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Home My WebLink About01-0050 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.-6611 Permit 00 S- 0 '/']/01 , s U. ?!' BUILDING E~ICAL PLU~G MECH~CAL Property Owner: Do 11 '" <A ~ "" + Job Address: 4 '1 ~ t...( I qo S'+. Parcel 1.0. # l"-t. 2b- Lt. 00(0- 00100- OIJO Date Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: DescriDtion of Work _((.e .- 11' 00.( Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector ~ City License Registration # State Certified License# ~09 Permit Fee - ~' ,.... Signature ~ . t:'(4I'~t') Company Address - Telephone# ~S'O.- ~ '/fY Valuation or Contract Price ss- 00. ~ . }k~~ ~o4--.T.'-l j~/~d Reo,{-.''''5 BUILDING S 6 ELECTRICAL SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts In I. Compr ssor Final Driveway RElNSPECTJON 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 ~V) ~IVED PLANS REVIEW FEE JOB ADDRESS floY! rt Q tlf3if ~tZr1 -f / fA .s'r PHONE 79,2~GY?3 OWNER'S NAME SUBDIVISION /Y) OOrP oS 1ft! d . LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL ID # / i -cl~ .....0{ / -CO/O - 00/0(.1 ~ 0/ sO (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: DNEW CONSTRUCTION o ADDITION DALTERATION o REPAIR o INSTALL DSIGN PROPOSED USE:~SGL FAMILY DWELLING o COMMERCIAL o MOVE o DEMOLISH I< tfE1260F DMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER DESCRIPTION OF WORK D RESTAURANT & HEALTH DEPARTMENT APPROVAL f(f..YOof- - ,':,~A(/&s SQUARE h SA('l,/~\ FOOTAGE <- ~ 0 ~ I PLANS & (2) SETS OF BUILDING PLANS OF BUILDING PLANS & (1) SET ENERGY REQUIRED FOR ALL NEW CONSTRUCTION. HEIGHT BUILDING SIZE RESIDENTIAL: COMMERCIAL: ATTACH (2) PLOT ATTACH (3) SETS PROPERTY SURVEY & (1) SET ENERGY FORMS. FORMS. rJBUILDING o ELECTRICAL $ s s-ooc:!!- PERMITS REQUESTED VALUATION OF TOTAL CONSTRUCTION AMP SERVICE o FLORIDA POWER o W.R.E.C. o PLUMBING o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION o GAS ~OOFING 0 SPECIALTY TYPE OF CONSTRUCTION: 0 BLOCK o OTHER o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES o NO SIGNATURE &L~/ COMPANy#lYlt! -4;{)1..xl>~~ ~n~ ' STATE CERT OR REGIST #. ) '~ ~ ,- ((7 CITY PROCESSING # BUILDER ****************************************************************** ELECTRICIAN !VA COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** PLUMBER SIGNATURE /J/A- COMPANY STATE CERT OR REGIST # CITY PROCESSING # **********~******************************************************* MECHANICAL SIGNATURE /1/71-- COMPANY STATE CERT OR REGIST # CITY PROCESSING # ***************************************************************** OTHER jt/~ COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** CONDI~IONS OF P~RMIT AFFIDAVI~ A. NDTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be su::>j ect 1:0 "deed restrictions" which may be more restrictive than City requlations. Th,~ undl~rsiqned assumes responsibility for compliance with any applicable deed ,r:est:rictions. B. UNLICENSED CONTRACTORS AND CONTR;!\'CTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to under'take 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 mmer 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 son~one ot:her 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 regulat:ing construction, zoning, and land development. Application is hereby made to obtain a permit to do ~~ork 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 1:0 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~E DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". ~4~ SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR acknowledged 19_ STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____day of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____ day of by acknowledged 19 (name of person acknowledged) Dwho is personally known to me, or (name of person acknowledged) [1ho is personally known to me, or o who has produced (type and whoD did 0 did not of identification) take an oath. o who has produced (type of identification) and who Ddid DUd not take an oath Signature of person taking acknowledgment Signature of person taking acknowledgement Name typed, printed or stamped Name typed, printed or stamped , ' I, 111111111111 11111 111111111111111111111111111111 11111I1II111I 2001006949 Rcpl: 468193 OS: 0. 00 01/18/01 Rec: 6.00 IT: 0.00 Dpty Clerk TO DE COMPL.f.TCD IF CONS"fJ{UCnON . VAL.UE EXCEEDS $2,500.00 JEO PITTMANd PASCO COUNTY CLERK 01/18/01 00: 34am 1 of 1 OR BK 4519 PG 1899 Permilll Tax Folio 1# /'1 - JC; - ,),/- 0010 - 00/00 - 0130 OFFICIAL NOTICE OF COMMENCEMENT Counlyof !b.SCc) .:"....... .,. Slille of Florida "iHf f!IHf:rJOlrJG IS A '/ICI!iALI\lT ON i'U,[ !ICSp,','"!:ll\iF5S MY i"'~' ,'12.. OF :';:";, :~f' ~l "--. , 1':I(C!Itu)~1 ("I' ;:-q!( UI"; THE UNDEHSIGNED hercuy gives nulice lhal improvemcl\l will Ul' IIIi1d,. 10 "I'J lidll 'l'.d properly, and in accordance wilh Chapter 'lIJ, Florhlil Stalules, lhc fullowillg illlllllll,Iliilll i~, provided in this Notice of Commencement. 1. Descriplion of properly: !fIQr;2- /)~~ /t1. 8 I Ptf-.s-2 . if 1-3. L/ I 'I u... . ~T.. 2 f ),,'^ _~/1s F L 33S'TV 2. Gl!llcral descriplion of impr?Velnf.!nl: -Ct:vvd-f 3. Owner lnformalion: ~ /"..l' l:l A. Nilme and ilddress ..J)OJ\t\Cl U " I ~? sf 11.. cS T, B. lnlcrcst in properly: ~UJ n.u- ~Y.fJ...,"lls ,F't.- 33S-?'O C. Nilnle ilnd ilddress of fee simple lilJdlOJdc.' (if oll\f.!r lH.11\ UW/H.I,.) ~e ~od 5;;~/</lerl };;pl.,?...----- ..207 Kel{ ('Ill ~n =-.5UIIe 6- J f;/'"t!^ I Fc. 3J~/1 ~ Conlraclon..~t: ~{d ~jress: 5. Surely (if required) A.' N <lme ilnd address D. Amounl of bond $ G. LCl\ucr name ilnd ilddrcss: --.. '-__I . /. Persuns wilhin lhe Slille uf Fludd" df.!sigl\i\lcd LJy OWIIL'I' "pUll IlIIli,',,:; III IIlf'I'1 documel\ls may be served itS provided LJy seclion 71J.1J (I) (il) 7 Fltnid.1 ~jl..llIll'." Nilme ana address: 8,. In "ddi lion lo I~imself, Owner design," les ,__ __ _ _. . I" "', . 'i ".' (, lUPY of lhe LIenor s NotIce ilS IJrOVlllcu 111 SecllOn 71J.IJ (1) (u) HlI.idd !jlil(lIl,':" 9, Exp! r" lion d" Ie ofN olice of COl11l11encel11en t (Ille ex pi rilli 011 d;, II' ;:; ." 1<' ( I) )" ',II from the dale of recordlllg unless .1 dlfferenl dille is spcci(icu) . 199_. Sign"lure of Owner or AUlhorized Agen~--Z-e? ~:' Z>t:J/1'14 GI'I f Sworn lo and subscribed before me lhis /5 day of TnYlIJ.~':l 11-99-_. 2..061 ~.~ Notary Public .-.- My commission expires: .' -:Jo,rtuo..ry {, ZooS- ~DON GOODSON A 'l!. My Camm Ellp. 119105 PUBLIC No. CC 971863 //P.""".'''I ~"'''''"~ - -----.-.-- --.-------.