HomeMy WebLinkAbout93-3334
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
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C;~~ GECHANI~
_3334E
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Permit N c,:>>
Date
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0UILDIN~ 'ELECTRIC~
Sewer Conn
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Water Conn:
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Zon;n9' -::it En"9Y Cod" _ ~'don G"~~ /.: ID -91
Description of Work _1f.JJ fi.-... r!~ " ;C ~ ~ /r - - U
FINAL
C.O. -'--
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector W. A. BURGESS
p~'m;t F"" _~ 7" ~
Slgnatur~ )~
Company
Address
Telephone#
Valuation or
Contract Price 9~ /J27J . t1lJ
City License Registration # -5/ 9'
State Certified License#
Tp.Serv'il_Of
Rough In {O-t'-t-f?-. p-
Meter Can (;....J-c:;..V
Const. Pole
Pool
Pre-Meter I - ':) f t.f &b
Final
SLB 'l-\ \. .q3 B I o..e
Tub Set \rr~-~ B...Q.Q.
Water Ie -{ J; 3 /G
Sewer fD -l<{-f?; fJb
Final
Breakers
Ducts Ins!. Jo,~-q3(3~
Compressor
Final
fiEJNSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
<-?v( a, 6 -c2~-:"- 72
jJ / -/() - 7r
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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APPLICATION FOR PERKIT
CI'lYOPZEPIIYRIIIU..S
. BllfIIJ1UiG DEPARIIIENT
, -
OWNER' S lWIE ~ t \...:)G Y 0 l.U ~ \... ') ~ PROD ~ '61<) -\::) \..\5 ~
OWNER' S ADDRESS 5 ~ \ ~ ~ ~ '--L ~ \. ,0 S2> ?":.E ~ t\ Y J2-- \-\ \, \.}.S F L 5:55 ~ \
JOB ADDRESS (0 -;).~~ CO \ L\J ~-' ~, a ~ \.:L S D ~
LEGM. DESCRIPJ'IOlI: Im(S) \ \ to BUJ(Z - SDBDIVISIOII~\\..\)P~~ ()~~ ~\-\ l il
PARCEL I.D.' S - d..\o - ~ \ - ~\cl-.C) -~~~~ - \ tlo 0
-
IIDRJ( PROPOSED: ~ev Construction _Addition _Alteration _Repair _Install
S. _!!love _De.o1ish
- 19I1
PROPOSED USE: ~ing1e Paai1y _KIF _, of Units _K/B
_~rcia1 _Indust. _Swill. P001 Other
_Restaurant 6: Bea1th Depar~t Approva1
" 1
BUILDING SIZE: :=:;Ct33~. 'd(1~ct \.-..'0 Square peet._l G
Beight
RESIDENTIAL: A'ITAaI (2) PLOT PLUS 6: (2) SEI'S OF BUIl.DING PLUS 6: (1) SEI' ENERGY FORMS. **
COHIIERCIAL: ATI'AaI (3) SILTS OF BUIl.DI8G PLUlS 6: (1) SEI' EIIERGY JIORHS.......
......mpy OF mllTRACT BIlQUIlUlD.
PERKITS REOOFSTED
x: BUlLDIIiG
VKLECl1UCAL
~CAL
~ PLOtIBING
$Co5~~~ ..
\. '5 CJ
s 3(j~ ..
Va1uation of Tot:a1 Construction
AtIP Service V P10rida Power Corp.
W.R.E.C.
Va1uation of Kecbanica1 Inst:allation
GAS
HOOFING
SPECIALTY
TYPE OP mIiSTRUC'I'ION: ~B1oclt _Pra.e _Stee1 Other
FDIISIIED FLOOR ELEVATIOJJS: 0t Cl $- FJ' . IS PROJECT IIi FLOOD ZOIiE AREA'!
v
YES NO
..............................................................................................................................
RIJTI.DY.R
Signature~
CDn'KACIOR SECJ'ION
COlIPANY R \ c:.... .. )s, \)~b\\ t::;..
