HomeMy WebLinkAbout16-16617 CITY OF ZEPHYRHILLS
5335-8TH STREET
. . (si3)�so-oozo 1, 617
BUILDING PERMIT
PERMIT INFORMATION ' � LOCATION INFORMATION
Permit Number: 16617 ' Address: 5121 19TH ST
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-20100-0060
Improv. Cost: 30,000.00 OWNER INFORMATION
Date Issued: 9/23/2015 Name: BACK, WILLIAM & DINA
Total Fees: 237.50 Address: 5121 19TH ST
Amount Paid: 237.50 ZEPHYRHILLS, FL. 33542
Date Paid: 9/23/2015 Phone: (813)355-1195
Work Desc: 320' SQ FT 2 RM ADDITION W/STORAGE ON DETACHED GARAGE
- CONTRACTOR S APPLICATION FEES �
BA O RUCTION BUILDING FEE 185.00 E E TRICAL FEE 17.50
BACK CONSTRUCTION PLUMBING FEE 17.50 MECHANICAL FEE 17.50
BACK CONSTRUCTION
BACK CONSTRUCTION • •
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" - Ins ections e uired � � � � �
FOOTER 2 D ROUGH PLUMB MISC INSULATIO CEI N
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: (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 maybe 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.
"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."
Complete Plans,Specifications Must Accompany Application.All work shall be pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
, �r.�� �l�J�/r`�
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
I PROTECT CARD FROM WEATHER .
813-780-0p20 City of Zephyrfiills Permit Application Fax 813-780-0021
Building bepartment -
Date Received �.2�,.- ''�,10 J� Phone.Contact for Permittin �� ✓��� - I� -�
Owner's Name wf� �� L�8R� Ownar Phone Number �J��•�ss�f/�
Owner's Address 3q�✓�� ��''��L""' ���� ���'`r Owner Phone Number G�r� �?��`3`�96
Fee Slmple Tltleholder.Name �6¢• � Owner Phone Number � �
Fee Simple Titleholder Address ��f"•
JOS AdORESS J�12.l J9� �T+�� ,z�P�Yr�ilLs��L.- 33�y2- LOT# � Y'CJ
suaaiv�sioH C�7Y v�Z-al1'�G.S PB.� P �S�'pa�c���o# //'?-��1—DD/O—ZO/Ol —0060
(OBTAINED FROM PROPERTY 7AX NQSICE)
WORK PROPOSED , e NEW CONSTR ADD T SIGN [�] Q QEMOLISH
INSTALL PAIR
PRdP03ED USE SFR Q COMM � 07HER
TYPE OF CONSTRUCTION BLOCK � Q FRAME �� STEEL Q
DESCRIPTION OF WORK �pQlrl �"Sad/J7'D�(,fcS .Z IrIlQ�.I�!� ����D1'� �rS?T3/�,�0� 11�tl �Q�T?I���I
�� i��oRr%f}�'-S �"-f?1�?
BUILDING SlZE Z� /.�'��c�STDR1�fo� SQ FOC}TAGE �2� HEIGHT �� '—�/
BUILDING $�8'�r��=b�., VA�UATI4N OF TC1TA1.CC?NSTRUCTI
_�
�ELECTRICAL $�i C�� � OC? AMP SERVICE �OZ� PROGRESS ENERGY W.R.E.C.
,�X/S�"Ti�lG
�LUMBING $ � �� � Gp �j
I .�� 1
�MECNANICAL $�f���� pt� VALUATION OF MECHANICAL INSTALLATION �G�� � �
C��S� � ��1
ROOFING Q SPECIAITY [� OTHER �,,�
FINISHED FLOOR ELEVATIONS ��s FLOOD ZONE AREA [�YES NQ � t ��
t1tiJ Nf�tJ�✓ _ �
BUILDER � w"� caMPw+rr /�4�1�'c��/�✓�--
StGNATURE REGISTHRED Y/ N FEE GURRE� Y/N
Address .����8 � �A�� Gl/�C'eY� Z�7LGS' License# �—� .��.�,.�.�
�LECTRICIAN � /�,�„ ��� COMPANY !?�'QJ�����
SIGNA7URE Kf � REGISTERED Y/ N FEE CURRE� Y/N
Addres� �'h�'/�'?E- �� p�D�P�E"'' l#cense# ��^"—""'"j(l.fi'�� ( i
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PLUMBER � � ����, COMPANY �1�D�d�
SiGNATUR� REGISTERED Y! N FEE CURRE� Y/N
Address c��E �`� �D��" License# f /t/.�� �
StGNATURE 1����ii��'"�� ROMPANY 1�n1�fJ�,P�'�uwzEn Y/N
Address rS�t'% Ff'�J�yci License# � ��'- ��
OTHER �kI/fI� COMPANY ��I�l1L�i�i�:�
StGNATtJRE REGISTERED Y/ N FEE CURRE� Y/N
Addres� +�i �}"'s ���- License# �` r�'!! f t . ���
RESIDENTIAL Attaah(2)Riot Pians,�(2)se#s of Bulidl'ng'Pians;(1)set of Energy Fortns;R-O-W Perinit for new co�struction,
M[nlmum.ten{10}wrarlcing:cfays.atter submtttat date. Required onsite,Constructian Plans;Stormwater Ptans w!Siit Fence installed,
Sanitary FacillBes&.1.dumpster Site Work;Permit for subdiv�stonsllarge projeats
COMMERCIAL Attach(3).complete sets of Buiiding Plans plus a Life.Safety Page;(1)set af Energy Farms.R•O-W Permit for new canstructio�. - --
Minimum ten(10)working days after submtttal date. Required onsite,ConstrucUon Plans,Stormwater Pians wl Silt Fence Instatled,
5anikary FaciliUss&7 dumpster.Site Wark Permit for ai!new proJects.Aii commerciai requirements must meat campllance
SIGN PERMIT Attach(2)sets of Eng(neer,ed•Flans.
