HomeMy WebLinkAbout01-0391
BUILDING PERMITN~
Inspector
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Company
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CITY OF ZEPHYRHILLS
(813) 788~6611
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
:~:::,~=~.'~/9'~~~~ g~ qAi~
Parcell.D. # 03-;t?~/-OtJ;~- 00000- 0.:250
Zoning: ~e::m Radon~
D7/0J:" of Wo<k / '5.:' F ~./, ~~
7.. a 0 I l,rJ~ 10: '-fo S "e,/
FINAL
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O,
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
~ iJ I 000 -
0391
Permit
Date
L - :2~ - 0 I
Sewer Conn I ~ ?' ri ",
Water Conn: ,:350
Water Meter: /9D
T.I.F.'s: II/to'
'~-hh-c '~/9'l'~
DATE
City License Registration # :1 ~;:Ll
State Certified License#
Address I
-~~~)
celePhone#
trrJ~
PLUMBING Ito9
c
J.L ~ 0A4vJ(~91t:
~~t1M-.
(LECTRICAL /? 0
BUILDING
77<7' 3516
Q~ WiW
/lJ:.
~ECHANICAL I?
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
r/IJA'- ~-/g'~OI-S.e..
Driveway
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final ?' - / :f - 0 I 5 l?.
SLB
Tub Set
Water
Sewer
Final 7 -I ~ - 0 I 5 I(.
Breakers
Ducts Insl.
Compressor
Final 1'-11-o/'S~
~
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, ddi -Jo-"" ILL ~
charge of Twenty Five and 00/100 Dollars ($25.00) shall be made for each trip for each trade: tJ~l- l-7"
.(;J&
a. Wrong Address
b. Condemned work resulting from faulty construction, ~
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919
ol-3::2?3
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
OWNER/
RENTER
WATER ACCT. NO. DATE h - ;2:;1:- 0/
\~~ ~t:~~f:.i W~~
3-if?Sf -~/f tJ
MAILING
SERVICE ADDRESS
SHUT OFF SERVICE 0
TURN ON SERVICE ~,
INSTALL METER ~
READ METER 0
CHECK METER 0
OTHER 0
o SEWER
o GARBAGE
~' IN CITY
o OUT CITY
-L No. OF UNITS
_ DEPOSIT AMOUNT
f'1 AJ '*- ~
_ AMOUNT LAST BILL
..~
~
_ DATE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
Retain white form in office at all limes.
Send pink & yellow forms to Water Service Dept.
Water Service Dep!. to sign yellow form & return to office.
~
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 B~ STRBET ZEPHYRHILLS, PL 33540
Phone:B13-7BO-0020 Fax:B13-7BO-0021
DATB RBCEIVED t. --- .:2:2 - 0
PLANS REVIEW FBE
OWNER'S NAME \Y).q ~ c.. E. ~ 'Do \ "I?$ .s l,)G, KD E-C~
JOB SITE ADDRESS 3 -, 7/7 N 1. wC\.l 1'\(\ ~ 2. ' 1-+1 \ !"j I
PHONE CONTACT('6I~) 7 ?:;....3SIQ
-f-Io tl. I r:;Jf\ 33541
~5
BLOCK
SUBDIVISION
.~p I ~>j
'-~pf\'lft j(.(h'rf:..
LEGAL DESCRIPTION: LOT(S)
PARCEL ID #
03 - ;;<G,. <). 1- ("C':l3()-CX.:r:::OO- , '...:.lS('l
~NEW CONSTRUCTION o ADDITION
DSIGN 0 MOVE
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED:
o ALTERATION
o REPAIR
o INSTALL
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING
DMULTI-FAMILY
0# OF UNITS
o SWIMMING POOL
~OBILE HOME
o OTHER
o COMMERCIAL
o INDUSTRIAL
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
-- .\.- ' I (~y . I I.
DESCRIPTION OF WORK .if)':") '-\ \ \ y').,t-,' ov, ~~ v), ' \""10; low ro'l"t~f...
;":;C611 s \..1
BUILDING SIZE
SQUARE FOOTAGE I I 3 '6 7
HEIGHT
1;;:'6
C~'__~.~!P~~~~~~ ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & ( 1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
)?j BUILDING
~ ELECTRICAL
9ii PLUMBING
'it. MECHANICAL
$
1JO,ooo
~OD
o c.)
AMP SERVICE
VALUATION OF TOTAL CONSTRUCTION
~/ W.R.E.C.
o FLORIDA POWER
$
\ I j('O 00
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
~ OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES )( NO
BUILDBR ve60MPANY Go ~ O~ "\ e..Avl:5~od
5=1? ^ 0 .lV\J\ f STATE. CERTOR. REGIST #
SIGNATUREU y.eIU)'l.I\fL ~. ' I VV\OLl'") CC~ PROCE:Ss-:i:NG:,r----,-_
****************************************IF.......**"*"*~~*********
ELBCTRICI~
SIGNATURE ~ Jf. ~ ~
COMPANY 3""Ore.OO(')
STATE CERT OR REGIST
CITY PROCESSING #
PLUMBER
SIGNATURE ~ ~ ~~
OTHBR
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAV~T
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 undersi9ned 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 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 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".
~~~~
SIGNATURE: OWNER OR AGENT
~ tJ(! ~
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF ?ASr..-",
The foregoing instrument was acknowledged
Before me this~ day of ;:Y1..uJe-. , ~~\
by
(name of person acknowledged)
~ho is personally known to me, or
STATE OF FLORIDA
COUNTY OF .:p ASi'"' D
The foregoing instrument was acknowledged
Before me this ~day of <J(l_4..I~ , -- &ol
by
(name of person acknowledged)
~o is personally known to me, or
o who has produced
(type of identification)
and whoD did gt(j.d not take an oath.
