HomeMy WebLinkAbout96-6282
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BUILDING PERMIT NO
CITY OF ZEPHYRHILLS Permit.
(813) 788-6611
~M Gu~U
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--k~ JV~ dEJ,:~AL
Pmperty Dwne' A-; ~~LJ (wL
Job Address: p~~ _ ____ -
Parcell.D. # ~t9..~-~~1 -
6282 E
4uU
Date /1 -;2;) -,9 b
/ J.J () <(9.3y
Sewer Conn 6 J:i "9.;2 ....5-:tJ
Water Conn: /t;!1dl~()
'IIatef Meter:~
T.I.F.'s: ZJ~I Od) . bV
BUILDING
Zoning: Eneq:~y Code:
De.en."o" of Wori< /1-"", A -'~ <t J?,-.. ~
-JLZj)~,-- "4-11 fV'-L~1.- ,m~
NO OCCUPANCY BEFORE C.O.
Radon Gas: <.5-:::s-c:r:- ::L~
/o;~~ Y1/1..t
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
7e: t/~J...J'J Inspector
DATE
Permit Fee
Signature
Company
Address
Telephone#
~3D~
~- --~
Valuation or
Contract Price __f) /, f-' 7; ;;; 7.S",. OV
City License Registration # dJ 1Y
State Certified License#
BUILDING
ELECTRICAL
')I t'VIl'Y/I ~,~J83 1/--r/l--3J>~
PLUMBING MECHANICAL
'/?~~j-
fL7? 1- /7 L
SLB
Tub Set
Water
Sewer
Final
l.rt
Breakers
Ducts Insl. I h'f!) 7 b:I{
Compressor
Final
i~~
Tp. Serv,
J , ~I-t-
Rough In I, hi I~ 7 I. u-
Meter Can jl-d:2.~9-'-
Const. Pole
Pool
Pre-Meter , 1.<; J'i 7 !.n l-
Final
JJ)t//f~
I f
Ftr.
Pre SLB
Lintel J
FRM. -t/J~ (~l ~
Insul. CL
WL
&:"\ C t"(
<J-l.] - 4 1
J- t.0't..L~ 'fit\;[
C, /JG3/c, 7
J. w" l(c..... S
Driveway
~ "q,q'ltp.6
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 '~UJ1. ~J,~~.~/II-~;;L-?b
b. Condemned work resulting from faulty construction. q h
c. Repairs or corrections not made when inspection called. to.. J.. I / - ;- ( /
d. Work not ready for inspection when called. I
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.
BUILDER: Poole Construction
ADDRESS: 7350 Dairy Rd,
OWNER:
sa. FT. PRICE
LMNG OR MAIN AREA:~ 55,m I $ 85.00 I
OTHER AREA UNDER ROOF=[ , $ - 1
OTHER:l 88,000 i $ 0.851
SQUARE FEET UNDER RooF:l 55,825 1
VALUATION:I $ 3,887,275.00 ,
ADDRESS:t $ 20.00 ~
DRlVEWAy:1 $ 20.00 ~
FEES:I $ 8,038.58 ~
BLDG. PLUMB. ELEC. MECH.
PERMIT FEES:f$ 12,088.341 $ 550.00 I $ 1,055.50 I $800.00 ~
314" 1" 2"
WATER METER SIZE:I $ 185.00 I $ 245.00 I $ 810.00 I $ 840.00 I
SEWER WATER METER
CONNECTION FEES:I $ 88,882.50 t $ 18,812.50 I ~
RADON GAS: [ $
PERMIT FEES:I $
CONNECTION FEE8:~ $
WATER METER:l $
558.251
14,304.84 1
87,505.00 ,
. I
TRANSPORTATION IMPACT FEES:
89%
1%
$ 31.031.00
$ 30,720.88
$ 310.31
CREDIT: 1
SUB-TOTAL' $ 133,399..091
~RlGATION METER~
TOTAL I $ 133,388.08 I
APPLICATION FOR PKRKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME
J;t1{;J
PH6tm P' ~t?-;2,#CJ
1L ::l~ 7Jj
OWNER'S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
SUBDIVISION
PARCEL LD.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____Sign
____Move
____Demolish
PROPOSED USE: ____Single Family
____M/F
____I of Units ____M/H
____Commercial
_Indust.
____Swim. Pool ___Other
____Restaurant & Health Department Approval
DESCRIPTION OF WORK, r~:;j;-~.I..
BUILDING SIZE: X . ~8. Square Feet,
Height / ~
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (11 SET
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
RESIDENTIAL:
COMMERCIAL
ENERGY FORMS.
