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Home My WebLink About07-6805 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 6805 Permit Number: 6805 Permit Type: MECHANICAL Class of Work: A/C CHANGEOUT Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 39007 BLUEJAY AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 13-26-21-0100-00000-0280 5,135.38 60.00 60.00 6/27/2007 A/C CHANGE OUT H ( . I' '. .1 ;- .....( i"O...\u..j (~ /0' /5- 7 T DUCTS INSULATED FINAL REINSPECTION 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 f) plans not at 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 recordin your notice of commencement." NO OCCUPANCY BEFORE C.O. ~~ OR SI A URE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER JUN.i7.200~ 11:44 7278168865 June 27,2007 To whom it mny-{\oncem, Air Conditioning & Heating #1073 P.002 /002 This letter is to authorize Linda Thomas and John white to sign for pcrmit~ on behalf of Millian-Aire 1.~1lt. Corp. Than~~ You, .' ~.:.~.(. ~/.ti.>, .~ ~." '-~'" .r\.:.," ," , '. slrsail Millian Vice President Millian-Ail"eHllt. Corp, Ii ;1 /.1/1 j, {I Yl - . r /I.,.l_....../~ -' LM-....._. !' ... a.. ."JAM;;S.R~ .tELLEZ.........., . . : ...."".,""11I ,..__~ : : .~..,r,j ''IA~' -...... t22I I ; !~ai~' ~~ i i ~~DF~ ~ "'" ("'3H254~ ,....:=..........~~Af:::~.~J UL'",n:;e 41 CA(;O~:' I? ( "-'-'"-'--~.. .-.----.'-" -.--~__.__.___.M______. ~? 780G Conwr,S$ Street I N"w hlrl Richey, Flon(l,:l ~14653 I Tel: 727.111';;;'.:> I()U I I ax: 127.816.BBG5 I www.millian-aire.com JUN:27.2007 11:43 7278168865 #1073 P.001 /002 ..~.: ":,. .... .~...' CI .. _ '- .......n.. ~~.:---1o ),. ";) ...::;. ~"~:1 ~-; '. ,~~:': 7805 Congress Street New Port Richey, Florida 34653 . Pasco (72t) 862-2100 '* Hernando (352) 688-1 i 70 Fax Number: (727) 816-8865 --....'-......,_-~.~_.. ....-...........-.0:-...- .....--..___1Ia:o;._.... ....".__. _.. .'_~_-':""__ ___ _ _'''__'', p,t'.J: Co\rE}~3.f-~;~\~~: To: ...r .' I,'.:" [j? 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Purchase Order No.: 8402 Footer Ok Sign Type & Name: Concept 41 OCQ-41 0-N-2000 i Column Ok - _.._-~ ~ .--.- Drawing Number: D7-3296(5)-N-2011 i Bolts Tension I Ok . - I Variables: ! Bolts Shear ----+ Date: 6/4/2007 I Ok ! Approx. Sign Wt. 750 Ibs. I Footer: 1 >-_ ____ Columns: 2 --.. Wind Speed 120 mph I diameter 1.5 ft. d1 0 - . n Directionality ~ 0.85 length L: 10 ft. do 0.00 ---- -- I ------. Exposure Kz 0.57 r width W: 2 ft. b= 4 in ! .---- ---....-.--. !d= Topographical Kzt I 1.00 Height H: 3.83 ft. 4 in --l ~.. . on -- - --4--- : Importance Factor* i 1.00 Depth D: 3.5 ---- .._.. .M___ -- Gust Effect G 0.85 Bolts: Spacing: 9 in. c/I h= 3.626 in Qty: 1 k= 3.626 in Dia.: 0.334 in^2 w= 0.187 in f------- Velocity Pressure: 1 I Qz=O.OO256KzKztKdV21 I Area 1 Area 2 Area 3 Totals Area: 9.92 40.00 0.00 Velocity Pressure: 1 17.86 height 1.24 4.00 0.00 width 8.00 10.00 0.00 Cf 1.60 1.60 1.60 centroid 0.62 3.24 5.24, 2.72 ft. .- ----- - wind pressure 24.29 24.29 24.29 ---.-- Structural Material: : 46000 wind force 240.96 971.62 0.00 1212.58 Ibs -..-- _____ __u___ ---- Moment 149.40 3148.04 0.00 3297.44 Ib-in ~ - ." ,-----~.- n_~ ~- .- --~-- --- -- Steel Fb = 46,000 psi P=j F(n) -t! Col. n .-.--. "- .---.---..-.--....".- Alum. Fb= 35,000 psi ! ____3=48.805 ~ 1.0 ---...- Allowable Lateral : 400.00 i 0.7 -....--..----- S = Lateral Soil , i Pressure I 466.67 psf I 3 0.5 Allowable Soil Load 2000 psf I I -- qz = Velocity pressure at height Z I - Z = Height off groung of Sign Ratios: Kz = Velocity Pressure Exposure Coefficient** Wind Force Aspect 2.50 I = Importance Factor ~ I 971.62 Clearence 0.76 -. V = Velocity I I .- - From ASCE 7-05 Fig. 6-20 P = Design Pressure G = Gust Response I : I _______1________ --- ---.--. -- I ----. Cf = Force Coefficient for Solid Signs I Cv =Coefficient of Total Shear ---r---- +---- D = Sign Width ---!- R1= SLD/3 _-0. r -- ~ H = Sign Height 3.24 I I R1= 5444.44 Ibs ----L-___ .--+- =1==- Wind Force I SLD/3-- Calculations conform to ACSE 7-02 and e----. - 240.96 R2= FBC 2004. 1--- - -- -- _: - --f r R2= 5444.44 Ibs i Notes: .~ : : 1. From ASCE7 -05 6.5.10 -- --------+ .- 0.62 I I 3. From table 1609.6D FBC 2004 I Vs .-----t- 4. Structural Tubing ASTM A500 Grade B. - 5. Bolts are ASTM A307. a h7 6. Concrete Strength 2500 psf minimum. -== 7. From table 1610.1 FBC 2004 1 8. Steel Pipe - ASTM A53 Grade B +-- 9. Steel Plates and Bares ASTM A36 3.83 - R1 10. Structural Steel Wide Flange and WT I .,----- -. shapes ASTM A992 or ASTM A572 Grade ---- ---- . ----.--- 2.33 - --~17 -=.,- ---+ IWt I ----+----~-- ~ : 50 -- R2 ... C; I --. ~ i --------~-+ ! ~ t 0 I ----~.." --------- --_...------- -. ':-l.. -- --- .--- -- ____~_.._._'n------.----. I I -- ----- r 1.33 -- -- n _~____ -_.~- --de R3 ----L- I Florida #44816 New York #063279-1 Page 1 of 2 John F. Barrett, PE 6/4/2007 John Francis Barrett, PE 8259 Barton Farms Blvd. Sarasota, FL 34240 C:\Windloading\JM Stewart\ 8402 ~arrett . ~ Wind load Calculations 0-15 Exp. B Footing Depth: FBC 2004 1805.7.2.1 d = .5A(1 +(1 +(4.3h/A)) 1/2) ..- 1.65 A= 2.34P/(S1b) 0.60 Weight of Footing: Wf= 150*A*D 11500 Ibs -- Calculations: Bearing Area: A= 20.00 sq. ft. --- Soil Pressure: ~ Overturning Moments: ~I== Ps= 612.50 psf Soil Pressure ~actor of Safety i OK 3.3 Overturning moment due to wind: I: Weight of Footing and Sign: I M1 = M2= IM3= --L- I . JM~~- (f1)( ci1-+HT i (f2)(d2+H) (f3)(d3+H) ..- u ---t------- - ---r-- -- 1 I ~-- I i I .-- --.-.------+--------. -.- WSF wAH + Ws WSF 12250 Ibs i ft-Ibs - I Resisting Moment Due Weight: MR= MR= (WsF)(W/2) 12250.00 ft-Ibs w = 100 pcf density of concrete H = Height of footer i Resisting Soil Moment: ~! R1= ~ . (ASL)L)(D/3) .. R1= ~_ 5444.44 I I R2= (ASL)(L)(D/3) i ! '~I I I ! R2= 5444~+--- I =t= . It~_-----~~~~tg~~~~:--+ Fact:;~:~afe~ ~: MT= 4036~+041ft-ibS I I Ma = (F1D1+F2D2+F3D3) ! I 1Ma = 13297.435~ft-lbS--+------- ---I-----i. Me = Main Assumes footing rigid subjecting !-- Mc = 1648.7176 ft-Ibs column to bending stresses .--- Active Soil Resistance ~ -- Total Resisting Moment: ~ Moment about (a) Ma: Column Design: Yield Strength (psi): Section Required: 46000 Sx= Sx= Mc/Fb 0.4301002 in^3 ! Moment of Inertia: 1= 609::797 in~ 3.4638899 in^3- - I I I I_~__- Column___L Ok Factor of Safety i 8.1 . '---- f--- Column Analysis: Section Designed: Sx= Sx= Anchor Bolts: Bolt Yield Strength Area of bolt Ab in2 based on minor dia. In Tension 64000 1.334 for 3/4 inch .606 for 1 inch .969 for 1.25 inch P= P= I ~-- Mc/L I 2198.2901!lbs . .. ...------r--------- --------..------. S= S= IP/Ab I 6581.7069 Ibs/in^2 Bolt Tension Factor of Safety Ok 9.7 Bolt Yield Strength In Shear f = Shear force I==:- 55000 d = bolt minor diameter Assume pure shear S= S= - P/2nAb 907.62 Bolt Shear Factor of Safety Ok 70.5 Florida #44816 New York #063279-1 Page 2 of 2 John Francis Barrett, PE 8259 Barton Farms Blvd. Sarasota, FL 34240 C:\Windloading\JM Stewart\ 8402 813-780-0020 City of Zephyrhills Permit Application Building Department F,,-a13-78I)-Oi- b <gcP Date Received Phone Contact for Permitting lJ{ f C 6wner Phone Number ~ Owner Phone Number I /7 '1r,~ 3 I .