~' Sl:ate Cert. or Regist. , C. ~,~C>) C~C)~
~ City License Registration , 3/9'
............................................................................................................................
F.T.P.cnrrCIAN COlIPMY f t~ S L~~\' ~ \. C-
~~::J~.) ~~ 'f: S~t:e ~rt. or R~gist. -' ~ D(')~ \.U~'-\ ~
I ,'-. ~ 0 - C1t:y L1cense Reg1Strat:1on , -StJ
-- '"
........................................................................................................................
PLOIIBER COlIP~~~Q:Bw~~, ~ ~:::>L'\5~
~\ _ \\ \ Sl:ate Cert. or Regist:. t
Signature ~t } \J\\~ City License Registration , 1 rt "S
............................................................................................................................
~
COlIPMY.~J ~-- \ ~ ~
Sl:ate Cen:. or Regist. ,
City License Registration ,
..............................................................................................................................
ItEalARICAL
Signature J ~
/ < y
0T1IF.R COlIPOY
Sl:ate Cert:. or Regist. ,
Signature City License Registration I
..............................................................................................................................
APPLIc&nOR APl'IIlWED BY 2/ ~ oJf. a/lAhJ PI!IlIIlY OFFICER.
_ , CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS . .
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be .ore re5trict~ve than City
regulations. The undersigned assu.es responsibility for cOlpliance with any ~pplicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they .ay 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 lay be
cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, 18131
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
"Contractor Sections" of this application 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 the work. If the contractor wishes you to sign
as contractor that .ay be an indication that he is not properly licensed and is not entitled to perlitting 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 with a copy of "Florida's Construction Lien Law - Ho.eowner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and ConSUAer Affairs. If the applicant is so.eone other than the
"owner., I certify that I have obtained a copy of the above described docutent and prolise in good faith to deliver it to the
"oNner" prior to cOllence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land develop.ent.
Application is hereby lade to obtain a perlit to do Nork and installation as indicated. I certify that no Nork or
installation has cOI.enced prior to issuance of a per.it and that all work will be perfor.ed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I .ust take to be in cotpliance. Such agencies include but are not lilited to:
f Depart.ent of EnviroDlental Requlation - Cypress Bayheads, Yeti and Areas and EnvironlentaIly Sensitive Lands,
Water/Wastewater Treat.ent
f Southwest Florida Water "anaqe.ent District - Wells, Cypress Bayheads, Yetland Areas, Altering Watercourses
f ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways
f Depart.ent of Health l Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environ.ental Protection Aqency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.., it is understood that a drainage plan
addressing a "co.pensating volule" will be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A pertit issued shall 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 perlit prevent the Building Official fro I thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beco.e invalid
unless the work authorized by such pertit is co.tenced within six lonths of issuance, or if Nork authorized by the per.it is
suspended or abandoned for a period of six lonths after the ti.e the work is cOllenced. One 90 day extension of tile, lay be
allowed for the pertit Nith fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six tonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COH"ENCEHENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
nOHKE . JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COKKENCEHENT".
(' ~ ~
~_ ~ Je,<2.J _ _
SIGNATURE: OWNER AGENT SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF P ~.-o
The foregoing instrument
before me this b - 'IS'
was acknowledged
, 19..E.3. by
STATE OF FLORIDA
COUNTY OF fJ ~
The foregoing instrument was acknowledged
befclre me this C; - IiJ -- , 19..:Ll by
~,,~.. \$l)~~b\\\~'
who is personally known to me Dr who has
produced 7> ,,1.<') ...... A I~ II.d<-I<"'o ~..J
as identification d who did/did not
take an oijjtl.. '_ /1l \
/J" Ch.A1 f _'--' ( t.~,L-,/'-e-J L././-J
(Signatw-e)
/" ,_ t5 ;.-. JA-
r..::r, t(,.t::: ,'r"~ ~ ~
(Name Typed, Printed Dr Stamped)
NOTARY PUBLI C
~t~'-.,Y a u. )~.~"\::>
who is personally known to me or who has
produced -Y:/7A)/r"v1 nj7~ k/J1 g' .-vi,)
as identifi ation and ho did/did not
take ~/:.~t;; ~ 1 6'-/~~ 4->>
(Signature)
G- r c< " c-- . \.e CJ L.r-rC--;v..:s
(Name Typed, Printed or Stamped)
NOTARY PUBLI C
MAP OP 1l0lJNDAIlV SlJIlVI':V
~'_________~ ___n___..
