HomeMy WebLinkAbout11-11690 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(si3)�so-oozo 11690
BUILDING PERMIT
Permit Number: 11690 Address: 4749 5TH ST
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: MOORES FIRST ADDITION
Est. Value: Parcel Number: 14-26-21-0010-03500-0030
Improv. Cost: 1,150.00
Date Issued: 3/28/2011 Name: MATHEW, GEEVARUGHESE & ANNAMM
Total Fees: 30.00 Address: 4749 5TH ST
Amount Paid: 30.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/28/2011 Phone: (646)416-4476
Work Desc: REPERMIT FOR WINDOWS (10) - 1/2 COST DUE OLD PRMT#10728
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FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site � 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 properly. If you intend to�obtain financing, consult with your lender or an attorney
before recording your notice of commencement.
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C NTRACTOR SIGNA RE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
a�s-?eo-oozo City of Zephyrhills t�ermit Application rax-uie-itsu-uuzi
Building Department
Date Received Phona Contact for Permittin _
Owner's Name �r/ �1�1�FGV �£��u �J1yFS� Owner Phone Number �� 7 83 - a 7° 9��y �
Owner's Address T 7�/ � S�� �7', 2{�'���5, �"��- 3�'� • Owner Phone Number � T6 ' 7'� 6– �� /� �
Fee Simple Titleholder Name � Owner Phone Number
Fee Simpie Titleholder Address
JOB ADDRESS � 7 T ' S'�'�'� Z�►���� L 33 s�.� ' LOT # ��
SUBDIVISION ����f �� ��S%oi✓ , pARCELID# �� ab �/-0�/o -0�'ap- DD��
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR 8 ADDlALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME [� STEEL Q
DESCRIPTION OF WORK GII��/✓/,O fi��•f
BUILDING SIZE �7^' �J�_ SQ FOOTAGEC� HEIGHT
OBUILDING $ � VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY C] OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER �� COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address �� � L� 331"5�.1 �Ytl License# �- �
ELECTRICIAN � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # �—
PLUMBER COMPANY
SIGNATURE . REGISTERED Y/ N FEE CURRE� Y/ N �
Address License # r �
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License #
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # � �
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,.
Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilitles 8 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 Facilitles & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Ptans.
"'"PROPERTY SURVEY required for all NEW constructlon.
Dlrectlons:
Fill out application completely.
Owner 8 Confractor 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 Applicatlon 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.
11NLiCEtV3ED 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 requfred by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are unce�tain 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
Counry.
TRANSPORTATION IMPACTIUTILITIES 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 vf existing buiidings, 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'SlOWNER'S AFFIDAVIT: I certify that ali 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 ail 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 Environmentaliy 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 8 Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmentai 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 Fiood Zone "V" unless expressly permitted.
- If the fiii 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 �II 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 adversety 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 is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYIN O R OR AN ATTORN Y� EFORE RECORDING YOUR NOTICE OF COMMENCEMENT.' CONSULT
WITH Y
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscribed and swom to (or afflrmed) before me this Subscribed and swom to (or aHirmed) before me this
by by
Who is/are personally known to me or has/have produced Who Is/are personally known to me or ha asaden
as (denUficatlon.
Notary Public Notary Public
Commission No. Commission No.
ed, rinted or stamped Name of Notary typed, printed or stamped
Name of Notary typ P
CITY OF.ZEPHYRHILLS
5335 - 81'H 51REEr
, , �si3)�sa-oo2o 10728
BUILDING PERMIT
Perm Number: 728 Address: 4749 5TH ST
Permit Type: ADDITIOWALTERATION ZEPHYRHILLS, FL.
Ciass of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Sectlon:
Square Feet: Subdivision: MOORES FIRST ADDITION
Est. Value: Parcel Number. 1 426-21-0010-03500-0030
Improv. Cost: 1,150.00
Date Issued: 7/15/2010 Name: A , V U HES 8 ANNAMM
Total Fees: 60.00 Address: 4749 5TH ST
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 7/15/2010 Phone: 646 16-4476 b �
o esc: AL I N WS 10
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FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUC3H ELECTRIC IINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MtSC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REZNSPECTION FEES: Rein�pec,tion fees will oomply wHfi Florida Sta4ibe 553.80 (2)(c) when extra inspeclion
trips aro �eaessary due bo any one of the f�ollowiny r�essons: a) wrong addre�s b) aondemned work resultlng
from faulty aonstructlon c) repairs or oorr+ectlons not made when in� called d) work not resdy for
inspectlon when called e) Permit not posfied on job si�e � plans not at job si�e �) woric not aaoesslble.
NOTICE: In additbn to the requirements of this permit, there may be additbnal restrictions applicable tc this property that
may be found in the public records of this county, and there may be additional permits required from �� g�emmental
entities such as water management, stabe agencies or federal agenaes.
