HomeMy WebLinkAbout02-1664
BUILDING PERMIT
Permit N~
IffJ ' e-O
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 780-0020
.L./ trO c7 ",-, fJ'O
'fer .5~
PLUMBING MECHANICAL
1664
fA -0
~6J
t?
BUILDING
Date
/1-2/-oc2
Sewer Conn
t :17 fJ . t:>-0
.
350,8-'C
Property Owner: 'fR m fI ?.J2~;:t(;o
'1'1 '7 c1. <x 1\1 f t-J PcYtX m.
Parcell.D, # O"-cXlJ. d-.l - 0130 .,OO(<}oo - cJ ;;:l 70
Water Conn:
Job Address:
Lld-I
.
Water Meter:
T,I.F.'s:
I ftl' fYL'
Zoning:
Descriotion of Work
Energy Code:
. f-( , S ~.t -
Radon Gas:
'1
.J ~
,2(r<
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,
DATE
Inspector
City license Registration #
State Certified License#
~?;l/
Permit F~ . L:J7~
;<Signatur~ .
Company
Address
/TelePhone# (ifI3) '?fs -7Sc;,7
Valuation or
Contract Price
cPO
~ "vJ~'
. ';0, cr....
(dvh-1 ~q,~.,:;(
BUilDING
'D~ G:<-
f1 / 7J'Y
ELECTRICAL
G:"~~J
#.;l<i':J/
PLUMBING
J)~ ~";J:
MECHANICAL
Ftr,
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp, Serv, SLB
Rough In Tub Set
Meter Can Water
Const. Pole Sewer
Pool Final l//2- 3- 02
Pre-Met~r
Finall / ,. 2 -:1 - 02... fL it. J t-tJo
Breakers
Ducts Insl,
Compressor
Final,/? 2-3-'02 R'l~ /1"5(;>
If,; 0, Rut
. .
Driveway
i.J {l...E c..
1.;<-3-0 2_ 9.'10 sfu,~. /J/--
REINSPECTlON FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of twenty-five and 00/100 Dollars ($25,00) shall be made for each trip for each trade:
a, Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e, Permit not posted on job site,
f, Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same,
OWNER'S NAME Trma.. r-pe.,loito
JOB SITE ADDRESS 3 7 7~? AI eLc' Pt rY-
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DBPARTMENT 5335 Sth STRBET ZEPHYRHILLS, PL 33540
PhoneI813-7BO-0020 FaxIS13-7S0-0021
DATB RBCEIVBD II- .:zoO ~O::z
PLANS RlIVIBW PBB
PARCEL ID # ~3-d<'o-oU -;- 6130'-0000::) ~ Oa70
PHONE CONTACT ($r.5 ..) 7/l.( - O/L(15~
Z.eOJU-lrA ,'lis
SUBDIVI~ION . ~Q.p~~"- R,dse
Dr-,'v-e.
LEGAL DESCRIPTION: LOT (S) 0{ rr
BLOCK C!C)CDO
WORK PROPSED: [JNEW CONSTRUCTION
(OBTAIN FROM PROPERTY TAX NOTICE)
[J ADDITION
[J ALTERATION
[J REPAIR
[J INSTALL
DSIGN
D MOVE
(] DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING
[JMULTI - FAMILY
[J# OF UNITS
1Q1:10BILE HOME
[J COMMERCIAL
[J INDUSTRIAL
[J SWIMMING POOL
[J OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK mOb: Ie... tbm-e P/(LC!..€menf
;)g Xi.rd 0
BUILDING SIZE
SQUARE FOOTAGE I, f11 [J 0
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (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.
MBUILDING
[if ELECTRICAL
g'PLUMBING
&'MECHANICAL
PERMITS REQUESTED
$ 34f)~O j:;'tJO()
. ,
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
[J FLORIDA POWER
D W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
[J GAS
[J ROOFING
[J SPECIALTY
[J OTHER
TYPE OF CONSTRUCTION: D BLOCK
D FRAME
D STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES [J NO
BUILDER TO-.'fY'\.es ~t\..ey
SIGNAW~ 1/.. tfl. ~
COMPANyG
STATE CERT OR REGIST #.::r:
CITY PROCESSING # ot~;L1
Jf
***~******r*********~.**************************************** ~,
ELBCTRICIAN /(' II COMPANy-oO(ph; h Eh~r-pr-i-z.es
J,--:' - . . l l (! ,", STATE CERT OR REGIST # Er<..ODOOSCD<...(
SIGNATURE .,"':!- \.::t CITY PROCESSING #
I
!
PLUMBER SO-VY'-E" os ~ \i'-.€. y-
SIGNATQ,~ ~
******************************************************************
SIGNATURE
..... -
*** *....* ~*******., *;. ***.'(1.*7*. ;************~**f'*~*t******~********..
it COMPANY Ublphl h t=\l (' ~~;~~$.
/Co. . /1'. l STATE CERT OR REGIST #C~('
.' > -'.. '"- - /' /( L '- \... ".:-.. CITY PROCESSING #
COMPANyGO-.~y-\rCL:Y'\..~ \:0 r-~
STATE CERT OR REGIST # ..::s:::"\:\ODClC <f f.n (
CITY PROCESSING # 'd.-2";}.-/
MECHANICAL
*****************************************************************
OTHBR
SIGNATURE
COMPANY
STATE CERT OR REG 1ST #
CITY PROCESSING #
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" \o{hich
may be more restrictive than City regulations. Th,! undersigned assumes responsibility foi:
compliance with any applicable deed restriction::;.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBII,ITIES
If the owner has hired a contractor or cont.ractors to undertake work, ,they n\ay be required
to be licen~ed in accordance with state and local ~egulations. 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 inte,ndf!d contractor are uncertain as to what
licensing requirements may apply for the intended \~ork, 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 Sec1:ions" 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 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 Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify 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 AFFIDAVIT
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 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 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 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, 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 fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volumeH 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 peDmit 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
WIT YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$ ",50 IN VALUE UO NOT NEED TO RECORD AND POST ~"7:fr~
SIGNATURE: SIGNATURE: CONTRACTOR
STATE OF F..LQRIDA
COUNTY OF ' I~a-$ C.()
The foregoing instrument wlj ackn9wledged
Bet:!6e me this l~ day of I\JOVet11"ber, ~ ~
by f') h t\. (L rYl 00 h....
~ame of person ackno~ledged)
~ho is personally known to me, or
STATE OF FLORID~
COUNTY OF a...s: ~
The foregoing ins.trtment w~a~~wledged
Befo~e this ~ay of I Oil '-'LIef', 1t!I'CJ!fl)C)...
by on l\ ll. m ~ l'I h.
_ /' (name of person acknowledged)
~ho is personally known to me, or
o who has produced
(type of identification)
~did Ddid not take an oath.
. ~MtlJ!u .
Signature of person taking acknowledgement
o who has produced
(type of identification)
and who Ddid Oiid not take an oath
~~~
Signature of person taking acknowledgment
Name typed/ .
d~~
Nolay Pubrc: . Slofe 01 Aortda
tilt Comm. e.pn,. Jun 18. 2:lO4
Commission # CC9257"-i
.....- ",.....- .--~ ~'-'---"''''''''~"-,"-,,,,-''''l'"
Name
~1:Qf; StS~ill
tilt Comm. Ex;:Ji'es Jun 18. 2004
Commis>lon # CC9257"-i
-~-;l""'~" .,.,.,_..."'.........'.-,-~
996786
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~
PERFORMANCE BUSINESS PRODUCTS. lNC. 813-719-8008 FAX 813-719-7919
, 0 ~---~~3 \
CITY OF ZEPHVRHllLS .
ZEPHvRHlLLS; FLORIDA
WATER ACCT. NO.
DATE II -;2/-0:<
OWNER/
RENTER
---
J.ifm,fJ
P~Jdto
MAIUNG
---::;:::;-
~
SERVICE ADDRESS
377;28
N4Jad cItr.
/
,i...p r- ~ 7
SHUT OFF SERVICE
o
Q/
GJ-/'
Q-wATER
TURN ON SERVICE
o SEWER
INSTALL METER
o GARBAGE
READ METER
o
G--lf(CITY
CHECK METER
o
o OUT CITY
,
-1- No, OF UNITS
OTHER
o
_ DEPOSIT AMOUNT
3
;:; I'
lu'cCtir ~y
- AMOUNT LAST BILL
_ DATE
_ MISC. CHARGE
VVORK COMPlETED BY
& DATE COMPlETED
ORDER lJU(EN BY
Retain wtlite form in office at all times.
Send pink & yellow forms to Water Service Dept
Water service Dept to sign yellow form & return to office.
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Fll..E No.874 11,.16 '~! PM 12=23 ID=raeS r:F I'ERlT
FAX =941 sa. 3639
Pf:GE 1
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I-BEAM PIER SFl'ACINO
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p~ IIZE 8CL P8F SPAcwa PAt;) 8IZE 80L ... SflACIG
-, 1000 4'
1000 N/A
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......-- (576 aq. in.) -.. '.'--
(2l5~ aq. in.) 2000 4' 2000 8'
.-....-- ~ 2500 - -.-
2600 5' 8'
N/A -. 1000 4'
1000
18 1/2" x 18 lIt' 1500 4' 2:4" x cJ4" Cr.WENT ~. 1500 7'
ASS (342 aq. in.) 2000 6' PAD (1;78 aq. in.) 2000 A'
.. ~..- .----- ......-
2600 7' 2500 8'
N/A .. tOOO S'
1000
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18- x 22 t/r 1~00 4' 22 t/lt x 32" ADS 1500 8'
.- ...- .-.... --- .-
ASS (380 Iq. In. ~ 2000 8' (?21:~ Iq. In.) 2000 S'
2500 7' 2600 8'
I N/A ,
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( 2cf x 20" ABS P.4~ 1600 5' ,
(400 .q. i . ~ .. "..--- '-----'-
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lor x 25- ABS ~_.1600 5'
(425 Iq. In.) 2000 7'
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I ,
MAIN I-BEAM BLOlCKINO 1M" PLOOA
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MlODEL A1651 28' X 60" (1,600 Sq. Ft.)
8
PASCO COUNTY, FLORIDA
Builder Name~wn~LNa~.A.m1(jc.. (;214i#A
Permit No, /0 h 1/
Date Permitted /1- --2/- fJ:L
Control #
County Parcel No. ~ g - ,;1(, - oi /- 0/:30 - DO 000- 0:2/1;) SubDiv:
Address/Location ~ 77.2. 2 7?.R.,,) 9~ Ci)~.
Classificationrrype of Use Lr/) tJ-f.J ~ ~ c./I~ _
/)~A (y~
/ ,.
TRANSPORTATION IMPACT FEE Rate:
Exempt 0 Yes IS<( No How ;>et~~ltne~
Impact Fee Amount $ I; i./Ro f:~)- "Zone No,
ji<ft J:;~j9'3
Sq Ft Unit:
TAZ:
SCHOOL IMPACT FEE
Account __,_(Q9m.__J?i~~y Detached House /J Amount
~!) Mobil~ !:fome=:- ~ O(JL. -z..--
Other Residential 4 /, 0
J.:123) ~ction Fee II L.,n;t;, 5<1 P--
Exempt U Yes If(l No How DeterminedJuP] I ;J!
$
"0/97-
PARKS AND RECREATION FEE
Land Account Land Credit
Recreation Account
Zone
Ion Credit Recreation Total
TOTAL AMOUNT $
Ex
o No
How Determined
LIBRARY FEE
Land Account
Land Total
Facility Total
o No
How Determined
Total Amount
RESOURCE FEE
TOTAL AMOUNT
ERU
Prepared By
Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does not imply acceptance of concurrence, but simply receipt ofa copy of this form, plachig
the building permit owner on notice of this assessment and the conditions of payment for same,
DATE
RECEIPT NO.
RECEIVED BY
DATE
BY