HomeMy WebLinkAbout91-1660
,
STATE OF FLORIDA
City of Zephyrhills
Property Owners Name:
Job Address:
Legal Description: Sub.Div.
1660~
!J.~..1-813-788-6611 . - 7- {f - (/"' /
1~1'-:..o- .;2,w11 Date
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PASCO COUNTY
Permit N~
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11, q:E5'
Type of Permit
...m__""",
~~.ILDI~
BUILDING DEPARTMENT
~~-
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C~
Lot
Blk.
Zoning CI:
Description of Work
{} is (J(/d(;t-Lih.)
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~
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" ~I All work shal! be performed in accordance
"' ,... with the above and all City Codes
and Ordinances.
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~ J Ftr.
~ Pre SLB ...
Lintel - d- VVater
.) N~ FRM~ Sewer
~ t.,. Insul.C . Final
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~.i Dn~Way ,
15o\ZiL PP,D5 C,-11-~iI ~ t o.-~ c,-qJ eA-iAl tElfte
~ ~ Re nspecdons: When extra inspection trips are necessary due to an>:.. one of the following reasons, a charge oft_u (SI9.QQ)
.-J.j dollars shall be made for ellJi~ ~Tra..de' O"ti n (f)~+~L (/-.j-.t?ZJ )
:<. (a) Wrong Address ~~.rzr..110 3~'2,.,yqt---l)l.U .~1"~ 4-(0'92-
.~ c:: (b) Condemned work resulting 'fr'~aulty construction r~,.' iJ..J1'I~ ,s~
V) e (c) Repairs or corrections not made when inspectio9, c~led for. L-JJ\l)3\ A V./
~ \'t (d) Work not ready for inspection when called.~':I::l~ ~'''-fl.~
~ \\ Thh payment of reinspection fees shall be made before any irtifer permits will be issued to the person owning same.
~~ f1tYltrlt fio/jJtv- 'J~'2J-11 P ~oi' CP~ . .0 I 'S"'A-t.L- 5J..~.5
- l.fJ .-If) fz,,3.t'Ji 1'/7-1fllJllVtr l1..~-i I
Gf.tJ;i:.Ilt.'rIJ?- 5L-t1~ $J~yt r~- ~w'q,Jf 12_,~_4}/~/l-ll-1l-cta--
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
.1 Ri
Estimated Cost: 11279, O{)/)' -
ADDRESS
APPLICATION FOR PERMIT
CITY OFZEPHYRHILLS
BUILDING D~PARTMENT
APPLICANT ~I rt;' f'O>fst"'l/.~'"
ADDRESS ;;~' 7tLD3', bJe ~ J/-
OWNER 7 I- co /JIlLc~ ' R JetL
705"0 tdl t3/v/. ~ :z1dL
PHONE
7~7-3~S(-
JOB LOCATION
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.f~
~ f:~I-ILA4<.v
WORK PROPOSED:____New Construction____Addition ~Alteration
_Repair
_Install
____Sign/Temp.
_Sign
_Hove
____Demolish
_Commercial
~Indust,
_swim. Pool
_HIll
&,,6/f~L Other
/I&~/' .
PROPOSED USE: _Single Family
_M/F
_fl of Units
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t,
Height
RESIDENTIAL:
COl-U'tERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.**
ATTACH (3) SETS OF Blf1LDING PLANS & (1) SET ENERGY fORt-IS. ,~*
**COPY OF CONTRACT REQUIRED,
.PERM1TS REQUESTED
_BUILDING
$
valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_H.R.E.C.
_MECHANICAL
$
Va~uation of Mechanical Installation
_PLUMBIN"G
GAS
ROOFING
"R.,.",,,,,p ~epl
-'" -_...... -- - -
SPECIALTY
TYPE OF CONSTRUCTION:
____Block
_-.-----~_Other
FINISHED FLOOR ELEVATIONS: FT,
******************************************
CONTRACTOR
Company
State Cert. 0 gist.
Signature City License Registration
F.TECTRTCTAN'- )~~~:~.....**...:::::::*~"~~~~ . AV6-~cj)Jc
r2/ /J~ ~_' . State Cert. or Reo s t, "'"-- OO~~ rl.
of .Mt"r. .x;;r~#,. ~ .. City License ReGis trntion" '. .
*1dr'" * ** ** *.**** ** ** *** * * *,~ * * **,~ of;,~ i: {: 1: ,',,~ ,': i, .:, 1:;:
~I,IJMnCR . Company ~"..".,........./ ~~ /~- -
... /~ '. State Cert. or Regist. !.! ~p:c oz.6r65
Signa.ture ~ - c.- City License Registration if
. * * * * ** ** **** ***** * * ****1' 1,>~ 1,* O{,1, i, 1: .:, ,', ,', ,', * 1, i,,~ ,',
MCCjjANTCA1. Company /~""~/ ~ /)(/~.
