HomeMy WebLinkAbout01-0235
BUILDING PERMITN~
02'35
75
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788-6611
SD"-
PLUMBING
Permit
~g{):5'O
-
Date
/1-/0 - 01
BUILDING
1S'
MECHANICAL
S.we, Cono ] ;J~
Water Conn:
Water Meter: -
Property Owner:
Job Address:
Parcel I. D, #
Zoning:
DescriPtion of Work
.E.? m.C
"7(JaD G4(L g~t/D ~
T.I.F.'s:
-
Radon Gas:
cr-
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
S-8 2. ~
Valuation or
Contract Price
€# '16J 0 gv
011/'1
~S:<- Jll9--- ':;;71; 0
BUILDING
Ftr, ,If-I" . plY R.
Pre SLB
Lintel
FRM.
Insul. CL
WL ~/Ldo, S~
ELECTRICAL /?:l..
PLUMBING gR..3
MECHANICAL ($~:2
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final /;s-,.:2..b -C ::l
SLB
Tub Set
Water
Sewer
Final '/A-.:!.h -()2. j?( '1
I~
Breakers
Ducts Insl.
Compressor
FinaIVd-~~ -t'.:l ,It'{I~
l"-tI'fi
Driveway
,RL'f
t.f;:ro
~~B-~JS-_L1-O{ 5'1C
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Twenty Five 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.
"
E.P.M.C.
7050 Gall Blvd.
Mammography
SQ. FEET PRICE
MAIN OR LIVING AREA 576 $ 80.00
OTHER AREA UNDER ROOF $ 15.00
OTHER
VALUATION $ 46,080.00
FEE SHEET $ 255.00
ADDRESS $ -
DRIVEWAY $ -
BUILDING: $ 382.50
CREDIT: $ -
BUILDING LESS CREDIT: $ 382.50
, ELECTRICAL: $ 75.00
PLUMBING: $ 50.00
MECHANICAL: $ 75.00
RADON: $ -
TOTAL $ ----_/
. --' ~~
s~ 319.50!:,VV
______~DTAL; ~ - - 4~~:~~ ~~~'
0'
WATER METER:I $ I
~8l..~ ~
\Y :\i:;,)A
~0
~~ .
Jt 1 L,O, I pG,IP'?t', r-
(b.b- , V
3/4"
I
: I
~~
/ "----
TIF'Sr
99% $
1% $
TOTAL: $
c:r~ or ZIlPB.nUaI.Ls
B'U1:WX1fG DDAa~
~'-b-()I
nAB IUl:Cl:I'VBD _
. PIAR'S Ja:V:[p I'IlI:
OWNER'S NAM.I!:
East Pasco Medical C€nter
PHONE
JOB ADDRESS EPMC - MJUmnoaraphv. 7050 Gall Blvd _ . :"ZeDhvrhills. P19rida
LEGAL DESCRIPTION: LOT(S)
PMCEL II' # ~EE ..-91'f"~#CP
BLOCK
SUBDIVISION
(OBTAIN' P'ROM' PItOPF.Jl'T'Y 'T':&."Jl' NOTTCE\
WORK PROPSED: ClNEW CONSTRUCTION
o SIGN
PROPOSED USE: [JSGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
o MOVE
CiAL'l'EAATION
o DD'lOLISB
o IUi:PAIR
o INSTALL
ClMULTI-F1\MILY
o INDUSTRIAL
0# OF UNITS
o SWI:MMING POOL
o MOBILE HOME
o OTHER
D RES'I'AU~T & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WOlUt
)llt:e:ration
BUILDING SItE
SQtJAR,E !"OOTAGE
HEIGHT
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLAN! & (2) S~TS O!" BUILDING PLANS & (1) SET ENERGY FORMs.
ATTACH (3) SETS or BUILDING PLAN'S & (1) SET ENERl;Y FO~S. A )
PROPERTY SURVEy RJl:QU~P.ED FOR ALL NEW CON3'rJ;tUCTION. I) g~;t...../
JiO 1- Rt, 1-" /'
PERMJ:TS REQUESTED
,
CJ BUILDING $ ~UAXION O!" TOTAL CONSTRUCTION
GlI ELECTRICAL ~ SERVICE 0 FLORIDA l;'OWER 0 W.R.E.C.
[! PLUMBING
IjB MECHANI CAL .$ '\OO.UATION OF MECHANCIAI. INSTALLATION
DG,As o ROOFING o SPECIALTY' 0 OTHER
TYPE O!" CONSTRUCTION: 0 BLOCK
o nwm
o STEE.L
o OTHER
FINISHED ~LOOR EL~TIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
BlnLDD.
