HomeMy WebLinkAbout08-7245
CITY OFZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
7245
Permit Number: 7245
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: RV PARK
Square Feet:
Est. Value:
Improv. Cost: 11,000.00
Date Issued: 11/29/2007
Total Fees: 155.00
Amount Paid: 155.00
Date Paid: 11/29/2007
Work Desc: LANAI
Address: 3516 MALACHITE DR LOT 131
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: EMERALD POINTE RV RESORT
Parcel Number: 24-26-21-0040-00000-1310
Name:
Address:
~~ 7\fJ
, ?/~iY 00
ROUGH ELECTRIC
PRE-SLAB
CONSTRUCTION POLE
LINTEL
PRE-METER
SHEATHING
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.
DRIVEWAY
MISC.
MISC.
ELECTRICAL FINAL
BUILDING FINAL
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."
i~Y
~ONTRACli SIGNATURE
PERMIT EXPIRES :t MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
812,-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
Date Received
11...11...11
Owner's Name J e:r.ue. (. -
Owner's Address 1.35U~ ~ALAC.~ln: Di2. ZeP/'bIIe.H 1'-'-5, F~
Fee Simple Titleholder Namel I
Owner Phone Number
Owner Phone Number I
Owner Phone Number I
Fee Simple Titleholder Address I
1.35/10 H ALACN- Ire De..., 7 F PH VLHILLS. FL ;3 3~~
I El-fE./ZALD ~/Nr~ RV RvzJ
JOB ADDRESS
LOT #
I~I
SUBDIVISION
PARCEL ID# I .)..'/ -ol4 -rL/ - 0 r) V d - aJOeJd - / J/ a
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE D
WORK PROPOSED
~
D
D
B
D
[Xl
(51-ora J atAtiL
SQ FOOTAGE I .3 8 tf
NEW CONSTR
INSTALL
ADD/ALT
REPAIR
PROPOSED USE
TYPE OF CONSTRUCTION
SFR
BLOCK
COMM
FRAME
DESCRIPTION OF WORK
I-a ntLC:
BUILDING SIZE
\3 ~ X I;)...
1$ I
, /tJ,()l)O.
1$ 1,{)O8, I
I$~I #0 /JIlt- I
D MECHANICAL 1$ ,J fA I
D GAS D ROOFING D
FINISHED FLOOR ELEVATIONS I.L" I
'r (J.,,'EIZ. e.XIS/lNG S~
BUILDING
D
IRJ OTHER I SID t?-Ft-GF.
D STEEL D OTHER I
Sc,ee.v-- roo""" / c::<t-d eonc.r~fe-
HEIGHT I I tJ I (;, Ii
DEMOLISH
~
ELECTRICAL
AMP SERVICE
VALUATION OF TOTAL CONSTRUCTION
PROGRESS ENERGY
~ PLUMBING
D
IKI
W.R.E.C,
PASCO PERMIT SERVICE
(813) 788-5314
VALUATION OF MECHANICAL INSTALLATION FAX 1-866-824-7894
SPECIALTY D OTHER
FLOOD ZONE AREA DYES
Address
MECHANICAL It/a.-
SIGNATURE, !(
Address I
OTHER I
SIGNATURE
Address I License #
111I1111I11111111111I1111111111111111111111111I111II1111I111II111111111111111111111I11111I11111111111111111111111111111111111I111111111I1111111111
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 subdivisions/large projects
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
Attach (2) sets of Engineered Plans,
....PROPERTY SURVEY required for all NEW construction.
BUILDER
SIGNATURE
Address
ELECTRICIAN
SIGNATURE
Address
PLUMBER
SIGNATURE
COMPANY
REGISTERED
COMPANY
REGISTERED
COMPANY
REGISTERED
COMMERCIAL
SIGN PERMIT
5{]NO
License #
t)wner-
I Y I N I FEE CURRENT
I Y/N
/1 / t:U
License #
Y I N
Y/N
FEE CURRENT
License #
Y/N
Y/N
FEE CURRENT
License #
Y / N
Y/N
FEE CURRENT
DI~~~ii~~~':' 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 oul 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 AlC Fences (Plot/Survey/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 comp.liance 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 hot 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 requir~d for elect~ica,1 work,
plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallatlons not speCifically 1n?luded.1n the application. A
permit issued shall be construed to be a license to proce~d With the work a~d not as authorl~y ~o vlol~t~, cancel, alter, or
set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the B~II.dlng OffiCial from the~eaft~r
requiring a correction of errors in plans, construction or violat~o~s o~ any codes. Every ~ermlt Issued. shall become, invalid
unless the work authorized by such permit is commenced Within SIX months of permit Issu~nce, 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 nln~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 YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) , _~ JJUL /. 117p
_ ).. ,L =:iLL' ~/c; -/-I'
J nWNER OR AGENT 0-4-LV - "N;ONT~CTOR -, . '
rsubscrlbed and sworn to r affirmed) before me this Subscnbed and sworn to (or f1ffirm~d) befp~ m~ !hIll
10-..30-07 by JiLNt U(J/le /O-.JO-tr] by If'l--~(,", ~1
Who Is/are perso I known to me or has/have produced Who Is/are personally known to me or has/h~ve p~odu~ed
. ~cation. as IdentificatIon.
N t~. ,PUl:)lic~S~t ..'.IE vd: ~
o a. 'I ~~).~;~. e ON\;l6W~~_,.
