HomeMy WebLinkAbout00-9493
BUILDING PERMIT
"'u
35, ..---
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788-6611
)S.~
PLUMBING
Permit
09493
~
YO.~
BUILDING
Date 5/30/ IJO
""I o~
..cS.'-
MECHANICAL
1'27 f. ~
Sewer Conn
J.so ....!i'
Water Conn:
~? f'-t::?
Water Meter: ( J O.
T,I.F.'s: 1'-/1 d, --$'
'J..-.r: fJ.
-.,
f75.~
/1'" ~
Property Owner: Cc. r 0 Iy n .to.f\f\ e c;
Job Address: ') '] (,. ~ 2 1Jil.u.. \c..o.""" ,4v'..z .
Parcell.D. # J<.t- :J~.~ ,. OOI()~ Cll1oo. tlOI-)
Zoning: Energy Code:
t:J;,7" of Wor.. '" .,t,; I. b ~
00 ~~ Relec-.!.e y
Radon Gas:
Sef - Lf~
PP I If); n 1h
City License Registration #
State Certified License#
FINAL
C.O.
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
~
J1;1c..r 5 l" II \) "" fH
BUILDING 90'1'0
ALe bAet
ELECTRICAL ( ~ ')
~ ~Lc.. (I r~llf,,~
,
PLUMBING Je> <) 0
A(.-R flee
MECHANICAL
<<--is
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl,
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 ($ 25.00) 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 CAlZoL.v/IJ &/1 M 13.$
JOB ADDRESS 3710 '12- A/clhM.. IJVf.
I
1-0, IS"
LEGAL DESCRIPTION: LOT(S)
SUBDIVISION (;;/fAAfp /-16 (2( 27JN
BLOCK
PARCEL ID # ?if-lJ;; -?-{ - 0610 - 01 '300 - no 15
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: [JNEW CONSTRUCTION
[J SIGN
PROPOSED USE: ~L FAMILY DWELLING
[JADDITION
~VE
[JALTERATION
[J REPAIR
[J INSTALL
[J DEMOLI SH
[J COMMERCIAL
[]MULTI-FAMILY
[J INDUSTRIAL
[J# OF UNITS
[J SWIMMING POOL
~BILE HOME
[J OTHER
DESCRIPTION OF WORK
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
5fSr
'lB X 5b
(Y/ 6fJI l-p
J-IOM~
BUILDING SIZE
SQUARE FOOTAGE
l5lrK
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 REQUESTED
~UILDING $ " ()(XJ. 00 VALUATION OF TOTAL CONSTRUCTION
~ECTRICAL 15'0 . AMP SERVICE ~LORIDA POWER [J W.R.E.C.
~UMBING
~CHANICAL $ (coo. 00 VALUATION OF MECHANCIAL INSTALLATION
[] GAS [] ROOFING [] SPECIALTY [] OTHER
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
[] STEEL
[] OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[J YES [J NO
SIGNATURE
~ 4- f21~
COMPANY tnfll15iM<<- Pfll7t--f/f
STATE CERT OR REGIST #.:r 1-1-0000'30'1
CITY PROCESSING # 2. 0 q 0
BUJ:LDER
******************************************************************
SIGNATURE
l~ /I ~ a,tdJ
COMPANY: ,4ci!' ~~ r7ltc.
STATE CERT OR REGIST #
CITY PROCESSING # J 1''7
ELECTlUCIAN
******************************************************************
~AdA
II~ ~
COMPANY mAa.$ /-IA<<... Ptl-bL--f1 f
STATE CERT OR REGIST #..I If - oooo~ 7
CITY PROCESSING # -:2-oq 0
~
~
PLUMBER
SIGNATURE
MIllCHANICAL
* * * * * ** ** * *,*** * * ** * ** * * * ** * ** * * * * * * * ** ** ** * *;t ~ *...:* **~ ***** *** *** *** *
COMPANY t1..C4'::- !::fill- COAJIl,
a/l~( Il ~
~
STATE CERT OR REGIST #
CITY PROCESSING # ~~
SIGNATURE
*****************************************************************
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 ~deed 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 ~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 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
*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 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 ~NOTICE OF COMMENCEMENT".
9?, ;J~
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SIGNATURE: OWNER OR AGENT
47 /)&'<:-"l.j
7J;/ ,~.....- i . -~~~. _
SfGNATURE: ' CONTRACTOR
STATE OF FLORIDA FAf C
COUNTY OF 0
The foregoing instrument was acknowledged
Be~ me thi~ day of 11111 " , _2<<Jo
by Iluc.F. 5~J;"L . .
(name of person acknowledged)
~o is personally known to me, or
STATE OF FLORID~A.>C'O
COUNTY OF
The foregoing instrument was ac~owledged
Before me this ~day of I'V1 R , _ ~
by BJLUCl~ ,4, fJ- 5815"t..
~. (name of person acknowledged)
~ho is personally known to me, or
Dwho has produced
(type of identification)
and w~did ~d not take an oath.
