HomeMy WebLinkAbout14-15532 �
• � CI � OF ZEPHYRHILLS
�x 5335-8TH STREET
� _ - � (si3pso-oozo 15532
� •1, B ILDING PERMIT ,
��.���....'�`..:_� _. P��RMIT$INFORMATION LOCATION INFORMATION
Permit�lumber: 15532 Address: 38800 9TH AVE
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIA Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
� Square Feet: Subdivision: ' CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-10700-0010
Improv. Cost: 17,400.00 OWNERJNFORMATION �
Date Issued: 8/05/2014 Name: EPPERSON, KOLBY JOHN
Total Fees: 367.50 Address: 38800 9TH AVE I
Amount Paid: 367.50 ZEPHYRHILLS, FL. 33542 ,
Date Paid: 8/05/2014 Phone: (606)260-0225 '
Work Desc: INTERIOR REMODEL I
CONTRACTOR S APPLICATION FEES
WOZNIAK BUILDERS INC BUILDING FEE 187.50 ELECTRICAL FEE 60.00
EAST PASCO ELECTRIC,INC PLUMBING FEE 60.00 MECHANICAL FEE 60.00
GENERATIONS PLUMBING COMPANY, I
SONNY'S DISCOUNT APPLIANCES
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In ections Re uired
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 corre ions not made when inspections called d) work not ready for
inspection when called e) permit not pos ed on job site f) 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 m nagement, state agencies or federal agencies.
, "Warning to owner: Your failure to record 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
, City Codes and Or inances. NO OCCUPANCY BEFO C.O.
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CONT C OR SIGNATURE PERMIT OFFI R
RMIT EXPIRES IN 6 M � NTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPEC ION - 8 HOUR NOTICE REQUIRED
PROTE T CARD FROM WEATHER
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� • ozniak Builders, Inc Business: (813) 377-4944
uild�ers p Box 326 Fax: 813-377-4945
_ - D de City, Fl 33526 WWW•WOZniakbuilders.com
Building Better Lives
, City of Zephyrhills
Perm t Authorization Form
I,Victor Wozniak or Wozniak Construction, Inc C C1505145
Hereby authorize the following to act as my agent(s) in obtaining permits in City of Zephyrhills, FI.
Ann Wozniak �
Patrick Mc Donald
Richard Patterson �
This form supersedes any previously submitted I tter(s)of authorization.
This authori ation will remain in effect until can elled in writing by the undersigned license
holder.
6�.��
License Holder's Signature
State of ��X_1�„��.
County of
Sworn to (or affirmed) and subscribed before me this
I day of �1 , 20�
;=�`'�YP°°�: TINA P
4 ERRITT
By ( , , y��� ts MY COMMISSION#FF052958
(Printed name of License Holder Makin Statement -•',?e� •"'op�s EXPIRES Se tember 10 2017
g ) ,or c�,,,,••� P �
(407y 398-0153 FloridallotaryService.com
No ary Public
I Y
(signature of Notary)
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�-�1io,�nzak
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, Woz iak Builders,Inc. Business: (813) 377-4944
'LuZG�ers P•0. Box 326 Fax: (813) 377-4945
- Dad City, FL 33526 www.wozniakbuilders.com
Building Better Lives
Remodeling Contract
July 12,2014
I
Epperson/Kelly Residence Remodel
38800 9th Avenue
Zephyrhills, Florida 33541
' _
Between: �
John Epperson
38800 9th Avenue
Zephyrhills, Florida 3 541
And the Contractor:
Wozniak Builders, Inc
� PO Box 326 "
Dade City, FL 33526
' CGC 1505145
813-377-4944
For the Project:
Epperson/Kelly Resid nce Remodel
38800 9th Avenue
Zephyrhills, Florida 3 541 .
SCOPE OF WORK
Original Items reviewed: ,
Item#1. Kitchen.
Cap off old plumbing and electrical.
Build beam as top of existing masonry wall.
Fur out wall, insulate, drywall and finish drywa I (smooth finish for ceiling and light orange-peel for
walls).
