HomeMy WebLinkAbout21-2669City of Zephyrhilis
5335 Eighth Street Emil,
Zephyrhills, FL 33542 BGR-002669-2021
Phone: (813) 780-0020 Issue Date: 08/17/2021
Fax: (813) 780-0021
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accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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CONTRACTOR SIGNATURE
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ITHOUT APPROVED INSPECTION
City of Zephyrhills
53358 1h St
(813) 780-0020
Permit No.-12-E- - 00 ;,"q — 2-0 --(
(AJ I, & )j OL, licensed under Chapter 468, Florida Statutes as a(n):
Contractor Z Engineer_ Architect— Building Inspector_
License No. P
On or about did personally inspect the:
Check: Roof Deck Nailing--L— Ivry in Flashing and Drip edge
Check which was used: 30# felt— Peel and Stick/ Other (List)
At the following
address:J ..-�
3ased t
Signature:—;L
STATE OF FLORIDA
COUNTY OF PASCO
Sworn to and subscribed before this day
BY:
Notary Public State of Florida
873a80-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Lute Received D6nnn CnntAr--t fnr Permittintl t
OW,
BUILDING $ VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ .......................
AMP SERVICE PROGRESS ENERGY W.R.E.C.
PLUMBING $
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y / N =FEECURR, EIK
Address License #
ELECTRICIAN COMPANY
SIGNATURE ` REGISTERED Y / N J FEE GURREK Y7 N
Address License
PLUMBER COMPANY
SIGNATURE REGISTERED Y / N FEE GURREN Y / N
Address License #
MECHANICAL COMPANY F
SIGNATURE REGISTERED Y / N FEE GURRER LXLN
Address License #
OTHER / COMPANY
SIGNATURE �i �- REGISTERED Y / N FEE GURRen Y Address t7
jJ / a { License#
° . RESIDENTIAL Attach (2) Plot Plans; ( seis,o Building P nS; (1 set of Energy Forms,
R-O-W Permit for new construction,
Minimum ten (10) workie r qys sifter subm ittal dote Required onsitoXonstruction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facili. as & 1 dumpster; Site Work Permit for su6dlAsionsAarg0 projects
COMMERCIAL, Attach (2j cor iete sets of Building Plans plus a Life SafetjPage-, (1Yset of Energy Forms.'R-O-W Permit for new construction.
Minimum ten,'(10) working days after submittal date. Required onslts, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach ()setsof Engineered Plans.
'PROPERTY SURVEY required for aW NEVV construction.
Fill out application completely.
Owner & Contractor sigrvbs& 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..n BROW
INSTR# 2021174603 OR BK 10417 PG 3027 page i of 1
08/17/2021 12:41 PIVI Ropt: 2340781 Rec: 10.00 DS: 0.00 IT: 0.00
Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller
Permit No. ParcsIIDNo jo--,a�
NOTICE OF COMMENCEMENT
state Of county of A1-4�
THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property, and In accordance with Chapter 7.13, Florida Statutes,
the fulowing Information is provided In this Notice of Commarxxoment
I D"*m of Propertf. Parcel Identification No. SL6 - :)-I P
$11roetAddress: 32�ZL
2. General Descriptor
3. Owner Information or Lessee Information If the Lessee contracted for the Improvement
Name of Fee Simple Titleholder:
(if different from Owner Usted above)
Address
4. Contractor
W
city state
5. Surety:
Name
Xd—dra"
city state
Amount of Bond: $
Telephone No.;
6. Lender.
Name
Address
city state
Lender's Telephone No.:
7. Pawns within the State of Florida designated by the owner upon whom n*Nca or other documents may be served as provided by
$action 713.13(1XsX7), Markle Statutes:
Name -- -
Address CRY state
Telephone Number of Designated Person:
In addition to himself, the owner designates Of
to receive a copy of the Llenors Notice as provided In Soctlon 713.13(1 Xb). Florida Statutes.
Telephone Number of Person or Err* 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 wol be one year from the date of recording untas a different date Is specified):
Under imp 1304WY. I declare that I have read the foregoing notice of commencement and that the facts stated therein am true to tirobeat
of my knowledge and belief.
STATE OF FLORIDA VVI,
COUNTY OF PASCOvs SHERRY WMNIR
Commission 0 00 102749 Signature of Owner or Losses, or Owners or LossaWs Authorized
Expires Decilmberill, 20211 Officer/01rackwPartner/Manager
Signatory's TKWCdo-i
The foregoing Instrument was acknowledged before me this %day of 204 by 4 vr,A -!) t
as (typq'of au *111loor, trustee. attlamey In fact) for
ln;�(-�a�ton beI ant was executed).
Personally Known QB Produced Identification 0 Notary Signature
Type of Identification Produced Nam a (Print)
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