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Home My WebLink About13-14117 ' CITY OF ZEPHYRHILLS 5335-8TH STREET (si3)�$o-0020 �� BUILDING PERMIT �� Permit Number: 14117 Address: 39048 CARDINAL AVE Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL. Class of Work: 434ADD/ALT RESIDENTIAL Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: EASY ACRES Est. Value: Parcel Number: 13-26-21-0100-00000-0200 Improv. Cost: 450.00 ,� , Date Issued: 4/25/2013 Name: BUCHANAN LENZY& SHELBY Total Fees: 240.00 Address: 39048 CARDINAL AVE Amount Paid: 240.00 ZEPHYRHILLS, FL. 33542 Date Paid: 4/25/2013 Phone: 813-782-9034 Work Desc: ELECTRICAUDOOR/WINDOWS FRAME WALLS(WORK W/OUT PERMIT DOUBLE) REESE ELECTRICAL INC MECHANICAL FEE 60.00 HOMEOWNER �� i �-�� ,'1�" �.-_ � �-� > 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� 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 federai 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 Acoompany Application.All work shall be pertormed in accordance with Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O. CONTRA OR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER � s rr�i1z� By order of the Building Official: �NiCC'iamA. �urgess All Building, plumbing, electrical and mechanical work shall cease at the below mentioned property. Address: � � O �� u r'C� Cl, � �� n I Date: �_ �- J� Code Enforcement Officer: Contact the Zephyrhills Building Department 5335 - 8th Street 813-780-0020 C C� �j(�" C tir��-(1� , � /3CL�ro�l�y1 � �� ..�. r`� ''=� ``'`� �� ,.. �� „ `� �� U �., �,. �, `,T� M � � � � � �� `� �� \�4� � � ^�' � ! . �i�� r �� ' � �;. "1� .} `- � ' � �� ` �� N, � *� ' � � � ,v . � i a�\_ � w � r� �v �, �✓s '�-i ^ ( T \ � ` � � \ � � w� � � � � � j�. \ s � � � S �., '`� � �' �� _ -� �-J � `�- ` . � � 1�� ' � ``� �_ C � � �, w ;� �� ''•� �� r.. a V` ,� �� ° � �--Q �: �� ,. ry, �n `�� ,'r . \ a � F s �� ' �J� �. -- _ c.� 1 "� ��,- C � c-�' � �.� �"._ '� �` '� -� � ''� c � h � �...N � � ^� � = '� � �1 � � � >_ �� C ti � �. h � r� `' `y'�. �, � � � _�� L° r'� S� �� =- ` �` a '� � � �i, ' \ ' Y n �� ,r'\ �� !� � .. `�? s ,� ^ • C�.� `� 1 ` l„ �� ` ;. o � . ni-'-, � �v �� ,; s� C � � C y� „_..,.� �n '.�:r � � � ` 1 � � �• �.' � r. � �. �� ,.�� 1' ` �'�" �' ('�' � '� �� J _'r S �, � ti ., , � � �� C� �.. S- � �' ,�. ^ , - � � 1 ,. � a� z� J ^ �, t� "�^ ^u `_2; `: v S d�` � � �' �� C: � �`i � �„\ �J n r� �� _ ...__.,,�..�..�_�._W,. .,. ... > �� `7' , (..�-r /', I;// i � , .._ �,,. _� ' J � 3/28/2013 3'03'03 PM � �!// �`�� _.r� ��' OMB Approval No 2502L265 r a. Settlement Statement(HUD-1) 3*�Y . ; �� U K s. ��o �o.� 8.File Number 7 Loan Numb�r 8.IdoRga9e Insurance Caee Numbflr 1.❑FF1A 2.Q RHS 3.�Conv Unm�, 01208-5881 �.❑VA S.�Conv In6. ❑Olher .Noh: t form I� i�hW Ic plvs you a statament ot ach,al x�lem�nt coata.qmwnts paid 1[and by ihe setllamerit apant are sham. Items markad"(POC)'v�en paid oulsidt the cbsiny;they aro�hown h!R(w IMOmatbnal puryotls antl a�!nol InGUdlO In 111e IL D.Nam�i Adtlrosa Buclunan 01 Bonovwr: Shalhy A Buchansn,811A Oar Lana,ZaphyrhAls.FL 33541 E.Narrr i Add�ass Fannk Mas a/kla Fed�ral N�l'anal MoRp4Qe Aawaadon,13�55 Nosl Road,Suits 500,Dalias,TX 75240 OI SdIN: F.Nam� Mdrpa ash of L�nd�r• .Prop�rry LocaUon; e CaMinal Ave.Zephyrhilb,Fbrida 33542 Lot 20,FASY ACRES Subdivisbn,Puco County,Florida 1128-27-0�00-00006-0200 H.Settlam�nt Ap�nt Stsv.