HomeMy WebLinkAbout10-11178 • CITY OF ZEPHYRHILLS /f
5335 - 8TH STREET
(813)780 -0020 11178
DRIVEWAY PERMIT
Permit Number: 11178 Address: 5701 13TH ST
Permit Type: DRIVEWAY ZEPHYRHILLS, FL.
Class of Work: DRIVEWAY /NEW 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 - 08400 -0080
Improv. Cost:
Date Issued: 12/01/2010 Name: COSTIGAN, LARRY
Total Fees: 30.00 Address: 5701 13TH ST
Amount Paid: 30.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/01/2010 Phone: (813)788 -2002
Work Desc: RESIDENTIAL DRIVEWAY
HOMEOWNER DRIVEWAY 30.00
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 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."
6 62_ • 4 1.
CONTRACTOR PERMIT OFFI 1-
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 11178
DRIVEWAY PERMIT
Permit Number: 11178 Address: 5701 13TH ST
Permit Type: DRIVEWAY ZEPHYRHILLS, FL.
Class of Work: DRIVEWAY /NEW Township: "' _ _. _. Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivisi CITY OFEPHYRHILLS
Est. Value: Parcel mber: 11 \,
Improv. Cost:
Date Issued: me: COSTIGAN, LARRY
Total Fees: 30.00 A ress: 5701 13TH ST
Amount Paid: ZEPHYRHILLS, FL. 33542
Date Paid: / hone: (813)788 -2002
Work Desc: RESIDENTIAL DRIVEWAY
HOMEOWNER DRIV AY 30.00
A pt=ed per_Mt 40 ati11
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 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."
fi 44 441
CONTRACTOR PERMIT OFFI �-
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO •
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
7 i n
' 1'`j eon ir'Cr ,
PERMIT APPLICATION � ! C.41i
DRIVEWAY PERMIT APPLICATION
CONSTRUCTION WITHIN PUBLIC RIGHT -OF -WAY
All information must be filled -in completely
City of Zephyrhills
5335 8"' Street, Zephyrhills, FL 33542
Telephone 813.780.0 0 Fax 813.780.0005
Dateeg a POI itatio Processed Bpi ` „; !" Permit # (/ � 6
-1404pKto C]copy`t 'Palk Wo ...
PROJECT/30B SITE: PROPERTY OWNER
Address: 5101 13 S +ree+ Name: LARRY Cos TICAN
Unit #: Address: 57oI 13 ST Unit:
Parcel Identification Number: Il cclO -o84 City, State, Zip "Z ,Phyrh;I1s FL 3
- o O S O Phone: 25i3- 788'-200 a Fax:
cc. lI f5I3- 7I3 -1144
CONTRACTOR:
Company: 7i^ ,19f
Name:
Contractor's License #: E -Mail:
Phone: Cell: Fax:
ARCHITECT /ENGINEER:
Name: Firm Name:
Address: City: State: Zip:
State License #: Phone: Cell: Fax:
Description of Proiect
TYPE OF DRIVEWAY LENGTH OF DRIVEWAY CULVERTS NEEDED
X RESIDENTIAL DRIVEWAY WIDTH OF DRIVEWAY ( ) REINFORCED CONCRETE
COMMERCIAL DRIVEWAY R.O.W. EXCAVATION ( ) CORRUGATED MATERIAL
PUBLIC ACCESS DRIVEWAY DEPTH LINEAR FEET ( ) BOX CULVERT
CONSTRUCTION MATERIAL CURB CUT REOUIRED ( ) OTHER (EXPLAIN)
ASPHALT YES NO
X CONCRETE
HEADWALL REOUIRED? YES NO
NOTICE TO APPLICANT: If actual work exceeds scope of this description, additional permits or drawings
will be required.
UTILITY LOCATIONS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770
Page 1 of 3
PERMIT APPLICATION
UTILITIES LOCATE CONFIRMATION NUMBER:
PROVIDE SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS
APPLICATION.
See G 4 �czch
AFFIDAVIT: Application is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing
information is accurate and that all work will comply with all applicable codes. I understand these codes shall take precedence over all
approved construction documents, and issuance of this permit is verification that I will notify the property owner of Florida Lien Law
req., F.S. 713.
The issuance of this permit does not ensure compliance with deed restrictions and I understand that additional deed
restrictions may apply to this property.
All work shall comply with the current Florida Building Code, Public Works Design Manual and FDOT Design
Standards (if applicable). (Public Works Design Manual online Zink: www.ci. zephyrhills .fl.us /public_works.asp)
APPLICATION IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT
TECHNICIAN OR NOTARY PUBLIC.
NOTE: The City of Zephyrhills is not responsible for maintenance or repairs of driveways. Driveways shall not alter /
interfere with existing stormwater treatment and / or conveyance.
PROPERTY OWNERS: By signing this application: I certify that I have read and understand the owner /builder disclosure
statement. (please initial)
Applicant Print Name Applican Signature Date
Permit Technician Signature (or) Notary Signature Date
Applicant is ( ) personally known to me or produced as identification.
