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HomeMy WebLinkAbout09-9958 L (1 C . �^ CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9958 BUILDING PERMIT 01 tt ,' F s '►, rfi jar Permit Number: 9958 Address: 38633 2ND AVE 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: 11- 26 -21- 0010 - 19400 -0110 Improv. Cost: 1,500.00.a a Date Issued: 1/04/2010 Name: GREEN, MARY LOU Total Fees: 95.00 Address: 38633 2ND AVE Amount Paid: 95.00 ZEPHYRHILLS, FL. 33542 Date Paid: 2/26/2010 Phone: (813)788 -9094 Work Desc: REPLACE 1- BIG - 2/ REPLACE FRAME WINDOW/ INSTALL 2 WINDOW - electric w, `, ;, ,, ; i, e ., r.: r S ,s s :E a H•M , _ t I DIN FEE 60.00 LE RI AL F E 35.00 �. ",�,, o.. ._ �; 3 "* � ..?taa.. ., : . .�', .: • • R 2ND ROUGH PLUMB MI C IN ULATION EILIN 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 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." /-1 RACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS 5335 — 8TH STREET (813)780 -0020 9958 BUILDING PERMIT F,, -..`,.4 . .' 1' . , . ai zP° : x.�ti Permit Number: 9958 Address: 38633 2ND AVE 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: 11- 26 -21- 0010 - 19400 -0110 Improv. Cost: 1,500.00 E ,: tr - t� : :. ' - , , : ` ,.,.,' '4,'',"5",:iiit4 Date Issued: 1/04/2010 Name: GREEN, MARY LOU Total Fees: BO OO 015' Address: 38633 2ND AVE Amount Paid: 60.66" € 5 . a- ) ZEPHYRHILLS, FL. 33542 Date Paid: 1/04/2010 Phone: (813)788 -9094 Work Desc: REPLACE 1- BIG WINDOW W/ 2/ REPLACE FRAME WINDOW/ INSTALL 2 WINDOW HOM WW1 R BUILDIN EE 60. in *q. t � . 3 �-- ,. ...y,. . T � ' 4 . 3 ' , 5 $ 7 F• • R _ .' , 2ND R•U PLUMB a*A MI C sa� , � , IN ULA " a .:; ..� I•N !LING 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 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." C� 4' /* C T PERMIT OFFI R SIGNATURE T PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER ______----------- 1 --- ------,-- ' ', \ i I i ■ 1 ...... ___ 1 ..) t 1 I , I I!' 1 I i 11 t , _.,... 1 -\ ■ , 1 I 1 , , 1 • ■ ■ , i - - . I J \ . , l 7'.--."› 4 C 1 [ i ' ■•■•."'"...'..." /.... - . - .............. ' 1 c'` ....--,, 1 ,.7. \ . ,...."' '... I -:: 4 ,....... , r ' i . „, 1 i ,. 1, 1 ,1 7 1 1 i it • ''' ,r, '”- . /I 7 i ■ 1 I 1 I f 1, , ( . , I II _...„ ........ ..., . ..) ....... , .... ,.„..... 4--- -I-3 , 1II p k M.. ......, ...., C, I C... , , .„.,. 4 — -........— r 3 f ' ALL W H •., A LC WITH AL I ' 1 " 1 1. PREVA G CO DEE, F 0 t UILDING , CODE, NATION ' ILE C CI 1 I kr ---. .,. CITY OF ZEPHYRH ' *Ai ANCES i t t ' I I (--• , REVIEW' DATE CITY r ..Y_F ZPHY 1 PLANS - .---------„,- . ft cr — F.-- .- ,--- '---- , .."- ...,..,.....,) ,, - • .- .---, ..,. .--- — ., < —c-LTD', ,..--.... r-4 .., `1,„,..,.. ... ;,, ■........ v..• e.- f .4 rz i ( na i t y C R BCIS Home Log In User Registration Hot Topics. Submit Surcharge: Stats &Facts! Publications: FBC lily '.h & „i % : : ...” i Product Approval USER: Public User Corrnimit\ Aff�rr � Product Approval Menu > Product or Application Search > Application List > Application Detail k FL # FL11152 - R1 'p Application Type Revision 4' 614°4:1EINC'T Code Version 2007 e ! Application Status Approved Comments Archived [ ' Product Manufacturer Pella Corporation Address/Phone /Email 102 Main St. Pella, IA 50219 (641) 621 -6096 pellaproductapproval@pella.com Authorized Signature Hughes Alan hughesaj @pella.com Technical Representative Alan Hughes Address/Phone /Email 2000 Proline Place Gettysburg, PA 17325 (717) 338 -1165 hughesaj @pella.com Quality Assurance Representative Alan Hughes Address/Phone /Email 2000 Proline Place Gettysburg, PA 17325 (717) 338 -1165 hughesaj @pella.com Category Windows Subcategory Double Hung 1 Compliance Method Certification Mark or Listing Certification Agency Window and Door Manufacturers Association Validated By James L. Buckner, P.E. at CBUCK, Inc. 7 Validation Checklist - Hardcopy Received Referenced Standard and Year (of Standard) Standard AAMA 101/I.S.2 -97 AAMA/WDMA /CSA 101/I.S.2/A440 -05 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 11/17/2008 Date Validated 11/20/2008 Date Pending FBC Approval 12/11/2008 Date Approved 02/03/2009 Summary of Products FL # Model, Number or Name Description 11152.1 Series 20/25 Double Hung Vinyl Double Hung Window (48" x 7 Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pell Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pei, Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +20/ -20 12/10/2010 Other: (411 -H- 859.02 & 411 -H- 862.02) H -R20 (48in x 