'j1;nk~ -a. ~
Signature of p rson tak1ng acknowledgement
o who has produced
(type of identification)
and who Ddid Bfid not take an oath
r:u?f!.L~~~" &,n. ;'"}"
Signature of pe son tak1ng acknowledgment
Service & Bonding Co
t:A/JILEE::A1 c""T. ~(NAl
Name tYPf~Print:@d' or
,,'....:...".. ;(.YI::1' ::eN I BROW' N
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~y.." " ,)\IMI:;s:n~:# CC S25.69
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PASCO COUNTY, FLORIDA
SCHOOL IMPACT FEE
Ordinance No. 01-06
Effective: February 28, 2001 at 2:08 p.m.
Permit No.
0.39/
~ 'I
Builder Nam~ner Na~ 'tk-lJ,./li2, r
Date Permitted: 6..,.:2.-a. - 0 I
(1~1,... C/lL q AlPL
Parcel 10: S t7~ T M R 0/.../ Sub.OtJ~V Blk~tJOOLot O.:J.SO
Address/Location: ~ 7/f /9 7'?..€l.V...L Ck...
Subdivision: Zri~ G?+)
ClassificationlType of Use:
o Single-Family Detached House
>eC Mobile Home
o Other Residential
o Collection Fee
(056)
(057) t /g7
(058)
(123)
$ h /89~
Exempt:
Total Fee
Yes X No
How Determined:
Prepared By:
Checked By:
The above impact fee has been established pursuant to the Pa$co County
School Impact Fee Ordinance No. 01-06 as adopted by the Pasco County Boar
of County Commissioners. This amount is payable PRIOR to the issuance of a
Certificate of Occupancy or where a Certificated of Occupancy is not required
PRIOR to the final inspection.
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL
INSPECTION PERFORMED UNTIL THE TOTAL AMOUNT LISTED HAS BEEN
PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF
PASCO COUNTY.
Acknowledgement below does not imply acceptance or concurrence, but simply
receipt of a copy of this form, placing the building permit owner on notice of this
assessment and the conditions of payment for same.
QJL;~~~
F~eceived By
6'''~:l-01
-.--. -~-_._~--
Date
OFFICE USE ONLY
RECEIPT NO. //97/(4 DATE~' 2..:2-01 BY
White Canary
Customer Finance
Green
School Board
Pink
Inspection
PC01045114
']~~:j':'~:;~~)'""'i~'" :;~;,. '
PASCO COUNTY, FLORIDA
SCHOOL IMPACT FEE
Ordinance No. 01-06
Effective: February 28, 2001 at 2:08 p.m.
Permit No.
,-:' I
,~. "1'.'
.. ".,~
~.. .",...:, _..1'"\
I
Date Permitted:
Builder Name/Owner Name' ,
'(.~ .t
'i'-..-'
ParcellD: S
T
R
" I
Sub.
Blk.
Lot
.... .' ,....,>
Address/Location:
/ J
, I .I
Subdivision:
j
,< "<-../
Classification/Type of Use:
\
a.- Single-Family Detached House
>& Mobile Home
a Other Residential
a Collection Fee
(056)
(057)
(058)
(123)
, ;/"
Total Fee
$
/ . /"7 .:..-
..
Exempt:
Yes
"
"...
"
No
How Determined:
Prepared By:
Checked By:
The above impact fee has been established pursuant to the Pasco County
School Impact Fee Ordinance No. 01-06 as adopted by the Pasco County Board
of County Commissioners. This amount is payable PRIOR to the issuance of a
Certificate of Occupancy or where a Certificated of Occupancy is not required
PRIOR to the final inspection.
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL
INSPECTION PERFORMED UNTIL THE TOTAL AMOUNT LISTED HAS BEEN
PAID AND RECEIPTED FOR BY ACENTRAL PERMITTING OFFICE OF
PASCO COUNTY.
Acknowledgement below does not imply acceptance or concurrence, but simply
receipt of a copy of this form, placing the building permit owner on notice of this
assessment arid the conditions of payment for same.
~.I J't.
Date
Received By
PC01045114
4
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PASCO COUNTY, FLORIDA
Permit No.
/
Date Permitted
,. ..~ -"'~-
I
--..,...
~
Builder Name/Owner Name
County Parcel No.
/ ....
Address/Location
l
Subd.
--,.
?'
Classificationffype of Use
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
Zone No.
Sq. FtlUnit
Impact Fee Amount $
Prepared .IJY
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
/
NONRESIDENTIAL
No. Units
Gross Sq. Ft. (GSF)
RatL' ERU - 52.00/Year
llr $0.142/Day
ERU ASSIgn No.
ASSL'SSTllL'llt- (No Units) x ($0.142)
x (No. Days)
Assessment -
(GSF)_x (ERU) x (0.142) x (No. Days)
100
TOTAL FEE $
TOTAL FEE $
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSlJED UNTIL THE AMOUNTS LISTED
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY,
Acknowiedgement below does not imply acceptance of concurrence. but simply receipt uf 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
----- -------------------------------------------------------------------------------------------------------------
OFFICE l'SE ONL Y
lft.-'..
TRANSPORTATION REC. NO. ",; 0(';'". ":j I
'_/ ....I 7 .._.1
RESOURCE RECOVERY REC. NO. ..-j ,],\ /
DATE
DATE
.r : /' Q /
BY
BY ,~~-~ ( / t
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecalce
PC93113094/D