HomeMy WebLinkAbout95-5378
BUILDING PERMIT-
IV! -; -. 5378.1. y') ,
CITY OF ZEPHYRHILLS Permit. LU
(813) 788-6611 Date i J -/3 -.7~-
1; O. t7V
BUILDING
3S':. .:5D
ELECTRICAL
3-J,.-. e/D
PLUMBING
02-0, oV
MECHANICAL
Sewer Conn i.:L) <f; po
Water Conn: .3.(1')., I.rv
Job Address: '
Parcell.D. #
Zoning: 7fn~rgy ~~de:_
Description of Work !J1 ~L ,Wrn-o
T.I.F.'s:
11-
o
Radon Gas:
~/-~
J:~- 1/111
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration # 5-~~
State Certified License#
Permit Fee
Signature
Company
Address
Telephone#
Valuation or
Contract Price
1/4
lI-./'7\,?;:;;J-~
BUILDING
~ffl L
ELECTRICAL dS
/'
Jl f((j-&7A1
/o&--
. PLUMBING
-
/f~ Aje.
MECHANICAL; 8'
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Serv.
Rough In
Meter Can //-11-7-.<./
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins!.
Compressor
Final
Driveway
a.
b.
c.
d.
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:
7J~_~--:!l'~/ JI-/S--Y~-
~/o-~-91
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.
e.
f.
g.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERN1.T
CITY OF ZEPHYIUIILLS
BUILDING DEPARnlENT
~/' ;'
, tJ~ "
l / :: ~ ~ 'is
PH~N~t3 ) l S" L- -7 ~ f b'
APPLICANT ~ER sfAT-=t:.
ADDRESS -3 ~ 2..(01 H uJ Y 5~" [.0 EST
H ~ ~ IJ\lruls TATt
Jon LOCATION 376'-15 PR..A/JO PLAli- . L01 '07
Db? 0 BwcJ<tft'Oa7sunDlvlsION 'Zt::.PI-t yf'l
3 - 26 - Z I - 6 J ~ () - {J {)tJ 00 - (')b 7 ()
O\\NER
LOT
SIZE~X I O{) !\REA SQ. FT. (; 0(/0
ex OG-E.-
LEGAL DESCRIPTION: LOTes)
PARCEL I. D. 1/
IWRK PROPOSED:~Nel~ Construction _Addition
_Alteration
_~ep:.1ir _Install
_Sign/Temp. _Sign
PROPOSED USE: JSinr,le Family ...:--M/F
_t-love _Demolish
_Commercial ~Indust.
_Ii of Units
l
_SI.Jim.. Pool
. .~rl/H
Other
IlUILDING SIZE:
_Restaurant & Health Department Approval
;) ~~ L/ )~:
12'60
Square Fcc t ,
/ .ST~f2V
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS [, (1) SET ENERGY FOR:1S.**
CNmERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~lS.~:*
**COPY OF CONTRACT REQUIRED.
PF.RMTTS REOUESTED
LBUILDING
LELECTRICAL
$
2<170fJ
.
l5 () AMP Service
/600
.'
Valuation of Total Construction
Florida power Corp.
-*-h'.R.E.C.
_rlECIlANICAL
LpL1Y:lf3IiiG
$
Valuation of Mechonical Installat,i,on
GAS
ROOFING
SPECli\LTY
;J;;fI
Other
TYPE OF CONSTRUCTION:
_Block
____Frame ____Steel
fINISHED FLOOR ELEVATIONS: FT.
*********~********************************
~ONTRACTOR SE~
. Company -H1::i-t' :c ~f~~mT€
State Cert. or Rccist. 0
3C1
City License gcr'..i~;t..I,;\t".inn il ~...;l JQ
********~****************~**************~*
Company jJ el---Sa t-J rZ Y ('{) A-N
State Cert. or Regist. 0
Signature City License Rcgistl'ClLion I,! { () X
, . *************************************+.+.***
[lEClIANT"_A'. ~ ~ ". Company BA+H~ <s QrLDPA"NE. <Lrrj c.
L4I1 A - State Cert. or Regist. Ii
Signatur~ /~ ~ . City License Registration ;.' .-:J<6
I / , ,',",( * ie *ie ie * *1, *** **** *.!C ,~**,~ *"*"le"le"le ,'c ic i: i: .:: -:: +.,~ ,',,": ,', +. ,', ,',
State Cert. or Rcgist. D
City License Rcgistrotion
**************************************~***
Signature
Compony
State Cert. or Rcgist. U
City License RCGistl~ation ~~
OTHER
******************************************
PER~lIT OfFICER.