~c- _. /h State Cert, or ReGist, I' -:H~ e2DA /..;!/
Signature. - ~~*~******~~;~*~~~~~~~"'~~~~~;~:~;~~~ "
-
Signature
Compa.ny
State Cert. or'Regist. 0
City License Registration 0
D-1HER
APPLICATION APPROVED BY.
PEm-lIT OFFICER.
/
bONDITIONS, OF PERMIT AFFIDAVIT
A.': NOT T CE OF DEED RESTR I CT IONS;, , ,
'.
Th. und.rsigned understands that this p.r.it lay bl subject t~ "deed restricti~ns" which ~ay b~ 5~re restrictive than City
regulations. The undersigned assules responslblli~r for co.pliance with any applicable deed restriction~.
. . .:. .:.\. :.. ~ .,~,
'. . .
B.
:,.~.;. .
UNLICENSED CONTRACTORSANO.tONTRACTOR RESPONSIBILITIES
If the owner has hired a c~ntractor or contra:tors to undertake wor~, they may be required to be licensed in a~cordance with
s~ah and loC~l regulati~ns. If the contfl~tor is not llcennd as re,quired by' law, be.th the Duner and contracteor lilY be
ctte~ for a Ilsdeaeanor violatl?n under state laM." If the owner or intended conlract~r are uncertain as to what licensing
requlrelents lay apply for the Intended work, they are advised to c~ntact the City of Zephyrhills Building Departlent (913)
799-6611. ' ','" '
Furth.rlore, if the owner has hirld I cDntracto~ or contractors, he is advised to have the contractorlsl sign portions of the
'Contractor SectIDn,' of this appllcatlDn for which they will be responsible. If you as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for t~e work: lf the c~ntract~r wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to per~itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided ~ith a copy of "Florida's Cc,nstruction Lien Law - HOleowner's Protection
Guide. prepared by the Fl~rida Departlent of Agriculture and Consumer Affair~. If the applicant is sOleone ~ther than the
.0Hner", I certify that I have obtained a copy of "the above described document and pro~i~e in go~d faith t~ deliver it to the
'oHner' prior to cOimencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all Hork Hill be done in co~pliance Kith all
applicable laws regulating construction, 20ning, and land develop!ent.
Application is hereby lade tc. obtain a p'enit to'do work andinstallaticln as indicaled, I certify that no HCork or
installation has co&!enced prior to issuance of a perlit and that all work will be perfDrmed to ~eet standards of all liWS
regulating construction, City codes, 20ning re~ulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations o~ other governmental agencies ~ay apply to the intended work, and that it is
ay responsibility t(, identify what actions I lDust'ta~e to be in compliance. Such agencies include but ~Ie liCIt li~ited to:
I Depart_ent of Environ~ental ReQulation - Cypress Bayheads, Wetland nreas and Environmentally Sensitive l3nds,
Water/Wastewater Treatment
. Southwest Florida Water ManaQellenl District - Wells, Cypress ~ayneatls, ~etianJ ~1~a5, ~l~:ring 4alerr~urses
. ArDV CorDs of EnQineers - Seawalls, Docks, Havigable Waterways
. Departlent of Health L Rehabilitative Services. Environ~ental Health Unit - W~lls, Wastewater Treal~en~. Septic Tanks
I US Environaental Protection AQency - Asbestos abatement.
I also certify that, if fill naterial is to'be used in FI(.od Z(,ne "A" or "{\,etc,', it is understc.c.d t,,~t a drainage plan
addressing a "colpensating volute" Hill be sub.itted which is prepared by a pr~fessic.nal engineer reqisli?icd in the State of
Florida prior to permit iss~ance.
A perlit issued shall be construed to be a license to proceed with the wor~' and not as authDrity to vioJite, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official froft thereafter
requiring a correction c.f erf(.rs in plans, cc.nstructic,n, (~r violations (If any cc.de, Every perilit issued :halI beee..e invalid
unless the Hork authorized by such permit is coaftenced within six months of issuance, or if Hork authorli~d by the perlit is
suspended or abandoned for a period of six lonths after the ti~e the Hor~ is co~menccd. One 90 day r:IE~5jDII of tile, lay be
allowed for the per~it with fee charge of $15.QO. The extension shall be requested in Hriting to the Building Official. An
approved inspecti(.n ",ust be lc,gged'during each six Mnth period, (Ir the project \ii11 be cc,nsidered ilb.;lidor,fd,
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. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SlGNATURE___~_~ '-----------
OWNE ~ ~
DATE___:?~~f___-_----------~------------
y' c~'~
SIGNATURE_~__. -... ----------
. , J~~1F {I ~ OR
DATE _ _ _ 2Uf'111- - - - - --- -- - -" -- - ~ - --- - ----
NOTARY A~,..~,,;: " ~
CONTRACT ~-~S::i\...L~~~-'-\
MY C6MMISSION EXPIRES__________________
NOTARY AS T~,~~~ .'
OWNER DR AG~~~_~
CO MISSION -XPIRES Notary Public. s~ate of fl~fl€1Ei
MY M _ t:. --Mr6on'n'n1s~-E'J!!l!fes..felr.+.-i~
~,.~,'""'.t~"41 Pi:b);c ~~+,~t(; :IT ri
~~~".
~.~-_...-_.__._-_._---_._---_._..._-_._-----
, TART.To', A - WORKSHF.F.T
CTTV OF. 7,F.'PHVlnJT,.,T,~ CONNF.r.TTON FF.P.~
atm. t, 3 ., 5 RESOLUTION 151 & 329 WATER $1.75/ GAT"LON SEI.JER $6,39/GALLON
RF.STnF.NTTAT. i.En..d1 Lot: or tJn; t)
Residence $ 350.00 $1,278,00
Travel Trailer Park 131. 25 479.25
. .,
r:()HMF.1H~T A 1. (PF.R FTXTtJRE)
Sinks 87.50 319,50
Water Closet 131.25 479,25
Urinal 87.50 319,50
Lavatory l,3. 75 159.75
Tub/Shower 87.50 319.50
Washing Machines 350,00 1,278,00
FOOD SERVICE
Dishwasher 700.00 2,556,00
Sinks 175.00 639,00
Car Hash (Per Stall) 1,000.00 6,390,00
FIXTURE
G.P.D.
i;
WATER
-
SEHER
-
TOTAL PER FIXTURE
::5/11
~/
-5
e.t 2 59
-? ? / c::S-
L- ~- ,
/J / ";)--
C-((h-. " --
()UU/ ~~ <9'l1 Q~ I~ ~
k: fJ",J; !: Ke..P(P(~i/, Gj r ljr~ .Ji..' GRAND TOTAL -4 ~~""'-i;)-$-
7~----' (]rlf" C'o"""trueJ;;;f( /ri:A{)V'. ~ ~A)~::;:J~P
-P:t.tflo;< 15Z3 ,l3>' c)~6,:;j;J~ 1
.lBd=: C,f'(,::;-r. 35'52.4, t#~ ~ ,v'
------1"" 11
/ 2 2- I . ,,~
_" WATER ~1ETER
~ l'
~:sl- ~$CO #/ed(-0:?3! (levt let'
~sp~fe~ .
0b"0 qhJLL ~lrtJ. FJ;..s T I tV ~
2-/0
* BL7;Ic-~i1~
~/eefr/@ (
, ;:rLJnfh/~(r
(cbni~c'9c.l- pr/cte....,) /f!ectaP(/~d(
c~~~cfrO'1 ;:::Pe~r.
.s
----
ree...s
2.9 22'-1_~$
ir pe.JI:
(! () uS 1;1/ 'i: ~ '"
$
~'2. 19,.~,oE
i2~5:~
'2t, 3 . z.S
1~7 ,50
"2..l~ '-17 , o~
,
50
!:2 J/ {,:.Q ..-
I J .
" '..3 4fQ--~-
I " ], ,-
~' ~1.:2 ff9.
~- ~ &; 7~~--~.._.------
,
I 32" ID
9 ~ 2..2. '132-, log
f
/ l'? 2. 9 2. zS-
5{3~3~ 3'J
,
.
- 390..o~
$?1'l13_~
yART~ A - WORKSHRET
(;T"Y OF 7.F.PHYRHTT.T.S CONNEC:"TON FEES
I
. ORD. i~395 RESOLUTION 151 & 329 WATER $1. 75/GALLON SEWER $G.39/GALLON
RF.STDF.NTT At. (F.ach I.ot ot' Unit.)
Residence $ 350.00 $1,278.00
Travel Trailer Park. 131" 25 479.25
d
(;OMMF.R (;1 AT. (PF.R FTXT1JRF.)
Sinks 87..50 319.50
Water Closet 131. 25 479.25
.
Urinal 87.50 319.50
Lavatory 43.75 159.75
Tub/Shower 87.50 319.50
Washing Machines 350.00 1,278,00
FOOD SERVICE , .
Dishwasher . 700.00 2,556.00
Sinks 175.00 639.00
Car Hash (Per Stall) 1,000.00 6,390.00
I/~
I r
l.
