HomeMy WebLinkAbout96-5701
BUILDING PERM!!., 157~lA
CITY OF ZEPHYRHILLS
(813) 788-6611
Date
'1-J-5'~
.yo - OD
BUILDING
3S--:07)
ELECTRICAL
JS'.c/z)
PLUMBING
:LO. c.ri)
MECHANICAL
Sewer Conn
Water Conn:
PmpertyOwne, '~ v:~
Job Address: ....3 / 7( A-ct..P
Parcell.D. # d. d-6 --r1.J - /) /) st'O... /') ~ <Lf d J --. 0 I Y D
Water Meter;
T,I.F.'s:
Zoning: ~ Code: Radon Gas:
Description of Work f2! . ~ .ta-I'~ a ~~ r
P'
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
Inspector
City License Registration #
State Certified License#
/ h-~-o
Permit Fe~e, . "':
Signature . . _
Company .,"
Address
Telephone#
Jso. cJ-i)
Valuation or
Contract Price
~&-JAA.Y:' )I ;-/~~
Z~~ \LI
ELECTRICAL /6SY
_4~L,;~ /I!:,() .-?J!LUJ- u/
/6 Yo
PLUMBING MECHANICAL
BUILDING
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins!.
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.
. .,-
,~----,...,-~~~-'C"
~-,
"
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Authority: Chapter ,381, FS & Chapter 10D-6, FAC
PERMIT II
RECEIPT #
FEE PAI:O
DATE PAID
<;' .::
, f
.' 'YC/
$
APPLICANT:
AGENT: k"-,.' <",__
, - Ie
PROPERTY STREET ADDRESS: ~
'-. , 7<.,'
/ '
[-- "-
- \
LOT:
. / t...
BLOCK:
!~.'
SUBDIVISION:
Ii k
i c." k-:
PROPERTY ID #:
~.. < ~ ,...!
", ~ ({(
( (, {#7.r-. -,/./L./(
[SECTION/TOWNSHIP/RANGE/PARCIE:L NUMBER]
[OR TAX ID NUMBER]
-------------------------------------------------------------------------.----------------
-------------------------------------------------------------------------.----------------
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH CHAPTER 10D-6, FLORIDA ADMINISTRATIVE CODE.
-------------------------------------------------------------------------.----------------
------------------------------------------------------------------------------------------
riI
TANK INSTALLATION
[01] TANK SIZE [1]
[02] TANK MATERIAL
[03] OUTLET DEVICE
[04] MULTI-CHAMBERS
[05] LEGEND
[06] WATERTIGHT
[07] LEVEL
[08] DEPTH OF LID
[2] ^_ /6'
SETBACKS
[27] SURFACE WATER
[28] DITCHES
[29] PRIVATE WELLS
[30] PUBLIC WELLS
[31] IRRIGATION WELLS
[32] POTABLE WATER LINES
[33] BUILDING FOUND1\TION
[34] PROPERTY LINES
[35] OTHER
....
""'t
DRAINFIELD INSTALLATION
[09] AREA [1] [2]
[10] DISTRIBUTION BOX/HEADER
[11] NUMBER OF DRAINLINES
[12] DRAINLINE SEPARATION
[13] DRAINLINE SLOPE
[14] DEPTH OF COVER
[15] SYSTEM ELEVATION
[16] SYSTEM LOCATION
[17] DOSING PUMPS
[18] AGGREGATE SIZE
[19] AGGREGATE SOURCE
[ 20] AGGREGATE WASHED ,rJ
[21] AGGREGATE DEPTH
'.
/.,
SQFT
FILLED/MO~ SYSTEM
[36] DRAIr;JhELD COVI~R{ /~:
[37] SHOgtDERS
I
[38] SIJ'PES
[39] S'l'ABILI ZATION }u\TERIAL _/ _/ _
t,'
.I
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] ALARMS
[43] MAINTENANCE AGREEMENT
[44] BUILDING AREA
[45] PLUMBING FIXTURES
[46] FINAL SITE GRADING
[47T CONTRACTOR
[48] OTHER
FILL/EXCAVA~ION MATERIAL
[22] FILL A'MOUNT
[23] FILL jrEXTURE
[24] EXCAPATION DEPTH A
[25] ExcfivATION AREA
[26] RE~LACEMENT MATERIAL
i
//1
"
ABANDOmstNT
[49] T~K PUMPED / /
I --
[50] TANK CRUSHED AND FILLED _/_/_
EXPLANATION OF VIOLATIONS:
b .' . ~.
'.#"
'-'~._ ^t"
!
,"'"
--....-.--..-----.....
CONSTRUCTION i.{~ioI SAPPROVED }.~,::.=,,~
FINAL SYSTEM (AP-;;;;;-;;)DISAPPROVED] : '_____
-. ~.._-_...---,.-....
CPHU DATE:
-;
CPHU DATE:
HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744-002-4016-4)
Page 2 of 2
BUILDING DEPARTMENT
!',,:: !('; r;; nc; 0:
(dal~ stabiEzed)
installing
OTHER (as rc4uircJ)
PU1'vlPED (JCJI"l
(date)
Record
arprov~J
H
SIIOT
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S N~eN\'.J ~/ L~v..>~o N
/
3 2 7 I g ~ -t) o~e.,
r-~~'71 -8 ~OS~
LEGAL DESCRIPTION: LOT(S) /~O
PHONE
OWNER'S ADDRESS
LF\N ~-
JOB ADDRESS
L p... "-.} '<-
BLOCK 13 SUBDIVISION {2Jfrk/ RR~/c-
PARCEL 1. D.' O.:? - dl C::r d 1- 06 90- oo/SOO- a/C/o
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition ---J\1teration _Repair _Install
_Sign _Move _Deaolish
"
PROPOSED USE: _Single Fsaily _M/F _' of Units V-;IH
_eo..ercial _Indust. _Swia. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:~Cl&~e ~1??~ ~-7u~
BUILDING SIZE: 4 ~ ~x:::z!!i. /37';; Square Feet. / q; Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQQIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
~ ~
,$ t3~" 000 Valuation of Total Construction
} 5'"'0 AtIP Service Florida Power Corp.
q 00
$ 00 -- Valuation of Mechanical Installation
W.R.E.C.
_ELECTRICAL
_KEGBANICAL
_PLUKBING GAS
ROOFING
SPECIALTY
#/a&.I~ bOther
TYPE OF CONSTRUCTION: _Block
_Frsae _Steel
FDUSBED FLOOR ELEVATIONS:
YES
~
NO
F'f .
IS PROJECT IN FLOOD ZONE AREA?
"<'''l!
..........................................
Signature
CONTRACTOR SECTION ?
COMPANY &o"Dw/(u //7/Jv?/ e
State Cert. or Regist.' t) II-
City License Registration' /0..56
...............................
) COMPANY ~/i'r/~/"".:d;s;;;>~..s
- ...-/ State Cert. or Regist. ,
~ City License Registration . _
..................*.***.........
- \ , r)
/ GOMPANYt:02tu/,~ 7?? /f/ -39~-eS
.;/" State Cert. or Regist. ,
~ City License Registration .
".....................*...........
COMPANY~ >rl&~ ~/t~~~/?~
State Cert. or Regist. ,
City License Registration' /(.-:PY?
.*...*.........*.......*..*..........
/ 6.!:J-/
PLUMBER
/-3
/(;SO
OTHRR
COMPANY
State Cert. or Regist. #
City License Registration #
.*..........*.............*...............
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A.' NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat this perait lay be subject to "deed restrictions" wbicb lay be lOre restrictive than City
regulations. The undersigned assDles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance witb
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be
cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents lay apply for tbe intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if the owner has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections' of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. 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 peraitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES 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 - HOIeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsDler Affairs. If tbe applicant is sOJeone other tban the
Rowner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to cOlleDcelent.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perforaed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDIental agencies laY apply to tbe intended work, and that it is
If responSibility to identify what actions I lust take to be in coapliance. Such agencies include but are not lilited to:
* Departlent of EnviroDJeOtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDJeOtally Sensitive Lands,
Water/Wastewater Treatlent
* Southwest Florida Wqter Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Natercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
* US EnviroDlental Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "AR or "A,etc.R, it is understood tbat a drainage plan
addressing a .cOJpeDsating volDle" will be sublitted which is prepared by a professional engineer registered in the State of
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 perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perait issued sball becOle invalid
unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work'autborized by the perait is
suspended or abandoned for a period of six IOnths after tbe tile the work is c_enced. One 90 day extension of tile, laY be
allowed for the perlit with fee charge of $15.00. The extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during each six IOnth period, or the project will be considered abandoned.
