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Home My WebLink About00-9567 BUILDING PERMIT 1-/0;'" BUILDING ,. CITY OF ZEPHYRHILLS (813) 788-6611 ~.~ PLUMBING Permit 09567 ~5 .- Date ~ - 02;:2-0 {) ELECTRICAL d)3 MECHANICAL .(';- Sewer Conn ~ C2. ~ -d , . - ~ Trl';:- Water Conn: ~!JO a.E~t7FMIIi Water Meter: /<;!L? - lJ;~O- , , T.I.F.'s: Property Owner: Job Address: Parcell.D. # FINAL Zoning: Description of Work {l 00 ~.{4 . ". &1~A.5€ /I: 00 4.)1.\ - 11;0 (" w~f' 1-1) 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. c.o. City License Registration # State Certified License# ~~ Permit Fee ~ Company Address ~hone~ (~~ -- PLUMBI . - Valuation or Contract Price ---_._,~ -;&-a-jfU BUlL G a <( I~",,~) ELE TRICA~.r' d?~~ ~ -l~/7 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 ($ 25.001 shall be made for each trip for each tr~ a. Wrong Address ~~~ l.JL K.e&ir 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. . ~ L1~ The payment of inspection fees shall be made before any further permits will be issued to the person owning same. OWNER'S NAME ;.j I tC :I-rrl-~<:,kk JOB ADDRESS wi ~ J-/lo K\d~~ Dr iY-€- LEGAL DESCRIPTION: LOT%ff,:L... BLOCK SUBDIVISION PARCEL ID # :, - L~ -21-0 130-('){YY)() ~ coello APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPAR'DdENT DATE RECEIVED (p .- cf2.;2'- D D PLANS REVIEW FEE PHONE (OBTAIN FROM PROPERTY TAX NOTICEI WORK PROPSED: ~W CONSTRUCTION o ADDITION DALTERATION o REPAIR o INSTALL DSIGN o MOVE 0 DEMOLISH PROPOSED USE: ~GL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS o MOBILE HOME o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER DESCRIPTION OF BUILDING SIZE RESIDENTIAL: COMMERCIAL: ~ BUILDING ~ ELECTRICAL 9 PLUMBING Izi> MECHANI CAL o GAS o ROOFING D RESTAURANT WORK ~4 N~ d~ 'f-Z5U & HEALTH DEPARTMENT APPROVAL '(Y)c)b~le l-tG'YLL-e SQUARE FOOTAGE j 460 HEIGHT 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. 8ERMITS REQUESTED $ d I?-J)D (;) VALUATION OF TOTAL CONSTRUCTION c90l:J AMP SERVICE 0 FLORIDA POWER ~ W.R.E.C. $ VALUATION OF MECHANCIAL INSTALLATION o SPECIALTY o OTHER ~ OTHER IS PROJECT IN FLOOD ZONE AREAD YES o NO TYPE OF CONSTRUCTION: 0 BLOCK 0 FRAME FINISHED FLOOR ELEVATIONS el4 II BUILDER SIGNATU~ ELECTRICIAN C=c SIGNATURE ' PLUMBER SIGNATUREq- o STEEL c --c:::::: COMPANY e '5. ~TATE CERT OR REGI ST # .::c C~TY PROCESSING # ~J' ****************************************************************** COMPANY (!-IN-:b,er\U'f) c Ice?, i'~ STATE CERT OR REGIST # CITY PROCESSING # ~~ (~ ~~~. ****************************************************************** ~ti.eeI~/elds # ::r: 11- t)OCX)O - ~ 0 , -- COMPANY STATE CERT OR REGIST CITY PROCESSING # ~>--~ -- ....~~** * ** * *** *** *** ** * *** *** ***** * ** **~~:,;;;~* *t;Fl'he.s* (1;;'; '+ *i!..r&A-n~ ;;:::;r- .-=::::> STATE CERT OR REGIST # SIGNAW:': - ----'<c - c ~ _ CITY PROCESSING # I '1 OTHER ***************************************************************** COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ********************************************************.