HomeMy WebLinkAbout11-12526 CITY OF ZEPHYRHILLS �
� ' S335 - 8TH STREET �
(813)780-0020 12526
BUILDING PERMIT
Permit Number: 12526 Address: 37438 PICKETTS MILL AVE
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: SILVER OAKS VILLAGE
Est. Value: Parcel Number: 03-26-21-0220-OOF00-0020
Improv. Cost: 3,300.00
Date Issued: 11/14/2011 Name: HOLLAND, DAVID 8� KAREN
Total Fees: 82.50 Address: 37438 PICKETT'S MILL AVE
Amount Paid: 82.50 ZEPHYRHILLS, FL. 33542
Date Paid: 11/14/2011 Phone: (813)355-3208
Work Desc: SCRN RM 13 X 17 ON EXISTING SLAB
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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 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.
"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."
Complete Plans, Specifications Must Accompany Application. All work shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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CO TRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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Company Name I.D. #
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License Holder's Name License #:
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Address
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To Whom It May Concern:
Please be advised that Suzanne Bahr, Kathy Mims, and
Stacie Hartwig of Pasco Permit Service have my permission to
sign and pick up permits for me until further written notice.
Sincerely,
� L r
cense Holder Signature
NOTARY
STATE OF FLORIDA - COUNTY OF PASCO
The foregoing instrument vqas sworn to and
subscribed before me this o1-'`�� da,y of �Q�i�/y�,�¢/� , p2,dl�
Personally known or Produced identification Y
NOTARY PUBLIC•STATE OF FLORIDA
""' •. Jeffrey Todd Reutimann
�i: Comuussion � EE053345
'•• ;�?.•' Expires: J�11v . O5, 2015 �
BONDED TE;gU ATLANTTC BOA'DLNG CO.. LNC p
Commissioned Stamp signature
and Expiration Date State of Florida.
County of Pasco
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: �� � �G{y`(� � (,L /�
Date Received: � /— � ��
s�te: � 75�. � ��'c�� t� �l� �/
Permit Type: �S Gl'/1 �/'� f'I `� )C/ f/_.SIG��j
Approved w/no comments: Approved w/the below comments: O Denied w/the below comments: ❑
This comment s�f hall b ept with the permit andlor plans.
��vl� --(
Kalvin witzer lans Examiner Date Contractor andlor Homeowner
(Required when comments are present)
813-780-0020 City ot �epnyrnnis rerr���� H�N���a���� � �
. Building Department
Date Received r Phone Contact for Permitting 3 7� .— `rd ` Y
Owner's Name �"Q-U� a f" `�-� ����K+4'°` Owner Phone Number �� � f.3 � �
Owner's Address � 7 �� /����� �^�/ Owner Phone Num�er
Fee Simple Titleholder Name Owner Phone Nurriber
Fee Simple Titleholder Address
JOB ADDRESS <7 7 �31 ' �` l ��� � �/ , LOT #� �'� �
SUBDIVISION • �/ �I" (/ !� /` � ' PARCEL ID# �3 ��`-r0 " — Q��� ���� �
. (OBTAINED FROM PROPERTYTAX NOTICE)
WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN � MOVE �] DEMOLISH
� INSTALL e REPAIR
PROPOSED USE Q
SFR 0• COMM � OTHER
TYPE OF CONSTRUCTION 0 BLOCK � FRAME �. � STEEL 0 OTHER
DESCRIPTION OF WORK ' ��� ���� �� v
BUILDING SIZE �� x'�7 SQ FOOTAGE °'�� HEIGHT
� BUILDING $ ��d� B�' VALUATION OF TOTAL CONSTRUCTION
0 ELECTRICAL $ AMP SERVICE 0 / PROGRESS ENERGY Q W.R.E.C.
PLUMBING � � � ��� �'� �E�MIT ���?���L�
� (S13) 788-53� �
� , �FAX 1 �56-8247�9
MECHANICAL � VALUATION OF MECHANICAL INSTALLATION �� �� `�
1/
0
GAS 0 ROOFING 0 SPECIALTY [� OTHER ��r�� ,
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES Q A' � n '�1���
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BUILDER � Q � �,/�� �, �� COMPANY �Q-f U�'
SIGNATURE i�� `"' ""l � REGISTERED Y/ N FEE CURREN7 Y/ N
Address y dd3� /�' �Q/�- �/r • Z ' License #
ELECTRICIAN • COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N
Address � License #
PLUMBER COIVIPANY
SIGNATURE ftEGISTERE� Y/ N FEE CURRENT Y/ N
Address License # I �
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N
Address License #
OTHER COMPANY '
SIGNATURE RHGISTERED Y/ N FEE CURRENT Y/ N
Address License #
RESID�NTIAL Attach (2) Plot Pians; (2) sets of Building Plans; (1 } set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) worl<ing days after submittal date. Required on$ite, Construction Pians, Stormwater Plans w/ Silt Fence instalied,
Sanitary Facilities & 1 dumps�er, Site Woric 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 Permlt for new construction.
