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10-10460
CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 10460 BUILDING PERMIT �? 3 3 q•, m� # y p 3 i I Y ` g v t W _ EC t.. ZESE •Se ^A "" 3 II?° R k' >•.�E e ., .. �e . .u.,: ar -.. .�. e ,.'t _ f ..,zv; _ •. :� �'. '- �s Y2 t6,11' nE�E �� . _, a�iYr •� „: >a�”" ._ Permit Number: 10460 Address: 6109 CRESTON ST LT#67 Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: PINE CREST M.H.P. Est. Value: Parcel Number: 03- 26 -21- 0210 - 00000 -0670 Improv. Cost: 7,000.00 4 4', , � :. � : < y� Date Issued: 5/12/2010 Name: PINECREST MOBILE HOME PARK Total Fees: 132.50 Address: 6109 CRESTON STREET Amount Paid: 132.50 ZEPHYRHILLS, FL. 33542 Date Paid: 5/12/2010 Phone: (423)902 -5838 Work Desc: CONSTRUCT 11 X 28 RM ADDITION W/ RUBBER REROOF ENTIRE HOME HOME•W - BUILDING 97.50 LE T AL F E 35.00 HOMEOWNER -)1(AQ x y li 8`� E e fa °�'� s ..;: , n. ff a w x ... .�v. �.. � . £�.c..E ;9. a.... �. , < -. a.'�s? FOOTER 2 1 ROUGH 'LOMB MI C IN ULATI■N 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 befo - recording your notice of commencement." :. ! / CONTRAC OR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER APPENDIX 13-D • FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 11008.08 Residential Component Prescriptive Method 8 ALL CLIMATE ZONES Compliance with Method 8 of Chapter 11 of the Florida Building Code, Residentit( or Subchapter 13-6 of the Florida Building Code, Building, may be demonstrated by the use of Form 11008 for single -and multiple- family residences of three stories or less in height, and additions to existing residential buildings. To comply, a building must meet or exceed all of the energy efficiency requirements on Table 118-1 and all applicable mandatory requirements summarized in Table 118 -2 of this form. If a building does not comply with this method, it may still comply under Method A of Chapter 11 or Subchapter 13-6 of the applicable code. PROJECT NAME: Lp ( C)ot C Ire < 1 .I 5t. BUILDER: AND ADDRESS: p t� !� / / p t i(i/1 1 1 i ( '-li OFFICE: c/ 7y O /- 2/ G • �C t'* L i t OWNER: 3y) t�1 JC_ PERIATr NO. JURistHC110N NO.: C-/ 1. New construction including additions which incorporate any of the following features cannot comply using this method: steel stud walls, single assembly roof/ceiling construction, or skylights or other nonvertical roof glass. 2. Alt in all the appicable spaces of the "To Be Installed" column on "Table 11B-1 with the information requested. M To Be Installed" values must be equal to or more efficient than the required levels. 3. Complete page 1 based on the To Be Installed" column information. 4. Read "Minimum Requirements for All Packages ", Table 118-2 and check each box to indicate your Intent to comply with all applicable items. 5. Read, sign and date the "Prepared By certification statement at the bottom of page 1. The owner or owner's agent must also sign and date the form. Pleas* Print CK 1. New construction or addition 1. Add . 2. Single- farntty detached or multiple-family attached 2.3I N C 1..L, 3. if multiple - family -No. of units covered by this submission 3. J/ 4. Is this a worst case? (Yeshx)) 4. 5. Conditioned floor area (sq. ft.) 5. 2G2.. 6. Glass type and area: ' S a. U -factor 6 e. - b. SHGC 8b. . zlo c. Glass area 6C. 1 Z_ sq. ft. 7. Percentage of glass to floor area 7 -3(0 B. Floor type, area or perimeter, and insulation: a. Slab -on -grade (R- value) 8a. R= lin.ft. b. Wood, raised (R- value) 8b. R= 13 Z52. sq.ft. c. Wood, common (R- value) 8c. R. sq. ft. d. Concrete, raised (R- value) 8d. R= sq, ft, e. Concrete, common (R- value) Be. R: sq. ft. 9. Wall type, area and insulation: • a. Exterior: 1. Masonry (Insulation R- value) 91"1. R sq ft 2. Wood frame (Insulation R- value) 9a-2. R. IS 233=sq. ft. b. Adjacent 1. Masonry (Insulation R- value) 96-1. R= sq.ft. 2. Wood frame (Insulation R- value) 9b-2. R= ) 3 2:1,:a4 s q. ft. 10. Ceiling type, area and Insulation: a. Under attic (Insulation R- value) 10a. R= sq. ft. b. Single assembly (Insulation R. value) 10b. R= 13 sq. ft. 11. Air distribution system: Duct insulation, Location 11a. R: ),/ /A �_� Test report required if duct in unconditioned space 11b.Tsst report attached? Yes .9) 12. Cooling system: 12s. Type: 1 . • (Types: central, room unit, package terminal A.C., gas, none) 12b. SEER/EER 12c. Capacity: ; • o o I ris 13. Heating system: 13a. Type: ti a `nJll (Types: heat pump. elec. strip, nat. gas, LP -Gas, gas h.p., room or PTAC. none) 13b. HSPF/COP /AFUE: 14. Programmable therm systems: 14. Yee No installed on HVAC a stems: 14.» N o Ig l ��n 15. Hot water system: 151. Type (Types: elec.. nat. gas, LP -gas, solar. heat rec.. dad. heat