********* .......U.1'(L'...1...l.J..Vi'll~ V.L.: .t:-..L::.lJ.:"\J."i...L.L .l-\..L;.l:.J...v.l-I..V....i...!. A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to "deed restrictionsH 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 SectionsH 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 GuideH prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "ownerH, I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "ownerH 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 "AH or "A,etc.H, it is understood that a drainage plan addressing a "compensating volumeH 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:Rn Tn ~~~AND POST A ,"NOTICE OF COMMENCEMENT', <C c:;~, ~~ /'---' (~~ SI~TURE' OWNER OR AGENT SIGNATURE, CONTRACTOR - - - STATE OF F~O COUNTY OF The foregoing inst~ent was acknowledged Bef~his ~r5' day.., of "Y u...Il~ , ~CD by ne_----K~ ~ ~~ (name of person acknowledged) ~ho is personally known to me, or STATE OF FLORIDA ~t.~ COUNTY OF ) The foregoing i~~Jffient wa~ack~owledged Befo~ this dJ~ da.Y of . l,I") , ~()O by e ~eJ)-€" ~ -t'... .~ (name of person acknowledged) ~o is personally known to me, or o who has produced (type and whoD did Ddid not of identification) take an oath. Dwho has produced (type of identification) and who Ddid [):lid not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped ft1) ft1 ~ A,..J r/I DP f{ f)~ /....G{ 1tp Z.EPA(~ R,D&:.E: . ~--='r I I i i i i i I - ~ ~i~ :1 .!,~ DXI. ~hEO D : ~ ~I ~ l, .:t , ~l)-) ~IW .. _.__....._. _n_._._...__ .__......_. , - - ---... I :JP Ll.8' ~jpc,.,/u.1(, ", ~ ~ v 00. '\ I iDO' ~~; ~/I(P l R= EJ PERFORMANCE BUSINESS PRODUCTS. INC. 813-71l1-8008 FAX 813-719-191D CITY OF ZEPHYRHILLS ZEPHYRHILLS, FLORIDA 00-3c;?'u WATER ACCT. NO, DATE ~ - c:2~-OO =~ (fY 9'-7? MAILING SHUT OFF SERVICE 0 TURN ON SERVICE ~- INSTALL METER V-~ READ METER 0 CHECK METER 0 OTHER 0 o SEWER o GARBAGE ~ o OUT CITY .-L No. OF UNITS _ DEPOSIT AMOUNT _ AMOUNT LAST BILL ~ ---if" N ~u. .A??~ -,,, _ DATE _ MISe. CHARGE 0..:..... --~~"'..o-.._ WORK COMPlETED BY & DATE COMPLETED ORDER TAKEN BY Retain white form in office at all limes. Send pink & yellow forms to Water Service Dept. Water Service Dept. to sign yellow form & return to office. ,~ N ," "' ~ 1: o l!. !.II ..J () ~ '.!l '" i i -- )--f.~' 't'....,..~-' -.-..... , ! i ~ i I , i! ! ! ! I ; 1 i; ; " ! ' : ! ... .,'>..,.- ! 1 '.1 1"\[! , I' i Ill' p/, ,~'''''.''c..";:;,",.........__... i! l:.; 1 " ': j-I! \ ; \ " i !I I!""' ! I / M \\ '. i f-li) < ,.,. /\ \ I,! < I .. ,; ! ' 't"l.O r ~i PASCO COUNTY. FLORIDA - Permit No. Date Permitted _ Builder Name/Owner Name --~"--- County Parcel No. Address/Location Subd. ClassificationfType of Use How Determined \ ~ TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 Why? Rate $ Zone No. Sq. FtlUnit 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 No. Units / NONRESIDENTIAL Gross Sq, Ft. (GSF) Ratc ERL' - 5J,OO/Ycar or SO.I~2IDav ERU ASSign No. Asscssmcnt - (No Units) x ($O.I~21 x (No Days) Assessment - (GSF) x (ERU) x (0 1~2) x (No. Days) 100 TOT AL FEE $ .. iff/" TOTAL FEE $ NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED VNTlL THE AMOUNTS LISTED HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. Acknowledgement below does not imply acceptance of concurrence. hut simply rCL'l'lpt of 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 "~riJ ~ 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 Bldgllnsp feecal"ce PC93113094/D