HomeMy WebLinkAbout14-15520 ,;.
CI OF ZEPHYRHILLS
5335-8T}i SfREET
(sis��so-oo20 15 20
B ILDING PERMIT
" � � �P.ERMIT INFORMATION LOCATION INFORMATION ..� � `
Permit Number: 15520 Address: 5251 5TH ST
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIA Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDEN IAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-13100-0010
Improv. Cost: 8,500.00 OWNER INFORMATIO.N °P r.',�p�--'`_ ` °
Date Issued: 8/04/2014 Name: ROBINSON, KATHRIN
Total Fees: 232.50 Address: 5251 5TH ST
Amount Paid: 232.50 ZEPHYRHILLS FL 33542
Date Paid: 8/04/2014 Phone:
Work Desc: CONSTRUCT ADDITION 1 X 2 4 LIVING RM
CONTRACTOR S APPLICATION FEES
SUN STATE ALUMN INC BUILDING FEE 112.50 ELECTRICAL FEE 60.00
I MECHANICAL F E 60.00
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i._' " � In ections Re uired ' � �°z� �=���'
FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING
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 omply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the fol owing reasons: a)wrong address b) condemned work resulting
from faulty construction c) repairs or corr ctions not made when inspections called d) work not ready for
inspection when called e) permit not po ted on job site� plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this p rmit, 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 anagement, 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 int nd to obtain financing,consult with your lender or an attorney
before recordi g your notice of commencement."
Complete Plans, Specifications Must Accom any Application. All work shall be pertormed in accordance with
Ci Codes and Or inances. NO OCCUPANCY BEFO C.O.
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 M NTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPE TION - 8 HOUR NOTICE REQUIRED
PROTE T CARD FROM WEATHER
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City of Zephyrhills
BUILDI?� PLAN REVIEW COMMENTS
Contractor/Homeowner: � U � � f � � �
Date Received: � 4 � �- ( �
Site: 5 5 t �-�� ��t��.�,-}- ,
Pexmit Type: 13 U 1 l-Q 1 �'V G
Approved w/no comments:❑ Approved w he below comments: �J Denied w/the below comments: ❑
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This comment sheet shall e kept with the pe it and/or plans.
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Kalvin wrtze lans Examiner D te or and/or Homeowner
(Required when comments are present)
NON-BESID IAL FABH BIIILDING AFFIDApIT
STATE OF FLORIDA ) '
COUNTY OF PASCO ) '
BEFORE me, the undersigned authority, personally appeared
, who being by me first duly sworn, under oath, d_esposes and �states as
follows: ',
I do hereby swear/affirm t at I own the property described as: - -- —
' ' �
- _ ' Address �l � -- ' _ � \\
� ��. I
Parcel Number �
ISCLOSDRE STATII�IIIT
I am applying for a permit for _ ���� � \ � �� ���5
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to be used strictly for agricul ural pursuit. The proposed structure will not be used
for the storage of personal or ecreational vehicles '
, personal articles, possessions or
any other non-agricultural item .
Under Florida State Statut 553.73, I am applying for exemption from minimum
construction codes. This exemp ion allows the construction of non-residential farm
buildings on farms to be constr cted without meeting the minimum State Building Code.
I, the undersigned, acknowledge that such waiver does not exempt the Applicant from
the requirements of the Pasco C unty Land Development Code, including but not limited
to: Article 306, Development R iew Procedures, Article .500 Zoning Standards, Article
605, Stormwater Management Requ rements and Article 701, Flood Damage Prevention. The
undersigned further acknowledges that any false or misleading representation may
result in penalty as establishe by law. , •
FURTHER AFFIANT SAYETH NOT. ' .
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Owner's Signature � ,
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Address
Dat �,�j � ;
SWORN to and subscribed before m this �'_� �
l day of p�j�L�l ��� .
