HomeMy WebLinkAbout12-12835 �
CITY OF ZEPHYRHILLS
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si3)�so-oozo 12835�
BUILDING PERMIT
Permit Number: 12835 Address: 4841 16TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 14-26-21-0010-02000-0040
Improv. Cost: 3,400.00
Date Issued: 2/23/2012 Name: PABON ISRAEL & MARIA
Total Fees: 55.00 Address: 4841 16TH ST
Amount Paid: 55.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/23/2012 Phone: (561)301-3397
Work Desc: A/C CHANGE OUT
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DUCTSINSULATED �
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� 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 properly 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,oonsult with your lender or an attorney
before recording your notice of wmmenoement."
Complete Plans,Specifications Must Accompany Application.All work shall be performed in aocordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
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CONTRACTO SI N URE PERMIT OFFI R
PERMIT EX IRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
)ate Received �-���-- Phone Contact for Permittin ,�ja � � - 9 �7
hvner's Name � Owner Phone Number � I �J —
)wner's Address �� t� �,r �L Owner Phone Number
'ee Simple Titleholder Name Owner Phone Number
'ee Simple Titleholder Address
lOB ADDRESS " � � " �� - � - LOT# �
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iUBDIVISION � PARCEL ID# 1����O�I "O�/�����yb� � �j/�
(OBTAINEU FROM PROPERTY TAX NOTICE)
dYORK PROPOSED � NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION [�'] BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK /, C �1an p U� C�
BUILDING SIZE SQ FOOTAGE�� HEtGHT
OBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $
CiIL U I ,7` � �
�MECHANICAL $ � �, VALUATION OF MECHANICAL INSTALLATION � � \
QGAS C] ROOFING Q SPECIALTY [� OTHER ,� ��
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FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES N
BUILDER • COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License# � �
MECHANICAL COMPANY ��S � H'( B
SIGNATURE � � G�.,,l�" REGISTERED Y/ N FEE CURRE� /N
Address �.9��3 d�- �� 3f�/ L7 � �r�'� �/`f�O_S�S 7�
5aS 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 Fortns;R-O-W Permit for new construction,
Minlmum 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
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 8�1 dumpster.Site Work Perm(t for all new projects.All commerciai requirements must meet compiiance
SIGN PERMIT Attach(2)sets of Engineered Plans.
"""PROPERTY SURVEY required for all NEW consVuction.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over 52500,a Notice of Commencement is required. (A/C upgrades over ST500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
DVER THE COUNTER PERMI7TING (Front of Application Oniy)
2eroofs 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 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 properly licensed and is not entitled to permitting privileges in Pasco
Counry.
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 fu�ther 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. Fu�thermore, ff Pasco County Water/Sewe� Impact
fees are due, they must be paid prior to permit issuance in accordance with appNcable 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 ail the information in this application is accurate and that all work
wiil be done in compliance with all appticable 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
ce�tify 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 1 must take to be in compliance. Such agencies inciude 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 8 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 aliowed 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 Fiorida.
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 wiil 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 fi��he�Iowner mayrbel cit d for v�olat ng
properties. If use of fill is found to adversely affect adjacent properties,
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 OWNE�R,t�ction!S I'understanld thatna�separat permit may be requ�ired for Ielectr cal work,
this affidavit prior to commencing as, or other installations not specifically included in the application. A
plumbing, signs, wells, pools, air conditioning, g
permit issued shall be construed to be I codesenor shall ssuaincehof a pe mitp event thehBu ding �Officeal from thereafter
set aside any provisions of the technica � ermit issued shall become invalid
requiring a conection of errors in plans, construction or violations of any codes. Every p
unless the work authorized by such permit is e od of six(6)mhonths after the t mpe thetwo kas co�mme ced Anhextension
the permit is suspended or abandoned for a p
may be requested, in writing, from the Building �o�ininety(90)rconsecutive days,the job is�consider d b�andonedstra e
justifia b le cause fo r t h e e x t e n s i o n. I f w o r k c e a s e
WARNING T O O W N E R: Y O U R F A I L U R E TO REPROPERTI(.TIF YOU I NT E N DE T O O B T A I N FA N A N CS N GTCONSULT
PAYING TWICE FOR IMPROVEMENTS TO YOUR
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO E OF C MMENCEMENT.
FLORIDA JURAT(F.S.117•03)
CONTRACTOR e �S �, �_._
pWNER OR A(3ENT Subsc�ed a�by to a rmed fo
Subscxtbed and swom to(or afflrmed)before me thfs n �{o me or sl ave prodtl d
by Who Islare pe,�on��N as Identifi on
Who Is—" /a�e personally known to me or haslhave produced r� ��L_
as Identlfica8on. __....._ �_ -j
--,� � , / .
� t�ry Public
Notary Public ' : _.
Commfssion No.
Commisslon No.
Name of Notary typed�Printed or stamped
Name of Notary tyPed.Printed or stamped