HomeMy WebLinkAbout97-6918
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N!
69:1.Si5
Date J - I 7 - 1}
~~ ELECTRICAL PLUMBING
Pmperty Owne" A::. 3fr 7 A L ~ ,.,
Job Address: ? ~ '7 I 7 /'~ -P 17-----..
Parcel I. D. #
Zoning: Energy Code:
Description of Wo;;- r( Cl .A ~
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
PI"
p~'m;t Fee t::? ~
Signature ~
Company I
Address
Telephone#
Valuation or
Contract Price
So? cf?l. L7V
,
City License Registration # 01. 7... if'
State Certified License#
c E-r //~
. -
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Ins!.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAME Kathryn perkins
PHONE (813) 788-1108
OWNER'S ADDRESS 38719 Camden Ave. Zephyrhills, Fl. 33541
JOB ADDRESS Same
LEGAL DESCRIPTION: LOT(S)
BLO(;1L-
SUBDIVISION
PARCEL LD.' (OBTAIN FROM PR~ERTY TAX NOTICE)
WORK PROPOSED:_New Construction -Addition ----Alteration \ //~epair _Install
_Sign
--..JIove
_Deaolish
P~POSED~E: ~S~eF~ily
--..JII F
_' of Units _M/H
_ec-ercial
_Indust.
_Swia. Pool _Other
--..Restaurant &: Health Departaent Approval
DESCRIPTION OF WORK: Re-roof
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valoation of Total Construction
_ELEC'l'RlCAL
AHP Service
Florida Power Corp.
W.R.E.C.
_HEClWfICAL
$
Valuation of Kechanical Installation
_PLUHBING GAS ROOFING
TYPE OF CONSTRUcnON: _B1ock _Fr~e _Steel
SPECIALTY
Other
FINISHED FLOOR ELEVAnONS:
Fl.
IS PROJEC'l IN FLOOD ZONE AREA?
YES NO
....................................***.**
CONTRAC'lOR SECTION
BUILDER
COMPANY
State Cert. or Resist. .
City License Registration f
**.***...*****.***************************
Signature
ELECTRICIAB
COMPANY
State Cert. or Regist. .
City License Registration .
**.***************************************
SionAture
PLUMBER
COMPANY
S~~te C~r~. cr Regist. f
City License Registration t
..............****.****..*...*.*.*********
Signature
KEGHANICAL
COMPANY
State Cert. or Regist. f
City License Registration f
*..***************************************
Signature
0TIgB ~ a>>WANYRyman Cons<ruction (Roofin~
. ,t.'" il State Cert. or Regist. t rc0061648
Signatur ;~.../..... / _ City License Registration t 275
~ .*.*.*.....*****..**.*..*.**..***.******
Di v. )
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF' PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this peIlit lay be subject to "deed restrictions" wbich lay be lOre restrictive than City
regulations. Tbe undersigned assOles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas 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 mmer and contractor lay be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents aay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
IContractor Sections. of this application for wbieb they will be responsible. If you, as the mmer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
as contractor that aay be an indication that be is not properly licensed and is not entitled to peIlitting privileges in the
City of Zepbyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided "it!! a copy of .Florida's Construction Lien Law - HOIeowner's Protection
Guide" p{epared by the Florida DepartJent of Agriculture and ConsUIeI Affairs. If the applicant is SOHOne other than the
.owner", I certify that I bave obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the,
"owner" prior to cOJleDcelent.
E. CONTRACTOR' SlOWER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all wort will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas cOllenced prior to issuance of a peIlit and that all work will be perf OIled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveIDIeDtal agencies aay apply to the intended work, and that it is
.y responsibility to identify wbat actions I lUst take to be in cOlpliance. Such agencies include but are not luited to:
t DepartJent of EnvirODlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater 'freatJent
t Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t AIly Corps of Engineers - Seawalls, Docks, Havigable Waterways
t DepartJent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater TreatJent, Septic Tanks
t US EnvirODlental Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "AI or "A,etc.", it is understood that a drainage plan
addressing a "cOlpensating volOle" will be sublitted whicb is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance.
A perlit issued shall be construed to be a license to procned 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 peIlit prevent the Building Official frOJ 'thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pmit issued shall beCOle invalid
unless tbe work authorized by such peIlit is colleDced within sil IOnths of issuance, or if wort authorized by the-peIlit is
suspended or abandoned for a period of Sil IOnths after the tHe the work is coaenced. One 90 day extension of tHe, JaY be
allowed for the peIlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during each sillOntb period, or the project will be considered abandoned.
liARNING TO MER: YOUR FAILURE TO RECORD A NOTICE OF COHHEHCEHBHT HAY RESULT IH YOUR PAYIHG TWICE FOR IHPROVEHElft'S TO YOUR
PROPERTY. IF YOU ID'EHD TO OBIAIJf FlKAlCIHG, COHSULT WIfH YOUR LEHDER OR All AnORm' BEFORE RECORDIlfG YOUR JfOTICE OF
C.DHHEHC!HEH!. JOBS UHDER $2,500 IH VALU HOT HERD TO RECORD AJID P031' A "NOTICE OF COHHEHCEHm".
i/' , ~
~ . ~- .
. SIGIIIllmif~. -- 3
51
~~
STATE OF FLORIDA ~
COUH'fY OF tr ~
The foregoin~ inst~~> was aCknowledged
h~fcre m~ thIS ~l~ , 19~ by
~~ ....
no, i. J)~
who is p nally Jmo to me or who has
produced ~
as identification and who did/~ ~~
take an oath f'-
who is
produced
as identification and who did/~
take an oat
(Signa
(Name Typed, Printed 0 Stamped)
NOTARY PUBLIC
"...... ""4
.() ~ ('~
W~ ~EJBURKE
MYCo~nCC~
~ ~ Expires Mar. 31, 2000
..,~ ~
~ OF fl.\)~
(Namf! Typed, Printed r tamped)
NOTARY PUBLIC
"...,IY "(J4.
+0,6("
... BOBBIE J BURKE
* * My Comml.sion CC543871
~ ~~ Expires Mar. 31. 2000
~ OF fl.\)"~
NOTICE OF COMMENCEMENT
Rcpt: 175649 Rec: 6.00
DS: 0.00 IT: 0.00
08/19/97 Dpty Clerk
JED PITTMAN, PASCO COUNTY CLERK
08/19/97 12:13p. 1 of 1
OR BK 3791 PG 699
11111111111I11111 1111111111 111111111111111111I1111
97092855
State of FT.()RTnA
County of
p~
TUB UNDERSIGNED hereby gives notice that improvement will be made to c~rtClin
real property, and in accordance with Chapter 713, Florida Statutes, tho
following information is provided in this Notice of Commonc('lIl(~IIL:
1.
Oeser iption of Property: Parcel No. ..:IS .t..5' 2 1
eJ CooS A ~ D () " D I 2. 9..1)
(Legal description
of the property and street address
Improvement fG, - if ~
if available)
2.
General Description of
3 .
O,mer Information I Name ;(~, ?~
l\ddress ~7(<j ~c&... 4VLCity 5 ~f"~
Interest in Property: ~
Name of Fee Simple Titleholder:
(If other th~n owner)
State '::;]I,
_Address
City
State
R.
Contractor: Name
RYMAN r.()NS'T'RTJr'T'TON . TNr. (ROOFING DJ:V.)
Address 17i?E; ~ R
E;.:1 wpc:rp
Ci ty ZEPHYl:ll ILLS
Stilte
FL
33Stf ,-
5.
Surety: Name
Address
City
State
Amount of Bond: $
6. Lender: Name
Address
City
State
7. Persons within the State of Florida designated by Owner upon whom
noti~es or other documents may be served as provided by Section
713.13(1)(a)(7), Florida Statutes:
Name
Addre~s
City
State
8. In addi tion to himself, Owner designates
of to receive a copy of the
Lienor's Notice as provided in Section713.13(1)(b), Florlda'Statutes.
9. ExplrnLion d"t.e ot Not-lce or Commencement. (the explration date is 1 year
fr0m the date of recording unless a different date is specified.)
DRIV~RS LICEN~ ~TE' -:--
Signature of Owner: - . '~;.UAA '<t~~4l I?Rlt!lT
: " .,' - ttr-
Sworn to and su~scribed b~fore me this /~ day of
; . .
NAME :k4fher1.n~ ~S
~~
19~.
Notclry Publi~~
MyCommi~sionExpires: