HomeMy WebLinkAbout94-3875
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N '!
3875,(3
Date ~ - 0) y - :? Y
'I' tJ. c:rt:l
BUILDING
3.J-: c.Jv
ELECTRICAL
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PLUMBING
01-6 ~ v-v
MECHANICAL
Sewer Conn Y cJcJ . ~
Water Conn: OJ-dt:}. cJV
Water Meter: /"..!:.-: VD
T.I.F.'s: f? ,/~e crD
Pmp"'V Owne, l::k?:z-~
Job Address: c ~ rb
Parcell.D. # IY~J" -,;)/-0/6 0 - () 0-0-0 C) . D 06 0
Zoning: . ,---E~e~~ Code: Radon Gas:
Description of work)1( ~ ,~ ~./- /
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Permit Fee ::; tJ ~ cJl)
Signature /iu ,,~j/ )t! ' & '" ./ P .i2C,
Company
Address
Valuation or
Contract Price
City License Registration #
State Certified License#
?~~}11/
r~~
II
Telephone#
?~.M
BUILDING
c;;J 70
ELECTRICAL
PLUMBING
4L- (L"
.( ~
MECHANICAL 9'<:f'
Breakers
Ducts Insl.
Compressor
Final . f.7-tFJ..f If<'j.(}
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
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.
AJa- .;L -;2y"-~ y
~ 3~~-7-5-
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
PAYLESS
MDBILE HDME SALES
10013 N. NEBRASKA AVE.
TAMPA, FL 33612
813-971-6506
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MY COMMYSSIOi\/ m<l', SE1"r 9,1996 I
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Quality Homes at Lower Prices
APPLICATION FOR PERMIT
CITY OF ZEPBYRBILLS
BUILDING DEPARTMENT
OWNER'S NAME IV~':"'- P kl-4AiJl tSudu)t(. ~NE ?/-S -7<fR-7 s.2? ,.
OWNER'S ADDRESS /::: r &-,: /7/2- I 7~/7/7~, fI::Z ~J':.~- S:;
JOB ADDRESS d 8- 00 :b i A WI'l- NJ> A L (/ ,1 P - 0 It: V W A-12. 0 (-t./III/ D S
I (
LEGAL DESCRIPTION: LaT(S) # 6 BLOCK SUBDIVISION
PARCEL LD.' 1'1- ;2(,.... ~I - C? I /it" - OeJ ~ f!!!J,t:) - DO '-0
WORK PROPOSED: New Construction _Addition _Alteration _Repair - Install
-
_Sign Move _Demolish
PROPOSED USE: Single Family _M/F _' of Units ~H
Commercial Indust. Swim. Pool Other
- - -
Restaurant & Health Department Approval
-f ,,'
BUILDING SIZE: Z'3 x-.i.:L, to I:J, Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. **
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. **
**COPY OF CONTRACT REQUIRED.
PERMITS REQUESTED
VBUILDING
v' ELECTRICAL
.../ MECHANICAL
$ Zo,ocro
I ~IJ AMP Service
$ 1./00 ~
Valuation of Total Construction
Florida Power Corp.
_W.R.E.C.
Valuation of Mechanical Installation
~PLUMBING GAS ROOFING
TYPE OF CONSTRUCTION: Block ~rame Steel
SPECIALTY
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES
--lfo
******************************************
CONTRACTOR SECTION
COMPANY III-) ~~ 14. It{, r~
State Cert. or Regist. #
Ci ty License Registration # 1) H 7,1 [(
*****************************
W~ COa~~ert.l~.1l!:/' ~-~L]d;
~ City License Registration' ~)72?
************ ***********************
C<>>!PUY I~ ~~ ;t4, (if,
d~~ "State Cert. or egist.'
Signature ~A./C.- ~ Ci ty License Registration' f) J/. p.:z.. JY
***************************************** .
MIlClWflCA~~;"~UY AD! nit f~ A-/~
, State .Cert... or fiegist. .
Signature . ~ . ~ . City License Registration . :c
******************************************
"
BUILDER
Signature
ELECTRICIAN
.f~
Si ature
PLUMBER
~~
9/~~J
'j' yrfY
OTHER COMPANY .
State Cert. or Regist. #
Signature City License Registration #
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this perlit laY be subject to -deed restrictions- wbieb laY be lOre restrictive than City
I regulations. !he undersigned asSUlt!S responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas hired a contractor or contractors to undertake work, they laY 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 lisdeJeallOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
reguireJents laY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furthel'lOre, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections- of this application for wbieb 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 wisbes you to sign
as contractor that laY be an indication that be is not properly licensed and is not entitled to peraitting privileges in the
City of Zepbyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of -Florida's COnstruction Lien Law - lkIIeoImer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsWler Affairs. If the applicant i8 SOMODe other than the
-owner", I certify that I have obtained a copy of the above described dOCUlll!llt and pfOlise in good faith to deliver it to the
"owner" prior to COllellCeJent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in COIpliance with all
applicable laws regulating construction, loning, and land developeDt.
