HomeMy WebLinkAbout18-20047 CITY OF ZEPHYRHILLS
5335-8th Street
(813)780-0020 20047
ELECTRICAL PERMIT
= -PERMIT INFORMATION_ =- LOCATION 1NFORMATION:
Permit.#:200;7 Issued: 7/30/2018 Address: 5233 GALL BLVD
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRICAL MISC Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 7,343.00 Total Fees: 45.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 45.00 Date Paid: 7/30/2018 Parcel Number: 11-26-21-0010-15400-0090
CONTRACTOR INFORMATION' OWNER INFORMATION
Name: J H HAM ENGINEERING INN Name: PEEPLES FAMILY CORP INC
Addr: PO BOX 5106 Address: PO BOX 1058
LAKELAND, FL. 33807 ZEPHYRHILLS, FL. 33539
Phone: Lic: Phone:
Work Desc: ELECTRIC SERVICE TEMPORARY UNDERGROUND REMEDIATION SYSTEM
APPLICATION FEES
e ELECTRICAL FEE 45.00
ASPEC111ONS REQUIRED
ROUGH ELECTRIC
CONSTRUCTION POLE
PRE-METER �I
FINAL
REINSPECTION FEES:(c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"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 and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
CONTRACTOR PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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813-7804= Cily of Zephyrhlll3 Permit Application Fo"13-78o-0021
Budding Department
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Date Recstod p i Conhid for Permkti — �
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Ownerls Nam The Peeples Family Corporation,Inc. owner theme Number
O►meft Address 11 Sunnybrooke Trail Clyde,NC,28721 0ynW Phonic Number
Fee SImple•Titlehoider Name I NIA Owner Phone Number
Fee Simple 70dwWarAdd. NIA
JOBADDRESS 5233 pall Blvd.Zephyritills,FL. LOT#
SUBDIVISION PARCEL 108 11-26-21-0010-154004090
tOOWNED FROM IDN" rYTAXNOTIM
WORK PROPOSI D NEW CONSTR ADDIALT Q SIGN 0 Q DEMOLM
E3 (NWALL R REPAIR
PROPOSED USE SFR COMM Q OTHER I KZMEDMArs—Ew
TYPE OF CONSTRUCTION QR BLOCK FRAME p STEEL p
DESCRWnON OF WORK EEctric Service For Florida DEP Funded,Temporary Groundwater Remediatlon System
BUILDING SUE N/A SQ FOOTAGE N1A HEIGHT
Q BuILDING s VALUATION OF TOTAL.CONSTRUCTION
Duke Energy
[56ELECTMCAL s -T 3 4 .sa AMP SERVICEZ0O Q Q W.R.E.C.
=PLUMBING $ 71
=MECHANICAL $ VALUATION OF MECHANICAL.INSTALLATION
®GAS Q ROOFING [] SPECIALTY ® OTHER
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FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY FRS evironmental remediatien Inc. DBA the FGS]Group
SWNATURE '' "'; •_ 2 HKiISTERED Y/ N FE£CURrrEA LyjN
Addms 120 E. Dr MLK Jr.Blvd.Tampa FI.33603 Lic nno
ELECTRICIAN COMPANY . 14 A A JE A&W 1rEttS J 6T sal
SIGNATURE REC48iEM I YIN FM CURM LY 1 N
Addrose PC) a,&b Zr Q 33st3 ucenae# FE G oe ao s-7 1
PLUMBER COMPANY
SIGNATURE MOWERED I Y/ N I FEE CUAM
Address Cleanse#
MECHANICAL COMPANY
SIGNATURE FEMSTERM L Y/ N I FEE cuRm I YIN
Address L kw"#
01"ER COMPANY
"WGNATURE I L Y1 N FEECIri�ET YIN
Address License#
.RMDENTM Attach(2)Plot Plans;(2)eats of BWkUM Plane;(1)eet of Energy Forma;Ft O`W FiwmR fiD new ooatructlon,
MWmum Ise(10)wa&ng days after mubaritW dates RwOW creeps,Conebumon Plans,StaniN tsr Plena wl SIR Fence hrli A
Sarrftery Facilities&I dumpatnr,Sits Work Permit forsubdf*loimJlerpe prgeda
COMMERCIAL Attach(2)oomplets sells of EUIdIng Plane pica a LITb Sd*PaW.(1)set of Energy Forma.R-O W PsanR for new=wkuc;nn.
M M&W ten(10)wW ft days after submhd deb&. RequUed onsite,Construction Plwre,StommnW Plena w/SIR Fence installed,
SmIlOW-Padiftiee&1 dumpatat:Site Wcrk Parmitfer all new proJecta.Al ownmec W Mufrmnw is must mast comoftnce
SIGN Pizurf Aftu t(2)seta of Engineered Plan&
PROPERTYSURVEY squired for el NEW o0nalrucUm.
Dlroettoner
Fill cut appt[cieon compLd*.