' Install new(6)can recessed lights, one pendan and one fixed light.
Install GFI plugs along countertops to meet co e spacing and circuit requirements.
Reverse electrical panel to exterior panel (sam location).
Item#2. Living room,dining area and hall.
Remove walls and closets that divide dining ro m from living room.
Build lam beam at load bearing point.
Install 3 columns,supports,style and spacing t be determined.
.
r .
Wozn�iak Builders, InC. State Certified Contractor License#CGC1505145
�
Item#3 Renovate bathrooms and laundry.
Hall Bath
� Remove tub,floor tile, wall tile,vanity and fixt res. .
Install shower floor with 4 inch curb.
Install new tub,floor and bath wall tile, new si k, base cabinet and faucet and toilet.
Install new lights and fan.
Laundry Room
Add plumbing and electrical for washer/dryer.
Bathroom 2 �
� Install new floor and wall tile, new sink, base c binet and faucet and toilet.
Install new lights and fan. �
*Additional Items reviewed July 10, 2014 at alk-through.
Install 10 recessed lights to new open space. C ordinate light plan with designer.
Enlarge bathroom#2 door opening.
Master Closet-enlarge door opening, install n w door and hardware. Remove one side of shelving for better
access to side and rear of usable closet space.
Widen sidewalk to front door to double the w dth and landing area,at front entry door.
*Additional items presented via email July 1 , 2014.
Install garbage disposal. Includes electrical to i stall designated circuit, plumbing and disposal. Disposal allowance
$200.00.
Install dishwasher. Includes electrical, plumbi g, and installation. Dishwasher appliance allowance$350.00.
The following items are estimated, however eed confirmation by subcontractor.
Lower electrical plugs throughout and check f r non ground wiring
Install new AC condenser and air handler 14 s er, relocate to carport and modify duct work for new air handler
location.
Total Contract: $17,400.00
*Costs include dumpster fees, permits, pl ns engineer's fees. Contractor reserves a 5%contingency to
allow unforeseen construction cost over ges. ,
Any changes to contract will be treated as a hange Order.A Change Order is any change to the original plans
and/or specifications. All change orders need o be agreed upon in writing, including cost, additional time
considerations, approximate dates when the ork will begin and be completed, a legal description of the location
where the work will be done and signed by bo h parties. 30%of the cost of each change order will be paid prior
to the change,with the remaining amount pai upon completion of the change order. A 15%fee shall be added
to all change orders and overages in excess of initial allowances. Additional time needed to complete change
orders shall be taken into consideration in the project completion date.
Any delays or changes in finish selection sch dules will delay the projected completion date.
INSURANCE
; Owner will purchase and maintain property in urance to the full and insurable value of the project,in case of a
fire,vandalism, malicious mischief or other in tances that may occur.
i . � .
' Woz yiak 8uitders, InC. State Certified Contractor l.icense#CGC1505145
�
The Contractar,Wazniak Builders, Inc., sha(I p rchase and maintain needed Workman's Campensation and
Liability insurance coverage a� required by la and deemed necessary far his own protection and will require any
subcontractors tp pravide the same.
GENERA�PROVISIONS
If conditions are encauntered at the construct on site which are subsurface or atherwise conceaEed physical
conditions or unknown physical conditions of n unusual nature,which differ naturally from those ordinarily
found to exist and generally recagnized as inh rent in construction activities,the Owner wiEl promptiy investigate
such conditions and, if they differ materially a d cause an increase or decrease in the Contractor's cost of, and/or
time reauired for, performance of any part of he wark,urill negotiate with the Contractor an equitable
adjustment in the contract sum, contract time ar both.
HAZARDOUS MA7ERIALS,WASTE AND ASBES OS
Both parties agree that dealing with hazardou materials, waste or asbestos requires specialized training,
processes, precautions and licenses.Therefar , unless the scope of this agreement includes the specific handling,
disturbance, removal or transportation of haz rdous materials,waste or asbestos, upon discovery of such
hazardous materials the Contractor shall natE the Owner immediately and allow the OwnerJContractor to
contract with a properly licensed and qualified hazardaus material contractor.Any such wark shall be fireated as a
Change Order resulting in additional costs and ime cansiderations.
