HomeMy WebLinkAbout01-0502
BUILDING PERMITN~
0502
CITY OF ZEPHYRHILLS
(813) 788~6611
Permit
~I n/UI
Date
L1 -, uU
,)..-
BUILDING
Property Owner:
PLU~G
f1D
MECH~ICAL
Sewer Conn
Water Conn:
Water Meter:
tl
T,LF:s:
Zoning: Energy Code:
DescriPtion of Work J Ll or u 'c. \ t'"
Radon Gas:
r~ - /":';0+
FINAL
- /;$-0
DATE
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.
City license Registration #
State Certified license#
Signature
Company
Address
Telephone#
Valuation or L . 00
Contract Price { ? () i). -
lJ~ lA, ( ScL-" pv ~(;, t'!'9
BUILDING 'J ~ 1
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
PlUMBIN
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers I
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 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.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIvED
PLANS REVIEW FEE
OWNER'S NAME
/~ ~~o,'e{j
~gf I ~ rYU.0i4cJ h (~
PHONE
7R?-/~s/
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BI,OCK
PARCEL ID # 3S-a5-~ 1- OD70-vO{)1)() ~ GOlfS
SUBDIVISION
fOBTAIN FROM PRO~RTY TAX NOTTCEl
WORK PROPSED: []NEW CONSTRUCTION
o ADDITION
OALTERATION
o REPAIR
o INSTALL
Os I GN
o MOVE
[] DEMOLI SII
PROPOSED USE: []SGL FAMILY DWELLING
[]COMMERCIAL
OMULTI-FAMILY
[] INDUSTRIAL
Off OF UNITS
o SWIMMING POOL
[] MOBILE IIOME
[] OTHER
DESCRIPTION OF WORK
CJ
~(MD La/2~
RESTAURANT & HEALTH DEPARTMENT
~ -~O~
SQUARE FOOTA E
AP PROVAIJ
BUILDING SIZE
IIEIGHT
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 AJ,L NEW CONSTRUCTION.
o BUILDING
, Vi)
LiL30D.~
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
[] ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
[] PLUMBING
[] MECHANICAL
$
VALUATION OF MECIUlliCIAL INSTALLATION
o GAS
[] ROOFING
[] SPECIALTY
[] OTHER
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
[] STEEL
[] OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE ARE1\O YES
o NO
BUILDER
SIGNATURE
COMPANY
STATE CERT OR REGIST
CITY PROCESSING n
******************************************************************
ELECTRICIAN
COMPANY
STATE CERT OR REGIST ff
CITY PROCESSING ff
SIGNATURE
******************************************************************
PLUMBER
COMPANY
STATE CERT OR REGIST ff
CITY PROCESSING II
SIGNATURE
SIGNATURE
* * * * * * * * * * *,* * * * * * * * * * * * * * * * * * * * * * I. I. * 1.1. * * * * I. * * * * * * I. * * * * * * * * * * * * * * * *
COMPANY
STATE CERT OR REGIST If
CITY PROCESSING II
MECHANICAL
*****************1.**********1.1.1.**************1.1.*****1.*****1.******
OTHER
COMPANY
STATE CERT OR REGIST II
CITY PROCESSING 1#
SIGNATURE
***********1.*************1.**********1.**1.*************1.***********
A. NUTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
ma'y'be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBII,ITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance witll 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 t:o 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 tlle
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 lie is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrllills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FI,ORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided wilh 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 lhat 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 D NOT NEED TO RECORD AND POST A "NOTICE OF CO NCEMENT".
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this~ day of~~ ' f'g--2J
by
(name of person acknowledged)
Dwho is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this dlo day of aA.A.f ' ~O I
by
(name of person acknowledged)
[1ho is personally known to me, or
e of identification)
take an oath.
Dwho has produced
(type of identificationl
an~d not take an oath
Signature of person taking acknowledgment
o who has produced
(ty
and whoD did Ddid t
Signature of person taking acknowledgement
.,.,~ '" Suzanne Douglas-Allen
* My Commission CC874208
Name typed, prin'\i 'g~irflll~,2003
. SYHAAe f)"'~I,n
Name M crint,e 0 stamped
Y vommflSlon CC874208
-""..no'. Explres October 25,2003
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112';:0:), H\V\' 98 Dad,:, Cit),. Fl. 33;;2~ Phou,: 3"2-567-8580 Fa'\: 352-567.7073
Stak C;:,rtitl,,'d CB C059B j! ,:\:CC' ('1)581H
5t.,.v~~ flM.\k'Z f-\-J-.!-tt H~.t1- 't &.~-Z';'{"'I.lr:'UZ S~~ '1176
AJtn: Or Batfa
Datr:: 8, l.t.t) 1.
i 81 7l~..h'diC'aj C ;:ukr An' {,'E?-:!;,-!-~~-f~-~/~::,-- !1)how."
813- ~83-J8.'9
Zephyrhi!!s, FL 33540 ,.
It'\" \ 0 unt\'
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Pare<.' I -;:;
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\V,: hC'r.:by' propo:,:,~ to finnif,h mat.:rial,.; ancllabor n2cC'ssary tor th", compl2tion of
Duro Lost rooting system
BaniC'ade ofT \1/ol'k ar",a as ll.:'::di;d
) Remov,' tom;~' d",bns from .tlat root
" R"iii0V,' 2xistmQ f],i..,;hings /-lilt! hoots a.,:- r;;>quir;;>d,
Clk'd :"ub."trak ,b.:kin12 f()!" I,Vafc>r da11lag;~, Replac.:'HlI.'Bt of dt'cking 'sill bi:" dOlk' 011 a fml<.' ,md matt:'nal
ha6lS fit tll;;" rat.' ofS360{1 dolhm.; per Illall -hOlU' pill'" matl:"nah, markc-d lip a 251)" contractor" h';.",
5 InstaH raB t()ld lnsulaclon. lIlt:'chfUlicaliy attadK'd pel' Duro Last :;pt:'citlcation
6. Install Dmo Last Hkmbralk' f(;r a 1 ";~c'ar mat2fial {lmllahol' 'v\i;,UTCmty
IwctaJl m'\v Duro Last b()Ol~:" custom ('urb and com,',:; ::l'3 rt'qUlrt;'cL
g histail l)uro Last tv.o-\\ay' \.:nl", a~ r,:quir.;od
9 Install Duro Last VV'lu/;> l 3. r hiSi: ia \\. ith coyer as r;;>quir.:d
11) R,'u:'<' ::xlstmg coping mda! \\ht'l~' in place
11. Install Dun' La:,;! Parap<:1 up <Uld 0\':;'1' wa! h
CuntnH:tufn:arnmtj: [:puii cGmpldwll of the ..V Oft amI pa}lH<."1ll'ofall monies vvved, Coutl'aC''tZt~~~1l ksu,-' a
t,'o (2 i Yr.'ar ,valTa!!ty ! IH!!tc>d to l~'ak:~ c:.m:,:,~d by ,my compollc>n! illstalfby th~' contra02tor, Drf\) Last shall is~'U,,'
a tlfh'~'n ( 1 '.;, y~~m' \VarnUl~..r on worlananship (llId mat<"riah
General Conditiom :\lll,\'ork -,:hall b.: carendly sup('n'is<:,d and compldcd by workm~n skill.:d and
knowJ-:dg;:abk If! Hi<:' mdhod~: rk~(bd to produce high quality work Tht' .lob Slt\." "haJI b~ h~pt dt'ml dady for
thi' duration ofrh", Job 311(1 th"gfound;,; shali be lett clean of aU roofrda!;;>d debris after cample-tlan The yard
~Iiiill to.: ,;<,vt'pr \\iil.h a magne-t \ 'ollc'dtOli cosh if any tOlZ,dhe-r with inh:,r,'st shall b,~ add;;>d to ilk COiif.ract pnc,'"
;fnrn..,'<T'n_),nt ,'Ll,-f~H.h n'-""lH-~' (-';::10'-' ~11'.l...;;.,.n ()frh,~ ,".-"f'dJ"qi,.t f".ltl..~r th..:. 71_fl."ll1" .-n~q'''''''_:A 1'L-':"1"';r.d- f'))'T'l,' tnC~H' q IH,..n;o.t:l) f_"'l~'.
