HomeMy WebLinkAbout93-3410
BUILDING PERMIT
Permit
3410..8
r-/I- 9...3
CITY OF ZEPHYRHILLS
(813) 788-6611
y-o. ov .3~ fT1) 3~-' cri)
~~ ~ECTR~ ~~~
Pmp"'Y OWO"" _ ~ ~
Job Address: ...5 :;-0...5~__,d_ __
Parcel I. D. # IY - ;)..6.-;).../ - 0/6 IJ- (; LJ- b c) d- t7 Y ,CJ 6
N4?
Date
02..0. tJ-tJ
~HA~
Sewer Conn ~ tJ, ~,
Water Conn: ';".00. QV
Water Meter: /~"': trV
TI.F.'s: Y 'Y;2 ~ c.:TV
-oJ. OY/O
Zoning: ~ Code:
Description of Work m . ~
Radon Gas:
.//~~
NO OCCUPANCY BEFORE C.O.
~..-
FINAl-'.
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
!"-
DATE
3-Sh
Permit Fee
Signature
Company
Address
Telephone#
Valuation or
Contract Price
City License Registration #
State Certified License#
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.-"~"
Compressor '\
F;nal J"
--, . I
~ rP[#~ fJ )
/;y;6 ~/3'/q!J. /
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to any e of the following rea
charge of Fifteen and 00/100 Dollars ($15.001 shall be made for each trip for e~
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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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--========::==:::::..
APPLICATI05 FOR PHRHIT
GI'IY OF ZEPIIYRBILLS
BUILDIliG DEPARDDJ:NT
OWNER'S IWtE I~A~.AA '*-( . ;diu ~~JAM/
_'S ADDRESS 5 MlO ~~ I J.d~d?. ~.
JOB ADDRESS ~ t:Ul ~
I..EGAL DESCRIPTION: 1DI'(S) * of't,l1
PROBE % 8/3 - 782-22- 76
IILOCK
SUBDIVISION dJ~ iJ~~
- ..,.. /'f -2-t. -~/-1J160 --OOO.ov - C ~/ 0
PARCEL I.D.#
j'-r- 2~ -;)./- 01100 - ()()tJot:J
- t) ~()P
WORK PROPOSED: ->IE liev Construction _Addition _Alteration _Repair _Install
S.
- 19t1
_!!love
_Deaolish
PROPOSED USE:
Single Faaily .> _KIF
_, of llfnits
it:::"IH
_ec-ercia1
_Indust.
_Swill. Pool
Ot:her
_Restaurant &: Hea1th ~t Approva1
I "
BUILDING SIZE: 52 8' X 2'g" J
/</-7'8
Square Feet,
Height
. RESIDENTIAL:
cotmERCIAL :
ATTACH (2) PI.OI' PI..ARS &: (2) SEI'S OF BUILDING PLUS &: (1) SEI' ENERGY FORlf.S."''''
ATrACH (3) SEI'S OF BUllDIRG PLUlS &: (1) SEI' EBERGY FORlf.S."'~
"''''roPY OF rolMTRAct BllX!tlJIRED.
PI!'RI!fT'TS REQUESTED
_BUILDING
$
::l S; Yd-o
Va1uation of Tota1 Construction
_ELECTIUGAL
/S'D
AKP Service
~ Florida Power Gorp.
W.R.E.C.
_ttEGllAlUCAL
$
I;).. SlJ
Va1ua.tion of Kechanical Installation
_PLUKBIIIG
GAS
ROOFING
SPEGI.AI.TY
TYPE OF WNSTRUCTION: _Block _Fraae _Steel
/n/N -
Other
FIIIISHED FLOOR ELEVATIONS:
FT.
IS P.RO.JJJ:ct IN FLOOD ZONE AREA?
YES NO
.........~............................................................................................................
COIIIIl'I'RACIOR SECTION
BIJTT.DRR / aJ!IP.DIY #.-/2. ~~tdL~~
~ ~ ~ State Gert. or Regist. I '
Signature /~ City License Registration' #3..:ST-
" ............~..........*****.........................................................~.
ELECl'RICIAR ~' ~ARY ~ <#. VO~;4AJ
::: ~~ )(~~~e Gert. or Regist. I
~ _c A-;'?' _ ~~iq License Registratloo .
~ ...... ...................~..............................................................~....
~~ aJ!IPAKY .iJc/s~ ~/HdI..l
State Gert. or Regist. I
Signature ~_~ _ City License Registration I
... ......................................................................................................
~~/"C.
H~
PLOtIBER.
#- /tf'?
