HomeMy WebLinkAbout02-1116
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(813) 780-0020
MECHANICAL
Property Owner:
Job Address:
Parcell.D. ,
1 1 1 6
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Descriotion of Work
Energy Code:
i\J eW pc&o
Radon Gas:
SIan
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.
Valuation or (;JO
Contract Price ~ Va.tJ .
Permit Fee
AS. ignature
/
Company
Address
'6elephone#
City License Registration #
State Certified License#
FINAL
DATE
Inspector
~
F /3 - 7 cf ~ - 6 5' e ,C;
1bAJ&d;h-rf SIVn~
BUILDIN'G ..JI ;)1;:; I ELECT
Ftr. h - 3 -tJ ~ ./(..-ro
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Ca
Const. P Ie
Poot
Pre-M
Final
SLB
Tub Set
Water
Sewer
Final
Driveway
AL
Breakers
Ducts Ins
Compr
Fina
/
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) shaH 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
CIT~ OF ZEPHYRHILLS
BUILDING DEPARTMENT
I rf"
~~~ 3.~7-t()~t5t-
,.-- _---.:.._---
~;TE 'RECElVED :3 - ~'l-de::L
PLANS REVIEW I'Ii:B
OWNER' S Nl\M;--11~ ~~~ l_ eJ-t.-W\h6~ (ear W~'5h )
JOB ADDRESS ~,5' 'I ~ (~'lL ( $1 LI~
PHONE 77 '1- ~1 77
LEGAL DESCRIPTION: LOT(S)
BLOCK
{ r -;{ b - :21- ~o 10 - O~'tt?- O;l..5(!)
SUBDIVISION
PARCEL ID #
IOBTAIN FROM PROPERTY TAX NOTICF.l
WORK PROPSED: ONEW CONSTRUCTION
~IGN
PROPOSED USE: OSGL F'l\MlLY DWELLING
o COMMERCIAL
o ADDITION
o ALTEAA'l'I ON
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
Nj~ ~/p
s " '^'
SQUARE F'OOTAGE
BUILDING SIZE
'y
HEIGHT
..2C;-~"
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.'h
PROPERTY SURVEY REQUIRED FUR ALL NEW CONSTRUCTION.
o BUILDING
$-
'" ___ tOt:'
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
r-
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SERVICE
o
FLORIDA POWER
o
W.R.E.C. ~~
S'/g
15~ ~''l!
c e.l/
a1s ;f61
VA LUA'!' ION OF MECIIANCIAL INSTALLATION
)TIIER
R-/1
HJ\ME
o STEEL'
o OTHER
IS PROJECT IN FLOOD ZONE AREAO YES
o NO
!!g
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING fi
SIGI
******************************************************************
ELli:CTRICJ:AN
COMPANY
STATE CERT OR REGIST fi
CITY PROCESSING n
SIGNATURE
****************************************************************..
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
MECHANICAL
***....***~**************************.****.**********.****.*******
COMPANY
STATE CERT OR REGIST n
CITY PROCESSING n
SIGNATURE
OTHBR ~~
SIGNATURE ..' ./ .
*****************************************************************
*********************.**.**..**......****************.*.***.....*
COMPANY ,y"II..JA T!4Wt't. s/'~ ~. \
STATE CERT OR REGIST n' SI ' '1 J f1 L 71t$(J~
CITY PROCESSING # :lS"S I
-.
.
COIWITJONS OF' PEHMl'l' AI:'n/JAVI'l'
A. NOTICE OF' DEED HF;S'l'IUCTIONS
'I'he 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 CONTHACTORS AN/J CONTAACTOH HESPONSIBll.l'l'IES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed ill accordallce with slaLe and local regulalions. If the contractor is not
licensed as requi.r:ed by law, both the oWller and cOlltractor 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 fOI: the intended wUlk, they are advised to contact the
City of Zephyrhills Building Department, 013-760-6611.
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 (ClIl\PTEH ., 13, F'j,ORIUA STATUTES, l\S 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 conunencement.
E. CONTRACTon' S/OWNEH' S AFF'IDAVIT
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 indit:ated. I
certify that no work or installation has cOllunenced 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 understatld 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 Envirorullentally Sensitive
Lands, Water/Wastewater Treatment
"'Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
"'Anny Corps of Engineers-Seawalls, Docks, Navigable Waterways
"'Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection A9".ncy-Asbestos abatement
I also certify that, if fill material is to be used in F'lood Zone "A" or "A,etc.", it is
understood that a drainage plan addressing a "compensating volwue" 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, callcel, 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 cOJlunenced 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 cOllunenced. 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 tile Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNEH: YOUR FAILURE TO RECORU A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS '1'0 YOUH 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 DO NOT NEED '1'0 RECOHD AND POST A "NOTICE OF COMMENCEMENT".
SIGNA'rURE: OWNER on AGENT
SIGNATURE:
CON'rRAc'rOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
19_
STATE OF FLOIUDA
COUNTY OF
'1'he foregoing instrument was
Before me this _day of
by
acknowledged
, 19-=-
(name of person acknowledged)
o who is personally known to me, or
of identification)
take an oath.
(name of person acknowledged)
Gho is personally known to me, or
o who has produced
(type of identification)
and who Odid [}::lid not take an oath
o who has produced
(type
and whoO did Odid not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
..
..
\
RMC Ewell, Inc.
P.o. BOX 3858
LAKELAND, FL 33802
TELEPHONE (863) 688-5787
1-800-282-4657
CORPORATE OFFICE
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..........,.-' Freshly mixed, cement, mortar concrete or grout
may cause skin injury. Avoid contact with skin where possible
and wash exposed skin areas promptly with water. If any
cement mixtiJres get into the eye, rinse immediately and
repeatedly with water and get prompt medical attention.
When sawing or grinding concrete blocks, wear approved
respirator and goggles to prevent eye and nose irritation.
KEEP OUT OF REACH OF CHILDREN.
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TOTAL
TODAY:
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WATER ADDED
ON THE JOB:
GALS:
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SUB TOTAL
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ANY WATER ADDED TO THE MIX ON THE JOB SITE WILL BE AT THE CUSTOME.B!S' RISK
The Company, when delivering materials beyond curb line. will not assume liability for damage to sidewalk, driveway,
septic tank or other property when directed onto property by Purchaser or Purchaser's agent/so One (1) hour allowed
for unloading. Overtime beyond Allowed Unloading Time, or after normal working hours will be charged per current
price list. Diversion of a load from one job to another will carry a Diversion Charge per current price list. A
Handling/Restock fee, per current price list, will be charged for all materials picked up by company equipment from _
the curb line of the Purchaser's property. Only materials in resaleable condition, as determined by the Company, will'..
receive, full credit. The purchaser of materials delivered agrees to pay for same within credit payment terms. and
upon failure to pay for same, and the necessity of placing the account in the hands of an attorney for collection, will
pay all cost of said collection including a reasonable attorney's fee. Interest will be charged on delinquent accounts at
the maximum rate allowed by law. Proper venue for suit will be Polk County; Florida.
.~;-
TIME ON JOB:
RECEIVED BY:
CROSS CURB RELEASE
TIME OFF JOB:
CliSTOMEiR'S COPY
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FORMS ""
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SILCOX ENGINEERING, INC.
5409 Nebraska Avenue
TAMPA. FLORIDA 33604
Phone(813)2~9755
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SILCOX ENGINEERING, INC.
5409 Nebraska Avenue
TAMPA, FLORIDA 33604
Phone (813) 238-9755
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( DIGITAL MESSAGE BOl~.RD ]
I, Douglas Clemson owner of Ben's Car Wash, authorize North Tampa Sign to permit
and install a sign. The sign wind load engineering and all necessary permits will be
obtained by NTS. The sign installation of (1) 6'X8' lex" Ie faced sign,
pole to meet engineer..ng wind load, and (2) 24" X digital message boards~ Wiring to
be done by an electrical contractor.-
Notary seal
The bottom of the digital message board to be at 18' above the road grade. This would
put the top of the sign at approximately 29'. The location of the sign will be in the North
West retention pond in line with area signs and approximately 10' from the North wall of
the pond. )
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Signed March 15, 2002 by Douglas F. Clemson
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~ KATHRYN S. KOCA
i*f ~~ MY 9OMM~SION # DO 006840
'. . . EXPIRES; May 12,2005
. . Bonded r.... NolIIy PuII/Ic UndonrnIer.
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1ms Instrument Prepared by: Linda C. Poston,
, An Officer of Associated Land Title Group, Inc. (280),
6301 Gall Blvd" Zephyrhills, Florida 33541,
For Purposes of Title Ins.
File # 280-7014
Parcel ID # 11-26-21-0010-08900-0250
Warranty Deed
me terms "grantor" and "grantee" herein shall be construed /0 include a/1 genders and
singular or plural as the context indicates.)
