HomeMy WebLinkAbout03-1766
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 780-0020
1766
Date
/- IS - 0 3
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel I. D. "
Zoning:
Descriotion of Work
/I e11r1- PotrS
'S9()'1 ForesT i-IJ.
Water Meter:
T.I.F.'s:
Energy Code:
R~ - OV~
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
~- 7 - t!J 3
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
If'L 'f d-- )lJo
~~l9'O
Permit Fee
)Signature ; /3?'~
Company
Address
yTelephone# 7qg'- i73J]I
Valuation or
Contract Price
~ '700 . FfO
.J' '1 ef(
City license Registration #
State Certified license#
Eac.f tJ~ ~.
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Tp. Servo
Rough In
Meter Can
Const. Pol
Pool
Pre-M
Final
SlB
Tub Set
Water
Sew
Fin
BUilDING
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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A, NOTICE OF DEED RESTRICTIONS
The undel::slgned understands that Lids permit In3.Y be sJbject to "deed restrictions" which
may. be more restrictive than City regulations. '1']1<= ulldersiqned assumes responsib1U.ty for
compLiance wi th any applicable deed r,=s trictL:>tls.
B, UNIJICE:NSED CON'l'RACTORS AND CONTRACTOR RESPJ~lEiII3IlJI'l'IE:S
If the owner has hired a contractol:: or contractors to undertake Hork, they may be r:equired
to be licensed in accordance Hith state and local reg~lations. If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeallor
violation under state laH. If the O1.~ner or intended contr:actor are uncertain as to \vhat
licenSIng requirement.s may apply for the intended work, they are advised to contact the
city of Zephyrhills Bui.lding Department, 813-788-6611.
~lrthermore, 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 whicll 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 tile 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 Zephyrhill.s,
C. 'II RAN S POR'l'A.'l' I ON IMPAC'I' FEES AND U'l'ILI'rY CONNEC'rION FEES
D, CONS'1'RUC'l'UION LIEN LAW (CHAPTER 713, FLORIDA S'1'A'l'UTES, AS AMENDED)
I certify that 1, the applicant, Ilave been provided with a copy of "Florida's Construction
1 Jen La\-l - Homeowner's Protection Guide" prepared by the Florida Depar.tment of Agricul ture
and Consllmer Affairs. If the applicant is someone other that the "owner", I cerify that 1
have obtained a copy of the above described document and promlse in good faith to deliver
it \;0 the "oHner" prior' to commencement.
E. CON'1'RAC'l'OR' S/OWNER' S AFFIDAVIT
I certify l;hat all the infor-mation in this application is accurate and that all work will.
be done in cm~liance 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 laHs regulating construction, City
codes, zonillg 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 Hor-k, 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 Sensttive
Lands, Water/Wastewater Treatment
*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
kAnny Corps of Engineers-SeawaLls, Dock.'3, Navigable Waten.Jays
*Department of Health & Rehabilitative Services, Envlronmenta1 Health Unit-Wells,
Wastewater Treatment, Septlc Tanks
*U.S. Envil::omnental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A,ete,", it is
under'stood that a drainage plan addressing a "compensating volume" 'will be subm.i tted Vlhich
is prepared by a professional engineer registered in the state of Florida prj.or 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 tecllnlcal 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 such permit is commenced within
si.x months of issuance, or if work authorized by the permi.t is suspended or abandoned for a
period of slx months afte.1: the U.me the work is commenced, One 90 day extension of Ume
may be alloHed 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 ped.od, or the proj ect will be considered abandoned.
WARNING TO OWNE',R: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUW' IN YOUR
PAYING 'l'WICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND 'IIO OBTAIN FINANCING, CONSULT
WI'rH YOUR I,E:NDER OR AN A'1''l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,TOBS UNDER
$2 500 HJ VALUE: DO 1'10'1' NEED '}'O RECORD AND POST A "NOT] CE OF COMMENCEMEN1'1''' ',.-: ~
' ,7 ? 8/,00- '1.7 -.;7 0 -~~O-t::7
/ - ~--- / ~/
OWNER OR AGEN'r SIGNA" RE:
STATE OF E'LORIDA
COUNTY OF ----..
