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Home My WebLink About01-0687 BUILDING PERMITN~ 0687 BUILDING ~ /04 ~:;. ELECTRICAL CITY OF ZEPHYRHILLS ~88.6611 ~ liS' I&D Permit ~ ;,90 I Date It?.- 3.0 '-0/ , PLUMBING MECHANICAL ~/T2.SD Sewer Conn ,. ~. . . 0 Wate, Conn Ir'~ ,5' Water Meter: /flJtl T,I.F.'s: .-'l: ~ 1)- - , P,operty Owne' ~;'-0 Z:it ~d a/~ Job Address: ?t ~ Parcel I. D. # Zoning: DescriPtion of Work ~~ode.: ( nJ41f/ ..A~ Radon Ga, 11:!.s A~410 /)/J. BUILDING ELECTRICAL /7 ot Permit Fee ~- Company Addr.~. C~p~on2 ~f2-~.24- n~ . fI /If(' /II Eo! ~ VJ2 /l{EefI- PLUMBING ~ fa... MECHANICA3'.22.- fcJ 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, Valuation or Contract Price -(2 h.~ I. ~ 9~ c:219 City License Registration # Stat." cgr. icense# ?&~ ~~I' 11~ Ftr. Pre SLB Lintel FRM. I!J.- '}'/)I- ~'-~ InsuJ. CL WL Driveway Tp. Serv. Rough In I~ - 7-0 I 12~Y' , Meter Can Const. Pole Pool Pre-Meter Final t/ If - ::1.& - 0 d- 'EL7_ 1+-.10 SLB Tub Set 1!2.- 7-() 1 bf Water Sewer Final. / ?-~-()~ RL~ - I-IJ() Breakers Ducts Ins!. J.:2-' 7-0 / ~Lf Compressor Final J ...f'- d-.~ - ()..t R(~ , I(fo 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, 09/13/2001 THU 11:20 FAX 4078628523 POOLE CONSTRUCTION cx", 01' ~:U.L' , BUXL%):t1(G1 m;:P1la~ nADl JtZCJl1'VJ!l!l 7' -/?i - 0 I JrUlXlI ~ r:a: OlfN!:R' S N~ East Pasco Medical Center PHONE 8.13-"j e8...24~1. JOB ADDRJl:.n 7n?n r-~11 g""']'''''U'r1rrl. ?:"'ppyrpi).lF'l. Florida 33S41 L~~ DE5GRIPTICN: LOT(S) BLOCK straDIv.t 15 ION PARCEl, :rn # Q-- :B.~+-..=:w,..""'_~ T.:ag-:::r.' ""-a........;r+-.;,.,.T1 (OR'I'JlfV lI"RCM "PRn'PRa't'V .,.~y Mn""Tr!1P.l WORK E'RCl'SED: D~ CONSTRUCTION CloUGH I'ROt'OSED USE: OSGL FAKILY DWELL;UIG fJ COMKZRCI.a.L D ADDITION OMDVa !iaAL':t'EllA.'1'ION D nI!:MOL:tSH D REI!AIR o ItlST~L DMULTI-!'AKILY D INL'lI1STRIAL [J 1# OF tlJUTS CJ SWIMKING POOL CJ MOBILE HOM!: CJ O'l'9R r::::::l qS'rAUAA.N'r & H!'ALTl{ 1)Bl'M'I'HZNT An~ DESCRIPTIOll OF WORK ~KVVVMVy.aa9V9MV~Z Patient Room ~~novation~ ZlU'ILDING SlZl!: SQUARE .fOOTME BEItm'l' RESID1!:N':t'IAL: COHKlUlCXALl ATTACH (2) 1'>LO'1' PLANS & (2) ,s!:'l'S CP BUILDING P1oM'1J , (i) SET ENI!:IlGY FoRMS. ATi'ACH (3) IJ!:TS OF BlJILnI~G PLANS .& (1) SET PfERGY FORKS. PIlOPER,"" SURVEY IU!:C1UIJ\EI;I FOR ALL NDf CON:!l'l'RUCTION. PERM:rTS REQOES~ ~ IlUTLDINC Xl );;:t.~RICAl. $ VolUoUATION Ol!' TO'1'~ CONSTRUCTION CI FLOIt:rDJ\. POWER A!U SERVJ:CE o W..a..I!:,C. :il 'L~IN~ iJ MECHJ\1II I CJl.L $ o GM 0 ROOnNC 0 SP!;CXAL'l'Y VALUATION or MECBANCIAL 1HSTAt.:r.A1'ION o OTKIP. TYPE OF CONSTRUCTION: CJ BLO<<:K D nAME CJ STEEL o OTHER. FINISaEn ~R EL~ION3 :ts l'ROo71ilt!'l' IN FLOOD IONIt AJU'.l\D YES 0 NO 1':"lLlIIJ)tltf1nj,IJI'Jr'''~'''''~;- '" ,'d'~1 "1";~"'IP~:m~""'-' \ i'" :" ~ ~~~~~. f - 'J"J I,';' 1:1':I,tll~~n1"::;-~\,'-;:-'7,1"; - ','_,,: JJjjl,k ':~.....U...J,-l.