HomeMy WebLinkAbout95-4907
BUILDING PERMIT
Permit ~
CITY OF ZEPHYRHILLS
(813) 788.6611
4907!?
C~~], ELECTRICAL PLUMBING
Pcop"" owne:C i'd( .;~
Job Address:'--' ( _,_ d.-> ~
Parcell.D. #
Date ~ ~-~5 - 7~-
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
TI.F.'s:
Zoning: Energy Code: .
'-tS/ ~
Description of Work "/,2,,1 A":I "
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL S:.5~';-
DATE
Complete Plans, Specifications and Fee Must Accompany Application, C.O. ___
Ail work shall be performed in accordance with City Codes and Ordinances,
Inspector
City License Registration # 9' :2
State Certified License#
Permit F~r vU
Signature ~( r.s'\ _,
Company ~ -
Address
Telephone#
Valuation or
Contract Price ,g. S~ 0, cJ()
--1,1 "f ('~ {".ML.i/
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftc. ~ ~ ~
:::t:'L\_,)1'_- Pi-
FRM. 'J I
Insul. CL ~
WL
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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.
"~9~~ ~ . ~N Ce.
\\2.~ 6. ~i~\~CJ"i I\:\..'
::Jo5"t
SCJ"22 Z3~ ~'\'. J "Z\-\:.
LEGAL DESCRIPTION: LOT(S)
PARCEL 1. D. ~~
WORK PROPOSED:_New Construction --Addition ~lteratiQ~;, -Repollif;
APPLICANT
ADDRESS
OWNER
JOB LOCATION
APPLICATION FOR PERMIT
CITY OF ZBPBYRHILLS
BUILDING DEPARTMENT
LOT SIZE
x
~;:'..~ \
BLOCK
SUBDIVISION
.
_Sign/Temp.
":0;,:. ~
<' \i-..t ,', ~
_Sign ' _Move
----HIp ____# of Unit"
PROPOSED USE: _Single Family
BUILDING SIZE:
RESIDENTIAL:
COMMERCIAL :
_BUILDING,
_ELECTRICAL
--.-MECHANICAL
.
_PLUMBING
_Commercial
--:-;..;.lnclu,.tll _Swim.. Poo+
... ,~! ; \: ' ~.: !
_Restaurant & Health Depa~tmentt Approval
x
Square Feet.
ATTACH
ATTACH
** COpy
~, ..
(2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENER
(3) SETS, OF..BUILD.INGPLANS... (1) SET,EN~Y-fP1.U1S. *~
OF CONTRACT REQUIRED. ":~l:"
....-.." .. . ':..,. m
PF.RMITS RF.OlJESTED
1."
t_>~
I.. .',
$
2 S9C-.cc
\
Valuation of Total const~ction
'-;' ,. ,J \~ .
H .~. . "'t"'..
$
,. --.~. ~ ' 1~-: --
AMP Service Florida pqwer)i~):."p, _W
,_ ,~~~~~~~~ ~f n~~~~~~~.~allat~~~.
GAS .X. ..,ROOFING . ,,~'E~~ALTY .
Otner
.--- .
TYP~ Of CONSTRUCTION:
~a~ock
_f~~e _Steel
:':i'A~;'
FINISHED FLOOR ELEVATIONS: " , FT. ,'.' ,. ;",' ..',' "',' 't~,;
4;,
**~**~~:****~~**~~~~*~*~******~******~~*.
" "L CONTRACTOR SECTIO~,~',
Company, ," l>it
-.. State' Cert:! or' Regi$ i~
.' '" ~tty~ice~se R~g~~t;.'~on #
*****~*~***~*~~~_~t~~*,~~.*~*~*~.~*t~~;,,'" '[**
Company ,,~.;'
, , "_, ,'," Stat~c~rt. or" R.egi..,; ~~
City'Lic~nse Regist~On it
**********************************.* .'..,.' .*
." ;" !,~,".,)t:..
Company , '.a. '
State Cert. or Re8~
City License Regist
**~~*.*..**..*~.************~..**~.
. . . . 1'1 . .' ". ; t, ' ,~,.,: ~ ~.
BHTIjDER
Sigllature
" I
:::::::::AN
PLl~BE~
SigY:lat~re
MECHANICAL
Signature
../L
)I'
/'
/
,/
/
/
.
/.
/-
.'
"'.'.
, ,',Company
State Cert. or Reg! '.'#
City License Regi,t~ion #
************************************ ***
"THEll ~
Sianature ~~~ ~ ....
*****~****************************f'
APPLICATION APPROVED BY
'-'. I
!',
,( ,",'
~,
~i>",
CONDIT10NS,C~ PiAMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The undersigned understands that this perlit lav be iUbjlct to -died r.strictions" which lay be lore rtstr~ctive tbta City
regulations. Th. undenign.d a"UUI,r,,,,".~\lltt~!.or....co...llancl with any applic.l",.t~ ,r,,~rictionl..;.
," " :,. . :;.JJ'l
'...
UNLICENSED CONTRACTORS AND 9Q~lH~~TOR RESPONSIBILITIES
';;'.
0/'.
B.
:q~.if
If the owner has hired a contractor or contractors to undertake work, theV lay be requir,d to be licensed in accor-..c. with
state and local regulations. If the contractor il not llclftltd I' r.quired by llW, both the owner and contractor laY be
cited for a lisde.eanor violation und.r Itlte llw. If thl Dwn.r or intended contractor are uncRrtain al to what l1Jl..i~
requirelents lay Ipply for the intended work, they arl advllld to contact the City of lttftvrhills 8ui14iAg Dlp.f ll131
788-6611.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractorlsl sign port.... of the
.Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the c"-"tttor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes V" to sign
as contractor that ,ay be an indication that he i5 not properly licensed and is not entitled to perlitting privil.... in the
City of Zephyrhills. )~~y
.. '\'
c. TRANSPORTATION IMPACT FEES AND UTILITY CONNECT~gN FEES
.. _ ,.$e',":
..-,
,.,'
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D. CONSTRUCTION LIEN LAW (CHAPTER 71a. FLORIDA STAJUTES,
I certify that I, the applicant, have been provided with I copy of "Florida', Cons~(ucti~n Lien Law - HOleowner'
Guide. prepared by the Florida D,partl.nt of Agriculture Ind Consul,r Affairs. If the applicant is 50aeone otb
.owner., I certify that I hav. obtaalld a, copy of th. ab~vl dll~rabed doculent and proli,e in good faith to d.li
"owner" prior to cOllencllent. .,.'.-.,
, ,
E. CONTRACTOR'S/OWNER'S AFFIDAV{T
I certify that all the inforlation in thil applicatiDn il accurate and that all wDrk will be done in co.pliantl
applicable laws regulating constructioR, loning, lid llad dty,!oplent. .
Application is hereby lade to obhin a perltt to do work and inshlliltion as indicated. I certify that no work,
installation has cOllenced prior to issuance of a plrlit and that all work will be perforled to leet'standards
regula'ting construction, City codes, loning rtgulatiDnl, and land develop.ent rl9ulatioRs in the jurisdiction.
certify that I understand that the regulations of other goyern.ental agencies lay apply~to the intended work, a
IY responsibili ty to identify IIhat actions I lUst tlke to be in COlpHance. Such agencies include but jilt 1I0t
..
. ..' '
. DeDartlent of Environlental Reaulation - Cyprtll Bavhl.dl, W.tland ~reis and ~nYif~ntallY Sensitive landt ;
Water/Wlltl>>iter Treatlent ;,"" " .
t Southwest Florida Water'"anaaelent District - Wells; CVpress Bayheads, Wetland Arpa~ Altering Wat~rcoUr5e$
. Arlv CorDS of Enuineers - Seawalls, Docks, Navigable Waterways "
. Deoartlent of Health L Rehabilitative Services. Environlental Health Unit - WellS; Waste~ater Trea~lent. Sep
. US Environlentll Protection Aoenc\'. -: Asbestos ~b~ttlent ' ,<~
"
---..'- .......
1 also certify that, if fill laterial il to be used in Flood Zone -A. Dr "A,etc.", it is understood that a dra
addressing a .colpensating volUl,-.will be IUblitttd which is prepared by a profe~sio~' engineer registarod i
Florida prior to pertit issuance. . , ' ."
A penit issued shall be construed to be a lieensl to proued with the work and !lOt ",.authority to viohte,'c
set aside any provisions of the technical codes, nor shall iSluance of a perait prevl.t the Building Off\,i.l
requiring a correction of errou in plins; construction, or violations of any tfldl'l~ ~yery penH isslll!d itlil~
unless the work authorized by such peni\is coHeneed within six lonths of issuance, or if work iuthonzed by
suspended or abandoned for a period of six lonihs after the ti.e the work is co..~n~~. One 90 day e~t~nsioll
allowed for the penH with fee charge of $15.00. The extension shall be requested.. wri ting to the 8ui1din
approved inspection lust be logged during each six aDnth period, or the project will be considered .bdlidoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEME
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTOR
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ~O~i UNDER $2,500
DO NOT NEED TO RECORP ANP POST A IINOTICE OF COMM~M~NT".
.s:,;~~J~~ii~~~~iO~/~IGNATLn1E~ >-
DATE ' ,I J.6'J~C- . .. DATE '~'II J;).~1t:;'5
____,__~.;..-_t:.J.~-------------- -------- ,,', ':::J:.I...-- ./.-...------,
,~
MY COMMISSION E
...
NOTARY AS TO
OWNER OR AGENT____
MY COM
r-x:.1-
1.1~
---JUrJrl'Ht:-Sc..IAPER
NoIaIy PublIc <:1'):8 of FlOIIda
Mv Comm, t:llJj. June 6. 1997
No. CC 292357
"". '.
":7:~7!:'?![',~~"--
Permit No.
. b
NOTICE OF c~uf=..r~MeNT
'lUll !!!P III 11II1'
State Of
FLORIDA
County of
PASCO
THE UNDERSICNED hereby gives notice that improvement will be made to certain
real property, and in accordance with Chapter 713. Florida St.-tutes, the following
information is provided in thl. Notice of Commencement: . . ..
1 . Description of Property: ..-p.rcel No. ..
3. Owner Information: ~ame rIA t/ (roJ.f .a IA
,
"Address S- 3 ~ V 'Z 3/ d....Jj-
Interest in Property: OU)...-, r-
-
City
Rcpt: 16~ Recl b.~o
OS: 0.00 ITe 0.00
05/03/95 Dpty Cl
.J~ PI..... _ Cll.ltTY rU:.Llt
05/03/95 10~ao.. 1 of 1 .. n,
OR BK 3421 AI J 148
Ku({y~
~ ~~I~~I iJSta....a
, STATE ..F FLO~IOA ._~~'_~_
\iOUNT. er p.~~ ~ &S A
tHIS IS TO CE~"T.M OM fILE
.... ANI 0llIlll"~ ~ ~, y
OR OF PUBUC Rf,CORt' &lnl nl$' . OAY. Of
,{AN OFFICIAt" ~ D":;' ,
19 +*'
T
D.C.
State~
'1'W"
Name of Fee Simple Titleholder:
(If other than owner)
Address
City
R'
JED PI
BY
Address 11250 S. HWY. 98 City DADE CITY
5. Surely: Name ~'::c.~~ L.u,^~"""4-
Addre$$_~ I~'~ CllY~~C."i--Sta...
Amount of Bond: $ S ~~
I _
NJA.
/ '
Contractor:
N.me
PAUL SCHAPER
t::-...... ,
6. Lender:
Name
Address
City
State
7.
Persons within the State of Florida designated by Owner upon whom notice.
or other documents may be served ..s provided by Section 713.13(1 )(a)(7), FIor.
Statutes: .
~.
Name
Address
City
State
8.
N~
of to receive a copy of the Lienor's NoUQa
as provided in Section 713.13(1)(b). Florid. St.tutes.
In addition to himself, Owner designates
9. Expiration date of Notice of Commencement (the expiration diate i5 1 year from
the date of recording unless a different date Is specified.)
t Signature of Owner:
'1S.~pt..:.. ~~ t~tA. f) _. .- j
Sworn to and subscri d before me t i. dlJ diay of l ~.f\
19~. . .Pf,.~ KfJ(p 'fBO ?JOf7
Notary Public: ~1~;I ~
My Commission Expires: '
- .
,'~
JUDITH l. SCIiAPED
AltCclrnm &p June.. ..
Nt" ::c 292357 ':,