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Home My WebLink About11-12337 CITY OF ZEPHYRHILLS � . 5335 - 8TH STREET (sss)�so-oo20 12337 FENCE PERMIT Permit Number: 12337 Address: 39517 MEADOWOOD LP Permit Type: FENCE ZEPHYRHILLS, FL. Class of Work: FENCE/NEW Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: MEADOWOOD ESTATES Est. Value: Parcel Number: 13-26-21-0140-00000-0700 Improv. Cost: 1,089.00 Date Issued: /� Name: KASSABAUM, KYLE & HICKS KRISTINA Total Fees: �! 0.00 Address: 39517 MEADOWOOD LP Amount Paid: 70.00 ZEPHYRHILLS, FL 33542 Date Paid: 9/09/2011 Phone: 8135055072 Work Desc: INSTALLATION 94' X4' CHAIN LINK FENCE FENCE OUTLET OF TAMPA IN (407)851-6660 FENCE 40.00 CONTRACTOR CERTIFICATE 30.00 �` /I , 6� � �_ 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 Com lete Plans, S person owning same p pecifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances O CONTRACTOR PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER • �° � .�'� �` l��' . ..,� "��' , °� -, : �i"%�tr>�+i`�'�:�?;', � , , o o n � .:.� �'�. ,. �� Z . �„ ha:��.,., :f;.;:f,:.:�:,..: . -,�:' ,- � ° o � o m m ° '' o '' �;�:�� p o O z •� -i cn y O� � � p 'ki; o `D ° o ,- A °�a a � o '��' i A o � c� � C� ��y �'C p �� I RJn ui o a D k � �� p�� - �i�1 Q ��b 1�*l ��*1�� , -+, ! b� p �Z Ozti �T p D�r � A � � �n z�(�n� Z � n � a ;L� Scn r zp =�l ��'7.` b �� `' V� � �2 OZ r'1 �? �DD UiCnw_tN�D � �\ o° o -iv� �'cn� pa n c��o ��oovcn m { O �Z y o c�� o � �r,°,"' rncnn°.,c�'.�o�"ocnZ `.S � N n� �<7y<'m r� C 0 �0 e s a a a r � � Z r �' R1 r+� =� � O 2 � �*1 i � y � �i :<z� �� --�2? -? � rn o ° cn -i z � ° "i � ' D \ � � \ N � � g� �o_ � �n �•► � N � �� x ��'� / . . ° � �U �S�b�� . �•O O C r�t c� ��+� tn . � y O � ' ,Si � ° g � .m- ° - ^� i n C! r 5d , . 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L ; ��mo�� , mi�'�n IS �..,, ?�,� �-� ;m Z I � Bc�VNDARY SVRYfY " '°jg.c.,oic� rn' ' (, ��;�' ?�, � � � ,'� � , � LOT 70 W y '�°!g � � � ° _ � MEADOWOOD ESTAT�S �� uu , , � . . „ a r :m s '.tr,,�g?%ti.�� as'rys'i�'.'§��4','`S:1'':x;t� I ,i , ' ., �7 x7 � 2 Z � ^C 2'.- -.� . �� , sei r��. r '�',*,.. , ., i E i � a o � �w o„�m ,'�.�� 'i oo� ° il +w; o • c cn ". m c. p � i°- °D� �� a �� aaa �. ��. ;Fi n � c� �Z � C� ��y rC p ��y ��t.e-• ti, � � ��' � �"o '��° - o �oo ��,� 0 4 b k o �Z �z� �� ° a�Z a c,� � 2 -, •"� z' _' v � � �1 O --i O i- C� n 1a� �cn r zo 2� m=t b �� = �r y� � � � �;� � � � \ o� ° �cZn u' p a n c ��o i"000v < I � �1 r^ �� Z 2� V� 'C � r�l C.i Gi p` Gi C.r -` Z `•S W NO � O� ��,� �� m O�z � UN(.i0o�ot��- °' v z o „�'' `�o� �z � �Z-� m � �� o o �' ° Z �om o � � \ � � � � � ti � ,� g � "°_ � � '� � � �� ^, \ � y �` s ��b��g�a ,�� j _� ° ��' o � oCO�pr_om a C S d . •^ ' �, L O , rQ� z�- r c --� ^ �f / � ry =2��-�O � �� \ �l . 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'C _ � � - . • � / z� �� ' � c�i� � / � ° � � v � a � �, - � - � - ;--- - r --- '�- > ' � °- °ti` . — �— - � r-- � v ' 4 • . � , . . � m , ; t ; � ,. , , � � a� a � � - i - , - r -- `-;- t1� C� -- f i - gO�'.d �� " � � -- �- � � ' �? � m ' � a o �, ' �, � ° � M£5; ��.