. ftECIIAlIICAL.~ ~ lDIIPMI' 13/11f'/2S: P/20/'mJ<C
State Gert. or Regist. I
Signature ~ City License Registration I
..................~... ..................................................................................
~/1.s ""A<.-.
-tr79'
0T1IF.R aJ!IPMiY
State Cert. or Regist. :f
Signature City License Registration I
.................................................................................~~.~.......
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.The undersigned understands that this perlit .ay be 5ubjert to "deed restrirtions. whirh lay be lore restrictive than C~ty'
regulations. The undersigned assules responsibility for cOlpliance with any applirable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ONner has hired a contractor or contractors to undertake Nork, they lay be required to be licensed in arcordance with
state and local regulations. If ,the' ~.ntractor is not licensed as required by laN, both the owner and contractor lay be
cited for a lisdeleanor violation under state IaN. Il 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
788-6bll.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s! 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 may 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 LaN - HOleowner's Protection
Guide" prepared by the Florida Department-of Agriculture and Consuler Affairs. if the, applicant is someone other than the
.owner", I certify that I have obtained a ~opy of the above described document and promise in good faith to deliver it to the
"owner" prior to commencelent.
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 developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no Nork or
installation has com.enced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand ,that the regulations of other governmental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
f Southwest Florida Water "anaQelent District. - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health L Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental 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 "colpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit 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 frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall becole invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, Dr if work authorized by the permit is
suspended or abandoned for a period of six lonths after the tile the work is cO.lenced. One 90 day extension of tile, lay be
allowed for the perlit with 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 lonth perIod, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR P~YING TWICE FOR IHPROVEHENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CDftMENCEOENT. JOBS UNDER '2,500 I ~AlUE DO NOT NEED TO RECORD AND P~O~
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
STATE OF flORIDA D
COUNTY OF " /IS c 0
The foregoing' instrument was acknowledged
before mF? this /1 // I~;i ' 191? _ hy
/I/~" / .../
"c,l---5,o/../ /1 '"I ~"i 4 ,-1...-
who is QersonaI11'kno~ to me Dr who has
produced
as ,identi f"ication and~hc, id/did not
t~) C'"dlA. '
,__~ .-/.,,/,~ vo.L~'1_, .~...,i
(Signatul-e) _)/,j( 'l---ry,('i,;.'J,~"'.il-j
STATE OF FLORIDA
COUNTY OF
The foregcl i ng
f)1 -1'(:- Q
instrument was acknowledged
b~f(;'rc' m:= th:. s ,//' Il,/"I , 19 "'{ \:' by
r",l
~1
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who i s~~.~!~tJ"y::7)~~~l1 to me Dr whc, has
produced
as identification and who did/did not
take an~~A~-1A-.J~:if
(S. t ') ~"~, -- '; r
1 g na u r e. ,~__ ~~ljl ....4..; t,. ..1-~~.(.<\' d.,." '? i 0/
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
..,,'~~A~~fU;;;,.. DAN FARNSWORTH
~*~.tb"'f.~ MY COMM1SSION /I CC 186067 EXPIRES
<~"~:O': April 21, 1996
~;:;f;,iif.,~~~" BONOEO THRU TROY FAIN INSURANCE,INC,
"UH.,
.~~Y,r~~ DAN FARNSWORTH
[.(~'\*~ M'{ COMMISSION /I CC 186067 EXPIRES
W'~'~l April 21, 1996
"'1f.fif.,'f,'J-" BONOEO THRU TROY FAIN It,SURANCE,lNC,
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FILED FOr: ;~ECORD
Warrant~~i~Y.FL.
(The terms "grantor" and "grantee" herein shall be construed to Include all genders and singular or plural as the contex, indica s.)
Made this
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day of
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BETWEEN
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of the County of
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, grantor, and
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~ ~!ER:1AEEL: ~~~SEL~2
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whose post office addrc:;s is:
:506 ~live Dri~e.
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of the County of -.. - .' , State of F: c :..- -:.. (, a , grantee,
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WITNESSETH: That said grantor, for and in consideration of the sum of Dollars, and
other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby
acknowledged, has granted, bargained and sold to the saidftrantee, and grantee's heirs, successors and assigns forever, the
following described land, situate, lying and being in =- fcS eel County, Florida, to-wit:
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21543004 V5535979 04/20/93
RECORDING/INDEXING
RECORDS t7H;[jEF:NIZATIGN FEE
r-::"1./'1. C"':!"":'M" I"Jl':-':'!~I'~I'"~~" t"'t,r-,r"MI""\
UUL ~jA5lr l~lti~fVt{1'-U~~Uj
10: 11 M1
5:00
1.00
9B~ 00
and said grantor does hereby fully warrant the title to said land, and will defend the same against the lawful claims of all
persons whomsoever. CHECK: 1[,V. DC
CECINO 01-'.:; r;r~iT PAID: 10it: 00
IN WITNESS \VHEREOl~ Grantor has hereunto set grantor's hand and seal the day and year first above written.