The ent of ins 'on fees shall be made beftire an further permits will be issued bo the rson ownin same
"Warninq to owner: Your faflur+e bo reaord a notioe of oommenaement may result in your paying twice for
impnoveme� b� your prope�y. M you intiend bo obtain flnandng. oonsult yvith
belbre reoordi ur no�li oommenaemen�" Your lender or an at�rney
v�-�t �
CONTRACTOR SfG URE �
PERMtf EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION R
CALL FOR IatSPECTION - 8 HQUR NO�IC� REQUIRED
PROTECT CARD FROM WEATHER
� � 813-784-0020 City of Zephyfiills Permit Application Fex-s�a.�so-oo2�
Build&ig DepaNnent � l 0,1. �
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Dab Rsesiwd —� �=`� Phons CoMact for PermttH _ -_
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Owners Name g� G✓ E�/I}RC1 �—S� Oiwnsr Phans N er ^���e ^�F �] f� �
Owrwr'a Addresi T7 9'S « xr ZM.�fr 33� 7' Ownar Phone Numbsr
Fm� Simple 7ltlaholdor Name -� pymer Phona Numbsr
Fw Simple Titl�holdar Add►qs
JOB ADDRESS � '�-`��, � myfi FL-33S a'
LOT A C�
sue�msioN PARCEL� ik-•�6 o3rrD-�►3o
(OBTAl1�D FROM PROPlRTY TAX NOTICE)
WORK PROPO$Ep e NEW CONSfq� ADDlALT Q SIC3N Q Q DEMOLISH
��T� REPAIR
PROPOSED USE _�' SFR Q COMM � OTHER
TYPE � CONSTRUCTION Q BLOCK Q FRAME � STEEL Q r"
DESCRIPTION OF WORK 1 � ' �Nf�B'Y�A�.t W/ '
BUILDING 81ZE � gQ FOOTA(iEC� ��p� �
QBUILDING S�/� , p,0� VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R,E.C.
QPLUMBING =
QMECHANICAL E VALUATION OF MECHANICAL INSTALLAT'ION
��S Q ROOFINO Q SPECIALTY
C� OTHER
FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO
BUILDER Q� � COMPANY
SN3NATURE �c,�srEqep Y/ N FEE qxtaEn Y/ N
Addraas LJcense # �
ELECTRICIAN COMPANY
SIGNATURE REGISIERED Y/ N � q�� Y I N
Addnss
u� #
PLUMBER � COMPANY
SHiNATURE � REGISTEF�D Y/ N �e cuaf�n y/ N
Addross
Ucense �
MECHANICAL � C � P � Y �
8KiNA7URE rs�c�o Y/ N � a�. Y! N
Addrass Ucense � �
OTHER � C011PANY �
SIGNATURE rtEG�sTERED Y/ N F� (�RR�. Y/ N
Addross �
u�e a �
RES�ENTL4l, Attach (2) Pbt Plans: (2) sels of Buliding Pla�: (1) set of Energy Forms: R-O-W PennR for r�ew oorffitru�or�� —
MinNnum ten (10) Mrorkirq days after �pmiqal date. ReqWred onalte. C�S�� P�. Stamweter Plans w/ Silt Fence hu(alled,
Sankary Fadlitles 8 1 dumpster: SRe yyoNc Permft for subdiylsbnsl�rfla projeas
CONNERCIAL Atfach (3) complete sats of gupdinp p�a� p�us a Life Safety Page; (t) set of Energy Fqms. R-O-W Permit tor new conatruqbn,
Mkdmum len (10) wa�kk�g days aRar submit�� d�te. Requlred onslte, Cons6uqlon Plar�� Stqmw��� Plans w! Sllt Fance Installed,
Sanitary FadNtles 3 1 dumpater, Site Work Pertnk for ag new pr�et�s, qfl commardai requirements must meet canpiarxe
9KiN PERMR Attach (2} sets of E�I�eered pla�,
""PROPERTY SURVEY requlred icr aB NEW oaistrue8on,
Dlnetions:
Fill oul appYcatbn competely
Owner & ConVactor sign badc of appitcatlon. nofarized
H owr �2500, a Nodq oi Commooc�� �s rsqulnd. (A/C uppradst uyer:7300)
,• A9ent (for tlie contrador) w Powar of Atfort�eY ffor the ownar) waAd be someone with not�ized IeUer from owner autlarizing same
OVER THE COUNTER pERMITTNp (�t p�,q �,�
Reroofs If shingles Sewe�s Service Upgrades q/C Fencea (PbVSurveylFOOtega)
�Nvaways-Not over Counter Ii on public roadwaya..neeAs ROW
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