HomeMy WebLinkAbout00-9325
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
09325
Date
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Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
~ --2'-~
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Valuation or
Contract Price
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MEC
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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 ($ 25.001 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
DATE RECEIVED
PLANS REVIEW I'D
OWNER'S NAME ~ni ~ Cl')I'\I~
JOB ADDRESS 38Co't\ I~~ ~
LEGAL DESCRIPTION: LOT(S) ~&D.~ BLOCK ~~
PARCEL 10 # \l-~1I.d-1- OO'D - OW{)DoJ' 0' ID
PHONE
,yx-490S
SUBDIVISION~~~~
(OBTAIN FROM PROPERTY TAX NOTICF.1
WORK PROPSED: ONEW CONSTRUCTION
o ADDITION
OALTERATION
o REPAIR
o INSTALL
Os I GN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
BUILDING SIZE
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
d,:ph .s~ ,<.)>/L01
SQUARE FOOTAGE
HEIGHT
DESCRIPTION OF WORK
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.
o BUILDING
$
3 .~CO( ,.
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
o PLUMBING
o MECHANICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES
o NO
SIGNATURE
..:.'....,.,.,.
COMPANY~ALt ~C ~OPil~J~
STATE CERT OR REGIST #i .
CITY PROCESSING # .;;l;:J...
BUILDER
ELECTRICIAN
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
******************************************************************
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
**********~*******************************************************
MECHANICAL
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
.
-
CONDIT IONS OF PEHfll T AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be
may be more restrictive than City regulations. The
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 "Florida'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 "owner", 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 cOllunencement.
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 corrunenced prior to issuance of a perIlUt 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
certi~y. 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 Managelnent District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-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 "A" or "A,etc.", it is
understood that a drainage plan addressing a "compensating 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 corrunenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
pe'riod of six months after the time the work is corrunenced. 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 OMMENCEMENT. JOBS UNDER
$2, 500 IN V;J~:ND'r"N,EED 'ro RECORD AND pos'r A "NOTICE OF CO NCEMENT" .
S~'..u.NER ~GENT
STATE OF FLORID~ .
COUNTY OF ""'0. "'::::>C.u
The foregoing instrument was ackryowledged
Before me this -1L day of fY)PvtU1. , ~
by
_ / (name of person acknowledged)
~who is personally known to me, or
~ . .
subject to "deed restrictions" which
undersigned assumes responsibility for
STATE OF FLORIDA ./l S
COUNTY OF . fA . CO
The foregoing instrument was ack~wledged
Before me this ~day of rnt:U r. , ~
by
(name of person acknowledged)
~ho is personally known to me, or
Dwho has produced
(type
Ddid not
of identification)
take an oath.
Dwho has produced
(type of identification)
~id not take an oath
,1I...1...e.t/)^-
~~ Suzanne Douglas-Allen
Name typed* .~mumn~~d
,".....!/ Expire6 October 25, 2003
Name*~tZlolp"}:~~lltilr stamped
'). * Commission CC874208
.....,,!/ Expires October 25,2003
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2000031686
NOTICE OF COMMENCEMENT
Rcpl: 398674
D OS: 0.00
State of Florida County of 1 QSc.O 03/15/00
Rec: 6.00
IT: 0.00
Dpty Clerk
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in
this Notice of Commencement:
1. Description of Property: Parcel No. ,{- ~ lJ - ~ } - 0'0 I D -
(Legal description of the property and street address if available)
2. Genetal O"cription ofImprovemcnt A..L - ^-o,
OtfODO -- OIlU
~~91~~~~M~':lfa~CO fOUN1~ C,ERK
OR BK 4328 PG 1853
3. Owner Information: Nam
Address
Interest in Property: &t~
Name of Fee Simple Titleholder: ('( II'r
(If other than owner)
Address
~~h,l~ St
Zip 33.5 " l)
City
St_Zip
R 4. Contractor: Paul Schaper - 11250 S. Hwy 98 - Dade City, FL 33525
5. Surety:
Boyett Insurance - 14114 7th Street - Dade City, FL 33525
Amount of Bond: $5,000.00
~
6. Lender: Name/Address:
~/fr
7. Persons within the State of Florida designated by Owner upon whom notices or other
documents may be servr as provided by Section 713.13 (1) (a) (7), Florida Statutes.
Name/Address: .f"Il It-
8. In addition to himself, Owner designates Paul Schaper - 11250 S. Hwy 98, Dade City, FL 33525
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is 1 year from date
of recording unless a different date is specifie(L~
C 5:1./0 43g--.:!,f., 5Is%f.':'eofOwne,1y~~ O~
Sworn to md ,ubecribed befo,c me this ~da~ 2000.
_Personally known C ID: __)
--
Notary Public, ~ -t~+--- !~
/ /
,,; ~ SUDIln8 Douglas-Allen
*~; *My Conmillion CC874208
,tl!I!/ Expires October 25. 2003
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 O~ PUBLIC CORD IN THIS OFFIC. 1 SS MY
HAND AN F. I AL THIS Y OF
F CIRCUIT COURT
DEPUTY CLERK