HomeMy WebLinkAbout03-1786
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N~
1786
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1:<1'
BUILDING
(813) 780-0020
Date
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j~
ELECTRICAL
~
.
~
Sewer Conn
Water Conn:
Zoning:
Description of Work
Water Meter:
T.I.F.'s:
Property Owner:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
ol-;20- C~
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
DATE
Z' d- /IT ()
Permit Fee
~igna~
"Company
Address
,.-. -~
c:-1.,Iephon~,!->
/~ ?: 9'~
"jg-r..-.- ;:J ,
Valuation or
Contract Price
~ D ?9/
City license Registration # c2- (~
State Certified license#
~~ {lum't ag -
~ ~~F ELECTRICAL /97
Ftr. //.;;L3 ~ o? RL-'f J/If:,. Servo
Pre SLB ./(- :2.q-"lI<L '1 t~ough In
lintel Meter Can
FRM. Const. Pole
Insul. Cl Pool
WL Pre-Meter
Final
'}fZ-fOeoy
PLU~'
~
M~-
-
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
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.
t)d' H c~~...;JuTi ~f\l
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j (~~j?LC? I () - / ? ,. t:J
l _-- Jd
- '\--. ---
ftGu;<< I tJ v.tA ? !tuurC--fv
SQ. FT.
PRICE
Main
Other Area
Under Roof
Valuation:
iDj 't>q, , D'?7
Building: 1271'S" 0
Electric: ?; f. ;~
Plumbing: tJ I fj
Mechanical: A.1) Jr
-I)
I b '7, ct l.f
Radon:
~ LfL/
School Impact )J ;..
Fees: h
Connection
Fees: JJ ) It
Trans. ImpactJ 1/'14-
Fees: tv , I
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~l'l:/i,~. ;i~. .;. l '~~~
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 PUBLIC RECORD IN THIS OFFICEAV~ESS MY'
H AND OFFICIAL SEAL THIS~AY OF
2{)/23
P , LERK OF CIRCUIT COURT
DEPUTY CLERK
~~~IJ~lm~!I!1I1111111111111111111111l111111111111111
Rcpl: 649019
os: 0. 00
01/22/03
Rec: 6.00
IT: 0.00
n ____ Dpty Clerk
~~92~~~1MA~2 : rc:;O fOUNTJ'f CLfRK
OR BK 5211 PG 1862
5 t ~ tel) f
rio ~ .Dft-
N 0'1' ICE 0 [1 C 6 i-u.re t.icp-lil NT
County ot
r ~SC 0
7ua uHnC1<SIGNc:lO hereby <]iveo not.ice t.h4t. im.provemllnt. ....ill be mode to c;~rt,)~n
re.:>1 prr.>pert.y, 4nd in 4ccord4nce ....ith Ch4ptor 71J, f'lorido Stotuteg the
follO"LnC) intorr:l4tion i. provided in this NotiCe) ot ComtllOncr.lnCllr.: .
I.
De.~cr.ipt.ioll ot Property:
3701lf Lo{lt:,.vA
(Leg,) e.cc~pt.~on 0
D 2c?oO - 0 1 5 c
e )
2 .
Ceneral Description of Improvement
AL V /111/V (./ M P li-t; Ie /lc, ~
). Ol'ncr Intornlation: Nomo C12lfiVD ,4-01Z-rZoN fVl.fi .1,
t.dcJress7~t.f'::'-&.71IfCN>~fc Pi, City zepl-ly/lH/f..,(.5 Stclte FL .sJSfI-rJI.,b b
Interest in pr.upercy:
NOlne of fee Simple Titleholder:
(If ocher th~n o....ner)
Address
City
SC.:lCC
b..~ ..
"
(Of
Contractor: NJme 13ft..;. cO/v:?TflU:f(c/J of Cp,jTf?AL
^u d r e 9 9 402 r:; f{I t:{/lLi <; 8ftl D6 ( /<V' C it. Y Zfil /flrJl/+' LL j
FL I
5 C ac e t:L
3 J 5'1- J
S. Surccy: NJlne
City
s(OC~
Address
lV"ounc ot Bond: S
6. L~nder:Name
AdJress
City
~tuCC
7 ,
Persons ""lchin che Scace oi floridll de9iqn/lced
notices or ocher documents mllY be. served 09
71J. 1)( 1)(a)(1) / Florida Stlltuees:
by O"nClr
provided
upon ,,~.c:r.