APPLICATION APPROVED BY
~~~Lr-1D:rT:OJ'\IS C:i".:'" ,i::>Ef:-;;i'"1IT rl;=-FIDr'I'.JT-;-
A. NOT I CE OF L~F:r::E)_!.J~:;Tr, I CT r ONS
Theuncersign~d undersbnds \h;,t \hi" p~fllji~ lIlay hI! subject to "deed res\rictie,ns' ~Ihich r.ay be ~c're re5trictive than City
r~9ulation~. Th~ undersi~n[d ,,~5tl~e5 r~5ponsibili~\r~'for. co~pliance llith any applicable deed re5\ridions.
B. UNL r CF:HS[::O CC~tiI.o.E.LCTORS AND CONTRACTOR RESPOJ:IS I n I 1_ I T I ~S
If the owner h~s hired a contractDr or conlractors to undertake Hork, .they ~~y be required 10 t~ Jic~n5ed in aCCDrdanc~ with
slal~ and local regulatiDns. If the cDntractor is not licensed a5 required by I,,", boll. \h~ Duner and contractDr nay be
ciled for a nisdeleanDr viol~liDn under 5tate laH. If the OHner Dr inlended conlraclor are tlnc~rtiin as \0 llhat licensing
require:enls adY cpply fC<J" tk. int~nde;! liork, they are advised te, ce,nlact Ihe City e,f 2ephyrhilJs 8uilding Dfparb~rlt, (813)
788-6611.
Further:ore, if the OHner h~s hired a cDntractor or contractors, he is advised 10 have the conlractor(s) sign porlions of the
'Contractor S~cliDns' of this ~pplicition fDr Hhich they will be respDnsible. If you, as the o"ner sign as the contractor,
you are indicating that yo',;, r.1tlilT Ihan the contractor, arc ;respe,nsible for the lie,rk. If lh~ ((,ntri:cte,r ui5hes yc,u tD si~n
as ce,ntractc,r Ihat J.ay be 0:1 iildicCl\ie,n thai he is not properly licensed ~r,d is r,Dt enli \ led Ie, per"i llirlg privi leges ir, the
City e,f Zephyrhills.
C. TRANSPQRT81:1iJ1LU':1f::.0CT FEES AND UT r L I TY CONNECT I gJ~'-E.f:E~?_
D.
CONSTRU~T J OiJ._"L-.J EN l_A~l.
(CHAPTER 713~ FLORIDA STnTUTES, AS AMENDED)
I certify t~a\ I, Ihe appliur:\, l1ii'10 been provi'ded with a copy of 'Fle,rida's Ce,nstructie,n Lien Lil)1 - H[,.~ec'rme;'s Prc,leclion
Guide' prepared by \he Flc.,iJ;) !!r.parl::;cr.\ of Agriculture and Consuller flffairs. If the "H,lieilnt i, 5c,:06,,0 ol~'Dr th"n the
'oHner', I certify Ihol I :,.-,'/2 e,b\:,ined a. ce.py of the above described dCoCumC'nl "fill pr(o~,jc[' in 0cc,ou f"ilh \0 deliver i\ tc, the
'oHner' prior \0 eD~~en:e~[nt.
;1,":;::,"" I:.
E. CONTRACTOR'S/PWNER'S AFFIDAVIT
I certify Ihat all the infsrcCltiDn in Ihis application is accurale and that all work Hill be done in co!p!ianc! "ilh all
applicable laMS regulating e~nstruction, zonirig, and land developcent.
'. .
ApplicatiDn is h~r!by nad~ to oblain a perDit to"do ~ork and ins\all~tion as indicated. I cerllfy Ihal no work Dr
installation has cD~~en[vd priDr to issuance of a permit and thai all Hork Hill he perfofQcd to ~~ct standards of all laws
regulating c(onstructi(on, Cily cDdC's, z0ning rD9ulali~ns, and land development regulations in the jurisdiction. I also
certify thai I undersland Ih~1 the regulatiDns of other governaenlal agC'ncies may apply. 1(0 t~e intended "ork, and !hal i~ is
ny responsibility te, identify llhol actions I oust take to be in cDmpliance. Such ;)g[':leles include bit! ,'10: nc,! lir.ited to:
.-.
. ,.
I ~Dar\~cnt (,f Environ~['nlal Reoulation - CyprDss Bayheads, 1I~lland nredS and EiI'Iirc'n'lcnLd]; Sensi ti'ie L3i:ds,
UatDr/HasteHater Treatment
t SouthMes\ FIDrida \later "an~Qe~cnt District - lIells; CyprDss Bayheads, Helland Areds, Altering "alcrcoufsfS
i Arty CorDS ~f EnQineer~ - Seaualls, Docks, Navigable "aterHays
f D['p"rt~erll (,f IJ.0:JJ~:f:hJ:.h-L!.H2UYe Services, Environment,,1 Ile,,]tl~ - 1,)[.115, lIi,steHatcr Trc'aL~.,:,t, Septic Tanks
I US En'lir:,n;~nt"~LtiHI line~ - Asbestos abatel~ent
als[; certify Ihdl, if fillllaterial is to be used in Flclod Ze,ne 'n' e,r '1I,e(C.', it is \JnGc.rs[e>[,J t:,.d d dujn~gc plan
addressin~ a 'cD~pensaling volu~e' Hill be submitted Hhich is prepared by a prDfes5iDn~J cngin~cr fCGi5l~fCJ in lhe Slate of
Florida prie,r te, per~it i;:suancc.