ARBITRATIQN OF DISPUTES
Any controversy or claim arising out of or relat ng to this contract, or the breach thereof,shal! be settled by
arbitratian administered by the American Arbi ration Association under its Construcfiion (ndustry Arbitration
Rules, and judgment on the award rendered b the arbitrator(s) may be entered in any court having jurisdiction
thereaf.
WARRAIUTY
Wozniak Builders, Inc. pravides a 1 year work anship warranty against defects in urarkmanship or mafierials
utilized. The manufacturers warranty will prev il. No legal action of any kind relating to the project, project
performance or fihis cantract shall be initiated y either party against the ather party after one year beyond the
completion of the project or cessation of work
TERMINATION OF THE CONTRACT
If conditions beyond Cantractor's control mak it impassible for Contractor to render performance as specified,
and Owner elects ta terminate the cantract, C ntractar will be entit(ed to a cancellation charge for any job
set-up, in addition to reimbursement in full for all of Gontractor's costs (including labor, services and materials),
plus a reasonable profit of twenty percent(2Q oj far al!work performed to date of written notification by the
Owner.
ATTt)RNEY FEES
In the event af any arbitration or litigation re(a ing tv the project, project performance ar this cantract,the
prevailing party shall be entitled to reasonable attorney fees, costs and expenses.
In any iegal proceedings against the customer elated ta this agreernent, including but not limited to col(ection
and lien foreclosure actions,venue shall be in asco Caunty, Florida.
. �
�``Wozniak Builders, 111C. State Certified Contractor License#CGC1505145
ATTORNEY FEES
In the event of any arbitration or litigation relati g to the project, project perf.ormance or this contract,the
prevailing party shall be entitled to reasonable ttorney fees,costs and expenses.
In any legal proceedings against the customer r lated to this agreement, including but not limited to collection
and lien foreclosure actions,venue shall be in P sco County, Florida.
This page shall represent the acceptance and agree ent of all terms,conditions,and scope of work descriptions contained
therein upon receipt of authorization,indicated by our signature,this proposal becomes a Contract between Wozniak
Builders,Inc.and the undersigned customer below
GENERAL CONDITIONS
1. Owner to provide access to building for delivery truck for loading/unloading of materials.
2. Owner to provide water and electric wi hin 100 feet of work area.
3. Wozniak Builders, Inc., to provide Gene al Liability and Worker's Compensation Insurance and all
permits required.
Payment to be made as follows: $15,000 DEPOSI DUE UPON SIGNING OF CONTRACT; 1ST DRAW DUE WITHIN 2 WEEKS
OF PROJECT COMMENCEMENT AND BASED ON PE CENTAGE OF COMPLETION;AND BALANCE DUE UPON PROJECT
COMPLETION.
ACCEPTANCE OF PROPOSAL:
The above prices,specifications and conditions ar � �� }�-
satisfactory and hereby accepted. You are authori ed � 514 A7URE
to do the work specified. Payment will be made a , + i_
outlined above. , i7�rl r� �j'�C� � t�y L.(J�l'�°s�;+�
' �RINTEd AME
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DATE
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,
VICTOR P.WOZNIAK
WOZNIAK BUILDERS,INC.
PRESIDENT
%"L �
� DATE
Invoiced amounts not paid in accordance with the paym nt terms shall be considered delinquent and bear interest at the rate of 1'/:%per
month. Owner agrees to pay all costs incurred, such s attorney fees, court costs, etc., for collection of delinquent invoices including
interest. Owner to carry fire, tornado, and other ne essary insurance. Our workers are fully covered by Workman's Compensation
Insurance.
