HomeMy WebLinkAbout03-1862
BUILDING PERMIT
. NO
Permit -
CITY OF ZEPHYRHILLS
(813) 780-0020
1862
Date ;? - dC/- P '3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
"'aperty OW"", ~~. '-fYJ :!f-r
Job Address: (.f/(!Jl.{f).. Pt.f.."t..J.- sT.
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
DescriDtion of Work
Energy Code: Radon Gas:
m. H. ~ OtJe~
NO OCCUPANCY BEFORE .c.O.
FINAL
.3- - 0 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
/<(4 J- MO
City license Registration #
State Certified license#
Permit Fee
)<signature
Company
Address ..-
yelephone# (?if) ~r - 2--32&
Valuation or
Contract Price
3 o2Y . fYO
I
3/ (;J{)
fJcll/&t,~ul /JuJh/1e ~ 5 Y 5.
BUILDING
ELECTRICAL
SLB
Tub Set
Water
Sewer
Final
MECHANICAL
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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 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.
PASCO COUNTY BUILDING PERMIT APPLICATION
CENTRAL PERMITTING OFFICES, · SHADED AREAs FOR OFFICE USE OfJIL't" /l
· ~ade City: (3521521-51~ FAX 13521521-5149 OCCUPANCY- SEa"~ DC. (ff1 c;t--rr
,3852 17th St.. Dade City _, --1l.
· New Port Richey: (727) 847-8126 FAX (727) 847-8901 NO. OF UNITS:
7530 uttle Rd.. Rm. 210 New Port Richey FIRE DISTRICT:
· Lana O'Lakes: 18131929-1266 FAX 18131929-1307
.i 111 Land O'Lakes 8lvd, IUS 41 \, Lane O'Lakes TYPE CONSTRUCTION .
-CIS APPUCATlON MUST BE 1YPED OR PRINTED IN INK cATE ;,ESE'VED: J-I, res.
':'ND IS VOID IF NOT PERMITTED WITHIN 6 MONniS
---------------------------------------------------------------------------------------------------------.
S TIiIS APPLICATION THE RESULT OF A STOP WORK ORDER OR NOTICE OF VIOLATION? :' _ .'-J_
13 OWNER'S NAME: NANCY MILLER / ZI4-c...K- rf'L.tJ r FHONE _ I , 779-3623
~ J08LCCATlON: 6042 PLEASANT ST Z/HILLS SU8DIVISION: -o-~l~ A'll-l-f'
~ oAACElIOl: S ~ T "" "~SUB oo.>p BUI> 0 30 oUlT"~ ffiOJECH TAl _LOT SlZE -C..-X_
~ OWNER'S PRESENT ADDRESS:6042 PLEASANT ST enY: Z/HILLS STATE: FL ZIP: 33542
~ FEE SIMPLE TITl.eiOLOER'S NAME Of other Ulan owneo:
allClress lit apPlIcatlIe): ellY: STATE: ZIP:
~~~~~~~~~-~;~~;;:--iijOiBi1:E--A(jMEf-R-OO~~(jVEfR---N~-13A15------------______________________________.
13 UVING AREA: PAllO: GARAGE: ENTRY: TPJt4~NDER ROOF:
3 # BEDROOMS - # BATHROOMS - - _ TYPE CONSTRUCTION: 0 BLOCK 0 FRAME tt'crffiER:
CIl ~1l.L Y _ N _ . ,
a IF M081LE HOME OR RV: MAKE Tw l ~ \;\-5
i=
a.
a: WORK CODE
u
C.I)
w
a VAlUATION S J e'SCf.-
PERMIT#:
:1 !II JJlV
::Y:
v
VI
YEAR \ ~d I
SIZE ~4 'I' l(.r
FEES BLOCK
PlANS ON FILE? 0 NO 0 YES
MODEL NAME
PRE.PAlD PlANS FEES: S
PLANS FEE: S
---------------------------------------------------------------------------------
REC8PT ,:
BUILDING: $
SaNDING COMPANY:
::.: ADDRESS:
u
o
a ARCiITECT/ENGINEER:
a: ADDRESS:
w
i=
o MORTGAGE LENDER:
AOORESS:
enY:
STATE: _ ZIP:
erTY:
STATE; _ ZIP:
---------------------------------------------------------------------------------
CrTY:
STATE; _ ZIP:
CONTRACTOR:
SIGNATURE:
::.: ADDRESS1 ~7t::..L.. ','
g STATE UC , Of appj.cablel
~
CIl
a:
g ELECTRICAl. CONTRACTOR:
~ SIGNATURE:
.... ADDRESS:
a STATE UC , (it ~caDlel
U POWER CO:
M T r"~OC'I M' U;lgOV OMq TOMOO
'- PHONE' (-l .5~o~JY.(r
gC'I\'O qT CrTY: I C1gr::n STATE; EL..- ZleLa.~41
r"r::r" 01 ~ ~q77 PASCo CO COMPUTER 10': W Vh
PHONE' (-l
CrTY: STATE: _ ZIP:
PASCO co COMPUTER 101:
SAWPOLE: AMPS:
ELECTRICAL
FEE: $
MECHAN~LCONTRACTOR: ~
SIGNATURE:
ADDRESS:
STATE UC , ~f ~catlIe)
o NEW 0 Al1ERATlON
PHONE. (-I
CrTY: STATE: _ ZIP:
PASCo CO COMPUTER 101:
VAlUATION: Sfi3Q'1A4 - 0101 (RtQUrecll
MECHANICAL
FEE: $
PlUMBING CONTRACToR:
SIGNATURE:
AOORESS:
STATE UC , ~f ~PPbtllet
, FIXTURES: SEPTIC PER ,
PHONE' (_)
CITY: STATE; _ ZIP:
PASCO co COMPUTER 101:
SEWER: WATER: WELL.:
PLUMBING
FEE: S
OTHER .