Minimum ten (10) worl<ing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site 1Nor1< Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
****PROPERTY SURVEY requfred for all NEW construction. �
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Directions:
Fill out application completely. '
Owner & Contractor sign back of application, notarized '
If over $2500, a Nofice of Commencement is required. (AfC 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 (PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways.:needs ROW
NOTICE OF DECD RESTRICTIONS: The. undersigned underst�nds that this permit may be subject to "deed" restrictioris"
which may be more restricfiive than County regulafiions. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITICS: 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 �(or a misdemeanor violation
under state law. If the owner or intended confiractor are uncertain as to whafi licensing requirements may apply for the
intended work, they are advised to�confact the Pasco County Building Inspection Division—Licensing Section at 727-8�7-
8009. Furthermore, if the owner has hired a contracior or confractors, he is advise.d 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 nofi entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT ANQ RESOURCE RECOVCRY 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 Impaci Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy" or final power release. If tl�e projecfi 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 5tatutes, as amended�: If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided wifih a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer A�fairs. I( 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 fiaith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify fihat all the information in this application is accurate and that all work
will be done in compliance wiih all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. 1 certify that no worlc or insfallation has
commenced prior to issuance of a permit and thafi 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. f also
certify that I understand that the regulations of other government agencies may apply to the intended work, and fihat it is
my responsibilifiy to identify what actions I must take to be in comp�iance. Such agencies include but are not limited to:
- Department of Environment�l Protection-Cypress l3ayheads, Wetland Areas and Environmentaliy Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheacis, Wetland Areas, Aitering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unifi-Wells, Wastewater Treatment,
Septic Tanks.
- US Env.ironmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fiil:�
Use of iill is not allowed in Flood Zone "V" unless expressly permitfied.
If the fill material is to be used in Flood Zone "A", ifi is understood that a drainage plan addressing a
"compensafing volume" wiil be submiited at fiime of permitting whicl� is prepared by a professional engineer
licensed by the Sfiate of Florida.
If the fiill material is to be used in Flood Zone "A" in connecfiion with a permitted building using stem wall
construction, I certify that fill will be used only to fill fihe �rea within the stem wall.
If fill material is to be used in any area, I certify thafi use of such fill will not adversely affect adjacent
- the owner may be cited for violating
properties. If.use of fill is found to adversely af�ect adjacent properties,
the conditions of the building permit issued under tlze 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 TFIE OWNER, I promise in good faiih fio inform the owner of the permitting conditions set forfh in
this affidavit prior to commencing construction. I undersfiand 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 anplication. A
permit issued shall be consthe echn cal c hall s�s a a pe mit�prevent the Iding Oificial ther
set aside any provisions of t
requiring a correction of errors in plan ermit s si a months e of permit pssua wo authoeized by
unless the work authorized by such p
the permit is suspended or abando the g ial fo6a per o not fio exc ed ne y days and will demo
may be requested, in writing, from
the ob is considered abandone .
justifiable cause for the exfiension. If work ceases for ninety (90) consecutive days, �j
WARNING TO OWNER: YOUR FAIL�RO YOUR PROPERTY. YOC1 INTE D OBTAIN NANC NG C
PAYING TWICE FOR IMPROVEMENT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F:S. 117•03) � � � `���{��-�""' I
CONTRACTOR
OWNER OR AGEN i� F—� ��'' ��,,� Subscribed and sworn t9, r a(frmed efor � this —e�
Subscribed and �worp�tcy(o� rme ) efoye� e this _ V
p V uL� ^u'-J
Who is/are personallv Icnown to me or has/have roduce
Who is/are personally known to me or has/ha e produced as identification.
as identification.
Notary Public
Notary Public
Commission No. 'OTARY PLI3LTGSTATE OF FI.ORIDA Commission No. SUZ2I1ri0 Balu'
uzanne a :• =. •
'ssion # EE044504 Name of Notary typed, printed�j 1�
ed, rf ', , �s: NOV. 22, 2014 .,, ,,; xpires. i+OV. 22, 2014
NameofNotarytyp P , .� gp�=D�TiIIiL'�A"iL.�.�"�'ICBOSll
BO\'DED TfII2L' ATLA.`7TIC BOr'DLVG CO., INC.
