HomeMy WebLinkAbout16-17279 CITY OF ZEPHYRHILLS '
5335-STH STREET
� (s13)�so-oo20 17279
�� MOBILE HOME SET-UP
- PERMIT INFORMATION - LOCATION INFORMATION
Permit Number: 17279 � Address: 7��Bi�D -7Zi5�,)-c/
Permit Type: MOBILE HOME ZEPHYRHILLS, FL.
Class of Work: MOBILE HOME SET-UP Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 35-25-21-0010-10500-0000
Improv. Cost: OWNER INFORMATION
Date Issued: 4/27/2016 Name: FL HOSPITAL ZEPHYRHILLS �
Total Fees: 140.00 Address: � �Z�-��%1' t
Amount Paid: 140.00 ZEPHYRHILLS, FL. 33542 ��'j��
Date Paid: 4/27/2016 Phone: (813)783-6189
Work Desc: TEMPORARY CONSTRUCTION OFFICE TRAILOR SET UP
CONTRACTOR S APPLICATION FEES
PG ELECTRIC INC. M BILE OME ELECTRICAL 40.00 MOBILE OME SET-UP 60.00
SEALANDER CONTRACTOR SERVICES I� MOBILE HOME PLUMBING 40.00
BRASFIELD&GORRIE LLC
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Ins ections Re uired
M BILE HOME SET-UP
MOBILE HOME ELECTRIC
MOBILE HOME A/C
MOBILE HOME PLUMBING
FINAL
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
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
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
CONTRACTO IGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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GENEpALCOHTRACTORS
To Whom It May Concern:
Tl�is letter is atithorization for Tim D�ryer, Peyton Robertson, Ren Tilden, George Paulson,
Tim Dealing, Lariry Grubb, Scott Keeler, �rik Sl�arpe, Sean Sweenej�, Jim�1lspermatul,
Jerry Whitf eld;Daviti�Shub.erg,'Mike Nolaii, Tim Joluison, Erik Lindquist,Richard Dalbo,
Rick Scheer, Craig Cai�tcr,L1�n•eiice, Anson Cottle, Jr.Wise; Ryan Whiteside,Matt Long,
Cluistian Bond, Josh Joluiston; John Trickey, Clll'15t1 TOI]IlS011, Se111 QUllll]', CI1T15 II11't117111,
Ivlike Sells, Josh Boi�d,;Tiiu Cleiiieiii,.Clu�i"s rvans,Michelle Vi7hitesicie, I'i�ed Henderson, Betsy
IVlarkliain, Will Sinitli,.Michael Chandler, Beii I'eterseil, Jinibo Cross,E1dam Co���aii, CI1T15
Loft,Ivlichael Peters;Eric Manning, Ryan Whiteside,Mattl�e��Sz��orka; Leon Keei�e, Justiii
Lomaa, Steven D�lffy, Thoivas Marcum,.Toe Gaspard, Justiii Greene,Beii l3radley,Tanid
Paredes;Patrick.l'ouncey, Clu�is Gregory, JT Sanders, Ben Rives, JC Petersen, Charles I�•ug,
Kcith Ivlerkel, Tiickei S�iure,Jesse Durliaiii, Sfeven Macaione,_Jacoli Stex•n,Dwayne GiUson,
James �ckat�t, Reecl_Leone, Bi•yce McClaiialiaii, Briaii Scliellhanuner, Clu•is Stioiig, Brian
Smilli and Jeff Puckctt to sign on velialf of tlie couipany for Perniit(s), Regish�ation(s);�uid/or
Application(s) for projects in the State of rlorida. `
Si�c i� ly, ,
C
Diii _.evas
Vicc President
Liceiise�F CGC 1'S08067
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Vditiiess Date
' r'Z-d`--� t'�
Wit�iess Date
STAT�Ur I'lorida �
OOLJNTY OF Orange
Sti sci•ibed, s�vorn to and aclaio«�ledged vefore me oii this�day of��_,
20�.
o arv Pu ic� ��I,J r`J" _
M� Con �S ion �xpi es�v ,` `�'�� �
�4-"Y P�,q�� Notery Public Steto of Florida
t1�-l r� �� ��� . lCiley Lynn Wagenschnur
V j ol� ���Q My Commission FF 040295
�RASFIELD&GOhRIE,LLC of R Expiros 07/28Y1017
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813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021
Building Department
Data Rec�ived Phone•Conta "for Permittfn �Z-� 2 Z'�'( ` �3 y�p
_ ,__----- — -- -=---=—=--- ---- - G-- ?
Owner's Name I�LD�(�A �}aS Q(T�L 2�H�t���LL-� Owner Phone Number O�)"' D?j" �O Z�
Owner's Address �YD�� �{V�E���t� j)2, S�'2ryj %i4�`p�l�nerPhone Number
` SAME Ai owN� - - 37
Fee Simple Tltleholder Name Owner Phone Number
Fee Simple TitleholderAddress S�M'C � 0 w��t '
JOB ADDRESS l��O �^'�1��►�.- ��-'�Y - Zl�'I LLS �L 33 5'�t LOT�# �
SUBDIVISION � PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
' INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME Q STEEL Q
DESCRIPTION OF WORK �CM P C,v N S�YL,��CT 1�� d FF I C-E ! iv ' �L�S
BUILDING SIZE SQ FOOTAGE� HEIGHT .
Q BUILDING $ VALUATION`�OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE [� b�&A6RE�S.S ENERGY
R Q W.R.E.C..
�
QPLUMBING $
QMECHANICAL $ VALUATION OF MECHANICAI INSTALLATIOM r D��/v
�GAS Q ROOFING Q SPECIALTY Q OTHER �(J�� �
FINISHED FLOOR ELEVATIONS N A FLOOD ZONE AREA QYES. NO
BUILDER COMPANY bRASF(ELDd-G��2�L
SIGNATURE REGISTERED Y N FEE CURRE� N
Add�ess qK( � M�s� 3�va 4�l�HTQ2 �RRK rL 3 `L� l:icense# �C (, 'rJvS���
� , _ - �G oda��g� /� PC-� ���2,t
ELECTRICIAN �„�� � COMPANY
SIGNATURE REGISTERED / N FEE CURRE� Y/N
Address �License# �C ���� �
PLUMBER COkIPANY � L���'�r�_ C�p�'l"2s`�'�o���1;�5 �,',
SIGNATURE � � � REGISTERED / N FEE CURRE� Y/N
Address License#
MECHANICAL n( (� " COMPANY
SIGNATURE REGISTERED Y./ N FEE CURREA Y/-N'
Address License#
OTHER �S/� COMPANY
SIGNATURE � REGISTERED Y/ N F.EE CURRE� Y./N
Addreu License#
RESIDENTIAL Attach(2)..PIot:Plans;:(2)sets=of�8uilding`Plans;(1)sef of Energy�Fortns;_R-0=W Permlt:for new,construction,
Mlnimum ten::(:10);working days:after's�ibmittal date. .Required onsite,Construction'Plans�Stortnwa4er Plans w/Silt Fence installed,
Sanitary Facilldes:&rl,dumpste,r.,.Slte Work�Pertnit for"sutidiqi'slons/large proJects. ��-� ' � -
COMMERCIAL Attach(3)�completo se4s'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. Requlred onsite,Construcdon Plans,Stormwater Plans w/SilYFence installed,
Sanihary Facilitles&1 dumpster:Site Work Permit for.,all new projects.All commercial.requl�ments must meet compllance
SIGN PERMIT Attach"(2)`sets of Engineered;Plans.;.,. ;�� -
""PROPERTY SURVIEY.reguired,for:all.NEW.construcUon. � _
Directlons:
FIII aut application completely.
Owner&Contractor sign back of applicaUon,notarized
If over E2500,a Notic�of Commencement ta required. (A/C upgrades over 57500)
.� �.
'" Agent(for the contra�tor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
DVER.THE,COUNTfR;,PERMITTING:,�.;��,.(Front of Application Only)
Reroofs if shingles; �_Sewers;.��, $ervice Upgredes A/C Fences(PlodSurvey/Footage)
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Driveways=Not over�Counter if on.putilic roailways..needs ROW _ _ ._.__:,___ - -, _ .. ,_ .
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POWER OF ATTORNEY
Date: 4/19/16
I hereby natne and appoini Julie Bennett
�� APG Electric, II1C. to be my]ativful attorney
In fact to act for me and apply to the City of Zephyrhills
�
Building Department for an Electrical permit
Por work to be performed at a location described as:
Section Township Range Lot Block i
Subdivision SITE: Florida Hos�ital Zephyrhills,7050 Gall Blvd,Ze�hyrhills FL 33541
on File
(Owner of Property and Address)
and to si�n my name and do all things`necessary to this appointment.
1
John R. Kavula��EC0000486
Type or P ' Nam� is�er or Certified Co�tractor and Contractor's License Number
-y`1 \ /
' ` Signatur fb�egist r or Certified Contractor
Tfte foregoing instrument was acknowledged before me this 7 day of A�ril of 2016
- By �'lr� 1Z �Vc�..�ez�
Who is personally l:nown to me/�vho produced
As identification and who did not take oath.
Staie of Florida -
""'' SHERRY TEW
Pinellas :���� Commissiori�t FF 160414
Coanty of �, °•= E;cpires October7,2018
`?,�R..���� omc:a n.�r�%v�iN�..�.eooaesao�e
---��i/� ./�C�,� Seal
Notary Pu ic, Pinellas County,Florida
2/12/2008
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