~
/
I
FIXTURE G.P.D. ~t WATER SEWER TOTAL PER FIXTURE
/b j IfO O. 00 t. -.5- / ;J , tJo
/0 / 3 / ~ . ~() 7 9d., 0U t / o~-, (lO
3so. crv / r, cf7) h,{2~, d7)
,
/ f' }, -..50 3/ , 0-0 I/o 1, c:Jo
/ . '7 - (/0 b.3 7'- 07) Y / i, ou
/ . ~.
/ 3-s o. ()7J I d: 7 ;g--, cJi) /6d.-8-. (/V
3 b 7 So c (] /3 'I / 7, {TV
/7 {J 9 y, (') ()
-,-tr WATER METER
GRAND TOTAL
\:
I
.'
~e...
-
-
9' 2..5{), ~
OSP
85 :sF
2...5"" 5. IC'
X CoS7C()N kTL X N
-
-
{=
c..... -"'D ~\
, ~ ~
Best.~~t.~~ec!!!~..~ pany
DADE aTY. FLOIUDA 3SSZS
~rll 199/
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'PU4~ ffi/ud~. r ~ ~
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AUG-21-1992 15:49 FROM HRS PLANS & CONSTRUCTION TO
68137836198
P,01
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STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
904/487-0713
OFFICE OF PLANS AND CONSTRUCTION
August. 21, 1992
Mr. Robert Dodd, Administrator
East. Pasco Medical Center
7050 Gall Boulevard
zephyrhills, Florida 33541
Re: East Pasco Medical Center
Phases I and II/East Addition
Log No. H-425-H / CON No. Non-reviewable
Date of Construction Survey: August 19,.1992
Dear Mr. Dodd:
The project referenced above has been surveyed by this office.
This is to advise that occupancy of the area surveyed is approved
for its intended purpose. Deficiencies 'noted at the time of the
survey will be sent at a later date.
Correction of these deficiencies is required, and we will conduct
a resurvey to determine compliance. You will need to notify this
office at least 30 days prior t.o t.he anticipated completion date
to schedule the follow-up survey.
The licensure rules require record drawings of t.his project be
submitted to this office at the conclusion of work. Kindly have
your architect and engineers provide a set of the record drawings
as soon as possible.
If you have any further questions, please contact this office.
sincerely,
~Gre
~~~~~ t:~t Su
Office of Plans
JRG/KE/BB/EL/sls
Copy to: The Edqe Group, P.A.
Peninsula Engineering, Inc.
Office of Licensure and Certification
, ~wroN CilLES. GOVERNOR.
2727 MAHAN DRIVE, TALLAHASSEE, FLORIDA 32308
ZEPHYRHILLS FIRE DEPARTMENT,
Zephyrhills, Florida 33540
38410 6th Avenue
(813) 782-8184
FIl':AL BUILDING INSPECTION
Fire Chief
William T, Fenton
Assistant Chief
Robert Hartwig
OCCUPANCY: EP/YJ(!, - EAs-+ !+l:f))t.),,,ttJ
ADDRESS: ?OS-O ~~LL f>{vb
BUSINESS PHONE: 1B8~ 04 f I OWNER/MAl':AGER: k.&rv G/!..-r:r;,J
DATE:
8-AI ~7;L
This h\lildin~ has het'n inspected by the Zephyrhills
Fire Department under the codes and re!?;ulations of the
NFPA Minimum Standards and other local fire safety codes,
~PROVED
NOT APPROVED
CO~t~lENTS: J)\,.( rz l N~ -\ \-\-c UR-S -=hv;PlC.cl(.CI c...J otJ 8 - (q - '1 L C;€c.JEfl. A-(
V \ (.? (p..-l to (V S t.OfS /L E ~ tV't-, 1J1.:+l (. ~t\- v-? E.-Il..~ J Cor-..;c t~Jl tV -to
z..~ . \l-\-E- c; c:... ~, <; C; I. (\...I ~ -K ~E ~A .---~~ fZ- <;; I (Y"\ (S c; l ~5 ~ ( a. jlJ.b
~l<w o~ ~c\k <;. "'tJ~):. 1.<1')" <.C s i-\A <--<=. g"""",,-, (}., "- ~€.J".1
fiLL esQ'^\.{tE~~S B.., Z--f:b '\-lA-UE €tG~ ~E-+f Z.F~
~ ' vE- <;, ~ "-'~ ~ F' e.,~ (). L *'~ (I, V . p~"'),' ~> tk.s ~ p.1'<> v'""L
INsPEcrOR~"'=-I-~~
DATE: ~-,z...l- '{Z- TIME:
~
SIGN En. '. ./.
TITLE:
06/17/86 als