9 JOB LOCATION: ,5cr3d-() -" _~, ~ _ _ "S'USOIVISION:
CD PARCEL 10#: S_ T - R - SUB BLK _ LOT _ PROJECT # TAZ _ LOT SIZE _x_
~ OWNER'S PRESENT ADDRESS: 3'l'l di\ ~ P. \/.R. CrTY: <<'P" yt h ,- i (", STATE: FL ZIP: '0'; S'I ;;J
3:
o FEE SIMPLE TITLEHOLDER'S NAME Of other than owner):
address (if applicablel: CITY: STATE: ZIP:
~~;;~;;:;;~-y--~---:;:--~~-->y::;P;i-r:--mn-----mn---n----------__n_____
~ UVING AREA: PATIO: GARAGE: ENTRY: TOTAL UNDER ROOF:
9 # BEDROOMS - # BATHROOMS -- _ TYPE CONSTRUCTION: 0 BLOCK 0 FRAME 0 OTHER:
CD FILL Y _N_
~ IF MOBILE HOME OR RV: MAKE
i=
Q.
a: WORK CODE PLANS ON FILE? 0 NO 0 YES
~ MODa NAME
C 'd
VALUATION $ {Or> () RECEIPT #: BUILDING: $
-------------_Jl_________________________________________________________________
BONDING COMPANY:
:.: ADDRESS:
u
o
~ ARCHITECTIENGINEER:
ffi ADDRESS:
j:
o MORTGAGE LENDER:
ADDRESS:
YEAR
SIZE
PRE-PAlO PLANS FEES: $
CITY:
STATE: _ ZIP:
CITY:
STATE: _ ZIP:
CITY:
STATE:' ~ ZIP:
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CONTRACTO :
SIGNATURE:
:.: ADDRESS:
8 STATE UC # (if applicable)
-'
CD
a::
e ELECTRICAL CONTRACTOR:
~ SIGNATURE:
~ ADDRESS:
~ STATE UC # (if applicable)
U POWER CO:
PHONE # (_)
CITY: STATE: _ ZIP:
PASCO CO COMPUTER 10#:
SAWPOLE: AMPS:
MECHANICAL CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE UC # (if applicable)
o NEW 0 ALTERATION VALUATION: $
PHONE # (_)
CITY: STATE: _ ZIP:
PASCO CO COMPUTER 10.:
(Required)
PLUMBING CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE UC . Of applicable)
, AXTURES: SEPTlC PER #
PHONE# (_)
CITY: STATE: _ ZIP:
--, PASCO CO COMPUTER 10':
SEWER: WATER: WElL:
OTHER CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE UC # (if applicable)
TYPE CONTRACTOR:
PHONE# (_)
CITY: STATE: _ ZIP:
PASCO CO COMPUTER /0#:
VALUATION: $
---------------------------------------------------------------------------------
OTHER FEE TYPE:
AMOUNT: $
RECEIPT#:
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JOBS UNDER $2,500 IN VALUE DO NOT NEED TO
RECORD AND POST A "NOTICE OF COMMENCEMENr
TOTAL BUILDING PERMIT FEE:
....NOTICE....
BOTH THE OWNER AND CONTRACTOR OF RECORD (Ucense Holder) MUST READ AND
SIGN THE REVERSE SIDE OF THIS APPUCATION
FEES BlOCK
PlANS FEE: $
8.ECTRlCAL
FEE: $
MECHANICAL
FEE: $
. OTHER
BI.DG.
FEE:
$
RADON
FEE:
$
hS
(permit form 1(191)
EDfTIONS OF THIS FORM RELEASED BEFORE 1/91 ARE OBSOLETE AND WILL NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF
PC93043032/G (OVER)
.;. 'JOTICE OF DEED RESTRICTIONS
The undersIgned understand that this permit may be subject to "deed restrictions" which may De more restrictive than County 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, thev may be reqUired to lle licensed in accordance WIth state and local regu-
lations. 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 Division - Licensmg Section at (727) 847-8009.
