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Home My WebLink About02-1272 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N~ 1272 - (813) 780-0020 J./o C~lJJ~Q.',N~ Date h - / f)- o::l- Property Owner: Job Address: Parcel 1.0. # El~~:IRlCAl p~iNCi _...-- ~i~J;f:;l;/~, ~"d Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Descriotion of Work Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL (P - 2- - 0 2- DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. DATE Inspector Valuation or ,_~. r7/'f~, D,.i:::; Contract Price ~~ L~ City license Registration # ~ 0 9 State Certified license# Permit Fee C, Company Address ~~rOf)-9J 7- 6b3S &~t;lo3 \ 1fA?~/.DL-' (2atC-. BUilDING ElECTFnCAt"'., - PLUM B.J,N6-'-. - ME~-""-.. 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. Compressor 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. OWNER'S NAME Le ~ + ~~ ,TOB srrE ADDRESS LJ <t 2'D C.i'li L..H.h,:; F4;H...b~:rl ..~ ""J~ICA'L..ON BUILDING DBPARTMBNT 5335 sth STRBBT ZSPHYRHILLS. rL 33540 PhoneaS13-7S0-0020 F.xa813-7S0-00~1 OATB RBeBIVBD Ji'LANS RBVIBW I'BB . W{A\S.h GoO of" ~ o~ ~. PHONE CONTACT 119 - aD b 9_ W \' ^ t~ ( s 1'1)11 /t,r/r I.EGAL DESCRI PTION I LOT (S) BLOCK SUBDIVISION PARCEL ID # )5- J. 6- ().7- '010.3 0- O~J\)()- '0\)/0 (OBTAIN FROM PROPERTY TAX NOTICE) OADDITIO~ o ALTERATION Jl REPAIR o INSTALL WORK PROPSED; ONEW CONSTRUCTION DSIGN o MOVE o DEMOLISH PROPOSED USE: DSGL FAMILY DWELLING o COMMERCIAL OMULTI - FAMILY 0# OF UNITS o SWIMMING POOL jgJ MOBILE HOME o OTHER o INDUSTRIAL c:J RESTAURANT & HBALTH DEPARTMENT APPROVAL DE.CRIPTION OF WORK ~ \(.'() (\:.s, w) ~ " '\3) ~ P)1 {{"" h k, ~ l'Y\ b { ~ !f(... BUILDING SIZE SQUARE FOOTAGE 7 r '3 HEIGHT RESIDENTIAL; COMMERCIAL: AT'rACH (2) PLOT PLANS & (2) SETS OF BUIIJDING PLANS & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. o BUILDING PBRMITS RBQUB~TBD $ '3 7 7. s-.~ VALUATION OF To'rAL CONSTRUCTION o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C. o PLUMBING o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION o GAS ...2iJkUOF ING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL _ OTHER FINISHED FLOOR ELEVA'l'IONS IS PROJECT IN FLOOD ZONE AREAO YES 0 NO BUILDBR .................................................................. COMPANY .x 1/ II" l"I ~ .. 61 e. As 5 () L- STATB CRRT OR R~GIST # c c. c. 0 L{ 9 3 6 7 CITY PROCESSING ~O~ SIGNATURE ELECTRICIAN SIGNATURE COMPANY STATB CERT OR REGIST # CITY PROCESSING # .................................................................. PLOIIBER COMPANY STATE CERT OR REGIST # CITY PROCESSING # ' SIGNATURE NBCHAHICAL ...........*..**.***.*k~k**~**..~.*..*****....*....**............. COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ................................................................. OTHBR SIGNA1'URE COMPANY STATE CRRT OR REGIST # CITY PROCESSING # ...................*.............................~.**............ CONDITIONS OF PF.HMIT ^FFID1\VIT A.'. NO'fICE OF IJEED RESTRIC'l'IONS 'rhe undersigned understands that this permit: mclY be subJect to "deed restrictions" which may be more restrictive than Clty regulatlons. The undersigned al'lSUllles respOlisibllJty for compU.ance with any appllcable de,!!'d restd,ctlolls. B. UNLICENSEIJ CON1'RACTORS AND CON'l'RAC'l'OF: RE:SPONSIBIJ.l'l'IES 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 regulat:lons. If the contractor is lIot licensed as required by law, bot~h the owner and contractor may be cited for a misdemeanor violation under state law. If thl;! owner or intended contractor are uncertain as to what licensing requirements may apply Eor the intended work, they are advised to contact the City of Zephyrhills Building Department, 813-788-6611. Furthermore" if the owner has hirf!d a contractor or contractors, he Is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for which they wll1 be responsible. If you, as l:he owner signs as the contractor, you are indIcating that you, rather than the contractor, <lre responsible for the work. If the contractor wishes you to sign al'l contractor that may be an indication that he il'l not properly licensed and 1s not entitled to permitting privileges in the City of Zephyrhills. . C. TRANSPORTA'rION 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 Gulde" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "owner", I eerify 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. CONTRACTOn'S/OWNER'S AFFIlJ1\VI'l' 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 installatlon as indicated. I certify that no work or installatlon has commenced prior to issuance of a perrnJt and that all work will be performed to meet: standards of all laws regulating constructlon, City codes, zonIng regulations, and land development regulatlons in the jurlsdiction. 