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BUILDING PERMIT~~
0478
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CITY OF ZEPHYRHILLS
(813) 788~6611
Permit
7~
~';~OING .
Date
q -9-0 /
,
PLU
'MEC~wer Conn
Water Conn:
Property Owne .
Job Address:
Parcel I. D. #
Water Meter:
T.I.F.'s:
Zoning:
NO OCCUPANCY BEFORE C.~ 6-~ OjL~,
Complete Plans, Specifications and Fee Must Accompan~licati9'ltf-
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
BUILDING
Permit Fee
~?
Company
c5< 9- / 7 Address
t!"t )/~:::::Phon~ ~~;fl ~~~~
ELECTRI AL 17iJ PLUM~-"'. MEO:lANIC~L
--
.-
Valuation or .4. . -9 i/ '7
Contract Price r ~ J ". .?
City License Registration #
State Certified License#
~~ att~
Ftr.
Pre SLB
Lintel
FRM. /1, Ii" -- 0 I ilL it
Insul. CL
WL
J)/-/)f.r/l.JIII- 4-/-0:2... /lq
Driveway
<? dlS-o/5L
Tp.Serv. ~
Rough In 11-110 -() I
Meter Can
Const. Pole
Pool
Pre-Meter
Final ./ 5 -/3-1) ~ flub
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Twenty Five and 001100 Dollars ($25.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
F~A. 1S77 LAWS
FS 71~.13
SEMINOLE FORM 408
NOTICE OF COMMENCEMENT
~:a;~;f o:lorida } 'PR~PAR& IN DVP~ICAT&I ~~~ll~~I!~l~1111111II111111II11I11111111111II11111I1
The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance
with section 713.13 of the Florida Statutes, the following information is stated in this NQTICE OF COMMENCEMENT.
Description of property . J.5:-:..;?.(#.~~!. -::. eN.?/!. -:. C?/ kP9~.t?('!.e. Q...............................................
.......... .~.7.7~.'i.. .4.1.tq~'4.:-. .Or:. ~..Or:~~~C.. .13l1?~~9.r:J.. .C.90.4().~!-.Y).~IA~"J-""""""""
. . . . . . . . . . . . . <:.. ~f?h't r. b.l~ .u.? j' . . .FJ... . . . . ~.~ ~.'-:I. .l. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
General description of improvements ...... C.l ~.~.e..... .;?:c..Cit ~~.~. t?:~.~..:\ VY T~... .<?J ~~.. ~.C?<?~
Owner .. . ..~ .~ ~ ~. ~ . .. ..~ .e.: ~ \' ~ ~o. N .. . . . .. . .. .. . .. .. .. .. . . . . . .. _ .. . . .. .. . .. . . . . .. . . . . . . .. .. . .. . . . . .. . . . . .. . ..
Addres~ . 3.77~. ':t.. ..A.U~~~. . Dr: 'l..2~p~y:r..b i.ll.$l'''' .Ft.. ..?!.~.?~.l...............................
Owner's interest in site of the improvement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fee Simple Title holder (If other than owner)
R
Rcpt: e13812 Rec: 6.00
DS: 0.00 IT: 0.00
07/18/01 ___ Dpty Clerk
Name ............................................................................... SCO COUNTY CLERK
. .' ~;~ 1~,~I"Ar2 : ~r m 1 of 1
Address ................................................................... OR BK 4669 PG 649
Contractor. . . :i> '\\. v. . e......s. . . . . . . ~ . h u . ~. . \ .~. . u. . ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .
Address.......;?: g.O.\..... G..A.\ \.... E \.v.. Q.~... .?~.h.'l r. h.,:J.l~ .~.. F.l.... ..?~?~.1............
Surety (ifany) .SV.Re.'"'1y. ..:t>.\'.v'.is.~ Q~...o.t=:.... ~:I..\h..... .\.'N.,.s. V ~"'ru.e....C-................. .-.....
Address .2 .0... .~oy. . ..,3q.~ '1... Pe~R.'~ .I.~L..l::t .\.b\a:-:.~ (Q.?. . . . . . . . Amount of bond $1 5l ~ ,.~..v
Any person making a loan for the construction of the impr vementa:
Name ...........................................................................................................................
Address .........................................................................................................................
Person within the State of Florida designated by owner upon whom notices or other documents may be served:
Name ..........................................................................................................................
Address ........................................................................................................................
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section..
713.13 (1) (h), Florida Statutes. (Fill in at Owner's option).
Name ..... ... . . . . . . . . _ . . . . . ......... '_.' ..__.__ . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Add,es. T~'~~~~~~;~~~~~~~~~~'~~;~~~;;""''''''''''''''''''''.. 0.............. ~~.......~......................
tY~.I...!!i?!:r........
Sworn to and subscribed before me this. . ...??6-,ac..................
STATE OF FLORIDA
COUNTY OF PASCO
TH!S IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMEf\; T ON FILE
OR OF . ,L1G REGORD IN THIS OFFICE.)jYi)I'JESS MY
HAN ADO ICIAL SEAL THIS...,tA:.. DAY OF
2l!2.Z
J IT RK OF CIRCUIT COURT
DEPUTY CLERK
.........:..............day o~ .~............. 2.00./.. .'2f............
J..-{d/~./hl..~......
Notary Public
"'U".,,
....~~~~'.ti'.o;:;___ Katherine M. Brewer
t~'" C,;," d MY COMMISSION I CC6n55-4 EXPIRES
-.:.:~~:..., September 26. 2001
"p.f..~;.." S()/'j{)fDTHIIU~OYFAlNINSURANa.INc:
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMBNT 5335 8th STREET ZEPHYRHILLS, PL 33540
Phone:813-780-0020 Pax:813-780-0021 /.1-/Yl d
DATE RECEIVED C ~
PLANS REVIEW PBB .
OWNER'S NAME ~~tt.l-S R.e..~ ~~'3\:'OY'J
JOB SITE ADDRESS .3?? ~ r /1-1. i..ss~ .Dtc.~
PHONE CONTACT 'I j do -3 S'l:fS-
33~4/
LEGAL DESCRIPTION: LOT(S)
t!J/7A
Do B ("')
BLOCK ()/ ~ Ilo SUBDIVISION
(XJ130
PARCEL ID # /$ -hlh - al- 0/7/1- -Olfoot:/- ~OBTAIN FROM
WORK PROPSED: DNEW CONSTRUCTION 0 ADDITION ~RATION
PROPERTY TAX NOTICE)
o REPAIR
o INSTALL
DSIGN
PROPOSED USE:~FAMILY DWELLING
Dt;10VE
o DEMOLISH
DMULTI - FAMILY
0# OF UNITS
o MOBILE HOME
o OTHER
o COMMERCIAL
o INDUSTRIAL
o SWIMMING POOL
DESCRIPTION OF WORK
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
Po \r'L~ .
C, lo s ~
s <:'~~e. ~
SQUARE FOOTAGE I 35
l\AJ
BUILDING SIZE
Q'x .
-1_15'
HEIGHT
~EE PiAU
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.
AMP SERVICE
o
FLORIDA POWER
Pasco Permt f Servlc;;
"7 8'~ - 5 ~L~."-,,). .
M.'./~
/..//~// ..."
/
.R.E. . .
.. ./
o
PERMITS REQUESTED
~ILDING
~LECTRICAL
$
'51'-13. {)O
VALUATION OF TOTAL CONSTRUCTION
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
DGAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA 0 YES 0 NO
SIGNATURE
~ COMPANY .J)V\Uf"~\ At-v",,- t""v~
, STATE CERT OR REGIST #~
V~/'.k'/ ~ CITY PROCESSING # -:1.9. ~~
' f 0(
******************************************************** *
COMPANY qqtf ~ RJ'1t"v ~/s[;;f-;
_ STATE CERT OR REGIST #
CITY PROCESSING # ,11'~ ~
* * * * * * * * ** * * * * * * * * * * * ** * * * * ****:~',j,* * ** * * * * * 6 *
BUILDER
BLECTIUCIAN
SIGNATURE
PLUMBER
COMPANY
STATE CERT OR REGIST #.
CITY PROCESSING #
SIGNATURE
******************************************************************
KBCHANICAL
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
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 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 ~hey
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 ~he 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
$~ IN VALUE DO NOT NEED TO ,::CORD AND POST A "NO CE OF CO NCEMENT".
STATE OF FLORIDA
COUNTY OF
The foregoing inst
Before e ~his
by
(name of person
~o is personally
o who has produced
(type of identification)
and whoD did Qdid not take an oath.
. /..~MJ~~ m. &.uIJ'et__
Signature of person taking acknowledgement
Ka ther ine M. BreWelZ'u;;,;>, Katherine M. Brewer
Name typed, printed or E$t~kif~I~~JUN# CC677554 EXPIRES
<.i~'" ~ptember 26, 2001
, . ''''''.,JED '0' .OCCV FAIN INSURANCE, INC
STATE OF FLORIDA R
COUNTY OF a.S-CO
The foregoing instrument was acknowledged
Before me this rRfi:day of .or IA-1 ~ ' 1I9 .;;!Ct.'),
by D~ve.. o...J~
. / (name of person acknowledged)
~ho is personally known to me, or
o who
has produced
(type of identification)
9Hd~ ~ake an oath
of person taking acknowledgment
and
Name
"~t~~',, Suzanne Bahr
t ~- @'~~rasslPrfo# aid
YP~""~A ;",,::: 'Fj("pI,es If .
~)?f''''''''&~:: aONDED THAU
...."'/~~(\\\,...,' ATu\.:,nj"c BONDING co., INC.
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Change Order No.
Contract Order No.
~IAILlNG ADDRESS
DATE
CERTIFICATE OF COMPETENCY 252
~~~
WORK TO BE COMPLETED
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In event Seller has to sue for collection of all or part of
contract price, purchaser agrees to pay collection costs
inclu ing reasonable Attorney fees.
t
SUB TOTAL $
SALES TAX $
BUILDING PERMIT $
GRAND TOTAL $.....s'..9'~~ ~
Please make all check. pavable to Dave's Aluminum
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