*"'PROPERTY SURVEY required for ail NEW constn.�ction.
Directions:
Fill out appticaUon completety.
Oumer&Contractor siga back of applfcatlon,notarfzed
If over�2500,a Notice of Commencement[s required. (AIC upgrades over�T500}
"" Agent(for the contractor)or Power of Attomey(for fhe owner)would be someone with notarized lettec from owner authorizing same
�VER THE COUNTER PERMITTING (Front af ApplicaBon Only)
Reraafs if shingles Sewers Service Upgrades AIC Fences(Plat/Survey/Footage)
Driveways-Not over Counter if on publlc roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned under.stands�.th�t this,p�rmlt.may be,subJect to"deed" restficttons"'
which may be;more�restrlct(ve=th�n County fegulations. �'TFie undersigned assurries responsitiility for compilance with any
applicable deed restrictions. .
UNLICENSED CONTQtACTORS AND -CONTR�►CTOR RESPAPiSIBIL1YlES: if the owner has hired a contractor or
contractors to undertake work, they may be r.equlred:to be�Ilcensed In accordance.with state.and•local regulations. If the
contractor ts not Ifcensed as required�by law, both the owner and contractor�may be-clted for a�misdemeanor violatfon
under state law. If the ow►ner or intended contraetot�are uncertain as to wh�t Ilcensing.requirements may apply..�or the
intended work, they are advised to contact the Pasco County Bullding Inspectlon Divlslon--Licensing Section at 727-847-
8009. Fu�thermore, If the owner has hired a contractor or�contractors, he is advised to have the contractor(s) sign
portfons 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 tha# he is not.properly_licensed and Is.not entitled to permitting privileges In Pasco
County. � � � -
TRANSPORTATION IMPACTIUTILI'TIES 1MPAC'�ANb-RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and.•Recourse Recovery.Fees may,�:appiy to�the constPuction of new buildings, change of �
use in existing buildings, or.expansion,of�existin�,�buildings, as speclfled.in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also,understands, that such fees�.,as�may be�.due, wfll�be tdentlfied 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 flnal power-.release. :If the project�does not involve a certificate of occupancy o�
final power release, the fees must be paid prtor to permit Issuance. Furthermore;if Pasco Couniy Water/Sewer Impact
fees are due, they�must be-paid prior to permit-Issuance-in accordance with applicable Pasco�County ordinances.
COfVSTRUCTIOIV LIEfV-LAW(Chapter 713� Flor�da Statutes�as amended): If valuatlon of work is$2,500.00 or more, I
certify that I, �he applicant, have been provfded with- a copy of the "Flo�ida Construction� Lien.Law.=Homeov�rner's
Protection Guide" prepared by the Florida Department of Agric.ulture and ConsumerAffairs. if the appl(cant 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.
CONTRIlCTOR'S/OWNER'S AFFIDAVIT: I ce'rfify that all the Inf.ormation In thl.s application is accurate and that aH work
will be done in compliance with all appl(cable laws regulating construction, zoning and land development. Application is
hereby made to obtain .a permit to do work.and Installatlon as_indicafed: 'I certify 'that no wark or installatton has
commenced prior to Issuance of a permit and that.all work will be,pertorrroed to meet standards of all laws regulating-
construction, County and City codes, zoning regulatio.ns, and land development regulat(ons�in the jurisdlction. ( also
certlfy that I ur�derstand that the regulatlons of other government agencies may�apply to the intended work, and that it 1s
my responsibility to identify.what.act(ons I must take to be�ln<_conlpllance: Such agencies include but are..not Ilmited to:
- Department of Erlvironmental Protection-Gypress.'�ayheads; Viletland Area� and Environmentally Sensitive
Lands,WatedWastewater Treatment. '
- Southwrest Florida Water Management .District-Wells, Cypres5. Bayheads, INetland Areas, Alter3ng
Watercourses. - �
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. �
- Department of Health'& Rehabilitative Serv(ceslEnvironmenfal Health Unit-Wells, Wastevvater Treatment,
Septic Tanks. , .
- US Environmental Protectlon Agency-Asbestos abatement. �
Federal Avlation.Authority-Runways. .
I understand that the following.restrictlons apply to the use of flll:� ,.
- Use of fill is not;allowed in Flood Zone"V"unless expressly permltted. � � '
- If the flll materiai is to be used_in �Flood Zone "A", it (s understood fhat a drainage plan addressing a
°compensating volume" will be submitted at time,of permitting which (s prepared by,a professional engfneer
licensed by the State of Florida. �
- If ihe fill materlal is to be used in Flood �one °A" (n�connec�ion vuith.a��permitted building using stem wall
� construction,.l�certify that fill�.wlll=b.e used only.to.fill the area within the stem�wall.
- If fill material fs to be used in any area, I certify that use of such fill will. not adversely affect adjacent
properties. If use of flll is found to adVersely���ffect ad)aeent�properties,.the owner may be clted_for viofat(ng
the conditions of the building:permit issued under the_attached permit application, for lots less than one (1)
acre which are elevated by flll, an engineered dralnage plan Is required.
If i am the ACEfdT FOR THE OWNER, I;�promise in good faith to inform the owner of the permitting conditlons set forth In
this affidavlt pr(or to commencing construction. I understand that a-separate permit may be requlred for electrical work,
plumbing, signs, wells, pools; air conditioning, .gas,�or othec installattons not�spec�flcally included�in the application. .A
permit issued shall be construed to be a Itcense to proceed with the work and nat as.authority to,vlolate, cancel, al4er, or
set aside any provis(ons of the technical codes; nor shall issuance�of a.permit p�event the Bulldirig O#fiicial from thereafter
requiring a correction nf errors In plans, construction or vlolatlons of any codes. Every permit issued shall become invalid
unless the work authorized.by such permit.�ls.commenced•withln sfx.m.onths of permtt issuance, o� if work authorized by
the permit is suspended or abandoned for a period of�six(8)montFts.after the fime_the work is commenced..� An eztension
may be requested, in writing, ftom the Building.Official for a period not to exceed ninety�(90) days and wiil demonstrate
justifiable cause for.the extension�. If work ceases.for ninety(90)cons.ecutive day.s..th�job�is considered abandoned.�� �
WARNING TO OWNER: YOUR.FAILURE�TO.REC.ORD �1 NOTIGE.OF CAMIVIENCEMENT MAX RESIILT IN YOUR
PAYING TWICE FOR�IMPROV@MENTS TO YOUR;PROPERTIf. I�YO.U�IN'FEND':'TO�OB7'AIN�PIRFANEING;'C.ONSULT
WITH YUUR LENDER OR AN AfiTORNEY�BfFORE�RECOR�ING_�YOUR�NOTICE"OF COMMENCEIIfIENT:
. ---
FLORIDA JURAT_(F.S._i77.U3) - - - - ---- - - -- — - -- - ^ � -
DWNER OR AGENT CONTRAC'TOR
5ubscrtbed and swom to(or afflrmed)before me this Subscribed and'swom to(or aflirmed)�before me'thls
by •by
JVho is/are personally knovm to.me or hasR�ave produced Who Is/are p.ersonallyknown to me or haslhave produced
as identlflcatlon. as idendflcatlon.
Notary PubOc Notary Public I
:.ommisslon No. Commission No.
Vame of Notary typed,printed or stamped Name of Notary typed,printed or stamped
; , CITY OF ZEPHYRHILLS ��
5335-81'H STREET
(813)780-0020 12893
BUILDING PERMIT
Permtt Number: 12893 Address: 5121 19TH ST
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est.Value: Parcel Number: 11-26-21-0010-20100-0060
Improv. Cost: 30,000.00
Date Issued: 3/13/2012 Name: BACK, WILLIAM& DINA
Total Fees: 237.50 Address: 5121 19TH ST
Amount Paid: 237.50 ZEPHYRHILLS, FL. 33542
Date Paid: 3/13/2012 Phone: 813 355-1195 • 2oc4�
Work Dssc: 304 SQ FT ADDITtON/835 SQ FT PORCH �GARAGE ADDITION
HOMEOWNER PLUMBING FEE 17.50 MECHANICAL FEE 17.50
HOMEOWNER
HOMEOWNER
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CS�I�K)�� ��Q
FOOTER BOND DUCTS j�U�.�4TED SEWER MISC.
ROUGH ELECTRIC LINT�L s� I-1 7-L 2-c���! '1/ MISC MISC.
1ST ROUGH PLUMB '�-o PRE-METER,S� INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRESLAB l 2-� -0� SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REiNSPECTION FEES: Reinspection fees will oomply witl�Fiorlda Siatube 553.80(2)(c)when extra inspec�tlon
trips are neaessary due b�any one of tl�e followlnq reasons:a)wrong address b)oondemned work resuitlng
from faulty aonstruction c)repairs or oon�ecdons not made when inspectlons called d)work not ready for
inspectlon when catled e)permit not posbed on job sibe�plans not at job site g)work not aooesslble.
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 reoords of this oounty, and there may be additional permits required from other governmental
entities such as water management,state agencies or federal a ndes.
"Warning to owner: Your faflure fio reoord a notioe of oommencement may r+esuit tn your paying twioe f�or
Improveme�s to your properly. If you intend bo obtain flnanc3ng,oonsult with your lender or an atborney
before recor+din our notice of commenoemen�"
Comptebe Plans,Specifications Must A000mpany Applicatlon.All work shall be performed in aoaordanoe with
CI Codes and Ordinanoes.NO OCCUPANCY BEFO C.O.
