HomeMy WebLinkAbout02-1649
BUILDING PERMIT
. NO
Permit -
CITY OF ZEPHYRHILLS
(813) 780-0020
1649
Date /1- lir () d-.
,
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. ,
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
~
NO OCCUPANCY BEFORE C.O.
FINAL
;: -~~ 02-
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
So
Permit Fee
')Signature
/ Company
Address
)eelePhone# fTo 0.... 'l.J 7 - 6b 3,-~
(")
3, 9ft&; ,. ~
City license Registration # . 30 9
State Certified license#
Valuation or
Contract Price
~viV'c,'b/~
f/55re. Me.
/
BUilDING
ELECTRICAL
SlB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl
Compr
Fina
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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 NAMB f V e. ) ~)J '" ~ (. h,-t. N
.TOB SITB ADDRBSS 5 <(;as \:)0.11'0 tJ
LEGAL DBSCRIPTION: LOT(S) If b
~.L~l( UJf ~......_. ,."'!Ul.Lt.JJ~ .to. ~...'<..6!tIT AP'ILICATION
BUXLDXNG nBPARTHmn- 5335 atJa ST.BB'l' ZBPHYRUILLS. I'L 335..0
PhoneaB13-7BO-0020 l'axaB13-780-0021'
DATB UCB:IVJID
PLANS RlIVIBIf nB .
PHONE CONTACT? ~3. b041
Sf. 2~~h~r h,' II s ) r, '-- 33"S '1/
BLOCK SUBDIVISION Tr -(~14l"-<.. V; 11 'I ~
PARCEL ID It J t)- ~ /; . 'J J~ OOD\)-a~ J \)~_ ~<::) ~ ~
(OBTAIN FROM PROPBRTY TAX NOTICE)
WORK PROPSRD: [JNRW CONSTRUCTION
[JSIGN
[JADDITIO~
[J MOVB
[JALTBRATION
[J DEMOLISH
[J REPAIR
o INSTALL
PROPOSED USE: [Jsm, FAMILY DWELLING
OMUJ.TI - FAMILY
Olt 0l4' UNITS
o SWIMMING rooL
~MOBILE 1I0MH
o OTHER
[J COMMERCIAL
o INDUSTRIAL
PESCRIPTION OF WORK
o RBSTAURANT & HEALTH DBPARTMENT APPROVAL
Q(.Q,,~,", vJ)S:,,~k~Jy ~...bbe, 0evY\bC'..~
//4 7
SQUARB FOOTAGE
BUILDING SIZE
RESIDENTIAL~
COMMERCIAl.:
HEIGHT
~~rACII (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
A1~ACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NBW CONSTRUCTION.
PERMITS RBOU.~TBD
~ BUILDING
$
39 b b
VALUATION OF TOTAL CONSTRUCTION
o ELEc'rRICAJ.
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
[] Pl,UMBING
D MECHANICAL
$
VALUATION OF MECHANCIAJ. INSTALI.I\.TION
o GAS
[] ROOFING
[] SPBCIALTY
o OTHER
TYPE OF CONSTRUCTION: [] BLOCK
D FRAME
D STEEL
D OTHER
!<'INISHED FI.OOR El.EVATIONS
IS PROJEC'r IN FLOOD ZONE AREAD YES D NO
BU'LDU ~
BIGNA'I'URE ~ '
~~~...............................................................
COMPANyJ 1/ lJ: l"I ~,b/e. As: 5 0 c..
STATB CBRT OR REGIST 4# C c::: c. 0 L( 9 :3 b 7
CI'I'Y PROCESSING 4# .3 0 Cj
BLBCTRICIAN
SIGNA1'URE
COMPANY
STATE CERT OR RHGIST It
CITY PROCESSING 4#
..................................................................
PLUllBBR
COMPANY
STATE CERT OR REGrST 4#
CITY PROCESSING 4# '
SIGNATURE
H.CHANICAL
..................................................................
COMPANY
STATE CERT OR REGrST 4#
CITY PROCESSING 4#
SIGNA'I'URE
.................................................................
OTHB.
SIGNA'l'URE
COMPANY
S'I~TE CSRT OR REGrST #
CITY PROCESSING 4#
..............................*............t~...................
CONDITI0NS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject ,to "deed rest:l:lclioIlS" whIch .
may be lUOre restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they May be required
to be licens'ed in accordance with state and local regulatious. If the contractor is not
licensed as required by 18W, 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, 813-788-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor 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 contracto~ wishes
you to sign as contractor that may be an indication that he Is not: proper.ly licensed and ls
not entitled to permitting privileges in the City of 7,ephyrhllls.
C. TRJ\NSPOR'fA'fION IMPACT FEES ANn U'f!},J'fY CONNECTION FEES
D. CONS'fRuc'rUION LIEN 1.J\W (CHAPTER 713, FLORIDA S'fATUTES, AS AMENDEIl)
'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", T cerlfy 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. CONTRACTOR'S/oWNER'S AFlIDAVIT
1 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 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 regulatlons in the Jur,t sd.i.ctlon. I also
certify that '1 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 Lo
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 Health Unit-Wells,
Wastewater Treatment, Septic Tanks
"'u. s. EnvJ.ronmenta1 Protection Agency-Asbestos aoatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A,ete.", ,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 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 Buch perml t 1s cononeneed wi tltl n
six months of issuance, or if work authorized by the perrott 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 Officlal.. An approved inspection must be logged durlng each six
month period, or the project will be considered abandoned.
WARNING 'I'O OWNER: YOUR FAII,URE 'fO RECORD A NOTICE OF COMMENCEMENT MAY RESUL1' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN NfTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NE.., ''0 R CORD AND POST A "N~OMM"'C~T.. ~ /
--~~
~NATURE: CONTRACTOR
~~~~~Y O~F FLORID~:""""'I-~~~ <-)
The foregoing instrument was aC,lowledged
:;fore 3~M}dZ2L , ~2qo~
(name of person acknowledged)
[Lho is personally known to me, or
~hO has producedR 7J. (. tJf-PiJ -79?-t..!J--:;5?-t
" , ,ype of identification)
and~!~d d n take an oa h
I
was~knowledged
t 't/, ~~
(name of person ackno~ledged)
Dwho is personally known to me, or
~ho has produced F'D L 1A)4;20-797b5'-,i/:iZ-
'. (type of identification)
a,,~aH w~., ld 1r1,A;" id" no otto ;,take an,;;;tOath
( 7~~J ~~/.f_~-L~'
~ ,
Signat4f~~f~ persdDb~~dacknow1edgement
!..//!;;.'\f: MY COMMISSION # CC893160 EXPIRES
h:.~.~j February 22, 2004
......~i:;,.f.PW...... Rrwm:nT~I:lIITP()\lF."AINW~IJPANrj: iNr
Name type(i', printed or stamped
Name
t!!~~.~
Cooley! Building Products
INVINCIBLE@
.' . 1/25/02
~ ~
We Sell
~AR
INVINCIBLE ASSOCIATES, INC.
10931 75TH ST. · LARGO, FL 33777
727/545-1800 · 800/937-6635 · STATE CERTIFIED LICENSE #CCC049367
MAKING FLORIDAA BETTER PLACE TO LIVE SINCE 1987... ONE HOME AT A TIME
. Phone: (HcrI3) JS.3- 0....,>q{(W) r7
Mailing Address: . - . CityUpA,/r-A.,l/fcounty5i2zsr.Jo. State~zi~1
(IfApPllcable)MHP=().L. (9~~.L ~LO'" Nff S7~oI/OJ/'
AlternateAddress~S--oO{() o8yf-oV\ Dr ity{fttJ S>S'(}qvVState:f1)H.ziPif/?? ~~: 1,99 ~(J
INVe, the e premises escn e , . fter referred to as "Purchaser" offer to contract with INVINCIBLE ASSOCIATES, INC., herinafter
referr 0 as "Contractor" to furnish, to deliver and arrange . lIation of all materials necessary to improve the premises located at:
city:~4 y rA ,II <' State:~iP:33.5-Y~
Name(s):
1. PROVIDE ENERGY-SAVING INSULATED WATERPROOFING SYSTEM FOR THE FOLLOWING AREA(S):
DD )11QJ """L hOP'tL d- ~{r;t7r1~_ ~O~
2. I~~E ENERGY-SAVING DOUBLE-FOIL FACED INSULATION AS INDICATED:
cYGOLD: DELUXE 1-1/4" INSULATION O~L ER: 3/4" INSULATION 0 BRONZE: ~
3. INCLUDE NEW SPUN ALUMINUM VENTS: - SMALL lARGE
4. INCLUDE UP TO 100 SQ. FT. OF NECESSA Y DECK REPLACEtENT. ADDITIONAL DECK
REPLACEMENT TO BE INVOICED SEPARATELY AT $2.00 PER SQUARE FOOT.
5. INCLUDE All REQUIRED PERMITS.
6. CLEAN UP AND REMOVE ALL JOB-RELATED DEBRIS FROM JOB SITE.
7. MAil OUT LIFETIME, NO-LEAK, NON-PRORATED, TRANSFERABLE WARRANTY FULLY COVERING ALL LABOR AND
MATERIAL, INCLUDING ALL STORM DAMAG.E FROM RAIN, LIGHTNING, HAIL AND WINDS UP TO 170 MPH.
WOTE: BRONZE SYSTEM (NO INSULATION) RECEIVES A 1-YEAR. LEAKPROOF WARRANTY.
8. ADDITIONAL INFORMATION:
~
INITIALS FOR
SYSTEM
~
~
\
~
~
"-
t:)
t:)
,
~
~
~
.z
~
.
\0
~
)
()
"
aTEVENS wHiTEE'P). STEVENS TAN EP · STEVENS LIGHT GRAY EP · EREZ TAN · EREZ WHITE . EREZ GRAY
COOLEY TAN ILLUSIONS · COOLEY GREEN ILLUSIONS · COOLEY CHARCOAL ILLUSIONS . COOLEY WHITE TPO
9. IT IS UNDERSTOOD THAT THE FOLLOWING AREAS WILL NQI
BE INCLUDED IN THE COVERAGE PROVIDED BY
THIS AGR~MENT (See Drawing at Right):
L}rO()~t
I
SHOW ALL AREAS OF HOME. DRAW ADDITIONS AS
NECESSARY. WRITE "YES" IN AREAS TO BE COVERED.
"" S NOT TO BE COVERED.
OTHER NOTES:
~o (Y\c4 \ ^ hovv"-L-
NOTE: RETAIL SALES TAX MUST BE CHARGED UNLESS THE CUSTOMER SIGNS THE FOLLOWING:
I certify that I own the land on which the structure I am improving is permanently affixed. Furthermore, I have filed a
declaration with the Property Appraiser requesting the structure be assessed as realty and it bears an "RP" decal.
SIGNATURE:
The CASH9NTRACT PRICE for all Labor & Materials (including any applicable discounts) is $ ~ 39&0' CO
T"m" ~h 0 C....ISubjecllo... '00""'" 01'" C"",', S"" Depa"",,,,,) , sm.. 'Tax I d.3 7. 2~
If this is a cash transaction, the purchase price ~hall be paid as follows: U 0 f' _ ~ 1fV\ ~ I
Cash down Payment (Minimum 33%) $ /00 - 0' 0 Balance Payable $ T / (') t3 . I 'P Total Price $ ~~ 'If'
If this is a credit transaction, the agreement for credit is contained in a separate document which is incorporated herin by reference and made a part thereof.
INVe the undersigned are hereby authorizing INVINCIBLE ASSOCIATES, INC. to verify and review my/our credit record with an independent credit reporting
agency and release them from allliabi/ity incurred from inadvertent omissions or errors.
Verbal understandings and agreements with representatives shall not be binding. All understandings and agreements must be set forth in writing in this
Contract. ADDITIONAL PROVISIONS ARE STATED ON REVERSE SIDE AND Af\E pART OF THIS CP)lTRACT. j
IN WITNESS WHEREOF Purchaser(s) have hereunto signed their name(s) this _ ~/1__~ day of _ /'LO'~ 1111:N'r- 20 ();;1.,
and acknowledges receipt of a true copy of this Contract. .
UNLESS OTHERWISE SPECIFIED, IT IS UNDERSTOOD THAT THE QWNER(S) IS/ARE READY FOR THIS WORK TO BEGIN. THE PURCHASE PRICE
QUOTED ABOVE WILL BE HONORED ONLY UNTIL ______ . Purchaser(s) understands and agrees that if this agreement is cancelled after the
rescission period, the Purchaser is liable for twenty five percent (25%) of the total sales price as damages to the Contractor. In the event this offer to contract is
not accepted by Contractor, any payment made hereunder shall be refunded to the Purchaser(s) and this proposal shall be null and void and of no effect.
Contractor is not responsible for existing structural defects, dry rot or other factors beyond our control. No repairing, plastering, painting, carpentry, or decorat-
ing is included unless specifically charged for and specified in writing herein. If Installation is not completed, Purchaser may withhold a maximum of 10% ofTotal
Price nlil completed. The remainder of Total Price is due upon installation or as otherwise specified.
r ---- - --____ ____________________,
~AA.lf,U..4/111 ~ C><;f-({-O;;l.rl
L ).Cc~Eo BY]u,,",se, ,.' '- D..
I I
I ACCEPTED BY:Authorized Signature for Contractor Date ACCEPTED BY: Purchaser Date I
~---------------------------~~---------~
TO BE COMPLETED IF CONSRTUCTION
VALUE EXCEEDS $2,500.00
""'" ""11"111"1111111 ""111"111111111" '"11 "" 1111
2002176681
Permit #
Tax Folio # I O'~b~ 1'-OOO~"'(J 01<)<)..... C)\)~
Rcpt: 632624
DS: 0.00
11/13/02
Rec: 6.00
IT: 0.00
Dpty Clerk
OFFICIAL NOTICE
OF COMMENCEMENT
State of Florida
County of pq S c.. 0
JED PITTMAN1 PASCO COUNTY CLERK
11/13/02 0 : 18pm 1 of 1
OR BK 5133 . PG 1204
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. Description Rfproperty: Ho ~} w "\ f'U...\o.iV~ \) ~ \\q~~ e.. -#Lj ~
5 7~ <b flP-JL' \0 s-f. -Z~\> ~'fr~,--nS I ,"Z-L "33.s Cf I
2. General description of improvement: Qe. Q. ~ ~
0.-+
3. Owner Information: ,
A. Name and address: ...
B. Interest in property: i!,.. ;- l -L '3 ') S
C. Name and address of fee simple titleholder (if other than owner): Tr~..l q~ '\J{ IqJ L
S 7;li ~ft)J/C) S~, UplyrA.,,-lJ~ r-t 3::SSlI)
4. Contractor name and address: :[{\ \l \ () C ~ ~ ~ Ii
Ja'131 5''''' 6"ty~- L~ 0 '""L
. ..
5. Surety (if required)
A. Name and address ~ \ ~
B. Amount of bond $ 1
6. Lender name and address: \~ \...f\
7. Persons within the State of Florida designated by Owner upon notices or other documents may be
served ~... provided by section 713.\3 (1) (a) Florida Statutes.
Name and address: N ~~
8. In addi tln to himself, Owner designates :t "" : '" ; \o}" tl S s 0 C.
Lienor's Notice as provided in Section 713.13 (1) (b) Florida Statutes.
to receive a copy of the
9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of
recording unless a different date is specified)
,20_
Signature of Owner or Authorized Ag~ ~ g1fytf~ ~f _/
Swo~ and sUb. sc~..t;."e.. befor. p'me this
I day of . #VJf~ ' 20P)-
i;' A~'~ "oj' :'I~ "
~,~:. .
~J\. Celeste Dawn Dolbeny
. ~.i My ComrniUion DDo28m
\;OI'~ Expires May 22.2005
otary Pub1iCt,;}~', >;/ .,
y coll'll1l.h8iQU expires:
" -
(INVINClBLF J
Making Florida a better place to live since 1987.., one home at 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 ~ V~( y1J y'Y\ <:) (lt~
at thIs location: 5 <t C) 5 \:) C\y-f \) N .s 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 fhat may be required In any
Jurisdiction throughout the Stote of Floricla,
AuthorIzed Person: s: -+ t.\.q {' 1:-
Authorized Person's Signature:
~t;4
.'#fI
Brian Stover
State LIcense #CCC049367
~~~
~":,:;~4'~ MONA L BU11.EA
II-...b.t * MY COMMISSION # CC 961647
"'~.. EXPIRES: August 16, 2004
"~O,,"~(!j Bonded Thru BUdget NOle", Services
INVINCIBLE ASSOCIA rES. INC.
J093J 75TH Sf. . LAf?GO, FL 33777 . 727/545-1800 . 800/937-6635
STATE CERTIFIED LICENSE /I CCC049.367. CRCOJ5276
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