fJESCR'IPTION: Lot 116, SILVER OAKS PHASE lA, AS RECORDED IN PLAT BOOK 30, PAGES
51-52, Public Records of Pasco County, Florida.
SURVEYORS NOTES:
1. No underground installations or improvements have been located, except as noted,
2. No instruments of record reflect ing easements, rights-of-way, ,snd/or ownership
were furnished this surveyor, except as shown.
3. Unless otherwise shown hereon, no jurisdictional wetland areas or other physical
topographic features have been located.
Based on Flood Insurance Rate Maps Community Panel No. 120230-0455C" dated 2-17-89,
the property shown hereon appears to lie within Zone "e".
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to eo r- / / .!!?
C<</toil." /Z.05!J '3~" C.I1on:l: ~!).1i>1'
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VACANT
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CS't#ili c4semen-l-..'..
K.I&d,~.. "30,00' Arc'~, 74>'
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s/(,ve/f OAlf4 PRIV,5
PREPARED FOR: 8MIrH CArTt..E ~ GIf'OI/G, INC,
REVISIONS
DA.TE
OESCRIPTION or WORK
ORDER NO, OWN CK' 0
~;~IERE ENGINEERING, INC.
~ CIVIL ENGINEERING
".. LAND SURVE YING
'.131 M., 73111
FAX: "3'21116
3750 GU'ooN HWY. SUITE 1-C, TAMPA,FL 33624
THIS SURVEY NOT VAL.ID UNLESS 1 ""RlIfTED WITH AN EMBOSSED
SU'WEYOf" S SEAL ,
SUItVBYON'S Cr.MTJP'JCATB
I hereby certify lhc"t the aurve'Y ft.-pre.ented hereon lIl.e'K Ih..
requI r.lIWnl. (If ChoJpter 21 HH"6 rlond. Adllllnlstutivf' ('uctr,
pursuont tn r:h.pt., 471.077 'lor ide S~ut...
FLORIDA REGISTERED LAND SURVEYOR j (~~ ~ Q., Q
Ronald H. Pol ~ P.L_S~ .4660
SCAI.E:
3 TWP. 265. RGE. 2/e.
DRAWN
O~(}f.P NO
,~2'S-A
owe. NO.'
116
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MAP Of' 1l0UND^HV SllllVI':V
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DESCRIPTION: Lot 116, SILVER OAKS PHASE lA. AS RECORDED IN PLAT BOOK 30. PAGES
51-52, Public Records of Pasco County, Florida.
SURVEYORS NOTES:
1. No underground installations or improvements have been located, except as noted.
2. No instruments of record reflecting easements, rights-ot-way, and/or ownership
were furnished this surveyor, except as shown,
3, Unless otherwise shown hereon, no jurisdictional wetland areas or other physical
topographic feature. have been located.
Based on Flood Insurance Rate Maps Community Panel No. 120230-0455C, dated 2-17-89,
the property shown hereon appears to lie within Zone .C".
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OA.KS r"#ASe ONE ~ R.!J.Z45~/j4.4tt.-~~
to D ~ / / .!!!J
DaN>. ./z.o5!!J '!J~" Chon!: (J,!!). 61'
JfCad,u.. !SIO.CO' Ayes fiI~,7dt.
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PREPARED FOR: !JMIrH CATTLe I GI'('O//4;INC',
REV IS IONS
OA.Tt
DESC' lPT ION or wo."
O_OE" NO OWN eM' n
~~E_ ENGINEERlNG.INo.
