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BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~ 1522
(813) 780-0020 Date /0 -/ - t? c2
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
Property Owner:
Job Address:
Parcell.D. #
Zoning:
DescriDtion of Work
/:~' Energy CEe:, ~adon Gas:
~~, 5('A-,tf2M e't1l>>n .
, {
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
City license Registration #
State Certified license#
P~rmit Fee .z;;.;;t
)SIgnature _ _~ -AC/f~
Company/
Address
y:e'ephone# 7 <6(: - ~3 I if
Valuation or
Contract Price
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Pre SLB kJ, '.l.. ~ 0 4 Jill)
lintel
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
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SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compr
Fina
BUILDING
ELECTRICAL
FRM.
Insul. CL
WL
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.
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, OWNER'S NAME-.:Be 1- A"lf.. '.I nv'estvY1e.VL-T~
JOB SITE ADDRESS 375/ L a...u.re-l Vc.<...ll ej
CITY OF ZEPaYRHILLS PERMIT APPLICATION
BUILI>IN(~ lHlPARTMBNT 5335 8th STRBllll'f ZBPHYRHILLS, PL 33540
Phon.IB13-7BO-0020 FaxI813-7BO-Q021 ~
DATB RBOBIVRD L-:~~ -0...2...
PLANS RBVIBW rIa
S (,,4..;Z..d..vl.v-. '(.... 'Bol-I r7 '3 8 - S 3 I Li
PHONEl CONTACT tlE:S-BBL-elB
30'^!:f3S llVoJ!:f3d 0::;
LEGAL DESCRIPTIONl LOT(S) BLOCK
------
SUBDIVISION
M a.jes +-i c.. 0 CLk =>
PARCEL ID # ,;J,4-.;1,(~r~/-0030-000C()-CJ.;J.90
WORK PROPS ED r ONEW CONs'rRUCTION IE ADDtTION
(OBTAIN P'ROM PROPERTY TAX NOTICE)
DSIGN
o MOVE
o ALTERATION
D DEMOLISH
DRElPAIR
[J INS'I'AIJI,
PROPOSED USEr I8lSGL FAMILY DWELLING
o COMMERCIAL
DMtJLTI-FAMILY
o INDUSTRIAL
0# OF UNI'rS
o SWIMMING POOL
o MOBILE HOMB
o OTHmR
o RESTAURANT & HEALTH DEPAR'rMEN'r APPROVAL
DESCRIPTION OF WORK CO-('!:Jort, Sc..reen Room, Shed) Concrete.
1,;( x. I 0 5c..r,-~,^" 1:2 1<- "il Sh <"'4 :;1.., rh
BUILDING SIZE 1)",)< I "il Ca.r'l:>o r t- SQUARE FOOTAGE ---!:L~
RESIDENTIALr
COMMERCIALr
A'I'TACH (2) PLOT PLANS & (2) BErra OF BUIl,DING PLMs & (1.) SET ENERGY FORMS,
ATTACH (3) SETS OF BUlfJDING PLANS & (1) SE'r ENERGY FORMS.
PROPEltTY SUJ:{VEY REQUIRED FOR ALl, NEW CONSTRUCTION.
sta.b C>/-dn~ew~
HEIGUT See.. ~a.~ S
PBRMITS RmOU~STBD
~ B(JII,[JING
[] ELEC'l'RICAL
$ 3500.00
VALUATION OF TOTAl, C()NS'1'RUCTION
AMP SERVICE
o FI.ORIDA POWER
[] W,R,E.C.
IJ PLUMB WG
o MI!lCHAIHCAL
III
VALUATION OF MElCHANCIAJ~ INSTALl,ATION
o GAS
o ROOFINr]
o SPECIALTY
LJ OTHElR
'l'YPE OF CONS'l'RUC'rlON r 0 BLOCK
I1J FRAMEl
o STEBlIJ
~ O'mER A-IU-V\'\.~nl^.~
FINISHED FLQOR ELBlVATIONS
IS PROJECT IN FLOOD ZONE ARBlAO YES 0 NO
"
BUILD.R
8lGNA'rURE~ W ~~~
COMPANY Mike Wi / I i aIM!> Con ~t .
STATE CERT OR REGIST #
CITY PROCE8SING # 3(O~
******************************************************************
IILBCTRICIAN
SIGNA'l'URJll
COMPANY
STATE CER'r OR REGrST #
CITY PROCESSING #
J..-___
******************************************************************
PLUMBIR
COMPANY
STA'I'Bl CERT OR REGIST #
CI'l'Y PROCESSING #
SIGNATURE
MBCHANICAL
******************************************************************
COMPANY
STATBl CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHIIt
SIGNATURE
COMPANY
STATE CERT OR REGIeT #
CI'I'Y PROCBlSSING #
*****************************************************************
CONDI'l'IONS OF PERMI'l' AFFIDAVrrr
A. NOTICE OF DEED RESTRICTIONS
'l'ile undersigned understands that this permit may be subject to "deed restrictions" whloh
may be more restrictive than City regulations. '1'he underslgned assumes responsibility for
oompU.ance Hith any applicable deed restrictions.
B. UNLWENSED CON'l'RACTORS AND CON'l'RAC'l'OR RESPONSIBHI'l'I.I!:S
I f the owner has hired a contractor or contractors t~, undertake work, they may be required
I to be licensed in accordance with state and local regulations. If the contractor is not
licensed as required by law, both the owner and contr'actor may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
lieeusing requirements may apply for the intended Hark, they are advised to contact the
city of Zephyrhills Buildlng Department, B13-766-6611.
Furthermore, if the OHner has hlred a contractor or contractors, he is advi.sed to have the
oontractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the OHner signs as the contraotor, you are indicating that
you, rather than the contractor, are responsible for the Hork. If the contractor wlshes
you to slgn as contracto:t that may be an indication that he 1.s not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. 'l'RANBPOR'l'A'rION IMPAC'l' FEES AND U'l'ILITY CONNEC'l'ION FEES
0, CONSTRUC'flJION LIEN LAW (CHAE"l'ER 713, FLORIDA S'l'A'l'UTES, AS AMENDED)
I cert1.fy that I, the applicant, have been provided with a copy of "Elorida's Construation
lien Law - Homeowner's Protection Guide" prepared by the E'lorlda Department of Agrlaulture
and Consumer Affairs. If the applJcant is someone other that the "owner", I oed.fy that I
have obtained a oopy of the Above described aocument and promise In good fa1.th to deliver
i.t to the "owner" prlor to commencement.
E. CON'l'RAC'l'OR' a/OWNER'S AFFIDAVI'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.
AppUcation is heteby m~de to obtain a permit to do Hark and installation as indicated. I
certify that no work or installation has commenced pripr to iSlnlance of a permit and that
all work wl11 be performed to meet standards of all laHs regulating t1onstruction, City
codes, zon1.ng regulations, and lalld development regulations in the juriSdiction, I also
certify tllatI understand that the regulations of other governmental agenoies may appl.y to
the Jntended work, and that it is my rfilsponsibility to identify what actions I lIIust 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, CYPEesB Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of EngineerS-Seawalls, Docks, Navigable WaterHays
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Enviromnental I?rotection Agency-ASbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A, eta,", it is
understood that a drainage plan addressing a "compensating volume" wl1l be suhmitted l-lhich
is prepared ))y a professional engineer reglstered in the State of Florida prlor to permlt
issuance.
A permit issued shall be construed to be a license to proceed with lhe 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, cons;ruatiol1, or vio~ationa of any oode. Ivery permit
is.ued shall beoome invalid unle88 the wor)cauthorized by suoh permit is oommenced withln
aix month. of is.uanoe, or if work authorlzed by the permit is suspended or abandoned for a
period of six months after the time the work is conunenced.. One 90 day extension of time
may be allowed for the permit Hith fee charge of $15,00. 'fhe extension shall be requested
in writing to the Building offioial, An approved inspeotion must be logged during eaoh six
month period, or the project Hill be considered abandoned.
WARNING '1'0 OWNERI YOUR li'AUURE TO RECORD A NO'l'ICE OF COMMENCEMEN'l' MAY RESUJ,'!' IN YOHR
PAYING 'l'WICE !l'OR IMPROVEMEN'l'S TO YOUR PROPER'ry. IF YOU IN'l'END '1'0 OB'l'AIN FINANCING, CONSUL'l'
WI'!'H 'fOUR I.ENDER OR AN A'r'!'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. JOBS UNnER
$2,500 IN VAI,UE no NO'l' NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCEMENT".
/Mku~.
SIGNATURE I OWNER OR AGENT
(h ?~~
SIGNA'l'UREI CONTRAC'l'OR
f:I'l'A'l'E OF FJ.ORIDA p
eOUN'l'Y OF ~ U>
'l'he foregoing instrument was acknowledged
ijefore me this ~day of SeF-re~~,...., ~O;;l
by Mike \A) i Il,'c;,'I-1AS
(name of person aCknO$iledged)
[~\-Iho is personally known to me, or
o who has produced
(type of identification)
and Hh fJ did Ddld not take an oath.
