HomeMy WebLinkAbout02-1236
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BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N2
(813) 780-0020
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~MBI~g,....) ~HAN9L
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1236
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Date ~ -;2../ -O~
Sewer Conn /2 7?
Water Conn: $;{)l)
IRo
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CJ!UILDJ.~G/
Property Owner: '\
Job Address:
Parcell.D. ,
T.I.F.'s:
Zoning:
DescriPtion of Work
FINAL
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.
DATE
City License Registration #
State Certified License#
o
28.;z/
Permit Fee
~~atlmb
Company
Address
~~~_~_~~'1J~~-111- 3510
Inspector
Valuation or
Contract Price /l'.z D 0 ()
BUILDING
PLUMBING Ita 9
MECHANICAL /7
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Finalt/5"-:J.~' --O-;;z
SLB
Tub Set
Water
Sewer
Final ,/5 ~.::J...5J-- tP":; NfC'
/ZLy
Breakers
Ducts Insl.
Compressor
Final /'5"- .21>>"-- 0 ::J...#,;To
RLy
f?t.. Y; #:fb
'I
Driveway
W~.E.o S kril e 10 ;3fl- (P!:;.u!rJ.. U
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.
b.
c.
d.
e.
f.
g.
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
/Ree, d~jJ
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
0II8B8'. 8AMO ,?CJ"-"-\' ,,~Jc'1Dc- DA<<-R.
JOB SITR ADDRRSS LrODO 1C-id..q t. L0 ALl D~ \,) <L
LBGAL DBSCRIPTION: LOT(S) ~ ~ BLOCK
CITY or ZBPHYRHILLS PERMIT APPLICATION
BUJ:LDIH'GJ DBPARTIiBHT 5335 8th ST.BIIT ZBPBYUJ:LLS. I"L 33540
Phone .113 -780-0020 Pax. 813 -780-0021 ' . -'_. 1_ ?;:2.,-
bATB UCJlZVlID, "7 04 0
e.
PLUS .IIVID nB . .
PHONR CONTACT ~''3-1(1-- sS/()
PARCRL 10 it 3- ze",- 2..1-:- DI:tJ- 00000- 05 2:0
SUBDIVISION
WORK PROPSRD: '~RW CONSTRUCTION
o SIGN
OADDITIO~
o MOVR
(OBTAIN FROM PROPBRTY TAX NOTICB)
o ALTRRAT ION 0 RBPAIR }g, INSTALL
o DBMOLISH
PROPOSRD uSB:DsGL FAMiLY DWBLLING
o COMMERCIAL
OMULTI - FAMILY
0# OF UNITS
o SWIMMING- PbOL
~MOBILE HOMB
o OTHBR
o INDUBTRlJU.
D'RBSTAURANT &
I?BSCRIPTION OF WORK ,....., I\s-t f.\\\ Nccw
BUILDING SIZB ;;1..(, .~)( 5~
HBALTH DBPARTMBNT APPROVAL
\1)06; L
Ho~E...,
I, Lf~9
HBIGHT
( c_'
SQUARB FOOTAGB
RBSIDBNTIAL:
COMMBRCIAL:
~TTACH (2) PLOT PLANS & (.2) .SBTS OF BUILDING PLANS & (1) SRT ENBRGY FORMS.
ATTACH (3) SBTS OF BUILDING PLANS & (1) SB'!' ENBRGY FORMS.
PROPERTY SURVBY RBQUIRBD FOR ALL NEW CONSTRUCTION.
~ BUILDI~G
.~ BLBCTRICAL
.~ PLUMBING
b MBCHANICAL
$ . 72, oC>C)
Zoo
PBRHITS RBouaSTBD
VALUATION OF TOTAL CONSTRUCTION
AMP SBRVICB
[) FLORIDA POWBR
v
W.R.B.C.
$
00
I ,S 00 VALUATION OF MBCHANCIAL INSTALLATION
o GAS
o ROOF;lNG . [) SPBCIALTY
o OTHBR
TYPB OF CONSTRUCTION'I 0 BI,QCK 0 FRAMB
''<_ <;;z l/
FINISHED FLQoR BLBVATIONS ~,)
o STHRL
~ OTHBR
rs PROJBCT IN FLOOD ZONE AREAl] YBS
'lrNO
BUILDB.
SIGNATURB. ~ :~
COMPANY G A.+Do'L l ~s.poa:t /0 <5c+-~u.p
STATB CERT. OR RBGIST # .::::t t\ D 00 0 l..f t, 7
CITY PROCBSSING # .Z~ 2-\
BLBCTa:rc:rU
'SIGNATURB~
c.
~****.**.**A*.****.****..*.**.****..***.****.*.*.*...**.*******.*.
'YV\~
,
COMPANY -..JOfLOOr') EIELf-Q,j- e-
STATB CBRT' OR RBGIST # C R 60CYG..; ~
CITY PROCI!;SSHIG # t { 0
\ r, "
PLUllBB.
SI(]NATtrnB~
**.*.**.*..*....***.*****.***.*****.***************.*.**********.*
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COMPANY .JO(l.()Of"\ -:Ph.L~~ .
STATE CHRT OR .REGIST # Rf' 00 ~ .lz-3Co <g
CITYPROGESSHlG #.' / ~ 9
IOICIIAH:rCAL'
SI""A~OD~' ~J(
**********************.****************************************1***
.. . COMP~\ S G-A..-5 j(1 A (}
STATE CERT OR REGIST. # ~.~
C!TY PROCBSSING # \~
Ll~CL ~~'
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OTaB. .
*****************************************************.***********
SIGNATURB
COMPANY
STATE CBRT OR REGIST #
CITY PROCBSSING #
*****************************************************************
CUNVITI0NS OF PERMIT AFFIDAVIT
A. NOTIC~ OF DEED RBSTRICTIONS
The und~rsigned understands t~at this permit may be subject:,to "deed restrictions" which
"lnay be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTAACTOR 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 contraotor is not
licensed as required by law, both the owner and contraotor may be oited for a mdsdemeanor
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 Becttons" of this application for which they
will be responsible. If you, as the owner signs as the contrillctor, 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 pe.rnrl.tting pr1~ileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEEB AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, ABAHENDED)
'1 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
bave 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 AFI"IDAVlT
I certify that all the information in this application is accurate and that all work will
be ~one in compliance with allap'plicable laws regUlating construction, zoning, and land
development.
Application is hereby made to obtain a peDmlt to do work and installation as indicated. I
certify that no work or installation has oommenced prior to issuance of a peDmlt 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 "1 understand that the regulations of other gove~ntal 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 Di_trict-Wells, Cyp.ress 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 ~ill material is to be used in Flood Zone "AN or "A,etc.N, it is
understood that a drainage plan addressin9 a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the Stste of Florida prior to permdt
issuance.
A permdt issued shall be construed to be a license to proceed with' the work and not 8S
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. Everypermdt
issued shall beoome invalid unless the work authorized by such pe~t is oommenced 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 OWNERz YOUR FAILURI!l TO RB<;:ORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
fAYING TWICB FOR IMI?ROVEHENTS TO YOUR fROfERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTOIUIEY BEI'O~ RECORDING YOUR NOTICE OF COMMENCBMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT""
.~R~OWIlB~~\\ ~~~ C<HlT~'
r,'"
STATE OF FLORIDA
COUNTY OF 7A~C.D
The foregoing instrument was acknowledged
Before me this~. day of H 4,,/ , ~:2..
by L el2.n....V\ n~ N ~AK.
(name of person aoknowledged)
'[('who is personally known to me, or
o who has produced
(type of identification)
and whoO did goid not take an oath"
~1I~,[t.jJ;<~ () (-8 L-~ .'
Signature of pelson taking acknowledgement
I< A T1-I L EE; IJ v::13 120 ~.hJ .
STATE OF FLORIDA
COUNTY OF '. '?A...<:.,c ,p........
The foregoing instr~ent was acknowledged
Before me this ~ay of 1-1 4 Y , ..:1.D~ 2-
by Lee.. DA.-.. '" e H V'a. k
(name of person acknowledged)
E(ho is personally known to me, or
Dwho'has produced
. (type of identification)
and who Ddid DUd not take an oath
'-j~-U4U ~.'A~ .
Signatu~e of pe son taking acknowledgment
K AT1-t" LG.:EN --:r. J3f<.o w tJ ..,'
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tJP.e, ~~-fl1f~~:fmt~,.mp d
oi'ml1: MY C,,,,,j'\~";c.:(Ji'J:; CC 825+69
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1-800-S-NOTAR'" (";1" ,-''.r:'nd!ng Co
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Co
993835
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PERFORMANCE BUSINESS PRODUCTS. lNC, 813-718-8008 FAX 813-719-7919
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CITY OF ZEPHYRHILLS
ZEPHYRHIUS, FLORIDA
C::J-o'7C/
WATER ACCT. NO.
DATE ...5 - 2./-0~
=':: W~, t!),1~t)J,-C ~/ L/ / '
'I p
SERVICE ADDRESS
SHUT OFF SERVICE 0
TURN ON SERVICE rt
INSTAll METER '"
READ METER 0
CHECK METER 0
OTHER 0
I~E
o SEWER
o GARBAGE
~ IN CITY
o OUT CITY
I
_ No. OF UNITS
- DEPOSIT AMOUNT
--'~Ii ;~
- AMOUNT lAST BILL
~
_ DATE
- MISC. CHARGE
WORK COMPLETED BY
& DATE COMPlETED
ORDER TAKEN BY
Retain white form in office at all times.
