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BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1700
If) () · tifD
BUILDING
36, {YO
ELECTRICAL
Date
Ie:( -/{J-eo<?
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D. ,
,~;~
~v~' H, P
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
En~rgy de:
c
-.J )
~'don G."
I.{. 5 (P
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.
Permit Fee
)::-5ignature
Company
Address
yelephone# tf y. 2- / /)(,1 i
frY' fJ (;
~ I/~ ~
Valuation or
Contract Price
~ 0 C/O. 9 {;
d&
City License Registration #
State Certified License#
/3rJ(~~.
1Jr't2 -# / cf- 'l
,
BUILDING ELECTRICAL
Ftr. /" 1:1 r/~ -02 R..L~ /l:ft7fp. Servo
Pre SLB~/2 -12 rV Z I' I, Rough In
Lintel Meter Can
FRM. Const. Pole
Insul. CL Pool
WL Pre-Meter
Final ./ 1- 7 - I) ~ R.L'1 ~ U;j- 0
SLB
Tub Set
Water
Sewer
Final
MECHANICAL
Breakers
Ducts Insl.
Com pre
Final
I
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 ~144A1o ~(l ( ZOjV /11-11 . f .
JOB SITE! ADDRESS '3 7 C; 3? Luf2..FiY1L_.Av[
CITY OF ZEPgYRHILLS PERMIT APPLICATION
BUILDING UBPARTtiBNT 5335 8th STRJilBl'r ZBPHYRHILLS, P'L 33540 . if 'f'
Phbrtel813-'lBO-0020 P'a~IB13-780-0021 , 1') '7 .,",
DATa RBCBIvaD u _~~_
PLANS RBVIR'" 1'11.____
~T
PHONEl CONTACT '11'2-1 bC: '(
I.Ll.~_-p- -1'/-tJ2. ~
SUBDIVISION C;~o 1-4/21 Zlflf/ f!!:fj,f.
LEGAL DESCRIPTION I LOT(S)
BLOCK
----
PARCEL ID # 3'-1--,7 S' -- 21 - DOlo - f)U Of) - 0 J , J (OBTAIN F'ROM PROPERTY TAX NOTICE)
WORK PROPSEDt ~W CONSTRUCTION 0 ADDITION o ALTERATION 0 REPAIR 1]-1'N8'l'AJ~JJ
DSIaN
PROPOSED USEI ~ FAMILY DWELLING
o MOVE
o DEMOLISH
o COMMERCIAIJ
OMULTI -F'AMILY
o INDUSTRIAL
0# OF UNI'rS
o MOBILE HOME
rro:;;IER
/1L(/IVIII..)(/"",,-
o SWIMMING POOIJ
~ c=J RESTAURAN~EALTl~DEPARTMENT APPROVAL
CY" ~) . .
DESCRIPTION OF WORK PI< (2... S"HEP, 12~ 0 CAf470/l.,
I
BUILDING SIZE!
SQUARE FOO'rAGE
'fSCp
HEIGHT
RESIDENTIAL I
COMMERCIAL I
A'l'TACH (J) PLOT PLANS & (J) SETS OF BUIIJDING PLANS & (1) BET ENERGY FORMS.
ATTACH (3) SETS OF BunDING PLANS & (1) SET ENERGY FORMS,
PROPERTY SUEtVEY RBlQUIRED FOR ALIJ NEW CONSTRUCTION.
~~rHnNG
OYELEC'l'R I CAL
PERMITS REQUmSTED
$
C(tJt.fD, CJ0
VALUATION OF TOrrAl. CmTS'1'RuCTION
AMP SERVICE
o FI,OR IDA PdWER
o
W.R,E,(], WI RE S,.;IE,??
[1 PLUMB tHG
o MEeHAN reAL
$
VALUATION OF MECHANcrAr~ INSTAIJll~TION
o GAS
o ROOFINO
o SPECIALTY
[J OTHER
'l'YPE OF CONS'l'RUCTlON I 0 BLOCK
o FRAME
o STEEL
o O'tHER
FINIBlUllD Fr~QOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDBR
COMPANY 15 ~ II C OIV S r fl..Jc.rr a/t-/ t!Jp CV~ r::-L.
1'7 17 /J /", STATE CERT OR REGrBT # C Bee ~7 rz .,p z..
~u... /J ~ CITY PROCESSING ~;;z (p
****************************~****************~~f::***********
B lGNA'rURE
JlLICTRIOIAN
COMPANY /k..e ELCc. r/Z( <.
