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BUILDING PERMIT
Permit N2
CITY OF ZEPHYRHILLS
(813) 780-0020
1817
Date ~-$-Og
Property Owner:
Job Address:
Parcell.D. ,
E~---'---'- PLU~--' M~--
t;~x ~ ~~ ~~
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning:
DescriPtion of Work
FINAL
C.O.
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.
DATE
Inspector
Valuation or d c") rt
Contract Price 7f 2)' I; 0 0 0 -
~:~;;,~=,~2.!:: ~~
Company
Address
. epho~e# -) .3e6 - e?ol- -, 20~
City License Registration' d f? 21/
State Certified License' t!.t' e. 0 S7913
BUILDING
ElECTRI.cAt'-
,~
PLUMBING-'
~
~-
Ftr.
Pre SLB
Lintel
FRM.
Insut. CL
Wl
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
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 catted.
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.
".
CITY OF ZIlPII'YIUIILLIl PRRJlU' APPLICA'rrON !....,
BunnING DBPARTIfJWT !J338 "t" S'1'R..T UPHirRHIl.LS, rL i!sco.. . ;, "".
I'holt.1813~'tIQ~o;o.QO "~U(r8.1:J-7Ia-oa21, .' , '.. "
. JJJl.T~ l.~lrlv*i) _' '~-'L..!.a.l"__
)o1,MI ..~IIW ~.Jt...... "W __
,
OHNBR'S NAJfl East 'Pasco Medical Ce~ter
JUS SITI ADVRBSB __-!050 Gall Blvd., Zephyrhills, FL 33541
I ~ _ ,.
PHONg CONrA~~~~~~
JJnltL naa aiu PT Iot~ , LO'r ( s)
PARdlL 1D R 35 25 21 0010 10500, 0000
--. ---
waka: PROFS.tJ I OW&:W {10Ns'rJttJC'tI01" 0 APCITI01'l
0000
BlJOCK
--.-------... ---....- .----
10500 SUBVIVISION
0010 . _~--"_''''_
/OBTAIN PROM PROPiRTY 'I'IUC Ncrrn::.)
(J SIGN'
o MbV!
o AtJrSAA'rION
o DIIHOLISII
o RBPAIR
REROOF
..----
[J nHjTATJ!~
PROlo'08J!lU USB r rJBalJ 'AMIl,Y OHBLIrINil
KK:OMMIIlIU! LA I.
OMUi..'I'.r - FAHIl,y
o INDUB'1'RIAT,
0" OF UNITS
OS~IMMnrG POOL
o MCJEIlz..iD nOMII
o OTff!7R
IJIll!lCRIP'rrON OF WORK
c:j RIST~q~M1T & H.ALTH VIPARTMINT APPROVAL
BtJ.tM'I[lfU dIU _
Remove existing roof. repLace with single Pl~~~ite RoQfi~stem
Roof'
SQUAitB li'OO.t'AGI ..!?800 sf _
Jflf IaR'I' ..:"--
-. .
RlrSIDllllTIAII I
lJOI'IMBRCIAL (
ATTACIl I') P""T now. · (' I ..TS OP BUrw INO PI.ONS . '" ..T .NR.". ""."..
AT!iJU'1l (3 J SBll'S OF Butt,nn'a PLANS 6't (1/ BRT B~IilR<JY 'ORMS,
PROPIRTY SU~V8Y RSQUIR&O FOR ALL ~EW CONSTRUCTION,
J SrIII,UINCl
._ 87,000.00
liBRMl:l'S IU:QltBSI~
;J ILmc'rRIOAI,
J P{,(lMBIRU
.,....: 'lfAhUA'.rItlN 0' TOTAL CO"SI!'R(Jc!1'lON
--- .....
. AMP ~l!lRVI(!8
o PLaRIOA POW~R
o tf,#'.I!J.r!.