-' Owner Phone Number -Owner's Name - Owner's Address Fee Simple Titleholder Name Fee Simple Titleholder Address I 13QC)(' 7 . f I BIVl e. ~ C)-I f) v'.J2.... II I PARCEL ID# - JOB ADDRESS SUBDIVISION --WORK PROPOSED ~ D I i---I v' {J C I s/ o o c...h61 "'l~ SQ FOOTAGE I ('?V,,-Y PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK ADD/ALT REPAIR COMM FRAME ...... DESCRIPTION OF WORK BUILDING SIZE TTfTTTI . I 11 I I I , , I I I I I I I . II I . I I , . I I I I I I , . I I , , I I I , I , I I , , I II . I II II I II I , I I , , II , I III , I I , I I I I II , I I , I , , I I I . 1111 , I I I , I , , I III I I , I II I I I . I I I I II I . I I , , I , . I I . I 1 D BUILDING 1$ I D ELECTRICAL 1$ I D PLUMBING 1$ I - D MECHANICAL 1$ ,-~}S_~, 3>'6' I D GAS D ROOFING 0 SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 1111I1111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 LOT # D D D (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH I D OTHER STEEL OTHER I HEIGHT I VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY AMP SERVICE o D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION BUILDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN I SIGNATURE . Address I PLUMBER I SIGNATURE COMPANY REGISTERED COMPANY REGISTERED OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N License # Y I N FEE CURRENT Y/N License # Y I N FEE CURRENT Y/N License # I ~;J} 141.1- ,Ai,~ EnJ. Y I N FEE CURRENT I Y I N I License # ~c, b l.f z 7? 7 YI N Y/N FEE CURRENT Address License # 1111I1111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111I1111111111111111111111111111111111I111111 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 wI Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects COMMERCIAL Attach (3) 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 wI Silt Fence installed, Sanitary Facilities & 1 dumpster. 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. Dl~~~ti~~~': I . . I I I I . . I I I , , I . . , I I . I , I . I , . I I . . . . I I I . . . I I . . . , , . . I I I . . , , I . . . , I I I I , . , I I I . . , . . . . . . . . . . . , I I I . . . . . . , I . I I I I . . , . , I I I I . I . . . . . I . . I . . I , , . . , I . I I I Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500. a Notice of Commencement is required. (AlC upgrades over $5000) 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 (Front of Application Only) Reroofs Sewers Service Upgrades A1C Fences (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW 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 deed 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 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 Inspection Division-Licensing Section at 727-847- 8009. Furthermore, if the owner has hired 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/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery 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 "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 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 set forth in this affidavit prior to commencing construction. I understand ~hat a s,eparate perm~t may ?e requjr~d for elect~ica.1 work, plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallatlons not speCifically 1n?luded. In the application. A permit issued shall be construed to be a license to proceed With the work a~d not as authorl~y ~o vlolat~, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the B~'I,dlng OffiCial from the~eaft~r requiring a correction of errors in plans, construction or violat~o~s o~ any codes. Every permit Issued. shall becom~ 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 (6) months after the time th~ work is commenced: An extension may be requested, in writing, from the Building Official for a period not t~ exceed mn~ty ~90) da~s 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 