HomeMy WebLinkAbout07-6352
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
DRIVEWAY PERMIT
6352
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
6352
DRIVEWAY
DRIVEWAY/NEW
NOT APPLICABLE
Address: 5336 5346 16 T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-17200-0075
1,000.00
1/05/2007
70,00
70.00
1/05/2007
INSTALL NEW DRIVE WAY
Name: GOLDNER, DANIEL
Address: 5336/ 5346 16TH ST
ZEPHYRHILLS, FL. 33542
Phone: 813 782-3901
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FINAL
REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site g) work not accessible.
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 permits required from other governmental
entities such as water management, state agencies or federal agencies.
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."
MUST BE 6" DEEP WITH WIRE MESH AT RIGHT OF WAY
" ~~
CONTRACTOR PERM IT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
81J-780-00fO
City of Zephyrhills Permit Application
Building Department
~1,.()' Fax-813-780-0W~?S 1/
Date Received
u/'? 7Y,t-:J9tJ
Owner Phone Number ~,J-
Owner Phone Number I 11 g-- ??"2- - J q d )
OWner Phone Number I flJ -7 ii.. ~ 3 Cjo )
Owner's Name
DESCRIPTION OF WORK
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NEW CONSTR
INSTALL
SFR
BLOCK
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PARCELlD#II/p('?-,(/-t~~)/t' /? ,200 -00 ~~
(QBT AINED FROM PROPERTY TAX NOTICEI
SIGN 0 MOVE 0
LOT #
JOB ADDRESS
SUBDIVISION
PROPOSED USE
TYPE OF CONSTRUCTION
ADD/ALT
REPAIR
COMM
FRAME
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DEMOLISH
WORK PROPOSED
OTHER I
STEEL 0
OTHER (
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~UILDlNG SIZE I SQ FOOTAGE I HEIGHT I
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D BUILDING 1$ /~ {lOti. d CJ I
D ELECTRICAL 1$ I
D PLUMBING 1$ I
D MECHANICAL 1$ I
o GAS D ROOFING D SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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:::1~~RE I I ~"<>~';.'::'~ I Y f N FEE "'ARENT Y f N I
Address I License # I
ELE., CTRICIAN I COMPANY I
SIGNATURE . REGISTERED Y I. N . FEE CURRENT Y 1 N
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~'~~':TURE It) J1,A1 ; c::! f7 . a01A i;lft I ;~.';."= I Y f N FEE ""'RENT Y f N I
Address I License # I
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RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
AtJach (3) sets of Building Plans; (1) set of Energy Forms.
Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster
All commercial requirements must meet compliance.
Attach (2) sets of Engineered Plans.
''''PROPERTY SURVEY required for all NEW construction.
1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111.1111111111111111111111111111111111111111111111111111
Directions: . . ,
Fill out applicatlon completely.
Owner & Contractor sign back of application, notarized
If oyer $2500, a Notice of Commencement Is required. (A/C upgrades over $5000)
.., Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing
OVER THE COUNTER PERMITTING (Front of Applicatlon Oniy)
. Reroofs Sewers Service Upgrades AlC
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
D
PROGRESS ENERGY
D
W,R.E.C
VALUATION OF MECHANICAL INSTALLATION
Address
License #
COMPANY
REGISTERED
PLUMBER
SIGNATURE
YI N
FEE CURRENT
Y/N
Address
License #
MECHANICAL
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
yrN
Address
License #
COMMERCIAL
SIGN PERMIT
Driveways
Fences
NOTICE OF 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. dee.d . restrictions.
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
understate 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 hl;1shlred 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/UTII,.ITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Re,?overy 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 I, 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 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, 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 "An In connection with a permitted building using stem wall
construction, I certify that flll.w1ll 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 i.ssued 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 OWNER, I.promise in good faith to inform the owner of the permitting conditions s~t forth In
this affidavit prior to commencing construction. I understand that a s.eparate perm~t may ~e required for elect~lca.1 work,
plumbing; signs, wells, pools, air conditioning, gas, or other !nstallatlons not speCifically 'n~'uded, in the applicatIon. A
permit issued shall be construed to be a license to proceed With the work a~d not as authorr~y !o v'ol~te, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the BUilding OffIcial from the~eaft~r
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 commen~ed within six months o.f permIt issuance, or if work authorrzed. by
the permit is suspended or abandoned for a period of SIX (6) months after the time th~ work is commenced: An extenSion
may be requested, in writing, from the Building Official for a period not to exceed nrn~ty (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, CONSULT
WITH YOUR LE R OR AN A ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT ,S. 1 7.0~)
OWNER OR AGE
Subscribed and swom to (or affi ad) before me this
by
Who Is/are personally known to me or has/have. produced
as Identification;
CONTRACTOR
Subscribed and swom to (or affirmed) before me this
. by
Who Is/are personally known to me or has/have produced
as Identification.
Notary Public
Notary Public
Commission No.
