HomeMy WebLinkAbout16-17294 CITY OF ZEPHYRHILLS
� '` 5335-8TH STREET
(813)780-0020 17 4� /
BUILDING PERMIT �
PERMIT INFORMATION LOCATION INFORMATION '
Permit Number: 17294 Address: 7050 GALL BLVD I,
Permit Type: DEMOLITION ZEPHYRHILLS, FL. I
Class of Work: 636-DEMOLITION Township: Range: Book: I
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: OWiVER INFORMATION
Date Issued: 4/27/2016 Name: FL HOSPITAL ZEPHYRHILLS
Total Fees: 75.00 Address: 7050 GALL BLVD
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542
Date Paid: 4/27/2016 Phone: (813)783-6189
Work Desc: DEMOLITION FOR RENOVATION TO ER & ORTHO
CONTRACTOR S APPLICATION FEES
BRASFIELD & GORRIE LLC DEMOLITION 75.00
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Ins ections Re uired
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 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 property. 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
Ci Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
O OCCUPANCY BEFORE C.O.
CONTRACTOR GNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 M NTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHEIt
813-780-002Q City of Zephyrhills Permit Application Fax 813-780-OQ21
� , Buitding Department
a
Date Eteaelved Phane Contacfifor Permittln ' 7� �� `� _ t ���
Owner's Name W +�-��/C' ��5���� �`�- �� �Awner Phone Number
Owner's Address Owner•Phone Number r- �
Fee Simpte Titleholder Name � � Owner Phone Number � � ,
'� '••_� .�
' Fee 3lmple Titleholder Addres� '"
JOB ADDRESS �� � ��� �L � f"F���5 FL LOT# C�
SUBDIVISION � � PARCEL.IR# �
(OBTAINED'FROM'PROPERTY TAX NOTICE)
WOR1C PROF'OSED `� NEW CONSTR ADD/At.T � SIGN Q � Q DEMOLtSH -
INSTAL,L REPAIR
; PR4P05ED USE Q SFR � GOtu1M [� OTHER"
TYPE OF CONSTRUCI'ION � Q BLOCK " �Q � FRAME � STEEL Q, �
i' J� t
DESCR�P110N OF WORK ', i/�M�� l�I G� -
BUt�DtNGSi2E � � SQ FOOTAGE�� HEIGHT ���
o����a,N� C . � -� -�_ �,_. . ._ _
VALUAi'iON OF TOTAL CONSTRCICTION
QELECTR1GAl. $��. � AMP SERVICE ' Q FROGRESS ENERGY Q W.R.E.C.
�..�
� �PLC1M8lNG ���
I
( QMECHANiCAI $ V,4LUATION t?F MECMANIGAt,tNSTAl6ATlON
, ..
�i OGA3 Q RQQFlNG Q SPECtRi.Tl [�] OTHER
FINISHED FLOOR ELEVATIONS r`� FLOOD ZONE AREA [�YES: NO
L
�ui���R � � CflMpA�IY �`����L1� ��r'`�t�1�
SIGNATURE REGISTERED N �e cuttRen N
Address Cicensa# C��� r7 4-���o� ��
E�EC't'RICIAN COMPANY '
SIGNATURE �' REGISTERED Y/ N FEE CUFtRE� Y/N
Address `Ltcense�#,� �
PLt1MBER COMP.ANY- , ,
SIGNATURE REGISTERED � ,Y/.N � •FEE CURRE� Y/N.
/lddre8S . LiCQ11SA# � �
i MECHAi�ilCitl: , .COMPAFtY
,, SIGNATURE ,Re�is7�o _Y.;/ N ,Fee cuw�en Y/�N' .
; Addre�s` , t : , ° . _ � _� Llcense# � I
��� O'iHER , COMPANY �� � - . - -
SIGN�TURE ' rtEG�STE�o Y/ N>.. ; �EEcurt�� . ; Y%N� .
