HomeMy WebLinkAbout18-19909 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19909
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 19909 Address: 37943 EILAND BLVD
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD/ALT COMMERCIAL Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 03-26-21-0010-06400-0030
Improv. Cost: 122,500.00 OWNER INFORMATION
Date Issued: 7/31/2018 Name: FEDJO REALTY CORP C/O CVS PHARM
Total Fees: 1,117.50 Address: ONE CVS DR
Amount Paid: 1,117.50 WOONSOCKET, RI. 02895-6146
Date Paid: 7/31/2018 Phone: (401)770-5784
Work Desc: RENOVATIONS INTERIOR/SITE/PARKINGLOT EXPANSION
CONTRACTORS APPLICATION FEES
ASA CARLTON INC BUILDING FEE 847.50
R J MARTIN ELECTRICAL CONTRACTIN ELECTRICAL FEE 202.50
FRED LEPLEY BUILDING & PLUMBING PLUMBING FEE 67.50
pA
Ins ections Required,
FOOTER 2ND ROUGH PL MB MIS(; 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: (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 rinspection,whichever is greater,for each such subsequent rinspection.
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 performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
1\j CONTRACTOR SIGNATI.�RE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
{ 2018128719
Permit No. Parcel ID No
NOTICE OF COMMENCEMENT
State of � County of y
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement:
1. Description of Property:: Parcel Identification No. 01
Street Address: ✓1141� tiy,+xp In .��f t,
o� fO
054
2. General Description of Improvement /V
jzeM eylr9-n�KS) AF ftrv-two Sfir�-r�DINI ff lhR'�
3. Owner Information or
Lessee
information if the Lessee contracted for the improvement:
Address w City State '
Interest in Property:
Name of Fee Simple Titleholder:
lZ�f lis a abo/*3* H n/ , Aiz„, I
Address
State
4. Contractor: S/
C
Name 90� •�1m Pao Cm�n ���� Gk
Address el el /� /- City State
Contractor's Telephone No.: "{el L `l — ;k 5
5. Surety:
Name
Address City State
Amount of Bond: $ Telephone No.:
6. Lender:
Name
Rcpt:1978184 Rec.: 18.50
Address DS: 0.00 I T: 0.00 State
Lender's Telephone No.: 07/31/2018 M. F. , Dpty Clerk
7. Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)(7), Florida Statutes:
Name
PAULA S.O'NEIL,Ph.D.PASCO CLERK & COMPTROLLER,
Address 07/31/2018 1}0'�„24 m 1 36511
°y¢�q q State
Telephone Number of Designated Person:
OR BK 9764 PG 3 i i
8. In addition to himself,the owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
Telephone Number of Person or Entity Designated by Owner:
9. Expiration date of Notice of Commencement (the expiration date may not be before the completion of construction and final payment to the
contractor,but will be one year from the date of recording unless a different date is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, 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 vs,
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
f� I
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the bests
of my knowledge and belief.
STATE O
COUNTY O
4anature of Owner or Lessee,or Owner's or Lessee's Authorized
Officer/Director/Partner/Manager
---
The foregoing instrument was cknowledged before me this-day of 20 -by
as `;j:lla?_a . . ;of;autho t ,e.ft: b6: y g.,officer,trustee,attorney in fact) Or `-
- f ��s behalf of whom instrument was executed).
