HomeMy WebLinkAbout09-9774 'CITY OFZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9774
:BUILDING PERMIT
Permit Number: 9774
Address: 473218TH ST
Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434 -ADD /ALT RESIDENTIAL Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14-26 21- 0010 - 02600 -0100
Improv. Cost: 27,648.00
Date Issued: 11/23/2009 Name - BAER, THEODORE
Total Fees: 319.16 Address: 4732 18TH ST
Amount Paid: 319.16 ZEPHYRHILLS, FL. 33542
Date Paid: 11/23/2009 Phone: (813)783 -2636
Work Desc: COMPLETE FROM PRVS PRMT #5826 UPSTAIRS GARAGE 1152 SQ FT
1 N • ' 0 35.00
HOMEOWNER PLUMBING FEE 70.00 MECHANICAL FEE 35.00
HOMEOWNER RADON 5.7)
HOMEOWNER
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FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE -METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE -SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: Reinspection fees will comply with Florida: Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one 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 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."
/ CONTRACTOR SIGNATURE PERMIT OFFI rR
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
1
SQ. FEET PRICE
MAIN OR LIVING: 576 $48.00
OTHER AREA UNDER ROOF: - $94.00
OTHER: - $-
VALUATION $27,648.00
FEE SHEET $170.00
ADDRESS
DRIVEWAY
BUILDING: $173.40
ELECTRICAL: $00.25 ?6 ' 3S o c r ' "Is''
PLUMBING: 33rA32&50 a 2O 014)4" 5 MECHANICAL: $17.0a 35� IJD � � 4_ f`
SUB -TOTAL $255.00 ' o noC
RADON: $5.76 fT
TOTAL 60 6 -- 'i'7S 4,6
SEWER: f $ -
WATER:
IRRIGATION: $ -
TOTAL: S-
WATER METER:I $-
IRRIGATION METE W $- I
FIRE DEPARTMENT FEES
PLANS TOTAL:
INSPECTION TOTAL:
PERMIT TOTAL
TOTAL: $-
PUBLIC SAFETY IMPACT FEES
POLICE $-
FIRE $-
5% $ -
TOTAL: $-
1 SUB -TOTAL I
PARK IMPACT FEESI S-
SIF'S: $-
100.0% . $-
1.0% 5 -
TOTAL: $-
TIF'S. S -
TOTAL:
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813-780 -0020 City of Zephyrhills Permit Application ,
. /'/. /Y — 0 Building Department Iig 17
Date Received . � `, A Phone Contact for Permitting C5 `V -- Z6' ?
.
Owner's Name � r ,' ,... Owner Phone Number 76'3 2 ? CP
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Owner's Address 73 Z /CJ ✓: - Owner Phone Number 3 / 0 ---5—Z-- c l v
Fee Simple Titleholder Name Owner Phone Number ,
Fee Simple Titleholder Address ,o
JOB ADDRESS `i 7 Z / R > .- r LOT #
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ‘ :.7""--. ADD /ALT I I SIGN I I MOVE 1 I DEMOLISH
INSTALL REPAIR
PROPOSED USE [14 SFR I I COMM I 1 OTHER morI,LlaggisiwA°
TYPE OF CONSTRUCTION I I BLOCK I I FRAME I I STEEL I I OTH a ' I
O I � � Q��i r i jj ezL.4 � DESCRIPTION OF WORK f�`� -c‘ ti's-3/ S / t (5 TAL C c* r ' —" '
BUILDING SIZE SQ FOOTAGE HEIGHT S I(o
I I BUILDING $ VALUATION OF TOTAL CONSTRUCTION
I ( ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I 1 W.R.E.C.
I I PLUMBING $
Poc,/
I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
I I GAS I I ROOFING 1 1 SPECIALTY I I OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I 'NO
BUILDER / i - _ COMPANY (/
SIGNATURE I/ REGISTERED � Y/ N I FEE CURRENT 1 Y/ N 1
Address , #
ELECTRICIAN COMPANY V
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address License #
PLUMBER COMPANY '-,---L___ SIGNATURE 1/ REGISTERED 1 Y/ N I FEE CURRENT I Y/ N 1
Address License #
MECHANICAL _ .e--5::7 COMPANY fr
SIGNATURE I/ REGISTERED I Y/ N I FEE CURRENT I Y/ N I
Address License #
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address I 1 License # F
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.
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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 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 Tots 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
job is considered abandoned.
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the j
WARNING TO UR
TWICE OWNER: Y FOR IMPROVEMENTS TO YOUR PROPERTY. T IF YOU INTEND TO OBTAIN n F FINANCING, CONSULT
PAYING TIC
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S � .'-
��- CONTRA
OWNER OR AGENT Subscribed and sworn to d) b- r e me this
Subscribed an. sworn to • .. • r• -fore me this i. L
�j.,2 »j b 4S,.... , /r .7 7 J ? by
Who is /are personally known to me or has /have produced
Who is /areBersonally known o me or has /have produced -- as identification.
