HomeMy WebLinkAbout93-3631
BUILDING PERMIT
Permit N <<?
363113"
CITY OF ZEPHYRHILLS
(813) 788-6611
~O... (.Tt)
BUILDING
r.J> s--" (/2)
ELECTRICAL
d.!:>-:ov
PLUMBING
:;j}fi!:f!j;
Property Owner: -
Job Address: ,//t?7 d ." ~II/
Parcell.D. # 3-cJ..6 - d..-/-/ - 0 Y/
Date J I - / ;;L -;; 3
00. c7V
MECHANICAL
Sewer Conn J ;;J., 7,f; dV
" 'In
Water Conn: J -.s u . 0-0
Water Meter: I 6....! -:tTO
T,lE~s: 14/.1) ~~6
" I
J./~)s--11
Radon Gas:
<?;7 ~
Zoning: ~ co~
Description of Work ~ ~- _ 0Yz-r.~
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.
Valuation or
Contract Price
,~A
City License Registration # J--.5b
State Certified License#
)/-rR~~
~~
ELECTRICA~ -
BUILDING
DATE
Inspector R.L. YOUMANS
pe'm;tF~a~
Slgnature_ _----=-=
Company
Address
Telephone#
71;1- ~'1(,
<Lf~ H~~v/lk
MECHANICAL .7<5-
/'kL';~~
PLUMBING /08
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can 11--1,;1-6
Const. Pole
Pool
Pre-Meter
Final
Driveway
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
REINSPECTION 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.
b.
c.
d.
e.
f.
g.
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
2/0 II-/;l-'i-? I
{7d.f-J'i'-'9
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLTCA'T'IOINI FOR PRRHTT
CITY OF ZE:PBYRHILLS
BUILDI.NG mr.PARl't"IE'NT
O"'lNER · S
NAME ,'21"/t /
d'//8'"
d/IA/J
/:L2~dJ72)/l..,
L.z'/flii-<-t''l./~-, ;'
'I /
PHONE ;7 Y 2 - Z 2 76
;r:.,. 33 [" <..//
OWNER · S ADDRESS
JOB ADDRESS ~~
LEGAL DESCRIPl'ION: LOT(S)
-:It' c:./ /
BLOCK
SUBDTVISIOKLZ-;O/-I't't" /U /)6 ~
PARCEL 1.. D. f {().3 .-:2..6 -0.2-/ -013'.0 - e:7tt::'CJ,~c> .- CJ7C/. cJ
WORK PROPOSED:~lNIewr Construction _Addition _Alteration _Repair _Install
_Sign
_l!fove
_DeaoHsh
PROPOSED USE:
Single Faaily
_H/F
_, of Units
~M/H
_eo..ercial
_Indust.
_Sw~.PooI
Other
_Res1taurant &- Health DepartJaent Approval
BUILDING SIZE: t + X Lf-f ,
/1756
Square Feet.
/~~
Height
RESIDENTIAL:
COHHERCIAL :
ATTACH (2) PLOT PLMIS &- (2) SETS OF BUILDING PLMIS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUIIDDlG PLMiUS &- (1) SET ENERGY FORMS. U
uCOPY' OF COINITRACT REQurlRlID.
PE.'RKITS RE.oIW_"iTED
* BUILDING
* ELECl'RICAL
~m:CHANICAL
~LUHBING
$
Valuation of Total Construction
I ~
,0.>0
AKP Service
Florida Power Corp.
~W.R.E.C.
s
V2'~uation of Hechanical Installation
GAS
ROOFI~G
SPECIALTY
TYPE OF CONSTRUCTION: _Block _FraJlle ~Steel
fh , I-J- ~
Other
FItu:SJIED FLOOR ELEVATIOlN!S:
FT.
IS PROJECT IN FLOOD ZONE ARE.."-?
YES NO
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
BUILDER
Signa tureji: /2,
COln'RACYOR SECTION
mHPAINIY J/,' IL .J;.i-U-t'7;tV:z; /lttdU<- ~~tA~
State Cert. or Regist. ~
City License Registration # ~~
~~~~~~~*~~~~~*~*~~~~~~~~~~**~*~~~~~
OOriPANY L7',4. .J'7J/'-"tJrftJ ~;~4" 'G
State Cert. or Regist. i
-
City License Registration I ~~~
~~~~~~~~~~****~~~~~*~~~~~~~*~~~~***~~~*~~*
PU]KBER ,,?} mHPAINIY A1c.4-.!JV e-xn--.J
'-/ j /7 J rZ:-r.A/( State Cert:. or Regist. :/If:
Signature~#7 ~/~ City License Registration I /tJtf'
~~~*~~~~~*.~~~~~~~~~~~w~~~~~~~~~*~~*~~~~**
HEc::::HANI~ ~ OO'!IPAINIY ~A-.s. ftU.VJ/4lI-L
, ;) '-7 ,i!, State Cert. or Regist. :/If:
Signature ,p~ 4- ~ City ,.~cense Registration 11
/ ~~~~~~~~~~~~~~~~~~~~~*~~~~~~~*~~~~~~~**~~*
~ " 4-<....
