HomeMy WebLinkAbout03-2539
I---~--
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
2539
Permit Number: 2539
Permit Type: RE-ROOF
Class of Work: ROOF REPLACEMENT
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 1,200.00
Date Issued: 12/02/2003
Total Fees: 40.00
Amount Paid: 40.00
Date Paid: 12/02/2003
Work Desc: RE-ROOF
Address: 38843 SOUTH AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: RAY DANIELS
Address: 38843 SOUTH AVE
ZEPHYRHILLS, FL. 33542
Phone:
------ ----~ - -
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
The payment 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. II
I-~--"-' ----- mplete Plans, Specifications and-F-ee Must Accompany Application. ~-._-_._-
! II e rformed in accordance with City Codes and Ordinances
1_____ N OCCUPAN-CYBEFORE C.O. __ --- ---------
~
!
ex
TRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhil1s, FL 33542
813-780-0020 FAX:813-780-0021
DATE RECEIVED
OWNER'S NAME4-j /! J ,4P; c.cj
JOB ADDRESS :JO'J-y::? So ,//7/ ~
PHONE CONTACT FOR PERMITTING
PHONE
~?J~~;2 6.~/b'
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # //-c2tt'--~/ cJO/ () -c2/VOd-o/YD (OBTAIN
WORK PROPSED: ONEW CONSTRUCTION 0 ADDITION ~ERATION
FROM PROPERTY TAX NOTICE)
o REPAIR
o INSTALL
OS IGN
PROPOSED USE: ~ FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
DMTJLT I - FAMI L Y
o INDUSTRIAL
0# OF UNITS
o MOBILE HOME
o OTHER
o
SWIMMING POOL
DESCRIPTION OF WORK
c:J RESTAURANT &
..s IA....., c; >(~,
/
HEALTH DEPARTMENT APPROVAL
l?e.. ~
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
/ .;2 eJ
C>-
=---
$
VALUATION OF MECHANClAL 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 0 NO
L____L_________________
OONTRAOmR~r14ltor.r:tQN
j .,....1, ",'.",. ':';_, '_,:- -"-",.1',:',' ",>_;;,,,..,-.fr,,,.- "">f. ':,,,~ ...,.".~.<:,:'..,.'::C.....;j-:-.. ::'- ..:.....,.;., "..
--------~
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
********************************************************.,*********
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictionsU 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 cont~actors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsU 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 indica~ion 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 Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerU, I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "ownerU prior to commencement.
E. CONTRACTOR' S/OWNER' S AFFIDAVIT
I certify that all the information in this application is accurate and ttlat 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 vwrk 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 "AU or "A,elc.u, it is
understood that a drainage plan addressing a "compensating volumeu wiLL be submitted whiCh
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
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 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 COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE~OR I Gm.;MENTS TO YOUR PROPERTY. IF YOU INTEND TO 0 N FINANCING, CONSULT
WITH YO~~. ~~ ~TORNEY BEFORE RECORDING YOUR NO):IO OMMEN, ..~1E"N-;r--"-------JOBS UNDER
$2, 5,~!}/IN UE N~EED TO RECORD AND POST A "NOTI, '?F C MENCE~p"J ", /
d-.::' ../ /,;.,/ /
~/~ / , /~ ~7v-~-~_
SI~ATURE: OWNER OR AGENT SIGNAT~RE: 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 acknowledged
Before me this _day of-----, 20
by
(name of person acknowledged)
Olho is personally known to me, or
(name of person acknowledged)
Dwho is personally known to me, or
Dwho has produced
(type
and whoD did D did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Odid Odid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
I,
agree to the provisions of this instrument.
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.
That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
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.
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.
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.
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.
That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
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' compensati hat ployee, all as prescribed by law.
Your construction must pl with 1 appl' able laws, ordinances, building
codes, and zoning re~~t'
2.
3.
4.
5.
6.
7.
8.
9.
OWNER'S
ADDRESS
PHONE
DATE
/P?/z~
,
WITNESS
PERMIT #