HomeMy WebLinkAbout01-0150
BUILDING PERMIT~~
0150
CITY OF ZEPHYRHILLS
6:2 ..- (813) 788-6611
10< 5 (p-
0-, IO..-,--.__.~.j.~ ~.".,
~ ~RIC~ ~ M~
P<aperty ownQ~: W41l'; i tJ4H<!Al~L-
Job Address: ij q ~ 0 - ~I C). .. ~ .
ParceII.D.' /'3-;26-.!2./- nlYlO- ()'l'/lIJO- l)t:)t?)O
Permit
Date
~ - :2'1-0 I
.
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
=;d"13f~1q-;~~~#~ 1Y~
FINAL
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
/D I, o8tJ '
-&
Inspector
Company
Address
0elephon~ g'1.3 -P?S"'/- ~G)3 "/
~E~ ~.
~~ T'RICAL. · 5/fO Pl::M .... '
/J/i
City License Registration #
State Certified License#
~1Yl!t)~~
~A5.
BUILDING
-~~-
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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 Twenty Five and 00/100 Dollars ($25.00)lshall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from falillty 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.
~
I
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 813-788-6611 FAX: 813-788-1516 ~ _ 2../- 0 /
DATE RECEIVED - -
PLANS REVIEW I'BJIl
JOB ADDRESS SI~~tI
filflf/~/<.. &Jft'/OP o.{ /J#1E"f'/;"
(/ .
;;? a.d ..r/Ie EE r ;:? t€ ~.JYA'4t d ,r L
, , /'
PHONE
~/s-7?J--/9S7
3' 3' .g-.P(:J
OWNER'S NAME
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # /.3 61~;;? / CIa 70 0 7~C7cJ
t'o~ CJ (OR'I'ATN FROM PROPF.R'I'V 'l'AX NO'l'Tr.F.)
WORK PROPSED: DNEW CONSTRUCTION o ADDITION ~ERATION o REPAIR o INSTALL
DSIGN o MOVE 0 DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS o MOBILE HOME
o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER
DESCRIPTION OF
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
WORK ./~21~k,.,~[hd~~~~~.
SQUARE FOOTAGE HEIGHT ~~
BUILDING SIZE
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.
~UILDING
~LECTRICAL
~LUMBING
o MECHANICAL $
PERMITS REQUESTED
/t? / / a 00 VALUATION OF TOTAL CONSTRUCTION
,
$
o GAS
o ROOFING
o SPECIALTY
o OTHER
o W.R.E~ ~
VALUATION OF MECHANCIAL INSTALLATION ~ ~/
,A~.
8""13 -- ~!b1r-/~.;l7
T4~ tfJ3 --;;<~S--07JY
o
FLORIDA POWER
AMP SERVICE
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL .
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
"'~]iig
BUIWn Qt/~ COMPANY ~ .#J k,I,//;##5-fbri/lc/(JA'S. .
/ . STATE CERT OR REGIST # rtr cd ~~ gr
SIGNATUR . CITY PROCESSING i L'/~ -#-~.~~/
****************************************************************** ~
JIlLJllCTRICIAN "A COMPANY E, r A..EA E/i{!#/~,,9/ tIJ~,.,dtWJ.:u){,1
~~ ~~ STATE CERT OR REGIST #
SIGNATUREV- 1- - --. CITY PROCESSING * ~~._JJa
****************************************************** . ~~***
4 ' COMPANY IVAllJJt/H/}///1 CJ .7/T/C-
r/. STATE CERT OR REGIST # <~
,~. CITY PROCESSING * ~
**************************~ ***** .. . .
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
PLUMBER
SIGNATURE
MECHANICAL
SIGNATURE
*****************************************************************
*******************
OTHlilR
SIGNATURE
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" whi~h
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
WIT LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
,500 UE DO NOT NEED TO RECORD AND POST NOTICE F COMMENCEMENT".
r
CONTRACTO
STATE OF FLORIDA /:J
COUNTY OF l Y~t(!J
The foregoing instrument was acknowledged
Befo~ this ,;j /day 9tA ' d !<.oD /
by ~E'/.l "'_" LilJ.I#f?Af/
l./. (name of person acknowledged)
~o is personally known to me, or
o who
o who
Name
Signature of Derson raking acknowled
,,'UI~ "'80\)018 ~wetJ]l1a
f~~ :"'f~ MY COMMISSION' C~~ EXP\IteS
. ~~TfR amped
I
FILE No.206 02/23 '01 10:45 ID:DIXIE SOUTHERN FAX:863 984 1825
'Feb.2i. 2001 2;45PMCI:!I!~T'~EF ~~~~~l~~u.s PJ:RNZ!! AnL:r~~~14 p. 1_
BlJItDntG ~u.!MDl'r 813 "HI!! 'ill OX;81;:l-,., LfU -(60-l-~_J- J _ I
-, f0 - ~()~ t,) nu. UQX'I1J:I) - I ~ _
K&1Q DVDIf .... _
i
PAGE
1
OWN8'a'$ ~ fllf,f/~,t( ~Il'''()'~.{ 8',I;7P/;,
JOil APOlU;5S ~~..:ld ;?~dv ..("'?"~c6" r ;::?~~/.d" rL-
l?!!om:
r/g-7 R'J- /9.s-p
J ..? r.Pe'l
LEGAL D2SCRIITIQN: LOT/51 ~LOCK SOap~VIS10N
PMCSL ID f /..3 /:91# it I dO 70 ~ 7""tf)~ "Ot? 0 11l~'I'llT1\l Inll'\~ PIlI'\P~Il"'v '!'!lV ~TC-~\
WOlU< 0'1\01'520: Q 1\19 CONS'ra{JC'l":to~
[JS!GN
l?~E'OSE:D USE: DSGl. E'ANILi' t>m:U-ING
o C064b4EIl.CIAI.
o ADOrnON
~!lRATION
[J REPAI:9.
D INSTALL
o MOv!!: 0 D~Lr.sR
ClMtJI.,TI-I'fAMJ:LY 0. OF ONITS
~ CI NOBILl!: Eotr1E
CI OTIi!:R.
q ~NDDS'l'RIAL
Cl SWJ:MMJ:NC POOL
t::l a2STAIJAANT .. HEALTH PUARTMENT AE'l?ROVJU.
~SClUE'UON O!' KOI<K /.~~~~~~~~~h_~~~~
BOILDING SIZE SQuARE FOO!AGt H~IGBT ~
RESIDENTIAL: ATTACH (2) p~ PLANS, (2) SETS or Btl:tLOING fUNS &. (1) SEl'l 2Ni\~Y FOIlWS.
~RCIAL: AT'l'ACH (3) SJi:1,S OF l>fJILOING E'lJW'S , (ll SilT ENS~y l!'ORMS.
nOl't:J.(:J.':r ::;UElVISY QOOIR!:O F05. Al.L blEW CONSTRUC'!'~ON.
~
P'BlUCJ:!L'S Rl:OD&SaD
/tJ //000 VALUA.tION OF ~O'fAL CONS'I'RDCTION
AM1> SERVICE
[:i}1iOILOING
~tIilC'J:'IlICJl.~
~L0H2INQ
[J KEc.aA.NIC1t.L
D GAS 0 ROoFrNG
~
Cl FLORIDA POW&lR
o S'l'UL.
D ..u~~
J:~S'J:'ALL1\'1':tON ~F~
tr /,3 - 'l9li'-I3,.;l?
r.-?.x tj'13 -.;u. s--o ??'p
Cl SI?IilCIzu.n
VALml.'r:!:Oll OF WSCHANCIAL
. D O!l':a:E:R
/" "'-.-':...
BU1::usaa~~ CotG'ANY ~.J'l ft/'/hAf~'s-Id~#Ch>A"'.s~
' . S'.l'ATE CEiR'1' OR UGIS'I' #. ~ CP r.3 ~ --=
:>.l.I.;I'lA'.1'U , . -") CITY P1tOCESSIb'lG I /?,!'-s/ .. __
~....p***..._~._*.w*.***~.....**._..~**~*.w..~~***~..~*****...***_
~. ~
COMI?AN'i E, r .(;:A .Eko',;"",/ (iJ.vI,.IIdiJ"Zt.
STATE CEa~ OR REGIST *
CrTY PRoceSSING f ..::?5'''7~ ..,/ ~~,:;t.....; ;Zq
%W~_.*..*~**.*..**w*w....*.7..* .rw~.*
v{)'~( ~- CONPAN): ~/ /J/VI/,j/'1 {;, :TAlC-
\ (J1,1,. STATE: CtRT tlI{ lU:GJ:8T .
--- ~ ~r~r ~ElOC~SSING #
.... ~--#?~U>~~
***~'*R****.....***~.....*.*w....****W*'*~WR**'...~'.~l~*......* t7
COMPANY
~TA~~ ~~ ~ ~~~~X f
CITY PROCESSING .
'1'Yilt OE' CONSTRUCTION: [J ElLOCK
FINI$H~O ~ooa mLEV~~IONS
[J FElAN!:
~C:l:Ali
SIGNATDai:
~
SXGN:A.'ttTM
KKCHNaCAt.
SIGNA'1'UU
~*..***.*.*~~*W~W7_~**~~.*.W*~*W..W.**W~...**~*..*y*~W*
onaa
COMPANY a)( I€ S2/;;7/&'!tAJ ~t.:c,.~, L~
S'l'ATE CIilB.'r OR !l.2GIS'l' j -1:& '" I~ 0
CITY PaoCBSSING f _
~._...*.~*.w.**v**.~~*~~~~
SI~NM'DILE
'..: '.
Cl 0'1' !1I!:a
IS l'lWJ2C'l' IN nooo ZOlllil lIiW\.D ~S CI NO
.. . (.... .' ~-':"""":I
Date: February 20,2001
From: Dale A. Kibby
Perrier Group of America
4330 20th Street
Zephyrhills, Florida 33540
To: Zephyrhills Building Department
Subject: Work Authorization
Dear Mr. Burgess,
This letter is to authorize R.M. Williams Contractors, Inc. to act as our Construction Agent for
improvements to a floor drain system in the N.E. corner of our existing building to improve and expand the
existing system to include trench drains and improve the pumping system. They will also be adding (3)
support columns to improve the roof integrity. Please accept their authorized personnel to sign our
Building Construction Documents regarding these improvements.
Thank you for your consideration.
;;;;111
c2 - ~() -t) /
/J. JJdL
j:::U:tL /.
~..~ Ruth L GII
Ii.: :.s MY COtMSSlON I CC911st7 _es
: ~.' AprH 13, 2004
~~ilr.;r.i .' BONlllOlllRUTROVfAIIIINSURAIICUIC.
"Pure Water from a Pure Place"
Zephyrhills Corp. · 4330 20th Street · Zephyrhills, FL 33540
(813) 783-1959 · FAX (813) 782-1166
f"EB. 20.2001 11 : 2~
t<M ~u.LL..LJ.'1;>
PSWlT NJMe~
S'Ua'E OF FlORl~
NOTICE OF COMMENCEMENT
PARCEL 1.0.. NUM8&R "BE Lnw'
.i- 13 Zh 2t ~<:>lo o74ro ooC>~
1111I11111111111111I11111111111111111111111111I111111111111I
2001024156
1M ~D......,QIIu.... ........._4N,.. be".,. D CtWtIIn .. JII'ClIMIftY .
...." .....-.. ca,.., 113.II\.ONDA srR\n'ES. "'1I:lIIcMIng ........ls pMdIa
in" NoIce of CoInner_".~
LaGAL ~k'" j feN (Null ~...., Iat. block. ~.. .,.....1aIInIhlp, ....)
Rcpl: 477426
OS: 0. 00
02/27/01
Rec: 6.00
IT : 0 . 00
Dpty Clerk
JEO PITTMAN PASCO COUNTY CLERK
02/27/01 10:07am 1 of 1
OR BK 4544 PG 1604
OWNER INFORIIA"nclN
NA"E '""DAQ A. \< I EBl1. - AOD"ESS 4330 d:J ft ~T.ef(T. ~EP~y1C1L.L~ FL.~3
'~ESTINFI"OPERTY 1>~<:>.:)~,-, N\I\NAI~~ .
NAME & AOCRI!SS OF ~E SIMPLE TJTt.&IQ..CER (j' QUW lnan owner) J?~Re.1 EJ2 G~r of AJl'l1<.1 cA.
777 \rJi.~\ 1'1iT~~)V\,-.A~.- ~1ZU.~~1C-\\. CT. Ob~S()
,
Q D~tf or: "PROIIEMDT
IN'Sif\U- Nt-...J T1Z.~Nc.." 1>QA,tJ~ IJJ N.€.. t...ol'lNLR. of f.XrSr/JJ G VtJIl.bIWG,
eON"mACTOR
Jj. NAME ~.tJ\.\J\LL.IAlY\S ~AAaC)~~ I JNC. AODFI!SSS6~
\ SOND AMOUNTS NAME &. ACOR&SS O~ SU"ETY
L5NDINQ O~NIVtnON
~ 1I'lCI~)
-.l'8Clns...... /tie SQI8 of FlarfcSa. desIgnat8d ~ 0WNlf \If)OftWho ~s cvocrterdocutrl.nts may b. ,eNed... /)~ by SECTION 713.13 I') (41) (7),
~QFllOA STRUTEs.
NAME ~uc A. kH3Bi
ACDRESa-133t> 2t:)-n\. Sit ZE.PH~12-t\\l-\'<;) FL. 55~40
if'\ addItJon 10 "m.et. own.r ~ Of
(Name) ~dr...)
Ia ~ a c::aw of Lienar'a .. p~ ift SECTION 713.13 (1) ~) R.ORIQA STA'MiS.
D~~~'~-r(
-...0-.. ~" .
Pmeeca ...,. A. klIJ
(One YHtfrom dMe of ~ unIess~)
Cl!Rnrn;ATION
STATE OP -F\ b,(",~da. J COUNTY OF ~ ~C!.O
The fO"'CIOIIlg irWIumtMwa&~1Mdore IN ~ dtttt of ~ ~I by
'lIflo .. p~ Ii:J me or has p"".- I . _ ~ftlillcatloq a'Id who C_ (Clld not) take 8ft 0lUh.
~ J X. ~ {f ; -= Coltmt8iClft Numhr ...... .
€~: :~IS~ # CC911597 EXPIRES
~.. 4 (IItIe)
....1,~:Rr.:th~,.:-
~ONDED THRU TROY fAIN INSURANC~ 1Ne.
'.
(( N\ (;VlLW A-M ~ ClDN rt1.i\<.;rcfl-~
'-t2;~o k~ ~.
SQ. FEET PRICE .
MAIN OR LMNG ~ $
. OTHER AREA UNDER ROOF $
O1lfER
VAUJAn(JN $ /DlioOD
BUILDING: $ cq 50 1jrf+L..
CREDtr: $
tJ
ELECTRICAl.: $ /05, C/C /./l:.iJ.50
" I .-:-
PWIIBIN$: '$ Z ~k>~:' ~ 90.
-.--- ....J
-.
$ tJltr ---'"
?c.>
//DSO'-
I TI F'SI:I $ fJ)fl I