-.L.BUILDING
-L.ELECTRlCAL
-LJiECHAlUCAL
-LPLUMBING
4t
$ 4' ~{)()I () 6~ Valuation of Total Construction
2~~o AMP Service Florida Power Corp.
,
PERMITS REOUESTED
_W.R.E.C.
$
700,0 0 ~ ,
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block ~Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
v-
YES NO
******************************************
BUILDER
~
./'
Signature
COMPANY A~ 5.a:-\K\.~\'I~c-,
-e: State Cer.!:. or Regist. # EC.c..~4-B~
City License Registration tl 172-
*****************************************
v
PLUMn~
~ " COMPANY Harper Mechanical Corporation
/~ f: )J1hYL ~i~~\~~~l~;'eo~e:~~~~~;:i~n iFCFCO~~O
******************************************
~
Signature
HE~TIANIC~~ COMPANY Harper Mechanical Corporation
C J...?A State Gerl. or Regist. tl CMC042548
r. Signature . C~ /'i~ City License Registration f1 3BA
************~*************~***************
............
.Q.'Ill&R
Signature
COMPANY_
State Cert. or Regist. #
City License Registration #
******************************************
APPLICATION APPROVED RY
PERMIT OFFICER,
CONDI'l'IONS OF PEHMI'l' AFFIDAVI'l~
A. NOTICE OF DEED RES'l'HIC'l'IONS
lhe undersigned understands that this p'"it may b. subject to "deed restrictions" whieb "y b. .ore restrictive tban City
regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions.
B. UNLICENSED, CONTRACTORS l\ND CON'l'RAC'l'OR RESPONSIBILITIES
If the oliner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be
cit.d for a .i sd..eanor ,i 0 la tion under s ta t. law. If tile nwner or in tend.d contractor are uncertain as to what licensing
requireJJenLs Jlay apply [or ,the intended work, Lhey are ,advised to contact the City of Zephyrhills Building Deparuent, (813)
788-6611.
Furthenore, if the owner has hired a contractor or contractors, he is advised to have tlle 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 may be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
C. 'l'HANSPOH'l'A'l'ION IMPACT FEES AND U'l'ILI'l'Y CONNEC'fION FEES
D. CONS'l'RUC'l'ION LIEN LAW (CIIAP'l'ER 713, FLORIDA S'fA'fU'l'ES, AS AMENDED)
I certify that I, the applicant, have been provided Wit/I a copy of "Florida's Construction Lien Law _ HOleowner's Protection
Guide" prepared by the Florida DepartJlent of Agriculture. and ConsuJler Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described document and pro_ise in good faith to deliver it to the
"owner" prior to cOllJlenCeJJent.
E. CON'l'RACTOR'S/OWNER'S l\FFID~
I certify that all the inforllation in this application is accurate and that all work will be done in cOJlpliance with all
applicable laws regUlating construction, zoning, and land development.
Application is hereby Jade to obtain a penit to do work and installation as indicated, I certify that no work or
installation has cODenced prior to issuance of a peult and that all )jork will be perforraed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies lay apply to tbe intended work, and that it is
my responsibility to identify what actions I lIust take to be in compliance. Such agencies include but are not lilited to:
i DeparbJent of Environmental Regulation - Cypress Bayheads, Wetland Areas and EnvironJJentally Sensitive Lands,
Water/Wastewater TreaLNent
i Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
i Army Corps of Engineers - Seawalls, Docks, Navigable Waterways
i De artJent of Health & Rehabilitative Services Environmental Health Unit _ Wells, Wastewater TreatJent, Septic Tanks
i US Environmental Pro~~~!~gency _ Asbestos abateJJellt
I al,o c.rlify that, il 1111 .at.rial is to b. us.d in 'Iood Zone "" ur "~,etc.', It Is ~der't~ that a dra~~e pian
addressing a "c"pensating vol".' wiJJ b. sub.itt.d wlrich is prepared by a Prolessional engineer register.d in the State 01
Florida prior to permit issuance.
, pmi t i "ued shaJJ b. cons trued to b. a license to proceed . i th tire work ~d not aa authority to ,ioiate, cancel al ier, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter
reguiring a correction of errors in plans, construction, or ,iUlations 01 any rod.. Every per.it issued shaJJ beco.. ~valld
unless the 'ork authorized by such per.it is co..enced .ithin six DOnths 01 issuance, or II work authorizad by the pet.it is
susp.nd.d or abandoned for a p.riod of si, .onths alter the tl'e the .ork is COOIenced. One 90 day eztension of ti.., lay be
allo.ed for lhe pernit with fee charge of li5.00. Ihe extension shall be reguested in writing to the Building Official. An
approved inspection must be logged during each six lonth period, or the project will be considered abandoned.
WARNIN, 10 ONNER: YOUR FAILURi 10 RECORU A NOIICR OF COMMiNC!NENI HAY RRSULI IN YOUR PAYING flICK FOR IKPROVKHNHlS TO YOUi
PROPER Y. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICB OF
COMMEN EHENT. JOBS UNVER $2,500 IN VALVE DO NOT NEED TO RECORD ANV POST A "NOTICE OF COHHEHCEHENT",
-SiGH"~
STATE OF FLORIDA -4
. COUHn OF Zj7-.:?t 6
/ The foregOing instr~.:nt was acknowledged
/ before me this ~/.3', 19 J ~ by
7N()/J11:f" _~E .?;,.,+/.)
who 18 personally known to me ~
produced
o.S j d.mtific~tion ~Ild who EHtl-/did not
take an ?ftj;.l~
( Signat~tqCL~
C/tt;J?vr J) ?'~~
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~v'" ~ C;J;l,RL~S D POOLE
"iii! ", eo"""'..oo cc",,,,,
* * [;;1,.... Feb, 14, 1Qg8
80nded by HAl
"-'.flt/H",.,.f>'t eOO-422.1655
STATE OF FLORIDA
COUNTY OF ~~~/~~?~
The foregOing ins:~ent was ac~wledged
before me this X.~_._, 19.)1.. by
f!#/fZ~.<E.r .JJ. ~AE
who is personally known to me
~du~ea ____________________
ao iycnt{ficatioft: and who d:i:do/ id not
11
...y,v 'ii,
~'~.'.I'.
..~.. DEBBIE BROCKiNO/ilOUQI;
* * My ComrmSSlOn CC~O
~ 1';'0( Expires Nov 28,1997
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.1'1;1s Instruwcnt Pl'c'pu,'cd Uy:
Nc.me:
A<:'drcss:
11111111111111111 1111111111111I111111 111I1111I111I
96105775
pCI'm1l No.
Rcpt: 105901
DS: 0.00
10/0B/9b
Rec:
IT:
NOTICE or COI~~1ENCD1ENT
10.50
0.00
Dpty Clerk
JED PITTMAN, PASCO COUNTY CLERK
10/0B/9b 04:2bp. 1 of 2
OR BK 36 4- 1 PG q 5 1
STATE or Florida
COUNTY OFPasco
TilE UNDERSIGNED herby gives notice thot improvement will be maje to certcin reul
property, and in accordonce with CIHlpter 713. Florida Statues, the following
information is provided in this Notice of Commencement.
1. Description of propcrty: (legel description of property, ~nd street address if
oveil"ble~
Attached
2. General description of impr'ov(:cJent:
3.
New Building
Owner inforwation
B. Name and address:
Sunbelt Living Center
Sunbelt Healthcare Centers, Inc.
500 Winderley Place, suite #115
Maitland, Florida 32751-7206
b.
Interest in property:
Owner
Name and address of fee si",ple titleholder (if other than owner):
c.
4.
Contractor: (name and address)
Poole Construction Co~pany, Inc.
544 Douglas Avenue
Altamonte Springs, Florida 32714
5.
Surety
a. Name and address:
b. Amoun t of bond S N/A
G.
Lender: (name and address)
N/A
7.
Persons within the State of Florida designated by Owner upo~ whom notices or
other documents may be served as provided by Section 7l3.l3(1)(a)7. Florida
Sta tutes: (name and address) Tom Sutton
Sunbelt Healthcare Centers, Inc.
500 Winderlev place, Suite #115
designates the (allowing person(s) to receive
as provided in Section 7l3.13(1)(bl,Florida
Maitland, FL 32751-7206
8.
In cddlt10n tc hi~self. Owner
H copy of the Lienor's Notice
Statutes: (name and address)
Expiration date of notice of commencement (the expiration date is 1 year frocl
the date of recording unless a different date is specified)
~ ~ ~~ Sunbelt Healthcare Centers, Inc.
(Signature of Owner) (Print Owner's Nacle)
Owner's Address: 500 Winderley Place, Suite #115 Maitland, Florida 32751-7206
The foregOing instrument was acknowledged before me thisl/ cf( b / ~bY
~OmA-S E 5f.(.71;;ij::,ho is p~lly k~ IE. me/whO produ.::ed
9.
and who did not take an oath.
S
OFFICIAL NarARYSEAL
E G JUDGE
NOfARY PUBUC srATE OF FLORIDA
COMMISSION NO. CC553387
MY COMMISSION EXP. MAY 19
Commission II Cc.,5~33 37
My Commission Expires: b-IQ-J!1ooo
All Information Must De Typed or Printed Legibly
to Comply With Recording nequiremcnts
OR BK :3 64- 1
2 of 2
PG <:)52
LEG^L DESCEIPTION
PORTIONS or TRACTS 75, 76, 85 AND 86 ZEPHYRHILLS COLONY COMPANY LANDS IN SECTION
..35, TOWNSHIP 2S SOUTH, RAr~GE 21 EAST, AS RECORDED IN PLAT BOOK 2, PAGE 6, PUBLIC
RECORDS OF PASCO COUNTY, FLORIDA BEING FURTHER DESCRIBED AS FOLLOWS::
COMMENCING AT THE NW CORNER OF SAID TRACT 75, RUN 5.00'09'18"W., 155.82 FEET
ALONG THE WEST LINE OF SAID TRACT 75; THENCE RUN 5.89'55'39"[" 131.80 FEET FOR
A POINT OF BEGINNING; THENCE RUN N. 70"00'00" E., 453.25 FEET; THENCE RUN
S.89'54 '02" E, 3409 FEET; THENCE RUN 5...3.3"02'4..3" E., ..34287 FEET; THENCE RUN
S 1:3"38'5..3" E., 385.36 FEET TO THE SOUTH LINE OF Tr\ACT 85; THENCE RUN
N89'5S'..3g"W, 73927 FEET t,LONG THE SOUTH LINE OF TRACTS 85 AND 86; THENCE RUN
N.OO'09' 18" E, 506.00 FEET TO THE POINT OF BEGINNING. (CONTAINS 8.847 ACRES,
MORE OR LESS)
Mm BEING TOGt::TH[R WITH M~ EA5EMENT FOR INGRESS, EGRESS, UTILITIES AND DRAINAGE
OVER AND ACROSS THE FOLLOVr'ING: COMMENCING AT THE NW CORNER OF SAID TRACT 75, RUN
S.00'09'18"\'/., ALONG THE WEST LINE OF SAID TRACT 75, 143.32 FEU FOR A POINT OF
BEGINNING OF EASEtJ.ENT; THENCE RUN 5.89'55'39"E., 129.57 FEET; THENCE RUN
N.70'00'OO''E., 4 1 6.88 FEET; THENCE RUN 5.89'54'02" E., 36.37 FEET; THENCE RUN
5.70'00'OO"W, 453.25 FEET; THENCE RUN S.00'09'18"W., 36.28 FEET; THENCE RUN
N.20'00'OO"W, 1832 FEET TO A POINT OF CURVATURE TO THE LEFT. SAID CURVE
HAVING A RADIUS OF 1 0.00 FEET; THENCE RUN 12.20 FEET ALONG THE ARC OF SAID CURVE
(CORD N.S4"S7'SO"W., 11.48 FEET) TO THE POINT OF TANGENCY; THENCE RUN ALONG
SAID TANGENT LINE N.89'S5'39"W., 214.83 FEET TO A POINT ON THE MAJNTANED RIGHT-
OF-WAY LINE OF DAIRY ROAD; THENCE RUN N,OO'09' 18" E., 25,00 FEET ALONG SAID
RIGHT-OF-WAY LINE; THENCE S.89'55'39" E., 98.75 FEET TO THE POINT OF BEGINNING
OF EASEMENT.
'.
CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET
ORD. #395/RESOLUTIONS 312/372 WATER $1.75 GAL. SEWER $&.39/GAL
RESIDENTIAL (Each Lot or Unit)
Residence $ 350.00 $ 1,278.00
Travel Trailer Park $ 131.25 $ 479.25
COMERCIAL (Per fixtire)
Sinks $ 87.50 $ 319.50
Water Closet $ 131.25 $ 479.25
Urinal $ 87.50 $ 319.50
Lavatorv $ 43.75 $ 159.75
Tub/Shower $ 87.50 $ 319.50
Washina Machine-Commercial Size $ 350.00 $ 1 278.00
Washina Machine-Domestic Size $ 87.50 $ 319.50
Dishwasher-Limited Use $ 87.50 $ 319.50
Food Service-Dishwasher $ 700.00 $ 2,556.00
Sinks (3-Compartment) $ 175.00 $ 639.00
Car Wash (Per Stall) $ 1 000.00 $ 6 390.00
SINKS 50 31 $ 2712.50 $ 9904.50 $ 12617.00
WATER CLOSETS 75 81 $10,631.25 $38,819.25 $ 49450.50
URINALS 50 $ - $ - $ -
LA V A TORIES 25 81 $ 3,543.75 $12939.75 $ 16483.50
TUB/SHOWERS 50 $ - $ - $ -
WASH. MACH. COMM. 200 3 $ 1 050.00 $ 3,834.00 $ 4 884.00
WASH. MACH DOM. 560 $ - $ - $ -
DISHWASHER COMM. 400 1 $ 700.00 $ 2 556.00 $ 3256.00
DISHWASHER LIMITED USE 60 $ - $ - $ -
SINKS-3 COMPARTMENT 100 1 $ 175.00 $ 639.00 $ 814.00
CAR WASH PER/STALL 1000 $ - $ - $ -
SUB-TOTAL $18,812.50 $68,692.50 $ 87,505.00
V j A TER METER
.
GRAND TOTAL $ 87,505.00
FiXTURE
G.P.D.
#
WATER
SEWER TOTAL PER FIXTURE
1 0/8/96
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STAn OF FLORIDA
AGENCY fOR HEALTH CARE ADMINISTRATION
904/487-07~3
OFFICE OF pLANS AND CONSTRUCTION
August 29, 1997
Mr. Laurence M, Mader
Edge Group, P .A.
444 Bunker Road
West Palm Beach, FL. 33405-3694
Dear Mr. Mader:
The revised construction documents, received on June 2, 1997, for tbe project referenced abOVe have been reviewed
and are approved without comment.
Sun belt Living Center, Zephyrhills
New Nursing Home and ACLF Facility
Log No. N-1124 I CON No. 7936 and 7742
Re:
You are advised tbat approval of the construction documents docs not alter or amend tbe requirements for a valid
certificate of ueed (or exemption thcrefrom) for this project. You also are advised that approval of construction
documents dOCS uot aUer or amend requirements for conformance witb tbe particular stipulations of your certificate
of need.
Tbe followiug comment(s) remain outst.,nding from previous review Iener(s) AC-2, AC-4, AC-5, FP-I, E-2", E-29
aud E-40. please submit your response in the form of revised construction doCUments, addenda. chauge orders or
field directives. as appropriate. wbicb are properly signed. sealed and dated by the respousible professional of
record. This project cannot be completed wit bout acceptable responses to the review comment(s). Not responding
may adversely affect the final approval of this project.
Thank you for your cooperation.
Sin
Ira B. Wagner
Architect Supervisor
IRAfFpas
IRA! ARlTGIRLM
Copy to:
Zephyrhills Building Department
Sunbelt Health Care Centers, Inc.
Peninsula Engineering, Inc.
Leming Associates, Inc.
Colwill Engineering, Inc.
O'Donnell, Naccarato & Mignogna
2727 MAHAN DRiVE . TALLAHASSEE. FLORIDA 32308
LAWTON CHiLES. GOVERNOR
RE: Sunbelt Living Center, zephyrhills
New Nursing Home And ACLF Fcaility
Log No. N-1124 / CON No. 7936 and 7742
August 29, 1997
ARCHITECTURAL
Approval without comment
MECHANICAL
Comment(s) remain outstanding from previous ARCA review letters.
Please submit your response in the form of revised construction
documents, addenda, change orders or field directives, as
appropriate, which are properly signed, sealed and dated by the
responsible professional of record. This project cannot be
completed without acceptable responses to the review comments.
Not responding may adversely affect the final approval of this
project. The following comment(s) remain outstanding from
previous AHCA review letters. AC-2, AC-4 and AC-5.
FIRE PROTECTION
Comment(s) remain outstanding from previous AHCA review letters.
Please submit your response in the form of revised construction
documents, addenda, change orders or field directives, as
appropriate, which are properly signed, sealed and dated by the
responsible professional of record. This project cannot be
completed without acceptable responses to the review comments.
Not responding may adversely affect the final approval of this
project. The following comment(s) remain outstanding from
previous AHCA review letters. FP-1.
ELECTRICAL
Comment(s) remain outstanding from previous AHCA review letters.
Please submit your response in the form of revised construction
documents, addenda, change orders or field directives, as
appropriate, which are properly signed, sealed and dated by the
responsible professional of record. This proj ect cannot be
completed without acceptable responses to the review comments.
Not responding may adversely affect the final approval of this
project. The following comment(s) remain outstanding from
previous AHCA review letters. E-28, E-29 and E-40.
Page 1 of 1
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