Owner a Corttsmor albrL back of application,notarized
H•awr$M.a Notice of Comffmnconim io mqulnwd. (ANC upgredse aver s7fiM
Agant.(forthe aonbacW)•or Power of Attorney(for the ewer)would be admeone with rraterhmd letter from owner aulherWrig same
OVER 7W.COUNTER PERUFMNM .(ocpy 0f=*acd Mulrsd)
Rerobh-Ustringtes Seww3 Sendce Upgrades Alt: Fences(PloUsurvey/Foofts)
Ddvwmyv-tM over Counterff on public madwaye..rtaada 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 compliarim with any
applicable deedyesib coons.
-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 stage and local regulations.I If the
contractor is not licensed as-requlred by law, both the owner and contractor may be cited for a misdemeanor violation
under state taw. 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 Divislon--Llc;ennsing Section at 727-847-
8WQ. 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 IMPACTIUTILiTIES 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 specifled In Pasco County Ordinance number 8"7 and
80.07,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'certl6cate of occupancy' or final power release. If the.project does riot involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, If Pasco County WaterlSewer impact
fees are due,they must be paid prior to penult issuance In accordance with applicable Pasco County ordinances. '
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes:,as amended): If valuation of work is$2,6W.00 or more, I
certify that I, the applicant, have been provided with a copy of the -Florida Construction Lien Law—Homeownees
Protection Gulde' 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'SIOWNEWS AFFIDAVIT: I oertify that all the information In this application is accurate and that all work
will be done In compllance with all applicable laws regulating construction,zoning and laced development Application is
hereby made to obtain a permit to do work and installation as Indicated. 1 certify that no work or installation has
commenced prior to Issuance of a permit and that all work will be performed to most 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,WaterMastewater Treatment.
Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Englneers-Seawalls,Docks,Navigable Waterways,
Department of Health & Rehabilitative ServicesfEnvironmental 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'N'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
constructoon, 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)
am which are elevated byffll,an enggineered 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
ft 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 liceinse 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 shelf 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(a)months after the time the work la 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(00)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 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR DER OR AN ATTORNEY RE RECORDING YOUR NOTICE OFCOMMENCEMENT.
FLORIDA JURAT(M 111
OWNER CONTRAC
to(or efBrm before mn Subsorlbed ad awgin ftr fdrrnad) a me ibis 0 o XK L.K Z b r
Who Wam PexnataW kwm to me orhasnowe produced Who Is/are ltv kamwlaaw ha eta e �A M
es Idendricetlon. as rderrtlflt_
�0on
Notary Public Notary Public
Commission No. Commission No
.......... NotarpPublic,State of Florida
Name ofNoWry WW.pdnwdoratampsd Name of Notary ty va l Zulu
Comm ss on Number FF9812
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PERMSSION TO ENTER PROPERTY-NON-SOURCE
The Peeples Family Corporation, Inc
1.The Parties.The undersigned real property owner, clo Mr. Ernest Peeples 9
("Owner"),hereby give(s)permission to the State of Florida,Department of Environmental Protection
("Department")and it's Contractor, subcontractors,and vendors("Contractor"),to enter the Owner's property
("the Property")(see next paragraph).
2. The Property.Owner owns the certain parcel(s) 11-26-21-0010-15400-0090
of real property located at 5233 Gall Boulevard , Zephyrhills ,Florida
3. The Source:The suspected source of the contamination is located at 5240 Gall Boulevard ,
parcel number# 11-26-21-0010-15300-0260 and FDEP Facility/Project#is 51/8519850
4. Permissible Activities.This Permission to Enter Property("Permission")is limited to activities which may
be performed by the Department or its Contractors pursuant to Chapter 62-780 or 62-730,Florida
Administrative Code,without cost to the Owner to locate contamination,determine contamination levels and,
when necessary,remove and remediate contamination which may be performed by the Department and its
Contractor. Specifically,to collect soil, groundwater(including the installation of wells),surface water and
sediment samules,removal and treatment of contamination on the Property:installation of a treatment system
(as necessary): and monitoring of contamination until completion of remediation.
5. Work Performed during Business Hours.The Department and Contractor may enter the Property during
normal business hours and may also make arrangements to enter the Property at other times after agreement
from the Owner.
6. No Admission.The granting of this Permission by the Owner is not intended,nor should it be construed,as
an admission of liability on the part of the Owner for any contamination discovered on the Property.
7. Activities Comely with Applicable Laws.The Department and Contractor agree that any and all work
performed on the Property and in association with this Permission shall be done in a good,safe,workmanlike
manner,and in accordance with applicable federal and state statutes,rules and regulations.
8. Well Permits.The Owner authorizes the Department and its Contractor to act as its agent in signing all
required forms and documents necessary for obtaining applicable permits related to well construction,repair,
maintenance,modification,and abandonment pursuant to Chapter 373,Florida Statutes.
9. Eauipment Ownership The monitoring wells and remedial equipment installed pursuant to this agreement
are the property of the Department.The Owner is responsible for replacing any Department property that may
be damaged or lost due to any actions by the owner.