Signed, Sealed and Delivcled in Our Presence:
~
~O-.M'\-,\G- cJ ~J!vY\~
TAMRA L. JOHNSOlf
PLEASE PRINT OR TYPE NAME AS IT APPEARS
~,-.' :7 .
r-::~I?d~) '1/1/ 1~/.YM;;::CLJ
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SHIRLEY:' N. MOATES
LINDA W. SMITH
PLEASE PRINT OR TYPE NAME AS IT APPEARS
~) A 0. n.,4; 0. ~ /'V
O.R. V 10 ~J P~\GE 1. V :i t)
STATE OF
FLORIDA
COUNTY OF
fASCO
I HEREBY CERTIFY that 011 the day of April 19., 199,3 before me personally appeared
SHIRLEY N. MOATES, a single woman
who is personally known to me or who has produced the identification shown below, who is the person described in and
who executed the foregoing instrument, and who, after being duly sworn, says that the execution hereof is his/her free act
and deed for the uses and purposes herein mentioned and an oath was/was not (mark one our) taken.
SWORN TO AND SUBSCRIBED before me the undersigned Notary Public by my hand and official seal, the day and
year last aforesaid.
D To me personally known
My Commission Expires:
April 26, 1995
fXi]Identified by Driver's License
~J '#J ~jh
Notary public
Commission No.:
CC
LL"'IDA W. S:1!ila
09041 R Notary Public, State of FIClfid:s LINDA W. SHlTH
My camm. mlpir'8s April 28, 1995'LEASE PRINT OR TYPE NAME AS IT APPEARS
No. OC080418
FORM 150 (12/92)
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(~'E~I'b-~:NT;~'G::LsE' ONLY)
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C E N T R ALP E R M I T TIN G
PASCO COUNTY, FLORIDA
CONTRACTOR #:
NAME: CLARENCE WHEELER
ADDR: 38050 LEONDIAS
C/ST: ZEPHYRHILLS FL 33541
FOR:
DATE: 08/:30/9:~:
PAGE: 1 OF l'
I S~=;UE OFF I CE: D
RECEIPT NUMBR: 00185825
OFFICE: DADE CITY
CHECK # 9656
RESOURCE FEE ON CITY Z~HILLS PERMIT
ACCNT
114
TOTAL AMOUNT:
COMPNY ACCOUNT CENTER
B450 - 363000 - 1
l/S. ::::5
16.85
AMOUNT
RECEI
DESCRIPTION/PERMT DATA DRICR
****** 60
PASCO COUNTY, FLORIDA
(_,/\"_l,-~",, Z I ~ \,,)
\.:'.
Permit #
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Date
Name/Owner
'" r-.' (, ,r"tt'"'\ .'
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, ~.,.
(: #.,
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County Parcel #
:;.:::\.,.
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. C';\ 1,...CCI" (.J
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Location
",~-' C'..,
,. ....-.--
.' --.) ,,:
Classification / Type of Use
\'y'-"'\ (" '
-;::/ ,"""",,, .-"". \, /.. '\
1\ (I ..l:... Y (....';., l $",.....
, \ '\" \ \i-,'--Ji_
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lRANSPORTATION IMPACT FEE CALCULATION
Rate $
Zone #
Sq. Ft. / Unit
Prepared by
Impact Fee Amount $
The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the Board of
County Commissioners. This 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 #
TOTAL FEE $
(# Units) x ($0.1315)
x (# Days)
i (( ~~.-:~ -, ..~:,~)
-
Assessment =
(QSfl. x (ERU) x (0.1315) x (# Days)
100
Assessment =
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.
THE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE CERTIFICATE OF OCCUPANCY.
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED
HAVE 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 form, placing the building permit
owner on notice of this assessment and the conditions of payment for same.
Date
Received By
OFFlCE USE ONLY
lRANSPORTATION REC. #
RESOURCE RECOVERY REC. # \ <., ~'1- ~
~ ~
DATE I I
DAm~1 ?l-)f'l~
BY ~..) .
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White
Applicant
Canary
Trans / Finance
Canary
RR / Finance
Pink
Office
Green
Bldg / Insp