<< S � . �� A � ��6•6p l 3 µ � z p � Z � 5 ' � � d) .0�� n�, i� � • �9 ' � � c., � �� _ G 9 N � !o d ia�'n °'� ° � �' � ; -"� � � � ~ ' `- � � � � BAVNDARY SVR ' / �` �;� '� m f!'� Z � YL 1 � o �p :� O lc� rn �� !O O ��' p,Z \ �: � ; � ,�!, � � � � , �,` �` " LOT 70 °'� �' � D ° ° � MEADOWDOD ESTATES � ;� � � 2 � , :, „ . . � ��,, .:,,, .�;�:",ri41� Pasco County Parcel: 13 -26-21-0140-00000-0700 001 Page 1 of 1 Data Current as Of: Weekly Archive - Saturday, September 03, 2011 Parcel ID 13-2 6 - 21-0140-00000-0700 (Card: 001 of 001) Classification 01 - Single Family Mailing Address Property Value KASSABAUM KYLE R& Ag Land �� HICKS KRISTINA R Land 39517 MEADOWOOD LOOP $13,498 ZEPHYRHILLS FL 33542-6714 Building $59,253 Physical Address Eutra Features $618 39517 MEADOWOOD LP Market Value ZEPHYRHILLS FL 33542-6714 �73,369 Assessed (Save Our Homes) $73,369 Leaal DeSCriDtion (First 4 Lines) Homestead 196.031 -$25,000 Non-School Additional Homestead Exemption - $23,369 See Plat for this Subdivision �"' MEADOWOOD ESTATES PB 15 PG 106 Non-School Taxable Value #25,000 LOT 70 School District Taxable Value $48,369 OR 7899 PG 221 Warning: A significant taxable value increase may occur when sold. Click here for details and info. regarding the posting of exemptions. Land Detail (Card: 001 of 001) Line Use Description Zoning Units Type Price Condition Value � 0100 SFR OOR2 7,940.00 SF $1.70 1.00 $13,498 Additional Land Information Acres 0.18 Tax Area 3 ZH FEMA Code � Residential Code ZHLGLPS Buildina Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1978 Stories 1.0 Exterior Wall i Concrete Block Stucco Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall i Drywall Interior Wall 2 None Flooring i Carpet Flooring 2 None Fuel Electric Heat Forced Air - Ducted A/C Central Baths 2,p Line Description Sq. Feet Repl. Cost New 1 � BAS 1,250 Z � � 120 $66,125 3 FOA $2,222 — 90 $1,217 4 � 336 � $7,089 Extra Features (Card• 001 of nni � Line Description Year , Units Value 1 DW WC 1978 667 $509 2 CLFENCE 1995 �-22p $109 Sales History Previous Owner BANK OF NEW YORK TRUST � Year Month Book/Page Type Amount 2008 06 7899 / 0221 WD $84,900—� 2007 12 7711/1292 � �� 2007 03 7498 / 0756 WD $ http://appraiser.pascogov.com/search/parcel.aspx?sec=13&twn=26&rng=21 &sbb=0140&bl... 9/9/2011 °/8/�011 � 3g Pp1 FROM: Fax TO 181378000U5 PAGE: 002 GF 002 � 7 ACOR�'" OP ID: CD � CERTIFICATE OF LIABILITY INSURANCE OATE(MM/ODlVWV) 09l08/11 THI3 CERTIFICATE IS 133UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGNT3 UPON TNE CERTIFICATE HOLDER TH13 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEdATIVEIY AMEND, EXTENO OR ALTER THE COVERAOE AFFORDEO BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTFIORIZED REPRE3ENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER. IMPORTANT• If tha cortiflcata holdor Is an ADDITIONAL INSURED, tha po8cy(ias) must be andorsad. If SUBROGATION IS WAIVED, sub�act to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certiflcate