HomeMy WebLinkAbout94-4063
BUILDING PERMIT
l:j~F ..s-(N' t7V
CiTY OF ZEPHYRHILLS
(813) 788-6611
Permit N~
4063L?
~--~---9Y
Date
3- 0-50. crV
/
BUILDING
Sewer Conn:1 :; 7 CJ /. t:J.V
Water Conn: / b/.;J .;2..S...... o-v
Pwperty Own", jJ, ~~.i,,____ / a...z:: wate: M~j", .
Job Address: 7 L2._ ~ _ _ TIF. s: J>~ 7;2 9. d() ~~1~
Parcell.D. # 1}-1J1)iL (!,OIJN:FEF~ ~EJt;' ;1,"-:i!l fr. .1-(-
Zon;ng' En"'gy Codoo ,LZ______ ,_Bari~a"; 1-r .-fY, ~Jff wATER ,,-,<,#J. 1,1/I,,{l.. SD
Description of Work :J...Jv1 ~ '-.? A; ~ ~~# ~
6 7~. trO
.JYt7. crv
PLUMBING
d 7'/, tTD
MECHANICAL
ELECTRICAL
FINAL /.f'/ Z C;;---,
DATE
C.O. -!I- - ~b-9 S-
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordarr:-e with City Codes and Ordinances.
pe'~;t Fee~~-"
Signature C_____ ___
Company
Address
Telephone#
Valuation or
Contract Price
o ,,?SO,SZ 0.0-0
-
City License Registration # J....?i
State Certified License#
BUILDING
~~A # ~ fi'O-Ar-1 JJuJ
,;20 "3 .J.S-r;-
ELECTRICAL PLUMBING
Ar~~ /lid
MECHANICAL /CJ<j
~~
Tp. Serv.
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Ftr,
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
5~fi.. ~t-t ';:'0
S J-\~~'-- ~"- l~f((:t-(l,A>
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.
7J~C(-tJ j::L-;.v-91
The payment of inspection fees shall be made before any further permits will be issued to the person owning
r same.
Elf'S! l?IlSC.O A1Eb~ (!~fiI1tR
e. ~-? 13? Fhov-
\1...1. ..................1/ :2 C"/) .r"" / [)--j
VdIUdLlUII'1 i C;J.::./U:r:J~C/, I
Permit Fees:
-...----.--.-. .--.- - ~-
Building 5050 "" sp
.-.---.---- -~----_..-
Plumbing ,3 90 . ~
Electrical 10 7& .._.._~~.....
__Me~ban..Lcal. e 7 7_~_~c:......
___~_~~total ~ aLf...C?_.
Credit ..500 . €:>p
--..----.---.- _ -;/----_.......
Total 5873,50
-----._---.
Connection Fees:
..-.-..--.---. -----. ------....---.-.-.. .---
___..___~ewer ~ ~ ~~1~-:...._
Water e> 32.5. -
--...--......-... ~----
Meter
Total g(f)2~~-
J ___..._
~~;:~t~I~~~~;ZT...
[-~.=il.F:;1 ..J
tl0! 'i2 ~ =- y?g- 9 ~%l. 7/
/. t!!I 0/-.1, 2.9
m "q,;
v tr o_ta~[~~--I
!Sq. Ft. LiVirtglE. ~ 3~D
[iq. Ft~h;!r----"~]
. EAS\" Yt'\~ "^~ ~--r~tl.
.s()sr~ A\)\)\ttO,j
CITY OF ZEPHYRIIlLLS CONNECTION PEr.S
F L-oo~ z..()- ~
TAJlLE A - WORKSHEET
~
1>\) \L.-V - c 0 ,
RESOLUTION #13 12 hrATER $1. 75/GALLON SEWER $6.39/GALLON
RESU)ENTIAL (Each Lot or Unit)
Residence - $ 3-50.00 $1,278.00
Travel Trailer Park 131. 25 1,79.25
COMMERCIAL (PER FIXTURE)
Sinks 87.50 319.50
\-Ia te r Closet 131.25 i,79.25
Urinal 87.50 319.50
Lavatory i,3.75 159.75
Tub/Shower 87.50 - 319.50
Washing Machines-Cooonercial Size 350.00 1. 278.00
Washing Machines-Domestic Size 87.50 3J.9.50
FOOD SERVICE - Dislmasher 70'0.00 2.556.00
Sinks (3 Compartment) . 175.00 639.00
Car h'ash (Per Stall) 1,000.00 6.390.00
FIXTURE G.P.D. #1 WATER SEI't'ER TOTAL PER FIXTURE
Sinks 50 41.v 'i 025. 0 u
Water Closets' 75 34 /., 41,2.. ,'-0 ,)0
Urinals 50
Lavatories 25 ~O 111~ DO
Tubs / Shatole rs so 110256,' cP
Washing Hachine 200
Washing Nachine 50
Dishwasher. 1,00
Sinks-3 Comprt 100
Gar Wash-pI st. 1,000
0325'.00 3 01 ~ Do 41> 02lo & i) 0
" rM8
"'ATER ~IE'J'ER
r.RANO TOTAL '-/ <6, 0210. (1)
.