U, Sec(~on
, tll....rnc
City
5 ( U L .~
Ac1d(eli6
6. jn additio.n to himself, O....ner oosiqnates
o( co receive " COllY o! (:~e
L.eno,'s Notlce a9 proYlded In Sect~on 71J.IJ(11(b), flor.dc:l SC~~II~CL
') .
r.pi'''I.J(Jn d/'lt.e or N(Jt.lce oC COf\lmoncemon\.. (Lhe o)/,plrotlCin d.)lU i:l J year
~r?m the uc)te u! rucordin9 unless II diiierent date is speci!led.)
SloJorn lO
/l-66v r
5 i C) r"\a t u reo f 0'-' 1'1 e r :
)!I$ {(XI'
NOl.HY PllbILC:
Pu~ R. Cb(~
{"\, CO""nj" S .on Expires:
i~ a\. Bruce A Asbel .
. ~ ,; My Commission 00116710
~ Of,.'" Expires June 22. 2006
'C1)O)~o.t
APPLICATION FOR PERMIT
CITY OF ZEPHYRBIu..s
BUILDING DEPARTMENT
OWNER · S NAME 6/44 N' 0 f-/ () (z (20# M /-I. P .
9~. Anl)--WfiB t;}l~ '1 ~ Cflv9:.;./ S i.-{) pE D i2. --:--.-----__
JOB ADDRESS 37Gt If L()[26V/f AVE. Lo r 130
LEGAL DESCRIPTION: LOT(S) BLOClL--SUBDIVISION&e14N& /-I-6fl( 20/11 fVI-IJ- f'.
PARCEL I. D.' 54-- 2 t; - 2-( - 00 I D - 0 2roo - 0 I 3 '0 (OBTAIN FROM PROPERTY TAX NOTICE)
PHONE
1t Z - I (), 'f
WORK PROPOSED: vNew Construction --6ddition -...Alteration _Repair ~Atall
_Sign _Kove _Deaolish
PROPOSED USE: ~ingle Faaily _KIF _' of Units _K/H
_<=<-ercial _Indust. _Swia. Pool _Other
_Resta~t &: Health Departae~pproval ~7 )
~ . ~
DESCRIPTION OF WORK: IlxfV .5:c.rzcGv /ZooM},J=-x SHt=o I2..K 2(., c."AflPOILr
, /
BUILDING SIZE:
x
sLfLl
Square Feet,
Height
RESIDENTIAL: ATlACB (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
COMKERCIAL: ATlACB (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
~UlLDING
~cnuCAL
PERMITS REOUESTED
$ I O~tj {- {)"3 Valuation of Total Construction
AMP Service Florida Power Corp.
L--./ It US S H {3 0
W.R.E.C.
--1IECBAIlICAL
$
Valuation of Kechanical Installation
~mmING GAS ROOFING
TYPE OF CONSTRUc.nON: _Block _Fraae _Steel
SPECIALTY
Other
FIlUSBED FLOOR ELEVAnONS:
Fl" .
IS PROJEC'l IN FLOOD ZONE AREA?
YES NO
..................................*.******
BUTT .DRR
Signature ~ ;J.
CONTRACTOR SECTION
COKPANY f Ii c aII~ <-TIDI..!
n,. /' State Cert. or Regist. . C
~~ City License Registration .
*.***********************.***.************
FL,
RT.RCTRICIAN
SiQflAture
. .
11{,~
/},
COMPANY !4Ge l;;U= C,(l (<-
State Cert. or Regist. .
City License Registration #
***...******..************..**************
CUJ
.
1t?'1
PLtDlBER COMPANY
State Cert. or Regist. .
Signature City License Registration .
**.*..*.*..**..*..*..**.*.*.**...*..*...*.
IIECBAIlICAL COMPANY
State Cert. or Regist. .
