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CITY OF ZEPHYRHILLS 5335-8TH STREET (813)780-0020 8856 LP/NATURAL GAS PERMIT Permit Number: 8856 Address: 36111 SHADY BLUFF LP LOT 6 Permit Type: LP/NATURAL GAS ZEPHYRHILLS, FL. Class of Work: GAS TANK/LINES-NEW Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): . Block: Section: Square Feet: Subdivision: SILVERADO Est. Value: Parcel Number: 4-26-21-0060-00200-0060 Improv. Cost: 400.00 .,.:; ... Date Issued: 2/26/2009 Name: WINDWARD HOMES Total Fees: 52.50 Address: 36111 SHADY BLUFF LP LOT 6 Amount Paid: 52.50 ZEPHYRHILLS, FL. 33542 Date Paid: 2/26/2009 Phone: (813)885-7744 Work Desc: INSTALL 48 GAL GAS LINE FOR EXISTING KITCHEN RANGE W1IUUP1 AMERIGAS PROPANE LP GAS FEE 52.50 e ^ FIRE SITE INSPECTION-Final Chapter 633, Florida Statutes,authorizes the City to charge and collect user fees to pay for the costs of fire prevention and protection related activities such as inspections, plan review,administrative fees,and other costs related to the aforementioned. Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final inspection shall be charged double permit fee per day of operation or a minimum of$100.00, whichever is greater. All work shall be performed in accordance with City Codes and Ordinances. "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." N R SIGNATURE I IC R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOURS NOTICE REQUIRED ZEPHYRHILLS FIRE RESCUE DEPT- Fire Marshal Office- 813-780-0041 City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: Date Received: 2-2-. 2 9 Site: / %g4 ,Bk i/ Permit Type: Approved wino comments:❑ Approved w/the below comments: Denied w/the below comments: ❑ J4 4, . j This comment sheet shall be e t with the permit and/or plans. Kalvin 'tzer—P1aniner Date Contractor and/or Homeowner (Required when comments are present) 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department `p Date Received Z Z 50 J Phone Contact for Permitting 'f7( 3 7 Owner's Name l U Owner Phone Number. I — 1 - b (Li Owner's Address I LO I Lcne I Owner Phone Number Fee Simple Titleholder Name f Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS I Yr1'Y).Q.. C3 I LOT# II SUBDIVISION I I PARCEL ID# - i L - (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED EJ NEW CONSTR e ADD/ALT Q SIGN Q MOVE Q DEMOLISH INSTALL REPAIR PROPOSED USE SFR Q COMM Q OTHER TYPE OF CONSTRUCTION Q BLOCK E FRAME 0 STEEL 0 OTHER DESCRIPTION OF WORK BUILDING SIZE SQ FOOTAGE HEIGHT Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION `1lJlJ ELECTRICAL $ AMP SERVICE E PROGRESS ENERGY W.R.E.C. PLUMBING . $ 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION GAS 0 ROOFING 0 SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO IIIIIIIIIIIJIIIIIIII BUILDER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT IY/N Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address P License# PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT Y/N Address License# MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT Y/N Address L, License# OTHER COMPANY 1 ' SIGNATURE REGISTERED Y N FEE CURRENT' Y/ Address I 1 ' t_ License# of ) 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 w/Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(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 w/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. Directions: Fill out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (A/C 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 A/C 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 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 IMPACTIUTILITIES 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'SIOWNER'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 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 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 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(6) 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 the ob is considered abandoned. justifiable cause for the extension. If work ceases for ninety(90)consecutive days, \j WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTSCONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT(F.S. 117.03) OWNER OR AGENT CONTRACTOR bsc ed and sw o(or affirmed)bef a me thi$ Subscrib and rr�to(or affirm e)befor m�e 1Gis` I SY_7? by � v �� �, l 2-25 O bhi! icSl—,V — to or has/have produced o is/�r persQnally wri lcne (o me or has/have produced 1p(h`o l a e pen iy �� as identification. W l�l X�ill l jas identification. (S (�, Notary Public Notary Public E BOLES ,P+Y""•. JACQUELINE ES Co isarrf Commission No. a; Expires December 12,201� Expires December 12,2010 '. 9ondad n r T Fain Inaugnaa B00.9AB 7D19 nnted or scam ed Name of Notary typed,printed or stamped Name of Not 'ry typed,p' P (a� Amer1(Ms America's Propane Company Inter-Office Correspondence Date: /c7 -- 9> Subject: �f(�f�'�IS / if 3a ii Shady 104© j ;,í/ 3_35` -1 ALL WORT{SHALL COMPLY WITH ALL PREVAILING CODES,FLORIDA BIDING ODE,NATIONAL ELECTRIC CODE AND ITY OF ZEPHYRHILLS ORDINANCES D IlOl��� (J� i C✓te0. REVIEW DATE CITE' OF ZEPHYRHILL§S PLANS EXAMINER______