HomeMy WebLinkAbout16-17552 CITY OF ZEPHYRHILLS
5335-8TH STREET
' . . (813)780-0020 17 52
� BUILDING PERMIT �
�
PERMIT INFORMATION LOCATION INFORMATION '
Permit Number: 17552 Address: 3517 MALACHITE DR LOT 153
Perrv�it Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class�of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book: ',
Proposed Use: MOBILE HOME PARK Lot(s): Block: (Section:
Squ�re Feet: Subdivision: EMERALD POINTE
E�t. Value: Parcel Number: 24-26-21-0040-00000-1530
Impr�v. Cost: 1,967.00 OWNER INFORMATION
Date Issued: 7/28/2016 Name: CONLEY DANA & ERNESTINE
Total Fees: 67.50 Address: 3517 MALACHITE DR LOT 153
Amoa�nt Paid: 67.50 ZEPHYRHILLS, FL. 33542 �
Date Paid: 7/28/2016 Phone: 606-232-0789
Work Desc: INSTALLATION EXTENSION CARPORT ROOF PANEL ADD 4'
1 CONTRACTOR S APPLICATIO.N FEES �
HOMEOWNER BUILDING FEE 67.50 I
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I Ins ections Re uired '
FOOTER I 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. I
' CONSTRUCTION POLE FRAME MISC. MISC.
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' REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local i overnment 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 restrictioris applicable to this property that
may b�e 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 performed in accordance with
� City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. �
� NO OCCUPANCY BEFORE C.O. �,
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� CONTRACTOR SIGNATURE PERMIT OFFI R
� PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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813-7$Q-0020 Gity of Zephyrhi!!s Perrnit Application Fax 813•�aaoo2�
• Building Department
Date Received ��/�l Phone-Contact�for Permlttin� `' –
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-Owner's Nalme �� ' ` . Owner Phone Number � � „
awne�•s a�a�ss � �f ' OwnerPhone�Humber � ' , -�
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Fee 81mplelTltleholder'Name-� ) wner Phone Number �! :�� -
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Fee SimpleIT[deholdee,�Nddress � ' "
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�JOB�0.DDRESS � � L07# �
SUBp1ViSt�N PARCEL IC►#` •- , - -
j ' `(08TAINED`FRClM"PROPERlYT1UC'NdTiCEj
WQRK PROPQSEO : - '" �;NEW CONSTR ,�:, •'"' 11DDIALT' �� SIGN _ [� Q., DEMOLIBH ' ,
I � , .. � e . INS?Al:L 8=- RERAIR� ` "
PROPOSEQ�USE . Q� 'SFR Q . "COMM'' .[� OTHER " - .
TYPE OF CONS'fRUCTION.� � � `BLOCK�' FRAME, ---=5�'fE�- ...
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Bt11LDlNG�SIZE� C�� �,3{1 FOOi'J�i1aE . , , .s _ � _ • � '
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� �,.-f •� VAlUATtOiV`�F"TO`TAL'CONS1`RCICTION , . . ,
[�ELECTRICAL $ AMP SER1lICE Q' PROC3FtE5S ENERGY 'a. �W.R.E.C., ,
[�P�UMBING $ ': ���� �
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[�GAS [�. ROOFING;. �Q SP,ECIALTY' �,_ 'OTHER �` �""�� �f�
FINISHED�L,OOR EL.EVATIONS FLOOD ZONE AREA QYES. N
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CX BUILDER � . ` , � r� GQMPANY� �°��
SIGNATUl4E � ��` RECiISTERED Y/ N FEE CURRE�� ' , ` �Y/N-..
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�►ddrea$ . ' V . License#`�� ��'
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ELECTRlCU4N� =� , - GOi41PANY n - �
SIGNATURE �"' aeGlsr�aen Y l N �cu�E� Y!N . .
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Addre� � � �.Licerise#=;- -
PLUMBER . � COMP�ANY� �: . " • , . .' '
SIGNATURE ` ' - .��P , >REGIS.TERED= -.::Y/.�N • �:cuaR��' �`Y/N:-
A�3dnass y _ , license# - -
MECHANICAL: . ._ �. � , y, < .. . >,COMPANY,. . � , ..,.,,{ � _ - ' .
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SIGNATURE ' ~": ' ' . , REGI57ERED=- •:.Y;/�N.,. t.EEE CURRET � � Y-/-lV_:;", - '
A�ldre�� '4 - . '- ,. - � _ :•� _ . ,_ . . _ ' ,;License#.. ... ., .
OTHER � " , a:: ,.' .. ; - � . ; �,CO{yllPANY._ ` . ., � ., • , : __ , � ..
SIGNATURE . : p` ` ,. ' � _ ,I2EGISTERED ,,. X/ N:_� " -FE�CURI3E�� �Y•/,:N�.,.., • -
Addee� • ,.� ;�����,; '�,,�_�r. � f �. ;F:. �,.; :r4 . �,L'ic�rnse#��—' �" �
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RESIDENTI,AL;_ ^�AkCac�i.(2�;,Plok'Plans;�(2)�:s+ats':iaf;Build�iig Plans,(1)seti'ofrEne�gy�Fiirms;"R 0=W°Permlt:fot nevy.coristruettbn; _
i .:ystillinl.�um;,ten�� _.�,......;� :: ,..: .,� ,«, � ` - {
,,. ,,,,,T µ„ (,1s0.�,workin_g;day;s:afler?`submlttal;dafe:�+Requlred.onslte;;�Ga'nstiucdon�Plans;tStortnwate�:Plans="vir/,SII#.Fence:installed,
�' ��SanEtai=yFacjli4tes&�;tac�umtPster,S14etWork;P,,+ar.mlt;�oc.stitidivl,'sionsliarge'projects:;:<.a:`s��"`�'� � ;~-- •' `.�_ � : ;�.` ,": ,
COMNlERCIi4L Attach(3)t'aomplete sets'of Bu`!l�itig`Plans plus a'Ufe Safety Page;(1}set of Energy Forms.RA W Permlt far new constructtan:
� Minimum ten(10)worlcing days after submNtal date. Requ6red onsite,,.Construcdon Plans,Stormwater Pians w!Silt Fence installed, , .,
� Sani�ry FaclliNes&:i,dump�ster.Site Work.Permlt•f4r alimew piri)e�:�All`obmmercial.requlrements must�meet`compliance ,
SlGM:PEFtMlT Attacti(2j"sets of"�ngliieeired%Ptaris;:;;�;:�r'�"�:.:; `-:_ „ , . , -
� "`"PRQPERI7.SURVEY.requlred-.fo�all:.NEW�consGvction.... _ _ � �- , • �
Dlrec!lonss � ..::��r.- . , . .. .._ . _. ,. .,., �_. ... . •
Flll out applicatlon wmpletely.
Ow+ner 8�Condactor sign back of appifcaUon,notadzed
1f'over�2500�a:Notice af Cammancemani ta raqaired. {A/C up�rades ovar S7a00)._., . - . "
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'* Agent(far ttie coniractot}°or:Powei of�lttomey(fo`r='tlte:cvuner)�wrauld be someone with notadzed letter from awner authariztng same
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'OVER�'THECt>UN.T.�R.FERIYliTTiNG�=`--:={Frcitt:of�ApP�tcationi3niyi}-.. _ ._. .;, , , w. .
Reruofs tf shi�ngles Sewers Servtce Upgredes NC Faqces.(PIoUSurveylFootage) -- - : _
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Drlvew�yra-Not aver Countar ff on�public roadw'ejis.:needs ROW
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�T10E OF DEED RE$TRICTIONS: The.undersigned.,undecgtands�:#h�t;this<p�r;mi�;.may.,�be.,subJe.ct�,to,�,deed";;rest�lctlons".f�:�`_ '
ich may.�tie:moreJre'st�ictirae��th��'Gounty��re�latfoitis�:'�Tfie`.�iiders1gned�'as�ume`sJresp�ri�Slbillt�':for`compliance with`any `
�Iicable;deed,re�tr.ictlons. � , : . :�.�s,�.:�:�.:.,�.?F_ , ,, � • _ .... ...._ _. ,.,.:_.....,.___ _ 1 �.�'��. .
ILICEN�ED_-=GONTR14C�ORS;:AND .CONTRACTOR RESPONSIH141T1�$:�•��tf°;�he�owner�:hes��hi�ed:`=a"i�r�ttactor�.or
�tractors io undertake-wo'rk :ttreV:maY;ttie�:r.�p[w{�u'ired��to:;i�e�llcensetl:ln�.'accocdance.;wtth-,staterand:�local,reg Iallons:=":If�the��r����;�=?=.
� V;_� �./ t;il`. :�_(l r� ' ':'._ i ' .i ' J.il'..�:_.aisr k..:- � ....�.� . ���.- . .. . .,
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�tracto�:is�:not�:ltcensed=�as-�re ulred�b ;law;.tioth`tl�e,owner�a"'��"""`.�`. `"":"?,�. -�. ,..,�,:, ,. . .. ; . � . .
� �� � �. .q:. y �. , . .,_.... .
� nd`Gcontractcr�may°=be-�clted:°�for'��=°misderneanot vlolation
ier state law. If the owner or Intend',ed��co.ntra�tcr,t�a�e,;:unaertaln:as,to wliat�licensing:,cequlrements:_imaya°apply�5fo�:�tF�e���s��;��-���=����
�nded wark,=the �are advlsed'to:coritact%tlie�:Pasco':County,Buiiding,`Inspectloii_:DIylslon-=Licensing:Section atT27=847-
Y '. Y�:-} '.: .. =l-' .:....::....:::.::i:::.:.,' >:,>:,.,..r.�:i
)9. Furthermor"e;�'If-the:owne���has'Fil'r�b`a°contractor'o��'contrectors,�he`Is�advised tv'have,.�he .conhacbor(s).,,slgn;. , _ -
tlons of the:"contrector Biock".,.of..thl8,:apPllcallon��for;whlch:they.,wili.,be;-r.e.sp.onsl6le,,-�Jf-you;�,as';:fhe'oviiner atgri�asi'ttie` � �-� 1� ,
. a, ..r r�--" , <'^'.,,",n�r,- e
itractor,'tliat'>may tie�an�indtcation [h�t��he Is�not''.properiy licensed`�and is='not°enfiGedVEo:permittingprtvileges tn Pasco, ,.;
un , � � � ::;,:-„:.,�f:,..;rt..�
ANSPORTATION:IMAPACT/UTIL17'I�S��YIRAC7;A �, ; ' . y!L :.` �; ,
ty, ; ; -, '� . - ... .:-�„- _ _ . �_
I�b=1�ESOUitCE RECOVERY�FEES: The-understgned'`unde�stands '�� `
tTransportatton Impact Fees:and.Reco.urse Recovery.Fees may:�:apply+#a�the constr,uction.of�new_�buildtngs;,.'.change�of"=F����"`f�°'��� �r ���
� in exisNng buildings;�ar'�expa�i'si�i�r.of��xistiR%g,li�illilings; a§�specffied.in P�sca��County Ordinance number 89-OT and
07, as amended,;;,,�h��undetsigned also;understa�ds, thg�`suoh fees�-,as ma�r''�s;,due;:,?wql���be ideniffied at the'Ltime�'of��-����'�:=;`��-:
mitting. It Is fu�the�'understood that Tra�gportation.Impect fees and�Resourae Recoii.ery�Fee§:must be�pald prior to
eFving a:"certHicate,�of=occupancy"�'or•�flnal�powec=;release. :i��the pro)��t,:does:not�involve'.a=.certifio'ate of occupancy�o�£;•:�''�4'��'
. : .-..
d power;release;�the�fees:,.mus.t;;tie�pald�prtor to,permit Is�t��nce. �F��tk�ermore;;�if�Pascdi Cauntyr:`Water/Sewer:impact,_��:._����� :.
s are due,;they�must be paid piior to,,permiE-lssuance:in_eccordance�with:applfcabte�Pasco��Gounty`ordinances. -
�NSTRUCTION'tIEN1Alf1�(Cliaptar 713�Flortda Stafutes�a�emended): tf valuatlon of work is$2�b00:00.or:mor.e;l� �: �:r�-
tify that I,,the„applicant,..�h�ve:::been�;.r�ivided.�with•-a��copy�•of=.the,,'Florida•-Construation'°;Llen=�Lau�r—Homeowner's
�,P
�tection Guide� prepared by tFie Flocida Dep�rtme�f of Agricult�re and Consnm�sr.Affairs. if the appitcant is sotneone .. :=--�n--- •
er than the`owner", I certKy,:that.I:.have�,obf�in���a��copy:of:the,abQve:.describetl"dbcu�ent�and;p.romis:e;tn;good}:faith�.to. _ �_
iver it to�thea'ownet�=prioi��to,�cvmmencemerit':':': , .,,` � . ; . ,_�`. . . . ` . . .--' � •._ ._._ _. , . .
�NTRACTOR'SIOVYNER'S AFFIDAVIT: I.cei.tity:,;t�ia�.all:�the:l�ormstton�imthl�.applicatlon is.accurate.�nd that all work
'be done in compliance.wr(th all.appltcabfe lauirs�regulatlng constructlon� zoning and:��land°;devefopment. Appltcatlon (s �
eby made:,to.,obtain•;a:permit:_:Co:�:•do.;�;wotk;=,and;"Ihstellatlon as indicafed:��;��I..�certify�tCiat no vuork=;or Installatton"'Fias
nmenced'p�lor to'Issuance of'a permit�and thaf.all work will be pertormed�to meet-standgrds_.of-all laws regulating-
istruction, County and City codes� zoning regulatians, and land development cegulations�irr`tFie:Ju�isdiction.•� �I��al'so
tify that I u�derstend that the regulations of other government agencies may�apply::to.the.:lntended:work, and that It is
responsfbility to Identiiy•what,�cttons I.must�take�o bedn:.compllance.:,Such-agencles-include�but�are:not Itmited.to.: � � �
- Department of E�lvironmental>'Pro�te'cti�n'-�4yprees''B�yhead�;`IlVetl`and-Areas and E�vironmentally Sensltive , �
Lands,WateNWast�water Treatment. - ;" - �
- Southwest Florida Water Managemen�.::l�tstrict Wells, �Cypress.*�.Bayh�ads,���Wetlaitd- Areas, Aitering �- ,
Watercourses. "� " ' � �� - � ' ' ': ,
- Army Corps of Engfneers-Seawalls��Dock`s� Navlgatile Waterways. .-
- Department,_of .Health;:.8,.ReMabllitative,ServtceslErnrttonmental-.Health Unit=Wells;�Waste.vitater��Treatment, - '
Septic�Tariks: ' � _ ' • • " - � ' �
- US Environmental�Protectlon Agency-Asbestas abatement. � � , ,
Federal Avlativn�AutMo�ty=Runways:� - � , � `
�derstand that the.follow�ng;:restrlctl.ons�apply to the use of flIL•• �
- Use of fill Is not aliowed In:Flood;;Zo,ne"V"uniess expressly.,permitted.
- If-the;flll_.materlal�=ls'-to'-:be._usetl`=lrt.�flood -Zone. 'A", (t Is underetood-that a drainage plan addresstng a
°compe�sating volume"wlll be submitted at#ime�of permltting vvt�lch is prepared by a professional englneer �
Ilcensed by��the��tateo.f'FloNda: �= . .
- If th�.flll-mat'erlat�:i���to;:be.used�fn �lood Zone 'A" In+connection�with:a���ermitted-bnilding using stem wall
� construction,.l,certify that fill:i�lD:be�:�sed only.to.flll the:.are.a..within�the:stem�wall.
- �if�flll �mate�lal'ts=fo��tie'•uBed ln any area; I'�certify that .use. of�sucfi"-flll will r�ot adversely affect adJacent .
properties. If use�of f111,is found to adversely.,�ifect"adJaEent�`praipertles,.the owner may be clted for violating ,
, . . ... .. .. _
the cond�ion.s';of th_e"ti�iilding:ap�rmit issued:under the��at�acfied_pecmit:��ppltcatlon, for:�:lots-less than one (1) -
acre which-are"elevafetl�tiy,illl;��t engtneered dralnage plan ls requlrsd. • , ' ,,
�m the A6ENT.FOR�THE<O.VIINER;°I�iromtse'�fn good falth to�'inform the�ownet of�the,_permitting condftlons.set forth in '
atfidav(t`prlor to:commencing constructlon:"1`�un,derstan:d`tfiet a,�,separate perinit may be requtred for elecMcal work�; - '; �,;
nbing, signs� wells,,.:pools;,,alr..cond(ttoning,,gas�.;or•.otbec inst�8tions:nok spec�ically included-in.the�application. �A' ,;, ' . ._. �.; �
nit issued'shall tie,conshued'to>be°a'license:to��proceed with"tFle":wo�k and nok•as:.authoNly to..violate��cancel� aiter, or ,
aslde any provisions of�'the:tecfinical:code�;•nor shall.issuance�of a.permtf.pcevent the Buildirig O�icial from thereaRer „ '�` '�
�iring a conection-��er_rors_In;plans,;conshuctlon.orvlolatlons-of�any•codes:�=Evsry�p�etmit,issued�s�hall become invalid
iss the work�aufhorized�:by'sucFi permif��s-coinrrienced`w(tFiln sfx,months�of;permit Issuance� or if work authorized by ,
permit is suspended or..abandoned.for•a�.:�.er.iod,rof;six;(6)�montfis;,:aRer the:time the�work��s commen�ed. An-extenston , `' `,
► be requested� in wcittng;.�f�om.'the Buliding,OffiElal.foc'a periodinot�to.exceed;ntnety{90)�.days�a�d wilf�demonstrate �� ��
flable cause for.�the extenstori; If work.ceases_for ninety(90)consecutive:day.s,..the)ob�is considered abandoned. '',,`, ;;
, . ,•. .. , �;���:,. ,,:.. �_ :.,. ,: ,
RNING TO OWNERc^'�YOUR.FAILURE TC1�R.EC;OR�;A:=1±lOT�GE;.OF;CCMMEMEEMENT�NFAY=RE$t1LT°IN YOUR .- -
nNG TWICE_FOR_:IMPROVEMEN�'3;TO;;YO.UI.i;RROPEI�`tY:�:�IF°:YO.UfI��E�ID YTQ�!�B�•''AIN��FINiAI�1EiNC�;�ONSULT �
- — - V � .� - �,�•- _ :" � .: . -_; ���� fs;�`i� - E - ------- ---- ------
tIDA JURA�•(F. 7.03} .. . .. � ' � , "�`' ` � � � `
IER OR AOENT ' � C.ONTRAGTO �
crlbed and swo .. (or aRirtned)be e me' Is ' Sutiscrlbed'a - (ot'atflrmedrb�fore e;fhlB.' . . � �
Is/arez - by f�-Z7-C 6 :,by , •e.�- � _ � _ . � � - u
�rs all kno�p�to•me or•haalhave prod Who•�'la•.n�per�s��ona�lI y.�cnown:to me�o,:haslhave-prod ced •
(,t��:P,rsle`[a��ildentlflcaUOri: - "�'`�d�N�-+'�U�`e"�'` '„as'Identlfica0o .
otery Publlc . 'u�1�-2- • Notary Publlc
nlsslon CbmrF�la o o.
�of Nolary typed,printed ar atemped Name`o(Notary lyped,printed or etamped
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- 7; .
� ' 36' �
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-._,:'- ; Permit No�� Q�
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Sft Setback
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YPICAL 36'X 68'�,pT
With -
" AX Concrete 26'x 63' �
. � REVIE DATE - --��
���'� ZEPNYRHI LS
� ��� ►� I�INER 1
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�C�s�'� ry , ,
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� ���K �ALL COMPL
� � ����A���� CODES
5ft Setback �� IDA Q
�� �� � ,OF � l.E��j�,��Q •
`�' z PH��i���'t9 �AP1D
R I(�qNCES
68'
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Rdd�i �-� �� . -
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. Lot#� qddress: ,
Owner:
Date:
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20 ft Setback from Inside of Curb to building �
IS ft Setback to coach.
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, Page 3 of 3 JL LotLayout 2015-01-12 '
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! City of Zephyrhills
; BUI�,I3ING PLAIV REVIEW COMMENTS
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Contractor/Homeowner: � `e � `
Date R Ieived• �f'�2 ��� ,
Site: `✓'�/� ����,r Y� �
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Permit Type: � �� `�5���� ��GGr�ht.�v�-( �t" � .
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Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
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This comment sheet shall b ept with the permit andlor plans.
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Kal I er ans Examiner Date Contractor anrl/or Homeowner
(Required when comments are present)
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� y DISCLOSIIRE STATEI�NT FOR OWNER
CITY OF ZSPHYRHILIaS BIIILDING DEPARTMENT
I. have read and fully understand and
agree to the provisioas of this instrument.
The undersigned states and affirms that he or she is desirous of coastructiag,
reuovating, adding to or reroofiag his or her o�,ra domicile, that he or she
actually occupies, or will oecupy by said domicile, and same is aot.for
rent, lease or sale. That he or she shall comply with the following coaditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owaer will comply v�rith all provisioas of the City of Zephyrhills
ordiaaaces and codes pertineat to the buildiag.