PI►SCO PERMIT SERVICE C , �, / � Z ��
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Permit No. Parcel ID No d�" �t "� De2eZ0 —(�� 0(� dQeL �
, NOTICE OF COMMENCEMENT
State of � �� p��
County of
THE UNDERSIGNED hereby gives notice that improvement uvill be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencemf nt:
1. Description of Property: Parcel Identiflcation No. �///MG/' 0�-,r' vllliC� ��J o1 /d,�s pF oa9 dlf�j [,a��.
Street Address: _ _ �? ��� �l e�Tf � ul� �l�. � ,��� � �j7�p1�
2. General Descriptlon of Improvement
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3. Owner InfoRnation or Lessee infortnation if the Lessee contracted for the improu�ment: /�s�-+ �•'
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�.i� 3 7S�� �.d.��'t Z.�.o�,r�.1 �'� ,��3J�
Address City State
Interest in Property:
Name of Fee Simple TiUeholder:
(If different from Owner listed above)
Address �,� �� �� City State
4. Contractor:
! 5���.30 pr • �l�/'`�.lN J� ,3•f� Y'�
� �� State
Contractor's Telephone No.:
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5. Surety: � N�
Name � '�
pm..
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Address City State
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Amount oi Bond: $ Telephone No.: � ;'
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6. Lender• � �
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Name , � �„�
e -i �
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Address Crty State p �
Lender's Telephone No.: • � �
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7. Persons within the State of Florida designated by the owner uporl whom notices or other documents may be served as provided by �c m
Section 713.13(1)(a)(7), Florida Statutes: , m
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Name . m
�
x
Address City State
Telephone Number of Designated Person: '
8. In addition to himseif, the owner designates of
~ a
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. ~'
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Telephone Number of Person or Entiry Designated by Owner: �
W �m
9• Facpiration date of Notice of Commencement the e iration date ma not be before the com letion of construction and final a �
� � y P p yment to the �� Z
contractor, but will be 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 �� i
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN Fi,�w o
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, CONSULT � D
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. �
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Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best � �
of my knowledge and belief.
O m
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STATE OF FLORIDA � _ Fi� �
COUNTY OF PASCO � '
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Si ature of wner or Lessee, or Owner's or Lessee's Authorized ��
cedDirectoNPartn /Man ger � A
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-J Signatory's Title/Office A
The foregoing instrument was acknowledged before me this �-�day of by �vf Llc-![-
as �Lt�I�r (type of authority, e.g., officer, trustee, attomey in fact) for
(name of pa on beh�lf of whom i trume was executed).
Personally Known 0� Produced Identification [� Notary Signature
Type of Identification Produced �✓L. Name (Print) {,
NOTARY PUBLIC-STATE OF FLORID
3tacie Hartwig
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STAT�. �J� FLORIL�A, COUN�T`r OF PA CO
TNIv IS TO CERTIFY THAT T►�I�REGOfNG IS A
T(�UE 4NC CORRECT COPY 0�'•�NE DC)CUM�NT
ON FILE OR OF PUBLIC RECORD tC���HiS dRFICE r- ;
WITNE MY HAND D OFFICIAL �. AL TMdIS .
DAY OF 2 `� �= �� . �
�.A LA S O' IL, CLERK COMPTROLLER
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. Proposal/Contract
FROM. JAR Aluminum
40030 Lynbrook Drive
Zephyrhills, FL 33540
(813) 782-4594 Cell: (813) 469-0594
Submitted to ' -
� y , �+, . �'X ; P-- # � � [ a I <<_ � % '' - � � � �-% `� / �� / • / l
NAME PHONE DATE
� i� !� ( � y I`��,_ t 1� j ���l d� r ! �' t�-�[i! ;l/y � Slt 1� 1 '�-'''--'``��
ADDRESS CI STf>TE ZIP
We hereby propose to furnish all the materials and perform all the necessary for the completion of�
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All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings
and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
� , ,, , Dollars ($ - � • � )
with payments to be made as follows� ,
�! - � �. �.-X ' /� } 1 � � .� �� j i �- i / { ! ! � �f ! _
'f_, � t 1 !' R ',� � �� - y i" r -� ' �� t/l.''�j � 1 f!\
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Any alteration or deviation from above specifications involving extra costs, will be executed only upon writ{er� orders, and will
become an extra charge over and above the estimate All agreements contingent upon strikes, accidents or delays beyond our
control Owner to carry fire, tornado and other necessary insurance upon above work. Workman's Compensation and Public
Liability Insurance on above work to be taken out by
Respectfully submitted '" 0 � � _ '� �
Per
Note - This proposal may be withdrawn by us if not accepted within days
ACCEPTANCE OF PROPOSAL/C6NTRACT
The above prices, specifications and conditions are satisfactory and are hereby accepted You are authorized to do the work as
specified. Payment will be made as outlined above.
,
Accepted Signature � ,��i t �.t�r�� �i�".�,;'��f �. i�_.�
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Date _ � � -( , / - / � signature
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