\~,~
8i natu~f p~~~~ taking acknowledgement
STA'l'E OF FLORIDA 0
COUN'l'Y OF ' a.s c..o
The foregoing instrument was aoknowledged
Before me this ~~ay of S...pt,....Ja~r, l:j 2=Qo-::t.
by Mik< Wi\l..a.......s .__
(name of person acknowledgedl
~ho is personally known to me, or
Owho has produced
(type of identification)
Diid not ta e an oath
~~
taking acknowledgment I
1.,,'-V{'j/1f'_
Nal;;-tYP~~~~~(~8r
'~:(~f;~f'J~/
!,O Buhr
sta",#.,,(;~~0817
"'~'.or , 002
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r:n.INC
Name
u Bdhr
di C,~!ofJPed
;~IHLJ
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NOTICE OF COMMENCEMENT
11111111111111111111111111111111111111111111111111111111111I
2002151674
State of F lor i da.
County of Jasco
THB lmOERSIGNED hereby gives notice that improvement will be made to c2rtaln
real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencemenl::
1. Description of Property: Parcel No. aLl-.;lfD-~I-0030-00000-0~qO
(Legal description of the property and street address if available)
2. General Description of Improvement cSc.ree.-nROOrYl 1 C arpb....+;- She'd.,
l/oncre,+-e.. slab ..,.. dr'lve~
3. Owner Information: Name --B.eJ- AI'~In"e5+me-nt~
l~ddress "~75 J , La.u.rel Va-lief City
Interest in Property:
Zephyrhills
State FI. 336Qo
Name of Fee Simple Titleholder:
(If other th~n owner)
Rcpl: 621901
OS: 0. 00
10/01/02
Rec: 6.00
IT: 0.00
Dpty Clerk
Address
City
State
n Contractor: Name 111; /( c.::... W : ({ ~11 nt.5
Address I :303~ COXS~n c.t. City J:i uAson.
State F\. 3LJfo(o7
5. Surety: Name
Address
City
State:
i~~0~~~~/'lAN8: r~;o fOUNT:, C1ERK
OR BK 5085 PG 361
Amount of Bond: $
6.
Lender: Name
Address
City
State
7. Persons within the State of Florida designated by Owner upon whom
notices or other documents may be served as provided by Section
713.13(1)(a)(7), Florida Statutes:
Name
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
9. Exp~ration date at Notice at Commencement (the expiration date is 1 year
fr0m the date of recording unless a different date is specified.)
Signature of Owner: ~ tr< ~ .#
Sworn to and subscribed before me this ~Co 1"h day of ~ernbe.r
.. .;2ao~ .
Notary Public:
~;UZi1nlle H<lhr
My Commission Expire
MAJESTIC OAKS
LOT: 0?1
PROPOSED
SCREEN RM
12 x 10
EXISTING
PARK
MODEL
14 x 36
(pI
70'
PROPOSED
CARPORT
12 x 18
PROPOSED
DRIVEWAY
12 x 24
-21'
ALL WORKS L.~V1Yl.d..YWlTHALL
p DES.FLORlDAB\J1LOlNG
CODE.NAnoNAL E.LECflUCCODBAND
em' OFZEP}iYRHILLSORDINANCES
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D.W. SMITH ENGINEERING CO.
Mechanical & Architectural Emrineerine:
Phone: 352-521-0865
David W. Smith, P.E.
9909 WaUaston Drive
Dade City, Florida 33525
Fax: 352-521-0867 E-Mail: zeDhvr27(Q2e:te.net
November 4, 2002
REF. Construction of screen room and carport existing Laural Valley Blvd.,
Zephyrhills, Florida
To whom it may concern,
I hereby certify that I have reviewed the plans and construction site and find
that for aluminum pan covered car ports, screen rooms &utility shed
applications having engineered base connections( aluminum base bracket
attachement with (6) ~" tapcons wi 2" min embedment will provide in
excess of 1600# uplift capacity req'd) to a slab with minimal grade slope of
2"/ft within 2' of the slab that a 4" thick slab 2500psi min. concrete w/6"x6"
-# 1 01# 1 0 wwm or fibercrete with no additional footer required complies
with the wind load requirements per section 1606 of the Florida Building
Code 2001 edition for a 110 mph windzone.
For applications with ground slope exceeding 2"/ft up to 10"/ft a minimum
footer of8"x8" wi (1)#5 rebar continuous is required.
David W.S ith, .e.#53608
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