�rt T�tle Company.3401 West Cyprew SVeet,Tampa,FL 33807,(813)872-G898 Plau of S�tU�m�nt 3407 Waat Cyp�ss StnoL Tampa,FL 33807 1.S�ltlMf�rk D�b: �I28/2013 Prorallon Date: 3/2Bl2019 Dbburs�m�nt Dat • 3l2a/2013 101. ContrfU pNt pAq 541.938.00{Ot. Contract aalr p�u 1.39E. 102 Pvaan�propsrty !02 P�rsorvl popsrty 103. SatO�meM��ry�s hi bortowr(lins 1�OB} 51,510,80�03. 104. 4pq. 105. �05. � �N'r aqix'� • e 1oe. CftyRown la�us 406. CMYRawn laxss 107 CoulAy httH l07 COUrky Ia7cN 10l. AuMim�nb 4G8. Asfsasmr7lt 108. �08. 110. 410 111. 111. 112 {12. 120. Orou AmourK Du�/rpm Bortpw�r t42,646,t0�20. 6rou Amount Due to ENHr :41,�36.00 207. D�pvit or a�masl mwiey ,t00A0 SOt. Exau d�pofil(sse nstvdiona) 202. Prindp�l��unt d nwv loan(s) 502 Setfl�rt�srrt rharp�s lo wtlr(line 1400) f2.837.53 $09, Existnp Inn(7)t�k�n w6' b 503. EsK' Iwn(t)hken l�d b 401. 501. P�yoR o(fint nqAp�p�I�n 205. 505. P�yoR of s10on0 maftp��bef 206. 306. 207. �7 20e• soe. �O• 50�. 210. Clly/bwn taxu 510. CityRown luu 217. Courriy 4u�w 1f1/201�10 Sl2l/2013 5110.19 511. County lazn 1I7/2015 Ic Y2&'.DU S1�OJ9 z1z Ass�wrrna s,z. bu+,n,.nb Z��• 513, zt�• 514. 215. 515. 216 51 B. 217. 517 218• S1B. 279. 519. 2t0. Total Pald Mor Borrower f4,240.18 520. Tohl R�CucUOn Amount Oue 3�Iler 52,771.7 301. Orw��mount dw from Earrowr pin�1201 ta2,848.l0 l01. Oroas�mant du�to stllr(Ilr��201 •541,736.0 �02 lw artnunls pW 6y/lor bortoww(Ilns 220) ItI,410.7 9)802. Lut raductlou in amount due f�lla Q4w 520) (52.771.72) 307. Cyh BFrom OToBonow�r f3d,606.61 601. CuA ■ToQfromS�INr f3�,6t4.26 EUBdTNTE RORM 101f�ELLER STAT[MENT• TT�informatbn contsuw0 h Bbck�E,O,H�nd I and on One�Oi(a, X Mn„01 Is astMakaO,Ynn 403�nd�W),408,�07 vid�0l-112(appOra61�pvt W buy��n�l�rtal�lu nportab4 lo Na IRS)b 4nparturt taz Inform�llm�nL 4 D�Inp lumislxd lo L1e IMemal R�vsnua Sarvk�.If you an raquind W fu a nWm,a npYqrie�p�nalty ar oMx uncfbn WULe 4nposed on you N thli k�m It nquWE fo Ee npataE ard Us IRS AMVm�ns�tnM t nu na bs�n nportsd SELLER INITRUCTION• H rila nW eitat�uru your pMdpal rudenp,Ne brm 7114,SUe a 6echary�of Prindpd R�rGnu for any qan.wN ywr nmme Wi ntum; for othr transaciqn�,cxnpbte Ne�ppllpble D��a��1�7,Form fi251 anC/or SU�stlul�D(Form 1 WO). You are requlred W prwWS Ihe SaClsmenl Ayant wMn your comd taxpayer qantRkatwn n�mDer. M yw do not provlGe Ne SatU�ment A9eM wrth your cprtect tupoyer ia�ntifcabon numGx,you may De aubjed lo civil w vlminal panaltles. FanMS Ma�a�kh FeC�ral NMionil Alortyaqa AasotL�tqn Tha Pvblic Reponinq Burtlen for t�is collation ol informatlon Is es4mated al 35 runules per nsponse for collsclirq,rwne�nq,viC rapor4nq��a Cata. TNS pency may not cdlW Wi inlomv�m,aM you ue not rsQuirW lo mrtfplNe Ws lorm.unbu it eispays.curtanfly v�i�a OMB mnVd number No confiden�tliry is auunC;�Ns du:losun �s m.nanwy 7Ns is cpi0�+�d io D�wda tlx p�rbu lo a RESPA mvorW VanseCJOn wnh rtAo�mytlon dunnq Nc