------ as identification. __.___•.___
' '
/ �� '` . �. Dn 7, r { r./ otary Public
y _ ` .. ii 7.'4. r .- • Nruranoeeoo-�esmia
- - ' • ' `t ' . Thr Troy Fain
B OBBIE S. SWETLAND •�
L�;; �•�, a. 1 � Commission N
Commissio _. e: - ' 22, 2012
t-.,0. Expires February „ . Name of Notary typed, printed or stamped
Name of N. t ., •. .: i=irii ... __
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L 1 i 1 )jjjj4 I i IIiiiiii l lll 11111 Iliiiiiiliiiiiiiiiiiii
NOTICE OF'COMMENCEMENT
Rcpt:1274172 Rec: 10.00
DS: 0.00 IT: 0.00
Permit No. 11/18/09 — __ Cl er k
PAULA S. O'NEIL, PASCO CLERK $COMPTROLLER
Property Identification No. l'(' U ' 2.1 ' O0IO - O is _O, oo 11/ 18/09 � j F K p rh' OR BK 8 i4gt 1 of
1
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real ro
p perry, and in accordance with
Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description:) LOT /o . . MI :nootas /'+AD0 1 r, a
a) • Street Address: 4 /7 3 L /ice ZalinYiteema
2.General description of improvements: INte rS. »4.. Pines µ c5c 9 re. la- e FtaGe. A-a - e
ft
3.Owner Information
a) Name and address: ib 4 KAP �^ y L. l b " . SF: +t*� ,,cj.t,LLS NL. - 3S'?
b) Name and address of fee simple titleholder (if other than owner)
c). Interest in property
4.Contractor Information
'a) Name and address: e'tar4 '(L
b) Telephone No.: Fax No. (Opt.)
5.Surety Information
a) Name and address: �h
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Name and address: N /h
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address: N/h
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: ki/
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):
•
s
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 S ,r1Y P ( .
• • s et, SOMA SANDERSON r e) C ,
COUNTY OF PASCO * . � � * , MY COMMISSION # DO 691248 ,t
7 EXPIRES: October 28, 2011 jiplature of Owner or Owner's Authorized Officer/Director/Partner/Manager
si4rrwn0e`" : Bonded Diu Budget NotarySeances 1itc006 A it .aAerk reta2LA t• �L/�tY�
Print Name
The foregoing instrument was acknowledged before me this is day of QC.-h) 2009 , by 5 ° n `.' 4be4Sa.J
as N o r (/ (type of authority, e.g. officer, trustee, attorney
in fact) for .T'j eeor+ anon t rant..• -8nt ( (name of party on behalf of whom instrument was executed).
Personally Known OR Produced Identification Notary Signature _
__-
Type of Ide1ification Produced /1'A Name t ,
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare. that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
FORMSMOC,rvsd2007 Signature of Natural Person Signing Above
STATE OF FLORIDA, COUNTY : ..$ C0.2' „,�
THIS IS TC CERTIFY THAT THE FOI,E GOING ISM"
TRUE AND CORRECT COPY ` ,,,THE P CUME,NT
ON FILE OR OF PUBLIC R : " 'INt:THIS CiiFFIcE
WITNES� HAND A • OKIOIAL EAL ,S
�L�� DAY OF t 2 4,
PAULA S- O' ,'CLER s P Re
BY ��� v DEPUT RK
.1
:DISCLOSURE STATEMENT FOR OWNER
CITY OF.ZEPHYRHILLS .BUILDING DEPARTMENT ezz have read and fully understand and agree to the
provisions of this instrument.
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 o
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 $75,000. The
building or residence must be for your own use or occupancy. It may not be 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 worker's compensation for that employee, all
as prescribed by law. Your construction must comply with all applicable laws, ordinances,
building codes, and zoning regulations.
OWNER'S SIGNATURE DATE / 1 ` /B - C .)9
ADDRESS cf73 Z HY/trfi
PHONE C! 3 - 761 - 7,G 3 G
WITNESS PERMIT
I/ Masterforms /OwnexsAffidavit/Nov07
£eev1 , 6 -7_(°
6.0)
June 6, 2010
City of Zephyrhills
Building Department
Re: 4732 18 Street, Zephyrhills
Permit: # 9774
Dear Sirs,
I am requesting an extension of my building permit for the remodel of my above
garage mother in law suite. I have been off of work since October, 2009 with a
back injury and I underwent surgery to correct he problem on May, 20 2010.
I only have my final inspections outstanding and would appreciate your
consideration in this matter.
P'yr
Sincerely, (>`` F 5p1 f D 7 , 1 D
U
Theodore R. Baer, Homeowner
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