pump, other. none) 15b. EF: I hereby caddy that the plans and specdkatlons . -, by the calculation are m compliance with Review of pans and speeinatlons covered by th • - Marion Indicates compliance with the Ronda the Florida Energy Code 1 1 Energy Code. Before co c . ..u1 f anima wig be inspected for compliance In f S BUILDING O (0 accordance well Section 553. a�p // PREPARED BY: / 1,1 r L , i DATE: ✓ ad n� * 1. OFFICIAL / I hereby can flat ' � �.,_ iRcomp - . y !Ida Energy Ca � de: - S :y OWNER AGE DAT �C� DATE: r l � r l V 2007 FLORIDA BUILDING CODE - BUILDING 13 =D.23 Effective 3/1/2009 FORM 1100B -08 TABLE 116 -1 MINIMUM REQUIREMENTS (See Note 1) All Climate Zones BUILDING COMPONENT PERFORMANCE CRITERIA INSTALLED VALUES: Windows (see Note 2): U- factor = 0.65 U- factor= .75 SHGC = O. 35 SHGC= CFA <= 16% % of CFA= 3 7 Exterior door type Wood or insulated Type: Walls — Ext. and Adj. (See Note 3): Frame R -13 R -value = J'3 Mass Interior of wall: R -6 R -value = Exterior of wall: R -4 R -value = Ceilings (see Notes 3 & 4) R -30 R -value = I'7 Floors: Slab -on -grade No requirement Over unconditioned spaces (see Note 3) R -13 R -value = ?� Hot water systems (storage type) Electric (see Note 5): 40 gal: EF = 0.92 Gallons = 50 gal: EF = 0.90 EF = Gas fired (see Note 6): 40 gal: EF = 0.59 Gallons = 50 gal: EF = 0.58 EF = Air conditioning systems (see Note 7) SEER = 13.0 SEER = Heat pump systems (see Note 8) SEER = 13.0 HSPF = 7.7 SEER = HSPF = Gas furnaces AFUE = 78% _ AFUE = _ Oil furnaces AFUE = 78% AFUE Programmable thermostat Must be installed on all HVAC systems Installed? Yes No Ductwork (see Note 9) Location: Unconditioned space' R -6, Tested Unconditioned spa Ddc•k'1e.S) R- value= Test report: //SC Conditioned space NA Conditioned space Unvented attic assembly per R806.4 with R-4.2 R -value = insulation at the roof plane (No test report required) Air Handler location: Location: Unconditioned attic' or garage Requires test report Test report: ��� Conditioned space or Unvented attic assembly per R806.4 with No duct test required . insulation at the roof plane (1) Each component present in the As -Built home must meet or exceed each of the applicable performance criteria in order to comply with this code using this method; otherwise Method A compliance must be used. (2) Windows and doors qualifying as glazed fenestration areas must comply with both the maximum U- Factor and the maximum SHGC (Solar Heat Gain Coefficient) criteria and have a maximum total window area equal to or less than 16 % of the conditioned floor area (CFA), otherwise Method A must be used for compliance. Exception: Additions of 600 square feet (56 m or less may have maximum CFA of 50 percent. (3) R- Values are for insulation material only as applied in accordance with manufacturers' installation instructions. For mass walls, the interior (Int) requirement must be met unless at least 50% of the insulation value is on the exterior (Ext) or integral to the wall. (4) Attic knee walls shall be insulated to same level as ceilings and shall have a positive means of maintaining insulation in place. Such means may include rigid insulation board or air barrier sheet materials adequately fastened to the attic sides of knee wall framing materials. (5) For other electric storage volumes, minimum EF = 0.97 - (0.00132 * volume) (6) For other natural gas storage volumes, minimum EF = 0.67 - (0.0019 *volume) (7) For all conventional units with capacities greater than 30,000 Btu /hr. For Small -Duct, High - Velocity units, Space Constrained units, and units with capacities less than 30,000 Btu /hr see Table 13- 607.AB.3.2A of the Florida Building Code, Building, or Table NI 107.A8.3.2A of the FBC- Residential. (8) For all conventional units with capacities greater than 30,000 Btu /hr. For Small -Duct, High - Velocity units, Space Constrained units, and units with capacities less than 30,000 Btu /hr see Table 13- 607.AB.3.2B of the Florida Building Code, Building, or Table N1107.AB.3.2B of the FBC- Residential. (9) All ducts and air handlers shall be either located in conditioned space or tested by a Class 1 BERS rater to be "substantially" leak free. "Substantially leak free" shall mean distribution system air leakage to outdoors no greater than 3 cfm per 100 square feet of conditioned floor area at a pressure differential of 25 Pascal (0.10 in. w.c.) across the entire air distribution system, including the manufacturer's air handler enclosure. TABLE 11B -2 MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQUIREMENTS CHECK Exterior joints & cracks N1106.AB.1.2 To be caulked, gasketed, weather - stripped or otherwise sealed. 