A per~it issued shdll be construed to be a lirens~ 10 proceed .Iith the He,r!: "nll n(,l as cllth(,rity te, "i[,j"li', uncd "ltu, (or
set aside any pr(ovisions of the lechnlcal codes, nor shall issuance of a permit prevent the DlIi Iding Ufficii! frD~ thereafter
requiring a ce,rrce tic,n (,f errors in plans; constructie,n, or '1ieolations c,f any ([,dc. [veri p;'r_i l i 5SI!L'J shJ J 1 becc,1C in'!al id
unlcss \he >lc,rk autl,[,r i~d by such perr.iit is C(,/uenced Hithin six r.ionlhs of issll.1ncc" c,r if IIC"1. :"rll,['1 i;d oJ" th~ pn1it is
suspcnd~d Dr abandDned f(or " period of six months after the tlJe the HDrl. is eonmenccd. One 90 day c~lcnsi0li Df ti~~, ~JY be
a11('Hed for the per;.;it ,,1\1, fee charge of $15.00. The extensie,n 5ha11 be reQur:slc.rj in IJrilin0 Ie, ~I,,' 8~lilJir.g Official. An
approved insp~ctiDn ~tlst be logged during each six month period, or the project "ill be cDnsid~r[d dbiJld0ncd.
\..JARNH1G TO Ol.-n.IErl: YOUR FAILURE TO RECORD A I\IOTICI:: or=- Cm1~lEr,ICE1'1ENT r'1AY
RESUL TIN YOUI'I PAY I NG TW I CE FOR I MPROVEMENTS TO YOUI-~ PROPERTY. I F YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al"TORNEY
BEFORE RECORDII~G YOUR NOTICE OF COMMENCEMENT. JOOS UNDER $2,500 IN VALUE
DO NOT NEED TO m::COFm AND POST A "NOTICE OF Cm'H"lENCr::i'l[:I'!T".
SIGNATUnE___ L(l1:.J~ I".-_____~______ SIGNATUnE~__~_ ___n-n
f~[R on AGENT P~'L'fJALL-Y I(;J/UJ,J cmlTn"~c~~At-LY K(JhJN
DATE _ __ _.____ _ -1L=fi=--xS-----.;.--------.-------
DATE______jl~_i_~~~___________________
NOTARY AS TO J/' z9B/~.
OWNER Of( fiGErH__r~--1 -_.iL);tp~.'
KII7l-ILEEN J" RD W,J .
MY COMMISSION EXP!nES______________________
NOTARY AS TO / ~,- -i~,
CONmACTOf(____-=-t:~4{_?_~ '_ _kdtdJ.-Gf">..--
~ j( ;(,..;:;; i.-EE tJ J; _ c) WN
MY COMMISSION EXrIf([S__________________
:\~I'y Pile
+'> n ""<0 KATHLEEN J BROI/VN
*.* My Commlssion CC449029
ElCpires~. 02.1999
~". ~~ Bonded by NFNU
~ OF fl.G~ 800-224-6368
",\~'io'i' ~IJIJ
""_.~~("<o
*)"'11' ",' *
e"::t. \
"~;> ~~
,. OF fl.G~
KATHLEEN J BROWN
My CommIssion CC449029
EIlpW" ~. 02. 1999
Bonded by NFNU
800-224.6368
SITE PLAN
(RESIDENTIAL US! ONLY)
rARCEL J.D.
2- ;;2(, J-I tJ/3d O{lO~{J () ~ 7()
SEe TWl' RNG SUBU BLOCK LOT
PROPEHTY HEASURE.HENT 6C X /~O
CUlUlENT OWNIlHS ~~e I/II-rUlSTAT[, U^TE /1- 7- 9 )'
All drawings shall be drawn to scale for all parcels or lots five acres or less.
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PASCO COUNTY, FLORIDA
Permit No.
Date Permitted
Builder Name/Owner Name
County Parcel No.
Location
....'}. .;
/ '
L
Subd.
Classification/Type of Use
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Rate $
Zone No. _
Sq. Ft./U nit
Prepared By
Impact Fee Amount $
The above impact fee has been estftt5t1shed pursuant to the Pasco County Transportation Impact Ordinance as adopted
by the Board of County Comrilissioners. 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 OmCE 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
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