HomeMy WebLinkAbout13-14313 CITY OF ZEPHYRHILLS
'` 5335-8TH STREET
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BUILDING PERMIT `
Permit Number: 14313 Address: 37405 DERBYSHIRE DR
Permit Type: RE-ROOF ZEPHYRHILLS, FL.
Class of Wo�k: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: WEDGEWOOD MANOR
Est. Value: Parcel Number: 10-26-21-0120-00000-0880
Improv. Cost: 5,500.00
Date Issued: 6/21/2013 Name: WHEELER, JANICE
Total Fees: 65.00 Address: 37405 DERBYSHIRE DR
Amount Paid: 65.00 ZEPHYRHILLS, FL 33542
Date Paid: 6/21/2013 Phone: 813-862-0283
Work Desc: REROOF SHINGLE
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TAPE JOINTS ROOF INSP �
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 t) 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 wmmencement."
Complete P ans,Specifications Must Accompany Application. All work shall be performed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
�
CTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES 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-813-760-0021
Building Department
Date Received . ho e ontact for Permittin __
Owner's Name C L� Owner Phone Number
Owner's Address � "'� , Owner Phone Number —1
Fee Simple Titleholder Name Owner Phone Number —�
Fee Simple Titleholder Addresa
JOB ADDRESS LOT# �
SUBDIVISION PARCEL ID�!
(OBTIUNED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN [� Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK FRAME 0 STEEL Q
DESCRIPTION OF WORK
BUILDING SIZE 3 FOOTAGE C� HEIGHT C
QBUILDING $ �/� VALUATION OF TOTAL CONSTRUCTION
� Q
QELECTRICAL $ AMP SERViCE 0 PROGRESS ENERGY Q W.R.E.0
QPLUMBING $
Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� ��� �
QGAS Q ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATfONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# —�
ELECTRICIAN COMPANY
SiGNATURE REGISTERED Y/ N FEE CURREP 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 Li
OTHER COMPANY
SIGNATURE REGISTERED N FEE CURRE� N
Address License# �
RESIDENTIAL Attach(2)Piot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)woiicing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Siit Fence installed,
Sanitary Facilities 8 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 construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence instailed,
Sanitary FaciNties 8 1 dumpster.Site Work Permft for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""*PROPERTY SURVEY required for all NEW constructlon.
Directlons:
Fill out application completely.
Owner 8 Contractor sign back of applicatlon,notarized
If over;2500,a Notice of Commencement is requlred. (AIC upgradea over E7500)
" Agent(for the contractor)or Power ot Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of AppNcation 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 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 tb what licensing r,equirements 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 identi�ed at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prio� to
receiving a "ce�tificate 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(Chapte�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 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
ce�tify that I understand khat 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.
1 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 witl 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 flll, 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 viplate, cancet, 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) ys and will demonstrate
justifiable cause for the e ension. If work ceases for ninety(90)consecutive days, the job i sidered abandoned.
WARNING TO OWNE YOUR FAILURE TO RECORD A NOTICE OF COMM ME T MAY RESULT IN YOUR
PAVING TWICE F R I PROVEMENTS TO YOUR PROPERTY. IF YOU INTEND OB AIN FINANCING, CONSULT
WITH YOUR E R AN ATTORNEY BEFORE ECORDI G YOUR NOTIC NCE T_
FLORIDA JURAT F. . 117 -
CONTRACTOR �''� �
OWNER OR A Subscrlbed a swom to(or ed before me t s
Subscrlbed an m efore me this b
yi Y
Who Is/ar er ally to me or has/have produced Who Is/are p rsonally known or has/t�aventlfication.
as Identlficatlon.
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Notary Public
Notary Public
Commission No. Commission No.
ed, rinted or stamped Name of Notary typed,printed or stamped
Name of Notary typ P
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Pertnil No Parcel ID No����������w�����"Do a/
�_ NOTICE OF COMMENCE�M;�ENT
State ot_���� Counry�ol l�'�IYJ W
TME UNOERSIGNED hereby givas notice Mat improvement will be made to certain reat property,and in accoraance witn cnaprer 7�J.Fionda S�atutes.
lhe following inlortnation is provided in this Notice of Commencement:
7 Descriptlon ol PropeRy Parcel Identificalion No.
Sireet Addross: � Z
2. General Description o(Improvement
3, Owner Intormation or Lessee inlormation if the lessee wNracted for the improvemenl
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^J'1�kb"� �.(bti+�.ttlunQ ZQ,�I��"S--��3'3"�Z.
Address City Slate
Interost in Property
Name of Fee Slmple Titleholder
(I/diflereM from Owner listed above)
� Address Gry State
Contrector
� � 3 2
Address , Cit� State
Contractors Telephone No. � �
5. Surety'
Name
Address Clty Stale
Amount of Bond: S Telephone No.
8. LenAer
Name
Address City State
lender's Telephone No.
7 Persons withm the State o1 Flortda designateC by the owner upon whom notices or olher documenls may be serveA as provided by
Section 713.13(1)(a)(7),Florida Statutes:
Name -` �
Address
City Stale �.Gv`� •� * *
Telephone Number of Deaignated Person: �� �,. ��
•
8. In additlon to himseH,lhe owner designates ��— � � ����� . �
to receive a eopy ol the Lienofs Notice as provided in Section 713.13(1)(b),Florida Slalutes. _
Telephone Number of Person or Enlily Designaled by Owner: Q � �'�., �
g. E�iretion date ot Notice o(Commencement(ihe expiration tlate may not be before the completion of consiruction anO final paymenl to the
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conVaIXor,but will be one year hom the date of recording unless a diRerent tlate is specified): t_ •��Q"
WARNING TO OWNER: ANY PAVMENTS MAOE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ��
ARE CONSIDERED IMPROPER PAYMENTS UNOER CHAPTER 713, PART 1, SECTION 773.13, FLORIDA STATUTES. AND CAN y �
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO VOUR PROPERTY. A NOTIGE OF COMMENCEMENT MUST BE ,IS1 � "� �
WITH YOUR ENDER OR AN ATTOR EB B�EFORE COMMENC NG WORK OR'RECORD NG YOU NOOTI�CE OF COMMENCEMENNSULT
Under penally of perjury,I declare thal I have read lhe foregaing nodce of commencemeM and thal lhe facts statetl therein are true lo�ne best ¢
of my knov�Aedge and bel�ef. z V �
STATE OF FLORIDA • � z � O Z�W }
COUNTY OF PASCO � � U (n J O �
�°�`�����g��� S i g n a r o1 O w n e r or Leasee,or Ownefs or essee's ulhorized
•u/ MtrC�o.�SS��NP�ixo% Offic uedorlPaAnedMa�3ger � U, 0 S d N � a
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Sig�atory's Title/ e 0 S J �
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The foregoing instrument was acknowledged betore me fhi��day ,ZD_,bY f"' LLJ � � U � C�
eS (type of a or� , .,oKcer,irustee,atlorney in tact)for ? � � � L.� �y ,
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(n of b f ent was executed). � �, d LL! o� Y
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PersonaUy Known�Q�Froducetl Identificaaon❑ Nolary Signature — � C� U J
Name(Print) � ~ � U
Type of Idenlification Produced � r U m Q L� ♦
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