Page 5 of 5
Initiats N w Initials �`
I
� ' µY" Jan. 17. 2414 4:SOPM No.$975 P. 1
:
} Settletnent Date:Jannary 97,2Q14 Loan Number.4244261 Fte Number.5-28881
� �„ Settlament Chal'ges I Paid from Paid from �
700.lotat S.a►as I Broker's�Commission:_35,Oa0;U0 � � Borrowers Sellar's
•'�Divislbn•of CommYsslao�lirie�7�u:as fo!ldws Funds at Funds at
70t. 2 520.�0 to PRUDE IAL TKOPlCAL REALTY I Settlement Settlemecst.
702. 2 520.00 te Chariea Rutenbe Rea Ina
7G3. Comm(ssian Paid at SsHiemsnt 5.U4o.00
70a. Tcansac6on Fee to PR DFSfTlAL TROP{CAL REAITY 325.00
600,.ltems Pa ble In Connection wltlt Loaa: -
801. 4ur origina6on charge tf�G��a6
802. Your cred'st or charge(points}for tha spec�c Ints st rate ahasen (£wm GFE 9i2}
�o.oa .
SQ3. Yeur ad ustad ori snation cha as ftom GFE i�A
804, Appratsa!Fee (fram GFE�3)
to RP FUND1 G INC. oc$350.00 b Borrower
805. Credik R rt
- 806. TaacSeNice
807. Fiaod Gertification
9�0:�It�msRe uired•b Lsnde�W be Psid in AcSvahce:. � . � �
901. Daity mterest charge fram Jan 17,2014 to Feb i, 014�5.33 0!day for 15 days (from GFE#10)
ta RP FUNDITSG tNC. 140.00
8d2. Mo a e tnsurance Premfurn from GFE tt3
9Q3. HaineowneYS Insurance for 1}year (from GFE#11)
to 3ECURI�Y FIRST INSURIWCE 1.165,79
10flG..Rsseroea De'ositsd•witb'Lender . . ..
30D1. tn'stlal deposit for your e5crow account (from GFE N9)
ta RP FUNDING iH . `��3g
1002. Momeowners Insurance 3 monff�s 7.14 r anth $281.42
1803. M e Insurance
1 Wd. Pro T�es 5 months 1.98 er month �459_9q
t099. ateAdustrneM 5-1�-�
41o0.Tiiie'Cha e� ' ' ' '
1901. Tdle services and lender's Utle insurance from GfE#4 885.8U
9102, SeE�ement or Closing Fee
to Sunstate TiUe A en .Inc. 5775.a0 400.�0
1703. Owners 7�tle InsUrattce(First American Ti�e lnsu nCe Company) {trom GFE�5}
W Sunst�te Title A en ,Inc. 483.40
'1104. Lendet's Title Insurdttce{F'ustAmeripn T !ns nce Gompany)
w Sunstace Title Agancy.lnc.
- Lenders Prem(um $25.00
- Endo�selnenY 8.1{RR$25) $35.06
- Endorsement FL Fartn 9 $50.80
� 71Q5. LendarsTdlePoli Umit5B72oQ.00
1 O6. Qwnera Title Pafi Umit$84 Q�D.00
1'IQ7. en'S attion of t e ToYd1 Tiria Insuranee Premfu �415.66
1108. UndetwMer's Partion of the Total TNe rs&nrance P lum S�79.A
1200:GOV�mcns�t:Record?n •and Transfer Ghar as:;
12Q1. Governm t Recordtn Gha es from GFE 7e 132.00
1202. Deed$20.00 Mo e$112.0o Reiease9$�.00
1208. 7ransEerTaxes fromGFEdte 957.50
'l2UA. Ci /Caun taxlstam s ed$0.00 Mo a e$o.p0
1205. Shata taWstam s Deed 5586.00 Mo a e$236.20
9205. tntartgb e Tax
to CleTk of the Circui#Court 5154.40
120 _ Oiher TaX 2
93o0_Addi4oaal Set�ament C a as: • �
1304. R uired services that ou ca sho for from GFE ti6 275.Op
i302. SUNey '
tp Eddie P.Jenkihs Surve In $Ma in $275.00
1303, 2 13 Reat Estate Taxes
ta Mike Fasano,Tax Cotiectar oc$I o70.62 b Se er '
1804. Home Warran d00.00
�R00.Totdi Seiliement ChaXges,(Enter oreline 103,Sec oa•.1and�tina.6QZ,,ssctimi K) . Sa,6o6.S2 $6,165.00
i have esrefulty reviewed I�e HUC}-1 Settlement Statement,a d to the best o4 my knovaledge and belief,it is a We and accurate sqtement of all
receipis and d'ubursemeMs mede on my account or by me in his trensactian. t fiirtheresttify that i have reoeived a copy of HUD-1 Settlemen!
