HomeMy WebLinkAbout13-14056 CITY OF ZEPHYRHILLS
5335-8TH STREET
- �sis)�so-oo20 14056
BUILDING PERMIT
Permit Number: 14056 Address: 38544 12TH AVE
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-05200-0011
Improv. Cost: 2,200.00
Date Issued: 4/05/2013 Name: MCKELVEY MICHAEL
Total Fees: 75.00 Address: 36124 PINE BLUFF LP
Amount Paid: 75.00 DADE CITY FL 33525
Date Paid: 4/05/2013 Phone: 813-997-0153
Work Desc: REROOF STEEL PANELS
75.
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TAPE JOINTS OF IN
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 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 property. 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 Cod and Ordinances. NO OCCUPANCY BEFO C.O.
c
CONT CTOR SIGNA RE PERMIT OFFI R
PERMIT EXPIRES I MONTH ITHOUT APPROVED INSPECTION
CALL FOR INSP HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Pasco County Parcel: 11-26-21-0010-05200-0011 001 Page 1 of 2
Data Current as Of: Weekly Archive - Saturday, March 30, 2013
Parcel ID 11-26-21-0010-05200-0011 (Card: 001 of 001)
Classification 01 - Single Family
Mailing Address Property Value
MCKELVEY MI-�Fta�k C✓ �y� � Ag Land �o
36124 P�YNE BLIJ�F LP �' �t` Land $i5,izo
DADE CITY FL 33525-9526 Building �29,s4s
� Physical Address ��--
Extra Features $ios
38544 Y2TH AVE
ZEPHYRHILLS FL 33542-3748 Just Value ;45,076
Le9al De5C1'iDtion (First 4 Lines) ASSeSS2Cl (Non-School Amendment 1) $45,076
See Plat for this Subdivision
TOWN OF ZEPHYRHILLS PB 1 PG 54 Taxable Value ¢45,076
WEST 1/2 LOTS 1 2 3 & 4
BLOCK 52
OR 3593 PG 327
Land Detail (Card: 001 of 001)
Line Use Description Zoning Units Type Price Condition Value
1 0100 SFR OOR2 8,400.00 SF $1.80 1.00 $15,120
Additional Land Information
Acres 0.19 Tax Area 30ZH FEMA �Residential Code ZHLHLP2
Code
Buildinq Information - Use O1 - Single Family Residential (Card: 001 of 001)
Year Built 1966 Stories 1.0
E�cterior Wall 1 Concrete or Cinder Block 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 Terrazzo Monolithic Flooring 2 Carpet
Fuel Electric Heat Forced Air- Duded
A/C Central Baths 1.5
Line � Description �—Sq. Feet �Repl. Cost New
1 BAS r 1,037 ��—$37,643
2 FOP 198 $1,815
3 �— UST 48 $690
4 FCP � 143� $1,307
Extra Features (Card: 001 of 001)
Line Description Year Units �—Value �
1 DWSWC 1966 222 $108
Sales History
Previous Owner WILSON ROBERT F
Month/Year Book/Page Type C de Condition Amount
06/1996 3593 / 0327 Warranty� Improved $50 000
Deed '
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http://appraiser.pascogov.com/search/parcel.aspx?sec=11&twn=26&rng=21&sbb=0010&bl... 4/4/2013
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�I Force Enginee�i-ing& Tesdng Ine. ,`�
19530 Rnmblewood Drive
Humble,TX 77338
Product Evaluation Report
STEEL ROOFING SYSTEMS, LLC.
Min. 29 Ga. AG Roof Panel over Ix4 Wood Purlins over 15/32"Plywood
,�(�� �,/} Florida Product Approval # 15837.2
Florida Building Code 2030
•'� i... t�' �5� Per Rule 9N3
✓ Method:1—D
Category:Roofing ' - , . � ,. ' ' ' , ;�`.�,� ,
Subcat };,,, � „� � . � � ` , � . , - :, �; ��
egory: Metal Roofing �� �
Compliance Method:9N-3.005(1��(d) '� � � �
NON HVHZ � ' ; ' , ` ' �
Product Manufacturer:
Steel Roofing Systems, LLC.
3517 Century Boulevard#102
Lakeland,Florida 33811
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EneineerEvaluator: ���1' C��=� ��p�{����.��� t_�
Terrence E.Wolfe,P.E.#44923 �j ��j c, �•,��p������, (
Florida Evaluation ANE ID:1920 � `_
Validator:
Shawn G.Collins, P.E.
2250 Massard BLVD
Tampa,FL 33619
Contents:
Evaluation Report Pages 1—4
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FL# 15837.2
August 10, 2012
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' Foree Engineering & Te�ting Inc. '
19530 Ramhlewood Brive
Humble;l7�7733R
Compliance Statement: The product as described in this report has demonstrated compliance with the
Florida Building Code 2010,Sections 1504.3.2,1504 7
Product Descriptton: AG Roof Panel, Min 29 Ga. Steel, 36" Wide, through fastened roof panel over
Sx4 wood purlins over one layer of asphalt shingles(optional) over min. 15/32"
APA Plywood decking.Non-Structural Appiication.
Panel Material/Standards: Material: Min.29 Ga Steel,conforming to Florida Building Code 2010 Section
1507 4.3. Paint finish optional
Yield Strength: Min.80.0 ksi
Corrosion Resistance.Panel Material shall comply with Florida Bui�ding Code
2010,Section 1507.4.3.
Panel Dimension�s): Thickness: 0.015"min.
Width: 36"
Rib Height: 3/"major rib at 9"O.C.
Panel Rollformer• A.S.C.Machine Tools
Panei Fastener: #10-15 x 1-1/2"HILO Woodgrip with sealing washing or approved equal
'/."minimum penetration through plywood
Corrosion Resistance:Per Florida Building Code 2010,Section 1506 6,1507 4.4
Substrate Description: Min.lx4 No.2 SYP wood purlins over maximum one layer of asphait shingles/feit
paper(optional)over min.15/32"thick,APA Rated plywood over supports at
maximum 24"O.C. The 1x4 wood purlins shall be fastened to the plywood with
(1)8d x 2%"Ring Shank Nail at 4"O.C.. Design of lx4 wood purlins,plywood and
plywood supports are outside the sCOpe of this evaluation. Substrate must be
designed in accordance w/Florida Building Code 2010.
Design Uplift Pressures:
Table"A"
Maximum Total Uplift Design Pressurc: 78.5 psf 101.0 psf
Fastener Pattern: 9„_9„_9„_9,• 6••_3•,_6•,_3,•_6»_3,•-6,•
Fastener Spacing: 24"O.C. 24"O.C.
'Design Pressure includes a Safety Factor=2.0.
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FL#15837.2
August 10, 2012
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� Force Engineering&Testing Inc. I��
19530 Ramblewooci Drivo
Huinhle,TX 77338
Code Compliance: The product described herein has demonstrated compliance with
The Florida Building Code 2010,Section 1504.3.2,1504.7.
Evaluation Report Scope: The product evaluation is limited to compliance with the structural wind ioad
requirements of the Florida Buiiding Code 2010,as relates to Rule 9N-3.
Performance Standards: The product described herein has demonstrated compliance with:
• UL 580-06-Test for Uplift Resistance of Roof Assem6lies
■ UL 1897-04-Upiift Test for Roof Govering Systems
• FM 4471,Section 4.4-Foot Traffic Resistance Test
Reference Data: 1. UL 580-06/1897-04 Uplift Test
Force Engineering&Testing,Inc.(FBC Organization ti TST-5328)
Report No.476-0160T-12
2. FM 4471-10,Section 4.4 Foot Traffic Resistance Test
Force Engineering&Testing,Inc.(FBC Organization q TST-5328)
Report No.476-0160T-12
3. Certificate of Independence
By Terrence E.Wolfe, P.E.(No.44923)@ Force Engineering&Testing,Inc.
(FBC Organization#ANE ID� 1920)
Quality Assurance Entity: The manufacturer has estabtished compliance of roof panef products in
accordance with the Florida Building Code and Rule 9N-3.005(3)for
manufacturing under a quality assurance program audited by an approved
quality assurance entity.
Minimum Slope Range: Minimum Slope shall comply with Florida Building Code 2010,including Section
1507.4.2 and in accordance with Manufacturers recommendations. For slopes
less than 3:12,lap sealant must be used in the panel side laps.
Installation: Install per manufacturer's recommended details.
Underlayment: Per Manufacturer's installation guidelines per Florida Building Code 2010 Section
1507.4.5.
Roof Panel Fire Classification: Fire classification is not part of this acceptance.
Shear Diaphragm: Shear diaphragm values are outside the scope of this report.
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19530 Ramblewood Dri��t
Humblc,'I7C 77338
Design Procedure: Based on the dimensions of the structure,appropriate wind loads are
determined using Chapter 16 of the Florida Building Code 2010 for roof cladding
wind loads.These component wind loads for roof cladding are compared to the
allowabie pressure listed above The design professional shall select the
appropriate erection details to reference in his drawings for proper fastener
attachment to his structure and analyze the panel fasteners for pullout and
pullover.Support framing must be in compliance with Florida Building Code 2010
Chapter 22 for steel,Chapter 23 for wood and Chapter 16 for structural loading.
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FL#15837.2 AuguS t 10, 2 012
MIN. 29 GA. AG PANEL OVER 1 X4 WOOD PURLINS
TYPE 1 FASTENER PATTERN AT 2L' O.C.
g' 9- 9. 9. tafllMwu6 W'E 5GL
fOR IRE ON St01+6
1F55 11E11 3:72
#10-15 x 1 1/2" HILO WOODGRIP W/ SEALING WASHER
lx4 WOOD PURLINS 2 24' O.C. ATTACHED TO PLYWO�D
W/ (1) 8dx2 1/2' RING SNANK NAILS @ 4' O.C.
ONE LAYER �F ASPHALT SHINGLES/FELT <�PTIDNAL) ❑VER 15/32' PLYWQOD
TYPE 2 fASTENER PATTERN AT 24" O.C.
6' 3' 6' 3` 6' 3" 6" 3' pp�qK L,pf s�.
raR usE oa ann[5
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#10-15 x 1 1/2" HILO WOODGRIP W/ SEALING WASHER
lx4 WQOD PURLINS @ 24' �.C. ATTACHED TQ PLYW�❑D
W/ (1) 8dx2 1/Z' RING SHANK NAILS e 4' ❑.C.
❑NE LAYER OF ASPHALT SHINGLES COPTIONAL) OVER 15/32' PLYWOOD
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MIN. 29 GA. AG ROOF PANEL STEEL ROOFING
LOAD TABLE OVER 1 x4 WOOD PURLINS SYSTEMS, LLC.
Buildings having a Roof Mean Height_< 20'-0'; Roof Siope: 2"/12"-6"/12"Gable or Hip Roof
Wind Speeds 130-160 mph, Exp C, Risk Category II, Enclosed Bldg. based on FLORIDA BUILDING CODE 2010
MIN. 29 GA. AG PANEL FASTENER SPACING
WIND SPEED ZONE
ZOnrE FASTENER SUBSTr�aTE 130 140 150 160
ON CENTER ON CENTER ON CENTER ON CENTER
SPACING SPACING SPACING SPACING
ZONE 1 #10-15-1-1/2" 1x4 WOOD 24" 24" 24" 24"
PURLINS TYPE 1 TYPE 1 TYPE 1 TYPE 1
ZONE 2 #10-15-1-9l2" �x4 WOOD 24" 24" 24" 24"
PURUNS TYPE 1 TYPE 1 TYPE 1 TYPE 1
ZONE 3 #10-15-1-1/2" �x4 WOOD 24" 24" 24" 24"
PURLINS TYpE 2 TYPE 2 TYPE 2 TYPE 2
PANEL DESCRIPTION: MIN 29 GA. GRADE 80,36"COVERAGE,3/4"TALL.
PANEL ROLLFORMER: A.S.C. ROLLFORMER.
PANEL FASTENER: (1)#10-15 x 1-1/2"HILO WOODGRIP Wt SEALING WASHER.
MAXIMUM ALLOWABLE PANEL UPLIFT PRESSURE: 78.5 PSF @ 24"FASTENER SPACING TYPE 1 FASTENER PATTERN, 101.0
PSF @ 24"FASTENER SPACING TYPE 2 FASTENER PATTERN BASED ON TAS 125, UL 580/UL i897 TESTING.
SUBSTRATE: 1x4 WOOD PURLINS OVER ONE LAYER OF ASPHALT SHINGLES/FELT(OPTIONALj OVER MIN.15/32"THICK APA
RATED PLYWOOD. WOOD PURLINS ATTACHED TO PLYWOOD W/MIN (1)8dx2 �'RtNG SHANK NAILS AT 4"O C MAX. PURLINS
AND PLYWOOD MUST BE DESIGNED IN ACCORDANCE WITH FBC 2010
ROOF SLOPE: ON ROOF SLOPES LESS THAN 3:12,LAP SEALANT MUST BE USED IN PANEL SIDE LAPS.
LOAD TABLE BASED ON WIND PRESSURES CALCULATED PER ASCE 7-10(Kd=0.85) MULTIPLIED BY 0 6 PER FBC 2010,
SECTION 1609.1.5.
LOAD TABLE DOES NOT INCLUDE OVERHANG ZONES
1YPE t FA5TENER PATTERN
ix4 WODD PURLINS 2 24' O,C. ATTACHED T❑ PLYWOOD
W/ Cl) 8dx2 1/2' RING SHANK NAI�S 2 4' �.C,
- TYPE 2 FASTENER PATTERN
lx4 WO�D PURLINS e 24' �.C. ATTACHED TO PLYWOOD
y10-15 x t i/2' HILO wOODGRIP W/ <1> Bdx2 1/2' RING SHANK NAILS 2 4' O.C.
9'-9'-9'-9' FASTENER PATTERN 2 24' O.C.
SHINGLES/FELT (OPTIONAL)
OVER t5/32' PLYWOOD -
� ZONE 2 ��o-is x i �/2` HILO WOODGPoP
6'-3'-6'-3'-6'-3'-6'FASTENER PATTERN Q 24' D.C.
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� Note:Dimension a is de R
;--- -------------------------------------------�- 9 �ol � t� � h of
the buildin or 40/ of the m� �rr ' h ver is
smaller,however, (a)cannot be� ����4°��e
ZONE 3 Eave minimum width of the building or 3 feet. �
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department � �r�^ � r D� ��„�
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Date Received � Phone Contact for Permittin � � �� _ � L
Owner's Name /� � '�T�1 �1 y�t f�`� Owner Phone Number
Owner's Address Owner Phone Number
Fee Simple Titleholder Name �- � Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ��,��� � Z ry � LOT# ��
SUBDIVIStON �- PARCEL iD#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEw CoNSTR 8 ADD/ALT 0 SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK �'e �� Z r �,N � `1 � �
BUILDING SIZE � $Q FOOTAGE� HEIGHT ��
UILDING $ /��LD� VALUATION OF TOTAL CONSTRUCTION � I ,(n j�
1� /��'t�
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
/� �
�PLUMBING $ �� G .rl � �� L� G� _�,9c�y.:- ���'-��G�G�
� � �)�,0 rs 1��,
�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION j� �
' �e�e( �c�� �ac
QGAS Q ROOFING Q SPECIALTY � OTHER � ����F�
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � " a� ���
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BUILDER . `�� COMPANY J'I P�
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 CURRE� Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
OTHER � COMPANY
SIGNATURE REGISTERED Y I N FEE CURRE� Y/N
Addreas 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)wo►king days after submittal date. Required onsite,Constructfon Plans,Stormwater Plans w/Silt Fence i�stalled,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsAarge 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 constructfon.
Minimum te�(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilitles 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.
Owner 8 Contractor sign back of application,notarized
If over E2500,a Notice of Commencement is required. (A/C upgrades over a7500)
" 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 Upgrades A/C Fences(PIoVSurvey/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 �esponsibility 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 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
County.
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 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. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with appiicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Ftorida 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 installation has
commenced prior to issuance of a permit and that all work will be pertormed 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 fil{ material is to be used in F�ood 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 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 1he 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 wo�k 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 O�cial 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 tN YOUR
PAYING TWICE DER OPROV ORN T� EFORE RECORDING YOUR NOTICE OF COMMENCEMENT.' CONSULT
WITH YOUR LEN
FLORIDA JURAT(F.S. 11 �)
OWNER OR AGENT CONTRACTOR
Subscribed and s d thi Subscrfbed and swom to(or afflrmed)before me this
b � by
s are ers nally known me or haslh pr d e Who islare personally known to me or has/Fiave produced
�,� �'j� ,�, ' as idenUfica6on. � as identification.
� �,
� I' � Notary Public
�. 7 6ta
-�� ;�'� :'- Cpmmission# E 14070196 Commission No.
Comm � Cvn,
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��7MU Troy FaM Inourance 80�'�S'70/9
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ed, rinted or stamped Name of Notary lyped,Printed or stamped
Name of Notary typ P
DISCLOSURE S'T'n'►''G•*�=NT .FOR OWNER
CITY OE ZEPHYRH=I�I,S BIIII.DING DEPARTMENT
_ �`FC 11�� 1F` y(,(' I� 7 have read and fully understand and
, -
agrae •to the provisions of �this instrument•
The undersigned states and affirms that he or she is desirous of constructing,
r�ovating, adding to or seroofing his or her own domicile, �that he or she
actually occupies, or wi11 o�cupy by said domicile, axid same is not for
•rent, lsase or sale. That he or she shall comply Frith the following conditions:
1. That the owner and_he or she alone sha11 act as the builder for al1 phases of
construction. -
2. That the owner wi11 comply with aZ1 provisions of the City of Zephyrhills
ordiriaaces and codes �*-�-;nent to the buildiug.
3. fihat in the event various phases of constxuction are subcontracted, he wi11
engage only •properly licensed subcontractors and will personally supervise
such .work.
4. That in the event the Huilding Inspector sha11 rec�"se corrections to be made,
the owner wi11 assume full responsibility to insure •they are made, and upon
completion will ca11 for a reiaspectioa before proceeding with the building.
5. T2zat the owner shall assume fv11 responsibility for the construction and wi11
not eapect_ supervision of his work from the Ci�.y of Zephyrhills Building
Depar�ent.
6. That prior to final inspection any aclditional fees, including reinspection
faes, must be paid ia fu11. A written request from this office sha11
constitute an official notice to pay addi.tional. fees.. _
7. That the owner sha11 comply with a11 City, State and Federal laws in regard to
social security, warkman's compensati.on, lien 1aws, etc. , where applicable.
B. Tha-t the owner sha11 comply with all the safaty codes issued by the Florida
Industrial C�*�+�ssion.
9. State 1aw rec�,;*-ss constrtiction to be done by licensed contractors. You have
applied for a ppT+�+�t under an exemption to that law. The exemption allows
you, as the owner of your propPSty, to act as your own contractor with certain
=estrictions even though you do not hane a license. You must provide direct
onsite supervision of the construction yourself. You may bvild or improne a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $25,000.
The builcling or residence must be for yovr own use or occupancy. It may not
be built or substantially improved for sale or lease. If you se1.l or lease a
building you have built or substaatially im�roved yourself withia 1 year aftES
the constructioa is complete, the law will presume •that you .built or
substantially improved •if for sale or lease, which is a violation of this
EXemption. You may aot hire aa unliceased person to act as your contractor or
to supervise people working on yovr building. 2t is your responsibility to
make sure that people employed by you have licenses re�+,;red by state law and
by county or mun.icipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is aot
licensed to perform the work beirag doaa. Any pesson working on yovs building
who is aot licensed must work undar your diract supervision and must be
P�ployed by you, which means that you must deduct E.I.C.A. and withholding tax
and provide workers' compensatiaa for that empl�yee, a11 as prescribed by law.
Your construction mus y with a11 applicable 1aws, ordinances, building
codes, and zo re a ' ns.
OWNER'S S2GAIATL7RE DATE � -Z�" ( �
ADDRESS "� "
PHONE �'r 1"3 S�c-S�'7 �+ �t G, Z
w2TNESS PERI�IIT #
�<'fl�'`^`_._'""'��''�, �
<i��� �c`J�
��' �
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
-- - . - �=a
Contra tor omeowne •
Date Received: _��6���(j
s�te: ti.�s������'�1
Permit Type: � - "
Approved w/no comments� Approved w/the below comments: ❑ Denied w/the below comments:
❑
This comment sheet shall be kept with the pennit andlor plans.
-� �,�'' �-i
Kalvin Switzer-Plans ' er Date Contractor and/or Homeowner
(Required when comments are present)