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: lake 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 1\reas, Altering Watercourses *Army Corps of Engineers-Seawalls, Docks, Navigable Waterways *Department of Health & Rehabilitative Services, Environmental lIealth 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 Florlda 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 pe.rmit prevent the Building Official f.rom 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 lf 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 chaJ:.ge of $15.00. 'fhe 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 WITII YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RE' RD AND POS'f A "NOTICE OF COMMENCF.MENT". SIGNATURE: OWNER 0 GENT SIGNATURE: CONTRACTOR STATE OF FLORID~ STATE OF FLORIDA COUNTY OF ~6e::.o COUNTY OF The foregoing instrument was acknowledged The foregoing instrument was acknowledged Before )De thJ.s -l..!i!!.: day oof.r ~ , ~a:L. Before me this _day of 19 by ~ 'Cu.d/rc ~.Y ~ ~_ by (name of person ackno"ledged) (name of person acknowledged) Dwho is personally known to me, or [1ho is personally known to me, or \. ~ho has produced F.t V.Q..l.I:::.. tJ .t/2lr 79?-t.5'":23"7-D 0 who has produced ";Z" 1J (type of identification) (type of identificatJon) a~flli~~di~ ot ik~,l oath. and who Dd:l.d DHd not take an oath Signature of person taking acknowledgment Name ",,-:;'~'r;:';.. Bobbie Swetland :~;ti;;": m COM~1ISSI0~1 tCCS9316C ~XPIR~ ~ .~l pdn1f.~2,sJlllttnped "'X;;, ",'t,~ BONDED THRU TROY FAIN INSURANCE, INC "".11" Name typed, prlnted or stamped TO BE COMPLETED IF CONSRTUCTlON VALUE EXCEEDS $2,500.00 111111111111 1111I 1111111111 1111I11I111111I/11I1 1111I111I111I 2002089191 Permit # ' Tax Folio # Repl: 594966 DS: 0.00 06/10/02 Ree: 6.00 IT: 0.00 Dpty Clerk OFFICIAL NOTICE OF COMMENCEMENT ii~1~~~T2MA1N~'2P7ASCO COUNTY CLERK ~. pm 1 of 1 OR BK 4972 PG 1616 State of Florida County of Dq s C. Q THE UNDERSIGNED hereby 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 the Notice of Commencement. 1. Descrip.tion of property: f/ 6 Me crb '-I { ). 0 J ~. ;l b" ;i / - OD30 - 0 OJ 00. (,;'0 I 0 2. General description of improvement: f2e t2 \) 0-1 Gal dotJ ~}. 2-eIAvfA. jls r'- "33511/ ' 3. . 'J I t "I -:. ~ ~ *1) /1.0'" Cm;;;""t", "an.e an<i address: .,.... 1\ \l.l'" Co J ~ l ~ /7 sse. / D 7 .3 / 75'/';' 'S I. P. 9 /" ~ ~ G~ 33 7 7 7 , R- 5. Surety (if required) A. Name and address /_ / s4 B. Amount of bond $ "?? 6. Lender name and address: ~?? 7. Persons within the State of Florida designated by Owner upon notices or other documents may be served as provided by section 713.13 (1) (a) FIgpda Statutes. Name and address: -L~ /h ~ G'" :/ /t:.- ~.) 0(; ~ 8. In addition to himself, Owner designates A~ . to receive a copy of the Lienor's Notice as provided in Section 713.131t'(b) Florida Statutes. , otary Public My commission expires: Celeste Dawn Dolbeny . ~; My CommiSlion 00028533 0;" Expires May 22.2005 -- ,- ~ INVINCIBLF ] Making Florida a better place to live since 1987... one home of a time. Contractor's Letter of Authorization I hereby authorize the below named indiVidual to act as my agent to obtain all necessary permits for residential roofing work for: Owner L ~ " t hCl. w~l~ ~ G~ ~J~N ~-+. at this location: LI <t ~ () This person Is also empowered to obtain, complete, and sign all forms, applications, registrations, and documentations, with this lim- ited power of attorney, on behalf of me that may be required to accomplish the Issuance of any permits that may be required in any jurisdiction throughout the State of FloriCI~ / Authorized Person: 6-htQr-l; ~ (/11 ~ Authorized Person's Signature: _ ~~ --- ~?j 'fA BrIan Stover State License #CCC049367 ~fJ;J~ ,Ii" · M~;i:;;~:~:~:::T~r;"'i? '!; fh d.,. INVINCIHLE ASSOCIA fES, INC. 10931 75THST, . LAJ<GO. FL33l!1 .121/545-11300 .800/937-6635 STATE CERTIFIED LICENSE fI CCC049367. CRCOl5276 .J