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Home My WebLink About95-4602 BUILDING PERMIT Permit N! CITY OF ZEPHYRHILLS (813) 788-6611 4602/J Date j- 9 - f..s- ~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Pmp,ny Owo", C1 ~ !1lf~ fA- Job Address: ~ -- (,$.... / 0 . Parcell.D. # J/ ~c2t-;;U-. O()I () - Od..sO() ~ 00-30 Water Conn: Water M~ter: T.I.F.'s: Zoning: Energy Code: Description of Work I;L X / e2. --:l'Af2..- c:lZ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL l-12'C;~ DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordarce with City Codes and Ordinances. c.o. DATE Inspector Valuation or Contract Price ~ Lj..f:> --0. o-D pe'm;IF~Ji) ~ S;gnatu<e - - q~,~- .. Company City License Registration # State Certified license# Address Telephone# (5')3) )J J'-Ic,t:2S- t1J.vYlI1/1_ BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. P,e Sl~V ?,; Lintel \ ..L\ FRM. 0/ InSUI.~~ r ro-Y Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Serv. Rough In Meter Can Canst. Pole Pool Pre-Meter Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons. a charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. ~~,~.-..-v~~___~ ....... ..._.___......---~.. ...._____.__w___~__._...___-...______........____~.............--~~,....-...~--'...-",.....-.--.--,,-----..-- .-,-.-,._~~ ~:~~~.~.___,_..._-...---._...~......,:...~.....~~.__A~_"'fr"""_""__'~!!I$>'_~~"'~~"'"'"",":I'''-,'.~- .-... ----..........-.-.--.'.*.,.. ,~,~,;;....,';- I "..#l.. V".~'" .' . .~ ... ...-"---"---~-""rr I --P' - 11'1 .. '~ 1 .j ., 17 ..- .. " ~_~m ti..~ - THIRTEENTH AVENUE (60' RIGHT-Of-WAY) SECTION II , TOWNSHIP 26 SOUTH. RANG[ 21 EAST PA S CO COUNTY, FLORIDA N +- .3 If 140,00' N ,6 50 00' 00" E, ~ ... -~_._)(-_._- f----. lin: fence J 31. 3' ; >- 1.0 < r-() ').5.0' : W U) (\J ..J r-() u ..J 0 "0... --1 <t Q CO Ii) (\J <t - ~ 0 Z +- () (\J 0 .3 ()) r<) "'> .1 S roR Y MAS)NRY RESIDENCE #-5813 '/ ~ /. 35,0 41. Of I hereby certify that the Boundary and Improvement Survey represented on this ~4p was made. under. direction on the date shown based on the information furnished tome as noted and to the best of my knowledge and belief conforms~to the Minimum Technical standapds~for Land Survey i n9 in :toe ,{(;$tate/: of Florida in' accordanc-o', wjth-,Gbapt.er 21HH-6, Florida?" .~cfm:rQ.istfative Cod"" . ".. r, ' PRE:~RED BY ~k~ /. ';- ~" ~ .. Maur ,'';0,,1#. Boa,l t..-' professlonar~~utveyor Florida Rog.'.HO. 428\ UNLESS 'IMPRINTED .r~,___~,~}~,";.::".:~..,'- " .. ~~ J N ~ , N,65000'(J)"E, 4'd\:linlinklenee 140.00' P) 139.l6(F) ,4' 1.0 +- .3 ,.' ,- DESCRIPTlhN Block 35, CITY OF ZEPHYRHILLS (formerly Town of zephyrhills) recorded in Plat Book 1, page 54, Public Records of Pasco . i . ... apparent surface encroachments' except as shown. hereon. :~~..,Ulld~rground encroachments,or.:r.utilities (if. any) :not located in .conjuiic <;r/'fi';"" .. . . ' . . .,.,-, "", . '- ,.. ,'. """( "~.;;,,, survey. .. ,','."' ' ,.,:C,. .' ~ ,', i(;.. - ,. 'j' ," ,.,. '.' '., . ,.~:: 1':_' ~:;' .':C-":'."." ,.. ,~ , , _ ,., ", ': .,.' ti"?):" .t:rp~De8.cx:iption shown"here9o,'.I.!urnished b,Y: F~r~"t.)~~.t.ional Bank ofthe>.soutJ\;~ "i,Bearings shown hereon are~8.~uIt\e.d. The " soutilf:B9,\}ndary of Thirt~,el,l~hf;~. 1 :,\00'00"-.8. ' . ,,;;'i\' ',. ..;..j."",~ ;~;.... . ,.., ;.,..":,.;:-i'~~i' ~;Th~.~.::surveyor not. J;~8pQl\9i91e foreas'e'me'nts} addit~onal Rights'.:.of~W'ai~;: ,..eoc:~m~J:.~I)Ce8 ..ofrec:or.d"':Ilot.~f\Jtn18hed to. .this office. ... .)?': ~~el)c~'s; .eh~~n' h~r~().n:'nq;t'dit~;.~faie;';:' .', .t';~"..;,',' .. ;~',;~~ ~.:"~ j". , t ~ ....' ,~ f{/' lF~ - ne/d Data - Com~ute-d Data ,. , J .,.,~ ~rt :'::;;'V;:'$;jj CY Cone;ut. Uonun'\~\':..'" ?OB -Polnt:of 8~1oo1r\9" ~'; : ~~n,~'~:';..~.X'" IR. - trOll Rod ',r;;' IP. - 1r0ll Pipe ':,:' .,.;: RRS. - Rallcood Spike J"', N &c 0 - No. and Dlak:;;>l1::.;:, GBV' Mw'B . ~~', ;,..-' .... .'. ~ '.'~. '''-<l ......' ~ .~ ... .k',~' ~~::,:, d., - _~~. ~-:",!.:Jt'~~ ''>'''~' -i,.:'" :"-'1;.',;'--' ...t:';;';';":_;:~.,"i~" ~:;;.,; ..~- i,- I i ~"""" "-,- ;-- THE RANCH BARN, EAVE AND STREAMLINE MODELS ARE AVAILABLE IN THE fOLLOWING SIZES: Note: Please check with your Dealer for window configurations and sizes not listed. .. ,f~E:~:~;~?~~ "\~;;.;;:~~.=-"~ r"" ,-""",,""~ ~., '.~ 'AA......'1~ ~ ...., """",~....' -t;o I 1~""~'~ I I ~& ,,,",-',,,",, "...--,,.,.,.;;.;=.> <'.,""""". d ",,"'~"~ "'~",,""j" ,. .. ,...~. ..~.,"'" .- ...~ "......' ~. .. ~ ~ .'~.~ DOOBLE WIDE - RANCH BARN, EAVE OR STREAMLINE \,......,...'~~:... ..,..~,.''"'.,......''., - ~. ""=" ~~ ..... ~~ .... ,- THE fLAT ROOf MODEL r~ c-_._~ :-==:=:---1 r~--~.-~ .~~ ;=:C:3 1 .- -- t-=::.../ r----., l-- ; r-::",,~l F~=~ ;~::a r~.-/ " I I I... I{-''(''O'' ....,."'...0........... ~ ,",-,- ,,,,",,,,,,"" ,w ~.,.~ (i THE ECOND'MUDEL -- , . ' PASCO COUNTY BUILDING PERMIT APPUCA nON SHADED AREAS FOR OFFICE USE ONLY CENTRAL PERMITTING OFFICES: . Dade City: (904) 521-4206 37918 Meridian Ave., Rm 234, Dade City . New Port Richey: (813) 847-8126 7432 Little Road, New Port Richey · Land O'Lakes: (813) 929-1266 4111 Land O'Lakes Blvd. (US 41), Land O'Lakes THIS APPLICATION MUST BE TYPED OR PRINTED IN INK AND IS VOID IF ~T PERM..!.TTED ~1!t!.1~ ~~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ ----- . OWNER'S NAME: . FEE SIMPLE TITLEHOLDER'S NAME (II other than owner): address (if applicable): . DESCRIPTION OF WORK: LIVING AREA: # BEDROOMS ~ g ~ CD ~ . IF MOBILE HOME OR RV: MAKE ~ Q. ~ o Ih W o . WORK CODE: 1t___~ PLANS ON FILE? MODEL NAME: VALUATION: $ )( #/'1>0 / - o NO 0 YES . BONDING COMPANY: ADDRESS: CITY STATE ZIP ~ 0 9 . ARCHITECT/ENGINEER: CD a: ADDRESS: CITY STATE ZIP w i!: . MORTGAGE LENDER: 0 ADDRESS: CITY STATE ZIP PHONE' ( CITY STATE ZIP PASCO CO COMPUTER 101: ~ 9 CD ~ . ELECTRICAL CONTRACTOR: ~ SIGNATURE: ~ ADDRESS: ~ STATE L1C , (if applicable): 8 POWER CO: PHONE # ( CITY STATE ZIP PASCO CO COMPUTER 10.: SAWPOLE: AMPS: . MECHANICAL CONTRACTOR: SIGNATURE: ADDRESS: STATE L1C # (if applicable): o NEW OALTERATION VALUATION: $ PHONE # ( CITY STATE PASCO CO COMPUTER 10.: (Required) ZIP . PLUMBING CONTRACTOR: SIGNATURE: ADDRESS: CITY STATE L1C # (if applicable): # FIXTURES: - SEPTIC PER ,: PHONE # ( STATE ZIP PASCO CO COMPUTER 10.: SEWER: WATER: PLUMBING FEE: $ WELL: . OTHER CONTRACTOR: SIGNATURE: ADDRESS: STATE L1C # (if applicable): TYPE CONTRACTOR: CITY PHONE # ( ) STATE ZIP PASCO CO COMPUTER 10.: VALUATION: $ JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT" (permit form 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 (Ucense Holder) MUST READ AND SIGN THE REVERSE SIDE OF THIS APPLICATION . . ' CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DFED RESTRICTIONS The undersigned uncIerstand that this permit may be subject to .deed reslliclions. which may be more restrictive Ihan County regulations. The undersigned assumes r86ponslblUty 'or compliance with any appUcabIe deed resllictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES " the owner has hired a contractor or contractors to undertake work, they may be required to be licensed In accordance wilh state and IocaJ regula- tions. If the contractor is not licensed as required by law. bolh the owner and contractor may be cited for a misdemeanor violation under state law, If the owner or inl8nded contractor are uncertain as to what licensing r8qulremenlS may apply for Ihe Inl8nded work, they are advised to contact Ihe Pasco Coonty Building Division - Ucenslng Seclion at (813) 847-8009. Furthennore, If Ihe owner has hired a contractor or conlraclOrs, he is advised to have the contractor(s) sign portions of Ihe .Contractor Block. 01 this application for which they will be responsible. If yoo, as the owner sign as the conlractor. you are Indicating Ihat you, rather Ihan the contractor, are responsible for the work. " the conlractor wishes you to sign as contractor, that may be an Indication that he Is nol properly llc:8nsed and Is not entitled to pennitting privUeges In Pasco Coonty. . C. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES The undersigned understand thai Tran&portalion Impact Fees and ResourOll Recovery Fees may apply to the conslNction 01 ngw buildings, change of use In existing buildings, or expansion 01 exisling buildings, as specllied in Pasco County Ordinance numbers 89-07 and G044. as amended. The undersigned also understand thai such f88& as may be due will be identifl8d al the lime 01 permitting, It is further understood that Transportation Impact F88& and Resource Recovery Fees m:lst be paid prior to receivll\g a .C8l1iflC8l8 of occupancy. or final power release. "the project does not Involve a certifical8 of occupancy or final power release, the fees musl be paid prior to pennltlssuance. Furthermore, If 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 (Chapl8r 713, Florida Statutes, as amended) If valuation of 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 Aorida Department of AgriculbJre and Consumer Affairs. " the applicant is someone other than the .owner,. I certify that I have obtained a copy of the above desaibed document and promise in good faith to deliwr it to the .owner. prior to commencement. E. CONTRACTOR'SIOWNER'S AFFADAVIT I certify that all the information In this application is accurate and that all work will be done in compliance with all applicable laws regulating conslruc- tion, zoning, and land development. Application is hereby made to obtain a permit to do work and installation as indicated, I certify that no work or installation has commended prior to issuance of a permll and that aU work will be perfonned to meet standards of all laws regulating constnJction, County codes, zoning regulations, and land development regulations In the jurisdiction. I also certify that I understand that 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. Such agencies Include but are not Umited to: o Deoartment 01 Environmental Raoulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, WaterJWastewater Treatment o Southwest Florida Water Manaoement District - Wells, Cypress Bayheacls, Wetland Areas, Altering Walercourses o Armv Corns 01 Enoineers - Seawalls, Docks, Navigable Waterways o Deoartment ot Health & Rehabilitative Services Environmental Health Unit - Wells, Wasl8wal8r Treatment, Septic Tanks o US Environmental Protecti01 Aoencv - Asbestos abal8ment I understand that the