HomeMy WebLinkAbout96-5934
BUILDING PERMIT 0 ~-' .
aTY OF ZEPHYRHILLS p.,m" N · . 59 3 ~
(813) 788-6611
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Property Owner:
Job Address:
Parcel 1.0. #
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
Date
~ - /7-9~
~
C~~~HANI~ _ Sewe' Conn /!nO =
Water Conn: ~ tJ 0
Water Meter: ~ / ~ ~ c;;:)
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T.LF.'s: '11c?'-
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
AI~ork shall be performed in acc~rdance with City Codes and Ordinances.
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Valuation or
Contract Price
....
City License Registration #
State Certified License#
~/'1
DATE
Permit Fee
Signature
Company
Address
ELECTRICAL 11 /
Tp.SeN.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 shall be made for each trip for each trade:
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a.
b.
c.
d.
e.
f.
g.
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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PBRKlT
CITY OF ZEPRlRBILLS
BUILDING DEPARTKBNT
OWNER'S'IWIB J;.l"ry U.nQ...te.S- S,..... PlIONE 771-3"$5(,
OWNER'S ADDussY' (). l?ll X (,:;'I'J.. 2(p h'Jl"h~ 1ft-. 8. 3MC/o
I ./
JOB ADDRES~~doj' l~a.NJ8.. ~cJf .74'f1~yt"t;fJ~ ('J. .13SL/O
I.EGAL DESCRIPTION: LOT(S) .J3-aJJd.3'f RWL'J. SUBDIVISION (J~D.rdLJI)JJ ntH. f~.
PARCEL 1. b.' JLI-). fL - 2/ - f) III () - () 00 () tJ -I , \ (OBTAII FROM PIlDPERTY TAX lOT ICE )
WORIC PROPOsED: _New Cons tt'UcUon ---..Add 1 t ion --fil teration ---..Repai r _Ins tall
.....~-~_...:.,,:~._--
---..Restaurant &: Health Depart.ent Approval
DESCRIPTION or WRIt: Se..t-lAp mob./-t J../cm~
RUlIJHNG SIZE: :J. (p~X &t~, .J7J:4. Square Feet,
_Sian
PROPOSED USE: ~ngle F_11y
_eo..erclal
RPKf) LDElTlAL:
(;OttHERCIAL :
--"ove
---PeIIOI hh
--"IF _' of Units ----"/8
[ndust. _Swi.. Pool _Other
Height
AtTACH (2) PLOT PLANS &: (2) SETS or BUILDING PLANS &: (1) SBT ENERGY FORMS.
ATrACII (3) SETS OF BUILDING PLANS &: (1) SET ENERGY fORMS.
PROPERTY SURVBY REQUIRED FOR ALL NEW CONSTRUCTION.
PERttITS REOUESTIW
$ /7/ COd) Valuation of Total Construction
- is 0 NtP Service Flodda Power Corp.
$-/1" O~O Valuation of Mechanical Installation
_RUIWING
~LECJ1tICAL
--"ECIlMICAL
-"LUHRING
GAS
W.R.E.C.
ROOFING
SPECIALTY
FINISHED FLOOR ELEVATIONS:
TYPE OF mwSTRUClION: ~loclt _Fn.e _Steel
Other
n.
IS PROJECT IN FLOOD ZONB AREA?
..........................................
YBS NO
BUILDER.
CONTRActOR SECTION
SIRtlature
cottPANY
State Cert. or Regist. .
(;fly License Registration .
.......................................
V.
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COMPANY lk;~i,tJ' f.:h, hi J f ~ S' - .
State Cert. or Regist. .i' (!)().~%H /.
City License Registration' /v
.......................................
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(.'OttPANY . s;. tv t- I \.e I~ IA S /N ;.,.
State Cert. or RegiBt.' ttI+ 114:? Z
City License Registration' .3 J?
..................................
'--
KECllANI~
S I Rnature r~t.-::;~.v~
COMPANY DtJlp,4,iJ IJlr Sj/[h(?r~.
State Cert. or Reglst.' ~<:!.9s. fF711S'
City License Registration' 7 /
..........................................
V--.
UIJlER COttPANY
State Cert. or Regist. .
SiRnAture City License Registration'
..........................................
^rrI.lG^TION APPROVED RY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
. 'A. NOTICE OF DEED RESTRICTIOlfS
fhe undtnlgnecJ UlllJentllldl tltat Uti, pertn la, be ,abJect to 'deed restrictions- .hich la' be lOre restrictive than City
regulaUOIII. tIte andtr.Jgned as~ reepm.lbUlt, for COIpIlIllCl ,It II an, applicable dl!ed rutrlcUOIII. .