Application i8 bereby Jade to obtain a pmit to do wort and installation as indicated. I certify that no work or
installation bas ~ced prior to issuance of a perait and that all wort will be perfol'led to leet stanc1ards of all laws
regulating construction, City codes, loning regulations, and land develo(llBllt regulations in the jurisdiction. I also
certify that I understand that the regulations of other gOYerDIIl!Jltal agencies laY apply to the intended wort, and that it is
If responsibility to identify wbat actions I lUst take to be in COIpliance. Sueb agencies include but are not lilited to:
Ii Departlent of EnvirOlllelltal Regulation - Cypress BaybeacJs, lIetland Areas and Envirollllelltally Sensitive Lands,
Water/llastewater !reatlent
Ii Southwest Florida Water KanageJent District - lIells, Cypress Dayheads, Wetland Areas, Altering Watercourses
Ii Al'IJ Corps of Engineers - Seawalls, Docks, Navigable Waterways
Ii Departlent of Health i Rehabilitative Services, BnvirODllel1tal Health unit - lIells, Wastewater !reatlent, Septic '1anks
Ii US EnvirODlelltal Protection Agency - Asbestos abatl!lel1t
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 -COIpeJlSating wIllie- will be sublitted wbieb is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perait 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 ffOl thereafter
reguiring a correction of errors in plans, construction, or violations of any code. Ivery perJit issued shall beCClle invalid
unless the work authoriJed by sueb perlit is ~ced within SillODtbs of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sillODtbs after the tile the work is C08eDced. One 90 day eltension of tile, lay be
allowed for the perlit with fee charge of $15.00. '1be eltension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb sillODth period, or the project will be considered abandoned.
wmIllG 'rO (JfIIR: YOUR FAILORB 'rO RECORD I IO'I'ICE OF aJIKDCBIlBI'f lilY RESUL! IK YOUR PIYIK' niCE FOR IKPROVIIIIIfS to YOUR
PROPIRft. IF YOU IIlDRD 'rO OB'fIIJ FIIIIRCING, COISUL! WID YOUR LIRDER OR AI 1!'fORIiY BEFORE RICORDIKG YOUR JIO!ICI OF
C(IIKINcmm. JOBS OlDER '2 SOO A VALUE DO N~~!O RECORD AND" POS'I A -NO'flCE OF aJlKBlCIKD'f, '.
W~ I(J~ .
"at . '~If'-
SIGJIA'fURI: OR P"'~fN\L Kj\.Owb~E:' SIGlA'fURI: COI'f R f'C:::;R="-AL ~~
S'IA!I OF FLORIDA .
coum OF \,\ \ \\ s \
The foregoing instrument was acknowledged
before me this 14 "'"f~8'1 ' 19.1.l1=-- by
\K '
\'J. ~ r.\, " '- ,
....." !'~}ct~ " Lt:..t/v
who is ersonally known to ~r who has
produced
as identification and who did/did not
~an oath.
\r<~ .~~t^A ~
(SigIiature f '
RAY~
(Name Typed,-Prirlted or Stamped)
NOTARY PUBLIC
SUfi OF FLORIDA
coum OF ~ ~\\f:. .
The foregoing instrument was acknowledged
before me this ILl.... 'V __,' 19 $. by
~l.ll.1iZP~ R\lSGitil ~l~\:\~. ~iA~dL
who i ersonally known to me r who has
produced
as identification and who did/did not
~~oa~
(Signature) ~~
'MY
(Name Typed . r St ed)
NOTARY PUBL C OFFICIAL NOTA, Y SEAL
N;\Y Gi\FF~'JP",\,' ~.
r~arAP.Y PUBL1C 5TI..TF:- i.:YF rLC\p.{DA~
l."XJ~A\'fISE.!ON NO c: ')?1 ,t'"TIj ;
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OFFICIAL NOTA Y SEAL
P/\ Y Gi\FF-;",iE"'f
'\ 1;-jTl..p'{ !'~.,:?>;_l(_~ (';r/\'T':~ OF FLORIDA
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PASCO COUNTY, FLORIDA
Name/Owner 7JdL~ '7?~~.A~'//
County Parcel # J Y-;)6~ - /J/b{) - 0 cJ LJO (J ,. CJ ZJb 2)
Location ..3f:D~0 ..f~~ ~
Classif'1cation/TypeofUse )Jt ~~ ~ 0
Permit# d~7S- t1
Date d2 -:;L Y -7 t.j
TRANSPORTATION IMPACT FEE CALCULATION
Zone #
Prepared by
Impact Fee Amount $
The above impact fee has been established p the Pasco County Tran . on Impact Ordinance as adopted by the Board of
County Commissioners. This am . payable PRIOR to the issuance of a Certificate of 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 =
(QSfl x (ERU) x (0.1315) x (# Days)
100
TOTAL FEE $
'I/, ~ 'I
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 Wil"L 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
------------------------------------------------------------------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
TRANSPORTATION REC. #
RESOURCE RECOVERY REC. # ~ 6 .s voS
DATE
DATE
3 -2 -qC/
I
BY
BY
.h
I'
White
Applicant
Canary
Trans / Finance
Canary
RR / Finance
Pink
Office
Green
Bldg / Insp