J MJ!lUHMtnlttl,
i
$--
I (JAB
o RoorING
tJ SPBatAL1'Y
o O'I'H8R
VJ\LUA.TION OF' MECJlAJrOIAL Il-fST)lLlJATrozq
'1''''1'8 or CONS'lfRU(!TIOl~ I D 81.001<
9'INlSHIID Ft,l;10A II,IIVM'IONB
o FiUlMBI
o STl!SIJ
o OTJUI){
.
IS I'ROJIICT IN P'LO(m EONI ARIi" tJ hIS D :no-
IUlth.1t
..............~----..... ..
(!OMPA~l(__
STATID CERT OR RI!I(UB1' II
CITY PRoemSSING H
---
---.------...-
IONATURI
~.IIlD'rRrc:!rAN
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"131'fATrJRlil ___~__
COMPANY : "---_
STA1'B CI!IRr Ok RIGTBT U
CITY PROCESSING N
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,tTM.B III.
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(:!OMPANY_ ___~__......___
BTATS C!R'l' Oil R2GIBT #1_
CITY PROCS8SI~Q #I
Cll4A1'rJRIl
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COMPANY
8TA~E ~BR~ OR RSatST .
eI'l'V PROCSSBINlJ 1#
~NATOftB
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a. RoOk _
NA'':~. . . ~ ~~ ~
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(JOl'1PAHY CEI FLORIDA, INC.
BTM'!! OIilRT OR DarST #I CCC057943
CITY PRocmSSING N ~~2~
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",-I 'd_gSO€' ON_
SlllH~^Hd3Z jO AIIJ
~V9v;OI €OOl 'Sl'uer
-- - - -N 0 ' 30 86-P, 1 /1
'J n,28, 2003 10:46AM CITY OF ZEPHYRH!~L~i~IW!QNa or fERMIT AFFIDAVIT
. a ~. NU~Icm or D~mD RES~~tCT~ON~
Th. .ad"'<.n6O .nd...t..d. tbl. th<. P'~t 4ay b. anb'.tt ta "d'.d ......at.a... kb1
moy b. ~r. "'triot,v. 'ha. ei.y r'..lat<oaa. Tb. .ad.'oion.d "'WO.. ....on.<b.l<t,
.CIQJUp11il1flPlI w.(th lUll' af.plicable deed J:e8triotion.::s,
B. U.NLICEN~2D. hONTRAC1'ORS ~D CONTRAcTOR RESPONSIBILITIES
If tbo Dwnar h.. hind · DD.tuotOt a. ca.traotou to .adortoko ko.k, th.y >lay b. '.qa
to ~. 1, c....d 1 a ,ocor...o. ~Hh >ht. aa. looal ....l.tioa.. If 'h. aontraato. '0 n
l.a....d .. ".u<... by l.k, botb tb. Own or 'ad aaatr.ctor moy D' c'to. fa. . m<'.nm.,
v<ol.t<o. Und.. .t.t. lak. If tb. own.. a. <."odo. CDat'.cta. ... .ao..t... a. Po kh,
11 c'.oing uqui....... ..ay .pply fo. tho <......d wo.k, they... .dvbod to an.to.t ~h,
City Qf ZephyrhUle aldldillg D~PllrtJ1lent, 813-711$-6611.
"'<th..,..<o, if tho -.. h.. bi... · cantmeto. o.eon<<.eto<o, h. 10 ,.v<"4 to hava
ca"t"ctn.,., d.n .o.tioa'af tho "CD.t..ctn. a'DUnn.- af this .p.l...t... f.. ""uh
"Ul b. '.apoaO<blo. l( YD." .a tho ...... .<... .. tho CD."Octn., Yo. 'r. <o....t...
ya., ..th.. than tho cD.tracto., 'U r",,0.db1. for th. kork. If tho caotuntnr w1oh.
