HomeMy WebLinkAbout09-9020 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 9020
BUILDING PERMIT
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Permit Number: 9020 Address: 38018 12TH AVE
Permit Type: ACCESSORY BLDG. ZEPHYRHILLS, FL.
Class of Work: SHED INSTALLATION Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-06000-0180
Improv. Cost: 2,100.00 r. _
Date Issued: 4/16/2009 Name: COOK, JACKIE JR & BESSIE
Total Fees: 67.50 Address: 38014 12TH AVE
Amount Paid: 67.50 ZEPHYRHILLS, FL. 33542
Date Paid: 4/16/2009 Phone: (813)838 -2888
Work Desc: INSTALL 6 X 14 SHED
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HOMEOWNER BUILDING FEE 67.50
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FRAME
SHEATHING
FINAL
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."
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CONTRACTOR SIGRE PERMIT OFFI �R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contract r/Homeowner / l
Date Received: 4l - 10
Site: RON M- y
Permit Type: ' //,`
Approved w /no comments: ❑ Approved w /the below comments: ❑ Denied w /the below comments: ❑
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This comment sheet shall be kept with the permit and/or plans.
4 - 14 --v 7 ■A0
a f Bill Burgess - : • ding Official Date Contractor and/or H •,` ' u er
(Required when comments are present)
813 -780 -0020 City of Zephyrhills Permit Application �" Fax-813-780-0021
Building Department 9 02 0
Date Received. Dc 09 Phone Contact for Permitting -- EMI
Owner's Name MIA ' t ' _ 1t J u j ' S Si- ',
Owner Phone Number O 0 U -`'��
Owner's Address 3 e 0 le IA-ft- 1" ► U e Z IA 71'A . / 47 Owner Phone Number Y 1.3 9 7 0 v ("3 7✓litiq
Fee Simple Titleholder Name . bd1 '1 / Z 41 % Owner Phone Number
Fee Simple Titleholder Address h r _ / 7
JOB ADDRESS 3 6'0 I `V k I Ai c i__ e i r' r rl S - 7 1 2_5 va LOT #
SUBDIVISION PARCEL ID# !/ 24 ~ 21 .00(0 -26'000 - 0 / 80
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED j NEW CONSTR ADD /ALT I-1 SIGN n MOVE I I DEMOLISH
INSTALL REPAIR
( PROPOSED USE 1 tr1 SFR I I COMM 1 ---- 1 OTHER I
TYPE OF CONSTRUCTION F BLOCK I I FRAME I I STEEL n OTHER 1 I
1 DESCRIPTIONOF ORK I( . i \_S.
BUILDING SIZE 0 ) (1 SQ FOOTAGE HEIGHT
( I I BUILDING $ 6 VALUATION OF TOTAL CONSTRUCTION
I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I W.R.E.C.
I I PLUMBING $
I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
I I GAS I I ROOFING 1 I SPECIALTY I I OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I
I1
BUILDER _ COMPANY OYl ( ow I e
SIGNATURE / REGISTERED (-1-o Y/ N I FEE CURRENT I Y / N I
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I
Address 1 1 License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I
Address I License # I
MECHANICAL COMPANY
SIGNATURE 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 I
Address I License # I I
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 NC 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 comptianoe 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 $2,510.00 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 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 i //v / GC/" CONTRACTOR . C4="1"7'--;"°11-'C4="1"7'--;"°11-'7C4="1"7'--;"°11-'7.--- S bscribed and sworn dr a rmed) 4 cef re me this, Subscribed an or to (or a )
med before met 's ,/I
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Who is /are person y known to me or has/have produced Who is /are personally known to me or has /have produced
(✓� C2,stsa_ as identification.
(A ` as identification.
,-h ' 'GIY�' `� Notary Public
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Co ssior ' . Commision DD 6
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A',. •. : • Expires December 12, 2010 Commission DD 621833
, os ' Bonded Thru Troy Fain Insurance 8093857919 C o r nbe, 20 I 0
Name of Notary typed, printed or stamped Name of Notary typed, pitnte Insurance 1 122, a 01
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DISCLOSURE STATEMENT FOR OWNER
�CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
I, C.03 `( have read and fully understand and
agre 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 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 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' S SIGN -,• !�C ' . DAMS J . J0 / o9
ADDRESS 0 , ! _ f . ? ?sl o
PHONE .11MIEMEMINIMM
WITNESS PERMIT #