does not conter rigMs to the PRODUCER 4�7�g9�2� Elliot leitenberg PHONE Bruce Morse Insurance Agency 407-862-765 1000 Wekiva Springs Road No : Lonyw ood, FL 32779 aooaESS: Leitenberp Insurance 3ervices T �. FENCE-1 INSURED IN9URER 9 AFfORDINO COVER/1pE NAIC * Fence Outlet Inc INSURERA Nationwide PSC 37877 Fence Outlet of Oviedo Inc IN8URERB Nationwide Mutual Fence Outlet of Tampa Inc 2378� 9671 S Orange Blossom Tr �NSUReRC.Nationwide/Allied P8C Ins 42578 Orlando, FL 32837 �NSUReRO.Brid efield Em lo ers Ins 10701 INBVRER E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD INOICATED NOIINITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEO HEREIN IS SUBJECT TO ALl THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. INSR LI TYPE OF INSURANCE POIICV NUMBER �� IMITS GENERAL 11ABILITY EACH OCCURRENCE $ 1,000�00 A X COMMERCIAL GENERHL LIABILITY 77PR8651613001 �Z/3�/�� Z/3�/�� pREMISES Ea occurrence $ �00,�� CLAIMS-MADE a OCCUR MED EXP (Ary one person) $ S,QO X Contractual Liab PERSONAL & ADV INJURY $ 'I�OOO�OO GENERAL AGGREGATE E Z,OOO,OO GEN'L AGGREGATE LIMIT QF'PLIES PER POLICV X PRa LOC PRODUCTS - COMP/OP AGG $ 2,000,00 AUTOMOBILE LIABIIITY $ COMBINED SINGLE LIMIT $ SOO,OO C X nNV auTO BAPC 3903684403 12/31/10 �p�31/ � (Ea accident) ALL OWNED AUTOS BODILY INJURY (Per person) .� SCHEDULEDAUTOS BODILYINJUFIY(Peracadent) � X HIRED 4UTOS PROPERTY D�V�AAGE � (Per accldenq X NON-OWNED AUTOS 3 X UMBRELLA LIAB $ X OCCUR E7(CESS LiA6 EACH OCCURRENCE $ S,OOO,OO B CLAIMSMADE AGGREGA7E $ S�OOO�OO DEDUCTIBLE 77CU8631613002 12/31/10 12/31/11 X RETENTION Q $ WORKERSCOMPEN9ATION AND EMPLOYERS' LIABILITY x D OFFICERMIEMBER EXCL DE �ECUTIVE v � N � A 830-36090 OA/O'I/'I'I (M/O�NZ E L EACH ACCIDEIVT $ 'I,OOO,OO (MandNOry in NH) �t yes, descr�ba untler E L DISEASE - EA EMPLOYE $ 1,��0,�0 E L DISEASE - POLICY LIMIT 'I OOO OO OESCRIPTION OF OPERATIONS I �OCATIONS I VENICLES (Attach ACORO 101, Atltlitional Remerke S�hetlula, i/ more fpeee i� requiratlj ZEPHYRH 6HOULD ANY OF TFIE ABOVE DE8CRIBEO POLICIES BE CANCELIED BEFORE Ciry of Zephyrhills TME EXPIRATION DATE TMCREOF, NOTICE WILL DE DELNERED IN Building Dept ACCORDANCE WITM TXE POLICY PROVI810N8. 5333 8th Street Zephyrhills, FL 33540 AUTHORIZEDREPRESENTATNE � 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name end logo are regiatered merka of ACORD � ,,�` � ,� =, , F � � � � � Proposal / Contract 96, � E 1� C E O U T L E T ❑ 1 S. Orenge Blossom Trail • Orlando, FL 32837 rei �ao�� as� • Fax (407) 4383181 www.fenceoutletonline.com � 1724 West Broadway St., Suite 100 • Oviedo, FL 32765 CUSTOMER NAME � '�' `��: �� C �; { ��, �= ;,� a �,,, - �, 7el (407) 359 • Fax (407) 366•2335 ^y _„ � 201 S. Falkenberg Road � Tam a, FL 33619 ADDRESS . ;'� - i `�j F ; ' 'J ' �i`�i(, �,�(.,,, �' : s i Tel (813) 651-3623 • Fax�813) 651-3655 � � r ,. _� =' �` • t -� �-�°S t f�►� � � ;_ ': �- �.� i DATE �Y'�¢ '�� % Cs;� ° �� =� ' s � y � PHONE: HOME# '�'.�. �}"°c, � �:..T (.� � : ' ;;: , ; �� WORK OWN PROPERTY? YES � NOC� MOBILE _ � �,i .?