yo. .., .<'0 .. oaah.cto. th.t ...y b. 'a <.d<caUD. <hat h. to not ,,'oPedy H.oe"... .,
aot .htitled to P'<!Ditt!o. privil.... i. tbe C<ty of '."hyrhill., '
C. T~~PORTA~IDN IMP~T 'E.ES JU~D UTILITY OONN~CTIOW FBES
o , C""STRDcrUI"" LI"" L!\w I CJU\l>rEll 113, PLORlDA ar,,'I'UT.S, JIB IIH"'DBD J
I C.rtify tb.t I, the 'PPli.aht. h.v. b..~ prov<... "itb a qOpy of 'P10r<.a'. Coa.t..ct
1<.. Lak - H""awn.r'. P.ot.ctio. Goid.' pr.p.... by tho 'la.i.. D'''.rt....t of ".,io.1<
'04 cooau.e. "ft.i... If the oppl<..ot 1a '~'Q" Dtb., that the 'o...or', I c.rity tb.
have ohtai... · DDpy of the 'hov. '....ra.. dODUma.t 'a. "r_.. " goo. 'oHh to d.li.
it to th~ ~ownarP prior to a~e"ce~ent.
Iii~ COl1TIlACTOll'S/OJiHER'lJ Ar~IDA"IT
I c..tity th.t .11 tb. iOfo~.t<a' <. th<. .""li.ati.o i. ,.cor.t. .nd th.t all >or. Wi,
h. da.. <a OOOpli.oc. vith All ."p1<oab1. 1... r...1atio. c..at'.ctioo, '.oi.., nod 1a..
claV,lgplIl",nt. ,
>Ip"li..tia. i. h.roby _.d. t. obtoi. . P'noit to do wark .a. i..t.l1atio. a. i.......d.
C..t<fy th.t .0 ~ork o. <"ata11.t.o. h.. c......c.. p.ia. to i....... of . P".'t ... th,
,11 wo,. vi11 b. P"f.~d to mo.t .tAn..r.. af .11 1.w. "..lat<.. cD."..oti.o, City
.odoo, ...... ....bUoa., ... laa. ..va10....ot ....laU.n. <. tho j...."'otio.. I als.
c.rtify tb.t '1 und...t.hd tb.t tbo r...l,ti... of athp. ,ov.rnmeat.1 .....i.. may .PP1y
the i.t.ad.. WO'k, .od th.t <t i. >w '.'P."<bi1it, td i.o.tify Wh.t ..tio.. I muot t.k.
h. i. ..."l..ac.. S.oh .....i.. i.o1ud. b.t or. .Dt l<m1t.d t.. 'D,pa.t4BDt of
&nv<'..~atai aOQUl.tl~-C"ra.a aaYb.'d., ~otl.n. Ar... 'h. S.viro....t.lly B.h~tlv.
LanQ8, W.t~~/N4.tewater ~reGtment
"..thk.ot 'lori.. W.t.. K....~nt D<.t..ot-W.ll.,.cy".... B.yh....} W.t1... ",....
Altering ~.t8rpo~r.8a
.......y CO"". of .........-...""11., Dock., Navi''''l. W.t..~.y.
.v.P....,..t of Bo.1th , ....biUt.tb. ".v<o.., ~avi<O""'oCOl H..1th U.<t-H.U..
W~.te~~tex Treat~ntl ~~ptia T~n~8
~U.s. EnvicQ~en~41 Protection A~encY-A.b.stos ~b.t~~nt
I .1.0 o.rti fy tho t, H f >11 m. tod el .. to b. U"4 <. '100. Z 0.. "A" or "'" .tc. ., <t i.
un.o..t..d thot · 4r'in... pl.o '..r...i.. . "ODOp....t<.. vo1.......11 b. '.bodtt.. Whi,
<. pr'par.d by · p.of...ioao1 oo.ino""..i.to,.. i. tll. Btat. Of 'lorid. P.iDr to P'~it
"'..aoo., ,
" pO'Mit i.~'4 .10.11 b. ca..t.... t. h. . l<c.... to P'.ooed with tb. .ork '.d 0.. ..
..tl'Odty .. Vioht., C'.co1, ~1t.., or ..t 'dd. aoy pro."io.. of t/,. t'''.ioo! ODd."
