HomeMy WebLinkAbout22-3515 (2)City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
11111 lilill 11111111111111111 Jill 111 111 111 111
BAC-003515-2022
Issue Date: 02/09/2022
Complete Plans, Specifications add foe 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.
CONTRACTOR SIGNATURE PE IT OFFICE
PERM1T EXPIRES 1N 6 MONTHS WITHOUT APPROVED INSPECTION
$113-780-0020 City of Zephyrhills Permit Application Fax- 13-7tip-0021
Building Department
Cats eceivedLPhow Contact for Perr ittin
nor@s rP E rear �hI �cz Zber�
bar. q ° .
nr Address - f / �r ho
Fee Simple-ratloholder Name Owner Phon*+Number
Fee Simple Titleholder Address
WORK PROPOSED
PROPOSED USE,TYPE OF'CONSTRUCTION
,
INSTALL,
`SFR
`ELCK-
I%
LOT 0
,
ADDIALT SIGH DEMOLISH
REPAIR
Connor OTHER
FRAME TEEL
SUILDIN9 SIZE S FOOTAGE HEIGHT'
;t
i3ILDl t , VALiJkTlt�tF.TIALCt�sTk1CTltJ
Ep ELECTRICAL AnneZERVICE PROGRESSENERGY. W.R,E.C.
MECHANICAL $ l � � VALUATION OF MECHANICAL IN8TALLAT°ION'
SAS ROOFING SPECIA4TYOTHER,
FINISHED FLOOR ELEVATIONS FLOOD NE AREA =YES N
Address;
PLUMBER
SIGNATURE,
Address
MECHANICAL
a
sl°�I�E
Address
License
Fill out applicatIon, completely.
Ownqf, i C066 r sign back of application, notarized
If over'25Q0,_ a Notice of Commencement is required. (A/C upgrades over $7500)
Agent1f r the contractor) or Poorer of Attorney (for the owner) would be someone with notarized letter from owner authorizing sage
OVER THEZOUNTER PERMITTING (dopy pf rs ct required)
Reroofs if shingles Sewers ServicIO Upgrades AJG Fences (Pldt/SurveylFootsge)
Driveways -Not over Counter If on public rosdways..needs ROW
certify that-t®t . pl'i ritj-...
Protection Guiders prepared by
other than ft "owner", i certify
deliver it to the "owner" prior to
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OWNER OR N"rr.
ubscribdncra rmtE
by a a i
rWhy ilae paroraiirm av pod as identification.
Notary Public
Commission No.
Fume of Notary typed, printed or stamped
Notary Public
Commission No.
Name of Notate typed, printed or stamped
Pwn*No.
.X' Property Identification
THE UMERSTOM bereby give informs You tW the Improvement will be made to in real
Section'713.13 of the Florida Sic tutes, the following information is provided in this NoTICE OF
f
cI.Description of property ftal
r a) Street Address: k
N
�a)N"6s#dadArass: 11CAAOV-01--i x F)
b) NiOn.6,and askims JR—Wsimple tifldholOer (if other than owner)
C) low" le property
4Zonoow Into
�OPL)
r7,
&
5-surety Irdivoni"Op
a) Nfte,wd addresw
b) Amount of Bond:
c) Telephone No: Fox No(Opt)
61ender
a) Name and address:
Phone No.
1 Identili of �person �%%iitbin the �Stete of F�10r* dcaigbMed by �owoei opoA whom vokice�er other —d..uwenUy be served:
a) Name and address,
b) Telephone No.� Faxhlol (opt)
&In addition to himseK ow� r Wdesignites �lhe fsl�lowinj poiaouto rw�ive a ropy of the Lienor's Notice as provided in Section
713J3(l)(b), Florida ftfixt=
a))4ame and address:
b) Telephone No: c Fox No, (Opt.)
9Mcpiredon dale of Notice R Commencement (the expiration date is one you from the dateTf recording unless a different dat is
spedified):
o,C c c)(" C) C)
-2--
and in accordance vvith
NCENEw t'Ks I &P
re-
-7
WARNING TO OWNER- ANCYMXNn MADE BY TIM OWNER AFTER THE EXPIRATION OF Tim NOTICE OF
COMMENCEMENT ARE CONSIDERED IINPROVER PAYMENTS UNDER CaAPTER 713, PART 1, SECnON 713.13,
FLORMA STATUTE% AND CAN RESULT IN YOVK PAYING TWICE FOR 11101MOVEMENTS TO YOUR PROPERTY.
A 140TICZ OF COMMMCF1101114i *S�i DE kRCOAb%0 AND POft= ON THE JOB SrM BEFORE TIM FnW
lNS?KM0M IF YOU INTENID TO QRTAJk VINA'NC , ING, CONSULT YOUR LENDER OR AN ATTOPNEY BEFORE
COMMENCING WORK OR RECO"ING YOUR NOTICE OF
STAU OF FLORTDA
COXV,fff OF PASCO
eir
W111
V 6k,"I U14"i L i;x
0 0 91 eowu acknowl] ed before me this day of 2 0 by
Ib Z!L —
of authority, 0.g. offi—, t-stae, Mornay
TIC
tk,
r (name dpaty an behalf of tvli Ment was Ay0Cuted)-/11,,1
Personally Xnawn )OR odtrcecl Identification Notary sigesture
--7
Type of Identification Produced Name (print)
Verification pursuant to Section 92.525, Florida Statums, Under penalties of pedvay, I declare that I have read the foregoing and That
the facts stated in it are true to the best of my knowledge and belief.
Sig.— Mauwal V—.. SWM Aa—
C% RJACQUELINE SOGES
COMNSSW # GG 276457
-W Exores Deoember 12, 2022
Boaded Thru Troy FaM hwanos W3*701 9
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1�20tc� F,'z-:VIEW DATE:
CITY OF ZEPHY—RHILLS—
BUILDING
WO RK
s I I
)E�z 95 1
d PJIONAL
%ND THE C
9
%M H PREVAIUNG
)WEUILDING CODE,
- CODE,
OFTRIC ZEPHYRHILLS
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
Date Received:
Site:
Permit Type:
Approved w/no comments: El Approved w/the below comments: El Denied /the below comments:
This comment sheet shall be kept with the permit and/or plans.
V� . . . ...
I . . . . . . . . . . . .
Bill rss—Buildin i# ieial Date Contractor and/or Homeowner
(Required when comments are present)