HomeMy WebLinkAbout19-21075 CITY OF ZEPHYRHILLS
5335-8th Street
(813)780-0020 21075
ELECTRICAL PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit#:21075 Issued: 4/08/20.1.9 Address: 4330 20TH ST
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE/NEW Township: Range:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 3,500.00 Total Fees: 60.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 60.00 Date Paid: 4/08/2019 Parcel Number: 13-26-21-0070-03900-0020
CONTRACTOR INFORMATION' OWNER INFORMATION
Name: HENRIQUEZ ELECTRIC CORP Name: NESTLE WATERS NA INC
Addr: 7713 BENJAMIN RD Address: 4330 20TH ST
TAMPA, FL 33634 ZEPHYRHILLS, FL. 33542
Phone: (813)877-1104. Lic: Phone: (813)783-1959
Work Desc: ,INSTALLATION 8 CEILING FANS
APPLICATION FEE
ELECTRICAL FEE 60.00
INSPECTIONS,REQUIRED .
ROUGH ELECTRIC
CONSTRUCTION POLE
PRE-METER
MCI
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 properly. 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.
C T OR PER OFFI
PERMIT EXP ES IN 6 ONTHS WITHOUT APPROVED INSPECTIO
CALL FO ECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting
Owner's Name 5 OL+ers ff6rHIIC C Owner Phone Number
Owners Address Pa 1200 2 Q Z Owner Phone Number
I
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 14,350 ZO f1h g f 7 h 11'S�j 33 ESLI Z LOT#
SUBDIVISION PARCEL ID# c�-/•I_(�070_Q?�f�0O •00190
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH
INSTALL REPAIR
PROPOSED USE = SFR 0 COMM = OTHER
TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL =
DESCRIPTION OF WORK iN SrALLAY10A) 9 G r�IL114G FAIj S C
BUILDING SIZE I I SQ FOOTAGE HEIGHT
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
EZELECTRICALI $. AMP SERVICE = PROGRESS ENERGY = W.R.E.C.
=PLUMBING 4 $
9
=MECHANICAI,'1 $ VALUATION OF MECHANICAL INSTALLATION
=GAS I = ROOFING 0 SPECIALTY = OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N
Address / 1, License#
ELECTRICIAN r+ COMPANY 'y: R� V C.ICer IL COR
SIGNATURE ,.` L Y/ N FEE CURREN Y/N
Addre 10 w• �-W V /1 VQ.- License# rewo2Q7
PLUMBER F COMPANY
SIGNATURE REGISTERED Y/ N I FEE CURREN I Y/N
Address I License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address I License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN L11 N
Address License#
1111111111111111111111111111111111111111111111111111111111111111111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
MinAlurn ten(10)working days after submittal date. Required onsite,Construction Plans,Stonnwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects
COMMERCIAL Attacl�(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minim pm ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Samtiry 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.
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
i
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 urther understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certi Cate of occupancy"or final power release. If the project does not involve a certificate of occupancy or
final power relea e,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 Guid prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"o, ner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"droner"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 tol obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prio�to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, Co my and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I und6rstand 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"V'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 fillmaterial is to be used in any area, I certify that use of such fill will not adversely affect adjacent
prop rties. If use of fill is found to adversely affect adjacent properties,the owner may be cited for violating
the onditions 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 prig 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 sh II 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 corre tion of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work buthorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is sus ended 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 Jor 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE O ENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTO
Subscribed and sworn to(or affirmed)before me this Sub cri ed or t (or ffrm d) ore m is
by
Who is/are personally known to me or has/have produced Who is/ar p rson y own to me or has/have prod d
as identification. as identification.
Notary Public ClA Notary Public
Commission No. Comm'sio N
Commission A GG 27
Name of Notary typed,printed or stamped Name R Note i(8ET c ®$geCembvr t 2,2l)22
�O ..' Bcnded flau Troy Fain IMrance E00.3M?019
HENRIQUEZ ELECTRIC CORP.
7713 Benjamin Road
TAMPA, FL. 33634
PH. 813'-877-1104 FX. 813-853-2513
EC#0002971 EC# 0001637
March 1, 2019
City of Zephrlls
To Whom It ay Concern:
Please be advised of our employees with permit-signing capabilities. Also,please
destroy any previous list you may have.
Authorized si ners:
Ken Henriquez #EC0002971
Stan Hankins #EC0001637
Sharon Henriquez
Leslie VanTrump
Sincerely,
HENRIQUEZ ELECTRIC CORPORATION
Kenneth Heniquez
President 4
r
4101 W. Line�augh Ave.
Tampa, FL 33624
813.877.1104
Sworn to and subscribed before me this date, 1 March 2019, did appear Kenneth
Henriquez who is personally known to me.
12-
4otary Date
KAREN PUTYRSKE
State of Florida-Notary Public
Commission#GG 11877
9. ao My Comm. Expires 07-14-2020
Bonded Through
Western Surety Company
Fezvut Number. Tax Folio Number:
.€r opq'address;
U
STATE OF IRLGRMA
C.
Before rye: the umersig ed authority: dul-y authorized to U&e ae�z�o�7,�ledameiits.and administer
oati personally appeared 02creinafrer.giant).
