HomeMy WebLinkAbout15-15998 _ ,
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CITY OF ZEPHYRHILLS ''
. � 5335-8TH S7REET
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QRI E1MAY PERMIT
PERMIT INFORMATION L,CICATION INFORMATION ��
Permit Number: 15998 Address: 5422 TANGERINE DR '
Permit Type: DRIVEWAY ZEPHYRHILLS, FL.
Ctass of Work: DRiVEiNAY/NEVU Tawnship: Range: Boak:
Proposed Use: NOT APPLICABLE Lot(s): Block: Secfiion:
Square Feet: Subclivision: ZEPHYR HEIGHTS
Es#. Value: Parcei Number: 12-26-21-0040-0040Q-0050
Imprav. Cost: 2,250.00 OWNER INFORMATlC?N
Date issued: 211012015 Name: HIGGINS CARROLL & SHARON TRUST
Total Fees: 40.00 Address: 39007 HAVEN AVE
Amount Paid. 4Q.00 ZEPHYRHILLS, FL. 33542
Date Paid: 2/10/2015 Phone: -
Work Desc: INSTALL DRfVEWAY 7 ' X 3 '
CONTRACTOR S APPLICATION FEES
HQMEOWNER DRlVEWAY 40.OQ
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Ins ections Re uired
D EWA
FINAL �, - 2 C1--t�
REINSPECTION FEES: Reinspection fees will omply with Florida Statute 553.80 (2)(c)when e�ctra inspection
trips are necessary due to any one af the foll wing reasons: a)wrang address b)candemned work resulting
from faulty constructian c) repairs or carre ions not made when inspections called d)work nat ready for
inspectian when ca!!ed e) per it not posted on job site g)wark not accessible.
NOTICE: In addition to the requirements of this p rmit, there may be additianal restrictions applicable to this property that
may be found in the public records af this county, and there may be additionai permits required from ather governmental
entities such as water m nagement, 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 notice af cammencement may result in your paying twice for
improvements ta your property. If you int nd to abtain financing,consult with your lender or an attorney
before recordi g your notice of cammencement."
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PERMIT OFFI
PERM XPIRES IN fi M NTHS WITHOUT APPRCIVED INSPE{;TIB
CALL FOR INSPE ION - 8 HOUR NOTICE REQUIRED
PRUTE CARD FROM .WEATHER
813-780-0020 Fax-813-780-0021
City of Zeph rhills Permit Application
B ilding Department
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Date Received Phone Cont ct for Permitting —
Owner's Name } 4. r��.L � Owner Phone Number D " �"� !b�
Owner's Address �`"6�� ��l�rV V Owner Phone Number ��31 6�Z�`3 3��j
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address " �
� -
JOB ADDRESS `T �� 5 2 �� �Y�)^�� �r LOT# �
__ SUBDIVISION___ P CEL ID#
� ` (OBTAINED FROM PROPERTY TAX NOTICE) - - -- - -— —
WORK PROPOSED e NEW CONSTR e AD�/ALT 0 SIGN Q Q DEMOLISH
INSTALL RE AIR
PROPOSED USE Q SFR Q CO M � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q F ME,- 0 STEEL Q
DESCRIPTION OF WORK h�� �
BUILDING SIZE SQ FOOTAGE x�� ^2` HEIGHT
OBUILDING $���T'O�-� VALUA ION OF TOTAL CONSTRUCTION
DELECTRICAL $ AMP S RVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
OMECHANICAL $ VALUA ION OF MECHANICAL INSTALLATION
�GAS Q ROOFING Q S ECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FL OD ZONE AREA QYES NO
BUILDER COMPANY �Tf� �C�� � )�S
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/ N FEE CURRE� Y/N
Address License#
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;( )set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal d e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8�1 dumpster;Slte Work Perm t for subdivisionsAarge projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal d te. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Perm t for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW nstruction.
Directions: �
Fill out application completely. _' �
Owner&Contractor sign back of application,notarized �
If over$2500,a Notice of Commencemen�is required.,.(A/ Iupgrades over$7500) �
"" Agent(for the contractor)or Power of Attomey(for the owner)vJould be someone with notarized letter from owner authorizing�same , `' �' ""
OVER THE COUNTER PERMITTING (Front of Application On .). -� ' , �
Reroofs If shingles Sewers Senrice Upgrades A/Cy ; F nces(PIoUSurvey/Footage) �� , � � � - � ' .
