HomeMy WebLinkAbout94-3878
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
_ 3878/3
DatH c2 -c:2 ~- 9~
~~)
P<operty Owne' . ~~
Job Address: r ?i . ~ \~~, --;;:::7
Parcell.D, # /f'-;)6-d-./- ()/6CJ - O/JOCJCJ - tfJ d..~<;."'yJ
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: E7Y Code: Z
Description of Work '~ '" ~ "vV-d
Radon Gas:
./~ ./~-~~(J ~.#7 /1A?t.
NO OCCUPANCY BEFORE C.O.
FINAL~
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
City License Registration #
State Certified License#
r2f-~
Permit Fee
Signature
Company
Address
Telephone#
~.t/V
~ t~J-.c
Valuation or
Contract Price
02 o--a--tP -
.
c-o
13/~~ ~
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
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. 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.
APPLICA.TIOIll fOR PERKlT
CItY OF ZEPIIYRIllU.S
BUIIJ)IJIC DRPARIIUl:ID'
OWNER · 5 RAIlE
GeAJe Pf+S('U.CC;
PIIOIIE c!/3) ?ko - 8>966'
OWIIER' 5 ADDRESS 3801 L/
JOB ADDRESS SA IV' e
1.n-wANc:I~
;"'00 ()
,
LEGAl. DESCRIPTIOI: I.OI'(S)
0).,50
~SUBDIVI.SIOII
b/.I;.o
,
PARCEL I;D.# JJ/ -;zfs., -;21 - O/&'O-OOQOO - 0;)..50
WORK PROPOSED:_1Iew Construction ----.l'ddition _Alteration ---..Repair
S.
- 19t1
_Hove
--P~lish
~ Install
Y/IV)/ W,N ~ovJ-S.
I.oof LI\ISL.t JI'~1-1 01V'
PROPOSED USE:
Single F_ily
_H/F
_, of Units
---1t/H
_~rcial
_Indust.
_Swm. Pool
FbR.-C ~
Other
---..Restaurant & Health Deparblent Approval
BUILDING SIZE:
x
~ Feet.
Height
RESIDENTIAL: ATTAaI (2) PUJI' PLAlIS & (2) SEIS OF BUIIJ)IRG PLAIIS & (1) SKI' EllERGY FORIIS...
mtIIIERCIAL: ATI'AaI (3) SEIS OF BUII.DIlIG PLAIiS & (1) SRI' ElIERGY FOIUIS...
..oopy OF ooll11lACI RllQUlRIID.
PIr.RJIITS REOUESTED
v" BUILDING
$ c2ooo. 00
Valuation of Total Cons1:ruction
_ELEcnuCAL
AIIP Service
Florida Power Corp.
__W.R.E.C.
---1tECllANICAL
$
Valuation of Hecbanica1 Installation
_PLUKBING GAS ROOFIRG
SPECIALTY
TYPE OF ooNSTRUCI'IOII: ---..Block _Fr.-e _Steel
Other
FINISHED FLOOR ELEVATIONS:
Fr.
IS PROJECT IN FLOOD ZONE AREAT
YES NO
..........................................
COIII'IRACIOR SECTION
BUTI.DRR (DIpAIIY ~h,ts A J-,l..\fI'I. (R..Atvl><j -~ 1-1- h 1l)
State Cert. or Regist. # <::!..:Bc. [;l,,~(p 07?
Signature City License Registration # .;1.89
..........................................
RI.F..cI'nCIAN CUlPARY
Stat.e Cert. or Regist. #
SiPIIAture City License Registration #
..........................................
PIJIIIBRR CDlIPAIIY
State Cert. or Regist. #
Signature City License Registration #
..........................................
IIEaIAlIICAL lDIPAIIY
State Cert. or Regist. #
Signature City License Registration #
..........................................
OTRIIR COfIPAIIY
State Cert. or Regist. #
Signature City License Registration #
..........................................
APPLICATION APPROVED BY PERIIIT OFFICER.
CUND 1 I J UN[~ UF PEEI'II T {)FF I J)()'v' I T
() . NQTJ.~~_Q.L._J)gslLg~!:l.JJ:Ltt;II..JJ.I\'-~3.
Ihp Ilndprsignpd undprstands that this ppr.it I~y bp ~ubjpct tD "dppd rpstrictions" whi[h lay be lore restri[tive than City
regulations. Thp undersigned ilSSIlIPS rpspol1sibility f(lr c(llllllliance with any applicablp dl!l!d reslridillns.
Fl _ Uft'=JJ~sN~!=-!tSm{I.Rl:.!'::TPJ::<!? (JI.JIJ... C(JLIT H{\~rL)lJ. B r=: ElF:.lJHl?!J::-{JJ,,,II.L~$.
If thp owner has hirl!d a contractor or contractors to Ilnderta~p work, they IlI~Y be reQuirpd tll be licensed in ac[ordance with
state and IDcal regulations. If the contra[tor is nllt li[ensed as required by la", both the owner and contra[tor lay be
cited fllr a lisdeleanor violation under state IaN. If the owner or intended [ontra[tor are uncertain as to "hat licensing
require.ents .ay apply for the intended Nor~, they are advispd tD [onta[t the City of Zephyrhills Building Depart.ent, (813)
71111-6611.
Further~ore, if the owner has hired a contra[tor or cDntractors, he is advised to have the contractor(s) sign portions of the
.Contra[tor Sections" of this application for which they Mill bp responsiblp. If you, as the o"nl!r sign as the contra[tor,
YDIl are indi[ating that you, rather than the [ontra[tor, alP responsible for the work. If the [llntractor wishes you to sign
as contractor that .ay be an indication that he is "(It properly licensed and is not entitled to peraitting privileges in the
City of lephyrhills.
C _ JTIAN!?F' OR TAT liJ1LJ I-IF' (~~LEs~_~_l}!JlJ.JJU'=J_D::__..t:;!J1tt~U~_~I..UJJ:L..FEE.!?.
n. ~QH2THUGT!'QH__'-=-LE1~Ll-I)H (CI 'tIP n=n 71:=1" n.un.T))() ST{HUTES ~ AS {WIEhIDEDI
I certify that I, the applicant, hilve bepn providpd with il copy llf "Florida's Construction lien law -- IIo.eowner's Prote[tion
Gllidp" prepared by the Florida Dppart.pnt of Agricllltllrp and [on~ll.pr Affilirs. If thp applicant is SO.l!llnp other than thp
'oM"pr", 1 [ertify that I have obtainpd a copy of thp above desclibed docll~e"t and pro~ise in good faith to dpliver it to the
"llW"er" prior to COllen[elent.
F. l,;(JI'!TR(~TQR 'SLQ~'J~.~B-'-_:?___BEEJ..Rl\'v'_LI
I cprtify that all the infor.ation in this application is accurilte and that all work Mill be donp in [o.plian[e with all
applicable laws regulating cllnstructilln, loning, and land develop.ent.
Application is hereby lade tll obtain a perlit to do wllrk ilnd installation as indicated. I certify that no Nork llr
installation has coa,enced prillr to issuance of a perlit and that all work "ill be perforted tll teet standards llf all la"s
rpglllating cllnstructilln, City clldes, 211ning re~ulations, and land dpvelllplent regulations in the jurisdiction. I also
certify that I understand that the regulations of lither governlental agencies lay apply to the intended work, and that it is
.y responsibility to identify "hat actions I lust take to be in co'pliance. Such agencies include but are nllt li.ited to:
. Departlent of Environl!ntal Requlation - Cypress 9ayheads, Wetland Areas and Environl!ntally Sensitive Lands,
Water/Waste"atpr Treat~ent
. SlluthNest Florida Water nanaqelent District - Wells, Cypress 9ayheilds, Wetland Areas, Altering Watercourses
. ~~orps of Enqineers -- Seawalls, Doc\s, Navigable Waterways
. Departlent of Health L Rehabilitative Servi[es, Environlental Health U~it - Wells, Wastewater Treatlent, Septic Tanks
, US Environ.ental Protection Aqency - A~bestos abatplent
I also certify that, if fill laterial is to be used in Flo~d lone "A" or "A,et[.", it is understood that a drainage plan
adrtres~ing a "[o'pensating volu~e" "ill be sub.itted whi[h is prepared by a prllfessional engineer registered in the State of
Florida prior to per.it issuance.
n per.it issued shall be construed tll 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 9uilding Official frot thereafter
requiring a corre[tion of errors in plans, construction, or violations of any code. Every per.it issued shall becll.e invalid
unless the Nor\ authorized by such per-it is co"enced within si~ Illnths of issuan[e, or if "or\ authllrized by the per.it is
suspendpd or abandoned for a period of six Months after the tile the "llrk is cll.lenced. One 90 day extension of ti~e, lay be
allllwed for the per.it Kith fee charge of $\5.00. The extension shall be requ!sted in writing to the Building Official. An
approved inspection Must be logged during each six lonth period, Dr the proje[t will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PRUPERTY. IF YOU INTEND TO OBIAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED 10 RECORD AND POST A "NOTICE OF COMMENCEMENT".
"...~~
""A1~'tl./'-~
STATE OF FLORID~
COlfNTY OF 't'ASC.O
The foregoing instrument
before me this r--E.~ ~q
",as ackno",ledged
, 19 ~ by
STAlE OF FLORIDA
COUNTY OF fhse ';}
The foregoing instrument was acknowledged
before me this F/3B &1.( ~ 19~ by
:nDI'I11 to me Dr Nho has
(-th~
personally knDI'Hl to me,c.,- l'~ho has
produced
as identificatiDn and whD did/did not
take n oath.
and ,,~ho did/did nClt
(Name Typed, Printed or Stamped)
NOT ARY PUBLIC :'-' JAMeS A. STOtl~
Notary Public, State of Florida
My comm. expires May 16. 1995
CC110274
(Name Typed, Printed Dr Stamped)
r:l.QI AR'LE..UBL I C
JAMES A. STONE
Notary Public, State of Florida
My camm. expires May i 6, i 995
. .' CCil0274
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STOnK n~M8H. . 't."1./1SCPIP/O'; . -. .. m'."PRICE-:r---AMOllNf.-
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t', -;;-:"'8 ALUMa ,. t ,; '.l l. ~ '"!"",1I1ARE INC
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37827 FC)'JNTc,:N RD,
ZEPHYR:--,;'. ..S, FL :::5,+1
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In case of claims or returned
o 504 goads, ~.Iea~e presenl th,s b,ll TOTAL
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CENTRAL PERMITTING OFFICES:
.
PASCO COUNTY BUILDING PERMIT APPUCA nON
SHADED AREAS FOR OFFICE USE ONLY
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. .oCClJPANCY:'
.:,......'.NO.OF.lJNITS:
'.....FIREPiSTRICT:.
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lil:
9 . OWNER'S NAME:
a:l JOB LOCATION:
ffi PARCEL 10#: S
Z OWNER'S PRES
~
o
LOT O~O
PHONE # ( 0' (3) 7:!tJ - ~
SUBDIVISION: tV I tUJ
PRdJ~6T~<ii> ..H LOT SIZE 5 x
ClrY:/~ _STATE: r--'1... ZIP , /..'
,
, FEE SIMPLE TITLEHOLDER'S NAME (it other than owner):
address (it applicable):
. BONDING COMPANY:
ADDRESS:
, DESCRIPTION OF WORK:
LIVING AREA:
~
g
...J
a:l
Z
o
.-:
n.
5 . WORK cODE:fiiiimt.'w PLANS ON FILE? 0 NO 0 YES
(/)
w
o
VALUATION: $
MO~ NAME:
;) OOC -=---
lil:
o
9 . ARCHITECT/ENGINEER:
a:l
a: ADDRESS:
w
~
o
CITY
STATE
ZIP
CITY
STATE
ZIP
. MORTGAGE LENDER:
ADDRESS:
CITY
STATE
ZIP
. CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE L1C # 'it applicable):
lil:
o
9
a:l
15 . ELECTRICAL CONTRACTOR:
l3 SIGNATURE:
~ ADDRESS:
!z STATE L1C # (it applicable):
8 POWER CO:
PHONE # (
CITY STATE ZIP
PASCO CO COMPUTER ION:
SAWPOLE: AMPS:
. MECHANICAL CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE L1C # (it applicable):
o NEW 0 ALTERATION VALUATION: $
PHONE # (
CITY STATE
PASCO CO COMPUTER ION:
(Required)
ZIP
, PLUMBING CONTRACTOR:
SIGNATURE:
ADDRESS: CITY
STATE L1C # (it applicable):
# FIXTURES: - SEPTIC PER #:
PHONE # (
STATE ZIP
PASCO CO COMPUTER ION:
SEWER: WATER:
PLUMBING
FEE: $
WELL:
. OTHER CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE L1C # (it applicable):
TYPE CONTRACTOR:
$
CITY
PHONE # ( )
STATE ZIP
PASCO CO COMPUTER ION:
VALUATION: $
----------------------------------
OTHER FEE TYPE:
. RECEIPT#:
----------------------------------
JOBS UNDER $2,500 IN VALUE DO NOT NEED TO
RECORD AND POST A .NOTICE OF COMMENCEMENT"
TOTAL BUILDING PERMIT FEE:
(permit torm 10/91)
EDITIONS OF THIS FORM RELEASED BEFORE 1/91 ARE OBSOLETE AND WILL NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF
PC93043032
. . .. NOTiCE....
BOTH THE OWNER AND CONTRACTOR OF RECORD (License Holder) MUST READ AND
SIGN THE REVERSE sloe OF THIS APPLICATION
CONDITIONS OF PERMIT AFFIDAVIT
A, NOTICE OF DFFD RESTRICTIONS
The undersigned understand that thJs permil may be subject to .deed resllictions. which may be more restrlctive than County regulations. The
undersigned assumes r96ponslbility 'or compliance with any applicable deed resllictions.
B, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed In accordance with state and IocaJ regula-
llons, II the conuactor Is not licensed as required by law, both the owner and conuactor may be cited for a misdemeanor violation under state law. II
the owner or intended contractor are uncertaln as to what licensing requirements may apply for the Intendod work, they are advised to contact the
Pasco County Building Division - Uc:enslng Section at (813) 847-8009,
Furthennore, If the owner has hired a contractor or contractors, he Is advised to have the contractor(s) sign portions 01 the .Contractor Block. 01 this
application for which they will be responsible. I' you, as the owner sign as the contractor, you are Indicating that you, rather than the contractor, are
r96ponslble lor the work. II the contractor wishes you to sign as contractor, that may be an Indication that he Is nol properly licensed and Is not entltied
to pennitting privileges In Pasco County. .
C. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FFES
The undersigned under6tand thaI Transportation Impact Fees and Resource Recovery Fees may apply to the construction 01 new buildings, change 01
use In existing buildings, or expansion 01 existing building6, as specified h. Pasco County Ordinance numbers 89-07 and 90-04, a& amended. The
undersigned also understand Itlat such fees as may be dve will be identilied at the time of permitting. It Is further understood thaI Transportation Impact
Fees and Resource Recovery Fees mJsl be paid prior to receiving a "certilicate of occupancy. or final power release, II the project does not Involve a
certificals 01 occupancy or final power release, the lees must be paid prior to permit issuance,
Furthermore, il Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance, in accordance with applicable Pasco
County Ordinances,
D. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended)
If valuation 0' work is $2500.00 or more, I certify that I, the applicant, have been provided with a copy 0' "Florida Construction Lien Law - Homeowner's
Protection Guide. prepared by the Florida Department 0' Agriculture and Consumer Affairs. If the applicant is someone other than the .owner," I certify that I
have obtained a copy of the above described document and promise in good faith to deliver it to the .owner. prior to commencement.
E. CONTRACTOR'SIOWNER'S AFFADAVIT
I certify that alllhe inlormation in this application Is acaJrate and thaI all work will be done in compliance with all applicable laws regulating construc-
tion, zoning, and /and development.
Application Is hereby made to obtain a parmitto do work and Installation as indicated. I certify that no work or installation has commended prior to
issuance of a parmlt and that all work will be performed to meet standards 01 all laws regulating construction, County codes, zoning regulations, and
land development regulations In the jurisdiction. I also certify thaI I understand !hat the regulations of other government agencies may apply to the
intended work, and that It Is my responsibility to Identify what actions I must take to be In compliance. Suctl agenc:les Include but are not limited to:
o Deoartment of Environmental Reaulatian - Cypress Bayheads, Wetiand Areas and Environmentally Sensitive Lands, WaterJWastewater Treatmenl
o Southwesl Florida Water Manaaement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
o Armv CorDS 01 Enaineers - Seawalls, Docks, Navigable Walerways
o Deoartment of Health & Rehabilitative Services Environmental Health Unll - Wells, Wastewater Treatmenl, Septic Tanks
o US Environmental Protectia:l Alilencv - Asbestos abatement
I understand that the following restrictions apply to the use af fill:
o Use of till is not allowed in Flood Zone "V. unless expressly pennitted.
o II fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of
permitting which is prepared by a professional engineer licensed by the State of Florida.
o If fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify !hat fill will be used only
to fill the area within the stem wall.
o II fill material is to be used in ~ area I certify that use of such lill will not adversely affect adjacent properties. If use of fill is found to adversely affect
adjacent properties, the owner may be cited for violating the conditions of the building pennit issued under the attached permit application.
III am the AGENT FOR THE OWNER, I promise in good faith to infonn the owner of the pennitting conditions set forth in this affidavit prior to commencing
construction.
I understand that a separate permit may be required lor electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not
specifically included in the application.
A permit issued shall be conslrued to be a license to proceed with the work and not as authority to violate, cancel, aller, or set aside any provision of
the technical codes, nor shall issuance 01 a permit prevent the Building Official from thereafter requiring a colTection of elTors In plans, construction, or
violations of any code. Every permit issued shall become invalid unless the work authorized by suctl permills commenced within six months of permit
issuance, or if work authorized by the pennitls suspended or abandoned for a period of six months after the time the work is commenced. One or
more extensions 01 time, for periods not 10 exceed 90 days each. may be allowed for the permit. The extension shall be requested in wriling to the
Building Official. An approved inspection musl be logged during each six-month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
lWlCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
SIGNATURE
SIGNATURE
,~
DATE
NOTARY AS TO L /2 \'~
CONTRAV'" . ~ L-/'. ~
MY COMMISSION JAMES A. STONE
EXPIRES Notary Public, State of Florlda
My comm. expires May 16, 1995
CC110274
DATE
MY COMMI
EXPIRES
JAMES A. STONE
Notary Public. State of Florida
My comm, expires May 16. 1995
CC110274