Send pink & yellow forms to Water Service Clapt
Water Service Dept. to sign yellow form & return to office,
BY
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CENTRAL PERMITTING
PASCO COUNTY, FLORIDA
CONTRACTOR tt:: 0:1,1241
NAME:: JAMES C WAGNER
ADDR: :LL':;Ol I=-:OZIER L.ANE
C/ST:: DADE CITY FL 33525
For.;:::
DATE: TIME::
PAf.,E:: :J. OF :I.
ISSUE OFFICE: D
I~ECE I PT NUMF.tR : 00559() 11
OFFICE: DADE CITY
ZHILLS RESOURCE
CHECK tt 28185
CONTRACTOR: 0:1.1241
TOTAL AMOUNT:
ACCNT COMPNY ACCOUNT CENTER
:L 14 B4~jO ,-. 36~::;OOO -- 2
32.12
AMOUNT DESCRIPTION/PERMT DATA DR/CR
32.12 .X'*-X'*** SOLID WASTE FEE 60
I:~ECEIVED BY
.!.ll"'j~j';~~>",......~_~..;WJ. _~1!'~..~' .,};7.'l..... !'Z\'l',""<',;,",_,"""",,,,,...,,,,,..,,~......_-,,_".i.~~.,_
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-
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PASCO COUNTY, FLORIDA
Perml't NIl. /' ..,<~ /.
. ---/- .~....... ,.. ~
.r'..
'-
Date Permitted
......-...- ...",.
/'.'.~
--
Builder Name/Owner Name
,4".;'
..;.
.r..
County Parcel No.
I
Address/Location
, ."
Subd.
~ ~.. .
1t. ~ ~~_,
Classificationffype of Use
,t ...."
'/
!",..'-
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
Zone No.
Impact Fee Amount $
Prepare~ B-y'/
Checked By
Sq. FtlUnit
The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the
Board of Pasco County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or
utilization of the permitted structure.
RESOURCE RECOVERY ASSESSMENT
EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No. Units
/
Gross Sq. Ft. (GSF)
Rate ERU -
54,OO/Year
or $0, 148/Day
ERU Assign No.
Assessment - (No. Units) x ($0.148)
x (No. Days)
TOTAL FEE $
Assessment -
(GSF) x (ERU) x (0.148) x (No. Days)
100
TOTAL FEE $
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowiedgement below docs not imply acceptance of concurrence, but simply receipt of a copy of this form, placing
the huilding permit owner on notice of this assessment and the conditions of payment for same.
Date
Received By
OFfICE USE ONLY
TRANSPORTATION REC. NO.
RESOURCE RECOVERY REC. NO.
'({t (1 II L DATE
\ ! L (
DATE
<"
'"
)(1-,(:) BY
/ It.'
":::-' / '- BY
++-'
\"~...
,~ ' :
"."! j j
"",.j .' ,
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce
PC93113094/E
PASCO COUNTY, FLORIDA
SCHOOL IMPACT FEE
Ordinance No" 01-06
Effective: February 28, 2001 at 2:08 p"m"
Permit No. /dl.$.&:,
Date Permitted: s- ~ -O~
Builder Name/Owner Name ~..~ L~~"'ir
ParcellD: /J.g-c2h-.:::J.../-OJ;Z.O -000/"')(')- D5'30
Address/Location: 00. .
Subdivision:
Exempt:
o Single-Family Detached House
~Mobile Home
o Other Residential
o Collection Fee
Total Fee
Yes ---.X.- No
(056)
(057) h/e~
(058)
(123)
$ I; ) R7
How Determined:
Prepared By: & Lt1~d
Checked By:
The above impact fee has been established pursuant to the Pasco County School
Impact Fee Ordinance No. 01-06 as adopted by the Pasco County Board of County
Commissioners. This amount is payable PRIOR to the issuance of a Certificate of
Occupancy or where a Certificate of Occupancy is not required PRIOR to the final
inspection.
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNT LISTED HAS BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
Acknowledgment below does not imply acceptance or concurrence, but simply receipt
of a copy of this form, placing the building permit owner on notice of this assessment
and the conditions of payment for same.
~- .:L~~O~
Date
~u~
Received By
OFFICE USE ONLY
RECEIPT NO. /~'1(jh/ DATE s- :;<[?-O~
BY ~r
White
Customer
Canary
Finance
Pink
School Board
Gold
Inspection
PC01005114/A