'.0' .h.11 i....no. of · p.tm>t "rovo.t tho B'<l~.. Offi.iol f'o_ th....ft.r r.~i..og .
.."o.tioo af "'0'. io plo.., oO'.t'.otin~. or .io~~tio.o af ooy 0.... ~v.ry P..~t '
<..... .h.ll boa... 'oV.1<. Dol... tb. ~.k a.tho.i..a hy .0010 P.rodt .. D~.o.d wLth..
'h m..th. Of .....Oa., .. H ....k ..thorh.d hy tho ".rUltt i. '.'P....d Or .10'..0".. !IIX
pO'1Dd of .1. Dooth. oft.. tb. tima tho Wa'k <. c."..o.d. 00..0 d.y ..t.noLD. of tlm.
may bo .1lDve. fo. tho p.rmit with f.. en.... af $15.00. Th. ..t...i.o oha11 h. roqU..~.,
'a ..it<ng to tho B.<ldiOg Of.io<.l. An approv04 1oOP.otio. mo.t h. io.... .o.<.g "ch 01
....th P.dad, o. ,tll. P..j.ct vill b. Oa.ai.o... obond.o... ,
""""IHO TO OlONR', YlllJ. 'AILV"" TO RRC!OIlD A HO'rICR O~ C.......HC..._ Kl\y ..BULT 1>/ YOtlll
PAYING THICI IDR IMP.o~s TO YDUa p,O' aRTY. I, YOU INTEHD TO OBTAIH 'INAN~IHq, ~'UI
WITH YOU. L!HD~ OB AN NtTOAN~Y ..m.. ABcORDlNG YOUR NOTICR O. C~C!K"T. JOB. UNo".
f2,50 IN Do N H~Q" ..,CORD AND POST. "NOTle. O. CDNHBHC....T.. '
' , ~\ \l...- Ji " \1./ lM...-
or \;h).HATU... coliTRACTOR ;
aTATJ,I Qf i'LORUIA '
COUNTY OF f-/r,(.<J...t".h-'
The foregoing ins~r~Bnt w
Dafoe. 8 bis ~da of
by' .
~ In.me of P~r8on .ckna~1Idg8dJ
~ho 1s pe~.Qnally known to ma, or
o WhQ hil~ prodUcaQ
(type of idqntitica~1on)
Odid nat take n OiJt:.h.
3TAT./!l 01' FLORIDA
COl1NTY 01' . Volusia
Th~ fpcego1nq in.trume~~ W4a aOknDwl~WI~
'.fo,. ... 'bie 28th..y 0;' T"~"a..,z"l'i"",-
by ~illiam R. Greene - ~ .
~~ (n~me Df per_on aaknowlB~9~dJ
'~l? 1,l!1 P~!;'ltpnilly l!:nQtm tQ lnC!l, ,or
o who haa ,P.t'OdI.JCfild
ltype of identJ.f'\Qill:Jtln)
and id npt ~ake an o.th
1.1 &lne
Georgia A. Boring
N_me typed, printed Qr at.mp6d
ilQJmow,hdfP1\ent
.....
01/31/2003 11:03
',!l,31/:!OO:) flU lO:J!5 HI
ENG ~ 386 668 1947
NO. 364 . ~01
'Id \IV." 'IV.
IIIIIIIII'IIIIIIIII~I !mllm! Imlli~' llltllWIlW 1m
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P~ndt No,
Rcpt: 5'79862
OS: e.0fJ
84/e9/112
R.~ : tl!I. 58
IT: 9.00
Clfl-V CS41'k
NOTler:; ()P COHl1lr11CgcEN"f
JEO PITT~NJ PASCO COU~TY CLiRK
04/19/02 e",:2J.-- 1 D'.l
.. 81( ~913 PG 10~7
:,r..-n: 01" !'lor1Q& _'
eoc~l''' OF _~-=---.
