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HomeMy WebLinkAbout02-1124 BUILDING PERMIT 0 CITY OF ZEPHYRHILLS Permit N_ 1124 (813) 780-0020 JJ -'J Date ' r - ~ r 0 :2.. Sewer Conn Water Conn: 1+\..1 SS/f!.l'~ Water Meter: G,r~ 1Io~/~ T.I.F.'s: fV\ H f? MECHANICAL BUilDING ELECTRICAL PLUMBING Property Owner: Job Address: Parcel I. D. , ~0/1~ f?hl1-~fS .1 5/ r e-v\e... l ve, Zoning: DescriDtion of Work Energy co~ Q.(J/~(e Y1W . ~ Radon G~s: {,a..- LJ .-....cU-W 5 FINAL DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. DATE Inspector p~rmit Fee ~5' n YSlgnatu~~~ Company Address ~elephone# fB(3. 01.4.."7 1.3 b 0 Valuation or Contract Price & I L( 5'y - ()O ;21/ V City license Registration # State Certified license# 7(rnA ~ sen/. Ff BUilDING ICAL PLUMBING MECHANICAL Ftr. Pre SlB lintel FRM. Insul. Cl Wl Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SlB Tub Set Water Sewer Final Breakers Ducts Insl. Compress r Final Driveway 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. CITY OF ZBPHYRHILLS PERMIT APPLICATION BUILDING DBPARTMBNT 5335 Sth STRBBT ZBPBTRB:ILLS. I'L 33540 PhoneIS13-780-0020 l'axI813-780-0021' DATB ilJICBJ:VlID PLUS RBVXBtf I'BB . OWNER' S NAMB(,)~",,.t;; ~ Pt'rl]~ ,(" ~S' sl ~ ~ JOB SITE ADDRESS 37 ->l o Lap.. ~ 1'Jp, !r0... PHONE CONTACT SUBDIVISION &1A~ 0 M-6LJ'Z..~ ~ P.4,&E ~ LEGAL DESCRIPTION. LOT(S) ('3 S PARCEL ID # BLOCK WORK PROPSED: DNEW CONSTRUCTION (OBTAIN FROM PROPERTY TAX NOTICE) DADDITIO~ DALTERATION o REPAIR o INSTALL DSIGN PROPOSED USE: DSGL FAMILY DWELLING o MOVE o DEMOLISH o MULT I - FAMILY 0# OF UNITS D SWIMMING mOL D MOBILE HOME o OTHER o COMMERCIAL o INDUSTRIAL c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL ~ .' I?ESCRIPTION OF WORK ~'tM..A. 1:1 R€',B~~'.S( v>v.abl.lI.J'.J" >t24Z ~~/ ~ BUILDING SIZE SQUARE FOOTAGE HEIGHT RESIDENTIAL: COMMERCIAL: ~TTACH (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. PBRMITS REQU8STBD Ip.-BUILDING $ 6Lr.f"g.. 00 VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C. D PLUMBING D MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION D GAS D ROOFING . D SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLqCK o FRAME o STEEL D OTHER FINISHED FLQOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREA DYES D NO :_.1 :,: ,,:,' , ',' ,': :, C'. I , : I ,".', ~ _ . ,:' ""~":"~."<\.': BUILDBll SIGNATURE. ~B : . .t?- -- COMPANY /( "Y'L--A 1~'S~,hUz~ ~ e:.- STATE CERT. OR REGIST # CRe 0.:>-8 $"6e CITY PROCESSING # c:t C( I Lf. ************************************.******************.**.******* BLBC'l'R.ICIAH SIGNATURE COMPANY STATE CERTOR REGIST # CITY PROCESSING # **.*.*********.******.******************************************** PLUMBBR COMPANY STATE CERT OR,R8GIST # CITY PROCESSING # . '>.", SIGNATURE IIBCRAHlCAL' **.**********~**************.*********************.*************** COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ************************************************...*......****..* O'l'BBR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ..*.*****.******..*********************************************** r,', CONDITI0NS OF PERMIT AFFIDAVIT A. NOTIC~ OF DEED RESTRICTIONS The undersigned underatands tljat thia permit may be eubject ',to 'deed reatrictiona- wbich" may be more restrictive than City regulations. The undersigned assumes responsibility for com,pliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner haa hired a contractor or cootractor. to undertake work, they..y 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, 813-188-66ll. 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 113, FLORIDA STATUTE~, ABAMENDED) 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 uowner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the uowner" prior to commencement. E. CONTRACTOR' SimmER' S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in compliance with all ap.plicable 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"r understand that the regulations of other governmental agencies may apply to the intended Work, and that it 1s 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 *S.outhwest 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 flll material is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a ucompensating 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 00 NOT NUD TO RECORD ANO POST ~_'::F ~__" SIGNATURE: OWNER OR AGENT ,....c' SrGN.ATURE: ~ STATE OF FLORIDA STATE OF FLORIDA (V 'e& COUNTY OF COUNTY OF . ,,__ 6L-5l. The foregoing instrument was acknowledged The foregoing instr ent was a Before me this _ day of , 1~ Befo e me this ay 0 by by (name of person acknowledged) .0 who is personally known to me, or Owho has produced ( type and whoO did Odid not of identification) take an oath. owl edged , a~~ Signature of person taking acknowledgement Signatu~o"of persQn takinci acknowledgment "",.,.,v.r!