3. � That in the event various phases of construction are subcontracted, he will
eagage oaly properly liceased subcoatractors aad will personally supervise
such work.
4. That ia the eveat the Building Iaspector shall recyuire correctioas to be made,
the owaer will aesume full responsibility to iasure they are made, aad upon
completion will call for a reiaspection before proceediag with the building.
5. That the owaer shall aesu:ne full respoasibility for the constructioa and will
aot expect supervisioa of his work from the City of Zephyrhills 8uilding
Departmeat.
6. That prior to fiaal iaspection aay additioaal fees, iacludiag reinspection
fees, must be paid in full. A written request from this office ahall
constitute aa official notice to pay additiona•1 fees.
7. That the owaer shall comply with all City, State aad Federal laws ia regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owaer shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires constructioa to be done by licensed contractors. You have
applied for a permit uader an exemption to that law. The exemption allows
you, as the owner of your property, to act as your owa coatractor with certaia
restrictioas evea though you do aot have a licease. You,must provide direct
oasite superviaion of the coastructioa yourself. You may build or improve a
� one-fasnily or two-family resideace or a farm outbuilding. You may also build
, or improve a commercial buildiag, provided your costs do aot exceed $75,.000.
The buildiag or resideace must be for your own use or occupaacy. It may aot
be built or substaatially improved for sale or lease. If you sell or lease a
buildiag you have built or substaatially improved youraelf within 1 year after
the coastructioa is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violatioa of this
exemption. You may aot hire an ualiceased person to act as your coatractor or +
to supervise people workiag ou your buildiag. It is your responsibility to
make sure that people employed by you have liceases required by state law and
by county or municipal licensiag ordiaaaces. You may not delegate the
�responsibility for supervising work to a licensed coatractor who is uot
liceased to perform the work being done. Aay persoa workiag on your building
who is aot liceused must work under your direct supervision aad must be '
,employed by you, which meaas that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your conatructioa must coinply with all applicable laws, ordiaaaces, buildiag
codes, and zoaing egulatioa .
_P,�WNER'S SIGNAT �ATE � �
�{ADDRES �)
PHONE ^
WITNESS PSRMIT #
- --- _ -- - �
�
�e �Recd �/�/ �� LOT IMPROV}3MENT REQUEST Permi t No ��p /���j .
; EppOA Lot Improvement Committee & Board of Directors
F=om (please print) : ��
yot#/A i dresa: �� �� ���='�i �Z��Lr'�C�� T� � ��D I1u 2 6� � � � �
Phone number where you can be reached:����p -� �„��� � R G}
69e requeet fiPPOA approval for construction, addition to our installation, on the following:
( ) Shed ( )Laaai �)RV Port ( )Park k+iodel ( ) Cottage , ( )Concrete Slab ( ) Pavers
� ( ) Coacrete Painting ( ) RV Skirting ( ) Landscaping
- All requesta for construction/additioas/remodeling are required to have a complete,
detailed/sketch, or pamphlet of Park Model to be purchaaed with pictures, to include footprint,
aetbacka, front elevation, back elevation, left & right side elevation and top elevation. All
elevationa muat include all aizes and locations of windows and doora, with length, width and
height of the overall atructure. Park Models are to include pamphlet with picturea. In
addition, all requesta require and must include the full deacription, including color of
eiding� trim, ahutters, doors, pavera_ and concrete painting if applicable. ^PRIOR TO BBGINNING
CONSTRUCTION" a copy of the Zephyrhilla building permit and �a copy of the coatpleted engineering
plans muat be RSTIIRNED to the "LOT IMPROVSMEIdT CONIDSITTSS^, t�iese will be returned to you for
conatruction. Upon completion of your construction a complete copy of the engineering drawinga
of the atructure, (as built) permits, inepections and final permit approvals muat be returned
to the Bmerald Pointe Lot Improvement Committee for Office filing.
ALL REQUESTS MUST COMPLY WITH CURRENT REQUIRED PERMITS FROM THE CITY OF ZEPHYRHILLS,PASCO
COUNTY,OR STATE OF FLORIDA CURRENT BUILDING CODES.
Commenta:
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Lo�t Owner's Signature Date
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� Page ]of 3 OF lotimp-r.odt 70/242015
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