S:IGNATURE
COMP}W''y: Poole Construction Co.. Iilc'(:
STATE CERT OR REGIST # CG"~O'7876
CITY PROCESSING # 249
SIGN
COMPANY ~Pr. V.l~cr.Tic
ST~E CERT OR REGIST # EC 0000486
CITY PROCESSINQ # 172
~*.***.*********.***.**********.**************.*************
l'LUNBD
SIGNATURE
COMPANY. H~r~eT ~p.ch~nieal COrDorat~~n
STATE CERT OR REGIST # CF -C033860
CITY PROCESSING # 383
la:c:BltlQ.UCAL
***************.**********~**********.****.*********~****.t*~***** .
. Harper Mecnan1ca corpo~at~on
COMPANy. .
STATE CERT OR REGIST # CM~~D42S48
CITY PROCESSING # 382
SIGNATURJ!:
*****************.*..*******.*..*************.****.*.*.*****..***
OTRmt
SIGNATURE
COMPANY
STA~~ CERT OR REGIST #
CITY PROCESSING #
**....****.*******.*******..*.*..*....************************.*.
coo/zoo ~
~NI ~IKL~~3 ~dV ~~~ NOI~~nH~SNO~ ~OOd CZS9Z99Lot XVd 60:Z1 IHd 100Z/ZO/ZO
c:rn 01' ~LLS
JroIUl:tHG DUM'.tNI:RT
DAB JU:CJaVJ:D
l'LMU ~ ru:
OWlaR'S N.lUa:
Ea.t Pasco Medical Center
l'RON!
L!:GAL DESClUPTION: LOT (9)
JOB ADDRESS EPMC: - MalIInoaraDhv. 7050 Gall Blvd.. .'ZeDhvrhills. Fl(Wida
BLOcK
P~CBL ID #
WORK PROPSED: ClNEW CONSTRUCTION
OSICN
SUBDIVISION
InRTll TW 1I'Qm.f DDnpP!1t'l'V .,.~y N'OTT~ \
o ADDITION
IJMOVE
U1ALTEAATION
CJ DEMOLISH
o REPAIR
o INSTALL
PROPOSED USEI OSGL ~LY DWELLING
o COMMERCIAL
DMllLTI-FAMILY
o INDUSTRIAL
0# or UNITS
o SWIMMINIW POOL
o MOBILE HOME
o O'rHER
CJ RE.'5TAURANT , HEALTH DEPARTl<<ENT Al'PRCMU.
DESCRIPTION 01' WOIUI;
Al~~"'iltion
Bun.nING SIZE
SQUARE FOOTAGE
KEIGIlT
RESIDENTIAL: ATTACH (2) PLOT PLANs & (2) SETS 01' BUILDING l'L1.NS , (1) SET ENERGY FORMS.
~CIAL: ATTACH (3) SETS OF BUILDING PIJl.N'S , (1) SET ENERGY FO~.
PROPERTY SURVEY REQUIRED FOR ALL New CONSTRUCTION.
lJ !It1ILDlNG
CI EL:ecTRICAL
l! l'LUMBING
m MECHANICAL
PERMI~S REQUES~ED
$
VALUAXION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o W.R.E.c.
$
D~
CJ ROOFING
o SPECIALTY
\I1U.tTATION or H!:~Cl:AL INSTALLlI.TION
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o S'l'tEL
o OTHER
FINISHED FLOOR EL~lONS
IS PROJECT IN nOOD ZONE AREAC] YES 0 NO
lttrUiDD
S I GNA.'1't11U:
Charles O. Poole
*.........***...*....*..........***....***......**................
COMPAJo:. P('Jt)l~ ynnRtruction Co.. Iiu:c:
STA'l'E CI!lRT OR REGIllT It CI:_m2'7A'76
CITY l'ROCESStNG # 249
EI.l:C'n\ICUN
SIGNATURE:
:PLUId8D
COMPANY ~~~ ~lA~~~'~
S~ATt CERT OR R&GIST # EC' 0000486
CITY 1>ROCESSING # 172
* **.******....****~*..*..*..***....****..*..._***...*.*......
CQMpANi- H.r~~ MAchAn~CAl Corooration
STA'l'E CERT OR RECIST * CP -C033B60
CITY PROCE!Smt; # 383
Sl:liNM't1RE
1aICJWa,QU,
......~...**...........*~..*.....*.........w...t.*~*.l******* .
COMPANy. Harper MeCn&n1ca corpcest1cn
-4~ STATE CISR'Z' OR ~GIS'l' It CM-c042548
/r {P, F-f CITY PROCESSING II 382
SI~
....**..............................**.w...............****..****
O'J:'II:D
SIGNATURE
COMl'JINY
STATE CDT OR RECiIST #
CITY PROCESSINCi .
...**.........**.*.**..**.*~..**.~.......*.****.*........*****....
COO/<:OO ~
'VJINVHJ3H HadHYH ~~~ NOILJilHLSNOJ aIOOd C<:98<:98LOt YVd LO:<:T IHd 100<:/<:0/<:0
CONDITIONS OF P!:~I'l' AFnDAVIT
A. NOT.ICE O:F DZED RES'l'JUCTIONS
The undersigned unde~stand. tha~ ~h1s per.m1t may be aubject to ~~eed re8~riction." which
may be more res~rictive ~han City re~lations. The undersigned assumes responsibility for
compliance ~th any applicable deed restrictions.
B. UNLICENSED CONT~CTORS AND CONTRACTOR RES~ONSIB~LITIES
If the o~er has hired a contractor or contractors to undertake WOrk, they ~y be required
to be 11censed 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 1aw., If the owner or intended contractor are unce~tain as to what
licenSing requirements may apply for tho intended work, they are advised to contac~ the
City ot Zephyrhills B~ilding Department, 913-780-6611.
Furthermore, if the owner has hired a contractor or contractors, he 1s advised to have the
contractor(s) sign portions ot the "Contractor SectionsN of this application for which they
will be re~ponsible. If you, as the owner ~igns as the contractor, you are indicating that
you, rather than ~he con~ractor, are respons1ble for the work. If ~he contractor wishes
you to sign as contraceOr that ~~y be an indication that he is not properly licensed and is
noe entit~ed to P.~tting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT !'US AN]) UTILITY CONNECTION FEES
D. CONS'l'~UC'l'1JION LIEN IJUf (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, ~he applicant, have been provided ~ith a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer ~ffairs_ If the applica~t i. SO~eone other that the ~ownerN, I cerify that I
have obtained a copy of ~he above described document and promise in good faith to deliver
it ~o ~he ~own.~n prior to eommebeem.n~.
E. CONTR1\CTOR' S/OWNER' S A!'I"IDAVI.T
! cer~1fy that all the info~tion in this applicatio~ 1- accurate and that a11 work will
be done in comp~lance with all applicable law. regulating cons~ruction, zoning, and land
development.
Application is hereby made to ob~ain a per.mit eo do work and installation as indicated. I
certify tha~ no work or installation has commenced prior to issuance of a pe:mit and that
811 work will be perfor.med to meet ~tanaards of all laws regulating construction, City
code~, zoning regulations, ana land developmen~ regUlations in the jurisdiction. I also
certify that I Understand that the regulations of other governmental agenciea may apply to
the intended work, and that it is my responsibility ~o identify what aotions I m~$t take to
be in eO~lianoe. Sueh agenoies 1n~lude but are not limited to; .Department of
Environm~ntal Regulation-Cypress Bayheads, Wetland Areas and Environmentally SensitiVe
Land., Waeer/Waste~ater Treatment
.Southwea~ Florida Water Management Distric~-Well., Cypre5~ Sayhea~, Wetland Areas,
Altering Wat~rco~r.es
*A~y Corpa of Zngineers-Sea~alls, Do~ks, Navigable Waterways
*Department o~ Health , Rehabilita~ive Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tank.
*U.s. Environmental P~otection AgenoY-~bestos abatement
I also certify that, if fill material is to ~e used in Flood Zone ~AH or ~A,etc.", it is
understOOd that a drainage plan addre8s1ng a ~compensating vo1ume~ will be Submitted which
is prepared by a p~ofe.sional enqineer regiseered in the State of Florida prior to pe~t
i..suance.
A per.mit iSsued shall be oonstrued to be a license to proceed with the work and not as
autho%1ty to viOlate, cance1, alter, or set aaide any proVision. of the ~echnical codes.
nor shall issuance of a pe~t p~even~ the Building Official fro.m thereafter requiring a
correction of errors in plana, construction, or violations of any code. Every po~t
issued Shall beoome invalid unless the work authorized by such per.mit is CO~nced Within
si~ months o~ i8suance, or if work authorized by the permit is suspended or ~andoned for a
period of six months after the t~e the Work i. COmmenced. One 90 day extension of t~e
may be allowed for the pe%mit with fee charge of $15.00. The extension shall be reques~ed
in wrieing to the B~ilding O~ficial. An approved 1n.pection must be logged during each six
month period, or the projeot Will be considered abahdoned.
WAlUiING TO OWNER: YOUR !"AILUl\l!: TO R.!Col\O A NOTICE OF COMMENCEHEN'l' !O\.'t RESULT IN YOUR.
PAYING TWICE FOR. IMPROVEMENTs TO YOUR PROPERTY. IF YOU r'N'l'END TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTIC!: OF COMMENCEMENT. JOBS UNDER
$2,500 IN ~UE DO NO~ NEED TO RECORD AND POST A "NOTICE OF COMHENCEHEN'l'q.
LL~AGmT SI~~R
STATE OF FLORlDA
COUN'l'Y OPO ~ C' D
The forego~n9 ip~ument Was acknow1edged
Befo~e me this \9 - dB.y of"'t=--e~\\,,)c-~, ~CX:>,
by \-( \'~'{'C'\ ~~L\~\""tl \Q , ~
. (n~e of perscn acknowledged)
ISfwho 1.5 per.onally known ~o me, or
o who has produced
(type of identirication)
and whoO cUd (2(did bot take an oath.
o. \>..~\~'-\-:\\ , ~\)Y\\,,\-,0.0'<\
~at~;re o~ person taking ackn.o-wled!1emen~
STATE OF !'LORInA. ~
COUNTY OF \ 0-..S c 0
The foregoing 1nstrumen~ w.s ~cknowledged
Before me this (0 ~d,u of ~'Ui'~~'t, ~ ~ 1
by ~ ~~'(.\ t:>" (). _~o \ 'Q.
J~ (name of person acknowlodged)
!Nho is peraona11y known to me, or
C] ~ho haa produced
~(typo of identification)
~id not take an oath
.~j, ,~
d'"",'~~';':':'.
Name typ ,?-.w..' . n~ed.lU~.Iftl~ed
~ { :' . \:~ MY COMMISSION # CC~80237
~ ..'ffJ EXPIRES: February 1,2005
'Fi:\.~':- I:.ianded Thru Notary Public Underwriters
1111"
..
COO/COO III :>NI :>nIJ.:>3'1H ~dV H-+-
Name typed,;~^P. ~eillltOlMlMI 237
~1 ~~'~.::":-dl! tXPIRES: February 1,2005
~jL. '~,9f.S~"" Eiunded Thru Nolary Public Underwriters
Nol~:>nRlSNO:> 3'100d CZS8Z98LOt XVd 60:Z1 IHd 100Z/Z0/Z0
, Legal Description
ZEPHYRHILLS COLONY CO LANDS PB 1 PG SS FOLL DESC PROP LYING
W OF DAIRY RD RfW AS NOW LOCATED TRS 105,106,119,120 &
122 & TR 103 EXC W 187 FT OF E 267 FT OF N 172 FT AND E 100.FT
OFTR 104 ALLEXC US HWY301 RIW ALLAKACOMNWCOR TR 105
FOR POB 1H ALG N LN TR 105 S89DG 56' 33" E 543.35 FT TO PT
100 FT W OF NE COR TR 105 TH NOODG 09' 03" 901.24 FT TO N
LN TR 104 100 FT W OF NE COR TR 104 TH ALG N L TRS 104 &
103 S 89DG 55' 34" E 480.69 FT TH SOODG 10' 45" W 172.90 FT TH
S89DG 55' 24" E 172.01 FT TO W LN DAIRY RD RIW AS NOW LOCATED
TH ALG W LN R1Q SooDG 10' 45" W 1137.22 FT TO S LN TR 122
SEING N LN DAUGHTER RD RfW TH ALG N LN RfW N89DG 59' 30" W
552.04 FT. TO SE COR TR 122 TH N OODG09' 03"E 316.21 FT TO SE
COR TR 120TNN89DG56' 31"W645.18FTTOE LNUSHWY301
RIW TH ALG E LN RIW NOODG 18' 30" E 562.80 FT TO POB
LESS THAT PT TR 122 LYING 30 FT N OF~OUTH LINE SEC
""'" "'" "'" "'" '1111 """"" '1'" "'" """'11 ""
2001015267
This Instrument Prepared Uy:
Nome:
,Ad"dress:
Rept: 472486
DS: 0. 00
02/06/01
Ree: 10.50
IT: 0.00
Dpty Clerk
Permit No.
NOTICE OF COMMENCEMENT
i~90;~~IMA~: r,;;O fOUNT:f C~ERK
OR BK 4531 PG 1881
STATE OF ?~fJ'9 .
COUNTY OF ~ __ .
2.
TilE UNDERSIGNED herby gives notice that improvement will be made to certain real
property. and in accordance with Chapter 713. Florida Statues, the following
information is provided in this Notice of Commencement.
1. Description of property: (legal description of property. ~nd street address if
available)
~G:A~ JlHeZY;(/4~ Aff~.#~
General description of improvement:~r~AIl'tJ hfE.P/~..A~ e'~/.,Q.
Owner information "'A.p~.eA;'#1 NA79'#tJ" /~ Jf'E#U/'A'APJ,,(/ .fl~AItItIA;QJ"'/
a. Name and address: ~AJ'r /lAst/) /1'I.tP/~ c (~.N7r4
7p!rll G,qu.. ':#~II.P - Ze,,;?-N)'A'N/t./S' ~ f~.F~1
b. Interest in property: ~IJJ Nel.,(!.J.I/ CFo '
c. Name and address of fee simple titleholder {if other than owner}:
3.
Ii ,. CooCoseco", 'o~c ~d oddoe.s)
5. Surety
a. Name and address: AI~
b. Amount of bond $ JVJ7
~,,~ ~AlSY'R~'7/4t4/ (10 ~~
~9~ ~()lIt~~ ~II'I'I'''~
A~7A.M'A71 ~/Z/P?-': :Ie, .:I.2.'7/~
G. Lender: (name and address) ~
7. Persons within the State of Florida designated by Owner upon whom notices or
other documents may be served as provided by Section 713.13(1){a)7. Florida
Statutes: (name and address)
8. In addition to himself. Owner designates the following person{s) to receive
ti copy of the Lienor's Notice as provided in Section 7l3.13(1){b).Florida
Statutes: (name and address)
9. Expiration date of notice of commencement (the expiration date is 1 year frolll
t e date of recording unless a different date is specified)
1
Owner's Address: ~~ gALl -B~tJ..D.
ft#A.€D $~8.l?
{Print Owner's Name}
- ..z:c~.R$,.(.t~ ~L. f~.:r~/
before me this~/~/~by
known~who produced f\.J \ 'if\:
The foregoing instrument was acknowledged
\.{ \ ~~ d ~~\'~ \c\ who is Gonally
as identification and who did not take an oath.
. State of Florida County of ~ C. ()
U \ ""'''~,\~ ~~~ My Commission Expires:
-~ry)
Commission /I C. (. ~t:.-od.'3 '1
c2- J- 05
r
(~t~f~)
.;,.@~~,.
....9f,,~\,'\
JUNE M. HERNDON
1J,y COMMISSION # CC 980237
tJ\PIRES: FebruaIY 1 2005
aonded Thru Notary Public U~8fWm.rs
All Information Must Be Typed or Printed Legibly
to Comply With Recording Requirements
. Legal Description
ZEPHYRHlLLS COLONY CO LANDS PB 1 PG SS FOLL DESC PROP LYING
W OF DAIRY RD RIW AS NOW LOCATED TRS 105,106,119,120 &
122 & TR 103 EXC W 187 FT OF E 267 FT OF N 172 FT AND E 100.FT
OF TR 104 ALL EXC US HWY 301 R/W ALL AKA COM NW COR TR 105
FOR POB TH ALG N LN TR 105 S89DG 56' 33" E 543.35 FT TO PT
100 FT W OF NE COR TR 105 TH NOODG 09' 03" 901.24 FT TO N
LN TR 104 100 FT W OF NE COR TR 104 TH ALG N L TRS 104 &
103 S 89DG 55' 34" E 480.69 FT TH SOODG 10' 45" W 172.90 FT TH
S89DG55' 24"E 172.01 FTTOWLNDAIRYRDR/W AS NOW LOCATED
THALGWLNR/Q SOODG 10' 45"W 1137.22FTTO SLNTR 122
SEING N LN DAUGHTER RD R/W TH ALG N LN R/W N89DG 59' 30" W
552.04 FT. TO SE COR TR 122 TH N OODG 09' 03" E 316.21 FT TO SE
COR TR 120 TNN89DG56' 31"W645.18FTTOE LNUSHWY301
R/W TII ALG E LN R/W NOODG 18' 30" E 562.80 FT TO POB
LESS THAT PT TR 122 LYING 30 FT N OF~OU1H LINE SEC
OR BK 4531 PG 1882
2 of 2
STATE (,t r! CY'.'i JA
COUNTY OF PASCO
THIS is TO GERT!!'Y THAT THE FOREGOING IS A
TRUE AND 1~().:i.R.EGT.CO f''r (,I.' 1.}. IE.OOGUM~m . FILE
OR OF PUfH,(: flECORn ,i\; I.':IS OFFIGy S5 MY
~) ND OH'/CIA'. Sl'"~-;:~~ AY OF
JED MAe,), " ':!"~CUIT COURT
BY. . ,. DFPUTY CLERK