���"� �
Notary Public My Cou�ission Expires �- ��-/(�
Sta�e of Florida at Large
,�� ",,, SHIRDEN IC
�� "!� DELC011'0
"'4 ��� MY COMMISSION q EE 198857
EXPIRES:,lune 26,2016
Prin oned Name bf
Notary Public
Personally known ✓ or produced identification
Type of identification
Rev. 8/25/95
� , i iiiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiii iiii
"' 2014122942
Rept:1620414 Rec: 10.00
' DS: 0.00 IT: 0.00
08/04/14 T. Stine, Dpty Clerk
PRULR S 0'NEIL,Ph D PRSCO CLERK & COMPTROLLER
08/04/14 09:53am 1 of 1
NOTICE OF OMMENCEMENT OR BK ���� PG 2�5�
'emut No.
'roperty Identification No. �,� � � o�,� ��� � 1 D� C�� � �
CHE UNDERSIGNED hereby give informs you that the impr vement will be made to certain real property, and in accordance with
3ection 713.13 of the Florida Statutes,the following informari n is provided in this NOTICE OF COMMENCEMENT.
�� u,-�` a a� ��
l.Description of property([egal description:) g� � Sq,^ il �10�ASv+�Q �� � �'
a)Street Address: 2.51 b�� '� 3 r Y. ° `�`'` ��
?.General description of improvements: �
3.Owner Information 11
a)Name and address: � �1�S�� ��� � 5� �_� �J� �~
b)Name and address of fee simple tit e o der(if oth r than owner) 33��
c)Interest in property
ontractoz Information ��/�
a)Name and address: �jV►� � �1- l.�!'C'(�1+��/V"1 ri�54 rJ��+'� ��
b)Telephone No.: Fax No. (Opt.) �(� ,1� L�S�
.
S.Surety Information
a)Name and address: - �
b)Amount of Bond: � ,�
c)Telephone No.• Fax No. (Opt.)
6.Lender
a)Name and address:
Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a)Name and address: _
b)Telephone No.: Fax No.(Opt.)
8.In addition to himself, owner designates the followmg pers n to receive a copy of the Lienor's Notice as provided in Sechon
713_13(1)(b),Florida Statutes:
a)Name and address:. '
b)Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement(the expiratio date is one year from the date of recording unless a different date is
specified)• '
WARNING TO OWNER: ANY PAYMENTS MADE B THE OWNER AFTER THE EXPIR.ATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER AYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,
FLORIDA STATUTES,AND CAN RESULT IN YOUR AYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEM[ENT MUST BE RECO ED AND POSTED ON THE JOB SITE'BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINAN G,CONSIJLT YOUR LENDER OR AN ATTORNEY BEFORE
COMM]ENCING R'ORK OR RECORDING YOUR NO ICE OF COMMENCEMENT.
STATE OF FLORIDA r` —
COUNTY OF PASCO �v
Signature f 0 er or Owner's Authorized Officer/Director/Partner/Manager
��-✓1 �-1 �C��UI I(�15nt/l
Print Name
The f regoing'�ins mer�t wa aclm wledged before me this / -day of LL� LlS� ,20�,by
��'�f�y �/�`����J�� C�/L�� (type of authority. , e.g, officer,trustee, �ttomey
in fact)for (n me of party on behalf of wh instrument was executed).
Rersonally Known �/ OR Produced Identification Notary Signa -l.�GC— /������
��Y r$°•. SHiRDEN H.DEL COTTO C � /J ,
Type of Identification Pro �?0.�}� MY CO�AA4I;S!ON N EE 198957 ������ l �L(��
;��w;= cxu,a.::• ,...n,� Naxne(print)��
'�;;u��,Q^ Bondecl Thru N�uary Puhiic Undenvrftera
Verification pursuant to Seetion 92.525,Florida Statutes.U er penalties of perjury,I declare that I have read the foregoing and that
the facts stated in it are true to the best of my l�owledge an belief.