Statement
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�o�� � Seller. ����'
J OLa�r EPPERSOr� RicHARD P.o�o�VAN '
ress Addrass
The HUD-9 Setdement St�tementwt,ich t have prepared is a �e and accurate account of this transackion. 1 have czused ar w�!rause the funds to be
dishutsed iq atcordanra with the instrtsctions of the par8es he to.
Settiementl�qent ��--L✓"�,���%Lll�t��,e� DaGe� .lanuary�7,2014
WAR.NING: It is a crime co knowingly make false smtements t the Unitad S=ates on this or any other simifa�form.Aenaities upo�conv�ction can
include a fina and imprisonmept For deta8s sse TNs 18 U.S. ode Section tOQ1 and Section 4010.
�1(�y��',`�--�--3"�_�-
Prevtous editions acQ obsolste Page 2 of 3 HUD-1
,)anua�y 16,2o94 7:19 pM
` `'Y` Jan. 17. 2014 4:50PM No. 8975 P. 2
� � Prcpared by and Rehun to:
X Sunstate Title AgenCy,Inc.
1393�7th Street
Dade•City,Florida 33525
File Number: S-29861
Warranty Deed
Mada this Jamtary 17,2014 A.D,By RICHARD P, 'DONOVAN,a married person,joined by pATRICIA O'DONOVAN,his
wife, he*eiaaner called the grantoz,to JOHN KOLB EPPERSON,a single pereon,whose post office address is:
hereinafier called the gran[ee:
(Whenaverused her' theteim"grsnmr"and"�tx"mcWdeaRthe
paz�iea to tl�is 3nstcum t ana che heirs,legal repnsrnmtiva end assigns
ofiadiVidusts,and th suocessocs aud assigns of co:porat�ons)
Witnesseth,thaz the��r,for and in co i iderafioa of the sutn of Tett Dollazs,($10.00)and other valuable considerdtions,
receipt whereof is heteby acl�owledged,hereby�an,ty,bargains,sells,aliens,remises,releases,Coaveys and epnfirms untp the g�antee�
all that certain laad situate m Pasco County,Plorida,�z•
Lots 1 and 2,Block 107,a map of the TOWN OF ZEPHYRHII,IS,accord��g t��e map or,plat thereof,
as recorded in Plat Book 1,Page 54, f the Public Recozds of Pasco County,Florida.
Paxcel ID Number:11 26 21 0010 10700 U01
. Together witk sll the tenemenrs,herediram ts and appunenances dieiern belon,ging oz in anywise appezrd�g_
To$ave and to Hold, the same in{ee s le forever.
And the ganWr hereby coveaants with said tee that the�anwr is Iawfiilly seized of said�and ia fee simple;rhat the grantor
has good right and lawful authority to sell and convey 'd land;that the�anWr hereby fiilly waYranrs tbe titie to said land and will defend
the same agai�st the lawful claims of all petsons omsoever;and that said land fs free o£all encumbiances except taxes accruing
subsequent W December 31,2013_
DEED Tadividua�WanaII�y Deed_��on Faoe
r
• ��•Y
. �
Jan, 17. 2014 4:50PM No, 8975 P. 3
i Prepared by and Reuuo[o:
w
Sunetate 1Yfle pgency,Inc.
13937 7th Street
Dade City,F1orlda 33525
F�7e Number: 5-29861
In.Witness'GVhel'e0f, the said grancor signed and sealed these presouts the day aad yeaz fust above written.