� � � � �'"p ` � OWNERS NAME F � �..� �- : �., PVC � WOOD � PvC Feet �" wood Feet �' ALUMINUM ,/ WELDED STEEL .-! CHAIN LINK f '-- = Aluminum Feet Steel Feet �� Chain Link Feet Height 4' ❑ 5' ❑ f � � Cypress � PT Pine 0 Pre lus❑ Height 4' ❑ 5' ❑ 6' J T&G Privacy ❑ :' B�B ❑ STKD ❑ VS � Height 4' ❑ 5' ❑ 6;�] Height 4' (�; 5' ❑ 6' ❑ Domed ❑ Scallo d❑ Style #203 ❑#300�` #303❑ Style Classic❑ Maj�stic❑ Other Height Privacy With Lattic�' ❑ O t her S le Other Style�__ Other Style ,�' �' � Montage❑ Mont e Plus❑ Residential � Commercial ❑ H e i g h t 6' ❑ f 8' ❑ R e s i d e n tia l ❑ Commercial ❑ Black ❑ Bron� LT Comm ❑ Industrial ❑ Gate_ Sizg� ` — Picket 1/2" x 4" s�] 1"' x 4" ❑ Bl a c k ❑ W h i t e� � I n d u s t r i a l ❑ Gate_ $ i�e Ga te_ Siz _ Galvanized Black Vinyl ❑ — Runner 2' '❑ Post Size -" Gate_ �� Gate `Size Gate_ ize ' _ Green Vinyl ❑ Flat C.��p ❑ Bal Capl ❑ Gate�'Size Gate �Size _ Gate_ Size ! Gate� Size Ga Size Gate Size � '� � ; U�- Go�,�'iic ❑ NewEng. ❑ — Gate �-Size•.,.1 f Goachman ❑ Tear Dro p ❑ thic Top ❑ Traditional Top ❑ G�e_ Size f� Gate_ S i z e � Other ❑ i f'' Good Side In ❑ Out �[ �� _ _,��....._..,�� .� Fence to Follow Contour of Ground C`�; �` �� `" `�' �? �� Y �� t� " r r Fence to be Level ❑ � � � � + � � � � � r ' ;° � � � ` ' `� ,�=. � -.:' ,� Remove existing Fence Ft. No � �� ' Fence Line to be Cleared by Fence Outlet ❑ �`" � �- f - �' Fence Line to be Cleared by Owner (�' t � Corner Lot Yes ❑ No [�' ;�� Permit Needed Yes [�( No ❑ � _� � ' ` HOUSE ` JurisdictionC.� �. � t . - � ° ; � ; �_ � � �{ �yj �� Speciallnstructions: ,� � �� ; ,..�� y .� `� �•� i" f �. s! t �. `�^#-= � � ��a �� ;i � , � q f r . :: r� G_'} = i r C t ;�� ' a, - r' c .: �; � : � e' ' ",e 1' :' '•e 'h�,g ' ;� � �. ,Z � .`:. tt '°'o �' d' j ` Fence Outlet will assist the customer, upon request, in determining where the fence is to be erected, but under no circumstances does Fence Outlet assume any responsibility concerning property lines or in any way guarantee their accuracy. If property pins cannot be IoCated, it is recommended that the customer have the property surveyed. Fence Outlet will assume the responsibility for locating underground cables and utilities, however, Fence 0 IS not 1+esoo Ible for 811v sorinlders or other unmericed burled II s M obleds Payment is due at the time of completion of work, and a finance charge of 1 1@% per month shall be appl�ed to all accounts not paid m full withm 10 days of completion. All matenal will remairi the property of fence outlet until payment is received in full. Right of access and removal is granted to Fence Outlet in the event of nonpayment per the terms of this contract. The customer agrees to pay all interest and any costs incurced in the collection of this debt including reasonable attorney fees. If the buyer refuses to allow the seller to begin work or complete wark already begun, or to accept materials contracted for, Buyer agrees to pay Seller liquidated damages of a sum equal to 33 113% of entire contract price, plus cost of materials and labor already fumished or in progress. Warranty may be voided if sign is removed. Customer assumes full resoons bllkv for o Inina�mecwners assocl lon approval for the type and locatlon of fence ACCORDIn6 i0 FLORIDA'S COnSiRUCTIOn LIEn IAUI (SECiIOnS 113.001-1i3.31, FLORIDA SiAiUiES), iNOSE UIHO WORN On YOUR PBOPERiY OR PROUIDE mQiERIALS AnD ARE n0i PAID In FUII HIUE A RIGHi i0 EnFORCE iNEIB ClAlm FOR POYmEni A6AInSi YOUR PROPERiY. iNIS CLAIm IS MnO�in AS A COnSiRUCiIOn LIEn. IF YOUR COniRACiOR OR p SUBCOniRACiOB FAILS i0 PAV SUBCOniRACiORS, SUB-COniNACiORS, OR mAiERIAI SUPPLIERS Ofl nEGLECiS i0 mANE OtiiFR LE6ALLY flEQUIRED PAY�IEniS. iHE PEOPLE �INO ARE OUIED mOnfY mAY LOON i0 90UR PROPERIY FOR PpYmEn1�, EUF If VOU HAUE PAID YOUR COniRACTOR In FULL IF YOU a FAII i0 PAY YOUR COniRACiOR, YOUR COniRACiOR mAY ALSO NAUE A LIEn On YOUR PROPERiY. iNlSl�lEp A6AInS1 YOUR UIILL i0 PAY FOR IABOfl, mATERIAIS, OR OiNER SERUICES iNAi YOUR COnTRACTOB Ofl 0 SUBC IF A LIEn IS FILED YOUfl PROPERiY COUID BE SOLD COnSiflUCilOn LIEn LAUI IS COmPIEN AnD li IS RECOmmEnDED iNpi I�NEnE�ER A SPECIFIC PROBIEm ARIS�S YO iRACiOR mAY HAUE FpILED i0 PAY. FLORIDA S NOTICE TO PURCHASERS OF WOOD FENCES. ' U COnSUIi An AiiORnfY. Wood fence materials are rough mill cut pieces. Wood fence has a tendency to shrink and warp in hot, humid weather and small gaps will appear between boards. Cracks in the wood are a common and accepted occurcence. Fence Outlet wi II only guarantee the workmanship on wood fences for one year. I HAVE READ AND UNDERSTAND THE ABOVE CLAUSE: CONTRACT AMOUNT: $ s:�'� t = ~ APPROVED AND ACCEPT�D f OR CUSTOM�R +.� ,",:^ � g'r��'i . ,, _ ,,✓� � : ,� � f � ; , }✓� .�P/41 ..._,...,..,. 7 �, f '. ,��''��''�,'� � F 7' �� r' x �f4 J�,� ?'�� ' ��' r vfi',��. 1 '„y r ` f WI�! MENT: ; � , $ a.> � f �' r 9 _,� �, -��. �.t • t � CUSTOMER �� ----°' DATE BALANCE DUE � � �� UPON COMPLETION � CUSTOMER DATE ACCEPTED FOR FENCE OUTLET �. " == ! =- ; ` + ? ; ,� „ : . {.�� : �, ` ,r , ,-y — — ' � , � �l __'"" ,� . ... e i f �. , a.._.�r y � � ' DATE STARTED DATE COMPLETED � ,.,- •. SALESPERSON DA7E INSTALLER -'' LABOR QUOTE VALID FOR � DAYS sis-�ao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 � Building Department )ate Received $�3 26 _ �d�� Phone Contact for Permittln lwner's Name �y �-E K1�1 �j S�► a/�1� M Owner Phone Number �� 3 �j � 5 ' ��. �uvner'sAddress 3 � 5 �� m �� ZE�»�Rt��i,.vs . .. � � F 3354 Z Owner Phone Number 'ee Simple Tltleholder Name Owner Phone Number � 'ee Simple Titleholder Address IOB ADDRESS �{ J I� ��A��Y✓O�D L:i�(7Q� Zr Qti�/RH( Ll. S F� �j ��{'Z LOT # �� iUBDIVISION ��RODV�I��D� E�'I�C�S , PARCELID# (� r Z�"Z� �O I�Q - L`�D�OO' O��O (OBTAINED FROM PROPERTY TAX NOTICE) NORK PROPOSED e NEW CONSTR � ADD/ALT � SIGN Q Q DEMOLISH INSTALL REPAIR 'ROPOSED USE Q SFR Q COMM �� OTHER fYPE OF CONSTRUCTION Q BLOCK Q FRAME �] STEEL Q DESCRIPTION OF WORK I�S��'T��N l�F ��'� �"� pF1(��.1 Ct4k+N Un► K�EN�E i�NEA� BUILDING SIZE '.