1.1... ~.lt.(.}'t41'-1.tt. ""...t_.o:.~_.'J.' '.'\,.\"..(u.1. ~_(,t11""''-.-ltf.U.I'.J~4 ~..:l. (11.1\., ....'!l..(_'.(,..~t. tU(;.,.J c.lt.... ,"'" 1.1....:(._11. .~...L..'\,.... iJ"'<.l.tL" ttl.(t..... .Ill 'L..... r..... 1..~t1tlltJ:<<.1.1 L........
Th,' cuntractor ,:;haJJ provide- jkllwt \VorkmL1n comp"il~at1UrL "U1d gi:"tlo'raJ habibf';. IlIStU'illl(';'. I, 'mVc>ntry
authori7ed dnmg,' orde-r" rUle! l,.\'orL willch EO'''' not co\,;;>r,'d lmd':l" rh", 8COJk of\.l/ork olltlm,'d iwr2'1fL ,.-hall b,'
i)t~r.t(H'in0)~:1 Gri ,; tUlii:' and nlalcriaj~ lJa~~:i6 uni;;.~:::s Gtlj~r\v.;;;:2 a!Zf'<;.~~ld Ui_H!fL
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l1250 S HWT 98 Dade City FL 33~ 2;': Phon.;' 3~2-567-8Sg0 Fax 352-567-.70 n
Statt' CC'11ifi::d CB C059817 &CC C1l58134
$t-tV~'$"'-& flM~'1. F~~'tt H~z \f-. ~~'trUz $~ 11/6
("ontrac! prict'
Duro Last Rooting i'}'i't'2'm
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:~;il.::n",d'
:;l~lt"d
S 4..300. 00 k'i:-.-2cQ_~. .~:_..__. _.________ ___
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200111!5130
NOTICE OF CO~GIENCE:\tIE~l
State of Florida
7~
County of
Permit No.
Key No.
THE IT~il)ERSIG~"ED hereby gives notice that improvement will be made to certain
real property, and in accordance with Chapter i13, Florida State Statutes, the following
informacion is provided in this Notice of Commencement:
1. Description of Property: Parcel No.
'0 5 ~ ~ 5"'~' .. 0010 .. 00000 -00 c.{..5
t~IL&iJ,P
2. 'General Description of Improvement
3. Ownerlnformation: Name ~. j)~
Address ~ 811 ~ ('II, tii.wl (....IJi:.i - - State
Phone No. rt-t?J - rg~ Fa.x No. \
4. Contractor: Paul Schaper, 11250 CS Highway 98 South, Dade City, FL
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5. Surety: Boyett Insurance, 1411..l-i1h Street, Dade City, FL 33525
6. Lender: Name/Address:
l^d (r
-:", Persons within the State of Florida designated bv Owner Lloon whom norices or orher
- . .
documems :nay be served as provided by Section i13.13(l)(b), Florida Statures.
3. In addition ~o himself: Ov.ner designates Paul Schaper Co nsrru,cti 0 111 Rooting, Inc. of
11250 l."S Highway 98 South. Dade City, FL 33525 to receive a copy of the Leinor's
Notice as provided in Section 713, 130)(a)(7), Florida Statures.
9, Expiration date of Notice ofComrnencemem (the expiration date is 1 year from the
date 0 f recording unless a differem date is specitled.)
~.f. M\~
Owner Primed Name: ~.-"P. ~'i-r-~
ill: g 3~ -15~- '12-- '5J-I-() PersonaIlyKnown
Signature of Owner:
Sworn to and subscribed before me this c:J..o day of ~
Not:u:, Public: ~
(Type. Pnnt. or St:unp :'-iame of0iotar:/J---
20 0 /.
Ii FOnrGUiNG!S r:~
t)()CI.Jr','1Er'j f- ()r; ".-':i_f:
...~ Suzanne Oouglaa-AI1en
~.:Mv Commission CC874208
~".... Expires October 25,2003
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