HomeMy WebLinkAbout01-0766
BUILDING PERMITN2
CITY OF ZEPHYRHILLS
(813) 788~6611
Permit
076t,
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i(- 2/- Of
Date
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BUilDING
?5'OO
ELECTRICAL
PLUM~
..
MECHA~
Sewer Conn
Water Conn:
Property Owner: :3T -30 Ser;.J, ~ t1; oft 'c- cA LlY c h
Job Address: <::;:2.. '10 /O...,..-t-r 5 r.
Water Meter:
T,I.F.'s:
Parcell.D, ,
Zoning:
Description of Work
Ener;Jde:
"7Je.1-c-. [ 0cvt~JL
Radon Gas:
;;J~~;;).V
NO OCCUPANCY BEFORE C.O.
FINAL / - d.?
C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
City License Registration #
State Certified License#
P",m;' Fee ~
;<Signature a ~
Company
Address
)(Jelephone# ?~2 -JORO
Valuation or
Contract Price
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:23'73
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BUILDING
ELECTRICAL
PLUM~G
,/
MEC~AL
Ftr. ~ 1 ~ 0 '~JI.JTp. Servo
Pre SLB ~ - o~~ ( /U'-7 Rough In ,/12-Z(-O(
Lintel Meter Can
FRM. Const. Pole
Insul. CL Pool
WL Pre-Meter
.s/lftl1rll/J);..- 1!ooF- WI9t.f-~~ Final
D' '.fl_/
r1veway "'"'e>
~y
2<"''{
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 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.
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~ WILLIAMS EARTH SCIENCES, INC. IN-PLACE SOIL DENSITY
CORPORATE OFFICE: NUCLEAR METHOD
r= : 10600 End..vour W.y, Largo. FL 33777 ASTM D-2922
~ : Lugo: (727) 141.- F...: /7271141-1510
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Pan.lII. CII,:
CLIENT: .. I,'"' ,- f PROJECT NO: /1 ) (': l .-, J
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PROJECT: I' i t.! " .'- REPORT NO.:
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SPECIFICATION: .-") - PERFORMED BY: ,
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SOIL TYPE: -' I DATE TESTED: J / ! ., , ,
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MAX. DENSITY: I R' , OPTIMUM MC %:;' / PROCTOR #
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Test No. DeDth or Description ot Test Location Dry Densitv Water Lab. Max Percentage PASS
Elevation Dct. content Proctor Com pactio" I ~
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COPIES TO: DATUM: -,,~'-j .. /::t,' J-"..... '.1 ~ .... /.."(,.:: '- T' /f ...(.
NOTES: \ '. f~' " .' !~G
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PLEASE SIGN TO ACKNOWLEDGE RECEIPT OF YOUR COPY:
WHITE. BILLING YELLOW: FILE PINK: CLIENT
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CITY OF ZEPHYRHILLS PERMIT APP't~O~~d-O~r:v
" .
BUILDING DEPARTMENT 5335 sth STREET ZEPHYRRILLS, FL 33540
Phone: 813-780-0020 Fax: 813 -780-0021 L! /11-0 I
' . DATE RECEIVED __ - _L
~ PLANS REVIEW FEE """===
OWNER'S NlIME fJ'flce f;e 0+' Sf fJe~,6~..5ff..,;'~ ~~PHONE CONTACT 7f'l- -:A ~/3
JOB SITE ADDRESS ~~ /~ g Ze~'IR..~'1A .k
LEGAL DESCRIPTION: LOT(S) Ift- j~- GO BLOCK ilil SUBDIVISION (..-IV O.{I Ge~rL~~'/d
PARCEL ID # 1/. 2. fD - "2./" 00/0 ".
WORK PROPSED: ~EW CONSTRUCTION
DSIGN
/3/00 - OJ30
(OBTAIN FROM PROPERTY TAX NOTICE)
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING
DMULTI-FAMILY
D# OF UNITS
o MOBILE HOME
o COMMERCIAL
o INDUSTRIAL
o SWIMMING POOL
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK De. fIKA (Lei GA-~A r P L 2-1 ~ Z. '1 I
BUILDING SIZE 2. 2./..L 2- tt J SQUARE FOOTAGE ,-c)<~8'
HEIGHT
RESIDENTIAL: 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
~BUILDING $
*ECTRICAL
o PLUMBING
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
1Q~
00
90b .