% BObbleSwetlClfld ~~A'A MY COMMISSION #CC893160 EXPIRES ~~'. :;: Februnry 22 2004 Name t.;YP,~: I>>~i'i~RCl(ftIN I~WipIt!l'd Name typed, printed or stamped 2 :: ~ > ~ ~ ~ ~ ... ~ " ~ n c 2 " ~ ~ > 2 " S > ~ > " '" ~ > ~ '" i ~ " ~ ~ ~ ~ > 2 ~ > " '" > " ~ ~ ~ in ~ ~ Cl > n n '" ." -i '" o O:l :'" Vl tTl;xl > (j tD c: ;:Q rT'l c: ,., -<: ~ b~~8:: =i ~~~~6 rri ZN-C: o ~8~~ ~ g8~a R~~~ -<:::aoc ~5~~ Oomcc ,.,?,>~ ~d~~ ?;;<a~ tTl~~~ -l::;;mtTl ~~a~ ;;laiii~ f~g~ >:::Q~ r"'" '" ~~~ C3::0): ~6~~ ~~~~ ::Q~E; R2~F; C -ltTl r'!"I ~~~~ a8Q~ ~6~~ :::"",C z~~~ > ><'l to:> ~.., ~ ~=;;d t ;:cIz tTl ~ ~~~~ -1m.. - ,~ ~a:;~ '.51 ~~~~ :'\) On tTls;: z""o-< ~Q~g ;::r::l-!-l:::O ~ Ii' ~ ~ ~ ~ ~ I' ~ ~ijf'..- r) (). 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" I~ lk ~~ ~a. ~~ H .~_cnl ill Hi ce _ ;::;::T:; =- ~., c.. -! 3 a.:.~ Ul ~ ~ -.-, Il __. = "", r...... e s-g.ii ~3:1 ~ =_ r. n _ ~~!~;H~ - e -. _~ ~ ~~ ~;; ~ " ~~ ~i ~ H ~i~ a~ ] ~ ~ ] ~ [~. a [~ [~~ ~ g !~.; _., n Ilol 0 ::T ~ O"::"C ~..!.. .., c..!:; g-~ ~ ~.:; ~a g~ g Q C;" e:.. n e:. ;~ ~ g>2. ~~ ~~: ;;.:. -g ~. if ~g. :1g,~ Q. ::T - 0 *;: ~ g.;i i-~ ~ ~ ~ =~ ~ 5 COon :::l ~ ~ ~ ~ "'C 3 V1 ri ~~. ~ ~~ . ~" E~ [~ ~ ~~ ~6 ;~ o ." 5> Q ..: z ~. ~ ~' ~ ~ ~ ~ ~ ~ e.g , :z ~Ul ~~ cr::: : r [ g' ~ ~ ~ g. fi f: ~~, ~ n ~ ~ l~ ~.~ ~ ~ " "' ~ ~ . <: ~ ~;; ~ ,,~::; c '" ~ ;> ,.. ,.. >: C 2 '" C 2 '" ;> '" --::e ~~~ "';J! ~ ~ N -5 .~ -J Return to: Name: RMA Home Services, Inc. Add.ress: 3200 Cobb Galleria Pky. Ste. 200, Atlanta, GA 30339 ,R;. ~~~~~~~~J~II 1111111/1/ 111I1 11111 '111111'" 11111111 This Instrument Prepared By: Name: Peggy Payne Address: 3200 Cobb Galleria Pky. Ste. 200, Atlanta, GA 30339 Rcpt: 574607 OS: 0.00 03/20/02 Ree: 6 0 IT: . 0 0.00 Dpty Clerk ~f92';~1"'RN PRSC OR 81( 48904p", 0 POUN~~ ClERI( 3 PG 264 Property Appraisers Parcel Identification: ,;: NOTICE OF COMMENCEMENT Permit No. Folio No. 34-25-21-0090-00000-1380 STATE OF FLORIDA COUNTY OF Pasco The undersigned gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. Legal description of property (include street address, if available: Lot 138, Grand Horizons-Phase One, Plat Book 34, Pa es 99-102, ublic records of Pasco Coun , FL NKJA 375/0 Lorena Aveune, Ze h rhills, FL 33541 General description of improvement: Installation of replacement windows Owner Information - name and address: Wayne E. Husslein and Phyllis J. Husslein 375/0 Lorena Avenue, Zephyrhills, FL 33541 Interest in Property: Name and address of fee simple titleholder (if other than Owner): .' . ---'~, :'," Contractor - name and address: The Home Depot Installed Sales 8: , '.~ 1212 North 39th Street, Suite 402, Tampa, FL 33605 , : Phone Number: 813-247-1300 Fax Number: ~,~,!1 ;:; Surety - name and address: Lender - name and address: Phone Number: 813-247-1313 Fax Number: Amount of Bond: $ Persons within the State of Florida designated by Owner whom notices of other documents may be served as provided by Section 713.13(1 )(a)7., Florida Statues: Name and address: Wayne E. Husslein and Phyllis J. Husslein 37510 Lorena Avenue, Zephyrhills, FL 33541 Phone Number: Fax Number: In addition to himself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13( I )(b), Florida Statures. (Fill in at Owner's option) Phone Number: Fax Number: Expiration date of Notice of Commencement (the expiration date is I year from t 01 Si~f wner Ph~ 'J."Husslein Printed Name of Owner Printed Name of Notary: Commission No.lExpiration: ........................".................... III"'I.~ R. YVENPeI,.L ~KINNEY : ~RIm88103 : · . EIlIIiret 1131/2008 i iJCIF landed through i ~'''"'''' P1DrIda Notary Assn., Inc. : .....TI..................................... /-31-~ ~~.'" /-\ ":-~.:- C;F~ F:.....~;,~ i :<~, ~\ OF pt'lSGO - ".., Tel C:ZF:: 'i!.- lril\TTHE FOREGOING IS A T, , L \',"'::i' II : hE OOCUMH.IT ON F'LE ~~2:,;'fl.", ::;:~~N~~~~; ':" ,'.,: , .: 1:...,/ ,I'J," , 3,:, ()f' WGUIT CURT L J'_____ ___. dTY CLERK