(type of identification)
Page 2 of 3
i
12,600 sq. ft. — Total Property
k '_ 630 sq. ft — Existing Concrete
Z f 1315 sq. ft — New Concrete
�
$ N Existing
� • F '` Concrete
19'
{
t 42'
_
� ar - ' klit
.4 90'
,� O
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u 20' Water Meter Cable In�ero�ond ox
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s
L.E.COSTIGAN No71- 2. ,' 4A/P0N A+71/AL t
5701 13st (Corner of 9th Ave & 13st)
Zephyrhills, FL 33542 Saw CUT e 13 % S%
•
PERMIT APPLICATION
OFFICE USE ONLY
PUBLIC WORKS USE ONLY
Concrete (min. 6 ") l) N b M tN. )(Tao) R W
Asphalt Base (min. 6 ") Y N
Asphalt (min. 11/2") Y N �R
Length (min. 19') 1100 N
Width (10' min - 20' max) CY) N
Existing sidewalk. Y dp
New sidewalk. Y ✓
ADA compliant. Y N 04
Expansion material required. N
Contiguous parking pad. N pu ?,2 (UA C P2opE2t`(
Triangular flare (3'W x 7'L) (Y�) N
Visibility triangle o.k.? N
Side set back (3' min. R.O.W.) Y SEE D aktuA /
Plan Review Fee v � A.h ?E
1 Additional description of work as defined by Public Works Director and or designee:
• SET /SACK /L1 /A// 4L/ Dc ? w /7?,,v /°O,w,
• Ay■NS /AV 4fA7L./A4( t` %.i V 7 ALo .6 11 / S T
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• P/Io° ry Gr✓drE" /CoNrZf ,e 45,9004a , AneiredfrAte,ta LW,/Tt f A/yi
t>T /1 /7/ LOCR .
• MiYer Y 5A416 1 R( devC7 't47O USING tK /Si/it.4 Pc�V47�OAJl /ei.' S Toem 1.)4
doNvepiNtv
Permit application approved by:' .erolr ! -L tr,t Date:
Page 3 of 3
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:DISCLOSURE 'STATEMENT ".FOR .OWNER
CITY OF.ZEPHYRHILLS: -- .BUILDING DEPARTMENT
have read and fully understand and agree to the
pro •sj• o t s 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 to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to social security,
workman's compensation, lien laws, etc., where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida Industrial
Commission.
9. State law requires construction to be done by licensed contractors. You have applied for a
permit under an exemption to that law. The exemption allows you, as the owner of your
property, to act as your own contractor with certain restrictions even though you do not have
a license. You must provide direct onsite supervision of the construction yourself. You may
build or improve a one - family or two- family residence or a farm outbuilding. You may also
build or improve a commercial building, provided your costs do not exceed $75,000. The
building or residence must .be for your own use or occupancy. It may not be built or
substantially improved if for sale or lease, which is a violation of this exemption. You may not
hire an unlicensed person to act as your contractor or to supervise . people working on your
building. It is your responsibility to make sure that people employed by you have licenses
required by state law and by county or municipal licensing ordinances. You may not delegate
the responsibility for supervising work to a licensed contractor who is not licensed to perform
the work being done. Any person working on your building who is not licensed must work
under your direct supervision and must be employed by you, which means that '. you must
deduct F.I.C.A. and withholding tax and provide worker's compensation for that employee, all
as prescribed by law. Your . construction must comply with all applicable laws, ordinances,
building codes, and zoning regulations. .
OWNER'S SIGNATURE - DATE V. /2 / ~ /0
ADDRESS
PHONE
/ 1/(
WITNESS ! J � t PERMIT / i /
I /Masterfoxms /OwnersAffidavit/Nov07 .
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813- 780 -0020 City of Zephyrhills Permit Application Fax- 813- 780 -0021
Building Department
Date Received ` 7-1 � Phone Contact for Permittln. —
Owner's Name L A sf:ky Cos I'a A N Owner Phone Number 813— 7 88 — 2007--
Owner's Address 5,70t 1 3 5t' ree-4 Owner Phone Number E313- 7/3- 2 O) g
Fee Simple Titleholder Name Owner Phone Number I
Fee Simple Titleholder Address
JOB ADDRESS 5 X)1 / SV LOT #
SUBDIVISION , PARCEL ID# 11— 2 b 21 - O O I o- o B t+OO" OO 8 0
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR n ADD /ALT 1 1 SIGN n I DEMOLISH
INSTALL REPAIR
PROPOSED USE n SFR n COMM 1 1 OTHER I
TYPE OF CONSTRUCTION n BLOCK ri FRAME I 1 STEEL n
DESCRIPTION OF WORK New 0 five Wa
BUILDING SIZE SQ FOOTAGE HEIGHT L r
Mil BUILDING $ 'vo
I/ 1, VALUATION OF TOTAL CONSTRUCTIQN
" �
I (ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY n W.R.E.C.
I (PLUMBING $
I (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
1 I GAS n ROOFING n SPECIALTY I 1 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I (YES NO
BUILDER / COMPANY ,/ "--c:: 7 1 " :;--- 1'
� //G'"
) �1
SIGNATURE OW" REGISTERED ,' I Y N I RREN 1 Y/ N I
Address License # 1
ELECTRICIAN COMPANY
SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN I Y/ N 1
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y/ N j FEE CURREN I Y/ N I
Address License # I
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N J FEE CURREN I Y/ N I
Address 1 License # I
OTHER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y / N I
Address I 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 $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 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 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' FIrE : The,understned 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 Law — Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer` Affair`s: 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 commbncement.
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)
/� CONTRACTOR j.,- ,411- 74/4 befax.eaue ( OWNER R AGENT � Subscribed and swo or affi efo�re this Subscribed and sworn to (or affirmthis
i" ' % /0 by , ,,..2 r v�'J by
Who is /ar_epersonally_ no o me or fias/h ve produced Who is /are personally known to me or has/have produced
!_ X. ) as Ide ca on. as identification.
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Notary Public
Commission No.
.;,Y BOBBIE S'! it ` D
. ,. .?% . mission DD 734406
N. p &pp* ritjblearpOltaleitihd Name of Notary typed, printed or stamped