HomeMy WebLinkAbout12-12903 ✓�
• CITY OF ZEPHYRHILLS
5335-8TFI STREET
(si3)�so-oo20 12903
DRIVEWAY PERMIT
Permit Number: 12903 Address: 4949 6TH ST see notes
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: 14-26-21-0010-01000-0010
Improv. Cost: 4,500.00
Date Issued: 3/15/2012 Name: SWEENEY, SANDRA& MICHAEL
Total Fees: 60.00 Address: 4949 6TH ST
Amount Paid: 60.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/15/2012 Phone:
Work Desc: NEW PAVED DRIVEWAY OFF OF SOUTH AVE AND 6TH ST
DAVID W. JOHNSON BUILDE , IN (352)523-0473 DRIVEWAY 60.00
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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 permitr will be issued to the person owning same
"Warning to owner: Your failure to reaord 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
befo rding your notice of commencement.°
CONTRA R PERMIT OFFI
PERMI EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
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
.
Date Received —l� —ap!� Phone Contact for Permittin �(� � Q� _ �~'y /
Owner's Name �/C � �L �J W t t��✓ � Owner Phone Number � !����,.5
Owner's Address ���� 7��� �! � {„ Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
� J�ADDRE�,� �/�y 9 � T � ��,,��.s'' LOT# �
�..—�--.,--�
SUBDIVISION , PARCEL ID# — ' � —U �D—D�DOD �" OO/Q
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME C, STEEL Q
DESCRIPTION OF WORK CLC� �i�Il/i°U eiye�/.t ` p� �'� �, �� ��S /�
BUILDING SIZE �--� SQ FOOTAGE HEIGHT
QBUILDING $
.y�� • (aQ VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAL $ AMP SERVICE � PROGRESS ENE GY�" � W.R.E.C.
QP�UMBING $ ,�
��� � i
�p�IECHANICAL � /
$ VALUATION OF MECHANICAL INSTALLATIO
QGAS Q ROOFING Q SPECIALTY � OTHER _._.
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BWLDER � / COMPANY �` r ��
SIGNATURE � % REGISTERED Y/ FEE CU E� Y/
Address D License# C �
ELECTRICIAN �p��L�
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address
License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address Ltcense#
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding 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,
Sa�itary Facilities 8 1 dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safery 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/Silk Fence installed,
Sanitary Facilides 8 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.
Owne�8�Contractor sign back of application,notarized
If over 52500,a Notice of Commencement is required. (A/C upgrades over t7500)
" 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 kJpgrades 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" re�trictions"
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 Buiiding Inspection Division—Licensing Section at 727-847-
8009. Furthermore, ff 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 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 spec�ed 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 identi�ed 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, Florlda 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'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all wvrk
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 a�davit 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 spec�cally 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 YO TE D TO OBTAIN FINANCING CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING UR NOTI,CE OF CO ENCE
FLORIDA JURAT(F.S. 117.03) �
OWNER OR ACiENT
CONTRAC�O ��_—
Subscribed aRd swom to or afflrmed bef e this
Subscribed and swom to(or afflrmed)before me thls �, b � �
by X
Who islare personally known to me or has/have produced o are,,A��onally known to m or h IF►ave produced
as idenBficaHon. �f as identification. ,
"'� � �
�_ ;
Notary Public � � I ry Public
Commission No. C0 B��E S �T
�y�pi.''+. �/��f�Yf
:+�, ��: �YV/U�7
Name of Notary ryped,printed or stamped Na • ��y d
.,'��, eo�aean�T�F�,�es�eeoa�sm+s
r....�._ �-_�:.�_ _.. .,._.w_..,::
Jac ueline Boges
From: Jacqueline Boges
Sent: Thursday, March 08, 2012 4:28 PM
To: Shane LeBlanc
Subject: driveway application
Placed in your box application for 4949 6th st driveway.