'ntF. ~O!f<~lCMED h~rDy rIvc. ro~ica (~.c ~.provc.c~~ w,ll be .a~a ~ CCT(Ain rG41
P';'pCl., ~y, ..nd 11'1 &c:.corc.llJ1cc wj. ~I\ el\IPtcC' 713, Flo""~. SUQ.IC:I. the tClUowif\l:
:r.Co~..ti~n ~J p~ov~d~~ i~ c.~is Noe~c. or ~o...nc.e.c~c,
4, ~c5crLp~iO~ or .rOPQr~~: (lel~\ do~ert~~LQI'I or ~ro~r~y. ~^d .troet C1ddr.ss if
.......1ht)1~)
~egal DeScrip~ion At~chea
~. Oa,.c~"L dCIISGrl,'=1.Qn or 1."ro"..o"e: Ea$~ Pasco Medical Center - t>1nJ.nq '9Qum Addi.t.ion
). ~I:;' illrol"lIGd(ln East Pasco Medical Center, II\C,
C1, ......... (,I',d .ddC'QU~ 7050 Gall Boulev61rd, Z.phyrb1l~s. !'lorida JJS41
b, 1.nccreo::c in ~L"o"t.:,.tp'OF\a.ld E. We1.eh, era
c;. Nul.:: ~cl Dd.}...:1l9 or~e.rl...1c C\uej,tlldar (.1( nr:hur tftol\ own..':
'j,
SUI"Ol)'
Q. 11_ 6I\d adclC'e!lS: N/A
Poole Cons~ction Co__ Ine.
106 S. pall\ ~v.n\1e
P. O. Box 279
Ho~.y-in-~he-Hille, Florida 34'3'
.'1.,\.
,s.,'~ t,.
".,~
C,.r'll"lU~tor: (nc.::lc IU'Id .ddrC!l~)
b, ^.o~nt or ~ond s~
U. l.cnl'lollr: (nGae tarlt .dd..ess)
!
N/A
'/. ,,~,'~~n. ..lc.l'lS,n Lh. s,C\~. of ~l.C1rJd.a dt'1.p&,CCl I)r O..n.... "'PO". ,"C1. no,Lce:: ot'
U~:16t' ~C'c:....e.'l:;; _1 be se4'Ve.d u ,ro",1ded by ~t10" 71,.11(11(1)7. Flot'i.4I
~cscules: (nbMe an~ ad~rts~)
0, l~ .dd1t1on to h1.se~r. o~~cC' des1;noLcs t~e rol1owl~~ pcr,an(s\ ~o C'ec.lvw
Ii c,"p')1 or t"e Lh""!'.'. ,",O(t.::", IUI pC'OVid.d in Sl!>r.uon 1l,.13(ll(b).f}.Uid.
Sc,1,II..UCe5: (r".lIe Gild AddrC!~ld
co..enC..et>l: (tt,. cotD1r::lc1ol\ date u 1 yOQ" fre.
e dirr.rent a.ce is spcelC1cdl
Ric:hard Byfielc! .i}.tf;l7'd/JJl" klli7N~
(~d.f\t. O""Ar":l N\tIt'e)
1/ ()..,,..r.r':!a "c1orc.' ~ ,'7050 Gall Bo~levaro.
ze~hyrhil'.. ~l~~tn~ ~~~41
Tr!... rOI'e,01l\r ins trovlII.n t \I1lS ftl:kno..led,t:4 tteror. .0 th1.S-!i::..J ....::l..-I.ai!... by
\3..5 (\"'\.I':"'"U Q~?~~--PCl':ondly lc.M"'~ r.~WhO produe.d~\?t-
_~ __65 idel\t1CJ.e.t10W\ ."d ~~llke en oAth,
"icQte r.;r FloridA County Or ?C"''-. "'"' r ~ ComaUUon ,(<:'1 is'O.;1. '111
(:.:~_~~,"\'t\ ,,~~~~'N\NY Co..Us1of\Explcoes: ~ - J '~CJO..s
~ lNet",.y)
All Inforaatlon ~~~ no Typ.d c~ Printld ~~1b17
t.~ Cc.P.~ With Re~ocd1n~ neq<llr~..nt.e
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