78in). Installation Instructions (411 -H- 859.03 & 411 -H- 862.03) H -R20 (1219mm x 1981mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 04E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.2 Series 20/25 Double Hung Vinyl Double Hung Window (48" x 6 Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_Rl_C_CAC_CCL for Pel Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pell Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +25/ -25 12/10/2010 Other: (411 -H- 859.06 & 411 -H- 862.06) H -R25 (48in x 62in). Installation Instructions (411 -H- 859.07 & 411 -H- 862.07) H -R25 (1219mm x 1575mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 04E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.3 Series 20/25 Double Hung Vinyl Double Hung Window (36" x 7 Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pet Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pell Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +30/ -30 12/10/2010 Other: (411 -H- 859.08 & 411 -H- 862.08) H -R30 (36in x 72in). Installation Instructions (411 -H- 859.09 & 411 -H- 862.09) H -R30 (914mm x 1829mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.4 Series 20/25 Double Hung Vinyl Double Hung Window (36" x 6 Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pel Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pel Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +35/ -35 12/10/2010 Other: (411 -H- 859.10 & 411 -H- 862.10) H -R35 (36in x 62in). Installation Instructions (411 -H- 859.11 & 411 -H- 862.11) H -R35 (914mm x 1575mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.5 Series 20/25 Double Hung Vinyl Double Hung Twin Composite Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pel Approved for use outside HVHZ: Yes FL11152_Rl_C_CAC_CCL for Pel Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +20/ -20 01/29/2011 Other: (411 -H- 866.01 & 411 -H- 867.01) H -R20 (89in x 78in). Installation Instructions (411 -H- 866.00 & 411 -H- 867.00) H -R20 (2261mm x 1981mm). FL11152_R1_!I_1596.pdf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_Rl_AE_1596.odf Created by Independent Third Part 11152.6 Series 20/25 Double Hung Vinyl Double Hung Twin Composite Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pel Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pel Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +25/ -25 01/29/2011 Other: (411 -H- 866.03 & 411 -H- 867.03) H -R25 (96.5in x 72in). Installation Instructions (411 -H- 866.02 & 411 -H- 867.02) H -R25 (2451mm x 1829mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.7 Series 20/25 Double Hung Vinyl Double Hung Twin Composite Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pet Approved for use outside HVHZ: Yes FL11152_Ri_C_CAC_CCL for Pel Resistant: No Quality Assurance Contract Expii Design Pressure: +35/ -35 02/02/2011 Other: (411 -H- 866.09 & 411 -H- 867.11) H -R35 (72.5in x 72in). Installation Instructions (411 -H- 866.08 & 411 -H- 867.10) H -R35 (1842mm x 1829mm). FL11152_R1_II_1596.odf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R 1_AE_1596. pdf Created by Independent Third Part 11152.8 Series 20/25 Double Hung Vinyl Double Hung Triple Composite Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pel' Approved for use outside HVHZ: Yes FL11152_Rl_C_CAC_CCL for Pel! Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +20/ -20 02/16/2011 Other: (411 -H- 872.00 & 411 -H- 873.00) H -R20 (89in x 78in). Installation Instructions (411 -H- 872.00 & 411 -H- 873.01) H -R20 (2261mm x 1981mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R 1_AE_15 96. pdf Created by Independent Third Part 11152.9 Series 20 /25 Double Hung Vinyl Double Hung Triple Composite Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pd Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pel Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +25/ -25 02/16/2011 Other: (411 -H- 872.02 & 411 -H- 873.02) H -R25 (108in x 72in). Installation Instructions (411 -H- 872.03 & 411 -H- 873.03) H -R25 (2743mm x 1829mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Parr Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.10 Series 20 /25 Double Hung Vinyl Double Hung Triple Composite Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pei' Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pel Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +35/ -35 02/16/2011 Other: (411 -H- 872.04 & 411 -H- 873.04) H -R35 (108in x 62in). Installation Instructions (411 -H- 872.05 & 411 -H- 873.05) H -R35 (2743mm x 1575mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.11 Series 20/25 Double Hung Vinyl Double Hung Window (48" x 7 Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pet Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pet Impact Resistant: No Quality Assurance Contract Expii Design Pressure: +20/ -20 12/10/2010 Other: (411 -H- 859.02 & 411 -H- 862.02) H -R20 (48in x 78in). Installation Instructions (411 -H- 859.03 & 411 -H- 862.03) H -R20 (1219mm x 1981mm). FL11152_R1_II_1596.odf Configurations of glass conform to ASTM E1300 O4E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.12 Series 20/25 High Performance Double Vinyl High Performance Double Hur Hung Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pel Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pell Impact Resistant: No Quality Assurance Contract Expir Design Pressure: +50/ -50 01/29/2011 Other: (411 -H- 866.07 & 411 -H- 867.09) H -R50 (72.5in x 72in). Installation Instructions (411 -H- 866.06 & 411 -H- 867.08) H -R50 (1842mm x 1829mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 04E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part 11152.13 Series 20/25 High Performance Double Vinyl High Performance Double Hur Hung Limits of Use Certification Agency Certificate Approved for use in HVHZ: No FL11152_R1_C_CAC_CCL for Pel! Approved for use outside HVHZ: Yes FL11152_R1_C_CAC_CCL for Pell Impact Resistant: No Quality Assurance Contract Expir Design Pressure: +50/ -50 12/10/2010 Other: (411 -H- 859.04 & 411 -H- 862.04) H -R50 (48in x 72in). Installation Instructions (411 -H- 859.05 & 411 -H- 862.05) H -R50 (1219mm x 1829mm). FL11152_R1_II_1596.pdf Configurations of glass conform to ASTM E1300 04E1. Verified By: Warren W. Schaefer, F Created by Independent Third Part Evaluation Reports FL11152_R1_AE_1596.pdf Created by Independent Third Part Back Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 (85Q) 487 -1824, Fax (850) 414 -8436 © 2000 -2005 The State of Florida. All rights reserved. Copyright and Disclair Product Approval Accepts: := o � City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: ai /Of Cff Ca4 Date Received: 1/ /16 Site: 38 6 33 See,-4 Permit Type: ildv� P YP /�� r � �� � ` 61.Ji)//lam` ( � Approved w /no commen 7:j Approved w /the below comments: ❑ Denied w /the below comments: ❑ This comment sheet shall be kept with the permit and/or plans. , l i C / "i Kalv' »" itzer ans Examiner Date Contractor and/or Homeowner (Required when comments are present) 813 - 780 -0020 City of Zephyrhills Permit Application , Fax- 813 - 780 -0021 Building Department ( J Date Received -" Phone Contact for Permitting VIII I II,IIItl Owner's Name /r r9' L or- 1` N Owner Phone Number ) f 3 .� 'g® �' - Owner'sAddi4ss 33 3 se. n ct f Veil L( \- �-7 1 lt 11C )1 S Owner Number (31 - Y T ' 3 c i 3 • \ l 1 1 Owner Phone Number T Fee Simple Tiilebolder Name ) Fee Simple Titlelit9Jder Address �j ` (( j % 3 3 J ` f < LOT # JOB ADDRESS e~ `�� � � � � f? L 4" >' "� }ti� , le i 1/ 1 ( f ' i l�� / SUBDIVISION PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR — ADD /ALT I SIGN I I MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR I I COMM I I OTHER 1 TYPE OF CONSTRUCTION I I BLOCK I I FRAME I 1 STEEL I 1 OTHER I I k a n , o 2 e _ - - P r o w + u): flcip-c R t ' 4 /t4Acit}2J N - "It' - "-.")." c.v, i ■ Q :, c � \ c%21 A'1 :a ► i k DESCRIPTION OF WORK �2 t0'Lc.vl,� ; t,titvfi�U- �') , `t� . 4-4)1 +- ( �i 'YV c� f� , (1) t`-e-- , ,' . ' ►. t`-e-- c.. Sl 3' �( - D ' , --;e e. 0' dea- e->v - ■ BUILDING SIZE SQ FOOTAGE HEIGHT BUILDING $ f3r O faro D VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY I I W.R.E.C. I I PLUMBING $ I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I GAS 1 1 ROOFING I 1 SPECIALTY I 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IVES I INC) - .) _ -,- ` BUILDER l✓ 4( A " i COMPANY tail ..-c 814 SS-y' (' e t 1 SIGNATUR REGISTERED I Y/ NI FEE CURRENT I Y/ N I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I License # 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 ; — ) tec. ' 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 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) OWNER OR AGENT CONTRACTOR Subscribed and sworn to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this s by by Who is /are personally known to me or has /have produced Who is /are personally known to me or has/have he produced a identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped