HomeMy WebLinkAbout95-5329
BUILDING PERMII-
CITY OF ZEPHYRHILLS Permit N!
(813) 788-6611
. 532~ 13
Date
/0 -.)b - 9~-
~c? ' V7J
BUILDING
dS " C/Z}
ELECTRICAL
....?...!;. --. <.?V
PLUMBING
...2 CJ - ,)()
MECHANICAL
Sewer Conn ~ I) 8: ~17J
Water Conn: 3....s '''1) , tTV
Water Meter: / b, S"": d7J
T.I.F.'s: / jI ytl. triJ
PmpertyOwn." ~. J
Job Address: .~ "- - ~ A-
Parcell.D, # .i -..2 - - I - <::).. . 0 DO" 0 ~ 'i)
Zoning: .Energy Code:__.. :t-- Radon Gas:
Description of Work JJI ~ /Jvt~ ~ - ~
FINAL -J.( .-
C.O. -1
,. f)
DATE--
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or , / ...L.
Contract Price ~ ~
City License Registration # ;2 /' '1
State Certified License#
Permit Fee
Signature
Company
Address
Telephone#
.;LK ~~~
,
EJAA,
LECTRICAL
/'/tJ
}f%~rtd4J27'b
PLUMBING
A~A Ale- /7
BUILDING
-
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can.ll) -Dlb-fl~-
Const. Pole
Pool
Pre-Meter
Final /I-c6'c,:; &I!J
SLB
Tub Set
Water
Sewer
Final / t- '5. 'J )- iSlLI.--
Breakers
Ducts Insl.
Compressor
Final J l-iJ{) iSbB
. f
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 _ _
. -:;;;-- . 7f-- 4 . . ~ / tJ -;26 -5-~
a. Wrong Address AJ~~ ~-
b. Condemned work resulting from faulty construction. . , c'
c. Repairs or corrections not made when inspection called. p-t? ~ ~ /J & " 7 c"J
d. Work not ready for inspection when called. ()l.iL' I v .:7-
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.
APPLICATION FOR PER1-rIT
CITY OF ZEPHYIUIILLS
BUILDING DEPARnlENT
;/ /},;--<J~
#I)~ /O-~j .
APPLICANT
I,;
~ 'i-R-- lill~R Srn:r-=E.
i-lL0y 91:(.u~
Ci, RiTA S ON i{ .
RID(r<L. WA~ DI2.Jr/{. LOT SIZE-'iiX /()() i\I~EA SQ.FT. t/)C7{)
01.50 BLOCdJOOOO sunDIVISION Zt-f'HY i2 [r,tJCrl.-
3- ;)0:" cJ./ - 01 3?J - 00 OO{} ~ (l'lj-J
PJl~~~t3 ) l S' z:.. -7 2--1 b
ADDRESS '3 ~ z.. f.o 1
ROl3ULi H,
Jon LOCATION 60Lf~
OI{NER
LEGAL DESCRIPTION: LOT(S)
PARCEL I.D.!I
\~ORK PROPOSED:~Ne\~ Construction _Addition _Alteration _Fcpnir _Install
_Sign/Temp.
PROPOSED USE: ~Single Family
_Sign
_novc
_Demolish
-..:...-M/F
~i~ of Uni ts
, ..-L~ll H
_commercial
~Indust.
_Swim.. Pool
Other
nUILDING SIZE:
RESIDENTIAL: ATTACH (2) PLOT pLANS & (2) SETS OF BUILDING PLANS (, (1) SET ENERGY FOR~lS.**
cmmERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~lSJ*
**COpy OF CONTRACT REQUIRED.
_Restaurant & Health Department Approval
d-i1x-IJ!; _~ '1:, 501/1
l~'?r
), :'lb~
Square Feet,
I SToIZ1/
Height -
PF.RMTTS REQUESTED
LnUILDING
LELECTRICAL
~~lECHANICAL
LPLillll3ING
s
_33 q{,?O
/50 AMP Service
Valuation of Total Construction
Florida power Corp,
~\{,R.E.C.
$
Valuation of Mechanical Inst3l1a~lon
.'
GAS
ROOFING
SPECI,\LTY
TYPE OF CONSTRUCTION: _I3lo'ck _Frame _S teel
(n. H.
Other
FINISHED FLOOR ELEVATIONS: FT.
ofe * ** -!,-!c "l" *-1:*"** ***********"* * ,/, * 0" ..', ~" -Ie "l; '.or .,'e ..'; '1: 1'; .:: ....; ..'; 1: -.':
Signature
f<ONTRACTOR SEQIIQli
" Company -8l:::L.f :c t\\-rFJe~mT€
State Cert. 01- g~(',iSl~, II ~
__ City License J\cr~.i:i U';ll". inn II --
~***************************************~~
:J '77
Company CCi--t-( .::Jl)tt.D A-N ~(. S ~v.
State Cert. or Rc(';isl~, II
~ I 7-0
. . "I' '. J ~
C~ty L1.cense hC['.1,st~r;:1tlon ,..
***********************~**************~*~*
Company :...JJ t::l---sa u rZ Y {'() A-N
State Cert. or Regist. 4~
City .License Rcgistrntion U ~ :J "1&1 ~
******************************************
signature
Company t3 A+l- e ~
State Cert. 01- Re['.ist, ;,'- ~
City License Regis tration ',' --=.1 D
****************************************~*
.,
P lLD P ~rJ E cl-fY J c-
/7
Signature
Company
State Cert. or l~eGj_st. f~
City License Rccistl~ntion ~~
OTHER
******************************************
rEl\~IIT OFFICER.
APPLICATION APPROVED BY
,~:c;r',!D IT: (j~j::; Ci'c, i"CI1['1 I T
I:'~ I Dr\'.' 1" ":-
A. NO-;"ICr:=: OF ~~f::F:-J~__IJ7J:;TrnCTIONS
The undersigned underst3nds Ih~1 this p~rmlt may be subject to 'deed restrictions' "hich ~ay be ~ere reslrjctivD than Cily
regulations. The undcrsignd ~,ssu~er, respDnslbllitfJor co~pliance Hith any applic;,ble deed restrictions,
E. UNL I C;::~JSJill CCIL!.I.flQCTORS AND CONTRACTOR RESPO!':IS I n I 1_ I T I r:~S
If the o~ner has hired a ccnlr~cl~r Dr contractors to undertake Hork, 'they nay be required to be licensed in accordancD Hilh
5tate and local regulations. Jf the cDntractor Is not licensed as required by l~", beth the ouner and cDnlractDr "lY be
cited f~r a nisdeaeanDr vio!~lion under stale la". If the OHner or Intended conlractor are uncertain is tD H~a! licensing
requir~:ents !\ay apply fe.r I,::,' inlcnd2~J HorK1 they are advised tc' ce.ntact the Ci Iy e,f Zephyrhi lIs Dui lain": Dcparber,t, (813)
788-6611.
Further:ore, if the Dlin!:r h25 hired a contractor or contractors I he is advised to have the contractDr(s) sign portions of the
'Contractor Sections' of Ih!s 2~p!ication fDr which they "ill be responsible. If you, 25 tho CHner sign as the centrae!or,
you are indica!in'] t:1at Yl,I", rai,her tlDIl the contriJctor, are 'rrspc'nsible fDr tho \i{,rr.. If the [C,nlr"cle.r l1i"hc5 y;.u \[. sir,n
as cC>r,lrac!c,r 1'1::1 ;."'( be ;,;: iddiu:ie,n thil! he is not prc'perly licensed ~nd is not entilled te, pH~iltir,g privilegcs h !t,e
City c,f Zephyrhi!\s,
C. TRAN:.";PQJH811DL!....J_.t'lc0CT FEES Af\ID UT I L I TY COf\lf\IECT I (J..~L_Efr::~i
D.
CONSTRUCT JJ.E'l._.L-J.I::r.1_LA\.-L
(CHAPTER 713. FLORIDn STnTUTES, AS AMENDED)
I certify that I, the ilpp!icanl, havD been provi~ed with a copy of 'Florida's ConstructiDn Lien La" - iID~eoHner's Protection
Guice' prepared by the Flc,rid.1 !)rpilT\:;ont of I\griculture and Consu~er Mfair5. If lhe "f,plle"n! i<, s(.:c.6r,c ot~,er Ihan the
'oHner', I cerlify th"l j :,,"12 (.blr,ined a. copy of the above described dc,cu;r,ent "nd pre,,,,j,e in ~(,od f;;ith to dclil'H i\ !e, lh~
'own~r' prior to cos~en:r~c~:,
:1.';.::.:. i:.
E. CONTRACTOR'S/pWNER'S AFFIDAVIT
I certify that all the infDrDJtion in this applicatiDn is accurate and that all work \1ill be done in cOlpliance with all
applicable liMs regulatinu c~nstructiDn, zDnirig, and land developoent.
Application is hereby ~ade to obtain a peroil tD'do ~ork and instal121lon as indicated. I certify that no Hork or
installatiDn has co~~enced priDr to issuance of a per~it and that all work Hill be rerror~ed to meet standards of all la~s
regulating [{,nstructic.n, City [[.dcs, zuning regulatic,ns, am! land dcvelopment rClj\llalie'115 in tI,e j\lrisdiclie,n. I alsD
certify that I undcrstand thJt the regulations of other governmcntal agencies ~ay apply' ID the intend2d "Dr~, and that it is
r.y responsibility Ie, identify IIhat actions I ,~ust tab! 10 be in compliance, Such ilgcncies ir,clude bll! ~le ile,t lir.iled to:
. J. >
I DeDart~ent of Environ~ental Reoulation - Cypr~ss Dayheads, Uetland nreas and EnvirDnmenlally Sensi liv~ L3nds,
Hater/HasteHater Treatment
I Southwcst FIDrida Ha\rr'"anilne~cnt District - Uells; Cypr~ss Oayheads, Hetland Areas, Altering Y2trrcDufses
i Ar~y CorDS ~f Ennineer~ - Seaualls, Docks, Navigable Hateruays
i Dep"rtcent {.f Hi.'alt.li_LI:s:!'J}.llilitiltivp. Services, Environrr,ental lle,.!tlt..Jl.iJ..U. - lie-lIs, llitstnl3tcr Tr{~t.:.:::I. Septic
I US En'{ire.n~('nl;;l Pre, te.!:Ji c.r, t.r.ency - I\sbestos abate~ent
Tanks
.lso certify that, if fjlllla\~rial is to be used in Fle,od Zone 'A' c.r '/I,dc.', it is uitoc.r"le,[.j tit.d "drainage. plan
addressin~ a 'cD~pensaling yolulc' Hill be sub~itted Hhich is prepared by a prDfessien~1 engiit~cr rC0j"l{r{~ in lhe State of
Florida priDr to per~it i~suance.
n per.ltit issued shall be construed tD be a li~ense to proceed tlith the Hc,rl: "nd ne,t ;1" illlthe,rily Ie, I'i[,j:,tc, cance! "Iter, or
set aside any provisions of the technilal codes, nor shall issuance of a permit prevent the Building Ufficii! fr{~ thereafter
requirir,g a cCorrectie.n (,( errors in plans; cc,nstructic,n, e,r '1ic.}ations c,f any ((,de. Ever)' pc'r"lt isslI,'J ,~dJI bece'le invalid
unl(.ss the H(.rk a\lU,e'l i;d by such perr.;it is cc.m~enced Hithin six Jlonlhs e,r iSsll.1JiCe, e,r if 11[.1 I: altll"" 1;00 Di the per!it is
suspended Dr abandone:! [[,r a perie,d {.f six ~onths after the t'j;lle the Hurf: is ce,r,menc(.d, l1f,e 'I,:; day c.~lc"sioll of li~e, ,JY be
alle'HeiJ fc.r the per;\it tlllh fci.' chiirge of $15,00. The extensic,n shall be rcqllJ:steiJ in Hrilir:~ l[, :hc' 8l,jlJing Official. An
dpproyed ir.s~Jeclien ...usl be !{,qged during each six month period, c,r the pre.jecl Hill lie ce,nsi,!,'r::d d~;,ii,d:'ild,
WARN I NG TO Ol,nJEfl: YOUR FA I LURE TO RECORD A f\IOT I CI:: or=- COi'1~~Er,ICE~1ENT f'1A'r'
RESULT IN YOUH Pr\YING TWICE FOR IMPROVEMENTS TO YOUF~ PROPErnV. IF YOU
INTEf\lD TO OBTAIN FINANCING, CONSULT WITH YOUR LEf\lDER OR AN Al'TORNEY
BEFORE Rf::CORD Ii.![., YOUR NOT I CE OF COMMENCEMEf\IT. JOlJS Uf\IDUi $2,500 I N VALUE
DO NOT NEED TO "'ECDZD POST ,A "NOTICE OF CO'''~:'/
SIGNA TURE U'i"Eii-6~P;;;,-;.-;q--K~~ GNATUm~_CO,"rii;;~S;:~iI;:;:Y- ktJitJN
DA TE ____.___I.f2~d~::,_~6..___.:._______,_______ DA TE ______../12.:...2:.3 _-_'f5:.. - - - --- - ----- ---
NOTARY AS TO ffJ."
OWNER OR (',GErH __ . ~_-?!..:f,L~~::L {J~_ ~~_
AnI~ w:~iJ'
MY COMMISSION EXrrnrS______________________
NOTARY AS TO ~
CONTRACTOR_____~~~ a,-~!!.~
"' k frrnL.ii:E::IJ '$.B R~ i/V IV
MY COMMISSION EXrIRES__________________
:\,,1\1 PI/#
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*tWI*
..... ..
.,~ ~
~ Of f\.a~
KATHLEEN J BROWN'
My Comrninion CC449029
Expires Apr, Of'!. 1999
Bonded by NFNU
800,224-6368
"'....1 Pl/~
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u"I,;.'~,~'f:'
<1't:: or: f\.\:'~'
!(ATHLEEN J BROWN
Mv Comml88lon CC44Q02Q
Expires Apr. 02. 1999
Bonded by NFNU
SOO.224-~
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(RP.SIDENTlAL USE ONLY)
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C E N T R ALP E R M I T TIN G
PASCO COUNTY, FLORIDA
[ll-'jTE:: to/::::t./9~5
P{~OE ~ :i OF 1
CCINTRACTOP ,I:t ~
NAME: H & R INTERSTATE
ADDR= 6048 RIDGEWAY
(:/:::::T:. Z/HILL:::;;
I '::;::;:;lJE OFF} CF: U
RECEIPT NUMBR: 00264173
OFFICE: DADE CITY
FC)R ~
CHECK :I:!: :t :::;8~;'?
ACYNT
114
03-26-21-0130-00000-0450
TOTAL AMOUNT: 9.38
COMPNY ACCOUNT CENTER AMOUNT DESCRIPTION/PERMT DATA DRieR
B450 - 363000 ~ 9.38 ****** SOLID WASTE FEE 00
RECEIVED B' --_______L~L~~___
'"
,
f{ L J..~_ L ~~ ..:.._ ,"'.. _~ __
-'~""I?'",\" . ;>"".' '.''"' .i....~'~-.~~.-."...'......-r.4.L. "'1.
'J':~;"D'''::t~~~:-.:.r;-;1.;,: i~~h~j..~..; ~,.'? ~ "~~~"1~-::;:-..::yt'\;~'f'19<TI~'.~:""':-0-:-:"';----'--~~;~'-';'..'K.-'-::;')~'tr.---;:__.....~-.orIT_ :-.~
...
PASCO COUNTY, FLORIDA
Permit No.
Date Permitted
Builder Name/Owner Name
County Parcel No,
Location
'/
Subd.
Classification/Type of Use
f
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Rate $
Zone No,
Sq. Ft.!Unit
Prepmcd By
Impact Fee Amount $
The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted
by the Board of County Commi$ioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy
or authority to utilize the permitted structure.
RESOURCE RECOVERY ASSESSMENT
EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No. Units
I
Gross Sq. Ft. (GSF)
Rate/ERU - 50.00 x 0.96*/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 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. NO.
RESOURCE RECOVERY REC. NO.
DATE
DATE
BY
BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce