HomeMy WebLinkAbout00-9322
BUILDING PERMIT
.-
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
09322
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a-~
PLUMBING
B5'
J - /tj-tJ(J
Sewer Conn t .2 "7fI -
Water Conn: ' ~ fj-o -
W"e' Mete' 'if _
TI.F.'s: /; 'i _
!/2J2/t'o, /l}If7e7l.. I PI) -
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W. t!- (IR!U;) /7:5
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BUILDING
3~
ELECTRICAL
Date
MECHANICAL
Pmperty Own., ~ ~O~~_
Job Address: ~ ' . .
-
Parcell.D./I ...s~'"db-.::J.I-ODIj) -DI:aOD-'.oIS~
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
2
Pe,mlt Fee ~5' e!!
~ 4~
Company
Address
C'fi,lePhoneD 1/3- 7f2- /161./
~i7JJlt ~
-
PLUMBING MECHANICAL Ik;.
Valuation or
Contract Price
/O,lh.tJ-
City License Registration # ~09D
State Certified License#
';7J;;~J'- a-,-
BUILDING ELECTRICAL / ~7
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final >-~--o {}/f/L
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor ~
Final "5 r 2-L/......Ot? ~
Driveway
~ -ur '5 ~ZLf-tYO S-IC-
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/1 00 Dollars ($ 25.00 I shall be made for each trip for each trade:
0/.9'5Tt=' ~SIKT roh1't 15~tJFJ::>
~: ~~~~~::ed;e;~rk resulting from faulty construction. ~'il' u~'l)--""--""--'~ '..
C. Repairs or corrections not made when inspection called. . . ~ ~ cJ
d. Work not ready for inspection when called. /2 .A:J.--t./
e. Permit not posted on job site. c7 -- t1'-
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.
J.U 7 t Lfv ~rL S;;
.get jj, C (.,N}Tf' !.xf('~/V'
tA..;~;-"' (55 G. j)',TNi) I i~~jLq",
'lJ'7 -;'Cur
SQ. FEET PRICE
MAIN OR LIVING AREA
OTHER AREA UNDER ROOF
OTHER
BUILDING: ~.co
ELECTRICAL: ~5-CO
PLUMBING: '~ S- _ 'J <)
MECHANICAL: S"' ~ "\:'
2--
RADON: f'J It"
CREDIT: ,J /~ j)O
~
.-?
t35"
SEWER: L7--7'j. .:,0
WATER: ~")o.o 0
TOTAL: 1"00. ,./~
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APPLICATION FOR PERMIT
CITY or ZEPHYRHILLS
BUILDING DEPART.MENT
DATE lUI:CEIVED 3 - it - 06
PLANS REVIEW I'D:
OWNER'S NAME tA...J I ~(AIIA (3ooTl-l
PHONE
JOB ADDRESS
LOT I S~
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL ID # 3/f- tS -1-1- (JOt 0- 0 1100 -0 ( 5~
SUBDIVISION (;/lA-f./tJ I-fOIl-( t{)#
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
o ADDITION
OALTERATION
o DEMOLISH
o REPAIR
o INSTALL
Os I GN
o MOVE
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~LE HOME
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK m O~'LE 1-I1)/lII/~
BUILDING SIZE 21)(5/
SEt'
uP,
SQUARE FOOTAGE
Ilfzt
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 FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~LDING
~ECTRICAL
~UMBING
~CHANICAL
,.... ..;1-
lO,l\.;J ·
PE
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE ~LORIDA POWER 0
15'0
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
W. /':~~~<~-~)
INSTALLA'I;(~t ~ 1004
/; Q?- /
1 IJ,pU;/
f/ ~/
Y;S (!t11O
$
500.00
VALUATION OF MECHANCIAL
o GAS
o ROOFING
o SPECIALTY
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE
SIGNATURE
~ 4. ~
/
COMPANY t17 A-(2-5>I-t/U..(, h'/}//,((..,~ !-I()nIIZ /NsrAi4~f
STATE CERT OR REGIST #:rH tXXJ0307
CITY PROCESSING # c1.o7fJ r/
BUILDER
* * * * * * * * * * * * * *'* * * * * * * * * * * * * * * * * * * * * * * * *.* * * * * * * * * * * * * * * * * * * * * * * * * * *
ELECTRICIAN ~
SIGNATURE ! 'IJ ( M.1I.J
COMPANY AuF I~nuc:
.
STATE CERT OR REGIST #
CITY PROCESSING # ) t; '7 /'"
/ (,.,
******************************************************************
PLUMBER
~<A< ()Ap
COMPANY hIlJ/Ul~ .mDIJ,uE I/w"tf /1./5111UU;
STATE CERT OR REGIST # .I V- 0000 30'7
CITY PROCESSING # ~~
SIGNATURE
* * * * * * * ** * *.* * * * * * ** * * * * * * * * ** ** ** * ** ** ** *** *.:h* *;.:t * ** *** *** ** * ** *** *
MBCHANICAL COMPANY l::K:!:::. pIll- Cc')~/l.
SIGNATURE ~. 1/-. aPd2
*****************************************************************
STATE CERT OR REGIST #
CITY PROCESSING # 1~"""'---
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
, .
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to ndeed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may 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 may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what'
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs 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 permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of nFlorida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the nowner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CONTRACTOR' S/OWNER' S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
certify that no work or installation has commenced prior to issuance of a permit and that
all work will be performed to meet 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 may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Arrny Corps of F.ngineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone nA" or nA,etc.", it is
understood that a drainage plan addressing a ncornpensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
A permit 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 permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A nNOTICE OF COMMENCEMENT".
/4 . .:s~~
SIGNATU~ O~R OR AGENT
tl~ 7j~
SIGNATURE: C NTRACTOR
STATE OF FLORIDA /)1)5
COUNTY OF ---J:~ (. b
The foregoing.in ument was ackn9wledged
Befor me this day of ~RaL{t , ~
by . =L
~narne of person acknowledged)
~who is personally known to me, or
STATE OF FLORIDA ;)
COUNTY OF [/ASC~O
The foregoing instrument was ac~owledged
B. efor..e ~e_ this ~day of:pJl1/Jkn- .' -.?::f;p=J
h Y ._~~~r -.tL......A -s,I3,::- t....
~ (name of person acknowledged)
~ho is personally known to me, or
of identification)
take an oath.
Dwho has produced
llYpe of identification)
and who Ddid [B'lid not take an oath
&~L tJ~ /Yd2
Signature of person taking acknowledgment
f)ttUG{; IJ. ff5B6L-
Name typed, pri'p'~~AdI*rnped
. ;".Q *Mv eommlssion CC7486n
~..1 expires June 22, 2002
......"
Dwho has produced
(type
and whoD did G:kfid not
~A.~
Signature of person taking acknowledgement
----BelJC{~
Name typed,
A. A-SfJJr:;~
printed or stamped
..",'.... Bruce A Asbel
#6-" .
*u:*Mv Commlslllon CC748677
'\;...~ Expires June 22, 2002
980058
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-71t-8008 FAX 813-710-7010
CITY OF ZEPHYRHILLS
ZEPHYRHIU5, flORIDA
o 0 - S-~ ~
SHUT OFF SERVICE
WATER AGGl. NO. DATE .Y - / 1- D iJ
<2b7J-/;;-: /YJtPl~ '7J1f1c1.A,~
OWNER/ / ~. ,~-+fJ..../ ~
RENTER .f:::T ./ "I1/ '~ ~ /J/)I' ~.I'7" I~
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MAIUNG -37t,/-/9 ~J1~ ~ ' ~/!JJ:
~Z'1!!j-1./l.lP.. I F L, -3 3 ~.(/ .::!~s+'~
SERVIGEADDRESS-~4~1 11,6 ~_ Anl/bs-'
.~
o SEWER
o
TURN ON SERVICE
~.
~
READ METER
o
o
o
o GARBAGE
~"
INSTAll. METER
CHECK METER
o OUT CITY
~ No. OF UNIlS
OTHER
_ DEPOSIT AMOUNT
/ - ~ II W'v?1?~
_ AMOUNT LAST BILL
_ DATE
_ MISC. CHARGE
WORK COMPlETED BY
& DATE COMPlETED
ORDER 'DU<EN BY
Re1ain white form in office at all timea.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office.
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r- 980058
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~ PERFORMANCE BUSINESS PRODUCTS. INC. 813-718-8008 FAX 813-719-7810
- ---
CITY OF ZEPHYRHILlS
ZEPHYRHILLS, FLORIDA
o {! -~-&3
WATER ACCT. NO. DATE '=i -/1/- 0 c)
~~., cm<1v'J~ 7J711 :J~ff~~
~~~iER~l ~ijJ'~l~tJoLf(~oJ~) -
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AD715r-
~
SERVICE ADDRES5'6'.40.....rn..L- 41, ~
SHUT OFF SERVICE 0
TURN ON SERVICE ~
INSTAlL METER ~
READ METER 0
CHECK METER 0
OTHER 0
o SEWER
o GARBAGE
~
o OUT CITY
L No. OF UNITS
_ DEPOSIT AMOUNT
_ AMOUNT LAST B1LJ.
I-~ 11~~/IT7r
_ DATE
_ MISe. CHARGE
'MJRK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office.
4. G~
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B&H CONSTRUCTION OF CENTRAL FL.
4025 MORRIS BRIDGE ROAD
ZEPHYRHilLS, FL. 33543
1-813-782-1064
SUBMITTED TO:
DATE: '2 - I ()- 2Lx;>O
NAME: mIL ~ fl1 (2 S 15ooil-l
PHONE:
STREET: Move- ~ 53'2- CLul3J..ltu To t'P(lIt,vp 11<)1/;/ zctl
CITY
STATE
ZIP
OUNT
UNIT PRICE
EXT
PRODUCT
SIZE
2.
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5. VIN-1L-
Co I LlNot{ IIf (
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SUB TOTAL
PERMIT FEE
TAX
TOTAL
ESTIMATE GOOD FOR 30 DAYS
BALANCE DUE UPON COMPLETION
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MAR-07-00 03:59 PM MARSHALL MH INSTALLER
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813 6770631
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STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOiNG is A
TRUE AND CORRECT COPY OF THE DOCUMENT ON FilE
OR OF PUBLIC RECORD IN THIS OFFICE/1P~S MY
HA AND OFF IAL SEAL THIS~ DAY OF
2.fJ2)
OF. IRCUIT COURT
EPUTY CLERK
1111111 111111111I1111I1111I1111111I1111111 1111111111 1111 1111
2000031461
....
Rept: 398!542
DS: 0.00
03/14/00
Ree: 6.00
IT: 0.00
-__ Dpty Clerk
~~91:~~~"~1~ID~O fOUNT~ CLERk
OR Bk 43~g PG i266
Stote l)t _F/..-()Il,,(/JA-
HOTICB O~ COkHEHS!~HT
County of PASC 0
';'UB lIHnCRSICNC!O horeby qive. notic. that improvoment w.l.ll be mode to c:JrtoJin
reoJl prQPlrty, and in accordance with Chapter 713, Floridtll StHutell, the
Col ~o\'/inC) intocr:l&tion h provided in thh Hotic. of Commonc~l"c"t.:
1 .
Parcel No.
~. Cener.1 D'~scr1Pt1on or IlllprOVllllnt /J1lJvE. /../(}yYIy: F tCl ul
e J
3.
OHncr Information: Ntllmo IAJtUtltM.. l1Do rlf
lid cJ res J 7' 4'1 f\/,; (/ ~JI'l II 1.It.. c it y 2&1/fy flJ.I.l u.. .f
S t <H e J:-L. 33 Sif(
Interest in Pr.operty:
Ntlllnl of Fee Simple Titloholder!
(It other thtn own.r)
Address
City
StoJtc
R.
Contrtllctor: N.:1me IYJRrl' I-iA(.L. PI-i!3lP5
^udress .5z53 IhAlJt$lJfII Li.e Cl~ty 7/tJ;n,~1J.
~(. 516ft{
State
5. Surcty: N.:1me
Address
City
St,H.e
^J1Iount ot Bond: $
6. L~nder: Name
Aduross
City
~t,HC
7 .
Persons within the State of Florida
notices or other document. may bo
7IJ.IJ(I)(tll)(7), Florida Statute.:
desiqntll ted by O\.o'ne r upon ....?".c:n
served tllS provided u~ Sec~lon
N.1mo
^c1d r e III
City
St.:lL-!
8. In additi.o.n to him..l!, Owner d'..i9nate.
ot to roceive. a COpy o! t~e
Lienor'. Notlee a.orovldedtl" C::'!!C"t.l.~~ 7~~.l;(li(bl, rlor.dil St4t"~C5.
\I. r."p..rfll.~On d"t.e ot Hat-J.ce ot COJllmOncomont...(t.he expJ,rAtlc.n d~tlJ i~1 yea'
tr?m the u~to ot rucordin9 unle.. a ditferent date is specified.)
Signature of Owner: ;?t-;;~.,;,...,.C~
WI u. (~ r.;:. 00 .,
S....orn to and subscribed before me thil It..( day of
~ Uat?
/Ill fl~ cf
NOt,) ry Pllbl ic:
~!l-L W
M.,/ Com," j !l S ion E xp i C II S I
~~ ~ BruceAAsb8I
*11; *Ikt ~on CC748877
.,!!If/I..I expires June 22. 2002
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PASCO COUNTY, FLORIDA
Permit Nu.
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Date Permitted _
/._', '.l'
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Builder Name/Owner Name
{' L ..'1......
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i,,-
County Parcel No.
F'., .....
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Address/Location
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Subd.
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ClassificationfType of Use
.,( /' , 1.:1", "-/',- l F ~ .
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
Zone No.
Sq. Ft/Unit
Prepared By
Impact Fee Amount $
Checked By
The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the
Board of Pasco County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or
utilization of the permitted structure.
RESOURCE RECOVERY ASSESSMENT
EXEMPT 0
RESIDENTIAL
Ratc ERL' -
/
I
52.00/Year
or SO. J --l2/Day
NONRESIDENTIAL
No. Units
Gross Sq. Ft. (GSF)
ERU Assign No.
Asscssmcnt
( No Un i Is) x ($0. 1--l2 )
x (No. Days)
Assessment -
(GSF)_x (ERU) x (0,142) x (No. Days)
100
TOTAL FEE $
TOTAL FEE $
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSVED UNTIL THE AMOUNTS LISTED
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTI~G OFFICE OF PASCO COUNTY.
Acknowiedgement below does not imply acceptance of concurrence. but simply receipt uf a copy of this form. placing
the huilding permit owner on notice of this assessment and the conditions of payment for same.
Date
Received By
----- ------------------------------------------------------------------------------------------------------------
OFFICE L'SE ONLY
TRANSPORTATION REC. NO.
RESOURCE RECOVERY REC. NO.
DATE
DATE
BY
BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecalce
PC93113094/D