....~~rJ:r~~'~~ta"p~I' :7~~ Nota"P,",",
Comm..on No. 0 J tJ r "" '1,f, 3'5't. c;;;:,m',,'on . :~Tt\R~-m 'lJIJC C"'TI 9r PLORIflA
.':\"\\'''''::'''.. c:.. .:~""! ,pc B h
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Name of Notary typed, printed..~!~,?8ltm'lk DD601110
"".,.., Ex' . U\!. 15,2010
1 '~~j,-, 3()~Dil\G CO'1 l\C.
Name of Notary typed, printed or stamped
,J;;a,JC'i [eCJ;J E-
Name
06/b Hfkftc#-ttc- ~
Addre~
ZCPH'jf--Ht US I ;LL .33.s;-tjo
To Whom It May Concern,
Please be advised that:
Stacie Hartwig and Deborah Dokendorf of Pasco Permit Service have my
permission until further written notice to act as my agent to sign and pick up
permits.
Sincerely,
~ ~if~
Si ture
/tJ -~-rJl
Date
NOTARY
STATE OF FLORIDA, COUNTY OF PASCO
The ftigOing instrument was sworn to and subscribed before me this ~~ ~Jay
of ~A) ,qt707.
Personally known ~r Produced identification
ANNE'f,L K. Wil\jDER
Notary Public - State of New York
Qualified in Erie County
My Commission Expires June 24, 20ItJ
Commissioned Stamp
and Expiration Date
~~~
otary Signature
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRBILLS BUILDING DEPARTMENT
I, JAUEI ~~ have read and fully understand and
agree to the provisions of this instrument.
The undersigned states and affir.ms 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 reinspection 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 reinspection
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 regulations.
)(OWNER'SSIGNATtJRE ~~/)~ .
ADDRESS .E5U~ MALA NITc Dli.Il/.e. ;():PHY2..HILLr::.. Pi
:~':s:/~-~C~ ;)~lwi1 .
-
DATE
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PERMIT #
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
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Site:
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Date Received:
Permit Type:
laX1~
Approved wino comments
Approved withe below comments: 0 Denied withe below comments: 0
Date Contractor and/or Homeowner
(Required when comments are present)
.~, -~
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LOT IMPROVEMENT .REQUEST
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To EPPOA Property Evaluation Committee & Board of Directors:
From 1:b.~J G;r/G jApe:( ~Jc...
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Wereqllest PO:AapprovaJ for tbe.followmg(mustinclude drawing for any
construction! additions / remodelfng / landscaping, etc.). .
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wtOwner'sSigF1atuieiP~J0r ,D~~~~?'",,~1
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EMERALD' POINTE BOARDOFDI.RECTORS'
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APPROVED:
DATE:
PROPERTY EVALUATION COMMITTEE
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STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COPY OF THE DOCUMENT ON FILE
OR OF PUBLIC RECORD IN THIS OFFI~2NESS MY
HAND AND VICIAL SEAL THIS DAY OF
/jJD 2m
N, RK 0 RCU OURT
~ DEPUTY CLERK
1111/1111111 1111I 1111I1111111111 11I11 111111111111111 11I1111/
2007193699
Rcpl: 1144480 Rec: 10.00
DS: 0.00 IT: 0.00
11/27/07 Dpty Clerk
NOTICE OF COMMENCEMENT
JED PITTMAN, PASCO COUNTY CLERK
11/27/07 11: 30am 1 of 1
OR BK 7697 PG 1331
Permit No,
Property Identification No.
:< I'j- c::< 6- ;< I- a ()If (;--000 (X) - /310
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and in accordance with
Section 713,13 of the Florida Statutes, the following information,is ;>royjdedi' thi~,NO'QCE OF C~MENCEMENT.
-tn.e. ~ (d no"/ f<'V KL.sc:.vr f'11ttSe- TWo
I ,Description of property (legal descriptijl,'J..:) P 3=:;- f'G5 9.7-/' 4J T /.3
a) Street Address: 357 ~ I r tel Cl / . ~ :5 .3"2.fO
2.General description of improvements: t:7l::n?1
Rer Information --
a) Name and address: i-eo n. .36:1 m
~ b) Name and address of fee simple titleholder ( f other than owner)
U c) Interest in property p tV n8r
4.Contractor Information /J
a) Name and address: IYtuner
b) Telephone No.: Fax No, (Opt.)
5.Surety Information
. a) Name and address:
b) Amount of Bond:
c) Telephone No,: Fax No. (Opt.)
6,Lender .
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other docwnents may be served:
a) Name and address:
b) Telephone No.: _ _._______________ ______ ___.. _, ___ ___ Fax No, (Opt.) ____________________._
8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713. 13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9,Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is
specified)';
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF PASCO
The foregoing instrum91t was acknowledged before me this cl7~day of ;JoveudJer , 20tl?, by cDehot"a.."'-
S . , Dok~"-4 or f- as &.'3 ~....:t- (type of authority, e.g. officer, trustee, attorney
in fact) for J a.n ~ T Leo., e.. (name of party on behalf of wh~ instrument was executed).
Pe"onally Known V OR Pmduoed IdentiJkation _ Notary Signature \L)~ ~
/
Type of Identification Produced Name (print) Ouz.a..V\ Vl€- Bah r-
Verification pw:su~nt to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated m It are true to the best of my knowledge and belief.
FORMS/NOC,rvsd2007
Signature of Natural Perso Signing Above
NOTARY PUBLIC-STATE OF FLORIDA
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