aettlemanl process P2viouf eORioru arc obsolete Paqe 1 HUD-1 Pasco County Parcel: 13-26-21-0100-00000-0200 001 Page 1 of 2 Data Current as Of: Weekly Archive - Saturday, April 06, 2013 Parcel ID 13-26-21-0100-00000-0200 (Card: 001 of 001) Classification 01 - Single Family Mailing Address Property Value FANNIE MAE Ag Land $o 3900 WISCONSIN AVE NW Land �ia,400 WASHINGTON DC 20016-2806 Building �33,09� Physical Address Extra Features $3,429 39048 CARDINAL AVE ZEPHYRHILLS FL 33542-2207 7ust Value �50,926 Le9al Description (First 4 Lines) ASS@SS2CI (Non-School Amendment 1) $50,926 See Plat for this Subdivision EASY ACRES PB 10 PG 100 Taxable Value $50,926 LOT 20 OR 8789 PG 3980 Land Detail (Card: 001 of 001) Line Use Description Zoning Units Type Price Condition Value 1 0100 SFR OOR3 8,000.00 SF $1.80 1.00 $14,400 Additional Land Information Acres 0.18 Tax Area 30ZH FEMA �Residential Code ZHLALP6 Code Buildin4 Information - Use 01 - Single Family Residential (Card: 001 of 001) Year Built 1975 Stories 1.0 Exterior Wall i Concrete or Cinder Block Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall 1 Drywall Interior Wall 2 None Flooring i Carpet Flooring 2 None Fuel Electric Heat Forced Air- Ducted A/C Central Baths 1.0 Line Description Sq. Feet � Repl. Cost New 1 BAS 880 $37,268 2 � FSP 112 $1,652 3 FGR 288 $4,870 4 FOP � 32 $339 Extra Features (Card: 001 of 001) Line Description Year Units � Value 1 DWC 1975 222 � $183 � 2 CLFENCE � 1995 768� $271 3 UDU-��-2003 1 � $2,975 � Sales History Previous Owner BRAUCHER ERIC JAMES Month/Year Book/Page Type Code Condition Amount 11/2012 8789 / 3980 Certificate of 12 Improved $0 http://appraiser.pascogov.com/search/parcel.aspx?sec=13&twn=26&rng=21&sbb=0100&bl... 4/9/2013 f� ` ' �� /�, � � �` `� ��, c S��' // , �.;�G��y-� � `.�—_ �,,� ��.�.1``��5�t'�? r' rj :�r � .F a •�' f�r.,ci'�� G- � �'!"�f _ ,�� /� � �t f� ��r" f� `��I �'`y � / .� � �pj�/��O ��,�,,.�1�. l�� j�� , v ( / � ,��!1 �stj� , �, , ,�, ��,y� �.�*s�S j��1 C'� �.=�! � - •�t � {' ' /� f�l �; � �� {/ •t ��'(�� a � ��1�`��/� r � �V< i � 1 � � ..�`� � z- �r ��p��,-�� ✓�:� �� = i�. , � �`�"�`-��' `� ' . . ��` ,�'s C— _.�'. � .,. �� .�� ; � 1-.- �:�' � �� . ° % �,� � ,� �� _ �� , ,�y, ��.� S�`�.�'� r . � - r,, , C�� .� ��`„'�''� ,�� ,!l /" � � � � �� -� .�,� ,��/� � . _ � �� , � � �,�-,�_ �-� � �3 � � �� Z � 1�� . ; � � �' ' � �� J �` `�`l `� � �� .� ,'" �'+/•1�� J°'t`��ir � � t��`:��P�� l � t! /t� �U� � � � . ; � `�+� .-� `� d 0 �,.��. ��.I� �:h�� Q r i - �� C�� o�, �,78 �., � � ,, �� . « , ._, � �,L��aT ; � � � fl ti , \ �� ' ` t � • . ' , � �.,o o �'✓f%✓l ,, G� � . /� � � �,��'` ---- . ; i i i DATE : 12/21/12 PASCO COUNTY PROPERTY APPRAISER 15 : 22 : 37 0 N - L I N E P A R C E L P R I N T O�'U T , PARCEL-ID: 13 26 21 0100 00000 0200 TYPE: STATUS : A DLA: 113Q12 SC TP RG SUB BLOCK LOT TR.ACT: 0330042 PARENT: DATE-SPLIT: 000000 CLASS : O1 NOTES : A/K/A FEDERAL NATIONAL MORTGAGE ASSOCIATION LETTER CD- OWNER CHG- NAME : FANNIE MAE 3900 WISCONSIN AVE NW /ADDR DC 200162806 FS119 CODE : WASHINGTON PREV OWNER: BRAUCHER ERIC JAMES STREET ADDRESS : 39048 CARDINAL AVE ZEPHYRHILLS F VALUE & TAX INFO: E X E M P T I O N I N F O: SOH HX APP LAND AG: NUM CD H W D V T PCT HX-OVRD YEAR DATE S YR DVD� -JUST: 14400 001 1 0 0 0 0 2001 071299 BLDG : 33538 XFOB : 3490 - - - - - - - - - - -- ---- - --- APPR: 51428 SOH : 51428 NS ASD: RPG : QUALIFIER NOTE DATE EXEM : 25000 BRAUCHER ERIC JAMES H 071299 BS TXB 26428 S DVD ; S DSM: S TXBL : 26428 AREA: 30ZH ACRES : . 