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Home My WebLink About14-14999 � CITY OF ZEPHYRHILLS 5335-8TH STREET ,��' � (si3)�so-oo20 149g� DRIVEWAY PERMIT �� 1� Permit Number: 14999 Address: 7130 DAIRY RD 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: 35-25-21-0010-09100-0000 Improv. Cost: 4,500.00 Date Issued: 2/24/2014 Name: EAST PASCO MEDICAL CENTER INC Total Fees: 70.00 Address: 7050 GALL BLVD Amount Paid: 70.00 ZEPHYRHILLS FL 33541-1347 Date Paid: 2/24/2014 Phone: Work Desc: 25 X 32 CONCRETE DRIVEWAY TREBOUR, ERNEST (813)782-2744 DRIVEWAY 40.00 CONTRACTOR CERTIFICATE 30.00 1 b � ' �� ,� � FINAL REINSPECTlON 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 permits will be issued to the person owning same "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,consult with your lender or an attorney before recording your notice of commencement." � � � �� CONTRACTOR PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER � �.i�� s�- ��`- 2� � �� P.ERMIT'APP.L7CATION _ ��` zDRIVEWA�f:PERM�IT AP.Pl��►;�ON r�QNS�RUC�ON 1N�'t�ITN:P.UB�IC�RIGtflf OE=WAY All information:ID,�be-filled-in compietely - ;City-of:Zephyrhills -5335:8�'Street,Zephyrhills,:FL"33542 7elephone.8.13.780.0000 Fax 813.780.0005 �:.. ..; , .,� _._: � . : , .� , �� .�.niti .� ,�,� �,��.' � �#; . , .. - - , : ' , u � :w .� � j � � t � �.'r.�. 3� 'u� +�,°.��.. � �f��' � ��'f�� ' . T:r'��:�,. <. a� ,r n.. vq?. .r_ s�s :�E {�.� j�{- a� ... , ,�� ,. . °x-- ,. .. - _.,. _ .. ., ,. �� ', . 1.�-. � .._. . .�..�-. "PRO�ECT .JOB�ITE: `PROPERTY'OWNER µ , Address ''i '�� ,t;� ,^�. w,,�.-. Name: � y ,.�- ..-.,�,,, ��, .- � . � ; Unit#: Address: 1 o s a �=�-/ Unit: _ � Parcel Identification Number: �3 _ � �� - ;, t t_ r•� a�` � Ci .State Zi �.� y.; ,��!, � �: ;. ;' ,� ;�Si �, .� �.�,r,.�« , • Phone: ?,�� /t'r 9 Fax: :CONTRACTOR:. Corr�panY' ^ �', �r � a.� �� ,�,:;� ; Name• sk�� ,�� t1 � _�.� '�.� ��,�°��`_> Contractor`s License#• %�� F` -�-- �r�� t��= ? � '�' F-Mail: -Phone��S;� �'�� :�_. ��.fE�r� Cell: �o >�� r� � Fax: ARCHITECT/ENGINEER: � �Name: ' Firm Name: Address: CitY: State: Zip: State License#: Phone: Cell: Fax: Descriotion of Proiect � TYPE OF DRIVEWAY 2-S LENGTH OF DRNEWAY CU T RESIDENTIAL DRNEWAY 3�_WIDTH OF DRIVEWAY ( ) NFORC CONCREfE �_COMMERQAL DRIVEWAY R•O•W. EXCAVATION O CO U D MATERIAL PUBLIC ACCESS DRNEWAY DEPrH LINEAR FEEf O BOX LVERT ( ) R LAIN) CONSTRUCTION MATERIAL CURB CUT REOU�,� ASPHALT YES ,-r``. NO �CONCRETE HEADWALL REOUIRED? YES .,:�NO NOTICE TO APPI:ICANT: If actual work exceeds scope of this description, additional permits or drawings wilt be required. UTILITY LOCATIONtS REOUIRED: CALL BEFORE YOU DIG: 1.800.432.4770 Page 1 of 3 PERMIT APPLICATION OFFICE USE ONLY PUBLIC WORKS USE ONLY Concrete (min. 6'� Y N Asphalt Base(min. 6'� Y N Asphalt(min. 1�/z'� Y N Length (min. 19� Y N Width (10'min—20'max) �2 Y N Co n.�M Ei¢C,�c. 2� w� Existing sidewalk. Y N New sidewalk. Y N ADA compliant. Y N Expansion 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.) Y N Plan Review Fee Additlonal descrl Non of work as defined b Public Works Director and or d nee: �i.b?ES A'� D! !'�/2QEJ /O E F- S ,D� Permit application approved by: Date: Page 3 of 3 PER.MIT APPLICATION UTILITIES LOCATE CONFIRMATION NUMBER: PROVIDE SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED, ATTACH TO THIS APPLZCATION. ��rS 0 �� z ` � � , �, � � � . _ _ r '_ ; � t � , :_, � , -.r , � � �_._.___ _._.._.___ n ,,_,�.,,�. _ . . _ _._.._._.. �._ . .. .. . �4.. _..�__. .-_ _ , E; _. : _. , , �- � �°�� - � c� � � � �_--� �- � r' e lK��j� � � f�A�'I�tf�L � � I � \ /!��X � '�.� � _ , �, _ .. , . __ ' � � _._ _ . _ , . �'�,.��,,°'_� , { �.r, , � Jo i 1 a 3Z ' ► � - � q 7 ,, -- _; . �f , �_' � ,r . _ /Lr�iv�i+IV,K . •� 4, �✓�✓� 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 rnmply with all appiicable 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 does not ensure compliance with deed restrictions and I understand that additional deed restrictions may apply to this property. All work shall compiy with the current Florida Building Code, Public Works Design Manual and FDOT Design Standal�ds(if appliCable). (Public Works Design Manual online link:www.ci.zephyrhilis.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 treatrnent and/or conveyance. PROPERTY OWNERS: By signing this application: I certify that I have read and understand the owner/builder disclosure statement. (please initial) Applicant Print Name Applicant Signature Date Permit Technician Signature (or) Notary Signature Date Applicant is( ) personally known to me or produced as identification. (type of identification) Page 2 of 3 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date R�ceived Phone Contact for Permittin � �f __ / Owner's Name ! /}SC P�.,l te�-- Owner Phone Number � "'�/� Owners Address �B,SQ y Owner Phone Number � —� Fee Simple Titleholder Name �— Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS 7� D D��`R- /�s- LOT# C� SUBDIVISION PARCEL ID# 3s" L s" L 1 -� d d/ D —Oq �Q d --oa a G � (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTR� ADDlALT [� SIGN Q Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL O DESCRIPTION OF WORK � (� ,S T6 �O� BUILDING SIZE �---1 $q FOOTAGE� HEIGHT QBUILDING $ Y s o OQ VALUATION OF TOTAL CONSTRUCTION O � QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. OPLUMBING $ QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �� QGAS Q ROOFING Q SPECIALTY 0 OTHER �/-�( � FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER �, r_ COMPANY IeNi� �Q�6p�L /Yl i9�3qw L.J, L SIGNATURE �l � ��p G�uYl� /�pµ/ 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# r— � OTNER 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 Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,StoRnwater Plans wl Silt Fence installed, Sanitary Facllities&1 dumpster;Site Work Permit for subdivisionsllarge 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 constructlon. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied, Sanitary Facilities&1 dumpster.Site Wor1c 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 construcUon. Directtons: Fill aut application completely. Ovmer&Contractor sign back of application,notarized If over 52500,a Notice of Commencement Is required. (A/C upgradea over 57500) "" 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(PIoUSurvey/Footage) Oriveways-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 undersig�ed 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 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 responsibie. 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 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 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 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, Wettand 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 m 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, wel�s, 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 Officia!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 YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMI�AENCEMENT. FLORIDA JUftAT(�.5. 117.�3) •�,,,� OWNER OR AGENT CONTRACTOR /'( � � Subscribed and sworn to(or afflrmed)before me this Subscribed and swom to(or affirmed)before mC is by Who islare personally known to me or hasRiave produced Who tsl personally ovm to me or haslhad ntlfication as Identlflcation. � �� Notary Public Notary Public Commissfon No. Commi io � 'r��. .