Commission No,
Name of Notary typed. printed or stamped
D:ISCLOS'DRE STATEMENT FOR OWNER
CJ:.TY OF -ZEPRYRH:ILLS BUJ:LDJ:NG DEPARTMENT
:I, MI;E'Lfl, /Jt') Ld/J1~r- . have read and ful~y understand and
agree to the provisions of this instrument.
The undersi~ed states and affirms that he or she is desirous of constructing,
renov.ating, adding to or reroofing his or her own domicile;, that he or she
actually occupies, or wi~l occupy by said. domicile, and same is not for
rent, ~ease or sa~e. That he or she shall comply with the following conditions.:
~. That the owner and. he or she alone shall act .as the builder.for all phases of
construction.
2. That the ownerwil~ comply with all provi,,!ions of the City of Zephyrhills
ordinances and codes pertinent to .the building.
3.. That in the event various phases of constructi~n are subcontracted, he will
engage only properly ~icensed 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. .responsibili ty to insure they are made, . and upon
completio:c: wili call for a reinspection before proceeding with the building.
.5. That the oW:c.er shall assume full responsibi.~ity for the construction and will
not expect supervision of his work from the City of ZephyrhillsBuilding -
Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office.shall
,constitute- an officia~ notice. to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws' in: regard to
social aecuri ty ~ 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 peDnit 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 s&ll.;or' lease. a
building yoti _ have buil to.rsubstantial.ly impr.oved yourseifwi thi:e: l. year after
the construction is complet~, the l.aw will presUme.tha:t you built: or
substantially improved if for sale or lease, which is a. violation of this
exemption. You may not hire an unlicens.ed 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 wj,thholding tax-
and provide workers' compensation for that employee, all as prescribed by iaw.
Your construct~onau c~ly with all appli-cable laws, ordinances, building
codes, and zo:z:u.ng eguI t.J.ons.
. . ,
OWNER'S SIGNA:. DATE ;r /.:?/o7 r
ADDRESS :.2 :r~L.
:E'BONB
WJ:'l'NESS
PERMIT .. #:
OWNER
EPIIYRHILLS BUILDING DEPARTHENT
L
/t
JOB LOCATION
PARCEL I.D.' #
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIHENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 &~
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FR
STREET
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1. SETBACKS FOR Rl, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
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10' P S 10'
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S I
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20'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
:PERMrr:~PPJ.:ICATION
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{[)RDlEWAYiP.ERMR'.,A~~l![CAmON
~OONs;rRUcn:ON'WI7[HIN ~P.tJBI3C :RIGHtr~OF~WAY
:AII information ~ be'filled-In completely
.\CiW.of~phyrhills
'5335 :SthStreet, 2ephyrhills,R33542
"Telephone .813.780.0000 Fax 813.780.0005
~
',CONTRACTOR:
"
~~~,
E-Mail:
Fax:
-
ARCHITECT/ENGINEER:
.Name:
Address:
StateUcense :It:
. Firm Name:
City:
Phone:
State:
Cell:
Zip:
Fax: .
Desc:riDtion of Proiect
LENGTH OF DRIVEWAY
/d.t.='l.WWTH OF DRIVEWAY
~ . EXCAVATION
_DEPTH ~UNEARJFEEr
.'CURB.ClIT'REQUIRED
_YES _NO-
CULVERTS.NEEDED
( )REINFORCED CONCRETE
( rCORRUGATED MATERIAL
( ) BOX OJLVERT
( ) OTHER (EXPLAIN)
::L OF DRIVEWAY
RESIDENTIAL DRIVEWAY
_COMMERaAL DRrVE)NAY
_PUBUC ACCESS DRIVEWAY
CONSTRUCTION MATERIAL
_ASPHALT
~CONCRETE
HEADWALL REOUIRED" _YES _NO
~,..,.'.'.'.'.....'.."J:..{1~..1,"..'.'.,.,.~"'.."....\....,.
~._. ...- .. ."fl. .. .:-: .. ,- _.-: ,..... .. .... '" -. ....
.- ...' ".,'
. ~ '.,
NOTICE TO APPUCANT: If actual work exceeds scope of this desaiption, additional pennits or drawings
will be required.
UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770
Page 1 of 3
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;PERMIT 'APP.tICATION
~OF.F.ICE~USE!ONLY
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. Concrete (min. 6'') ( Y ) N "" ( -r....t..,' f''-' 6L.l (! 2. \. G ~-r of "'" A "(
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. Asphalt.Base (min. 6") . Y N -;
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Asphalt (min. :1112') .y .N J
- .
Length (min. :19') 1 y, N '-l.l.{ I. _ OU
~
Width (10' min-20' rnax) 7y~) N \0'
EXisting sidewalk. Y (N)
-
.
New sidewalk. Y (N) .
-
ADA compliant. . .y N. ~/A
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Expansion. material required. r y) N
\...,./' ~
Contiguous parking pad. Y (<N ) .
.- --
Triangular'flare (3'W x 7'L) ( Y ) N .
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Visibility triangle o.k.? rV) N "
-
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Side set bac:k (3' min.R.O.W.) I Y ) N .
'-- .
Plan Review Fee
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Date:
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Page 3 of 3