�� ��
Signatuie of Natu Person Signing Above
FORMS/NOC;rvsd2007
813-780-0020 Lity ot[ phyrni��s rermit App�ication rax-��s-iau-uuz�
Building DepartmenE
Date Received phone ontact for Permitting � — 6 3D v
Owner's Name .�5�i 1 1�°� S �� OwnerPhone Number ��� �� 4 �
Owner's Address �� � Owner Phone Number �
Fee Simple Titleholder Name Owner Phone Number '
Fee Simple Titleholder Address
JOB ADDRESS ��\n~� LOT# ��
SUBDIVISION . PARCEL ID#
_ _ _ __ ._ __ _ _ _ (OBTAINED FROM PROPERTY TAX NOTICE) __ _
WORK PROPOSED B WS7'ALLSTR� REP ART �J SIGN Q Q DEMOLISH
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
� 11 � 11 ,+�lC— Qs��,w1 � _�
DESCRIPTION OF WORK l��
BUILDING SIZE SQ FOOTAG � HEIGHT
[�]BUILDING $���� � VA UATION OF TOTAL CONSTRUCTION
QELECTRICAL $ ��� ,.� AM SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
QMECHANICAL $ VA UATION OF MECHANICAL INSTALLATION � ��
,��`�
� QGAS Q ROOFING Q SPECIALTY Q OTHER � ��
,I
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER - �`' - _ ��a�ANY ��`'� ��—�
SIGNATUR REGISTERED Y/ N . FEE CURRE� Y/N
Address S '� �� � License#
�a.o �
I ELECTRICIAN c� i(}� � � COMPANY (n�
SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/N
Address • License# �
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N ' �
Address License#
MECHANICAL `COM ANY C���GY \
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 Plan ;(1)set of E�ergy Forms;R-O-W Permit for new construction,. �
Minimum ten(10)working days after submitta date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster,Site Work P rmit for subdivisionsAarge projects
COMMERCIAL Attach(3)complete sets of Building Plans plu a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcdon.
� Minimum ten(10)working days after submitta date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8 1 dumpster.Site Work P rmit for all new projects.All commercial requirements must meet compliance •
SIGN PERMIT Attach(2)sets of Engineered Plans.
"'"PROPERTIf SURVEY requlred fo�all NE construcllon.
Directions:
Fill out application completely. �
Owner 8 Confractor sign back of application,notarized '
If over$2500,a Notice of Commencement is required. ( C upgrades over$7500) ,_ • , �
*' Agent(for the contractor)or Power of Attomey(for the owne)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application nly)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
.,� .••.a r�h�aNn+o.. z 9a*.Tse�ost_�...,!�in.,x...,�.n..w.,.-v..x.r_..., a ry 1
Driveways-Not over Cof�nter"�f�it��u�lic roaci�ways:.needs:, .1N,. ;'"`" t � ,�-, '�' ;,. '-
�;i O',��:�: ''.:.Kt�:t:�.�. ;c�. 4� ,� ;Tii'. l..it: .�u'�i., .. .. .
�4 ?:;,.,4•,5, :�,,,;� ,. :mi ;.r;: 'f�• g ,... ,�3:v�C(?:.:S' ., , .
i . ,���,.,��,�..�.. _,-,�. , .,. .. ��,i, 1'� �`` . ....... .. . . ...'is;_ -- ." :
I :' :rtl" 1� 'Y! '�
�:I�ifeN�+V�-Ai�C�AI+�-b.a.vla.�,c..��t�-.v-fnr�li�yw+1 Yv� cW�•• 'i:��..r+n. .��... err4�.-•.+. ..y . .r-.�,_=a.
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
' coritractors 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 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 invoive a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
I 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'S/OWNER'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 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 ficense 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
ma be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
Y
� ustifiable cause for the extenslon. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
1 �
- .
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 COMMEI�EMENT.
FLORIDA JURAT(F.S.1 7.03) _
�
OWNER OR AGENT C� CONT '-^� -�---m�-'^---"�
bscribed and swo o(or aftirm efore me t Is �, t�,s er o'("o��irmed)b`fore me this [�GS/
GPGI� b by 1 �5�� e�C.l�/�� bY���/�G1���f2�f�/
Who is/are aersonally known to me or has/have produced Who fs/are personally knovm to me or has/have produced
—'' as Identificatlon. as identification.
� L' 27 Notary Public e/J�l��- ��i� ���� Notary Public
Commisslon No. GEI���� � Commtsslon No.��`�����
Name of Nota
��„��• y� 3NiRDEPI K DEL 001T0
ame o `� P� ' SHIRDEN K.DEL �TTO •���Er�
" i: MY CAMMISSION R EE 198857 +: r. MY COMMISSION N EE 198857
����• � *= EXPIRES:June 26,2016 �'• �a= EXPIRES:June 26,2016
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