-9,71ho after being,dull?-sworn,deposes and says:
1. Alhant_is the(clie&one).- �&7ner of the abo-ve described prop��a -
e Owner's Authorized.Agent
2. A Notice of Commencement, as.required pursuant to Section 71 3.13"of the
P49da Statiates,has been filed fox_recordingm the off.cial public records.of
County, Florida, as it relates to improvements to be made to
that.certain real property described herein.
3. "A copy of said recorded Notice of Cornmezoementis at=hed hereto.
Afant Signature. -
Shmn ffe�.tri. ez
Print hlasnc: ,
e
S«rom to.and subscribed before me on this ?X— . day of�w—I �20.1
S
Y 1 kL�' rr is ersonall r im-ol to me or has.produD.
. ' , vtha _p c
as idantiLEcaticrL.
Notary Public Signature:
� C,�REN PUTYRSK77
t'yyPrat��4� state of Fic ide-Notary Pu 77
blic
Print.Name` : — ° �� CommissionrG0 -14-2
o� " Ny.Comm.Expires 07-14-2020
y oF` sondedThiough
west rn Surety Company
Ny Comnssion Expires:
INSTR#201.905040.0 OR-BK 9879 PG 738 Page 1'of 1
0312712019 09:11 AM Rcpt-2040221 Rec:10'00 DS:"0.00 IT-0.00
Paula S.uxeiC Pk.D.,Pasco Cotmt y Clerk&Comytroffer
Pennmo. Pdf6dID"No ��J'L�e-2!~0070--OW6b-gip
_ NOTICE OF COMMENCEMENT
state of FL 0 yL County of C l a
THE 6rvERsirNEO hereby gives notice that Improvement vAI be made to certain real pmpeny;and In accordance%An Chapter 713,Florida Stables,
the ta0cwtalg Intortha0on is proWdad m this Natice of,Camimncenient - - -"
1. Desalpoon of PropW..Parcel Identirmfion No. Y r
Address `i`33 Q Z Q S 1iQicG T z t 1 eµ}t-Zs,FL."33-s--7 Z
Street
2. General oesmption of Improvement Ve N-T)LAC i
WqYtG Hv 1.
3. OHnerinfonnatwn or lessen Womtadon if the Lessee contracted fcrthe Improvemenb
NiVST L� wAFtiEVtS NoK--kW 4entvLjC4_ ittL.LS —19MI,.,r� 1n14�r�
t 33b imy S" nv1&-C TW llif A I L LS r L
Address City State
frderestin Propamr
Name or Fee Slmpiaiidshoider.
Of diferent tram Owner risled above)
Addrea nnquez Electir Orply state.
a. contractor. Nam +F161 W'IneHallghlti�o
O Tampa,FL"M624
Address - 813-877-1196 city Sta'a
Cornradoes Telephone No.: - "
S. Sraety: 01
Name
Address City' State
Amourd of Bond:s Telephone No.:
S. Lender N /V
am e. -
Address rtty " state
Lendofo Telephone No.:
T. Persons vdlhin the"Statc:of Florida designated by the owner upai'whom notices or other doetiments ntay he served as provided by
Sedan 713.13(1)(e)(1),Florida Sttdules:
,SVAwN W11klV6,00
Name
►f 3'ao 2D �gpAS►euv Li's Fe
Address. Cily State
Telepherre.Nw+beroTT)eslgnategPenom FSIS-40 '7d04
a. In addition Id himself,the amerdr*gnates "of
to receive a copy of the Lienors Notice as provided In Sedion 713,13(1)(b),Florida Statutes.
TctcphoneNumberofPer-ancrEnbtyDeogr►itedbyDWaerr -
9. E)bailon dde'df Noliw of Commencement(the aWwation dald may riot be bcfam the complolien of cm-zhuclion and Roof payiment to qte
eanbadar,butwill be one y=fmm the data of roeorrfng unloss a digdient date,Is spodffad):
WARNING TO CWNErt ANY PAYMENTS MADE BY THE OWNER AFTER THE-EXPIRATION OF TIC NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPERPAYMENTS UNDER CHAPTER713.PART 1.SECTION713.13• FLORIDA STATUTES.AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO'YOUR PROPERTY. A NOTICE OF COMMENCEMER+ MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING.CONSULT
WTI I YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDINGYOUR NOTICE OF COMMENCEMENT.
Under penalty or palmy,I declare that I have read the trsogdtng notice of commencemerd and that the fads shod therein are tare to the teal
of mylamudedge and ba➢el. - - -. -
STATEOFF COUNTY OF PASCO PASCO
-Inig-nal5ra or Owner or Lessee,or(vrnaes or Lessee's Authomed-
Otncerl0trecmrlPatmedMarGaer '
K-�ScGT AAA-P,4-c-Cti-• M0% LTS IJ�-Zu'L-S
Signatorys 7111WOnlm
ThaforegcirginsWmentvasada�,aW dPedoer me gcs�dayof ni{- ."20 ,by YDjuz %Tt4A !q-9;(
S-4*00�u)I�b �+ + QQ O j-iZ-r V♦{v� (type of authority,e.g.,officer,trrratee.agamcy in fact)for
Si1►a1.1M pdnliBt, lulfgh4;64 (name of arlye n behalf of whom inpstru�rnont was asen,ted).
Personally Ma%vn O QR Producod 1Cont�ation�{ Notary SInature _-I$ _ F n "I.f.LAvt,�
Type of Identification Produced lF-01 DA per.• Name(?ditty 'I
.�xp 91a 1 Jaoa�
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Nabs Dubuc
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