BLOG.
FEE: $'
OTHER CONTRACToR:
SIGNATURE:
ADDRESS:
STATE UC , Of ~caDlel
TYPE CONTRAcTOR:
PHONe. (-I
Cnv: STATE: _ ZIP:
PASCO CO COMPUTER 101:
VAlUATION: $
---------------------------------------------------------------------------------
OTHER FEE TYPE:
AMOUNT: S
REC8PT':
RADON
FEE:
$
$
---------------------------------------------------------------------------------
JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO
RECORD AND POST A -NQT1CE OF COMMENCEMENr
TOTAL BUILDING PERMIT FEE
IPI/llII bm lC1/11)
EDITIONS OF THIS FOAM AR 1=A.c:m R~l! .... ...... ......._. _ .. ._
....NOT1CE....
BOTH THE OWNER AND CONTRAcTOR OF RECORD (Ucense Holder) MUST READ AND
SIGN THE REVERse SiDe OF THIS APPUCATION
.:. ',OTICE OF DEED RESTRICTIONS
7he unoerslgnea understand that this oermlt may oe suolect to,"Oeed reSotnctlons' which may oe more restrictive than County regUlatiOns. The
underSlgnee assumes responslolllty for comOllance with any appllcaOle deed restnctlons.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hlled a contractor or contractors to undertaKe Worl(. they mav De reOUlrea tJ ue licensed In accoraance with stale and local reau-
lations. If the contractor IS not licensee as reoUlree Oy law, Ooth the owner and contractor may De CIted for a miSdemeanor Violation under state
law. If the owner or Intendea contractor are uncertain as to wnat licenSing reaulrements may aoply tor the Intended worK. they are aov1S8d to
contact the Pasco County Building DiVISion - ucenSlng Section at 1727) 847-8009.
::'-.Jrthermore. If the owner nas ntree a contractor or contractors. ne IS aovlsee to have me contractonsl sign portions of the .contractor BloclC :::~
:~IS apPlication tor wnlCh thev WIll be resoonSIPle. IT 'IOU. as m~ owner sign as me contractor. '.'8U are !nOleatlng that You. rather than tne comrac-
: Dr. are responSlole for the WOrK. If the c:mractor wlsnes YOU to sign as contractor. mat may oe an InOlcatlon that he IS not propeny IIcenseo ana
,s not entitled to permitting pnvlleges In Pasco County.
,..
....
TRANSPORTATION lMPACTIUTILlTIES IMPACT AND RESOURCE RECOVERY FEES
The undersigned undersUtna that Transoortatlon Impact Fees and Resource Recovery Fees may aOPly to the constructIon Clf new OUlldings.
change of use In eXIsting bUildings, or exoanSlon ot eXisting buildings. as specifIed In Pasco County Ordinance numbers 89-07 and 90-07, as
amenaed. The undersigned also unaerstands. that such fees. as may be due. Will be Identified at the lIrne of pennmlng. It IS further understood
that TransporuitJOn Impact Fees and Resource Recovery Fees must be Paid pnor to receIVIng a .certlficate of occupancy. or final power release.
If the prol8Ct does not Involve a certIficate of occupancy or final power release. the fees must be PalO prior to permit Issuance. Furthermore. 11
Pasco County Water/Sewer Impact fees are oue. !ney must be Paid pnor to permit Issuance. In aCCOrdance With apPlicable Pasco County Ordi-
nances.
D. CONSTRUCTION LIEN LAW (Chapter i13. Flonda Statutes. as amended)
If valuation of wortc IS S2500.00 or more, I certify that l. the applicant. have been provloea wltn a copy of "Flonda Ccnstructlon lJen Law _
Homeowner's Protection gUide" ai'eparea by the Flonoa Department of Agnculture ana Consumer Affairs. If the appliCant IS someone other than
the .owner.. I certify that I have oOtalneo a coPy of the above descnbeO document and promise In gOOd faith to deliver It to the .owner' pnor to
commencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the Information In thiS application IS accurate and that all work Will oe aone In comPliance With all appllcante laws regulating con-
struction. zOning and land development.