.,� � ��- ,
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTNS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
� eta-�eaoozo City of Zephyrhills Permit Application Fex-e��-�eaooz�
, Bullding Departrnent
' DSte Recelved Pho�re Contect for Pertnittln 8 r 3 3$5 _ //95
, ovm�rs Name �I�Lli4A'1 A. �f1C�C. Owner Phorre Nmnber cS�7E /9d V F
� ownersAddrean.3�I/OJ'r C�d/A/�IL s!✓E. �-IHc[s.F�33Sy OwnerPhoneNumber
I Fee Slmple Tilleholder Neme Owner Phone Number
i Fee 3lmple Titleholder Addrc�a
I
�os�oor�ss S/2/ /9� S'I: Z�Yk///GGS�P�� 33 S�� LOT i �
SUBDMSION � PARCEL ID�
(oerNrrto Faow r►eoreFmTroc Nonc�
WORK PROPOSED B NEW CON57A e ADD/ALT SIGN Q Q DEMOLISH ,
INSTALL REPAIR
PROp08ED USE Q SFR �] COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DESCRIPTtON OF WORK
BUILDINO SIZE Sq FOOTAGE� HEIOHT r.�
QBUILDING S VALUATION OF TOTAL CONSTRUCTIQN
QELECTRICAL y AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING a ' � :A�'t'(�(�}�
I �T. .
QMECHANICAL a VALUATION OF MECHANICAL INSTALLATION }��CO�F� �
r
I QGAS Q ROOFINO Q SPECIALTY Q OTHER
FlNISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO
BUILDER �� h /► � _ COMPANY ��P. ' �J9MFOW�E/t
SIGNANRE «- ���� RECIs�aEo Y/ N �Ct�en Y!N
Addrosa 39Jo-S �d�^��= �'E Z N'1G[S u�rrse#
ELECTRICIAN � � �D COMPANY
SIC�NATURE <U`�'�� ReGtslERen Y/ N FEE CURqEr, Y/N
Addro� License#
PLUMBER � � � COMPANY
SIGNA7URE REGISTERED Y! N FEE CURREn Y!N
Address ucense#
MECHANICAL � � �� COMPANY
S�GNATURE REG�sr�E� Y/ N FEE qltuEn Y!N
Addroee Ucense#
OTHER COMPANY �
SI(iNATURE ` REG�s7ERED Y/ N FEE CURREn Y I N
Address Llcense#
RESIDENTIAL Attach(2)Plot Plans;(2)sets ot Bullding Plans;(1)set of Errergy Fortns;R-O-W Partnit far new constructlon,
Minlmum ten(10)worMng days atter submlltal data Required orelte,ConsWctlon Plans,Stormxater Plans w/SUt Fence irofalled,
Senifary Fedlftlea 6 1 dumpster,31te Work PermN for subdlWslonsAarge proJecfs
COMMERCIAL Altach(3)complete sets of B�rilding Plans plus a Liie SaFely Page;('I)set of Energy Fortns.R-O-W Permit for new construdlon.
Minimum ten(10)xmrk(ng days after su6mittal date. Required onslte,Construcllon Plans,Stormxrater Pians w/Sift Fence installed,
Sanilary Fadlitles 61 dianpster.Site Work Permit for all new proJecte.All wmmerdal requlrements must meet compliance
31GN PERMR Attadi(2)sets of Ergineered Plans.
"•'PROPERTY SURVEY required for all NEW construcllon.
Dlnctiona:
Fiil out appHwtion oompletely.
Owner 8 Contractor sign badc of appliptlon,notarized
If over�.{'00,a Notice of Commencament Is requlred. (A1C upgredes over f'l600)
" Agent((or the contractar)or Power af Attomey(for the owner)would be someane wfTh notarized letter from ovmer aufhorizing same
OVER THE COUNTER PERMITTING (Frnnt of Applintlon Only)
RefooTs H shingles Sewers Serviee Upgrades MC Fences(PbUSurvey/Footage)
Drlvewaya�Jot over Counter K on publ'ic roadways..needs ROW
' ' ClTY O�F ZEPHYRHlLL5
, . sa�-erH st�-r
tes3)�so-oozo 9886
j BUt1.D=NG PERMIT
�
Perm um . . �:
ParmitTyps: ADDITit3N1AlTERATICtN ZEPHYRHILLS. FL.
Clssa a�#Work: 434ADD/ALT REStDENTIAE. tawnship: RanQer: Book:
Proposed Use: NOT APPLICABl.E �ot�s): Blodc: Secdon:
Square�eet: Subdivlalon: CITY l�F ZEPHYRHILLS
�#,�/;��uo; Parc:el Numbsr: 11-26-21-0010-2010U-0060
lmprov.Cost: 49,t�0.00
Q�rte lssned: 10/27l2009 ame:
Tdal Pees: 552.00 Address: 5121 19TH ST
Amourrt Pald: 552.00 ZEPHYRHILLS, FL.33542
Date Paid: „38f�'t12�� Phone: 813 355-1195
c• 3 ! Nt 8 A 1
Pl�UM61NG i�E � .04 MECHAH1CAt.FEE 35.00
•-�'�?�� � � ,ia o
� t ly ���� `��,rar� 1'v.'.�-
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,�` ` � `�ca►'�+ �"I�+� � �s`Gt �a
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FOOTER EOND DUCTS 1NSULATED � SEWER MISC.
ROUt�N EtECTF2IG LIPYFEt, MfiSC MISC.
1ST ROUGH Pi.UMB tx' -0 PRE-METER INSULATIQN WALL MlSC.
DUCTS iNSTALLEO WAIER MISC CIRIVEWAY
PHE-SU18 t Z-t -�� SHEA'r'tlltdG MISC. MISC.