IfARJlIHG TO MER: YOUR FAILURE TO RECORD A NOTICE OF COMMBNCKMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU IIITEIm TO OBTAIN FINANCING, COIfSULT WITH YOUR LEimER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UHDER $2,500 IN VALUE DO NOT NEED TO RECORD AIm POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OIfIIER OR AGENT
SIGNATURE: COIITRACTOR
STATE OF FLORIDA
COUNTY OF
The foregOing instrument was acknowledged
before me this , 19____ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
[[IJ...~ STATE OF FU ,,,,,,.\
~ DEPART\If-:'.T elf' I I F...\I Ti.j .-\'.D m:HABILlTATIVESERVICES
DISTRICT fIVE?ASCO' OCWNr~ ?~B~rc HEALTH UNIT
Environmenta: Health Servlces
37918 Meridian Ave., roo~ 101
Dade City, Florida 33525
Da te: 1/-. 2~ - fs-
TO:
FROM:
Chief BUlldinq Official
Environmental Health Division
SUBJECT:
SEPTIC ~A~K EXISTING/SEPTIC TANK FILE SEARCH
This is to confirm that oersonnel of the HRS Pasco Co. Public Health
Unit inspected the exis~ing septic tank system or completed ~ file
search and found the fo:lowing:
Lot No. I '-I Q
Block No.
6
..,~)A t:.
.. --....: ;::..
'j)A 121c..
Subd i v is ion (>7..;?G - 2. (_. Oc..., 0 _ Oo/', vp . O'I{()
Owner I Agen t ~(I-~.( r \ ('11 Jr-l/() / t='ar--e.~1
, /
Size of Septic System / () :5 (j 9J
,
cr 5~ G:;z, t.,/ II
-
Approval No.
Da te of Inspection) /_ ,2Z - ?..J'"
.. .
APPROVAL IS FOR THE FOLLOWING:
1. J'
2.
3. ~
4 .
5.
I~
/
bedroom d\"elling with Ic~oC) square feet
square foot addition to the dwelling
nool aooroval
garage shed aporoval
of bUilding area
COMMENTS
other
IF SYSTEM FAILS IT IS THE Olv~ER I S RESPONSIBILITY TO REPAIR
OWNER'S RESPONSIBILITY TO ~lAI~TAIN REQUIRED SETBACKS
~ ._..u.........,.....,...".
~
I"r" . ~:;:.
f t ---j
--, -
. .....,_4.'_. ......._..........- _ ____.__..
En~iro'~~ental He'al~h D'-vision
(904) 521-4229
nlSTHICT FI\'I':' j()M41 l.Irn.F. RO,",i) , ,'\,E\\' PORT RICHEY, FL 34654'2533
! \\\ r t I' \ It i ~ "I, I 1(', lie
-- ...- --J~?.7'::r
v
")-~ ,
~-79
0>,
---r
! I
f/
o
1(1
\/ .
~
\:1-
~'t',
)1/
'-u'!i-S ~
J~- _____ __==-~-----
~
~5-
"'. e\
..-"., !"\
,'" l'
~
r/
I
P
~
/
"----
...,.
'-.J
r
I~ r
!~,
I --,
~
~
:D
~--v
" ..c:-
(?
~\- ~(
Sb r
v_
--
C)
rjd
-~
~-. :
i:..
f':H CF:
....:::.
" .
. ;...;
:..i'
,. i.'d.'''' c'
j.....ii '..'
!'/j
, i.! ,'.,....',
:'-1 "
: ':'. i! :..' i'
l..: ._ t..it.ij""-.}
:..1
'.:'! \.....:..
.,. :>
j' ,"f;
i"j
l' ~
"':::',;.:
., :.'1:,
'1 ;..'.
r
i.' ;-";
1...,,,/":> !