LENDER OR AN ATTORNEY BEFORE RECORDING Y UR NOTIC COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT Subscribed and sworn to (or affirmed) before me this by Who Is/are personally known to me or haslhave produced as identification. Notary Public Notary Public Commission No. Name of Notary typed. printed or stamped Name of NDtary typed, printed or stamped Parcel Information for: 13-26-21-0100-00000-0280 Card: 001 Page 1 of2 $.l;)~n:;b8gi:.ljD Show Map Generalized Building Schematic Estimate Taxes See Tax Collector Information - CurrenUDelinquent Taxes Frequently Asked Questions Mailing Address GONZALEZ PEDRO & EUGENIA MARCELA 39007 BLUEJAY AVE ZEPHYRHILLS, FL 335422202 Physical Address 39007 BLUEJAY AVE ZEPHYRHILLS, FL 33542-2202 13-26-21-0100-00000-0280 (Card: 001 of 001 ) 01 - Single Family Assessment (totals) Ag Land Land Building Extra Features ParcellD Classification Total Assessment Save Our Homes Homestead $0 $31,040 $83,549 $518 $115,107 $69,990 - $25,000 Legal Description (First 4 Lines) EASY ACRES PB 10 PG 100 LOT 28 OR 5192 PG 660 Taxable Value $44,990 Warning: A significant taxable value increase may occur when sold. Click here for details and info. regarding the posting of exemptions. Land Detail (Card: 001 of 001) Description Zoning SFR 00R3 Additional Land Information Tax Area 30ZH Fema Code Building Information - Year Built 1972 USE 01 - Single Family Residential (Card: 001 of 001) Ext Wall 1 Concrete or Cinder Block Ext Wall 2 None Roof Str Gable or Hip Roof Cov Asphalt or Composition Shingle Int Wall 1 Drywall Int Wall 2 None Flooring 1 Carpet Flooring 2 None Fuel Electric Heat Forced Air - Ducted AC Central Baths 1.50 1 100 Line Use Line Description Sq. Feet Repl. Cost New 1 BAS 1,236 $107,581 2 FOP 36 $783 Extra Features (Card: 001 of 001 ) Line Description Year Units Value 1 DWC 1972 111 $104 2 UDU-M 1978 1 $90 3 CLFENCE 1994 600 $324 Sales History Previous Owner Year Month 2002 12 1983 04 1979 CANNETTE LAURIE J Book/Page I Type 5192/0660 II WD 1245/1864 II 1016/1477 II Amount $73,000 $0 $0 http://www.appraiser.pascogov.comlsearch/offline _ tca. asp? Sec= 13&Twn=26&Rng=21 &S... 6/27/2007 . PASCO COUN U~L ING ERMIT APPLICATION CtfNTRAL PERMITTING OFFICES: Dade City: (352) 521-4279 Fax (352) 521-4 8 ~ 14236 - 6th Street, Suite 203. Dade City r;c UPANCY: SEQ#: New Port Richey: (727) 847-8126 Fax (7 7) 847 01 . 7530 Little Road, Room 210, New Port chey :X N. OF UNITS: Land 0' Lakes: (813) 929-1266 Fax ( 3) 929-1307 . 4111 Land 0' Lakes Boulevard (U.S. 4 ), Land 0' Lakes Ire District: Permit#: ~' THIS APPLICATION MUST BE TYPE OR PRINTED IN INK Type of nstructlon: "f11 IV V VI AND IS VOID IF NOT PERMITTED THIN SIX MONTHS D Description of Wort<: E S C R I P T I o N Is this Application th N L/'" o Owner's' Name: Phone #;J1X3 ) 7'2 _ q(p cJD W Job Location: 3 q DO 7 Subdivision: ~ ParcellD#: s--'-3L T d&, R~Ub t?OBIk~Dt O..;)Z-OProject# TAZ Lot Size X R Owner's Present Address: 3Q(Xn l5UU Jay fJU..e City: 2t'f~yrhILts State: P( Zip: 33sL/.J- Fee Simple TItleholder's Name (If Other than Owner): Address (If Applicable): City: State: Zip: tJ tift(, r)Dfrt.R/lf ;2'TTf..?P?hi1/bClJI1, ;) 1 tc Y3~!310C()t4 I . Patio: Garege: Entry: # of Bathrooms: Type of Construction: 0 Block 0 Frame 0 other: By: Living Area: # of Bedrooms: Total Under Roof: Fill: Yes No If Mobile Home/RV, Make: Wort< Code Model Name: Valuation $ Year: Size: Prepaid Plans Fees: $ Plans on File? 0 No 0 Yes Receipt # C;" 3'5.3 g FEES BLOCK , Plans Fee: $ BUilding: $ o T H E R Bonding Company: Address: ArchitectlEngineer: Address: Mortgage Lender: Address: state: _ Zip: City: City: City: State: _ Zip: State: _ Zip: Contractor: Print Name: Phone # ( City: state: ~ Zip: Pasco Co. Computer 10# Signature: Address: State License # (If applicable) Electrical Contractor: Signature: Address: State License # (If Applicable) '''-.._,' C Power Co.: 0- - N T .R A C T G R Pririt Name: Phone # ( City: State: _ Zip: PasCC1 Co. Computer 10# Sawpole: AMPS: CeK'J rint Name: ~ G t (Ale; L Phone#2"n ) ~~ - diDO City: N .,p State: PL Zip: ~L{~ e~co Co. Computer 10# lff5-j~- 51 ,~. 