� Addr�ss . . _.. `;- . .. ._ , _ . .. � . . _ '-Li�cense# �� �
RESID�NTIAL� -Attai�.2 P!o#`;P.,lan's�.:� SA�S-Of k� { _ , „ '- • ' , j 4. `Y:�, : ��-:. ��<.,.'.� ,
{ )` ,.( }. 8ultding'Plaris;(4}sef of=Energy;Foilns;12-0=W�Perinit:for.iieini,,c9nstruc#ton,.,�
. . . 9 . " _ .- , - ... . . �. ..,:. ,: _,
Minimum,.ten;(10.)�workin �;days�afte'r„'su6mittal"date.�Requlred onstte,•Constitiction�Plans;�Stortnwate�'Plans w/Sllt Fence tnstalled,
�� �Sanitary�FaciltUesr&a1{dumpste_r,�-SIte:WorlcAPerrnft,forsutidivislons/lerge`proJects�'',`=��';;',� °,_ ':s� " �`
COMMERCIAL Attach{3}'coinplete`.s`e#s tif Btillding�Pians plus a'l:lfe Safety Page;(1}set of Energy Forms.R-{?W Petmtt for new canstructton.
h7�nirr�um ten(10)worktng days after submittal date. Requlred onsite,GanstrucNan Plans,Stormwater Plans w/Silt Fence installed,
Sanlfary Fadlitles&1 dumpster.Site Work Permtt_for�It n+auv`proJects.All commercial requirements must.mest camp4fance
S16N PERMIT Attacli{2)"sets ot"Engineer.ed;,Plans;,.;,,,.�, • . - . . .
' """PROPERTY SUR1lEY regulretl for;all NEl(V construction..
Dlreatlans: ;, .`::.. _
�� FIII out epplicaUon completely.
Owner 8 Contracto�sign back-of appllcallon,notatized
j if over 52500,a Natice afCommencement is requlred. (�4/C upgmdes over f7500)
� �„ t`�.,is t��:rr.,,
li Agent(for th�e contracfor)or:Pbwe`r of Attorriey-(fo�#ti'e�owner)would be�someone with notarized letter from owner autho�izing same
' "C)VER THE CQUidTER..P.EitMl'fTiNG -- (Front-of�ApPlica�orrOniy)
� Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
i Drivswaya-Not over Counter N on pubiic roadways.needs ROW
t .. �.
NQTICE OF DEED RESTRlCTfI?�l�: The:.uttdersigned�.under�;�ta,nd5;th�t.#hls,pg�rmi#.may.be�subJec�,to_�deed"restrtcttans"-: �� „
which may be~moresrestcict(ve�th�n Gaunty.'ieg�latrons: --r�;e��-uriaer�i�nea"assumes;responsibifity`for compltance°with ariy �" � �
applicable�deed rest�ictlons. � . • - � ' • .. � �_ • .
UNl.i�ENSED•;CQNTRACTOR5.AND -CONT#ZACTOR RESP�NSI�ILITt�S:�-�{f-tiie owrter°has��'hired�a`�cantractor ar
contraotors to undertake work, they m�y.be��r.equlre.d<:.toa'be;licensed.In�accordance.wlth_state,and:-local,:regulatians:��If khe •
contracto�.i��.not-�licenseil��as�:cequlred``6y law, bot�i'the owner an�l��contcactoT=�`mi�y�be-•cEted�fiir=a;.inisdemea�or vioiatton
under state law. If the awner ar intend:ed:cant�a,ctor.are::unce�tain es to what Iicensing.requ,irements:,;meynapply�io�>utfie•- -�� � °-� '
�., ... �r „
intended wark, they are advised'to coritack'ktie Pasco..County�ullding�lnspecttan._Divisloi)y-1:Icensing Sectton at 727-847-
8009. FurE�terinore; #ftheAowner lias�=fitred a ciinfr"actai"r`ot�coritractors� he is ailvi�ed tc have'the con#ractar(s},,sign
portians of the"contrackor Bloak° of.;this appllcatlon for.which,they will�be.r.esponsl6le. .If�.y.ou;-�as:.the'owner:'sign'as�'fiie �� ' `�
contractor, that�tnay be=an indEcatlon�Etiat=he�#s'�ot�:prope�y tEcensed arid-'Is`'iiot`+entl�eil to petnilt##iig piiulleges in Pasca. .
Counky. �. . .. . •L, _ � , .. - , - . ,. _
TRANSPORTA7IQN.-lMPACT/UTlLITI�S�IMRAC'T A(�b��tES011�tCE RECOYERY�FEES;�The un�erslgne�d�understands
thatTranspartation impact fees.and.Recoarse Recave.ry,Fees may�appiy��#a�tFie construction_af.new.buildinSs;:.chan�e°6f � '
use in existing bulldings;:o�':expansi�in��of��riil�tin�:°�6uildings; a�s spectfled.in Pasco County Ot`dinanae number 89-07 and
90-OT, as amended,�,�he unde�signed a1so,.understands� tha�=suct�fees„as�ma}�:be�..due;�will>�be lderitl#led at the�time":,ofz� =:��.. ~
permikting. It is furt�ier unders'tood thet Transpo�tatlon Impact Fees and�Resoutce Rec6very�Fees.,musf be pald prio�to
rece�vtng a�"ce�flflc�te.of occupancy°�or€inal�-power=release. :!f`the proj�ct,,does':nqt tnvotve.a--cert�tcats af occupancy or
final power release;:the fees-.mu�t�tie paid�prior ta permit issuance. F�rthermore;:�if Pasco�County�lNaterJSe.wec,-:imp�ct -
fees are due�they.must_be-paid•_pNor to,permlt•lssuance��n accardance.wltfi;appAcable Pasco�.Caunty ocdinances.
CONSTRUCTI�N"i:lEN`L.A1t�{Ch�pter 713,Fla�tda Stahttes,as�m�ndedj: if vatuation of work is$2,500.00<armore;i
certify that I, the .applicant, have-been�_pravided-�with, a~copy of:the "Elorida��Cons#ruction Llen Lav�-�-Hom�owner's
Protection Gu1de" prepared by#1�e Flo�lda Departmerjt�of Ag�fcult�re and Consumer�Af�alrs. If the appllcant Is someone - ,
nthe�than th$'owner", I aertlij►,th�t.l_.have,obtained1a copy.of the,above..descrltied tlociir�ent°,and:promise�'In<goad faith to
deliver It to-the_'owne�'�p�ior�to�comrriencemerit:'-� . , � . . `
CONTRACTOR'S/CIWNER'S AFFIIDAVIT: 1.ce�#Ky;,that ell:tha�;lnformatiorr in this application is accurate�nd that atl work
will�be done in compllance with all.appl(cable'laws regulatlng aonstruotlon, aoning and��land devefopment. Appltcatton !s
hereby made to ob#a1n .a.permEt..to:da,worlc;4and� lhstallatlon as {ndt�efed.��,. `I certifjr�t�ist na woric�or Installatlan has
commenced p�(or ta Issuance of a pennlf"and that.all work will be pertormed to meet standards of all laws regulaking-
const�u�tlon, Gounty and City codes, zoning regulations, �nd tand develapment regulations-in the'jurisdiction. 1 also
certify that I unders#and that the regulations of other government agencles may�apply�#a the lntended work, and that it is
my responsibllity to Iden#ify�what.act(ons I.must•take to beYln:.conlpllance. Suoh agencles Include but�are.not Ilmtted.to: '
- Dep�`rtmen# af Etivlronment$t�'Protectibn=Cyptess.Bayheai#�,�WeNand.Areas snd Envfronmentally 5ensitive
I.ands,WaterlWastewater Trea#ment. s �
- Sou#hwesi Ftorida V1later Mana�ement ..t�fstrlcE-Wells,> -Cl►Pres�. Baytieads; Wet�and Areas, Alte�ing
Waterca�urses.
- Army Corps of EngfneersSeawalls,Dacks�Navlgable Wateruvays.
- Department of.Health-8 Ret�ab{Iitafive Services/Environmenfat Health Unit_WeO.s� Wastewater Treatment, `
Sept(c Tanks. � � - . � �
- US EnviEonmental Protectlon Agency-Asbestos�batement. _ ,
- Federal Avlak�an_Authorlty-Runways.