AoPllcatlon IS hereov mace to obtain a oermlt t:J ao work anc Installation as InCICatea. I cer1,1I/ 'hat no wor!( or installation nas commenceo
prior to Issuance 01 a permit and that all worK Will oe penormeo to meet stanoaras 01 all laws re1~lat''1g constnctlon County codes. zOning reg-
ulations. and lana development regUlatlO'lo; In the IUrlSOlctlon. I also ce",tv that I unoerstana that tt,e regUIi:.tlons of other government agehCIes
may apply to the IntenOea WOrK. and that I' I:; mv responsibility to Identify wnat actions I must take to be In compliance. Such agencies Include
but are not IInl1ted to:
· Deoartment of Environmental Protectlon - Cypress Bayl,e&os. We:lano Areas ana Envlronmentallv SenSItive Lan~s. WaterlWastewater Treatment.
· Southwest FlOrida Water Manacemelll District. Wel!". Cypres!. Bayneaos. Wetland Areas, Altering Watercources.
· Armv COrDS of Enclneers - Seawalls. DOCkS. Navl~abl'! Waterways.
· Deoartment of Health & Rehabilitative Services EnVIronmental Health Unit - Wells. Wastewaler Treatment. Septic Tanks.
· US EnVIronmental Protection Acencv - Asbestos abatement.
. Federal Aviation Authorltv . Runways.
I understand that the follOWing restnctlons apply 1:J tt';~ use of fill:
· Use of fill IS not allowed In Flood Zone "V" unless e'~ressty permmed.
. If fill matenalls to be usee In FlOOd Zone "A". It i!. ,;-;. -f)d that a oralnage plan aadresslng a .compensatlng vOlume" will be suommee at
lime 01 permmlng which IS prepared bv a profeSSional elgl..eer licenSed by the State of Florlaa.
· If fill matena/ls to be used In FlOOd Zone "A" In connection with a permmed building uSing stem wall construction, I certtfy that fill will be used
only to fill the area WIthin the stem wall.
· If fill matenalls to be used In any area. I certify that use of such fill WIll not adversely affect adlacent properties. If use of fill is founcl to
adversely affect ad,acent properties. the owner mav be cited for VIOlating the conditions of the building permit Issued under the attacned permrt
application. for lots less than one (1) acre whiCh are elevated by fill, an engineered drainage ptan IS reqUired.
If I am the AGENT FOR THE OWNER. I promise In good faith to Inform the owner ot the permitting ccnditlons set forth In thiS affidavit poor to
commenCing construction.
I understand that a separate permit may oe reoulred for electrical wOr!(. plumbing, signs, ,weIlS.!1:lOOIS,. air ConditiOning. gas. or other Installations
not specIfically inctuded In the application.
A permit ISSUed shall be construed to be a license to prOCeed WIth the work and not as authonty to Violate, cancel, alter, or set 8SIde any proVI-
SIOnS of the technical Codes. nor shall Issuance of a permrt Prevent the Building Official from thereafter reQUlnng a COrrectlon of errors In Plans.
construction, or Violations of any COdes. Every permit Issued shall become Invalid unless the work auttlanZed by such permit is convnencea
withIn SIX months of permit Issuance. or If WOrK authonZed by the permit IS suspended or abandoned for a penod of six months after the time
the work IS commenced. An extension may be requested. In wntlng, from the Building Official for a penod not to eXCeed nmet'( (90) days and
WlU demonstrate justifiable cause for the extension If work ceases for ninety (90) consecutive daYs. the ,ob is conSidered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
DATE
C-
OWNER OR AGENT
.f ;.ji 3{ 03
SIGNATURE
DATE
__ _ t'"?
CONTRACTOR
J2ll.J/~>
SIGNATURE
NOTARY AS Tq
OWNER OR AGENT .
NOTARY AS TO
CONTRACTOR
~..-!.t- :2
'.,,- '.'
MY COMMISSION
EXPIRES
MY COMMISSION
EXPIRES
ADVANCED MO!!e.~:;:YSTEMS ~AI..UmOH AGl1E~EI!IT CONT. NOr.,,~O 1 2A OATE ~.,:'pv"
AMSEM.1, Inc. CO COSS977. CC C042787 -~ ")t:ZJ ..