~oD
~
~q~'
q
~o
o MECHANICAL $
VALUATION OF MECHANCIAL INSTALLATION
o GAS 0 ROOFING D SPECIALTY
\
TYPE OF CONSTRUCTION: 0 BLOCK
o OTHER
o FRAME
D STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT
YE
COMPANyW.A.N eUhlANI\J c'~s.J, J'A.)(.
unA) STATE CERT OR REGIST ~ (13- COSJ?Js;;.,
SIGNATURE ~ CITY PROCESSING ~:2$'7::?). ~~
~~ ~O''''~11
**********************************************************~******
ELECTRICIAN ~ ~ COMPANY CIl-S; PIJS( 0 e/ e<:..f,
- /.:L" STATE CERT OR REGIST # ~/15"y/
SIGNATURE L If CITY PROCESSI~G iL~ /-178 V
***** **** **********************************~***********~*******
BUILDER
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
MECHANICAL
******************************************************************
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
T~e 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 contrftctor 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 requi~ing 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
$~~U~OT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
STATE OF FLORIDAt,:)
COUNTY OF (\ ~ ( 0
The foregoing instrument was acknowledged
Befor~ f!le this \ ~ )day. of t00 ~, , ~
by L" <::'C"~"i 'c .q {, c: L 'j ( rc '
(name"of person ackn~wledged)
Owho is personally known to me, or
plWhO has produced t=-l.--- r-- o:A.?-v ~v \ - 1") - c.') '-1[e
(type of identification)
and who[ldid ~did not take an oath.
,-- (:j ,-',-
STATE OF FLORIDA
COUNTY OF
The forego~ng instrument was
Before me this _____day of
by
acknowledged
19
(name of. person acknowledged)
[1ho is personally known to me, or
D who has produced
(type of identification)
~id not take an oath
and who Ddid
Signature of person taking acknowledgment
~gnature of persorCta ~
acknowledgement
Name typed, printed or stamped
. ~ mtYEOOMMISSION # CC 831436
EXPIRES: May 14,2003
.' Bonded Thru N*ry Public UndtlWril81'8
------~.._.,.._----_.,
State of //oil. J' t! If
County of
1111111111111111I1111111111111111111111111111111111111111111
2001158663
~~rCJ
NOTICE OF COMMENCEMENT
TUB UNDERSIGNED hE:reby gives .~. ~::~~p. ~he.~': ii1lprovement will ~e made to c~rtain
teal property, and in accordance with Chapter 713, Flor~da Statutes, the
following infor~ation is provided in this Notice of Commencement:
1. Description of Property: :?arcel No. )}- z.,,-2J- (Jo ({) I JJ>JOV- Ol,fo
(Legal' ddscr~ption of the property and street address ~f available)
2.
General Description of Improvement
D 0 IfJr 4~,j {;J.Atf.,~ -e
O"ncr Information: Namc D;ttfl.J;tje C!>f' Sf f{j.(JL~,L..~ /cjt~9!f 1t...I-.
)U!> \:I city Cep47~kj{, State ;:1-
Interest in Property:
3 .
l~ddressS Z t../o
Name of Fee Simple Titleholder:
(If otter th~n owner)
Rcpl: 543757
OS: 0.00
11/15/01
Rec: 6.00
IT : 0 . 00
Dpty Clerk
Address
City
Stilte
4 .
R
l,~ontractor: Name !lJ.1l;?)eUhl4A.1"v/ GtJS..J1l ur -i'~7"'../
Address f? [) 80 ~ ):J [> '7 City ~ ~Iv.jo.v..u
State .rL.-
33,rJk>
5. Surety: Name
Address
City
Stat.:!
Amount of Bond: S
JEO PITTMANft PASCO COUNTY CLERK
11/15/01 00:43am 1 of 1
OR BK 4774 PG 391
6.
Lender: Name
Address
City
State
7 .
Persons within the State of Florida
notices or o~her documents may be
71J.13(1)(a)(7), Flot'ida Statutes:
designated by Owner upon whcm
served as provided by Section
tl~me
Add.r: e 5 S
City
State
8. In addition to himself, Owner designa+-es
of to receive a copy of the
Lienor's Not~ce as provided ~n Section 713.13(1)(b), Florida Statutes.
M-
, I-S+---
this _
Fe R:)..~. 3.0 l - q -> - (ll \ l 'U
day of f\J ~ Ve"n I~fr
.fa to C.' I . '::1
Not.:>ry Public: ~. ~~-c'5?~~-
MYC:,):n;n.lSS~OnEfp~res: /. - ~
TRlNA BURY
rQMUJSSIcw.l!.C~~.l
EXPJRES:'May 14. 2003
Bonded Thru NOllry Public Underwrit....
----
PC93053048