Personally Known t4R Produced Identification❑ Notar :ignatii
Type of Identification Produced : ra A.Vol 11
'+ yS of ode Island
sI expires 4/26/2019
HO
����(111111111
wpd ata/bcs/n oticecommen cement_pc053048
OR BK 9764 n 3612
2 of 2
EXHIBIT"A"
LEGAL DESCRIPTION
OR BK 4337 PG 9� 98
3 of 4
A portion of Tract 64, ZEPHYREILLS COLONY COMPANY LANDS, as recorded in Plat Book 2, Pace
6, public records of Pasco County, Florida, being in Section 3, Township 26 South, Range
21 East, being more particularly described as follows:
For a point of reference commence at the Southeast corner of the Northeast 1/4 of said
Section 3; thence North 89 deg 41 min 31 sac West along the South boundary of said
Northeast 1/4, a distance of 94.08 feet; thence departing said South boundary, North 00
deg 18 min 29 sac East, a distance of 31.00 feet to a point on the Northerly right-of-way
line of State Road 54 (as it now exists) ; thence North 89 deg 41 min 31 sac West along
said Northerly right-of-way line, a distance of 10.00 feet to a point on the Westerly
boundary of a certain parcel as described in O.R. Book 1223, Page 1713 of the public
records of Pasco County, Florida for a POINT OF BEGINNING. thence departing said Westerly
boundary, North 89 deg 41 min 31 sac West along said Northerly right-of-way line, a
distance of 55.21 feet, thence North 88 deg 57 min 25 sac West along said Northerly
right-of-way line, a distance of 133.94 feet, thence departing said Northerly right-of-way
line, North 00 deg 28 min 16 sac East, a distance of 207.28 feet; thence North 89 deg 41
min 31 sac West, a distance of 170.90 feet; thence North 00 deg 28 min 18 sac East, a
distance of 90.92 feet; thence South 89 deg 44 min 00 sac East, a distance of 370.13 feet
to a point on the Westerly right-of-way of U.S. Highway 301 (as it now exists) ; thence
South 00 deg 28 min 18 sac West along,said Westerly right-of-way, a distance of 296.19
feet to the Northeast comer of said certain parcel; thence North 89 deg 41 min 31 sac
West along the Northerly boundary of said certain parcel, a distance of 10.00 feet; thencel
South 00 deg 28 min 19 sac West along the Westerly boundary of said certain parcel, a
distance of 4.00 feet to the POINT OF BEGINNING.
TOGETHER WITH those certain non-exclusive easements as set forth in Declaration of
Reciprocal Easements and Restrictive Covenants recorded February 9, 1998 in O.R. Book
3878, Page 33 of the public records of Pasco County, Florida.
Sembler/Eckerd @ Zephyrhills (30335-0406)
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}
alsaaD•oozD City,Of ZephyrhillsPermit Application F8x-813.780-0O21
Building Department €'r t+��r�rrSG 5
Data Received; Phone Contact for Permitting t ) t!J."-3
I tI t:taiA 1_Li1I mo{. , . . ..
Owner s Name .f/ti"Y r f41 }� } J ��p q Oviner Phone Nurtiber
Owner's Address it+�`7f(✓}� Q '�' Owner Phone Number
FoeSimpteT?Uehbldet.Aame t ILL 1 "r / Owner Phone Number
Pee Slmple..IitleholdefAddress
30S ADDRESS '" + +•i11Y 't'r''Ij LOTV
SUBDIVISION PARCEL ID;
tOSTAINEO MCIA PROPERTY TAX NOTtC%
' YJOR(i PROPOSE'O. NEW MN5'ltt� ADOy� � .SIGN "Q DEMOLISH
INSTALL REP,
PROPOSED USE �. SF.R X�J CORM OTHER,
TYPE OF CONSTRUCTION _ BLOCK Q FRAME aTE1 Q- p
t" U � .#c
DESCRIPMNOFWORIC� •,�l� i � 'l+[�ttriT�t�tI�7; ijt fDP-
i,
BUILDI'r(GSIZE �Ji5goy T -.. soF60TAGE. HEIGHT'
F ...._-•moo .. _
BUILOIidG S.1 /t r1 r �p,LUATION OF TOTAL CONSTRUCTIO �F��"'Z.tNi..�—S1"i'�-
`�ELECTRICAL S. I / r��_�'.• .AMP SERVICE PROGRESS ENERGY Q 1N.R.E_C.
I r�f"l
.=PLUVSING. S .
�rAECHFN)CAL. 5. VALUATION OF MECHANICAL INSTALLA.TioN
iC$ ROOFING Q SPECIALTY'= OTHER
FINISHED FLOOR EL VATiGNS FLOOD ZONE AREA =YES NO'(((
iLJICDE, 60ji1PANY .�i
.,,,�
` SIGNATURE: 1.i=-� 13-f-. nc.?S1C:s-OLVI P! r-E£Curc.,E. I .'f 1 N
Address. 374 n_ yTcsri, 4 Licenser
EL EC tAN. /// COMPANY t�J tG(YT14��� $SL�S� '.f GY43�
SIGNATURE .( RECtsrEa=_oI Y 1:1 P FEC CURPE Y i N 1
dj License g
P f E COM N fi. ..� [ �t't r.I� %
Wii�NA•TURc+� r.Et�r TEED Y IN C' Rz-r om r_YIN -
1Addrass}: License#I[ t,: FC0,� -r?172 11
h1ECRAN?CRL}�+';j ---• COMPANY I' -
'SIG J V RE;tsr_ a YIN FEE Rn9, LY f N 1
Address Lanse _
COMPANY �"SS�CLYJIKt CJI�I li!L _
SIGNt��RE' t?EGIsTEREo I Y I N E�cuRgEn L Y i N
Addiaas� t I 3D5 Liwnse r
z.m S=i7i1/ P�zQv►�e�v�d tJt F
It:ftiti=1211_t"t'II1III111IIdI11-I1ttli.I I I I I tttl'litflhlF7tft11't_t [[it I -.
RESIDENTIAL: Attach,(2j Ptot Plans;(2)Sets ofBuilding Plans;(1)set of Energy Forms,R-O-W Permit for new construction:
Minimum ten(10j working days after submittal.date. Required onsite,Construct n Plans;Stormivater Plans wl Slt Fence utstaDLd,
;Sanitary Faplities 81 dumpster;Site Work;Permit for.subdivisicnsilargg projects
COMMERCIAL Attach(2)'complete sets of Building Pie plus a Life Safety Page:'(1).set of Energy Forms.P-0-111 Permit for new construction,
' Minimum ten(10)working days aftersubmittald;te..Required onsite,Construction Pans,stixmvrater"Plans wl sltFar ce Installed,
Sanitary Facilities 8 l dumpsler.Site Work Permii fr r all new projects.All commercial requ€rements nust.meet corripllance
SIGN PE,RMIt' -Attach.(2)sets of Engineered Plans. -
-PROPERTY SURVEY reti fired for al NEW consimatlom
.l�a 'a.,s.a• t.a i 1 a.a�b i a I a-n-�:t a'a,1'o s..a-.rat 3� ,
Directions: - .. .
Fill out application completely:
tlwsser.E Contractor sign hack of application,notarized
if over$2500,a Notice at Goinme6ceinent is regliired. (AIC upgrades over$7500)
Agent(for the cantraclar)or Pawer of Attorney(for the owner)would be samebrie with notarized letter from owner authorizing same
OVER THE.COUNTER PERMITTING (copy ofc ilRet reg1.15"
Reraats IF.shingtes iseviers Service Upgrades"A/C Fences(PioUSurveylFoctage)
Drtveways•Nat over Counter if an public Taadways-heads ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions 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 that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or expansion of existing buildings,as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands,that such fees,as may be due,will be identified 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 final power release. If the project does not involve a certificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowners
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant 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.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws 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 and that all work will be performed 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 of other government agencies may apply to the intended work,and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"W 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 submitted 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 in Flood Zone "A" in connection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or
set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction 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 period of six(6)months after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
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 FIA4ANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR A dlki
Subscribed and sworn to(or affirmed)before me this subscribed and sw n to( affir d)before�')tnte���
by ///K by 6- h 6'�a
Who is/are personally known to me or has/have produced WhQ i re perso ally known to me or ha have produced
as identfication. 1�11/i,lPr�//C P�CL+' as identification.
Notary Public i � Notary Public
Commission No. C mission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
; tj DEBRA ELAINE RUFFELL
-Commission#GG 045343
Expires November 7,2020
%;o'F fCg"•' BorU Thru Troy Fain Iruurance 800.3115.7019
Z Z
July 24, 2018
Asa Carlton, Inc.
5224 Palmero Court
- Buford, GA 30518
RE: Authorization Letter for Permit Pick-up
Location: CVS Store #0651- 37943 Eiland Blvd, Zephyrhills, FL 33542
_-" Building Permit: 37943 Eiland Blvd
` ?z'? Site Plan approval is file: #16-18-SPR
Please allow Joe Gately of Asa Carlton, Inc. to pick-up the above referenced
permit. Please contact me immediately with any questions.
5224 PALMERO COURT
Thank you for your business!
SUITE 200
BUFORD,GA 30518
P: 770-e45-2195 Scott L. Hester
F: 770-945-5640 Asa Carlton, Inc.
www.asacariton.com
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department I..__a J1 �/ 0.� &.m
Date Received
Phone Contact for Permitting
1 1 1 1 1 1 1 1 1 1 1 1 1
t/V`/
Owner's Name r 7oA r'✓1 I Owner Phone Number
Owner's Address ONe cvV , V 2ivt CV MOVA-'1' d7,,VMJ Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS / IN+I�Y 1 ve LOT#
SUBDIVISION u s PARCEL I D#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR B ADD( SIGN Q DEMOLISH
INSTALL REPA
PROPOSED USE SFR ® COMM 0 OTHER
TYPE OF CONSTRUCTION BLOOC.(K�j���,r,0-r7�F_IRAAME SpT/EEELLp�y�� p■� t� ex7v,-I� 1.
DESCRIPTION OF WORK INt�R10(� f'r rl`r/VA't u/N/ +A41NOP V 1 (y�rAVW/✓-0
BUILDING SIZE to `c/v SQ FOOTAGE +�0�� HEIGHT `At_L9#
BUILDING $ f D/J /1�'�i VALUATION OF TOTAL CONSTRUCTION �Co-17kc/INGl�SITE: I5(�p�-
,ELECTRICAL $ I�/)�r o`o, AMP SERVICE PROGRESS ENERGY W.R.E.C.
=PLUMBING $
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
GAS ROOFING SPECIALTY OTHER
0 0 0 0 R
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
(C��KDf
t i i i t t i i i l i�'r�i��
BUILDER 'b 9MPANY nG-
SIGNATURE •' REGISTERED Y/ N FEE CUR Et Y/N
Address_. 3� y n 4 License# CSC050,-1 09
;EI E�C 1QIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N I'
$-Address License#
Iip It- _ —
OM
SJ GNATURE REGISTERED Y/ N FEE CURRE�
L
-Address— License#
MECHANICAL -- z COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREK
I,=L---Addre"ss` � `' License# �-
COMPANY
1� GN QT-- REGISTERED Y/',N FEE CURREN Y/N
License# �r
'1'-1'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIt1111111I1111111111 1�1 -=--�
RESIDENTIAL Attach(2)Plot Plans; (2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(2)complete sets 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 dote--Required onsite,Construction Plans,-Stormwater Pibns-w/SilfFence iristalled, -
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
■ L.
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 Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions 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 that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified 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 final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant 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.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws 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 and that all work will be performed 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 of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone W" 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 submitted 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 in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction 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 period of six(6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
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 LENIVER Qlk AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F. .
OWNER OR AGE CONTRACTOR
, pscnpe' d savor to(or affirmed)beef re me this Subscribed and sworn to ed)before me this
�/a// �v— � 5 14 ► b Heath Peters
Who is/are rsonall tom or as/have produced Who is/are'-ersonallv knowi to me or has/have produced
as identification. as identification.
t,[� l� Notary Public W t,v.0W Notary Public
Commission No. CD Commission�� 7 Commission No. Jr
Debra®oiroln � T�9
0�►via \N sor �A
Name of Notary typed, rinte IC Name of Notary typed,pr' d or stamped o
�tate of Rhode Island
-my CoMmisslon sxpires 4/26/2019 _
o�
�'�'iPA110 EXPiR�S��`���
JUL/05/2018/T.HU 12:33 PM PAX No. P. 001/001
�Coaors .
� �njert i5�'anagenaeat•.
July 5th,2018 '
City of Zephyrhills
5335 8"Street
Zephyrhills, FL 33542
RE: CHANGE OF CONTRACTOR LETTER
To Whom It May Concern:
I hereby notify the City of Zephyrhills that GLR, Inc.will no longer be the general contractor for the CVS#651
located at 37943 Eiland Blvd. Zephyrhills, FL 33542.The general contractor will now be Asa Carlton, Inc.
If you should have any questions,please contact me at 937.890.0510.
Sincerely,
Heath Peter
Owner
G.L.R. Inc.
STATE OF Ohio
COUNTY OF MontgoWely
Sworn to and subscribed before me this 5th day of July, 2018.
(X) Personally known ( ) Produced Identification
!:Jal�rr�r4
Notary Public—Stale of &io a
My Commission expires: 9
3795 Wyse Road Dayton.Olio 45414 Phone(937)890-Oslo • Fax(937)$90-30 4 .
'
Jacqueline
From: Rodney Corhveau
Sent 3. 20180t10AM
To: Cody Akers
Cc: BrettJacqueline
Subject: RE: C\S#O051@37943EUand Blvd.ZaphvrhUko. Fl-City mfZeohvrhi||e Permitting Question
Cody,
The scope of the work for this particular job needs to be certified that it is in compliance with the approved plan. So it
would just be the ADA ramp, reconfiguration of the parking spaces, bike rack, landscaping, etc.