'rhe foregoing instrument VIas acknowledged
Before me this ___ day of , 19_
by ____
(name of person acknowledged)
D~lo 1s personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this __day of
by
acknowledged
, 19 ~
(name of person acknowledged)
C1ho is personally known to me, or
[)who has produced___
( type
and wllo[] did []did not
II who has produced _____________
(type of ident ificaUon)
and who Ddld Gild not take an oath
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name l~yped, printed or stamped
Name typed, printed or stamped
Permission To Pick Up.txt
__f~r~L~W-LLd_~2n5tc~~Q~
-----1~-L:l-11>---1L2~J:bA,T-3P--L~~~------
__:DML_Cd~,__El~__~~~~~____
To Whom It May Concern:
Please be advised that Suzanne Bahr has
my permission until further written notice
to sign and pick up permits for me.
Sincerely,
-G *-_L~
signatu e
NOTARY
STATE OF FLORIDA - COUNTY OF PASCO
The foregoing instrument was sworn to and
subscribed before me this _~day of ~~~~__,
~-'
Personally known_~or Produced identification
Type of 1.0.
,,'',.I:~~'"'' Jeffrey Todd Reutimann
~::~~:= Com.mission #00159234
~~.1h.: Expires: Nov 15,2006
-,-;itD;.'~.'-'" Bonded Thru
"""',,\ Atlantic Bonding Co., Inc.
Commissioned Stamp
and Expiration Date
1Ik7dof ~~
~ signature
e of Florida
County of Pasco
Page 1
111I111111111I1111I11I111111I1111I11111I111111I1mlllllllll.
2003007636
NOTICE OF COHMENr::'EMENT
State of
Florida"
County of
Pa..sc.o
THB ImDERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement:
1 . Description of Property: Parcel No. 10- J,& - ;J.l- 0 II 0- 00000'- 0 I 00
5 Cj 0 L/ Fo f't! s 1-n.
(Legal descr1pt1on of the
2 .
General Description of Improvement
RCl::JF - ove .r
Rcpt: 646840
DS: 0.00
01/14/03
Rec: 6.00
IT: 0.00
.._._._.u____ Dpty Clerk
3 .
Owner Information: Name --.l:f enY'j Potts
llddress .JfC(OY fo(e~t LV\. City Zf'phyv-hi \I ~
Interest in Property:
State Fl. 335'"(/:z.
Name of Fee Simple Titleholder:
(If other th~n owner)
JED PITTMANA PASCO COUNTY CLERK
01/14/03 0~:30am 1 of 1
OR BK 5202 PG 1352
Address
City
State
, ~~:.:\
$....ii~
Wi 4.
Contractor: Name WOO&. COv1S+CL.t.C-tl'Ov-.-,
Address Id-L\t<b U.S. H-t.(;'j' =5DI
City 'vr)dp LI'+l
Sta te PI. 335';;J.5'
5. Surety: Name
Address
City
Stat~
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
71J.lJ(l)(a)(7), Florida Statutes:
Nc:mc
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.
<J. f'xp.i.rnt.l')n dnt.e ot Uot.lce of Commencement. (the explration date is 1 yea.r
fr~m the date of recording unless a different date is specified.)
./',
-:'1'1 Signature of Owner:
....//
...../J." . <
'. '
" I' , ,
\, ...- ..,,:" .----~
co . _' .~ .,"~___
Sworn to and subscribed befo-te me this /.1 <14. day of ,7CUUILt.I-.)
1fJ (~OO q . ;;l
Notary Public: "--..J'A04-h-'N'
/ ----;
" , '--../
My C :):11,;]] S S .lon Exp~res :
i3a~
'~l"~ Sll'nmne Rahr
:~~.>:. Com!llission #00157131
::~: . :.= ExplTes: Nov 15,2006
':.,~~ . , . 'o'#..~ Bonde<! I nru
"."~~.';.,,, Allantic Bonding Co., Inc.
PC93053048