OOh1STRUCTION P'OLE FFtAME I1MSC. MlSG.
RQN ON FEES:RelmpeCtlon fYee�wtll c�a►mpty wlth�lorldi Sbtd�e SSS.80(2�c)w!�entra f
bip�aro neoe�sry due ba anr are of+tl�e fiallowtn�r+e�or�s:a}wrorp address b)aondeRmned w�ark r+esultlrp
f�am fauity aansbru+ctlw�c}r+�trs a�care+eetia�t not made wha�n f�calied c�woric not t+e�ntfy br
M�on when cafted a)permlt eat pasbed on,�att W6e!}ptans not at�ob s�ba�p}work nat aac�We.
NOTICE: in add�ion tr►the r�eqult�nents af th�permit,thene may be addttlona!�shictlons appl�ble tia this property that
may be found tn ttre public reoords of thi�aounty,and there may be addttlonal per�mits requb�ed from other gavemmental
entit�s such as water manag�ement,stabe agendes ar federal agendes.
The rtt of 1 ' fr�sha�ll be made laefore a furthe� t!�w1l1!�e issued to#he n awn same
"Warnln�bo+owner: Yaur failuro bo naoor�d a notice ot axnnEena�ement n�alr�M yrouc p�Ylny twlce tor
im�ds�a yaur praperty. It ycw Inbidnd bo ob�sin 8nandn�,cantuR vWtf�yaur len�de�r or an a#brney
be�lbr+e notloe d oamrna�cement"
� ���
CONTRAGTCIR SiC�NATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS 1NITHOIIT APPROVEQ INSPECTION
CALL FOR INSPECTION -8 HOUR NO"RCE REQUIRED
PROTECT GRD FR�'iM WEATHER
. s��-�ao-arzo City of Zephyrfiiils Permit Appiicatlan �C��j� F����-�2�
�� . ' ' au�►�o�a��
aaa n�e.ir.a ' Pnoo.CaN.a ror wm, l3 ,3'� _ ///s
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8KiH117URE ` REGre7ii� Y!„,. FEE CURREm'i�„Y/N �
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PLUYSER �� v "1� � COMPANY ��r"� �
d���� � � Y1 F�ar�rrt YtN
AddtrMi� "" � IJarft�i� � �
itEC�iANCAL w � �� CGMPANY I ��ti"�*�
�b��E Y I R�ain�mrr Y!N
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071fER "� ._o �� COIAPAlIY 1 '`"^�'"' �
BKiNA7URE OFGA�.. 1�GiS1s�Fn Y/ �aE asa�+r Y 1 tt
AddMlt �`" � 1 I
Ltcens�i�
Risl�!!TlAI. Attach(2}Pkt P4nsi(2)sett W BUIdinQ P1ans:{t)set af Ette�gN Farms:R-0�W Pamit br tsew aon�udton.
Mtntm�m ten�to)vrocktg d�ye ashr�ubmkbi t�te.R�adnd ardte.Cawnx;tlai Pian��stamwatrr Ptaw wl S/t Fr�oe d,etated,
Sadtry FadNY�s!i 1 dumpprr;8He Wak P�rtnll la wb�vbb�nf�p�i Prok�
COYNERCIAL AM�ch(t11 aompNb pb of BaMWYip Ptatr plue�Llf�SafatY P+�;(�)�l o(E�Mrs}y Fonoa.R�W Pamf!bt�ew oontYUpic�t.
MNmun Utn{14)wotklnQ Mrs aih►p#nHmi dat4. Raqctn6 matts.C�antrtxiFon P1an�.Stamw�ta�Piare W S�F�nce!nsla�d,
SaNfarY FacRtuea s t d�enptMr:Sim Wark PetmH tor ati new projedn.Atl dommerci�i reputremanta must mwt�
a�a�t►ur �u.a��sf..e�a�n�.�a r�.�.
•••'PROPERTY SURVEY requ6ed for tll kEW apnslructlon.
IIi�atifans:
F7 out appNcaUon wmpleLMy.
owne�a camredur slg,trsdc or.pp8e.�wn.noWzed
N ow!f�6Q0e a NoUe�ot C�mm�e�ctmint is�d.(AlC upptad�a ars��7iIXlj
•• I�p�M cre.n,e«2ntracto.r nr�►w a+bn,ey(ror n,.aw�r)woua be.omaa�e w�h►war�ea bqer fiom vn„e►autl�a�np eune
QVER THl:COUqTER PERMITfYdO (FrorN of AOPM�t�on OnN)
Rxooh &exers Servica Upgradss AtC F�txae{Pk,VSsrveY��Be?
o►Mw�ray��Not over Cautter if on pubNe roodwrys..neW s ROW
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SURY�Y,OF: Lote 6, 7� aa� B, Block 241 , CITY OF ZEPHYRF;Ij,y,g, ae •
per plat thereof lreoorded in Plat Book 1 , Page 54� .I'ubli� Reocst�ls �
of Pssco County, Florida. • •
-- .. .. ..�his. �s�Lif.�,,�,s.�tl�at�.�ve .�de �he surve,y a� .ahnxn hsre.on, �bt�st .:t:ts�... .. .._-_: �.� . A
eurv�,y ig correct to the best cf out� knawledge a.nd belief and �
that thie plst ie a true rep�e8enta.tion therebf.