Driveways-Not over Counter if on public roadways..needs RO � � - ' - ' � -� - .�
� •
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 COFVTRACTORS AND CONTRACTOR RESPONSIBILITIES: If ttie 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`iicensed and is not entitled to permitting privileges in Pasco
County.
TR/�NSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE FtECOVERY 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 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 accordari�e with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, �lorida 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 gQOd faith to
deliver it to the"owner"prior to commencement.
COFITRACTOR'S101fVNER'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, 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 8� 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 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 pe�mit 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.
WA�2NING TO OWNER: YOUR FAILURE TO RECORD �► NOTICE OF COMM_-�E�TCEM�T MAY RESULT IP1 YOUR
PAYING TWICE FOR IIIAPROVEMENTS TO YOUR PROPERTY. IF YOU INT�E_N�D T OBTAIN FfN NCING, CONSULY
, WIITH YOUR LEIVDER O '�►TTOFZNE BEFORE RECORDING YOUR No7"IC OF C M E
FLORIDA JURAT(F.S. 117. -- `
� OWNER OR AGENT CONTRACTOR
Subscribed and sw e th(s Subscribed and sworn to( me e
by by .
Who islare personal known to me or haslhave produced Who ts/are perso known me or has/have produced
as Idendfication. s identification.
' "'� CON
otary Public .�•:�• • Notary Public
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Name o o ary ped,printed or stamped Name of Notary typed,printed or stamped
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Ati informa ion mu -be-fiiled-in completely
• ~ � it�.af�Zephy:hitis
'S335:8�'Stre�t,Zephyrti'sils,:FL�3542 '
� Telephone. 3.780.OQQQ Fax 813.780.(lQQS .- - - -
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`PRQ7ECT .JQB;SI"T�: �PROPERTY'OWNER
Address: 2 ' �... � • Name: �P�-�t�1.�. �rz vhH- ��5
, Unit#: � „5' �?L Address: f�B �i� ' ��'�" �
Parcelldent icati n Number: L °Z 2 l"'� Ci .State .Zi L- �
��.--„2 �. � �-=,. r�'� D -- r� oe D_5"� Phone: --'yF's2-� ax: n.1r�
I . � � �o°y.�9� —�%�c�
�:CONTRACTt3R: '
Com an : '�" — � Y � � ' ,
Name: ��a � o�,ts�, ,— .�s �o�-p �
Contractor's License#: ���� E-Mail: � �'e �" �t- a � - '
�Phone: 8'l3�'Z —07 b��"- �Cell: F�: 3 �-- 7 t 1� .� �
�2 c—�d �o".v.�-[3('e 0
ARCHZTECT/ENGINEER: _ �
�Name: � •F :Name:
Address: - C � State. Zi •
State License#: P one: Cell: Fax:
_ escri tion �Pro'�ect
PE F DRIV�WAY �{O _CENt,TH OF�DRIVEWAY ` CULVERTS�NEEDED.
;RESIDPMIAL DRIitFWAY � WIDTH OF DRIVEWAY { )REINFORCED CONCftETE.
COMMERQALDRIVEWAY • R. :W.., EXCAVATlON � ( ):CORRUGATED MATERIAL
PUBLTC ACCESS pRIVEWAY DEPTH' LINEAR FEEf ( )BdX Ct1�VERT ,
COPlSTRklC7'Idhl MATERIAL ` . GU CUl'RE .UIRED � { ��/v��C/��c�)
ASPHALT YES =�,..NO- �
—�CONCRFfE ' ��
�. � � s ' �
HEADWALL REOUIREb? YES NO �`�,.,��G� 1 /
N07ICE TO APP[SCANT: If actctat wark ceeds seope of this descripiion,additional permits ar drarrvings �
�wiii be required, � .
UTILITY�.00ATIONS RE IRED: CALL BEFORE YOU DIG: 1.800.432.4770 �-
Page 1 af 3
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�Concrete (min. 6'� Y N
�Asphalt�Base(min. 6'� Y �N
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� Asphait(min.1�/z� -Y �N
Length (min.79� Y N 3 �
Width (10'min-20'max) �Y N �DlTi�1�f4�, 7� r�
Existing sidewalk. Y . N.�
New sidewalk. Y N
ADA compliant Y N � �
� Expansion�material required. Y E' S L'ETC�4 �
Contiguous parking pad. Y
Triangular�flare(3'W x 7'L) Y T StDES -
Visibility triangle o.k.? Y N •
Side set back(3'min. R.O.W.) Y
Plan Review Fee '
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Permit appl'cation approved by Date: S
Paae 3 of 3