B. UNLICBHSBD CONTRACTORS AND. CONTRACTOR RESPONSIBILITIES
If tile OIlIer ... lIr" I contractor or contractor. to unc1trtllle wod, tiler ., be required to be IIctmMl In accora-e wUb
state 11II1 Jocal rl9ll.tfOlll. If tile contrlctor II not IlCl!llled .. required b, Jaw, boUt tile OIIIIer .... aJIItnctor III be
citf!d for a .I.....r dolaUon Iftdtr .tate law. If the OIIIIr or Intended contractor are uncertain .1 to ,lilt IIceulng
requlrl!leDtl .., appJr for the Intended worl, the, are ad,ised to contact tbe City of Zephrrbilll Building OepartIgat, (813)
788-6611 .
FurtherlOre, If tbe owner has bired a contractor or contractorl, he Is advlled to ha'l! the contractor(l) sJgn portJOIII of the
-Contractor IecU..- of Util appUcatJon for whlelt the, .ill he responllble. If Jou, as tbe OIIIIl!r Ilgn u the aJIItractor,
'ou Ire indicating tMt roo, rltller thin tlte CODtractor, are re.ponelble for the worl. If tile contractor 'I ,lie, roo to Ilgn
as contractor tIlat iii, be an Indication tJlat he Is not properly licensed and iB not entitled to perlUUng pddll!gllln the
City of Zeph,r.III..
c. TRANSPORTATION IMPACT FEES AND UTILITY CONNBCTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certif, that I, th! applicant, ha'e been provided with a cop, of -Plorlda'l Construction Lien La. _ HoIeowner', Protection
Guidl!- prepared by the Plorlda IJeparllent of Agriculture and ConsUftr Affairs. If the applicant is 8011!01'1e other than tJIe
-ownl!r-, I certlf, tltat I ba,e obtained a copy of the abo'e 4escrlbed docuIent and prOllse In good faith to dell,er It to the
-owner- prior to COIIencelent.
E. fONTRACTOR'S/OWNER'S AFFIDAVIT
I certif, that all the inforaatlon in this application II accurate and that all worl will be donI! In coapllancl! with all
applicable laws regulating construction, lonlng, and land de'eloplent.
Application il hereby lade to obtain a perllt to do worl and in8tallatlon al Indicated. I certilf that no worl or
in8tallation bas ~J~ prior to llIDInct of a perllt and that all worl will be perfOrled to teet Itandards of all I...
rl!qlllatlng construction, Cit, co4eI, lonlng regulations, and land deYeloplent regulations In the jurisdiction. I 1110
certlf, that I under.tand that lite regulations of other go'ernlental egencle. II, .pplf to the Intended wort, and that It i.
Iy relponslbllltf to Identlff .ltat actions I IUlt tale to be In COIpllance. Such agenclel Include but are not lillted to:
· ~larllent of 1n,lrORlefttal Regulation - C,prels Ba,heads, Wetland Area8 and Inviroftll!ntallJ Sensitive Lands,
later/Vastewater 'reallent
· ~QU.~est 'Iorida Water Nantg~t Diltrlct - leI Is, Cypress Ba,heads, letland Areal, Altering latercourses
· !!I' CO!PI of IDQlneerl - Sl!awalll, Doell, lavlgable laterways
· ~rlleat of BelltIt , RIbabIIJtatJ,. Serrlcee, In'i~OOIental Health unit -. lells, laste.ater 'reallent, Septic lanls
· ~JnvlJCJII!l!IItal Protection ~ - As,,"tOl abateltmt
I alRO eerUfr that, If fUllilterial Is to be used In Flood Zone -A- or -A,etc. -, it Is understood that a drainage plan
addressing a -COIpenI.tlng YOIUll!- ,III be lublltted wbich 18 prepared bJ a profelslonal engineer registered in the Stat. of
Florida prior to per.lt Il8UInct.
A perllt Issued shall be construed to be a license to proceed wltlt the worl and not as authorltr to ,Iollte, cancel alter, or
set aside an, protl.IOftI of tbe tecbnlcal codes, nor 8hall issuance of a perlit pre,ent the lulldlng Official frot thereafter
requiring a correction of error. In pllnl, CORItflctlon, or ,lolltlODl of anJ code. I,er, perttt llsued shall becoIe tfttllJd
unlHs the wod autlJorbed b, _II ptnft Is ~ced within sll IOIItItt of Issuance, or If worl autllorlled bf the penlt II
8U8~ or aballdoned for a period of .11 IOIIUII after the tile tile wod Is~. One 90 da, I!ItensJon of tt., iii, be
allowed for th penit .Ith fet! charge of tI5.00. ne I!Iten81on shaH be requl!8ted In writing to the Building Official. An
appro,ed llIIpeCtJon lUst be loned during I!adlsh _tit period, or the project ,IH be conlldered abandoned.
WIIRIIIIG YO Mn: JOOR nlLURI YO RICORO A MICI or l1RIICIIIIlr IIA' RlSULr III lOOR PAJlIIG "'lei FOR IIIPROVIRurS YO JOUR
PROP1!m. IF 100 InDO IV Cln'AIII 'IIIAICIK, CDSULr IIIR fOUR LIIIIIIR 011 All ATrOIIDf BI RIl'ORDIIG lOUIIfOrlCl OP
~. US - tz,5GO II :- III 2 IlIID 10 _ lID lOST I '1UI1C11lF '.
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STATE UP FLORIDA n
coonf OF Y aLlto
The foregoing instru.ent was ,~knowledged
before .e this S... ).~ , 1~ by
SUfI OP FLORIDA P f
room OF c-{/.)C 0
The foregOing instrUllent was acJmowledged
before IDe this fr.){J , 19Q(,;, by
who i'--~~c:..-~~~;-~ to me or who has
produced------ '
as identification end who did/did not
talte->>h. /f d
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(Name Typed, Printed or 811ped)
~_O!^~Y PUB~lC
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as identification and who did/did not
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(Na.e Typed, Printed or amped)
NOTARY PUBLIC
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~:L.__c:. My CommIeslon CC477279
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PASCO COUNTY~ FLORIDA
Permit No.
Date Permitted
Builder Name/Owner Name
County Parcel No.
Location
Subd.
Classification/Type of Use
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Rate $
Zone No.
Sq. Ft./Unit
Prepared 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 Commissioners. 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
Gross Sq. Ft. (GSF)
Rate/ER U - 50.00 /Year
or $0. 137/Day
ERU Assign No.
Assessment - (No. Units) x ($0.137)
x (No. Days)
,~~-...
.;~......~
Assessment -
(GSF) x (ERU) X (0.137) x (No. Days)
100
TOTAL FEE $
TOTAL FEE $
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
! r.". DATE
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BY
BY
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;
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White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce
PC93113094/A
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-T-~Al. wmf ~ -~ ~ Jrax NQ. (tiT.)! Y6'.}-1782// <--J I
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This Instruneot Prepared by: BEVmLY BARTH,
An Offic-er of Asaoci.ted lAnd 'l'ttle Group, Inc. (280),
38233 Daughtery Road, Suit. B, Z~rhi 11s, Florida 33540 ,
For Purpoees of '1'i t1 e Ins.
File I 280-5846
Parcel ID , 14-26-21-0160-00000-0340
Warranty Deed
(The ref7'lS "granlor" lind "grantee" herein shall be cOlls!med to include all genders and singuiar or plu"a! <1S the con/e.tl indicous.)
Made this day of
JERRY H. MOATES, SR.. a married person
June
1996 ,
BETWEEN
whose post office address is: POBOX 6212
Z~ILLS FL 33539
of the County of P ASeO , State of
JERRY WTI10RE and TRESEA \-.YMORE. his wife
whose post oftlce address is; 38009-11 Lawanda Loop, Zephyl'hills FL 33543
FLORIDA
. gramor, and
of the County of
PASCO
. State of
FLORIDA
, gramee,
WITNESSETH: That said grantor, for and in consideration of the sum of Ten ($10.00) Dollars. and
other good and valuable considerations to said grantor in hand paid by said grantee, the reeeipt whereof is hereby
acknowledged. has granted. bargained and sold to the said grantee, and grantee's heirs, succe,snrs and assigns forever. the
following described land, situare. lying and b~jng in PASCO County, Florida. to-wit:
Lot. 33 and 34 of WAYWARD WINO MOBILE HOM! SUBDIVISION, a. per
plat thereot as recorded in Plat Book 28, Pages 61 and 62, Public
Records of Pasco County, Florida.
Subject to easements and restrictions of record, if any, ~hieh are
specifically not extended or reimposed hereby. Subject to 1996 taxes
and assessments.
PROPb:l-'..TY J)OES ~OT REPRESENT THE HOHESTF.AD OF THE CRANTOR
and said grantor does hereby fully warrant the title to said land, and will defend the same against the lawful claim., of all
persons whomsoever.
FORM !51) (ll1n)
Page J 012 p,.g~s
Pa~e 2 oIl pag!:s
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AL! I,~
FAI~E 01 .
ASSOCIATED LAND TITLE GROUP, INC.
DATE:
PAX COVER SHEIn
TO:
00
L ~, / "/] .1
e--} 2/W!-r:.d
PROM:
~
MY FAX t;: (813) 788 - 9855
FAX ii:
3
TOTAL PAGES SENT INCLUDING PAX COVER SHEET:
IP YOU HAVE QUESTIONS OR PROBLEMS. CALL
AT (813) 782-7531
COMMENTS: ../C{//L.,'U.e -~~M
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