~~~~~~~I~I~I:hl,'..~II,,: .. , .,.. .:....J.. ",,' '. ,.' , ' -~ . .:_~ ":ll'J:'W'J:':',!IIIIIII, , .. ~ .... .. _ ._,. ",,"'-_,,"~_:I." e.>/ti BO%IDI:R COMPJUlY 'Pnnl Q ("',...,.,a"''P''''~~~ ^or. ,,""" w T.,.,,... STA't'i: Cl:R'l' OR IlEli:I8T II ~ ~ . CITY l'ROCEs:!iINli # 2'1' '1 W II *......_~.~.******..*.~****..~..... SIGNATURE ~ ------- w.._.~";;::...w..........~.**.*.***.*****.t ........ /1 - C~ ~__ """"""" R.....~ .....;:...,..... ""........i.." ~~ ~'( ST.M'l!: C~'1' OR REliZS:: ~ ;n;f- ~ .,....... ............................::~.::::::::::.:..~......~~.~ MZOD.1a.cAI. COXl'~ HarD&r M----a!:!' cal COt"DCl at~on 5TJ\.Ti: CERT OR REGIST # SI~ CITY PROCESSINli # *.~*....._.******.**......~~...~**..*~***.._*w..w..w..ww... ~ O!rDlal. COMPANY STJ\.Tl!: CO'1 OR lU:GtsI' t CITY PROCESSIN~ # :1]: GN1\TUR!: .........~.._....****~~-~~.~~..w*.~..*....**...*...*..*..*****.** I4l 002/002 cJ1~ -Z(JJ .-t 1ft t'-J ( 'I)?J- ~ ' U'^+:; CONDITIONS OF PERMIT AFFIDAVIT A.NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to ~deed restr;,~tionsH which may be more restrictive than City regulations. The undersigned assum~~ :es;'nsibility 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 UContractor SectionsN 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 uFlorida's Construction lien Law - Homeowner's. Protection GuideH prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the UownerH, I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the UownerH prior to commencement. E. CONTRACTOR' S/OWNER' S AFFIDAVIT I certify that all the infor.mation 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 uAH or uA,etc.H, it is understood that a drainage plan addressing a ucompensating volumeH 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 YOm; LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500/ VAL DO NOT NEED T CORD AND POST A uNOTIC OF COMMEN S t' o who has produced Jtype !l3'dTd not Name t ~~ SIGNATURE: C RACTOR STATE OF FLORIDA ~ c;...S c. t:> COUNTY OF \. The foregoing inst~ent was~~~led~~~ j Before ~"t.h_i;;S , ~ay.Q..( ~~':h ~ by ~'\>-.....:, '\ "E' 'So ....w ' __ \ <::::::. ---Lname of person acknowledged) ~ is personally known to me, or o who has produced , (~e of identification) ~d not take an oath Name type CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET ORD. #395/RESOLUTIONS 312/372 WATER $1.75 GAL. SEWER $6.39/GAL RESIDENTIAL (Each Lot or Unit) Residence $ 350.00 $ 1,278.00 Travel Trailer Park $ 131.25 $ 479.25 COMMERCIAL (Per fixture) Sinks $ 87.50 $ 319.50 Water Closet $ 131.25 $ 479,25 Urinal $ 87.50 $ 319.50 Lavatory $ 43.75 $ 159.75 Tub/Shower $ 87.50 $ 319.50 Washing Machine-Commercial Size $ 350.00 $ 1,278.00 Washing Machine-Domestic Size $ 87,50 $ 319.50 Dishwasher-Limited Use $ 87,50 $ 319,50 Food Service-Dishwasher $ 700.00 $ 2,556.00 Sinks (3-Compartment $ 175.00 $ 639.00 Car Wash (Per Stall) $ 1,000.00 $ 6,390.00 SINKS 50 3 $ 262.50 $ 958.50 $ 1,221.00 WATER CLOSETS 75 1 $ 131.25 $ 479.25 $ 610,50 URINALS 50 $ - $ - $ - LAVATORIES 25 1 $ 43.75 $ 159.75 $ 203.50 TUB/SHOWERS 50 $ - $ - $ - WASH. MACH. COMM. 560 $ - $ - $ - WASH. MACH DOM. 200 $ - $ - $ - DISHWASHER COMM. 400 $ - $ - $ - DISHWASHER LIMITED USE 60 $ - $ - $ - SINKS-3 COMPARTMENT 100 $ - $ - $ - CAR WASH PERlST ALL 1000 $ - $ - $ - IRRIGATION METER SUB-TOTAL $ 437,50 $ 1,597.50 $ 2,035.00 3/4" WATER MATER 1" IRRIGATION METER IRRIGATION CONNECTION FEE GRAND TOTAL $ 2,035.00 FIXTURE G.P.D. # WATER SEWER TOTAL PER FIXTURE FEES FOR NEW FIXTURES EpMC Ul~'1 CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET ORD. #395/RESOLUTIONS 312/372 WATER $1.75 GAL. SEWER $6,39/GAL RESIDENTIAL (Each Lot or Unit) Residence $ 350.00 $ 1,278.00 Travel Trailer Park $ 131.25 $ 479,25 COMMERCIAL (Per fixture) Sinks $ 87.50 $ 319.50 Water Closet $ 131.25 $ 479.25 Urinal $ 87.50 $ 319,50 Lavatory $ 43.75 $ 159,75 Tub/Shower $ 87,50 $ 319.50 Washing Machine-Commercial Size $ 350.00 $ 1,278.00 Washing Machine-Domestic Size $ 87,50 $ 319.50 Dishwasher-Limited Use $ 87.50 $ 319.50 Food Service-Dishwasher $ 700.00 $ 2,556.00 Sinks (3-Compartment $ 175.00 $ 639.00 Car Wash (Per Stall $ 1,000.00 $ 6,390.00 SINKS 50 2 $ 175.00 $ 639.00 $ 814,00 WATER CLOSETS 75 6 $ 787.50 $ 2,875.50 $ 3,663.00 URINALS 50 $ - $ - $ - LAVATORIES 25 6 $ 262.50 $ 958.50 $ 1,221.00 TUB/SHOWERS 50 6 $ 525.00 $ 1,917.00 $ 2,442.00 WASH. MACH. COMM, 560 $ - $ - $ - WASH. MACH DOM. 200 $ - $ - $ - DISHWASHER COMM. 400 $ - $ - $ - DISHWASHER LIMITED USE 60 $ - $ - $ - SINKS-3 COMPARTMENT 100 $ - $ - $ - CAR WASH PERlST ALL 1000 $ - $ - $ - IRRIGATION METER SUB-TOTAL $ 1,750.00 $ 6,390.00 $ 8,140.00 3/4" WATER MATER 1" IRRIGATION METER IRRIGATION CONNECTION FEE GRAND TOTAL $ 8,140.00 FIXTURE G.P.D. # WATER SEWER TOTAL PER FIXTURE FEES FOR NEW FIXTURES fi)'l/\ L... to E.-lN FI ~r\.J~s Poole Const. 7050 Gall Blvd. Interior Renovations 1::1-- flu a IIIl11ilisA_ SQ. FEET PRICE MAIN OR LIVING: 9,864 $ 64.00 OTHER AREA UNDER ROOF: $ 15.00 OTHER: $ - V ALUA TION $ 631,296.00 FEE SHEET $ 1,934.00 ADDRESS $ - DRIVEWAY $ - 2,901.00 2,901.00 104.52 125.00 130.00 98.6 3,359.16 SEWER: $ 4,792.50 WATER: $ 1,312,50 IRRIGATION: $ - TOTAL: $ 6,105.00 I I I WATER METER:I $ IRRIGATION METER $ SUB-TOTAL $ 9,464.161 - I [V~ $ 14,984.161 SIF'S'I $ 97.5% $ 2,5% $ T IF'S: $ 5,520,00 99% $ 5,464.80 1% $ 55.20 I TOTAL: Name: Address: ~~~IJ'1~W~l~IIIIIIIIIIII ~I" 111111111111I1111111111 Permit No. Rcpt: 531166 OS: 0.00 09/25/01 Rec: 10.50 IT: 0.00 _____ Dpty Clerk ~~92;~~IMANi : rcs;o fOUNT:, C~ERk OR Bk 4729 PG 517 TilE UNDERSIGNED herby gives notice that improvement will be maje to cerptn real property. and in accordance with Chapter 713. Florida Statues. the foIl ing information is provided in this Notice of Commencement. NOTICE OF COM~IENCEMENT F~orida STATE OF COUNTY OF Pasco 1, Description of property: (legal description of property. ~d street address if available) Legal Description Attached 2. General description of improvement: 3. Owner information a. Name and address: East Pasco Medical Center, Inc. 7050 Gall Boulevard, Zephyrhills, Florida 33541 b. Interest in property : (Donald E. Welch, CFO) c. Name and address of fee simple titleholder (if other than owner): R. 5. Surety a. Name and address: pOb1e Construction Co., Inc. 106 S. Palm Ave., P.O. Box 279 Howey In The Hills, FL. 34737 Contractor: (name and address) b. AIIIoun t of bond S N/A N/A 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 113.13(1)(a)7. Florida Statutes: (name and address) 8. In addition to himself, Owner designates the following person(s) to receive H copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes: (name and address) 9. is 1 year frolll Owner's Address: (Print Owner's Nawe) Ga~l Boulevard, Zephyrhi11s, FL. 33541 The foregoing instrument was aCknowledged before me this ()q I C)., r I ~ / by \<\c....~..c-~~ \~\1"\Q~~rsOnally kn~/WhO Produ=-~~ , as identification and who did not take an oath. ~ State of Florida County of VQS <'-6 ~~~:L\"\""" :.....~~)'.."l'...;:-\c)\f" My Commission (Notary) CollllDission N f C ~o~3 '7 Expires: .,:l-I-::2.........s- All Information Must Be Typed or Printed Legibly to Comply With Recording Requirements ~~"r~. 6:A)~ .Il,'t.....;.ff:~~ ,Rr..~" JUNE M, HERNDON MY COMMISSION # CC 980237 EXPIRES: February 1, 2005 80nO,0 ThN -IV Pulllio Uncltrwlilell Legal Description ZEPHYRHILLS COLONY CO LANDS PB 1 PG SS FOLL DESC PROP LYING W OF DAIRYRD RIW AS NOW LOCATED TRS 105,106,119,120 & 122 & TR 103 EXC W 187 FT OFE 267FT OFN 172FT ANnE 100FT OF TR 104 ALL EXC US HWY 301 RIW 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 lH S89DG55' 24"E 172.01 FTTOWLNDAlRYRDRlWASNOWLOCATED lH ALG W LN RlQ SooDG 10' 45" W 1137.22 FT TO S LN TR 122 SEING N LN DAUGHTER RD R/W lH ALG N LN RIW 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 120TNN89DG56' 31"W645.18FTTOE LNUSHWY301 RIW lH ALG E LN RIW NOODG 18' 30" E 562.80 FT TO POB LESS TIIAT PT TR 122 LYING 30 FT N OF.&OUTII LINE SEC OR Sf( 4729 PG 518 2 of 2 STATE OF' ~'"nn'n" c,, 1;,1'-1 JOUNTV CF Pi, " THiS is to (:;-"i",: mUE AND co",C:[ci . "TH~ r oriEG0/NG 'S A OR or. f'L!B/ Ie: " F'UcurlsEln 0'/ ;~L E ~. I), I--'(t:: l"IIl"~'r.S HA,~', 11'J', l'" , ',,?,-:,,,, :) M, / .~~" ,lA' ',~ JAr' OF JE~J ':i.'i;;i'<~2(J42/ BY / L' V'~' 'C>!lT CO, L, I RT . ..;t: ;?/ e2 C't 1'r:pU',"Y nL--!) "-,,/., G t lK