....
-
~...,....;:,_._"
'." '""":"" ...'T.....--. -- ... -;-,!~-.,.,..,-. .
'. t~
!
. APPLICAT.IOIi FOR PERKfT
GI'lY OF ZEPIIYRIliLLS
BUII.DIRC DEPARlHF.NT
OWNER'S NAME /!LJYcl/,06r #~AL?#S,Y.s7.F/I11/SUAlPL:<.7 PIroNE""" ?8!?;,~t.;'l""f".
OWNER'S ADDRESS ~ H5;r.~5to /7/E/?/G4~ eecl7B2
JOB ADDRESS j'~.:fD fJ./1u ~Aj) / .zE?~.e;r.//~.~ .7Y~llc
LEGAL DFSCRIPl'ION: IJJI(S)
BUlC({
SUBDIVISION
PARCEL 1. D.'
.seE' AdA<!.lk:b
It'URK PROPOSED:-L~ew Construction --.JWdition _Alterati~)Q ~e~ir ___Iw>_tall
_Sign
_Hove
_Deaolish
PROPOSED USE:
Single Faaily
_R/F
_' of Units
_H/H
_~rcial
_Indust.
_Stria. Pool
Other
_Restaurant & Health Departllent Approval
BUILDING SIZE:
x
Square Feet,
Hei~t
RESIDENTIAL:
cotmERCIAL :
ATTACfI (2) PLOT P.LABS &: (2) SEIS OF BUILDING PJ.MS & (1) SET ENERGY FORKS. **
ATTACH (3) SILTS OF Bun.DIIIG PLABS & (1) SET ENERGY FORKS. **
**COPr OF COBTRAcr Rll'.QUIRIID.
PRRnITS REOUF..sTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power COrp.
W.R.E.C. .
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
JIDOF1-;:iG
~r~(;.Lu:n
~
TYPE OF CONSTRUCTION: _Block _Pralle _Steel
Other
FllfISHED FLOOR KLEVATIOBS:
Fr.
IS P.ROJEeI'- IN FLOOD ZONE AREA?
YES NO
******************************************
RUII.DER
cmrrRACJOR SECTION
~ . COIPAJIY ~ ~"'n:e,,~~ C" .#c
. ?:'l... s?-te ~ert. or R~gist..' CQ C.O,f/1 ~~
7'I/U- C1ty L1cense Reg1strat1on , -::I
******************************************
Si.gnature
HEClfAHICAL
~x~ ~ OOIIPARY ~-/'a. ~~:.~
(# Sl:ate Cert. or Regist. #. _ (!-a~o"l; !t .:I .
Sf \Jr _ City License Registration I ~~-3
. ******************************************
{DfPABY ~LLbl y;,~~J'-~
~ . Sl:ate Cert. oJ'Regist. I
City License Registration ,
******************************************
COIPAIIY J.k ~ )1v1I1
State Cert. or egist.'
City License Registration"
*************..****************************
PLUKBER
Signa ture
J~
J&
~.
10 ~
I
".
Signature
:1
OTHER cmfPMff
S~ate Cert. or Regist. ,
Signature Ci~ License Registration ,
*...*************..******..*****....*****....,**..**
! .~
t\PPLICATION APPROVED BY PERKIT OFFICER...
~ ~ ~
---~---":-. .. '.'.--"CONDITIONS'OF PERMIT AFFIDAVI\T ,w
A. NOT I CE OF DEED RESTR I CT IONS _ ..;:
The undersigned understands that this penH 'Ia)' Ilt!: sul;ject tll.Glld restrir;tiDnl" which lilY be lore rntrictive than City
regulatiDns. ,The undersigned assules responsibilit( for cOlpliance with any applicable deed restrictions. .