Thanks
Jackie Boges �o: ��C ���
Code Support Specialist
e�. 3513
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� STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
i DIVISION OF WORKERS'COMPENSATION
CONSTRUCTION INDUSTRY
� CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
�
{ WORKERS'COMPENSATION LAW ''�+..
EFFECTIVE: 11/22/2011 EXPIRATION DATE: 11/21/2013
� PERSON: DAVID W JOF�ISON
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FEIN: 593583856
BUSINESS NAME AND ADDRESS:
' DAVID W 10HNSON/BUILDER INC
DBA DAVID W JOHNSON/BUILDER INC.
. 9504 FORT KING ROAD
DADE CITY, Fl 33525
SCOPE OF BUSINESS OR TRADE:
1- Contractor-Eaacutiva 2- PROJECT MANAGEMENT
3- CONSTRUCTION MANAGEMENT 4- CERTIFIED GENERAL CONTRACTOR
3TATE OF FLORIDA A� '�'������
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PERMIT APPLICATION �`
DRIVEWAY PERMIT APPLICATION
CONSTRUCTION WITHIN PUBLIC RIGHT-OF-WAY
All information must be filled-in completely
City of Zephyrhilis
5335 8"' Street, Zephyrhills, FL 33542
Telephone 813.780.0000 Fax 813.780.0005
�be��Ppli��ip�t �- �1 Z ° .,�
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#o�1`r�, - . , ��i�tt�iY+t�las.
PR07ECT �OB SITE: PROPERTY OWNER
,4ddress: 9 T� ?',e�tT Name: /Y1 c ,¢�L ����c
Unit#: Address• oS3 � �ST, Unit:
Parcel Identification Number: Ci State Zi 7r r�G �� Ls F� 33S
- - OD/ -C�/DDo- DGy/D Phone:� 0- no- 9 Fax: �3- 7�0� 3aS
C`fll �,�CJ
CONTRACTOR:
Com n : i p rrJS'T,eucTio
Name: �' FF' 1��Xp
Contractor's License #: E-Mail:
_Phone: / -�30 (o Cell: Fax•
ARCHITECT/ENGINEER:
Name: /�� Firm Name•
Address: City• State• Zip•
State �cense #. Phone: Cell: Fax:
pescriution of Proiect
TYPE OF DRIVEWAY �/� ,LENGTH OF DRNEWAY
RESIDENTIAL DRNEWAY �!WIDTH OF DRIVEWAY )REINFORCED CONCREfE
COMMERCIAL DRIVEWAY R.O.W. EXCAVATION (�)CORRUGATED MATERIAL
�PUBLiC ACCESS DRNEWAY DEPTH LINEAR FEEf ( )BOX CULVERT
�ONSTRUCTION MATE ie� ( )OTHER(IXPLAIN)
ASPHALT YES NO
�CONCREfE
FIEADWALL REOUIRED? YES �NO
NOTICE TO APPLICANT: If actual work exceeds scope of this description,additional permits or drawings
will be required.
�JTILITY LOC!►TIONS REOUIRED• CALL BEFORE YOU DIG: 1.800.432.4770
Page 1 of 3
PEftMIT APPLICATION
UTILITIES LOCATE CONFIRMATION NUMBER:
PROVIDE SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS
APPLICATION.
��...� �rp�2C9c�e ci, �: TL= D�it�
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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 dces not ensure compliance with deed restrictions and I understand that additional deed
restrictions may apply to this properly.
All work shall comply with the current Florida Building Code, Public Works Design Manuai and FDOT Design
Standards(If appliCable). (Public Works Design Manual online link: 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/
intertere 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)
ppli nt Print Nam Applicant Signature Date
� 3-��-�Z
Pe Tech ' n Signature (or)Notary Signature Date
Applicant is( ) personaily known to me or produced as identification.