Zephyrhills
K30
ZEPHYRHIl&S-HOMETOWN AMERICA IN THE HEARTOF TAMPA8AY!
Rodney\/. CQrri\/eaU, /1ICP .
Assistant Planner
Physica|/Mai!in8Addresa:
City ofZephyrhi||s Planning Department
Historic Captain Jeffries House
385375 m Ave.
ZephyrhiUs, FL33542
Phone: O13.7Q8.O2D1
Fax: 813'780.0005
Under Florida law,e-mail addresses are public recordm' If you dm not want your e-mail address released nn response mwa
public records request,do not send electronic mail*mthis office'
' ------- -----'------------------- -------------'---------------------' --- ------'-----'---------
From:Cody Akers<cakens@Dfo-inc.net>
Sent:Tuesday,July O3,2O187:57AK4
To: Rodney CorriVeeu<RCorriveau@c|.cephyrhi||s.fl.us>
Cc: Brett 8asquin<bbasquin@fo-inc.net>;Jacqueline Boges«iboges@c[oephVrhi||sJO.us>
Subject: RE:CVS#O651@37943EUamd Blvd.Zephyrhi||s, FL-City ofZephyrhi||sPermitting Question
Rodney,
What is needed to be shown on the final as-builts?Just the replaced landscaping? Does the surveyor submit that directly
to you,ordn they need to come from the engineer?
Please advise.
\ �
Jacqueline Boges
From: Jacqueline Boges
Sent: Wednesday, July 25, 2018 10:14 AM
To: 'Julie Lyon'
Subject: RE: Building Permit: CVS#0651 - 37943 Eiland Blvd
Attachments: contractor certificat.docx
Julie received,
The low voltage will be a separate this we do not do permit for only label that cost$45. It will have to be filled out and
post on the equipment than called into our office for the inspection.
Fred lepley-will need to register see attached sheet once he is registered than the building application will be sent over
to be signed once I receive application back this company will be done with registration and added to the permit.
RJ-will need to register see attached sheet once he is registered than the building application will be sent over to be
signed once I receive application back this company will be done with registration and added to the permit
Once everyone registered and signed onto permit than the permit will be ready for pick up.
1A,
dacklc Bogcs
SP-780--0020 ext 3513
"A rule I have had for years is:to treat the Lord Jesus Christ as a personal friend. His is not a creed, a mere doctrine, but it is He
Himself we have."Dwight L. Moody
Florida has a very broad public records law. Electronic communications regarding most City
of Zephyrhills business are public records and available upon request. Your e-mail
communications may therefore be subject to public disclosure. If you received this message in
error, please do not read, forward, copy, etc. and delete immediately.
From:Julie Lyon<jlyon@asacariton.com>
Sent:Wednesday,July 25, 2018 9:33 AM
To:Jacqueline Boges<jboges@ci.zephyrhills.fl.us>
Subject: Building Permit: CVS#0651-37943 Eiland Blvd
Good Morning,
We'll be picking up the permit for the above referenced project on Monday and wanted to list the Plumber and the
Electrical/Low Voltage Subcontractors.
Plumbing
Fred Lepley Building and Plumbing, LLC.
239-877-9859 Travis Conner
i
RjMart1n. ,.1,i,'w('.-,,".,
NATIONAL CONTRACTING
License Holder Signatory Authority
WHEREAS,Timothy T.Martin desires to grant signing and authority to certain person(s)-described
hereunder.
1,Timo4hy T. Mar!tfri'hereby authorize and approve to grant signing and authority,to conduct business to
Joe Gately on my behalf: The foregoing signing and authority
granted shall include, b'Ut shall not be limited to,obtaining business licenses,the,submission-cf,perryiii
alYplications,powers of attorney,transfers,and other instruments of whatever nature necessary to
obtain permits,
'IN WITNESS WHEREOF,,I have executed,My name, Timothy T: Martin
fir.rio-t-hy'T:Martin
Acknowledgment" of Individual
STATE OF` OHIO
COUNTY OF CUYAHOGA
The foregoing instrument was acknowledged before me this 250 Day of July,2018(date) by Timothy,,T.
Mar-tin'(narrie of-per.son acknowledged).
N'ot.a 401 C
Print Name: 14a ry CQ-t"e'd,r�c
My commission expires,':
Oix'PAIAL.,
R'% MARY GARDENHIR&
NOTARY PUBLIC
STATE OF OHIO
y
Recorded in
Cuyahoga County
MY:Comm Exp.811912022
22841 Aurora Rload.,Bedford'Heights,OH 4414 v218662.7100 F2-166132.7195 VVV`J1N.Rl.kAART1Kf.NV
225 Seven Farrhs Drive,Suite 203,Daniel Island,SC 29492 r 843352.9820 1843.362.9821
CVS Pharmacy
One CVS Drive
Woonsocket, RI 02895
April 25, 2018
Building Official
City of Zephyr Hills Building Department
5335 8th Street
Zephyrhills, FL 33542
RE: CVS Store#651 —37943 Eiland Boulevard, Zephyrhills, Florida 33542
PID#03-26-21-0010-06400-0030
Dear Buiilnlding Official:
I, rr�� of CVS Pharmacy certify that I am an authorized representative for
CVS Pharmacy, the Lease Tenant of the property described above.
I hereby authorize the firm of Robert Reid Wedding Architects and Planners, AIA, Inc. to act as an agent
in order to submit plans for review for the Interior Renovations to the existing CVS Store 651.
Interior renovations are the main focus of the project, including improvements to the Checkout, Entry,
Photo, Coolers, Retail, Pharmacy and Restrooms areas of the store. Proposed scope of work also
includes insertion of a new Audiology enclosure within the existing Retail store.
Scope of work also includes upgrades to the existing parking lot, consisting primarily of restriping the
parking group nearest front store entry and repairs to the accessible path of travel (perimeter sidewalks).
Should you have any questions, please do not hesitate to contact me at 401-770-5784
Sincerely
C S rmacy
STATE OF RHODE ISLAND
COUNTY O
Sworn to subscribed before me this o�day of 2018 by
(wo ersonally known to me ( ) Produced Identification
Type of Identification:
( ) DID TAKE`OATH DID NOT TAKE OATH
Debra A. Doiron
Notary P1 Ib lic
Notary Publi;`—St' fe of Rhode Island My G'09'i Mh6� 1SIand
-- -_ - MY Commission expires 4/26/2019
YR'
General Contractors
NC.
Project Management
April 7, 2018
City of Zephyrhills, FL
5335 8th Street
Zephyrhills, FL 33542
RE: AUTHORIZATION LETTER FOR G.L.R. INC. CONTRACTOR REGISTRATION
QUALIFIER REPRESENTATIVE
To Whom It May Concern:
I hereby notify the City of Zephyrhills that I give authorization/consent to Susan Bradley
to register on behalf of G.L.R. Inc.
I hereby also authorize/consent Susan Bradley to submit, process and pick up plans and documentation that
may be required for permitting review and approval for the CVS Pharmacy Remodel #651 located at
37943 Eiland Blvd. Zephyrhills, FL 33542.
If you should have any questions, please contact me at 937.890.0510.
Sincerely,
Heath Peters
Owner
G.L.R. Inc.
STATE OF Ohio
COUNTY OF Montgomery
Sworn to and subscribed before me this 7th day of AUL 2018. G-�NQTq�%%
(X) Personally known ( ) Produced Identification 9�A'
Notary Public—State of 01i = ory
My Commission expires: 9I3I I0 1
c
3795 Wyse Road . Dayton,Ohio 45414 Phone(937)890-0510 . Fax(937) 890-3094 .
^� ILU RIUR
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: if
Date Received:
Site: - / �� �� r�Cl_�� Mlvd-
Permit Type:
Approved w/no comments: ' Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
Kalvin Sw' kr ns Examiner Date Contractor and/or Homeowner
(Required when comments are present)
CITY OF / / / BUILDING
ZEPHYRHILLSNOTICE DEPARTMENT
OF ADDITION OR CORRECTION
M • NOT REMOVE
ADDRESS DATE PERMIT#
3_2��Z 9)L" guilp- lqqy uq
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job
will be accepted.
It is unlawful for any Carpenter,Contractor,Builder,or other persons,to AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the work with flooring,lath,earth
or other material,unlit the proper inspector has had ample time to approve 780-0020 FOR RE-INSPECTION
the installation.
OFFICE HOURS 7:30 AM-5 PM MON.-FRI. INSPECTOR V �