6 lJ (Required) Electrical Fee: $ Mechanical Fee: $ Plumbing Contractor: Signature: Address: State Ucense # (If Applicable) # of Fixtures: Septic Per.,#: Print Name: Plumbing Fee: $ Phone # ( City: State: Zip: Pasco Co. Computer I~ Sewer: Water: Well: Other Contractor: Print Name: Signature: Address: State License # (If Applicable) Type of Contractor: Other Bldg. Fee: $ Phone # ( City: state: Zip: Pasco Co. Computer lor- Valuation: $ Other Fee Type: Amount: $ Receipt #: Radon Fee: $ JOBS UNDER $2,500.00 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT." TOTAL BUILDING PERMIT FEE $ - NOnCE **- BOTH THE OWNER AND CONTRACTOR qF RECORD (LICENSE HOLDER) MUST READ AND SIGN THE REVERSE SIDE OF THIS APPLICATION EDITIONS OF THIS FORM RELEASED BEFORE 03105 ARE OBSOLETE . . dv/pc93043032 Rev. 311/05 A. NOTICE OF DEED RESTRICTIONS The undersigned understand that this penn it may be 8Ubject to "deed restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrlctlons. 8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, he may be required to be licensed in accordance with State and local regulations. It 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 Is uncertain which Ifcerislng requ~nts may apply for the intended work, he is advised to contact the Pasco County Building Inspections Division, licensing Section, at (727) 847-8009. Furthennore, If the owner has hired a contractor or contractors, he is advised to have the contractors sign portions of the "Contractor Block" of this appllcatlon for which he will be responsible. If you as the owner sign 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 Pasco County. C. IMPACT FEESIUTIUTlES IMPACT AND RESOURCE RECOVERY FEES The undersigned understands that Impact Fees and Resource Recovery Fees may apply to the construction of new buildings, change of use In existing buildings, or expansion of existing buildings. The undersigned also understands that such _ as may be due will be identified ~t the time of pennlttlng. It Is further understood that Impact Fees and Resource Recovery Fees mUlt 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 pennlt Issuance. Furthermore, If Pasco County Water/Sewer Impact Fees are due, It must be paid prior to pennlt Issuance in accordance with applicable Pasco County ordinances. D. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, a8 amended) If valuation of work 'is $2,500.00 or more, I certify that I, the applicant, has been provided with a copy of the Florida Construction Lien Law- Homeowner's Protection Guide prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant Is someone other than the owner, I certify that I have obtained a copy of the above-descrlbed document and promise In good faith to deliver It to the owner prior to commencement. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the InfonnatlOfl in this application Is accurate and that all work will be done in compliance with ail applicable laws regulating construction, zoning, and land development. Application Is hereby made to obtain a pennlt to do work and Installation as Indicated. I certify that no work or installation has commenced prior to issuance of a pennit and that all work will be perfonned to meet standards of all laws regulating construction, County codes, zoning regulations, and land development regulations In the jurtadlctlon. I also certify that I underatand thet the regulations of other govemment agencl8$ may apply to the Intended work and that It Is my responsibility to identify which actions I must take to be in compliance. Such agencies Include, but are not limited to: . Department of Environmental Protection: Cypress bayheads, wetland areas, environmentally sensitive lands, and water /wastewater treatment. . Southwest Florida Water Management District: Wells, cypress bayheads, wetland areas, and altering watercourses. . Anny Corps of Engineers: Sea walls, docks, and navigable waterways. . Florida Department of Children and Family Services, Environmental Health Unit: Wellb, wastewater treatmant, and septic tanks. . U.S. Environmental Protection Agency: Asbestos abatement. . Federal Aviation Authority: Runways. I understand that the following restrictions apply to the use of fill: . Use offill Is not allowed In Flood Zone "V' unless expressly pennltted. . If fill material Is to be used In Flood Zone "A," It Is understood that a dra~ plan add~111.Q a "com.Pf!nsatlng volume" will be submitted at the time of permitting whIch is prepared by a professional engineer lICensed by the state of Frorida. If fill material is to be used in Flood Zone "A" In connection with a pennitted 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 adlacent pJ".Operties. If use of fill Is found to adversely affect adjacent D.l'OP.8rt1e8, the owner may be cited for violating the c;gndlUons of the BullCl.lng Pennlt INued under the attached pennit applICation. For lots leas than one (1) acre which are elevafiKI by fill, an engineered drainage plan Is required. . e If ram the AGENT FOR THE OWNER, I promise in good faith to Infonn the owner of the pennittl09 conditions set forth in this affidavit prior to commencing construction. I understand that a separate penn it may be required for electrical work, plumbing, signs, wells, poo,-, air conditioning, gas, or other Installations not specifically Included In the application. A pennlt Issued shail 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 pennlt prevent the Building OffIcIal from thereafter requiring a correction of errors In plans, construction. or violations of any codes. Every pennlt issued shall become Invalid unless the work authorized by such pennlt Is commeneed within six months of pennlt issuance, or if work authorized by the pennit Is suspended or abandoned for a period of six months after the time the work has commenced. An extension In writing, may be requested 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 PAYING lWlCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. SIGNA".,., ~~ SIGNATURE, _/fJ1~~ STATE OF FLORIDA COUNTY PASCO STATE OF FLORIDA COUNTY PA CO The foregoing instrument was acknowledged before me this 200 by (name of person acknowledging), whO Is personally known to me or who has produced The foregoing instrumel't was acknowledged before me this 200 by (name of person acknowltldglng), who Is personally known to me or who has produced NOTARY NOTARY (type of (type of dv/pc93043032 ........ ................ ... .................. : JAMES R. TELLEZ : . \"IUHIII C . : l~~\ 0I1llTlM DOCl34I22I i : s ~ ~. ~ ExpllM 1123I2OOI : : \'J?'CI'l\.~1 Bonded l/lru (800)432-4254: . ~1"'It"'" Fbrida Not8rv Assn Inc . I............... ... ....... ...... i......;.....i r...........jAMES. R~ .TELlEZ...........! . . i ~......~~~',I" ComrnI DD0348228 : : g~~~\ Expi_ a/231200l1 : i ~"f!Jl Bonded l/lru (BOO)432-4254! ......:::~:~.......~~~~.~~2.~~.;.'~~.i Rev. 3/1/05