following restrictions apply to the use of fill: o Use of fill is not allowed in Flood Zone .V. unless expressly permitted, o If 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 that fill will be used only to fill the area within the stem wall. o If fill material is to be used in ~ area I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adwrsely affect adjacent properties. the owner may be cited for violating the conditions of the building pennit issued under the attached pennit application. If I am the AGENT FOR THE OWNER, I promise in good faith to infonn the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and 110t as authority to violate, cancel, alter, or set aside any provision of the I8chnicaJ codes, nor shall issuance of a permit prevent the Building Official from thereattar requiring a correction of errors In plans, construc:tion. or violations of any code. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit Issuance. or if work authorized by the pennit is suspended or abandoned for a period 01 six months attar the lime the work Is commenced. One or more extensions of time, for periods not to exceed 90 days each, may be allowed for the permit The extension shall be requested in writing to the Building Official, An approved inspection musl be logged during each six-month period, or the project will be considered abandoned. SIGNATURE DATE DATE NOTARY AS TO OWNER OR AGENT NOTARY AS TO CONTRACTOR MY COMMISSION EXPIRES MY COMMISSION EXPIRES k /77 ~5b- <f'd../-&9-- ~~>L~Zj OWNER-BUIlDER AFFIDAVIT STATE OF FLORIDA ) COUNTY OF PASCO ) , . BEFORE me, the undersigned authority, personally appeared, ') () h,...~ f"{\ -€.. ~/\.\r(j f ~ . who being by me first duly sworn, under oath, deposes and states as follows: I do hereby swear/affirm: That lawn the property described as II - ;;).0.- J-.I-- 00 I 0.--0 :::. s;cx:)-oO:.:rQ Disclosure Statement State law requires construction to b8 done by licensed contractors. You have applied for a permit under an exemption to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license, You must supervise the construction yourself. family residence or a farm outbuilding. building e.t a cost of $25,000.00 or less. You may build or improve 8 one-family or two- You may also build or improve 8 commercial The building must be for your own use and occupancy. It may not be built for sale or lease, If you sellar lease a building you have built yourself within one year after the construction is complete, the law will pre- sume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by State law and by County or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F,I.C.A. and withholding tax and provide Workers' Co~pensation for that employee, all as prescribed by law, Your construction must comply with all applicable laws, ordinances, building codes, and zcning regulations, That I have read the foregoing, and am aware of my responsibilities and liabilities for construction work on the above-described property and do hereby agree to each of the aforesaid stipulations. FURTHER AFFIANT SAYETH NOT. C-flZ'J~~ 9 . Owner's Signature v / It!=- p~ 2 - ~ /~ 23f?1D Address f t.!~ ate ~ SWORN to and subscribed before me this day of 19 Notary Public State of Florida at Large My Commission Expires: Print, Type, or Stamp Commissioned Name of Notary Public Personally Known _____ or Produced Identification _____, Type of IdentificBt~,* 1rJ-d,;)&::>- '/;:;;1 ~9--3&V~ PC93053047