MULLIA'8 A:�iD SHOUta `
i�,-,�. �....-�. .
io be r ho�n. lo�i 8 � �ut�ve�Er'�a .
Re�iatr�tion No. 5r1 -- , .
, FOR e F�ranc i e �:. C h�rl t on ; . �• �
ORDER NG. t�39 . � ' �� � �
January 27, t965 ' •
SI�./�-/9�J,�� � . ..
� 33s�� � . � � : .. . .
DISQ,OSURE STAT@�t]T P'OA 09�R
CITY OF ZEPHYR�I.LB HVI7�ING DEP�NT
I► �l�jl�, b . �j�Tc�- hav� r�d aad ��ully aad,�ra�lsad and
agr�e �to tho provisioas of th:i� insr�++■+�*+t.
Tho uadar■iga�d �tato� sad affirns t2�at hs or sha ia claeirous of constructiag,
r�aovati_ng. add3ng to or roroofiag hia or hor o�a donici].�, that h� or ah�
aotuslly ooaupi�s, or Kill occapy by �aid damiaa.lo, and saao is not for
r�nt, laas� or sala. That ho os sh� ahall co�ply �►ith t�►Q folloxi.aq coaditione:
1. That tho oevnar aad h� or �he alone shall sat aa th� l�uildor for �11 pbas�s. of
constsuotioa.
2. Thst th� oxn�r xill ca�ply xith all proviaioae o� the City of Z�phyrhilla
ordi.naaaon and esod�s p�rtiaoat �to th� buildiag.
3. Tlsat ia th� av�nt variou� phasas of avn�truation ar� �ubaontractad, ho M;��
�8�9e ��Y P=�=ly liau�eod subaoatraators and Ki].l poraonally aup�rvia�
� euah �rork.
i a. That i.a thr av�nt th� Building Insp�ctar shall raquir� cornationa to bo aade,
tha owanr will sss� full soapoaaibility to itisur� th�y az� aad�, aad upon
complatioa aill aall gor � rn3.nspoction bofox+� pro�g Mith tho building.
5. That th� o�nn�r shall ass� �full r�apoasibil.ity for ttu constructioa aad will
aot a�aoct aupnrvision o! hia work gro� th� City of Zaphyrhille Building
Dwparta�nt.
6. That prior to fiaa7. inap�ction any additioaal f�s, iaaludiag x�ia�ation
f�s, nust bo paid in full. A Ktitt�a r�qua:t fram this offio� shall
aonatituto an official aotiaw ta pay add�tioisal f�s.
7. That th� oxsar �ha11 aomply Kith all City, Stat� and 8��� lawa in raqard to
social aacurity, Morkaan'� compansation, lian laws, otc. , Nh� appliaablo.
8. That tho oxaar ahall oomply xith all th� safsty aocLs iesu�d by the Florids
I�trial Co�uuissioa.
9. Stato lsw r�qu�.zp coastruction to bo doaa by 1ic�asad coatractors. You lsavo
sppli�d �or a pormit uridor sn �zoption to that laM. Tha �tion sllows
you, sa t� oxaar of your prop�s�ty. to act as your ona coatrsctor �►ith a�rtaia
x�atriatioa� �v�u thouQh you do act Lsva a liooaso. You a�tta! provido diroat
onsit� suparviaioa of th� aoastructioa your��lf. You aay build or inprov� a
onw-fami.ly or txo-faaily r�sid�noo or a fasa outbuildinq. You say also build
or improve a camsvrcial building, provicLd your coata do aot �zaMd $25,000.
Th� building or r�aid�aa� �uet b� for yossr oKa na� or occupancy. It may aot
bo built or subatantially iaprov�d for sale or l�a��. 2f you anll or l�ta� a
'�,;ldinq you havo built or �ubstaatially isprov�c! your��lf xithia 1 yrar aft.�r
, t� aoa�tructioa ie aompl�t.�, th� law nill pz�s�•th:t you built or
svbat.�atially iaprov�d if for sal� or laa��, Mlsiah is a violation of this
azomption. You nay aot hir� aa unliaoaa�d porson to aat s►s your contraator or
to su�rviso p�oplo vorkiag on your buildiag. It is your r��ponsibility to
maka suz� tbst p�opl� �playQd by You ha,w lioons�� *�+,;rrd by •tst� lax snd
by aouaty or auniaipal lia�nsing or +*+� c�o. You may aot d�l�qat� tha
rosponsability for suparvisiag Mork to a lia�ma�d aoatraotor who is not
. lic�na�d to p�rfora► fih� wotk b�a.aQ dnno. Aay p�rsosi Norkit�q on your building
xho is aot liooas�d aaaat work und�r yovr dir�ct sup�xvision sad nast bo
�PloY� bY You. �vhiCh s�atie that you �ttrt daduot F.I.C.A. aad �rithholding tas
aad provid� Kork�rs'• aosp�nsata.on for t]sat a�Plc'Y'��. a11 u Pr�scsib�ci by lsM.
Your construation must cosply xitla all appliaablo lawa, o+-a+����o, *+�•;ldiaq
cod�a, aad zoairig ati e.
CJf@�:R'S SIQdATORE ��� �� DJ�:E& D" 2—� f
ADDR�SS
PH��
WITt�88 P'a18��T �
tQ W1I.L�,AM D.HACK and DINA BACK,6ia wife. whose post office addness is: �121 19th S�Zenhyrhills FL 33542
hereinaRer called t�e gwatoe:
(W6enev�r uted Ibren th�tam'�1uilor"nid'�trntee'inciude all the putip to thie inatr�m�ent and the heirn.kgal rapn,�ta6ves�nd qsipu of
� individu�6, and the wccenors Nd�seipv of cmpo�sdo�)
Wit11q3eth,thet thc g�antor,for and'ai coa4ideretion of the sum of*•*NO COTTSIDERATION��'* aad other valuable
consideiations,rec��t�vhec+eof is heroby aclmowledged,he�ebY�,ba�Sa�s�se11s,eliens,remises.neleeses,com'eys and confmns
w�to t6e grantee.nll thet cerf�n leud situate m Pasco County,Flori�,via � .
� Lot,� b, 7 and 8, Blocl�?Al, Clty of ZepLyr�ilis�a per pl�t oi th� Town of ZePb}►r�ills
recorded in Plat Boolc 1,Page 54,Publ�c Records oi P�sco Coanty,Florida.
�
�
i .
' 1'rlr lastr�e�t a�u pr+eN�e+ed b�Morroe Bmlrew So1�tlu�u,lRc.�5.�36 6TS Sb+ed.Z�ptn6111�FL 335�2.wM c�eliAa tMt
tM�'Rr�pa�d tke aae tnm i�Coroatio�sivn bo iin by!ie partla,aud a�tWar 1��orirelabtlty of tlde�or�oc�uary o[le�al
dheHpflon b Mnby�wtra�beed.
�Said property l� not the homestead oi the Gra�tor(s) a�der the law� aod const��tlon o!f�e 3bh o!Florids in ths�t udtLer
Gra�bor(s)or sny o��bers oi ttie iwoehold oi Graabr(d)rnide thereon,nor b k wnti�aous trereto.
Pe�+cel ID Ntanber:�1-?,f�21-0014�ZA100-0060 �
�,
Togdhee with all the tanements,haodi�and apptateflanas thareto belonging a in anywise appartainmg.
� To HAve aed to Hold, me s�e in fee aimple faa+ever. '
, And the �tor heroby coveneds whfi said�that the g�antar ia law6illy aeiaod of aaid lead in foo aimple;tt�et the
�antor hns Sood right�d lnwful a�hority to aell end convey eaid lead;that the giantor henRbY t�1fY waa�a tLe tRb to said laud snd wi11
defend We eeme sge.inst tbe l4wfW cla�s of all pe�soas whomsoever;and ttmt seid I�d is 6ee of all eac�nbranoes except teocn9 acauing
aubsequeta to Decmnber 31,2007.
I
i In Wltaea�Wher+eof, We said granror 6ea aigned end aealed thase pre�auts the day and year fust ebovo writbe�.
' Signec�sealed and delivered in our presence: .
� ���'� [�s�;�a....� � �
EMANUEL B.BACK «
WNna�Printed Na�ne T �- • d YI�b'L� �►�� 3903a Cifsdel Cir�7�hille,FL 33542
. � cs�n
� wtmaa rt�e V S-GD� �01'V�►v✓ Adaoera: 39036 Citado]Cir
' T9i'ODIFNEI�SIVT'Wl77NB3S&S ����FL 33342
Stete of Flaidd
Cmsmy of Paxo
The fot+egoing in�Cument wsa acimowled�ed befan me thie J,Qm day of ]uae.2008,b'Y EMANUL►L B.BACK�ad w�t[e LU1.A J.BACK.
who ielea+e pasoanlly Icnown to me or who l�se prnduoed ddver'a licen�e ee i�vrLo did/did�t Woe aa oatb.
� . �
r �t,t�w•i
� ' J09EPH ViCTOR IIORROW rY
�'• •'=MY COMMI6810N�DDOa217f t Na
EXPIREB ApM 07.2011 MY Coria4+loa L�pirex
I . (�rs�1
i
DEsn�oatriawu w.r�ry noea wim troo-c�omate.d-c�l a,F.ce
ii
N OF COMMEN T ���I���i��I��li�����I�li1��1���I1t�IN��������
Z009!',i4i39
P�rmit No. . . . Rep!s iZ7�99 R�a: 10.00
Taac Fo1io Na. J- -,,�1-�?�?(a/Q-?19/p0-L.'�L7 E�: 0.00 YT: 0.00
-r- 10127l09 DPty Clerk
THB UNDE�RSIGIVED hareby givas noti+cc that ia�ovane�ts will be.m�cie ta cactain raal ptcy�erty.and in�danae with Saxion
723.23 tffttie�Ftor�t SbmutC�,tit�fnil�iv#ng ii�Onzmdose is provided inlh#s 1qOTICL�CiI�'COi1�1�ICEMENT.
1-�of�+r c���:�g,.7.,�8�..��2�' Zo� ��r>Y�,F-r..��ly,e�ic�Gs ,
$>��ea tla�)A��'��5�'=�-�EF�1 Y.�t�,,FL 33�'�2
2.c3ona�l d�riptia►of�rad,�: ,l"��?�aa EC�''iJGyG'4d d,�[T•e.rr.r ,�_.E.X1S'�?'I/�-�cf'�•� .C'.�,•�
�,t"�,t� ,,�t_cre t�/C� �
3.Uvvna I�ficsm�ion
���v��a�:l,�JYIU�►�! �D/�/'�ck 51.2! /'9�r�,1 s'T. .�'�+y,e,rh►ct5�fY
� b)xame an;d sdd►�ss ofEa�simplc titld�alda{if ahetr thaQ ownar}�j,,,�, -
c)It�esk a�ptq�crty
4.C.anitrac�r�'I�'n�madon
a�Nat�e asd a+ddt�s: L�i�2�?II
• b)Tele�ane No.: - Fax No.(Qpt.)
S.Suray Infa�ion
a}Nama snd add�rms� ,�J}
b)Amoont of BancL• '
c)T�elepboneNa: FaxNo(C1�tt). aau�a s. a�t+Et�. � ct�ttc s cenarRa�t
�.� �$���� ��Q��33
a)x�,�a.aa�: �,�A. , - --
P�rro.
7.I&atity of pasan within ihe S�Ua,/te of Florida dqi�na�d by awna upan vvhum notIces or ot�er�may be aetved:
a)Name and ad�ne�s: j!'���F� �.�" �
b)Tat�SatteNo.: • Ft�ci+Ta(Opt.)
B.Ia ad�tion b hinn�ov�r da�ptes tbe follawing pason W t�eceivre a oopy of thc Lianor's Notke as provided in Sadion
713.13(lxb�,Flarids�: '
a}Name at�d add�ras:��, ,
b)TWephotae No.: Feac Na.(f�pl.) '
9.E�i�an dsts of Notice af Cornmenoaaoart(tic es�irniaa d:te is oue�+aur�+c�ti�e da�e oirc�o�di�olaw w�t dat�e
6 q�eei6e�'j: ,
WARNiNG'1�Q CiWNER ANY FAYMi�NTS MADE BY T.E�OW'PiEB 11FTER 1�EXPIRATIQN QF�HE NOTTCE UF
DOMMENCEIY�NT A�E CON$IDERED IMPAOP'BB PAYMEN"iS UNDEIt CNAPTRtt 913,PART I�SECTION 7'13.13,
FGt1�RIDA STAIVTEB,AND CAN R�SULT IN YO[!R PAYING TWICE t�UR IIV�ROYBMENIS T�Q YOUA P80PEBT'Y.
A NOTli�OF CO MUBT'BE BF�t.''t)ItDEU ANDPt}ST1CD{}l�t THL�OE SlT��THE FII�4I'
II�ISFECI'YON. lF YOU INTEND TO t�HT�lW F�lANCII�G�OOI�IBULT YOUR LENDLrR OR AN ATPORNEY BEI�+ORiC
COIYIIYISNCIl�TG WOAK 08RLGORDING YOUA 1�i�Dri'ICE OF 1MIIVIFNC$1�.N't:
SI'A'17SOPlLDnIDA �
couxrYOF�►s PAStss la.
8i�xia afOveezaOwmar's '
�A//L�'���? ,�AGe
� i s�r�eme '
'I71e fcl�+egoit'yg io�t wes acimdwted�gai l�ef�krie nse itiis��d�y of ��„�io�, .2d'J�.____,!iy l+L�k-!ig�., �. �c�.
+�s ��= D� ?1�"'�- (t9P�oxa�or�ity.�r o�a+r,�r
aiton�e�ii Sctj for {asoie ai p�eef}�o�e bdt�K of rryoa t�atrt�neat wn�s ezecuhd}.
PcraanaUy Knowa OR�mduced Idmtificxdian ✓ �Notary Signapn+e �R.s.yd��,,-�,
of IdarniBcatian Produced 1 c. '' ol.�t0.v�nc �,.. ����
'� n.�.�►„ ��'��!1�"'-��} �
V�pe�nt ta Se�ctia�92.525,Plorida Statutes.tTndet pp�ald� f P�,1�3'.I decine d�at I�read Ifie fo�going and dmt
the fi�statcd in it ar�true to the best of my kaawledge md bdicf. �
�n.��, �. �wr.a� �.. �Ar.-'�_
�� �•�b s�afx��s���►���are.�w�
�y ti::�mi�MaA 0�46101�
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BURV�'Y OF: Lots 6, 7. an� F', B�2.ock 2�1 , CITY OF ZEPHYft�:ILLB, �s �'
pez� plat thereof recorded in F1at Book 1 , Page 54� .Publ.ic Ftea�sz�i��
oP Pasco Coun�.y, Flarida. � '
__ .. ......�hi8...�c�t.r�if.S,�.s....t�ha�..._we -made �he suz�ve,y aa .shQl�rn .l�ere..on�, th6i� �'�h�.......r..:_... :,_. _.
surv��; is colrz�ect to the best cf ouX� lcnc��rled�e and be11eF wnd �
t,hab thia plat i� a true �ep�ese�t�.tion tt�zet�eof.
MULLIArS AI�D uHOU��
�``fA�-�� ; '� � -
Horbsrt Shoun� lo�rid��'�urvey�+a
, Re�Zlatr�.tion No. 5�1 . - �
FORt Francis E. Ch.�rlton � -' . �; •,; �
CRbER NG. 1�34 ' • : �
Jam�ary 27, 1965 ' ,.
�j���- /9��� � � � ,�
� �3.s�� . . . , : , : , .