B. UNLICENSED CONTRACTORS AND CONT~ACTOR RESPONSIBILITIES
If the owner has hired a contrac~or Dr contracto~s to undertake Nork, they lay be required to be licensed 1n accordance with'
state and local regulations. If' l~;""cDnrractor iiHlot"Uceusedas required by law, both the owner and contrachr uy be
cited for a lisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as to "hat licensing
requirelents aay apply for the intended Nork, they are acvised to contact the City of'Zephyrhills Building Departlent, 18131"
799-6611. .
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 ~ill be responsible. If you, as the ONner sign as the contractor,
you are indicating that you, tather than the contractor, are responsible for the Nork. 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 FE~S 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 - H6feowner's Protection
Guide. prepared by the Florida Departlent of Agriculture and Consueer Affairs. If the applicant is sOleone other than the, .1.'
"owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith, to deliver it to the
"owner" prior to cOllencelent.
E. CONTRACTO~'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work "ill 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.ented prior to issuance of, a perlit and that all work Nill be perforled to leet standards of all laws'
regulating construction, City cDdes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental 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, Hetland Areas and Environ.entally Sensitive Lands,
Hater/Wastewater TrEJt.ent
t Southwest Florida Hater ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways ,.
t Departlent of Health & Rehabilitative Services, Environlental Health Unit - ,Wells, Wastewater Treatlent, Septic Tanks
t US Environ.ental Protection AQency - Asbestos abate.ent
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
addr!!;!;l!'~' ! "C!!!!I'!!1Hti!!~ V!)!!!!!!" II!!! !!! 5!!~;'H.~'~ !!h!d! !5 l'f!!l'af!'d hI' :!::'f'.:'f!'5!;!'mal !!!g!!Ip.er r!!~!it!f!d l!!th!! Stat!! I)f
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 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 pertit is cOI.enced within six Ronths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the tile the work is cO.Denced. 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 Offici'al. An
approved 'inspection lust be logged during each six month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOT'~E OF COMMENCEMENT nAY RESULT IN YOUR PAYIIlG THICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF ~OU INTEND TQ ,OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEV BEFORE RECORDING YOUR NOTICE OF
COnKENCEKENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COM EIIEII1".'
~.
~; .. .; :......:~~ ...,
STATE OF FLORIDA
COUNTY O{ Pas ceo
The foregoing instrument
befc.re me this 4/26
was ackno~ledged
19~ by
STATE OF FLORIDA
COUNTY OF Pasco
The foregoing instrument
befc.re me this 4/26
lo'las acknolo'Jledged
" 19--21- by
David Hauqen ____ _._ _
who is personal! y lmown to me Cof'-wi+eo--I=na~
~~~---------------------------
..a__i.da.I:I.tj.'f.i..c;.aU;.ic:r.n. and who 4I...tWdid not,
~~~.\\O~
~ture)
June M. Herndon ,,'
(Name Typed, Printed or Stamped)
NOTARY PUBLIC tiotary PUblic, StatlftJr Ffjjl'ld'C
JUNE M. HERNDON
I.1Y. :commission Exp. Feb. i, 1997
.Comm. No. 252632
Charles D. Poole . l'~
;;h~ per~~-ll y k~c,wn t;"m-;-o-F;"'I1a7i"~'
pr~~~-------------------------
l!l'5--i.eept1l-K-!ee-.~and who e.).&,Idid not
an oa
(Si
Ju e M. Herndon
(Name Typed, Printed
NOTARY PUDqC
. Public rlda
*,-I'Y -- 'HERNDON '.
JUNE M. ,
_ Ell' f..h '.1997.
of'l1y;~e " ')No. 2526~2 " , '
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_~:....:-...-% . ~ ftleC.. JIfI- . ",~"f
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-'11.&11 ..&1 ~ .,.. .', _ _ IMIJI.III-..a ~ O'J....--=" '-." . -.. ---
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~
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'I'J!e .. 'IL ..A\._"",:",' on"., ~~.. .Odlcw:
u.._ RIa~. 11.--' 'DI ~ ~.MIla! __-J-.:.:;
U8 )II
...., lIIi_...II..&M_MJl..L.............._..A,J..........
"...61:1:..:...... ~ I
...
---
~QIId- -~p'
_g. r.a-. .r~t - ."I;~ t
.aA...,........~- .r.R~....&...-v~,.~~~..
. .
SI..--.
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.-...nt ,....
.... ~I:. _ -..a.. 4J
Qlg u.c-.. ~ I
.....-..............*-*....
n.-
&f~
.~~
~ ~ .. ...... ,.2:
_ GlW u.-,.. ~.u.. . '
. 1..~........I..,li_ ._AIl".
'-,- -hk~,e ~N~~N.. ~
..... ~- --~. . 4,,).76.
_13' u.- ....-.-. · "0 r'
.......~.... '
~
.... o-t... .... ~'c:. "
.....uoe.. -.s..~ .
".....&...__.~.,.. ........-....--.... ...............-.
......-.
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$. I. "A!
vtUGlIifl- ...... 'ft
ftIDIIT lrl'I"Xf:lIIl.
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TOTAL P. 212
. III
3 rt-V (LoolL
(; 1 CL
LL
~u.L
7-b'~ 4
')-\'-G\~
'lA~-'t~
7-2/ C;{
't.vv~
~ -c!-Cf '-f
'73 ..-{ ().q'f
i> -12> ,1''(
~-\~..qlf
(1/ /(} q '-I
tJ- 2']-11
~-'2.<t..~~
10 --IT -c;'-f
/i-I-1<-f
/2-0d-(( <t
~-l~ 'is
!Jt-Lf-c;)
III
-.:::::::.,
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-- - .----,..- '-.- - - -. -----,...-l-- _ ~ --.. _'._ _. _.----. _ __ _ _. __ _ _ _ ___
...
"
C E N T R ALP E R M I
PASCO COUNTY, FLORIDA
T TIN G DATE: 12/21/94
PAGE: j OF 1
I ::;;:::;I.JE OFF I CE: D
RECEIPT NUMBR: 00234114
OFFICE: DADE CITY
C:UNTF:(."CTOF:.. :J:!::
NAME: EAST PASCO MED.CENTER
ADDR: 7050 GALL BLVD
c: / :::: T : Z .I It ILL
FOf~.' :
CHECI< # CA:~;H
f.:iCCN'f
. 1/+
TOT AL AI'10UNT:
COMPNY ACCOUNT CENTER
B4::;O - ::;:63000 .. .2
13.77
AMOUNT DESCRIPTION/PERMT DATA DRICR
13.77 ****** SOLID WASTE FEE 60
.' ~
, ,
;' . /" /~ .--;:/// ~
m~C:E I VEL BV ,,--_."L~..:.',_I_..'1.i..J____L~L___.L__!..L.t.._i_.!...~::_~.:._t (
I
/
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., ""J'_'C.!"',,'=" ::~~~r:~~ ':r.,.;~ ... . ---"7_ .....' -.,."" .."~'l."'.:__ ----'.' - ~- -"}j\"--_:..-~';~J.f:'; '.:~~.-..t ~_',,;/,"'" _ ~
'''''l''i-~ ;.~,
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PASCO COUNTY, FLORIDA
Permit No,
Date Permitted
./ ,I;...
./
Builder Name/Owner Name
County Parcel NO,m-'
,/ .....
,..
Location
Subd,
Classification/Type of Use
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Rate $
Zone No.
Sq. FUUnit
Pr.epared "By
Impact Fee Amount $
" .
..- -~," "' .- .........
The above impact fee has been establisbedpursuant to the Pasco County Transportaiion'lmpl,!.ct Ordinance as adopted
by the Board of County Comm~ssioners. This amount is payable PRIOR to the issuance of a Cei'tiflCi!J~ of Occupancy
or authority to utilize the. permitted structure,
RESOURCE RECOVERY ASSESSMENT
EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No, Units
Gross Sq, Ft. (GSF) /
RatelERU - 50.00 x O,96*/Year
or $0. 1315/Day
ERU Assign No,
Assessment - (No, Units) x ($0.1315)
x (No. Days)
Assessment -
(GSF) x (ERU) X (0,1315) x (No, 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.
THE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE CERTIFICATE OF
OCCUPANCY.
NO CERTIFlCATE 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, NO.
RESOURCE RECOVERY REC. NO,
DATE
DATE
,;
BY
/"
BY"
/
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce
~ ----_..__._---_.__._--~---._.._.._-------~~------~--~--_._--~----
--~-_._--_._---~----------_._"~--~._~.._._._---.~-