Made April 15, 1999, BETWEEN
Richard E. Schendftlnd Lois E.Schen~k, his wife as Trustees of The R.L. Sche~cl4Living Trust
dtd 9/25/89
whose address is
of the County of , State of Florida, grantor, and
DOUGLAS CLEMSON and GAIL CLEMSON, his wife
whose address is
of the County of , State of Florida, grantee,
WITNESSETH: That the said grantor, for and in consideration of the sum of Ten ($10.00)
Dollars, and other good and valuable considerations to said grantor in hand paid by said .
grantee, the receipt whereof is hereby acknowledged, has granted, bargained and sold to the
said grantee, and grantee's heirs, successors and assigns forever, the following described
land, situate, lying and being in Pasco County, Florida to-wit:
A SURVBY OP THAT PORTION OF THE VACATED BCL RAILROAD
RIGHT-OF-WAY IN SECTION 11, TOWNSHIP 26 SOUTH, RANGE 21 BAST
DEScaIBBD AS POLLOWS:
COMHBNCING AT THE SW CORNER OF BLOCK 89, CITY OP ZBPHYRHILLS, AS
RECORDBD IN PLAT BOOK 1, PAGE 54 OF THE PUBLIC RECORDS OF PASCO
COUNTY, PLORIDA, RUN S. 63028'30" W., 60.0 FEET TO THE WESTERLY
R~GHT-OF-WAY LINE OF 7TH STREET, THENCE N. 26025'00" W., 440.80
FEET ALONG THE WESTERLY P..!GHT-OF-W.l\.Y LINE OF 7TH STRBBT POR A
POINT OP BBGINNING, THENCE S. 63028'30n W., 200.0 rBBT TO THE
EASTBRLY RIGHT-OF-WAY LINE OF U.S. HIGHWAY 301, THBNCB N.
26025'00n W., 80.0 FEET ALONG THE EASTERLY RIGHT-OF-WAY LINE
OF U.S. HIGHWAY 301, THENCE NORTH 63028'30" E., 200.0 FEET TO
THE WESTERLY RIGHT-OF-WAY LINE OF 7TH STREET, THENCE S.
25025'00" E., 80.0 FEET ALONG THE WESTERLY RIGHT-OF-WAY LINE OF
7TH STREET TO THE POINT OF BEGINNING.
Subject to easements and restrictions of record, if any, which are specifically not
extended or reimposed hereby. Subject to 1999 taxes and assessments.
and said grantor does hereby fully warrant the title to said land. and will defend the same
against the lawful claims of all persons whomsoever.
Page lof2
...
'510
For Recorder S Use Only
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~d by/Record & Return to:
, : J, Trow, Esquire
J. Trow, P.A.
t Avenue, Suite 303
Fl 34470
'';I -8830
1111I11 11111 11111 1I11i 111111111111111111111111/11I11 IIIIIW
2001097705
Rcpt: 51405~c: 15,00
os: 0. 70 //', . T : 0 . 00
07/19/01 Cz.~;f' Opty Clerk
JEO PITTMAN PRSCO COUNTY CLERK
07/19/01 0S:51am 1 10f943
OR BK 4670 PG
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WARRANTY DEED
l~
; 'is INDENTURE made this ~ day of July, 2001, between DOUGLAS
CLEMSON and his wife, GAIL CLEMSON, whose maiHng address is 39746 Otis Allen
Ro( 1, i ,"phyrhills, FL 33540, whose Social Security Numbers are
and
-' respectively, GRANTORS, and BEN'S CAR WASH, INC., a Florida
corporation, whose mailing address is 6400 12th Street, Zephyrhills, County of Pasco,
Sto;, , iorida 33540, and whose Federal 10 Number is 59-3609506, GRANTEE,
" I NESSETH, that the said Grantors for and in consideration of the sum of Ten
ane) , 00 Dollars, to them in hand paid by the said Grantee have granted,
bar( Ii :.j and sold to the said Grantee and Grantee's heirs, successors and
ass!.: il ever the land described on Exhibit "A" attached hereto.
I \:0 County Tax Parcel No, 11-26-21-0010-08900-0250
defc: I 'I~ same against the lawful claims of all persons whomsoever.
. said Grantors do hereby fully warrant the title to said land, and will
, " iTNESS WHEREOF, the said GRANTORS have hereunto set their hands and
seal~, 'j
:ay and year first above written.
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REVISION S
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DRAWN BY:
C,E.T.
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ENGINEERING, INC.
5511 7th STREET . ZEPIlYRIllLLS. FLORIDA 33540 (813) 788-0400
ENGINEERING BUS. NO. 5331
98277
B E'N' S
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1-21-02
SITE PLAN
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98277PDREv
EDWIN J. ROGERS
P.c. No, 50082
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