~1 /L. f11utJ
Signature of person taking acknowledgement
&WU:.. If . (+SB/!L
Name typed, pr~4lruc:Im'~mped
~; *Mv CommIsSion CC748877
t.J Expires June 22. 2002
... II "
o who has produced
(type of identification)
and who Ddid [Qdid not take an oath
/).fJd!,UP
(hAk<-
Signature of person taking
acknowledgment
Name
gild c. E //. - /JSI5 cL--
typed~~~-"biI stamped
*~ *My Commission CC748877
~; Expires June 22, 2002
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1111111111111111I1111I1111I11111111I1111111111111111 1111 I11I
2000066840
Rept: 416767
OS: 0.00
05/30/00
Ree: 6.00
IT: 0.00
________o Dpty Clerk
'!~3~~1~"Ar2 : ~~S;O fOUNT:f CLfRK
OR BK 4374 PG 1956
5 tat, f) t Fto(l( Oft
NOTICB 01' COkxzH'c;E~HT
County of PASe 0
'iUS \/..,nCflSIOHCO hereby 91v.. notio. that l'mpc-ovom.nt wLll bo mldo to C:lnJ ion
reJl property, and 1n &ooocodano. with Ch.pteco 713, rlorLda StatuteD, the
Collo",~nC) Lntoern&tlon 11 pcoovided in thh Notice of CO/MIOnCnlllclft.:
I. Paroel Ho. "'?,Lf-2-~ --1-/ - 001 b - 01 :3 00 -OOI..s"-
\A~ .
o peopor y an ~l
2.
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Centr.1 O'scription of laprov..ent
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fVl 01.> ( Lr /-Iv J?1, E
) ,
-
Oltn'or lntornlltlonl Hamo (AflOI-VfJ CfiMI5S
"delru. 37(,;l!-Z N&UUwt A,-€.C1ty Uf'IIl((l./-IIU..5
5tH. FL.
lnterut in Pr.upertYl
Nalne of r.. Simple TitloholdoCOl
(It othor th,n ownocol
Addre,.
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City.
Stl1tc
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Contractor: 1'1.)/110 /YIftl2...~/-If+G.L PI/eLP5
^lJd re ,,52-53 /llAASDtJ LAK-E City --r Ih'I1P f}
State u. 33bf9
, .
S, Surety: H.)ffl.
Add rOil
City
Stat.e
N\lOunt of Bond I $
6. LlInder: Ham.
Adurol'
City
St4tO
7, Perlonl loIith1n tho State of Florida ded9natod by Owner upon "'~.c:n
notices or other documont. may bo .eeved 4. provided uy Sec~~on
71)'1)(I)(a)(7), Florida Statul:..,
Hilma
^c1dre..
City
Stl1l..,
8, In additl,o.n to himul!, Owner d'ol!9n6tu
ot to rocoLvo I copy ot t~e
Lienor'. Hot1.co .. proV1.dod 1.n Soot.l.on 7lJ.13111Ibl, rloddo SC,HII~"1.
'J, r,.p~r"l..irJn d,,". ot H(lt..1.CCl ot cOJ!\ll\onQe:unl,o.!\.he ollp1c6tLon d.ltll L. I yeo'
".M:::: o'th~w:::~ ;iiiii."j~:;;:j' .p.oil "0 I
'wo," to 'nd .ub.o r"&.d "~~r.. ~.. thlo C/ ";.~ o~ /fI fll(
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M'r ,C 0 m'n I a I ion E: lC..p l r. . I
... ~ 8NC81,. AsbeI
:..e.; *tIIY CommlssiOf'I CC748677
~.I expires June 22, 2002
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MAY-15-00 09:37 AM MARSHALL MH INSTALLER
813 6770631
P.03
eu'tomer:
Same: _ CAflOL YAir A/VI F _S
Address: 37 &_t?::_ N F uK<>J1/l AvE.
Cit),. State. ZIp ...7:dffHYfl-H/I..--C5 F-L '
D<<ler/ln.talter {YJA~HIJI.J_ RI ~L.,P.$
Lic, "I;I- ~()~3f'?_.
-----
Lor
IS-
Pocket Penetrometer Test
ec{)I'7AtJ
· Tell the perim.tlt' of tbe: home It aix (6) il')C.ti..U1~
· rake the l'e:adiftll at the d~pth of the foo!e:'.
· t.:.in8 ~oo La in,rement. take lowest rewn, lU\d
round dowu to that III'rm\4Jt\!.
l'
perimeter
loSt location3
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MAY-1~-00 09:36 AM MARSHALL MH INSTALLER 813 6770631 P.02
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PASCO COUNTYtt FLORIDA
Permit No, "/- <'1 <:) :>
Date Permitted '. !30~'.)()
Builder Name/Owner Name ./! c" <', t, t; t I
,
i )1'1 ,,' t 1(
" , J'~
County Parcel No. 5(/. ) ,; , ..' I Dol Ll . ,"')1 ~ Ou vO! <;
Address/Location l' 7 {.. l.j Z
A-lf 'vi \t u'-'" rt,
, J f
Subd. CO""",,! "",)1 ::1.)1>"'"
Classificationffype of Use
d \ I,.. I...
, . (,,'1 'w . 'f'
i'
t", Iii
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
Zone No.
Sq. FtlUnit
.,,0'
PrePm:~d B'y"
Impact Fee Amoynt"$ ''''Checked By
,..-
The abovyrfu;act fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the
Board,,Q'[ Pasco County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or
,or
ut~hzation of the permitted structure.
,,'/~ESOURCE RECOVERY ASSESSMENT EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No. Units
Gross Sq, Ft. (GSF)
Rate ERl' - )~OO/Year
or SO,I.+2/Dav
ERU Assign No,
Assessment - (!\io, Units) x ($O!.+21
\ (No Days)
Assessment -
(GSF)x (ERU) x (0 I.+~) x (No, Days)
100
TOTAL FEE $
TOTAL FEE $
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED VNTIL THE AMOUNTS LISTED
HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTI~G OFFICE OF PASCO COUNTY.
Acknowicdgement below does not imply acceptance of concurrence. but Simply receipt llf 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 L'SE ONL Y
TRANSPORTATION REC. NO,
RESOURCE RECOVERY REC. NO,
.>1"
DATE
DATE
BY
BY,,~
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
teecalce
PC93113094/D