('ii" :-. ]"'(-1).
j".:
:.. .
.. ,., ... .,.1
/ !..- f"'~ l"
. 1" :::' J
.:[...: ...
l'j.L i. j
'. ..., i
;,
j'.:
r' i
("Ii...' ;,.
{.:, I. ,
j j..' i
'," ('rL.":
.. h
j":!
f': ;,'
\"j
if
f",
j"' L..
;..j....
::)
"!.
.,; ~
iii
1.:.
I:.
f)
!.~!
)hi"
(.;
i :i.'
! "f..
j,
c
'::.
{;:.,!., I L[...
~:~
j.'
j"';.,; 1 I...:
;'-;;:' ~.
~.:j..-
i'~
I..'
i;
!. ~
; "i J ,r: ~.; L .... j
j:i r-", : ('I L.. i".
;,) :,.,; ~.:,; L..
!::::;,
i.. :).....
1:"",1
i J r> J.
("j
i "'~
; j;"-.:
"J', .
u
j.,. !.
i i:
'.! I
.. i...i ....
, "f" "j
:< -:
":',
i. .j' 'f...
....i !,' ,".
:",1"1,"; .
; ,
; '. , L..
;'", ~
,1! ;" n \
]-.,
i j i,.j"!
.-: ~,
I'i,:
;", i,i' :':' j
(.,-'!
i.:jl
i..
;..'
;"'.
'..'1...'...
;', i':,i,.
L..
'( i?
:.'!
i:' I." l"I
j: : ~
HI!.' "
i" . . j L" i::.
""II:
i:-'!
"..i._: !.:n.,
c
l "',i
.<.! ~ ;....j i..'
:..!;"-.
,! I.::
[-!
iJ ....1 !::.!:;:
,,'
;...
!,;
f',"i i:'i I;.' i.'
....; i f i...ii.
1. ;"
:'.1 ie'
; ;'. P', ....
;..!:-:.
I"
j"
~ :::; j::
.i.! ".'
! '.'
i i ;i
!";
:'.: L :-:> ~..) .;':
:::'
.. ,.. C
(.!!.', .....
",.' ,.'j-;.
. ..t.';.,
i.: ...
i..
L . ,
:..".J
i . f.:',;
(.:
'..fti':
i"t,
i..j
!,:.:i". ....j..,
:)
j.,'i "
: i ~..
...:. ...
.:;"{
('"!
j ;.';
.... !.:~
!\.
~: :.' i-:
\.'1
')/".
;......1(:: '"'
'.."...:'..,: i
.i.,.
i: . ~ .. .
Wm. A. "Bill" Burgess
Director of Building,
Licensing, & Zoning
! ~
~ A-~
~ 1
~~
~ .
5335 Eighth Street
City of ZephyrhiIIs
Building Department
Zephyrhills, Florida 33540
(813) 788-6611
March 18, 1996
(J;q-~t~-~)I- 00 ~-/o -oogpo ~c)/V~
Godwin's "AAA" Mobile Home Sales, Inc.
35162 S.R. 54 West
Zephyrhills, Florida 33541
Re: Mobile Home Replacement
38718 Rose Lane
Zephyrhills, Florida
To Whom It May Concern:
Your company installed a mobile home at the above address without
any of the required permits.
Your immediate response to this letter is required to avoid
involvement of the City Code Enforcement Board and State Department
oC Professional Business Regulation.
You shall obtain all required permits including approval from the
County Health Department concerning connection to existing septic
t.ank.
You shall pay all fines required by Section 104.7.2 of the Standard
Bll ilding Code.
You shall uncover all trenches for inspection of the building
services. You shall remove all skirting for inspection of the set-
up.
Jf you do not respond and meet all of the above requirements, your
company will be turned into the Code Enforcement Board and the
Department of Professional Business Regulation.
If you have any questions, or comments, please contact me at
788-6611, 8 a.m. - 5 p.m., Monday through Friday.
Sincerely,
Bo3~
Bill Burgess .
Diroctor of Building, Licensing & Zoning
BB/bs
CC: City Attorney
Ed Comer, Pasco County Health Department