1/ Exterior windows & doors N1106.AB.1.1 Max. 0.3 cfrnlsq.ft. window area; 0.5 cfm /sq.ft. door area. ,/, Sole & top plates N1106.AB.2.1 Sole plates and penetrations through top plates of exterior walls must be sealed. Recessed lighting N1106.AB.1.2.4 Type IC rated with no penetrations (two alternatives allowed) Multistory houses N1106.AB.1.2.5 Air barrier on perimeter of floor cavity between floors. Exhaust fans N1106.AB.1.3 Exhaust farts vented to unconditioned space shall have dampers, except for combustion devices with integral exhaust ductwork. Water heaters N1112AB.3 Comply with efficiency requirements in Table N1112.AB.3. Switch or clearly marked circuit breaker electric or cutoff (gas) must be provided. External or built -in heat trap required for vertical pipe risers. Swimming pools & spas NI112.AB.2.3.4 Spas & heated pools must have covers (except solar heated). Noncommercial pools must have a pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78 %. Heat pump pool heaters shall have a minimum COP of 4.0. Hot water pipes N1112.AB.5 Insulation is required for hot water circulating systems (including heat recovery units). Shower heads N1112.AB.2.4 Water flow must be restricted to no more than 2.5 gallons per minute at 80 psig. HVAC duct construction, N1110.AB Ail ducts, fittings, mechanical equipment and plenum chambers shall be mechanically insulation & installation attached, sealed, insulated and installed in accordance with the criteria of Section N1110.AB. Ducts in attics must be insulated to a minimum of R-6. HVAC controls N1107.AB.2 Separate readily accessible manual or automatic thermostat for each system. 13 -D.24 2007 FLORIDA BUILDING CODE — BUILDING • Jul 29 10 03:117p Lg Edwards Ins 3525676766 p,1 t ) ACORD 'CERTIFICATE OF LIABILITY INSURANCE OP ID KS DATE (MM/DDIYYYY) 07/29/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LUNIAI.I NAME: PHONE >AX L.G. Edwards Insurance Agency (aC, IL No, Ext): I (A/c, No): MA P.O. Box 1548 ADDRESS: Dade City FL 33526 -1548 PRODUCER CUSTOMER ODONO -1 Phone:352- 567 -6751 Fax:352- 567 -6766 INSURER(S) AFFORDING COVERAGE NAIC0 INSURED INSURERA: Allstate Insurance Co 09020 O'Donovan' Air Conditioning & INSURERB: Maryland Casualty Co 119305 Heating Company Timothy O'Donovan INSURER C : 4839 Allen Rd INSURER Zephyrhills FL 33541 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHS I ANUING ANY REQUIREMENT, TERM OR CONDITION or ANY CONTRACT OR OTHER DOCUMENT WITH RFCPFCT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN POLICY H MAY HAVE BEEN REDUCED BY PAID CLAIMS. I TYPE OF INSURANCE NSR , WVD' POLICY NUMBER ( MMUD 1(MMID MCP LIMITS GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 UAMACat I (Ea 1itNIEU I S 1D0 DDD A X COMMERCIAL GENERAL LIABILITY 049851744 01/07/10 01/07 PREMISES occurrence) CLAIMS -MADE l X OCCUR , MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1 , 000 , 000 GENERAL AGGREGATE E 1 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG L$ 1,000,000 X POLICY n J n LOC 1 $ AUTOMOBILE LIABILITY 1 COMBINED SINGLE LIMIT g 50 ,GOO (Ea accident) A ANY AUTO 650419867 10/15/09 10/15/10 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) r $ X NON .OWNED AUTOS ' S UMBRELLA LIAR 1 , OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DEDUCTIBLE a RETENTION $ I $ B WORKERS COMPENSATION WCO29841 06/02/10 06/02/11 X TOR STA ITS I I LI AND EMPLOYERS' LIABILITY ABILITY CUTIV9J N E.L. EACH ACCIDENT $ 100000 (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ 100000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L.OISEASE - POLICY LIMIT $ 500000 If DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD tot, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITYOFZ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. *30 days for CITY OF ZEPHYRHILLS (813) 780 -0021 - AUTHORIZE() REPRESENTATIVE 'fork comp 5335 8TH STREET ZEPHYRHILLS FL 33541 I ©1988 -200 ACORD CO P N. A rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD O'DONOVAN'S AIR CONDITIONING & HEATING CO. N° 0 0 0 3 2 7 4839 ALLEN ROAD • ZEPHYRHILLS, FL 33541 PROPOSAL PH (813) 782 - 4075 FAX (813) 779 - 0100 STATE LIC. # CACO54731 ®,P.°sir;3S _ 7/10 C SUBMITTED TO PHONE CELL D ATE N N P O: STREET JOB NUMBER OR NAME P l 6 Cke -- o CITY STATE ZIP JOB LOCATION s _ 2 - Os.c- in.fn A MAIN CONTACT JOB PHONE OR E -MAIL „L / A/ C l' "WE^`RESP FULLY:SuBMrrTHEFOL"LOWING SP CiFJCATIONS- AND'ESTIMATEI FOR: Ja"______ 15 5.' e/.K 6 1 c - A - 7 / , c - 7 6 ---- - -_ '-- 7 1-- 2 _ s_- _ i4 Q....,// eA.....1.......- / / - d 0 y e A A 1. f a , s Wee ' Z /;� _--- _....__ -------------- � CIA-- kt,`°n --, c �, °�+�� - - -- - - - -- gei - - - - -- - -- _ ems'._ ___ _..____.___- - - - -- _ -_ ._ 11 :7 2 _ a ?-6 6-4 I AZ9Y ier ,,6-,44-___ 4fry et,c_did_ ____ _________ WE OFFER TO FURNISH MATERIAL AND LABOR AND COMPLETE THE ABOVE IN ACCORDANCE WITH ABOVE SPECIFICATIONS FOR THE SUM OF: / �r DOLLARS ($ 3,L' .27 ). / / le PAYMENT TO BE MADE AS FOLLOWS: A O4 °� � /eft' � - — � :;t�� � �fl� � 1 . -' _ / 1 0, All materials is guaranteed to be a specified. All work to be completed in a r workmanlike manner according to standard practices. Any alteration or deviation S ,' /' � llIKA from above specifications involving extra costs will executed only upon AUTHORIZED SIGNATURE �� _f written orders, and will become an extra charge over and above the estimate. ,. �" All arrangements contingent upon strikes, accidents or delays beyond our OFFER MAY BE WI HDRAWN control. Owner to carry fire, tornado and other necessary insurance. Our IF NOT ACCEPTED WITHIN workers are fully covered by Workmem's Co'mpensation Insurance. DAYS. A c The abov: prices, pecifications a • • , ditions ar satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment wit be made as outlined above. C. E P T 0121_112 N -: AUTHORIZED SIGNATURE DATE OF ACCEPTANCE AUTHORIZED SIGNATURE ` PRA 813 -780 -0020 City of Zephyrhills Permit Application 4 I + U v_ „G Fax-813-780-0021 Building Department ` Date Received d — 7-- l p • ne Con : ct for Permittin ! L 0 . -- 0 S Owner's Name Pr, it/ q 1 s) D A / f» 2 k\ Owner Phone Number 4 .3 ( L k .9• " 5 i 3 1 Owner's Address 6//, / 110!/C L 5 D \il 57't, Z h � 4,.ais Owner Phone Number )-_3 - 79z) •- 9- /3 7 Fee Simple Titleholder Name ~""- -- - =' Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 6/0 9 e f.L ,1 I1) 7/* 2L -- PA y 4 h i Li. 5 FL• 33 Syc LOT # ZJ SUBDIVISION P( /I+'1% C,t 5 '/ PARCEL ID# (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR 11 ADD /ALT I I SIGN n MOVE I 1 DEMOLISH INSTALL REPAIR PROPOSED USE n SFR 1 1 COMM I I OTHER 1 1 TYPE OF CONSTRUCTION 1 1 _BL nC 1 ----7- FRAME F7 STEEL n OTHER 1 I C1 DESCRIPTION OF WORK Ze Ec& f // ,( c p 12,-,o ,- A- PP t € ,,J BUILDING SIZE / / °- d SQ FOOTAGE ..7G> ? $ i'FS. HEIGHT ! I I BUILDING $ 7GO c, v C� VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY 1 I W.R.E.C. I 1 PLUMBING $ I 1 MECHANICAL $ 5' 2T VALUATION OF MECHANICAL INSTALLATION I I GAS I 1 ROOFING I 1 SPECIALTY I 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ I No s NIP BUILDER V\ • COMPANY 1 ./.Qiti F, ✓ 42 G�rJ° J SIGNATURE "71/ PetAk REGISTERED Y / N FEE CURRENT I Y / N I Address 1 , 9 e Slc Ai .. 7k. 2 c /a c/X A ; S - ` License # ELECTRICIA f COMPANY SIGNATURE REGISTERED 1 Y / N . 1 FEE CURRENT 1 YIN I Address I License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address . # I COMPANY f .9 ✓tit ( I (0, MECHANICAL .! . SIGNATURE REGISTERED 1 Y/ N i FEE CURRENT 1 Y/ N 1 Address I License # C 4 C- n 5 V 7 3 ( I OTHER COMPANY SIGNATURE REGISTERED I Y/ N j FEE CURRENT I Y/ N 1 Address License # 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 A/C Fences (PIot/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 1, 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 LEND - OR AN ATTORNEY BEFORE RECORDING YOU OTICE OF CO MENCEMENT. FLORIDA JURAT (F.S 11 03) fp 9 OWNER OR AGENT .. JL 0 • ✓I CONTRACTOR .. r and s' to (or affir a thi Subscribed and orn to (or affirmed) Wf e s y S b bed a bsy ! -(o alb'" • z /�/ l srx?i/`tfe duced Who is /are personally nown to m or has/have produced Who is /ge ersonall kndwn to me or has /have p ,_,...,c �. as identlficatlon. f' as cation. ti ,,,,,i ' ( f ; / // 0 ,6e/ / , , , _ AO° (\ , C^ ..' o. Commission No. -:' ' BOBBIE S. SWETLAND w = .. „ . - „ ,.y. ped Name of Not '' 6,11T 001Ar i A 7 , j. , . P ; 34406 2 ;� ,,. . , i i - . res ebruary 22, 2012 ,1.0- = Expires Februa 22, 2012 ( , i r ' Bonded Thu Troy Fein Insurance 804385.7019 , ”' ` • Bonded Thru Troy Fair, Insurance 804385.7019 Pasco County Parcel: 03- 26 -21- 0210- 00000 -0670 001 Page 1 of 1 Data Current as Of: II Weekly Archive - Saturday, May 08, 2010 I Parcel ID I 03- 26 -21- 0210 - 00000 -0670 (Card: 001 of 001) Classification 1 02 - Mobile Homes I Mailing Address Final 2009 Value PINECREST MOBILE HOME PARK Ag Land $0 RESIDENTS INC OF ZEPHYRHILLS Land $9,200 6043 HARRIET ST Building $5,026 ZEPHYRHILLS FL 33542 -3273 Physical Address Extra Features $239 Physical Address N/A Market Value $14,465 Legal Description (First 4 Lines) Assessed (Non - School Amendment 1) $14,465 PINECREST MOBILE HOME PARK CO-OP OR 4767 PG 100 & Taxable Value $14,465 OR 4814 PG 662 LOT 67 Land Detail (Card: 001 of 001) Line II Use IlDescriptionll Zoning II Units II Type II Price 11 Condition II Value 1 0200 MSUBM 00M2 1.00 LT $9,200.00 1.00 $9,200 Additional Land Information I Acres II 0.05 II Tax Area II 30ZH 1 FEMA Code I) -- IlResidential Codell PNCSLP1 I Building Information - Use 02 - Mobile Home (Card: 001 of 001) I Year Built 1976 Stories 1.0 Exterior Wall 1 Pre - Finished Metal Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Min Roof(Corr. or Sh M) Interior Wall 1 Plywood Panel Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted A/C None Baths 2.0 Line II Description II Sq. Feet II Repl. Cost New 1 11 BAS I I 384 $11,965 2 II FSA II 102 II $1,433 3 II FOA 11 24 $ 187 Extra Features (Card: 001 of 001) Line II Description 1 Year it Units ( Value 1 I A /C -1 I 1992 I 1 II $33 2 II UDU -M 1 1988 II 1 $206 Sales History Previous Owner I BROOKS LINDA L Year 11 Month 1 Book /Page II Type A Amount 2009 II 03 I 8061 / 0379 II AL 11 $5,500 2001 II 11 I 4814 / 0685 II PL II $0 2001 11 02 1 4567 / 1952 II WD II $0 http: / /appraiser.pascogov. com/ search /parcel. aspx ?sec =03 &twn= 26 &rng=21 &sbb= 0210 &b... 5/12/2010 :DISCLOSURE ' FOR OWNER CITY OFZEPHYRHILLS—.BUILDING DEPARTMENT I, V�' kl , have read and 'fully understand and agree to the provisions f 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, 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 $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 woricto 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, a ning regulations. . / OWNER'S SIGNATURE 1 4,4-- DATE /_ v ADDRESS PHONE • WITNESS PERMIT I/Masterfonns /OwnersA. davit/NovO7 Pasco County Parcel: 03- 26 -21- 0210- 00000 -0670 001 Page 1 of 1 Data Curren as Of: I Weekly Archive - Saturday, May 01, 2010 Parcel ID 03- 26 -21- 0210 - 00000 -0670 (Card: 001 of 001) I Classification 1 02 - Mobile Homes Mailing Address Final 2009 Value PINECREST MOBILE HOME PARK Ag Land $0 RESIDENTS INC OF ZEPHYRHILLS Land $9,200 6043 HARRIET ST Building $5,026 ZEPHYRHILLS FL 33542 -3273 Physical Address Extra Features $239 Physical Address N/A Market Value $14,465 Legal Description (First 4 Lines) Assessed (Non - School Amendment 1) $14,465 PINECREST MOBILE HOME PARK CO -OP OR 4767 PG 100 & Taxable Value $14,465 OR 4814 PG 662 LOT 67 I Land Detail (Card: 001 of 001) I Line II Use IlDescriptionll Zoning II Units II Type II Price II Condition II Value 1 0200 MBL SUB HM 00M2 1.00 LT $9,200.00 1.00 $9,200 Additional Land Information I Acres 0 0.05 II Tax Area II 30ZH I) FEMA Code II -- IlResidential Codell PNCSLP1 I Building Information - Use 02 - Mobile Home (Card: 001 of 001) Year Built 1976 Stories 1.0 Exterior Wall 1 Pre - Finished Metal Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Min Roof(Corr. or Sh M) Interior Wall 1 Plywood Panel Interior Wall 2 None Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet Fuel Electric Heat Forced Air - Ducted A/C None Baths 2.0 Line II Description II . Feet II Repl. Cost New I 1 BAS 384 II $11,965 I 2 U FSA II 102 $1,433 I 3 II FOA II 24 II $187 I Extra Features (Card: 001 of 001) I Line II Description I I Year II Units II Value I 1 II A/C -1 II 1992 I 1 II $ I 2 II UDU -M II 1988 II 1 II $206 Sales History I Previous Owner I BROOKS LINDA L Year Month I Book /Page II Type II Amount 2009 II 03 II 8061 / 0379 II AL II $5,500 I 2001 II 11 II 4814 / 0685 II PL Q $ I 2001 II 02 II 4567 / 1952 0 WD II $0 http: / /www. appraiser. pascogov. com / search /parcel.aspx ?sec =03 &twn= 26 &rng=21 &sbb =02... 5/7/2010 Map - Pasco County Property Appraiser Page 1 of 1 Pasco County, Florida Section 03, Township 26, Range 21, 1.0 miles NNW of Zephyrhills Mike Wells -� w. sao €€ a �6i0 III . 10 ' 7` } sa •a-. B �B, R When I click on the map: , mso s 1:0;t:—.7,',,,,,.:;:.:,,:::::::— 0 Quick Info (� C Full Info* 0510 q111) = Zoom In 1.5x Choose Layers: Parcel Lines (Default) r '� U40 Parcel Labels (Automatic) 1150, Street Names (Automatic) 2009 1 ft Color "` -- Select Additional Layer Draw Hel Prin -- Select Grouping A : oQ 1,- A t i 1 >g� "�65F $�,, P Image Size / Quality: o ZS ,l Ni _. @ EE y , ..... 4 :: (Quality applies if imagery is selected) : ' 0590 , x Low Quality (Fast / ]PEG) Links of Interest: - • Recent Sales in this area Search for property in Pasco I� 11 Map Search 159 Feet MapID# 9279831/4423 Street name information is maintained by the Pasco County BOCC GIS Department. http: / /maps.pascogov.com/ maps /showmap.asp ?Name= PascoMap_New &mdi= 9279831 &oc... 5/7/2010 . . .. .. • /1) ' - e !ie -. - - -- 5 - , - -: - . ' - , : i .. 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Garcia, Dpty Clerk • NOTICE OF COMMENCEMENT PAULA S. o' NE I L , PASCO CLERK & COMPTROLLER • 05/12/10 R BK 83 ' 0 1 PG 1895 Permit No. Property Identification No. 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 provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal description:) . �6. O c� / ' ^ vevc es 0 — p670 CL 551 7 j ..i $ C- tl ( ) a) Street Address: 6 / O e/ / t if o .t 5 . 