�',� CAmmission#EE 040520 Name of Notary typed,printed or stamped Name of Not�'�rt� '�iri �B �1019 c3 •,f��d�.;• Bontied7M�TmYFenMw�� . iiuuiiuiiiiiiiiiii�iiiiiiiii�iiii�iiiiiiiiiiiiiiiiuiiiii 2014028039 Repl:1883810 Ree: 10.00 OS: 0.00 IT: 0.00 02/24/34 D. 8onilla, Dply Cle�k PiiULq 5.0'NEIL,Ph.D.PqSCO CLERK L CONPTROLLER 02/24/14 2•3 1 ef 1 °R �" �� P� 3251 � �y 9 9 y NOTICE OF COMMEIVC M .NT 4 Permit No. �Q Properry Identification No._3Jr�015'L'l�00lO"d9/d0�'QO00 � THE iINDERSIGNED hereby gives notice that improvements will be made to certain rwl property,and in accordance with Section � 713.13 of thc Florida Statutes,the following iaformation s provid in the NOTICE OF COMMEIYCE�yE %I'AefJ�J-I e L w/s1 C1cC 7�/.�r, C'/JV'r 9��a F1'�Aeles a�.p� I. Dcscription of property(ltgal descr'1Ton: Z CQ I,vi2�i.l L� ('n 1 ti,t�y a) Street Address:_20 SG' C',.�yl l )g�v d � �f" 7/3 n A w....i.`'��3�� i�s vn�'� /�� S 2. General description of improvemtn s �� roi,.d^e.1£. �M�•.s' 3. Owner Informat�on a) Name and address: e T • OS o �s.tll iQ�l/�, b) Name and address of fee simple titleholder(if other than owner) ,L c) Interest in property y� ontractor Information a) Namc and address: F1G+U•`� i ReJ�peayL ►y►,�,rw.ri,4 �L(,� 3P'6ae f��Ti� �__d R�. ZYOI��.�Lf ) T.elcphonc No.:_� Q Q 7—/yp' Fax No.(Opt.) 5. Surety Infortnation W Y a) Name and address: J��/� a Z U � W b) Amount of Bond: —� o Ur � t�i — J U c) Telephone No.: Fax No.(Opt.) V Z � ��' J } 6. Lender � � G= ¢�� a) Name and address: /v�i�" 0 � w � a W 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served; � p = z —i � a) Name and address: } LL I— p Q � b Tcl hone No.: !— � � U ) eP Fex No.(Opt.) Z = O O � �2 8. In addition to himsetf,owner designates the foUowing person to receive a copy of the Lienor's Notice as ptovided in Section � � � W LL Y. 713.13(1)(b),Florida Statutes: ) Name and address: a H a U Q O � R b) Telephone No.: Fax No.(Opt.) Q� � J J 9. Expiration date of Notice of Commencement(the expiration date is one ywr from the date of recording unless a different date is � >- U ro p � specified): � LL w � Z O J F- � dQ � — WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF O W p p = p Z' COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.IJ, � U U �� , 0 FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IPROVEMENTS TO YOUR PROPERTY.A Q � Z O � O?i�►t NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST w � Q w (1�^ INSPECTION.IF YOU INTEND TO OBTAIN FINANCIIVG,CONSULT YOUR LENDER OR AN ATTORNEY HEFORE 0— W J LL� COMMENCING WORK OR RECORDING YOU NOT[CE OF COMD�NCEMENT. � _� z H STA7'E OF FLORIDA O � H- I— O� O. m COUNTY OF PASCO ��,j C, t �ignetbre OF Owner a Owner's Authorized OK�cc/piroewr/Puma/Managa r�A-��i�✓ F LO ./�.....� * � * Prwt Name The f,orey�oing instrument was acknowledged before me this o��day of ..[ 20�.by I��I1.�� A' J�� b�drO 1�t,t.l�t/� _ as � � (ryp of authoriry,e.g,o�cer,Wstee,attomey in fact)for � � } 4.L � (n e of party on behalf of wA instrument was ezecuted). � `s ,) � • Personally Known_OR Produced Identlfication t/ Notary Signature � � � ,"-"" °��°, o 0 Type of Idcntification Produced Y1� �]� Name(print) f k �. O�`I'I�..I,S� � •• � - � Verifcation pursuant to Section 92.525,Florida Statutes.Unda penalties of peryury,I declare that I have read regoing and that the facts stated � � � in it are Vue to the best of my knowledge and belief. '`') � //// Q ♦ FORMSMOC.rvW007 /(//� � ` (/ � . �� • � � ' S�pr4ee fNrunlPa�aiS�pnnlAbeva s � DEBORAH E.WOR7Hq18 Noluy Public-Sl�le ol FbNd� • My Comm.Expint Oet 10,2015 Commtasion M EE 1�64W • �adM TMOUqh N�bnY NOqry Mu1, ,. ,