Signature City License Registration .
..*.....**....*.*.....*..**.....*.........
OTR"RR COMPANY
State Cert. or Regist. f
Signature City License Registration .
.....*..**.****..**.*...*.*...*..*.*.*..**
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this perlit lay be subject to "deed restrictions" wbicb lay be lOre restrictive than City
regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lal be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents lay apply (or the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (8Il)
788-6611.
FurtberlOre, if the owner has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions ot the
.Contractor Sections. of this application for which tbey will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, ratber than the contractor, are responsible for the work. If tbe contractor wisbes 10U to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to peIlitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<'
~
D. CONSTRUC'l'ION LIEN L1\W (CHAPTER 713, FLORIDA STATUTES" AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law ~ HOIeOIDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConSUler Affairs. If tbe applicant is sOleORe other than the
.owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the
"owner" prior to co..encelent.
E. CONTRACTOR' S/OWNER' S AFFIDAVI1'
I certify that all the inforlation in tbis application is accurate and tbat all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developlent.
I
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that DO wor1 or
installation bas cOllenced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of otber goverDlental agencies lay apply to the intended wor1, and that it is
IY responSibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are oot lilited to:
t Deparlleot of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Nastewater Treallent
t Soutbwest Florida Nater Hanagelent District - NeIls, Cypress Bayheads, Netland Areas, Altering Watercourses
· ArlY Corps of Engineers - Seawalls, Docks, Navigable Naterways
t Deparllent of Health' Rehabilitative Services, Environaental Health Unit - Wells, Wastewater TreableDt, Septic Tanks
· US EnviroDleDtal Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood tbat a drainage plan
addressing a .cOlpensating vol 018 " will be sublitted whicb is prepared by a professional engineer registered in the State of
Florida prior to perlit. issuance.
. A perlit issued sball 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 sball is~u~nce of a perlit prevent the Building Official trOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Iverl pertit issued shall heCOll invalid
unless tbe Nark authorized by sucb perlit is cOIIenced witbin six IOnths of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of six IOntbs after the tile the work is coaenced. One 90 day eatension of tille, -I be
allowed for the perlit witb fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection .ust be logged during eacb sil IOntb period, or tbe project will be considered abandoned.
NAMING TO OIflfER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCBJlENT HAY RESULT IN YOUR PAYING !WICE FOR IMPROVIIIBIIS TO YOOR
PROPERTY. IF YOU INTEND TO OBTAIN FIlfANCING, CONSULT WITH YOUR LiNDER OR AN ATTORlEY BEFORE RECORDllfG YOUR 1f000ICI OF
COMHENCEHENT. JOBS UHDER $2,500 IN VALUE DO NOT HEED TO RECORD AND POST A "NOTICE OF COtlMENCBJIEN1'II.
4~ 1J~ ~~~ flpcJ2<<:
:1IGHArU : qNIf OR AGENT IGNATURE:" C TRACTOR
. I
.
STATK OF FLORIDA A
COUNTY OF . ;q.,s- Go
The foregoing instrument was acknowledged
before M' this [EC/fi>VJEK. 12., .. 2PJ2 by
_-B6c.4<<. l ~ ~ c;l25~ !Jb/&{J1f
who is personally know to me or who has
produced 'ALJ...- bW;/'
as identification and who did/
take an oath~ 1/ ~
(Signature) . f1
1? RUL{: ,[/, S15fi L
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
STATE OF FLORIDA ])
COUHTY OF r' A ~c 0
The foregoing instrument was acknowledged
before me this !Fu:;,rII1Eu I L, .. ~ by
C/za; eFFftE .
who is personally known to me or who bas
produced PFF5f);</AUrY kA/iJW/./
as identification and who di~
take an oilth~ ,4, atsf!
(Signature)T7 _ II 11 ~
Q72vCt N, IlSf5t:L
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~ eruce AAIb8l
r- ... , . My CornI'/IIIIiO" 00116710
~Offi Elqllre& June 22. 2006
~~ INceAAebeI
~.j MyCommlulonOD116710
~Of".l ExpireI June 22. 2006