2.6P Ct. iu 5 A1_ t 5 2.General description of improvements: _ � .J, _� j 6 P57` 3.Owner Information I l' ) SPO C cc. ),-17 t1. a) Name and address: 7) PA 2 /( i/o 12 k'L 5 /17 5 6 f iFl. -- )2Z- 5 i- l b) Name and address of fee simple title�lder (if other than owner) 3 35 4 -- c) Interest in property e j I it) / Rid c /, /= p- 4.Contractor Information • a) Name and address: 5 4 S G i U tv t' 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 documents 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, C SULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE O MMENCE . STATE OF FLORIDA COUNTY OF PASCO Si ature of Owner or Owner2a4uthorized Officer/Director/Partner/Manager 16ti 1- k Print Name The foregoing instrument was acknowledged before me this / 2 day of May 20 /d by as (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on behalf .f hom instrument was ecuted). • Personally Known, OR Produced Identification _ Notary Signature '' fib- / `,r'y �U Type of Identification Produced Name (print) / 1!� ► -A GES �C� � I . '• 1- :* box' :sSIOn DD 621833 "-`5*-7'..‘.!--..W Expires December 12 2010 Verification pursuant to Section 92.525, Florida Statutes. Under penalti f perjury, I de e that dfa` ' read )iftg itntblltieo- 385.7010 the facts stated in it are true to the best of my knowledge and belief. Signature of Natural Person Signing Above FORMSINOC,nad2007 Pasco County Property Appraiser - Legal Description for: 03- 26 -21- 0210 - 00000 -0670 Page 1 of 1 Welcome : Records Search : Parcel Details : Legal Description OR BK 8330 PG 1896 Legal Description 2 of 2 03- 26 -21- 0210- 00000 -0670 Assessed in Section 03 Township 26 South, Range 21 East of Pasco County, Florida PINECREST MOBILE HOME PARK CO -OP OR 4767 PG 100 & OR 4814 PG 662 LOT 67 OR 8061 PG 379 Please be advised that our legal descriptions are for assessment purposes only, and are not intended for use in legal conveyances. Pasco County Property Appraiser Page Layout Modified: 2/17/2009 11:49:04 AM The Local Time Is: 5/12/2010 2:10:06 PM STATE OF FLORiCA, COUNTY OF 'sib THIS IS TO CERTIFY THAT THE FOREGOKG IS A' : TRUE AND CORRECT COPY OFYF{E DOCUMENT ON FILE OR OF PUBLIC RECOND IN THIS OFSIJ WITNESS MY HAND} A D `FI="+CIAL SEAL THI >;•` Lf h21 OF PAULA S '1 EIL. CLERK & MPTI'O ER^ BY .1A) DEPUTY CL •/ - k http: // appraiser .pascogov.com /search/legal. aspx ?parcel= 2126030210000000670 &cache =F... 5/12/2010 City ofZephyrhills BUILDING MAN REVIEW. C OMIVIENT Contracto /1-I meo Date Received: _ 7 / ( ) Site: t0 - Permit Type: u/�ii // Appi ovedw /no comments :EI Approved /thebelow comments: Deniedw /the'below comments: "D 1 � �� � , � ivy r I o r k _ 5 C t. ( VI No j,� G c cc 41.4.1 ' -e /x F13 C ccvo 60g YO 6C. • 3 ) /l0 0 caf le - -oc- - This comment sheet - ' ept with the permit and/or plans. / "4° Bill Burgess 'ar • g Official Date Contractor and/or Homeowner (Required when comments are present) • 813- 780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021 Building Department Date Received "'my "ll «' Phone Contact for Permittin ' 7 -- ` 'I -7 7 7 Owner's Name 'P `- Owner Phone Number 73 20 -- Owner's Address Ly 57,490 Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address / JOB ADDRESS 6/09 C7 �S�o�l 3-�7e,.)— j y / /j /"7' k > 3 �4 LOT # SUBDIVISION PARCEL ID # � oi / OO 1 1' ° '� (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR n ADD /ALT SIGN I I n DEMOLISH INSTALL I I REPAIR PROPOSED USE 1 1 SFR n COMM I I OTHER I TYPE OF CONSTRUCTION 1 1 BLOCK n FRAME I I STEEL I 1 1 DESCRIPTION OF WORK /1, c A > ! P (i -7 i BUILDING SIZE SQ FOOTAGE HEIGHT I (BUILDING 0:741 VALUATION OF TOTAL CONSTRUCTION 1 (ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY I 1 W.R.E.C. 1 IPLUMBING $ 141MECHANICAL $ 7 / , r(if VALUATION OF MECHANICAL INSTALLATION 1 IGAS 1 1 ROOFING n SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IVES NO BUILDER COMPANY SIGNATURE REGISTERED 1 Y / N I FEE CURREN I Y/ N1 I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N 1 Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y / N I FEE CURREN I Y/ N I Address License # l MECHANICAL �� / ✓ COMPANY ' �'� � V l� S - :// -,--- -) SIGNATURE ( ��/ �` Cam^ REGISTERED I Y / N I FEE CURREN I N 1 / Address / . 1/(7 % l ( < c � y / // � q , I =) ? ( cense # V( (9 > c ( 7 3 OTHER COMPANY SIGNATURE REGISTERED I Y / N I FEE CURREN I Y/ N I Address License # 1111111111111111111111111111111111Iltil111111111111111111111Itllitll1111111111111111111111111111111111111111111111111II II llllllliilllililtii 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 $7500) ** Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles 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. 