Sigaed,sealed and delivered
in ourpresenee:
,�lc�.�� � � P U �.a✓ �s��>
Witness#1 Signature RICHARD P.O'D01�OVArT
W�ssiPcmcdwma ��t.°nr1cT� �'� (t�ac�7G Addmss:
� �
l.� � •w (s�)
wim�nx s;�t�S �/� arYrrcza o'DONOVAN
'K�l2Pcin�Neme �p'"� Y'T' _ �9rJb Add�eyy:
TWO DIFFERENT WITNBSSES
Smte of Florida
Counry of Pasco
TLe{oregoing insccumcnt vvas acImowledged bcfore�me this � day of January,2014, by RICHARD P. OrDONOVAN, a
married person,jo;ned by PA17tTCIA O'DONOVAN,his wife,who is/aze personally�own to me or who has prodnced driver's
license idenrificauon and who did/did not rake an oa
Nofety Pablie
Prlut Name:
My Commissiou Expires•
(Notary Seal)
' :�;+a�, sUSAtdaN.�RROW
� � M1'CU�7MISSION8�182407
��,° D(F!SE3 FeC
�J(,..,,' Dondw'RwNaI�P�cp U5'rxle�lm�'FHa
DEED Individusl wertanry Deed-i.egal on Faoe
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
a
� 2 7 i
Date Received phone Contact for Permittln �J ✓ �� -
Owners Name Owner Phone Number
Owners Address t ( � ; Owner Phone Number �W 7
Fee Simple Tltleholder Name Owner Phone Number
Fee Slmple Tltleholder Address
JOB ADDRESS � � 1�I J, � , r y LOT# �
- SUBDIVISION O D PARCEL ID# ��-a�-�I a�o J 0 1 U�—vO
� (OBTAINEO FROM PROPERN TAX NOTICE�
WORK PROPOSED NEW CONSfR ADD/ALT 0 SIGN DEMOLISH
INSTALL e REPAIR �l '�����
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION � BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK ������ �./1 G� 1��i71"'
BUILDING SIZE SQ FOOTA�E� HEIGHT �
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION [��('�� I
�7J
T� V
QELECTRICAL $ � IMP SERVICE (Q PROGRESS ENERGY � W.R.E.C.
OPLUMBING $ � � ��G����
0
� � ��� �8�,���.-
I QMECHANICAL $ ,. ALUATION OF MECHANICAL INSTALLATION /� ,n„
. , � z �� � ` n� ``'�
OGAS Q ROOFING Q SPECIALTY � OTHER . � �AM j th�p�`�
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO, /2� � �� C �'�� �
V +
� /Q� �BUILDER /(/ f/L f O PANY ��1 '�Q•�� LL�II•L�.IJ` I 'I� T" j���/
�� SIGNATURE REGISTERED Y N FEECURRE� Y N
y � n
Address (� � License# ,` . �
��� SIG ATURI� ��� V�C�. �� '= O ANY �l� � SW �. �' ,`����Ir 1�'�
REGISTERED Y N FEECURRE� � Y N �
Address lPi� r� 4.�,/ I �� 5 License# �l� �
_ ��PLUMBER p �Il� �eY�C�I I „S IM/I� Ll.�
� �
SIGNATURE REGISTERED Y T N FEE CURREA YJ/N
Address � (JW �U� W��� C!l�i I�T 1 ��SL��License#
�� s
��MECHANICAL � -� ( � ANy �Mt�rf�j�� .���i,�CC1f/�.9!`�> ,j�' �
SIGNATURE �� v� EGISTERED Y/ N FEE CURREA Y/N
Address License#
OTHER COMPANY �
SIGNATURE REGISTERED 'Y� N FEE CUR EA � Y N
Address __ � _i�. v License# I N _ '�
IIIIIIIIIIIIIIIIIIIIIII�IIIIIIII��IIIIIIIIIIIII111111111111111111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building P�ans;('I)sat of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after subm ttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities$1 dumpster;Site Wo Permit for subdivisions/large proJects
COMMERCIAL Attach(3)complete sets of Building Plans lus a Life Safety Page;(1)sel of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)woricing days after subm ttal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
Sanftary Facilities&1 dumpster.Site Wo Pertnit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all EW construction.
Directions:
, Fill out application completely.
, Owner&Contractor sign back of application,notarized
If over$2500,a Notice of Commencement Is required (A/C upgrades over$7500)
, " Agent(for the contractor)or Power of Attomey((or tha o er)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Applicati n Only)
Reroofs if shingles Sewers Service Upgrades A/CI Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..need ROW
I '
y NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
� which may be more restrictive than County reg�lations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions. �
UNLICENSED CONTRACTORS AND CONT CTOR RESPONSIBILITIES. If the owner has hired a contractor or
contractors to undertake work,they may be re uired to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, oth the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended con ractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the asco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this appli tion for which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he i not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMP CT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may appiy to the construction of new buildings,change of
use in existing buildings, or expansion of exis ng buildings, as specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also u derstands,that such fees, as may be due,will be identified at the time of
permitting. It is further understood that Trans ortation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final p wer release. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid pri r to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit ssuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,F orida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been prov ded with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida De artment of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner', I certify that I have obt ined a copy of the above described document and promise in good faith to
deliver it to the"owner'prior to commencemen.
CONTRACTOR'S/OWNER'S AFFIDAVIT. I c rtify that all the information in this application is accurate and that all work
will be done in compliance with all applicable aws 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 an 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 o other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I mus take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Pro ection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WatedWastewater Treatm nt.
- Southwest Florida Water Man gement District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawall ,Docks,Navigable Waterways.
- Department of Health & Rehabil tative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
-, US Environmental Protection Age I cy-Asbestos abatement.
- Federal Aviation Authority-Runwa s.
I understand that the following restrictions app y to the use of fill:
- Use of fill is not allowed in Flood ne"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 su mitted 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 i Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will b used only to fill the area within the stem wall.
- If fill material is to be used in ny area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found t adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building per it issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill,an ngineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I pro ise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing constructio . I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditionin , gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a licen e to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provisions of the technical code ,nor shall issuance of a permit prevent the Building O�cial from thereafter
requiring a correction of errors in plans,const uction 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 p riod of six(6)months after the time the work is commenced. An extension
- may be requested, in writing,from the Buildi g Official for a period not to exceed ninety(90)days and will demonstrate
�"o justifiable cause for the extension. If work ce ses for ninety(90)consecutive days,the job is considered abandoned.
N N E
i— o o � WARNING TO OWNER: YOUR FAILURE O RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
�— u�. � ° PAYING TWICE FOR IMPROVEMENTS TO OUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT p
� � n z WITH YOUR LENDER OR AN ATTORNEY EFORE RECORDING YOUR TICE F COMMENCEMENT. �=:,��j5'�"or',
W O � �,:•; 3�:
E vi FLORIDAJURAT(F.S.117.03) �:+�:
a� 9':?`:�.'�;
a v� a � `/ � o;�,;.. ,,;
Q V) y o OWNER OR AGENT CONTRACTOR �V ••.,,o�,� o�,.'
Z g � � Subscribed and sworn t affir ed)befor i Subscribed and swo fi o( r affirmed)before e this � �
� W :°_ -'� ��-I�bY �n �'a S')� by ` ( �O n��Y �,.�,,,,
�"' O ¢ `o Who is/aGe'e onally wn to me or ha have produce Who is/ personally know or has/have produced X -�
U d � � ��L as identi �f' as identification. � � n
� W � � � �
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;;vj� oiyo;'o Notary ublic � i L. Notary Public � � �
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:� o:� o 'sion No. Commission No. —�� � � z Ri
';rc : ,-�f`;-� � ��/1�} � � m � �
,�N..�:e+ °� u�IIA �rr� t-r � �, �
Name of Notary typed, rinted or stamped Name of Notary typed,printed or stamped � � o +�
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS �
Contractor/Homeowner: 1/J C� N ( A I� Q U 1 L�C�S , I N C
Date Received: � 2 S ' l y !