18 SPEC HX: BC TXB 26428 ADD EX: 1428 C DVD : C DSM: C TXBL : 25000 PRIOR YR VALUE : 51428 PRIOR YEAR MKT: 51428 HX VAL': ' 51428 NON-HX: 0 'MK'�' DIFFERENCE : � MK'1' CHG HX: 0 NON-HX: 0 PRIOR HX VALUE : 51428 MC LAND HX : 0 NON-HX: 0 PRIOR HX PCT: PHYS HX: 0 NON-HX: 0 PRIOR NON HX: 0 PRIOR N-HX ASD: 5142F3 S A L E S : YEAR MON BOOK PAGE SALES-AMT INST XFER QUAL ST LIFE I/V TOI 2012 11 8789 3980 CT T 12 I 1998 05 3944 0047 41800 PR I P'I 1987 04 1608 1484 QC I 1976 06 0845 0719 22750 I L E G A L D E S C R I P T I O N: ASSESSED IN SECTION 13 , TOWNSHIP 26 SOUTH, RANGE 21 EAST, PASCO COUNTY, FLORIDA EASY ACRES PB 10 PG 100 LOT 20 OR 8789 PG 3980 8�s-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received •r �'� -� j � /> � � ' ��T� _ Phone Contact for Permittin ZS Owner's Name `�itl� t� $�/��''L f3 e�L�-t%f��}N A/ Owner Phone Number ��3 - �� - `�o i ��n Owner's Address $�a S� yP� �.�, Z� }/ _/-{,"L LS �L 3 3 S`E-1 Owner Phone Number � !3 -7l 3 -o s y �i Fee Simple Titleholder Name Owner Phone Number I Fee Simple Titleholder Address JOB ADDRESS ,��/'o�f-8 L� ,e D/�v,qL V �'I°µ�R!�f•�L G 5 G 3 3S i��, LOT# � d SUBDIVISION E/�Sy%Ci2� S PARCEL ID# ,� 3 a 6 3 r 0 / � o U � �° � G'� p u (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEw CONSTR e ADD/ALT � SIGN Q Q DEMOLISH INSTAL� REPAIR PROPOSED USE Q SFR Q COMM � OTHER TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q UESCRIPTION OF WORK J� I✓C)L C EL E C. �C'eC L'�7 A C L c's S7vr TC N L � T . D(�0�, BUILDING SIZE "��i X�-� SQ FOOTAGE /S HEIGHT �BUILDING $ � 3 p 6 " VALUATION OF TOTAL CONSTRUCTION �]ELECTRICAL $ ��S,O � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. �SO Ii/n P SQ p �� ( .n r . , �, QPLUMBING $ � �/� ��f,?° � � QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ' / /��/�/ � � �GAS Q ROOFING Q SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO Q� � L BUILDER ,, "" " � COMPANY �.��-- SIGNATURE � � . � REGISTERED Y/ N E CURRE� Y/N Address License# -� ELECTRICIAN �1 ` COMPANY � SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address ��+c. Zf G�-- Z 3�'t License# -� �j PLUMBER COMPANY ' SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N Address License# MECHANICAL COMPANY `9`" SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N Address License# OTHER COMPANY SIGNATURE REGISTERED Y J N FEE CURRE� Y/N Address License# RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit fo�new construction, Minimum ten(10)working days after submittal date. Required onsite,Constniction Plans.Stormwater Plans w!Silt Fence installed, Sanitary Facilities&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&1 dumpster Site Work Permit for ail new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. '""PROPERTY SURVEY required for all NEW construction. Directions: Fili out application completely. Owner&Contractor sign back of application,notarized If over s2500,a Notice of Commencement is required. (A/C upgrades over;7500) " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMIT'TIN(3 (FFOr�t of Application Only) Reroofs if shingles Sewers 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" 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 requi�ed to be Iicensed in accordance with state and local regulations. tf the contractor is not licensed as required by taw, 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 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 ce�tificate 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 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 ce�tify 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 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 a�e not limited to. - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentalfy Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercou�ses. - 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 pe�mitted building using stem wall construction, I certify that fill will be used only to filt the a�ea 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 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 NOTIC� OF COMMENCEMENT MAY RESULT IN YOUR PATH O R'LENDER OR AN ATTORNEY BEFORE ECORDING YOUR NOTICE OF COMMENCEMENT.� CONSUL7 WI FI,ORLDA JURAT(F.S.117. 3) °� S— CONTRACTO ��`��"� O NE R AGENT . ' /X�s orn ( a med)b e me t Su scrib J n s�m t� ��i d)be ne this , by by , Who is�ce�persona�Y�nown m o�has/have produced Who f �e4�on�knovm to or hasa aden fi at on. --�--- `_ as identification. � � ; �� ,� f � `� � � � Notary Public - I,1�� liblic , � ,,...�..�.....�..,,K,, Com I ��Y g��$i��. --::'.': ;_'.'. Commission No. ,,,„Y' -. -.: � mm ssbn#EE '�U709 _.: ::� Commission#EE 140709 Expires Februa L' � � . =,: :_ �a�y r Name of Notary ty�ecf, ,„ d mi��e1lE1RIf�9f#dn�a�ceaoo-�es7o�s Nam ..LL-v.�.,..n..�,-. DISCLOSiJRE S'►'a'T'�•*�•NT .FOR OW1�R CI.TY OF ZEPHYRIiSI+LS BiT=LD2NG DEPARTMENT 2� ✓ •��e`�y ��-�}w Lfr,/ have read and fully understand and agree �to -the provisions of �this instrument. The undersigned states arid affirms that he or she is desirous of constructing, r�ovating, adding to or reroofing his or her own domicile, •that he or she actually occupies, or wi11 occupy by said domicile, and same is not for •rent, lease or sale. That he or she sha11 comply with the fol7.owing condi.tioas: 1. That the cwsier aad he or she alone sha11 act as the builder for al1 phases of constri.icti on. � 2. T2zat the owner wi11 comply with a11 provisions of �the City of Zephyrhills ordinances and codes perti.neat to the buildiag. 3. That in the event various phases of' construction are subcontracted, he will engage only properly licensed subcontsactors and will personally supervise such work. 4. That i.n the event the Building Inspector shall ree�';re corrections to be made, the owner will assume full responsibility to insure �they are made, and upon completion will ca11 for a rein�cti.on before proceeding with ttie buildiag. 5. That the owner sha11 assume fu11 rasponsibility for the const-suction aad wi11 not axpect_ supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection aay additsonal fees, including reinspection fees, must be paid ia full. A vrritten request from this o£fice sha11 constitute an official notice -to pay additional fees• . 7. That the owner sha11 com�ly with a11 City, State and Federal laws in regard to soci.al security, worlcman's compansatian, Lien laws, etc. , where applicable. 8. That the owner shall comply with a11 the safety codes issued by the Florida Industrial C��ssion. 9. State 1aw rarn�ires constxziction to be done by licensed contractors. You have applied for a permit under an exe�ption to tt�t law. The exemption allows you, as the ooazaer of yovr propESty, to act as your owa contractor with certain restrictions even though you do not hane a license. You must provide direct onsite supervision o�' the constxl3ction yovrself. You may build or improve a one-family or two-family residence or a fatm outbuildiag. You may also build or improve a commercial building, provided your costs do not exceed $25,000. The building or resideace must be for yovr ovrn use or occupancy. 2t may not be built or substaatially improved for sale or lease. If you sell or lease a building you have built or substaatially improved yourself within 1 year after the constsuctioa is complete, the law will pres�e that you built or substantially improved •if for sale or lease, which is a violation of this ex�ption. You may not hire an unlicensed person to act as yovr contractor or to supervise people working on your building. It is yovr responsibility to make sure that people employed by you lza.ve licenses rez,;red by state law and by county or municipal liceasa.ng ordiaances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the ovork beiag doaa. Any person working on your building who is not licensed must work under Zsour dirsct sispervision and must be P�ployed by you, which meaas that you must deduct F.I.C.A. and withholding taz and provide workers' compensation for that employee, all as prescribed by law. Your constrtiction must comply with a11 applicaUle laws, ordisiances, building codes, and zoning ragu.lations. o�R- S S=�� D� �-_ a s- �3 ADDRE S 5 / d�/.2�L � PHONE -7 2_ g�3 � t - 7! -f� S�l W=TNESS PERMIT # .�e;*��y�_..t�,.J, _`�lf�l�S K i�l�/=j��' ? - c;`� f�i$�`.: \�� - ,c.�ir+!?�' �.:�!ar.�::' City of Zephyrhills BUILDING PLAN REVIEW COMMENTS - , �- . Contra or� om _ �� r�� >, ,� ��" Date Received: �- �� j _� Site: � �� ,r,�C.�:��.(��l (�ln��, Permit Type: � , f .,r- �}J?"�� / Approved w/no comments:❑ Approved w/the below comments: � Denied w/the below comments: ❑ t� � , c � , �C�Y1 � ✓1 ' .S . �.. � �.�� v .�C. ��{' �� ti� i `.�� , �- ��"�,L � /�� a( � C� i`C� L �'� C V� -� �-� � �c' ��1 t� -r.' L._�,��, ,. c� �°� r�� _ i�� -� ,� � � �� .� �� ' ��-._ �t �� ;L r°.1 , � �. �_ c; ,.�:-�r-�E-/ This comment sheet shall be k t with the pennit and/or plans. � � :� � �� Kalvin S 'tzer Pl s Examiner Date Contractor an� or Homeowner (Required when comments are present)