� FOOTAGE �� I HEIGHT y� N 1!oH QBUILDING $ ��fNGF� � i� g� VALUATION OF TOTAL CONSTRUCTION [�ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. �PLUMBING ($ — � � �- : � Z 3 QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � QGAS Q ROOFING Q SPECIALTY �� OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER S � � x• � J�� COMPANY r ENC E O�J'T �.t T O F T/}MPA �� N C, 51GNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address '2.�1 5. F�lIsKEN6U2(v �,40 '(qMPA ft3� Lice�se # C-' 1 � Z S Z ELECTRICIAN COMPANY 51GNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address LlCense # �- 'LUMBER COMPANY iIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # �— AECHANICAL COMPANY i1GNATURE REGISTERED Y/ N FEE CURRE� Y/ N Address License # —� ITHER COMPANY IGNATURE REGISTERED Y/ N FEE CURREA Y/ N Address License # �— ESIDENTIAL Attach (2) Plot Plans; (2) sets of Buliding 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 Facilities 8 1 dumpster; Site Work Permit for subdivisions/large projects OMMERCIAL 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 IGN PERMIT Attach (2) sets of Engineered Plans. "**PROPERTY SURVEY required for all NEW construction. irections: Fill out application completely. Owner 8 Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is requfred. �(/i/C upgrades over 57500) Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same JER THE COUNTER PERMITTING (Front of Applicadon Only) :roofs if shingles Sewe�s Service Upgrades A/C Fences (PIoUSurvey/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" ��strictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with �any appiicable 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 Iocal 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 properiy 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 finai 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'SIOWNER'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 instailation 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-Welis, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Department of Health 8 Rehabititative ServiceslEnvironmental 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 wali 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 Iots 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 electricai work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specificaliy 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 vivlations 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 PAYING TWICE DER AN ATTORNEY BEFORE RECORDING YOUR OTICE OF COMMENCEMENT.' CONSULT WITH YOUR LEN FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swom to (or afflrmed before me this Subscribed and swom to (or affirtned) before me thls b �Ca 1� 1� •� k c� �2. bY Who islare ersonally known to me or haslhave produced Who isjare personally known to m as Id nUficaH �roduced P r -- a'dentificatfon. Notary Public ` { N Public `• �= �"' bet 1 14 Co issio " � Commission No. ',, ��,�, so�,marwT�o+Fd^�� Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped