HomeMy WebLinkAbout02-1666
BUILDING PERMIT
. NO
Permit -
CITY OF ZEPHYRHILLS
(813) 780-0020
1;liJ , f{YO
BUILDING
-:3 5' e-rO
ELECTRICAL
PLUMBING
MECHANICAL
Property Owner:
Job Address;
Parcell.D, ,
-,f q 3
1666
Date /1-c2 /'- tJ ::;
Sewer Conn
Water Conn;
Water Meter:
T.I.F.'s:
Zoning;
Descriotion of Work
J Ene. r~y Co e: Radon Gas l-J
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FINAL I ~ I Y - 0 3
DATE
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,
c.o.
DATE
I/JO
Inspector /,
Permit Fee ~~
~~::~n~/- - - - ~_.te,1
Address
),4elephone# it J- Z-ff7-// R ~
Valuation or
Contract Price
~ 2&0~ 6UJ
City License Registration # c::(;;2 y/
State Certified License#
j?~hn 4~ ~~
/9C-z
. :# /87
ELECTRICAL
BUILDING
Ftr, /1 ( - 1.'7 - 01.. l-tJ (J
Pre SLB /JI-21- 02 \t\o
Lintel
FRM.
Insul. CL
WL
Tp. Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Driveway ./ ([-1/- () L 1-(00
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,
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A. NOTICE OF DEED RESTRICTIONS
'I'h'e undersigned understands that this permit .nay be subject to "deed restricthms" I1hich
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CON'l'RAC'l'ORS AND CON'l'.Rl-\CTOR RES PONS IBILIT'IES
I f the owner has hired a contractor 0 t: con.tractors to undertake work, they may be required
to be licensed in accordance with state and local regulations, If the contractor is not
licensed as requlred by law, both the OHner and contractor may be cited for a mlsdemeanor
violation under state law, If the m.JneJ~ or intended contractor are uncerta.in as to what
licens.lng J:equirements 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
wili 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 elltitled to permitting privileges in the City of Z~phyrhills.
C. TRANS PORTNl' I ON IMPACT FEES AND UTILITY CONNECTION FEES
D. CONS'l'RUC'l'UION LIEN LAW (CHAPTER 713, FLORIDA STA'l'UTES, AS AMENDED)
I certify that I, the applicant, llave been provided with a copy of "Florida's Construction
lien Law - Ilomeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cel~ify that I
have obtained a copy of the above described document and promise in good faith to dellver
it to the "owner" prior to con~encement,
E. CONTRAC'l'OR' 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 illdicated. I
certify that no work or installatlon has commenced prior to issuance of a perm.tt-. 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 Hhat 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 3ells~tive
Lands, Water/Wastewater Treatment
*Southwest FJ,orida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
"'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of HeaJth & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U. S. F,nv! romnental 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 dralnage 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 sllall 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 tectlnlcal codes,
nor..tlall 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 such permit is commenced wJthin
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of slx months afte.t: the tlme the work is conunenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
1n writIng to the Building Official. An approved inspection must be logged during each SlK
month period, or the project will be considered abandoned.
WARNING TO OWNE',R: YOUR FA.ILURE '1'0 RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR
PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND 'l'0 OBTAIN FINANCING, CONSUL'!,
WITH YOUR I.ENDER OR AN A'l"l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
$, 0 IN WE DO i' T NEED '1'0 RECORD AND POS'I' A "NOTICE OF COMMENCEMEN'l'''.
SIGNA'l'URE: CON'I'RAC'l'OR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF ---------,-.-
The foregoing instrument was acknowledged
Before me this ,---slay of------, 19
by
(name of person acknowledged)
[1ho .Ls personally knoHn to me, or
STATE OF F'I,ORIDA
COUN'I'Y OF ---
The fotegoing instrument was
Before me this _ day of
by
(name of person acknowledged)
[J who is personally known to me, or
of identification)
take an oath.
o who has produced_________._.____
(type of idellUficaUon)
and who Ddid DUd not take an oath
[J who has produced
(type
and ~~ho[J did [Jdld not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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Perm i t Num ber 1111111111111111111111111111111111I1111111 lilll 11111 1111 111I
2002181427 .
P~rcel Identification Number 3 i- ;},J'-Z-/- uO/ ~ "- tJ ~ rtJ tJ - CI 0 9.3
Prepared By:
palm Harbor Construction
808 South Frontage Road
Plant City, Fl33566
Rcpt: 634745
DS: 0.00
11/21/02
Rec: 6.00
IT: 0.00
-..-.---- Dpty Clerk
Return to:
NOTICE OF COMMENCEMENT
State of '?:j/ M ('1fA...-
County of IClL-LiJ
i~~ii~~1MA~: ~:;O fOUN~~ C1ERt<
OR st< 5142 PG 1847
The undersigned hereby gives notice that improvement(s) will be made to certain real property, and in
accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of
Commencement.
]. D~~cription,qf property (legal description of the property, and street address if available)
v<tt tbw{ I~ IJ.~ t.rJ f q.3
3 '76 3~ - ~1Vt>g /C}-,vc;
2. Gener. scriptIon ofimprovement(s) ~'/,'\."(/Ii~ + ~~
3. Owner information
Namej'dt tJ.-1J ),k...,/ J..-tH"-4-- Telephone Number ,f / 3- 7:1 ;<- 3~ 11_
Address31f3 ~-X;q)//)/5 #i/E, Fax Number e--yj. SCt3
~t:;;;uJ..u / tJ/r
4. Fee Simple Tifle Holder (if other than owner shown above)
Name Telephone Number
Address Fax Number
f=t
5. Contractor "alm Harbor Construction
Name a05 South Frontage Road
Address . Plant City, FL 33566
Telephone Number
Fax Number
tY/3- ?.,j;Z - 366/ F;el 50 3
6. Surety (if any)
!
Name I
Address I) /}-
Telephone Number
Fax Number
Amount of bond $
7. Lender (if any)
Name ;'
Address j} /1-
Telephone Number
Fax Number
8. Persons within the State of Florida designated by Owner upon whom notices or other documents may
be served as pro/tided by 9713. 13(1)(a)7., Florida Stattltes.
Name ) / Telephone Number
Address VI/r Fax Number
9. In addition to himself, Owner designates the following to receive a copy of the Lienor's Notice as
provided in S713.13(1)(h), Florida Statutes.
Name
Address
Telephone Number
Fax Number
10. Expiration date of notice of commencement (the expiration date is one year from the date of recording
unless a different date is specified):
. .\.
Q~~~ l-.,Q~ .~~_
Signature orOwn~ ~
t< day of 1)01). _,20_0:(, by
, who is V- personally know to J~ OR
, entitlcc tion,
Signarll of ora~r below) ---..-
#"6," Roger Lee Blevins .
*JjJ *My Commission CC816932
~"".... Expires March 11, 2003
I j.. j;). ~ D ~
Date Signed
Swo
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