(type of identification)
Page 2 of 3
� P�MIT APPLICATION
OFFICE USE ONLY
PUBLIC aAIORKS USE ONLY
Concrete (min. 6'� Y N
Asphalt Base(min. 6'� Y N
Asphalt(min. 1�/i'� Y N
Length (min. 19� Y N
Width (10'min—20'max) N
Existing sidewalk. y
New sidewalk. Y N
ADA compliant. Y N �
F�cpansion material required. Y N
Contiguous parking pad. Y N
Triangular flare (3'W x 7'L) Y N
Visibility triangle o.k.? Y N
Side set back(3'min. R.O.W.) N
Plan Review Fee
Additional descri tion of work as defined b Public Works Direcbor and or desi nee:
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Permit application approved by: Date: �q
Page 3 of 3
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2012041787
Permit No. Parcel ID No`��co �� —Qt�/� — �l�Q�/Q
NOTICE OF COMMENCEMENT
State af_ �,�,
County of_ ��.�(''('�
THE UNDERSIGNEO hereby gives notice that Improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,
the following lnformaUon Is provided in this Nodce of Comme�cement:
1. Descriptlon of Property: Pa�cel Iderrti�caUon No./ - Mcat�s �F,A i+7� f P� �-7 �o�
�i-ov�o-o�oao-,�,�o i�+�v/� o� .�,Cx c w ya ,�T,�l,���
s�et�adre$$: y� / � cTvt�T��ohv,e�,LLS `L 33Sf2
2• General Descripdon of Improvemer�t .� A ��rJ �uJ l� � �T�C.r RUC d (��� �cv,,}- 0 f�F
d���,�TN �4dN. ��v� �� �'`ST,e«T
3• Owner Informadon or Lessee informatlon tf the Lessee contracted for the improvement:
� L � �r��
� Nam�STi�trT Zr �i ,C �L .S `...-
Address
Interest in Property: � C omG t�T C�ry State
S Z...
Name of Fee Simple TiUeholder:
(If different from Owner Iisted above)
Address
4. Contractor: � Te.✓ ��ty-'� �� �' Sta �
�
F�ait T em.[�. � d 9S� '� 3.h1vw^ _L�4/
naaress P
Contracto�'s Telephone No.: Q �3" ��y—'y��� ��ry State
5. Surety:
Name
Address —
Amount of Bond: a Rept:1421756 Ree: 10.00 State
DS: 0.00 IT: 0.00
g. �ender. 03/14/12 D. Bonilla, Dpty Clerk
Name
AddrCS8 PRULR S 0'NEIL,Ph D PASCO CLERK & COMPTROLLER
Lender'sTelephnneNp.: .�„_� 030R4BK2 � �'�� 1PG�f'1��� State
7• Persons within the State ot Flo►ida designated by thg owner upon whom nottces or other documents may be served as provided by
Section 713.13(1)(a)(�,FloNda Statutes:
Name
Address
Telephone Number of Designated Person: Ciry State
$• In addiUon to himself,the owner designates
of
to recefve a copy of the Uenofs NoUce as provided In SecUon 713.13(1)(b),Florida Statutes.
Telephone Number of Peraon or Entity Designated by Owner.
9• Explratlon date of Notice of Commencement(the expiratton date may not be before the compledon of constructlon and final payment to the
contractor,but will be one year from the date of rec;ording unless a dlfferent date is specifled):
WARNING TO OWNER: ANY pqYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDEREO IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TIMCE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE bF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTENO TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and tha e facts stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA
COUfdTY OF PASCO
�°f � ee,or Owners or Le ee's Authorized
Officer/Di or/P ner anager
Signatory's Title/Office
The foregoing instrument was acknowledged before me this�day of�,20�by_� � r, � l��w ��
'-- as �
(type of authority,e.g„officer,trustee,attomey in fact)for
(name of party on behalf of whom instnimen was exec ed).
Personally Known Produced Iderrtiflcatton❑ ^
Notary Signat
Type of IdentNicffiion Produced �
Name(Print) �9
,�;iR��P%;., CYNTHIA C GUEST
r°+ `�: Notary Pubifc-State of Florida
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"�l �' Commission�DD 979617
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"������`� Bonded Throu9h National Notary Assn.
wpdata/bcs/noticecommencement_pc053048
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