1 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 CONTRACTOR Subscribed and sworn to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this by by Who Is /are personally known to me or has/have produced Who is /are personally known to me or has /have produced as Identification. as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped Florida Building Code Online http:// floridabuilding .org/pr /pr_app_dtl.aspx ?param= wGEVXQwtD... y orri r t un i ty Affairs .. ji1 ,1 . .. `t. H..,_ C, OCA r''. V BCIS Home 1 Log In 1 User Registration Hot Topics Submd Surcharge 1 Stats & Facts 1 Publications 1 FBC Staff 1 BCIS Site Map I Unks ' Search Product Approval '� I USE Public User Commun G ICS Product Approval Menu > Product or Application Search > Application list > Application Detail R cXwMu Nrrr PLANNING FL # FL163 -R2 'Ir MOUSING S COMMUNITY``., Application Type Revision DEVELOPMENT Code Version 2007 MANAGEME . Application Status Approved aOFFSOe Comments l Archived Product Manufacturer Custom Window Systems, Inc. Address /Phone /Email 1900 SW 44th Avenue Ocala, FL 34474 (352) 368 -6922 Ext 207 mlafevre @cws.cc Authorized Signature Michael LaFevre mlafevre @cws.cc Technical Representative Michael LaFevre ## Address /Phone /Email 1900 SW 44th Avenue Ocala, FL 34474 (352) 368-6922 Ext 207 MLaFevre@cws.cc Quality Assurance Representative Ralph Emminger ## Address /Phone /Email 1900 SW 44th Avenue Custom Window Systems, Inc. Ocala, FL 34474 (352) 368 -6922 Ext 208 Ralph @cws.cc Category Windows Subcategory Single Hung Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed Roberto Lomas the Evaluation Report Florida License PE -62514 Quality Assurance Entity Keystone Certifications, Inc. Quality Assurance Contract Expiration Date 12/31/2010 Validated By Steven M. Urich, PE Validation Checklist - Hardcopy Received Certificate of Independence FL163 R2 COI 510510A (Eng Eval Rep SH- 35001.odf Referenced Standard and Year (of Standard) Standard Year ANSI /AAMA /WDMA 101/IS2 -97 1997 Equivalence of Product Standards Certified By Sections from the Code 1 of 2 3/4/2009 9:53 AM O+ XP V W ZP. SA l W Vp X P°>2f p > a 3co y ms m . . 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C ommuni t y Aff airs ; 0 .1 % 11 .x ,. r OCA HOME ABOUT DCA OCA PROGRAMS CONTACT OCA .. • BCIS Home Log In User Registration Hot Topics Submit Surcharge Stets & Facts Publications FBC Staff BCIS Site Map Links Search a ! Product Approval Q \� --- -/ USER: Publk User Com munity Affairs Product Approval Menu > Product or Application Search > Application List > Application Detail 0 CAMNtAWTY pLM/NNG FL # FL7858 -R2 11,mous4NtaacomaniosY Application Type Revision oEVEW'T Code Version 2007 ;NCx Application Status Approved 6 Comments ire amce s "" o .' — Archived Product Manufacturer Custom Window Systems, Inc. Address /Phone /Email 1900 SW 44th Avenue Ocala, FL 34474 (352) 368-6922 Ext 207 mlafevre @cws.cc Authorized Signature Michael LaFevre mlafevre @cws.cc Technical Representative Michael LaFevre ## Address /Phone /Email 1900 SW 44th Avenue Ocala, FL 34474 (352) 368 -6922 Ext 207 MLaFevre @cws.cc Quality Assurance Representative Ralph Emminger ## Address /Phone /Email 1900 SW 44th Avenue Custom Window Systems, Inc. Ocala, FL 34474 (352) 368-6922 Ext 208 Ralph @cws.cc Category Exterior Doors Subcategory Sliding Exterior Door Assemblies Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed Luis Roberto Lomas the Evaluation Report Florida License PE -62514 Quality Assurance Entity Keystone Certifications, Inc. Quality Assurance Contract Expiration Date 12/31/2010 Validated By Steven M. Urich, PE Validation Checklist - Hardcopy Received Certificate of Independence FL7858 R2 COI 510463A (Eval Rep XO 8080).odf Referenced Standard and Year (of Standard) Standard Year AAMA /WDMA /101/I.5.2/A440 -05 2005 ASTM E1300 2002 ASTM E1886 -02 2002 ASTM E1996 -02 2002 PAT/TAS 201/202/203 1994 1 of 2 3/4/2009 4:57 PM Florida Building Code Online http: // floridabuilding. org/ pr/ pr_ app_dtl.aspx ?param= wGEVXQwtD... Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Submitted 09/12/2008 Date Validated 11/10/2008 Date Pending FBC Approval 11/13/2008 Date Approved 12/10/2008 Summary of Products FL # Model, Number or Name Description 7858.1 8900 Vinyl SGD 8900 Vinyl 2 Panel 2 Track SGD. Large Missle dp = +/ 60 psf (96" x 96 "). Limits of Use Installation Instructions Approved for use in HVHZ: Yes FL7858 R2 II CWS -165A (SGD -8900 Impact XO Approved for use outside HVHZ: Yes 8080).pdf Impact Resistant: Yes Verified By: Luis Roberto Lomas PE -62514 Design Pressure: +60/ -60 Created by Independent Third Party: Yes Other: Large Missle dp = +/- 60 psf (96" x 96 ") Impact. Evaluation Reports FL7858 R2 AE 510463A (Eval Rep XO 8080).pdf FL7858 R2 AE DuPont SGP NOA 07- 1116- 04.pdf FL7858 R2 AE Mikron NOA 06 -1220 01.pdf Created by Independent Third Party: Yes Back) I Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 (850) 487 -1824, Fax (850) 414 -8436 © 2000 -2005 The State of Fbrida. All rights reserved. Coovrioht and Disclaimer Product Approval Accepts: I � eC hzck Bob APPRO+'E 2 of 2 3/4/2009 4:57 PM • 1 111 CC =Z i iii1":- ii to 1� 0 G � 'TI x v m Z ,_ ri ,i,..g 0 i , , 1 i ' iLi ill 1 '11 X � aD v 4D o i g 13 z o s m aim cn i 440404D m 10 g r m q ;? ° 1111 N z P A P 1 t OI V<Q ' .2 ) I !/ w "* r o P m v m N A 5 !. m y 1 as 't 7 •, } i� + n� ¢ '�/ y D • • m 0 A 0 37 m> • y zm 3.. G) r...j < • q ' 0 T 0 0 2 O m ZOmcn T m m '� O T2. ° Ok a Zv I -I 0 w`�r . ` r G 1 Z 21 -Nfm = A y m g � m n' 0 0 a # ° + `` ! c;i' P n y R 0 m ! (4 m 4 T. rg 4 Om f m A ° m o C r- n -. o Z a7N m a S O Sw , r - Z2m 0 to S co cn • '' - � ' ` - O _ , :_ 9 0 R D 9 N T n gWO T = mT p; o a m a m m_ 1 i ,. ^ ♦ D N n Z M, 00 oo Q 7 0 F 0 0 o N 0 r a w • 0 O . o � � O 1 app o O m B° gt 3 a ?....z y m r D O �r ?9 z 32 ° o m �yo m i • z • r � , �' ln fit 53° 0 > N m [A n9 m�.-r • C ° m a ° m o a m $ a a ? 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'�Y,' ,. ; , . mA x m I _ � v �q ma, r m S - ;1 ,,,,‘ ` .gt D mm j F �i L�I'I - '� o Z > >< [ 1: 7 4 ______ MINIM _ ' \� m m .. ,�� �� i i z G o . • r o ;� S co C7 0 .0 m p C C 0 D m m mm o 132,tg :2N m < O< wl, m n z O 5 m). . 0 0) xa y8 � � m co. • ( w �t ' :i � #2 L • 1 } ` S uC S K $y`A''` W�` • y� �yyy 2 k �. ^ M1 A 1 +314, V rn P i�, T - x Y � 7 ' M.m� ,s1 BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats & Facts Publications FBC Staff BCIS Site Map Links Search a� s (Product Approval Ik, s ,� '� USER: Public User Community Affair s Product Approval Menu > Product or Application Search > Application List > Application Detail a v` tti• x . FL # FL7699 -R1 Application Type Affirmation ;0=0:fi, Code Version 2007 aM� 7 , Approved � �, r YR ��. Application Status •,k't Comments Yg Arc Product Manufacturer Cooley Incorporated Address /Phone /Email 50 Esten Avenue Pawtucket, RI 02860 (702) 525-3474 ReedL@cooleygroup.com Authorized Signature Stephen McWilliams mcwilliamss @cooleygroup.com Technical Representative Address /Phone /Email Quality Assurance Representative Address /Phone /Email Category Roofing Subcategory Single Ply Roof Systems Compliance Method Certification Mark or Listing Certification Agency Miami -Dade BCCO - CER Validated By Referenced Standard and Year (of Standard) Standard Year ASTM D4434 2004 Equivalence of Product Standards Certified By itt p: / /www.floridabuilding.org /pr /pr_ app_ dtl. aspx? param= wGEVXQwtDgs4uUmmA52Cf2XE4f %2fR2gBm... 1/29/2010 Documentation from approved Evaluation or Validation Entity Product Approval Method Method 1 Option A Date Submitted 03/18/2009 Date Validated 03/18/2009 Date Pending FBC Approval Date Approved 03/25/2009 ;Summary of Products ,LFL # Model, Number or Name Description 7699.1 ! C3 Plus :PVC Roof Membrane Limits of Use 'Certification Agency Certificate Approved for use in HVHZ: Yes FL7699 R1 C CAC NOA 06022703 = Wood.df Approved for use outside HVHZ: Yes FL7699 R1C CAC NQA 060418 SteeLpdr Impact Resistant: Yes FL7699 R1 C_ CAC NOA_060418 - Concrete.pdf Design Pressure: N/A FL7699 RiCCAC NOA 06041803 - Wood Fiber.pdf Other: See System and General Limitations set forth in FL7699 R1 C CAC NOA 06041804 Gypsurn, Miami Dade NOA FL7699 R1 C CAC NOA 06041805 - Reco_ver.pdf :Quality Assurance Contract Expiration Date Installation Instructions FL7699__R1 II NOA 0602270 - Wood.pdf NO FL7699 R1 II A 06041801 SteeLpdf FL7699 R_!. II NOA 06047.802= Concrete.pdf FL76S9_R1 II NOA 06041803_Wood Fiberdf FL7699_Ri II NOA 0604/804 _ GyJ2surmodf FL 7699 R1 II NOA 06041805 - Recover_pif Verified By: Miami -Dade BCCO - CER Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: i Back 1 Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 (850) 487 -1824, Fax (850) 414 -8436 © 2000 -2010 The State of Florida. All rights reserved. Privacy Statement 1 Coovright Statement 1 Accessibility Statement 1 Plua-in Software 1 Customer Service Survey I Contact Us Product Approval Accepts: RE ® khaki ittp:// www. floridabuilding .org/pr /pr_app_dtl.aspx? param= wGEVXQwtDgS4uUmmA , 52Cf2XE4f%2fR2gBm... 1/29/2010 s i - N O < O m 12' -0" 0 0 1 t . -1 m EXIST. • -1�-1 EGRESS Y 0 sk— I 1 1 A ) - A 1 CI m ,Y 12' -0" / N 30X52 - -' 'r--- 1 1 \ W 0 m 0 < � 1- 3 Z to v 60 X -<_ I mD \ I 0 0 -I 0 m d< I C z1 w 0 o to � X rm \-- - Oc CO m a N.rtl • m IR ri N 0 0 D_ i Z -4-. 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