Site: ' ��� v 0 �}L �V l
r--
Permit Type: RE M � �EL LNTC+R�c��
Approved w/no comments: Approved w/he below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the pe it and/or plans.
�)�.,�..�''z�-� ...�.�:�.tih.-��•c. �l!� � 2�14
Kalvin Switzer—Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
i iiiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiiii iiii iiii
2014119004
�
w Permit No. ParcellD No �
N TICE OF COMMENCE NT � ��� /��
I State of I� Counry of i �� �" l�J '
THE UNDERSIGNED hereby gives notice that improvem t will be made to certain real property,and in accordance with Chapter 71 ,Flori ta , `-'
the following infortnation is provided in this Notice of Com encem1ent: �7 1
1. Description of Property: Parcel Identification No � I—a� �'� I — �� I � � '� /U U—Q� � �J �
SVeet Address: � I l� � �
2. General Description of Improvement 1 i � (JIJt�C_. Y
L
� �
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3. Own r Infortnati�or Lessee inf�rtnation if the see contracted for the improvement: �� �
1 a '�� � � �0m O.
�C� Name .� �� � .1. 335'�1 I � �i •0 G
Address 1 City State � � „ �
Interest in Property: ( , � ��F- C
M •�+
�
Name of Fee Simple Titleholder. `— , N
(If different from Owner listed above) _� r
Address �/) /' City State �i l0 H
4. Contractor• V I 1.,�7� � ��� �.�� _
�p I�m�
P�s mo,2� a�� p I ��lmP�v I � �;.�-���
Address P �I� ��I� �^ �� � ���/ State a0 N
Contractors Tele hone No.. � � �'� So
U N I�
5. Surety• — �G m
Name �
�. —
Address I City State �
� Amount of Bond: $ �� Telephone No. W
J
6. Lender. � ;� �
Name
F �/�
_ .__ — a �i/
Address City State �
Lenders Telephone No..
�—I ���
7. Persons within the State of Florida designatQd by the owner upon whom notices or other documents may be served as provided by i�w
Section 713.13(1)(a)(7),Florida Statutes: I �J �
� � l7
Name I o .�a
U
�` ..—� � ln
Address City State a E` �
Telephone Number of Designated Person: '� �N
a��
8. In addition to himself,the owner designates I � of_ I�N�
-- to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. �w~
, Telephone Number of Person or Entity Designa ed by Owner --- �z�
o.�Y
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9. Expi2tion date of No[ice of Commencement( e e�iration date may no[be before the completion of construction and final payment to the � ln
contractor,but will be one year from the date o recording unless a different date is specified): ��N O
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT r
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 7't3.13, FLORIDA STATUTES, AND CAN ¢�
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BE�ORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have r ad the foregoing notice of commencement and that the facts stated therein are true to the best
of my knowledge and belief.
STATE OF FLORIDA �
COUNTY OF PASCO
.'Si nature of Owner or Lessee,or ets or Lesse 's uthorized
iceND i rect'or/nPa,rtnerlMQanager
V L�J�l.il
Sign tor�/s Title/Office
The foregoing instrument was acknowledged before me t is�day of�,20�b�7��a 1����.� ���D�
as e/ � (type of authoriry,e.g.,officer,t stee,attomey in fact)for
(nam bf party on be o hom instrument was executed).
� Personally Known�OR Produced Identification Notary Signature�.��/ J H-^C. �nA�
Type of Identification Produced 1 � �� Name(Prin[) l I 1 Il_L � l �f 1
�2�"�'i�"'�:;- TINA PERRIIT
:.� ; MY COMMISSION:ifFF052958
',F�..oi
'=:'F.FF,,oP:� EXPIRES September 10,2017
wpdatalbcs/noticecommencement�c053048 (407)3�i-0153 FloridallotaryService.com
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