~ CIVIL ENC3INEEI'lINC3
r LAND SUI'lVEYINC3
11131 HI 731'
FAX: H321.
37l5O Gl..I\IN HWY, SUITE 1-C, TAMF'lCI,FI. 33624
DUWll IY, L.~ CHEeKf.D IY, ~p, sEe,::1 TWP, 265. RCE. 2 II!!.
<nr,t, 1"'20' OA'" 11-4-~Z nOllE_ ~o ,!12'5-IM. OW(;, NO,' 1Itt.
TillS su.vr'l' NOT YALlo UNLesS ''''111.,..0 win .If rMIO...ltD
SU..YEYO.... SEAL ,
SUIlVWrntf'. ClJ.IITIPICATI
I he-r.by c.rti''f thl't t". lurv.y h'pr.'.n'ed h.reoft ".t. th_
''''quIUtwnt. ('If Cholpt.r Jl ""-I 'land. -_'"IUrAtlY,. CIH'"
.ursu..t tn ':..pt.r .'l,Oll Plor.4. .~.. .
n.ORIOA REG'STERED LA~O SURVnO' j ~ ~ iJ...}Q
Ronald H. Pol P P.L,S. '4660
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3-~la-~\ -O\~(')
ClOOGO - If (P 0
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C E N T R ALP E R M I r TIN G
PASCO COUNTY, FLORIDA
DATE: 01/10/94
F'A(;E~ 1. OF 1
CONTRACTOR #:
IW~ME: R BURNE TTE
ADDR: 6225 SILVER OAKS DR
(:/:::;;1': Z/HILU::
I :::;;':.UE (:IFF 1 CE: D
RECEIPl NUMBR= 00199610
OFFICE: DADE CITY
FOR:
CHECK # 652
~KC:l'n
114
TOTAL AMOUNT:
COMPNf ACCOUNT CENTER
8450 - 363000 - L
4:=:.64
AMOUNT DESCRIPTION/PERMT DATA DRieR
48.64 ****** SOLID WASTE FEE AO
. ~h I
/", //' /' "// I~ /,~ ~.
HECE I VED BY ,____I.....:-,__:,_LC~i.!..i _-.__L..i:_!..LL_(J...{:_t..!...~____,..._
/
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PASCO COUNTY, FLORIDA
Permit #
Date
Name/Owner
COlDlly Parcel #
Location
Classification / Type of Use
lRANSPORTATION IMPACT FEE CALCULATION
Rate $
Zone #
Sq. Ft./ Unit
Prepared by
Impact Fee Amount $
The above impact fee has been estab!~bedPWsUantt&.the Pasco County Transportation Impact Ordinance as adopted by the Board of
County Commissioners. Thi&.amount is payable PRIOR to the issuance-of a Certificate of Occupancy or authority to utilize the permitted
structure.
RESOURCE RECOVERY ASSESSMENT
RESIDENTIAL
NONRESIDENTIAL
# Units !
Gross Sq. Ft (GSF)
Rate / ERU = 50.00 x 0.96* / Year
or$0.1315/Day
ERU Assign #
Assessment = (# Units) x ($0.1315)
x (# Days)
Assessment =
!QSflx (ERU) x (0.1315) x (# Days)
100
TOTAL FEE $
TOTAL FEE $
*Discounted for Prepayment
The above assessment has been established pursuant to the Pasco County Ordinance No. 89-07 and Resolution No. 89-197, as commended.
TIffi ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF TIffi CERTIFICATE OF OCCUPANCY.
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIl, THE AMOUNTS LISTED
HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this fOrim, placing the building permit
owner on notice of this assessment and the conditions of payment for same.
Date
Received By
----------------------------------------------------------------------------------------------------------------------------...----------------------------------
OFFICE USE ONLY
TRANSPORTATION REC. #
RESOURCE RECOVERY REC. #
DATE
DATE
BY
BY
White
Applicant
Canary
Trans / Finance
Canary
RR / Finance
Pink
Office
Green
Bldg /Insp