Furthermore. If the owner has hired a contractor or contractors. he IS aavised to have the contractor(s) sign portions of the "contractor BlOCk" of
thiS application for wn,ch thev Will be responsible. If you. as thl:! owner sIgn as the contractor, you are indicating that you, rather than the contrac,
tor, are responsIble for the work. If the contractor Wishes you to sign as contractor, that may pe an Indication that he IS not properly licenSed ana
IS not entitled to permitting privileges In Pasco County.
C. TRANSPORTATION IMPACT/UTILlTlES IMPACT AND RESOURCE RECOVERY FEES
The underSIgned understand that Transportation Impact Fees and Resource Recovery Fees may apply to the construction (1f new bUildings,
change of use In eXisting buildings, or expansion of existing buildings, as specified in Pasco County Ordinance numbers 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 pala prior to receiving a "certificate of occupancy" or tinal 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 oe paId prior to permit issuance. In accordance with applicable Pasco County ordi-
nances.
D. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended)
If valuation of work is $2500.00 or more, J certify that I, the applicant. have been provided with a copy of "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.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application IS accurate and that all work will be aone In compliance with all applicable laws regulating con-
struction, 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 commended
prior to Issuance of a permit and that all work Will be performed to meet standards of all laws regulating constnctlon. County codes, zOning reg-
ulations, and land development regulations In the junsdiction. 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, WatertWastewater Treatment.
· Southwest Florida Water Manaaement District - Wells. Cypress Bayheads. Wetland Areas, Altering Watercources.
· Armv CorPs of Enaineers - Seawalls, Docks, Navigable Waterways.
· Deoartment of Health & Rehabilitative Services Environmental Health Unit - Wells, Wastewater Treatment. Septic Tanks.
· US Environmental Protection Aaency - Asbestos abatement.
· Federal Aviation Authoritv - 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 till 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 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 till, 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 provi-
sions 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 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, CONSULl WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
SIGNATURE ~OS rt t; Ml'1r fb S
\: OWNER OR AGENT
SIGNATURE~l\~ ~
CONTRACTOR
DATE
DATE
NOTARY AS TO
OWNER OR AGENT
NOTARY AS TC
CONTRACTOR
MY COMMISSION
EXPIRES
MY COMMISSION
EXPIRES
OWNER-BUILDER AFFIDAVIT
BEFORE me, the
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)
{~ M \
undersigned authority, personally appeared a. E. QccfA.S
, who being by me first duly sworn, under oath, deposes and states
)TATE OF FLORIDA
~OUNTY OF PASCO
'IS follows:
I do hereby swear/affirm:
That I own the property described as
z.~pl\yrl\' \lS
3q :~{JO ~ #
pL- ~ ~6c.td.-
.r; ve.
Disclosure Statement
State law requires construction to bp- done by licensed contractors.. You have applied
:or a permit under an exemption to the law. The exemption allows you, as the owner of
four property, to act as your own contractor even though you do not have 8 license. You
lust supervise the construction yourself. You may build or improve a one-family or two-
:amily residence or a farm outbuilding. You may also build or improve a commercial
)lii lding at a cost of $25,000.00 or less. The. building must be for your own use and
lccupancy. It may not be built for sale or lease. If you sell or lease a building you
lave built yourself within one year after the construction is complete, the law will pre-
;ume that you built it for sale or lease, which is a violation of this exemption. You may
lot hire an unlicensed person as your contractor. It is your responsibility to make sure
:hat people employed by you have licenses required by State law and by County or municipal
.icensing ordinances. Any person working on your building who is not licensed must work
.nder your supervision and must be employed by you, which means that you must deduct
'.I.C.A. and withholding tax and provide Workers' Compensation for that employee, all as
,rescribed by law. Your construction must comply with all applicable laws, ordinances,
,uilding codes, and zoning regulations.
That I have read the foregoing, and am aware of my responsibilities and liabilities
or construction work on the above-described property and do hereby agree to each of the
foresaid stipulations.
FURTHER AFFIANT SAYETH NOT.
([:<C6ct t; - LA (f C (a 5
Owner s Signature
Address
Date
WORN to and subscribed before me
his day of
0_
otary Public
tate of Florida at Large
My Commission Expires:
rint, Type, or Stamp Commissioned
ame of Notary Public
ersonally Known _____ or Produced Identification
----- ,
~pe of Identification
;G3053047