/3. /l Chi! C2.. STATE OER'r OR REGtST #
~ 'Jf{ CI'I'Y PROCESSING ~' 1?7
************************************************~*~************
S IGNA'l'tJREl
PLUMBIR
COMPANY-
STATE CERT OR REGIST #
CITY PROCESSING #
S lGNA TURE
HBCHANICAL
**********************************************************~*******
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURllI
*****************************************************************
OTHIIR
SIGNATURE
COMPANY
STATE CHRT OR REGIST #
CITY PROCESSING #
*****************************************************************
CONDI'J.'IONS OF PERMI'!' AFFIDAVIT
A. NOnCE Ol!' DEED RESTRICTIONS
'l'he, undeJ.:signed understands that thi:i permit may be subjeot to "deed restrictions" whloh
may be more restriotive than City regulations. The underslgned assmnes responsibility for
oompliance with any applicable deedcestl:ictionfl.
B. UNLICENSED CON'fRACTORB AND CON'l'Ri\CTOFl RESPONSIBHI'I'IEB
If the owner has hired a contractor or contractors to undertake work, they ~ay be required
I to be licensed in acoordance witll state and local regulations. If the contraotor is not
licensed as required by law, both tile owner and contractor may be cited for a misdemeanor
violation under state law. If the o\mer or intended contractor are uncertain as to what
licensing requirements may apply for the intended \'iodc, they are advised to contact the
City of Zephyrhills Building Department, 613-768-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advi.sed to have the
oontraotor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs ~s the contraotor, you are indioating tllat
you, rather than the contractor, are responsible for the'work. If the contractor wishes
you to slgn as contractor that may be an indicat10n that he 113 not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPOWrNrroN IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUC'rUION I,IEN LAW (CHAP'l'ER 713, FLORIDA S'l'A'rUTES, 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 E'lorida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I oed.fy that I
have obtailled a oopy of the above described document and promise in good faith to deliver
it to the "owner" prior to conunencement.
E. CON'l'RAC'l'OR' S/OWNER' S AFFIDAVIT
I certify that all the information in this applioatloIl is accurate and that all work will
be done in oompliance with all applioable laws regulating construction, zoning, and land
development.
AppHcation is hereby ma.de to obtain a permit to do work and installation as indioated. I
certify that no work or installation has commenoed 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 lalld development regulations in the jurisdiction. I also
certify tllatI understand that the regulations of other governmental agenoies may apply to
the lntended work, and that it is IllY ~,sponsibility to identify what actions I lIIust take to
be in compliance. Such agencies inolude but are not limited tOI *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Bouthwest Florida Water Management District-Wells, CYPEess Bayheads, Wetland Areas,
Altering Wateroourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
""Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Waatewater 'rreatment, Septic 'fanka
*U. S. Envlronmental I?rotttotion Agency-ASbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A,ete.N, it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared IJY 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 ~he work and not as
authority to violate, oancel, alter, or set aside any provisions of the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiriJlg a
correction of errors in plans, oonstruotion, or vio~ations of any oode. Every permit
iuued shall beoome invalid unless the wor:k authorized by suoh permit is oOllullenoed within
aiH month. of issuance, or if work allthor1zed by the permit is suspended or abandoned for a
period of slx months after the time the work is commenced.. One 90 day extension of thlle
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Offioial. An approved inspeotion must be logged during each six
month period, or the project will be considered abandoned.
WARNING '1'0 OWNERI YOUR li'AILURE TO RECORD A NO'!'IeE OF COMMENCEMEN'1' MAY RESUJ.'l' IN YOUR
PAYING 'rWICE ll'OR IMPROVEMENTS TO YOUR PROI?ER'fY. IF YOU IN'l'END TO OB'l'AIN FINANCING, CONS U L'l'
Wl'l'1I 'fOUR I.ENDER OR AN A'r'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. ,JOB8 UNDER
$2,500 IN VAI,UE DO NO'1' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMENT".
~~
WNER OR AGENT
fj'l'A'l'E OF Il'I,ORII.lA i)A"""C '
COUNTY OF L ~I c
'l'he foregoing instrument was aokn~wledged
eaton lIIe this ~_ day of cx.To(3~~1L , ~Z-
by ~~ [? bFj,'E
. . .-lname of person aoknowledged)
r~o is personally knowri to m~, or
[Jwho has produced
(type of identification)
and who!] did [3tl1ci not take an oath.
--~~
Signature of person taking aoknowledgement
STA'1'E OF FLORIDA D
COUN'!'Y OF rASe c
'l'he foregoing instrument was.aak,.Jlowledged
Before mJ'o this ~. a~ of (Y fJtV:R.. , .. 2dJL
by (j;?{2t;~ !?>CrI'?L- .
(name of person aoknowledged)
~ is personally known to me, or
and who Ddid
~~ II.
o who has produoed
(type of identifioation)
(Jd1Cr not take an oath
~
Signature of person taking acknowledgment'
S(2Jc.(. 11-, IJ 515E'-
Name typed, printed or stamped
~J\. Bruce A AIbeI
. ?If. j My CommiIIIon 00116710
\; Of...' ExpiIwI June 22. 2006
__S reV Lt~~_. /},5oP L _ .___
Name typed, printed or stamped
0: BlUctAAlbeI
\.'7:.) ="~x~j710
~ -~
fr.}- ;.'J {. ,'..,.... t....'. "
~';l\'\';',r..~ J. ,. \ .,~~
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
OR OF PUBLIC RECORD IN THIS OFFICE. WITNESS MY
HAND AN~ SEAL THIS.t.!!- DAY OF
. 2tJ<J"2--
JEO PI~~~IT COURT .
BY ( /PLePUTY CLERK
~~~W!~I!~!I!II 111111111111111 111111111111111 II~ 1111
Rcpt: 638864
OS: 0.00
12/10/02
Rec: 6.00
IT: 0,00
Dpty Clerk
JED PITTMA
12/10/02 ~:frSCO COUNTY CLERk
OR Bk 5163pm 1 of 1
PG 951
5 , <1 ,e I) r-
----
j-/.-o (ZI Off
NOTICE O~ C6~HSEKnNT
County ot PA5c 0
7Ua \il-<ncf'SIGNCO hct"eby 9iveo notice thAt impt"ovcmen, ",ill be m~dc ,0 c::r,.Jin
ra.)l prQpen.y, And in AccordAnce wit.h ChApt.er 71J, florido S,o,\He~, ,he
Collo'-'LnC) intorr:\At.ion i. provided in thi8 Not.ico of Commoncr.IOCIlr.:
I. Oe.~cr.ipt.iOIl of Proporty:
e }
2. CCiltral Descrlp,ioil 0' Improvemen, ALv,V/f/Vr.//Vl PAc../((lC,t
3. alincr Information: Nllmo ~N;j1 !-IDf..(CD/J jYl,f/, f.
/,d(jre~s '7tA-~ CRce;v'5W~ P;l.Cit.y zEfJdy,/U-flL-{.5
S,He FL, 335'f{-7C-'c
in,eres, in pr.upert.y:
Nalne of fee Simple Titloholder:
(I! ot.her th~n owner)
City
5,.;),c
Address
~ .
Con,ractor: NJmeJ5~{,f- (otJ<;f(l.u<.TIOr.! pF C[IlIT(ZAL FL .
^JdressIfOz.~ }11ot/l/5 Btl~i PtJ, City 2[Pl!Yfl-Htl.-l5 S~,He r:L. "?"55L("J
f\
Surcty: NJlne
City
SC.cl'~
Address
IWoun, o! Bond: S
6. L~ndec: Name
AdJress
City
S,il,C
7 .
Persons wit.hin the Stat.e of FloridA desiC]nAt.ed by O",ncH ...:pon \.Jr.c:!'
no,ices oc other documents mllY boo served 05 pL'ovided U,/ Sec~~on
713.1)( l) (a)(1), Floridll Stlltu~es:
. 11M""
Arld(e&8
Cit.y
S ,.;) L'~
6 .
In additio.n t.o himself, O\.'net" oasi9nates
of ~o roceive 0 copy o! ,~e
t..ienor's Not.l.ce as provl.ded l.n Sectl.on 71J.1J(1)(b), Flor,dil 5tcl~\I:C'I,
r.p.rnt..ir;n d,,\.e of Not-ice oC CO/l\moncemonl,..(l.h8 e)<.pl'o~lvn d.)lU l~ ! year
tr?m ,he u~to u! rucordinC] unless a different date is speci!lec. J
') .
Si,oo,""ofOvo'" ("if..o. A. 1) ~ /...~~ n.//vE/f 1/66';,
/2l~ /-' ::HI::p/~ -
S\.Jorn to and subscribed before me this /" dllyof ()Fr.{-/I/L/7t:./?
No,.)ry publi.c:
~/r~
'7/}'iZ-
-~.
1"'<1 C OCT'.O I :; s ,on 1:" pi., e s :
jq,Fil a\. Bruce A Asbel
. ~ ; My Commission 00116710
~ Of,.df Expires June 22, 2006
, C' )0\ }i).,
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LEONARD G. "GEOFF" WOOD. P.E.
4034 THE FENW A Y
MULBERRY, FLORIDA 33860
(863) 646-5517
Date: 10-3-02
B & H Construction
Zephyrhills, Florida
Re:
Address
2003 Jacobsen
37537 Lorena
Zephyrhills, Fl. 33540
Mod # CL 3 4489B
Lot # 113
Dear Sirs,
This letter is to certifY that I have reviewed the above referenced project to
determine the structural adequacy of the existing structure to receive the attached
structure. The proposed structure is roughly a 8x12 shed, 12x30 Carport. The
existing mobile home, to be considered an adequate
host structure, should be blocked and anchored in accordance with the
manufacturers suggested and permitted set-up permit.
Therefore, it is my opinion that the marriage of the proposed structure with the
addition will not compromise the structural integrity of the host structure, if the
addition is constructed as per the attached aluminum engineered drawings.
As always, should you have any questions, please feel free to call me at any time.
sillJkly/( ({J
~G~Wood
4034 The Fenway
Mulberry, Florida 33860
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4034 The Fenway
Mulberry, FI. 33860
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