'/K
OTHER.
mHPA!fflY
S~ate Cert. or Regist. :/If:
City License Registration :/If:
~~~*~~~~~~*.*~~~~~~**~*~~~**~*~~**~~**~~*~
Signarore
APPLICATION APPRO\l'IID BY . &~~~
PERIIIT OFFICER.
!< --~ ~
..~.b<<IJtlr
l ~S!:>j
<(..-..<:....-u._~~_.. ......~~~.'... ,.~~_'\..,.......,'..~._
,.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to 'deed restrictions' which lay be lore restrictive.than Cify
regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR F:ESF:J.~NSIB!.l:..ITIE~
If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with
state and local regulations. If the contractor )s. not licensed as required by law, both the owner and contractor lay be
cited for a lisde.eanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing
require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (813)
7BB-bb 11.
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 lay 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 FEE~
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 - Ho.eoNner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is so.eone other than the
'owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the
'owner' prior to cOI.ence_ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIr
I certify that all the infor_ation 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 work and installation as indicated. I certify that no work or
installation has cOI.enced prior to issuance of a per_it and that all work will be perforled to leet standards of all laws
regulating construction, City codes, zoning regtlations, and land develop.ent 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 li.ited to:
f Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways '
f Department of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatment, Septic Tanks
J US Environlental Protection Aqencv - Asbestos abatement
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 'cotpensating volule' will be subtitted w~:ch is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A permit 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, nnr shall issuance of a pertit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction; or violations of any code. Every perlit issued shall becole invalid
unless the work authorized by such per.it is cOI.eneed within six lonths of issuance, or if work authorized by the permit is
suspended or abandoned for a period of six lonths after the tile the work is commenced. One 90 day extension of time, lay be
allowed ~or the perlit with fee charge of $15.00. The extens~on 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 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
C,"",'C""T.. JO:, UND" ",'O~ 'AlUE DO 'OT "'D TO "CO'D A'D PO.'T"A "OTIC' OF CO":'C""T',
~~ ~~
SIGNA URE: OWNER OR AGENT IGNATURE: CONTRACTOR
}.J~'-SoJ..J 7<y l'1AJJ
who is personally knDwn to me"€l- d1t: ~,a-
~reelL\E:e:J
~!! ~delltif~,-""Ll.'" and whc, -8+EWdid not
STATE OF FLORIDA 11
COUNTY OF rA 5 eO
The foregoing instrument was acknowledged
befcq-e me this A.IDilG'1~ 3~ 19_U by
W/Z.I SO Ai 7( Y HAJJ
who is pel-sonally kno\.oJn to me .,r IJhl> h2~
pn: elUEfid{;;l
.:\:; i{;;lgpf; r'" ~tiU'l1 and who ~/did not
tak~m~ 9b-'>7VYJ
(Signature) Ai
)( A Tf..f I ~e.1J J: 15 Ro--tAJ
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
STATE OF FLORI~
COUNTY OF 1/ A se 0
The foregoing instrument was acknowledged
before me th i 5 J.)ova-f6a 3, 19.2.2_ by
tak~12rl~ 9 ~
(Signa ure)
J.( Am LiiE e; ^-.J ..r 13R-t7WN
(Name Typed ~ Pl- i nted or Stamped)
NOTARY PUBLIC
KATHLEEN ..1. ,",c','
StOlt.., :f .
My Comm. Exp,
Camm. , CC
(~\
Jtl
KATHLEEN J. 8ROWN
State of F;c,""'.
My Comm. Exp. April 2, 1~95
CoIII'Il. . tc 095617
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PASCO COUNTY, FLORIDA
N_/Ownu 'fi7~ Jj(~
County Parcel # J-:2. 6 ':1.../.... /.3>- - y /
Permit# J 6.3/ /J
Date II -;;)... - 9-3
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 establish uant Pasco County Transportation Impact Ordinance as adopted by the Board of
County Commissioners. Thi nt is payable PRIOR to the issu f a Certificate of Occupancy or authority to utilize the permitted
structure.
RESOURCE RECOVERY ASSESSMENT
RESIDENTIAL
NONRESIDENTIAL
# Units
/
Gross Sq. FL (GSp)
Rate / ERU =
50.00 x 0.96* / Year
or $0.1315 / Day
ERU Assign #
Assessment =
(# Units) x ($0.1315)
x (# Days)
34 . d. 5
Assessment =
ffiSfl x (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.
1HE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF 1HE 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 form, placing the building permit
owner on notice of this assessment and the conditions of payment for same.
Date
Received By
----------------------------------------------------------------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
lRANSPORTATION REC. #
RESOURCE RECOVERY REC. # ;;l.. IOl/(p7
DATE ~ BY n
DATE <f-~S-<=7'(~O\) ~~~
Canary Pink U Green
RR / Finance Office Bldg /Insp
White
Applicant
Canary
Trans / Finance