10. Property Restoration.The Department shall pay the reasonable costs of restoring the Property as nearly as
practicable to the conditions which existed before activities associated with contamination assessment or
remedial action were taken.
Page 1 of 2
PRPOMiteAccessAgreement 04042016
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11. In to Department. The Owner shall not be liable for any injury,damage or loss on the Property suffered
by the Department,Department employees or Contractors not caused by the negligence or intentional acts of the
Owner's agents or employees.
12. Sovereign Immunity.The Department acknowledges and accepts its responsibility under applicable law
(Section 768.28,Florida Statutes)for damages caused by the acts of its employees while on the Property.
13. Public Records. All documents created or received associated with the Permissible activities are a public
record pursuant to Chapter 119,Florida Statutes.The Owner may retrieve any documents or other information
related to the Permissible Activities online using the facility or project number referenced above in paragraph 4.
hqp://dgpedms.dgp.state.fl.us/Oculus/servlet/login?action=login
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Signature of each Property Owner SS ature of Witness
T
Pr�' t Name Date Print Name Date
P.6— a()/C 10S-s
Mailing Address 1�`^
61PLL- Lei '& <gMdiz,Coc.-A
Telephone or Cell Phone Number E-mail Address
Accepted by Contractor on behalf of the State of Florida Department of Environmental Protection:
Signs a of ctor Signature of Witness
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Kimball D.Ergler f Z
7/41 v-
Print Name of Contractor ate Print Name Date
FRS Environmental Remediation DBA The FGS Group KPA b q It Ffy I �--
Contractor Company name Contractor's Contact name
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120 E MLK Boulevard kergle@thefgsgroup.com
Contractor Mailing Address Contractor Contact email address
Tampa FL 33603 813-623-1557
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Contractor Company City and zip code Contractor Contact's phone number
Paget of 2
PRPOMIteAccessAgreement 04042016
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7/24/2017 11-26-21-0010-15400-0090 1 Pasco County Property Appraiser
Data Current as Of: Weekly Archive - Saturday,July 22, 2017
Parcel ID 11-26-21-0010-15400-0090 (Card: 001 of 002)
Classification 11 - Retail Stores, One Story
Mailing Address Property Value
PEEPLES FAMILY CORPORATION Ag Land $0
INC THE Land $86,500
11 SUNNYBROOK TRL Building $70,387
CLYDE NC 28721-6752 Extra Features $1,373
Physical Address-See All 2 addresses (First
Shown)
5233 GALL BLVD Just Value $158,260
ZEPHYRHILLS FL 33542-4064 Assessed (Non-School Amendment 1) $158,260
Legal Description (First 4 Lines)
Taxable Value $158,260
See Plat for this Subdivision
TOWN OF ZEPHRYHILLS PB 1 PG 54
LOTS 9 10 11 &12 BLOCK 154
OR 3227 PG 1011
jurisdiction
City of Zephyrhills
Land Detail (Card: 001 of 002)_ _
(De_scription__Oni ng 1Un1ts _ Type TPrice - (Condition Value -
_ STORE 1FLR ; TCBD R j-�11,000.00 i- �SE $6.50 _ ' 1._00_ _ _$71,500 _
2� -- 1100 - STORE 1FLR I TCBD ; 3,000.00 j SF^--M$5.00- ; -1.00 -y - $15,000
Additional Land Information
Acres 0.32 Tax Area j 30ZH j FEMA Coder- X^ _J Commercial Code CMAJ9AG
Building Information -Use it - Retail Stores (One Story) (Card: 001 of 002)
Year Built 1954 Stories 1.0
Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 None
Roof Structure Flat Roof Cover Built-Up Tar and Gravel
Interior Wall 1 Plastered Interior Wall 2 None
Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet
Fuel Electric Heat Forced Air- Ducted
A/C Central Baths 2.0
Line (Description Oq. Feet !Repl.Cost New
1 SDA 3,456 $255,260
2 - - -- 864 $25,556- - - -
Extra Features Card: 001 of 002
--...• _. ..__.._. _........._..-----....-__..._.._-_____-_.-_....--___._._-____ --_-_ -- -____---__.._.----
Line --_ -_-_ Description mar Units --_---__- -_-__-_ _ !Value
No Extra Features i
Sales History
Previous Owner: PEEPLES LOGAN &CORINE
httpJ/search.pascopa.r,om/parcel.aspx?sec=l l&twn=26&mg=21&sbb=0010&blk=l5400&lot=0090&llmit--FromMap 1/2
7/24/2017 11-26-21-0010-15400-0090 Pasco County Properly Appraiser
Month/Year Y Book/Page trype IDOR Code Condition (Amount
12/1993 ; 3227 / 1011 i Warranty Deed l Ti Improved i Multi-Parcel Sale
httpJ/search.pascopa.com/parcel.aspx?sec=11&twn=26&mg=21&sbb=0010&blk=15400&jot=0090&limit=FromMap tit