1 wderstat�d that the follciwing�cesUlc#ions apply to the use of fllt:
- Use of ff{I is not atiaviied in Flood Zone"V"untess expressty permltted.
- If the fill�materlal 'Is to be used: In ��lood Zone "A". It ts understoad that a dralnage plan addressing a
"compensating volume"w18 be submltted at#ime of permifting whlch is prepared by a prafess#anal englneer
Ilcensed by#he State~of floftda: � _
- tf ihe fftl materlat��.is:to be used in ftood Zona 'A" in�cannection�wtth.�a'�ermffted bt�iltling us�ng stem wall
� canstruction, I certify that fill:wall.be used oNy.to.fiil#he.area withln the•stem�wall.
- If flA materlal Is ta be used-ln eny area� 1"�certlfy that .use. af such�flll wlll not adversely affect adjacent
properties. 1f use�of#ilt Is t'onncF#o advetsely.�ffecf adja�erit•�prctperties,.the owner may be aited for viol"ating
khe conditions-of the"building::permit Issued�under the at�cfied permit appllcatlon, for:lots less:.than.one (1)
acre whtch are eleva#eil�by�fll�,a�t engEneered dralnage plan[s requlred. .
If I am the A13�NT.FOR THE OWNER,'I;:promise In good falth#a inform the=owner af-the permltting condltlans set forth In '
this affidavlt'�prlor to commericing coristrvctlort. "1'understand that a�se�arate perntlt may be requlrec!for etectrlcat work,
-s^Y-r"*f}'f�' 4 '�
plumbing, signs, welts,:pools; air_.condttiaMng,.,gas,:oT othec insf�tCa#tons no�.spec�tcatly included-in the�apptication. .A �
permit issued shall be�coristrued to-6e�°Ilcense-ta��proceed wlth'Ehe'wo�k and not as�authodty to..vlolate,�cancel, alter, ar !
set aside any provEsfons of the techcilcal.codes;�nar shall tssuance�of a.permlt.pcevent tl3e Bulldlrig OffEclal from thereafter � ��
requlring a correction.nf errars In�;pians, consfructlan or vlolatlons�of any codes. .Every.p�rmlt Issued sfialFbecome invalid
unless the work authorized:by such permltis.commencedvSrtthln.s�C=manth� of�permlt fssuancej or If vvark authorized by ,
�he permit is suspended_or..abandoned Ffor:a.:period�of;six f 8}�manfiis:.after the time#he�wark�is commenced. An ex#enslan
may be requested, In writing,.from`the Buil`ding'Officlal�for a perlod.:not to.exceed�nlnety(90) days and w111 demonstrate
ust�iable cause for.�#he extensio�: tf�rork ceas�es:for nl�ety{90}cons.ecuttve:day.s�..th��ob=�s�considered abaadoned. �,
_ . ,;
NARNlNG Tt? QWNfR; YOUk_FAll.fJRE T4sRE�QEtD�:A-,NQTIGE<Of:C+QMME�+IEEMENT.NtAY RESULT IN�YOUR
�'AYING'fWiCE.FORiMPRO�/.EMEN�S�TO.Y�OUt�:PROpERT1f.��;IF°YO.U�If!1'�E�t��'TO'�IB��AIN•� IN�1N ;'CONSULT '
IT Y U ND �O� AI� TTO �.� PO'. �� . O G`; f:7 ' , ;� ° �- �
�t,OR�OA.J!lRA�'{F.S:117.03} ---- , - _, . , .. . � '
)WNER Ott AOENT . CONTRACTO- - - - - - -�- -- - - - — — — _ -
iubscrttted and sworn to(or afflnned)before me thls Subscrlbed and'suvam�to(at flrmed}�befa Uii� .
by �by -
Vho Islare pe�sonelly known to.me or has/have produced Who:ls/are p.ersonellyknown hs me or.has/have,�roduced
as Ide»�fl�Bon. � as Iden��ca8on,
Notery Pubttc _ Notary Publlc
commisslon No, Cam�G�slon Na.
lame of Natary lyped,ptlnted or stampert Name of Notary typed,ptlnted or atampsd
i