13764 W. Rsna Drive -Largo, Fl33771 . 1-800-282-3572 SOURC,"c/ ~ PR070,UCT ~ ~
Phone;i;i (Ot' J) 1 J t-...J
OWNeR: Mr. - AM.... ~A/~y LAST NAME &IU~J7-
_bL>YL.- /~-:'(lc:..., a~~~~N4) T",3/,PI2.cc.. _ ~IL
U;~/9 --,). M~I!J;l.~
County ~ n...uc.-z. Hom..own _ Flent _ Land-Own Rent RIP #-
=:.ot1da):~69D J;(1t://JzJU Oity ~7;"c.bN/P';' State .I!1rZip ~hone~(?i7);.2.. ~ l/r?t.-
o AMSEM-1. INC. (nAMS") Pf'OpO$M to fumish all m:ltcrialc and labor tor the lob(s) specified below: (Out of Florida)
~~uq~~~4,L /;r'~~,
Q ELIMINATe GAS VENT _ _ ClGAS BURNfN~ IJNIT HAS OR WILL SEEN REMOVED BY CUSTOMER
INIT. INIT. . """iN'ii: INIl.
CJ SEE ADDITIONAL SHEETSFOR ADDITIONAL.. SPECIFICATIONS INCORPORATED INTO THIS AGREEMENT
AMS REQUIRES A 30% -RE LE OEP SIT, WtTHT~IS AGREEMENT NO BALANCE DUE ON CO~PLET/O~
CONTRACT AMOUNT ~. f" - .. / J ut (US. DOLLARS S) S ;;;(::><jfY/.t?fJ
v Sales Tax S ,:;.../ ~ ~ n
CHK ##!2/ P I TOTAL S ~J t?tJ
CASH Oeposlt Amount S t. ptJD, ~Yf)
. Balance Due on Completion S~ -.J~ I /Ii)
A. separate written Wi:lrranty r$lating to the Weathgr-Lo\<TM Roof sy.st.em wjIJ be mailed when CXlntract price is p6ld in full and a completed
application for warranty is received. A copy of the form of this warranty is available upon request.
AM$ is authorized to furnish all materials.and labor rQCluired to complete the work described in the above proposal, for wtlich IIWe agree to
PlllY the full amount specified in said proposal, and in accordance with all terms of this Agreement.
THE UNDERSIGNED AC!(OOWLEOOES THAT BEFORE SIGNING HE HAS READ, UNDEFtSTOOD. AND RECEIVED A COMPL.ET~. LEGIBLE
COPY OF THIS AGR~EMENT AND OF EVERY OTHER DOCUMENT' INITIALLED OR SIGNED BY ME DURiNG CONTRACT NEGOTIATIONS. AND
AGAEeSTO BE eoUND BY AU. THE TERMS THEREOF, INCLUDING THe TERMS AND CONDITIONS ON THE REVERSE SIDE..
This Agreement shall be binding upon the Buyerls written acceptance hereof In the space providt:>d below or upon the AMS's oomml'lnClng
performance. Upon such a<x:eptanCG or commencement of performance, this Agreement shall constitute the entire contract and ~ binding
upon the parties hereto, there bGing no oovenan\s, promi&eS, warrnntiQE or agrQ<i:ment. written or oral. '"'Press or implieKl. except as harein ~t
for1h or as created by applicable law.
BUYERS RIGHT TO CANCEL
THIS IS A HOME 5OUCITATION SALE. AND IF YOU DO NOT WANT THE GOODS OR SERVICES. YOU MAY CANCEL THIS AGREEMENT BY
PROVIOINGWRITT'ElHIOTICETOTHESEUERIN PERSON, BYTELEGRAM,OR BY MAIL-THIS NOTICE MUST INDICATE THAT YOU 00 NOT
WA/IIT THE GOODS OR SERVICES AND MUST BE DELIVERED OR POSTMARKED BEFORE MIDNIGHT OF THE THIRD BUSINESS DAY AFT
YOU SIGN THIS AGREEMENT IF YOU CANCEL THIS AGREEMENT. THE SELLER MAY NOT KEEP ALL OR PART OF ANY CASH OQWN PAYME I
NOTICE~.O BU. YER: THE. TERMS AND CONDITIONS ONTHe BACK HEREOF ARE PA. T O. F~~ &ME NT._, ..!
(lNtT.)x_Vl./I??-=--_ X___- EVERYTHINGPAOMISEOASPARTOFiHISC" :BA7;'~ ~ I A r .
~A ~4 z? /~"'7'.
ACCEPTED AND AGREED: BY AM$ R!::? - --I .~ - . -,.-
X ..::r!-t:VUw~~___SOCIAL.SECUA\TYiI. ~-.~ D,3~a :L-.JR- 20 ~~._--
-,- SOCIALSECURtTYit _____ _ C".\._ __ .20__ - -- -.-
X ____.- - --..-'
(8UvER.$ SIGNATURE)
td ~~:60 ~00G L0 'q3~
~--------..----
96SS966~t8 : 'ON ~~
WO(j~
AMS, Layout Sheet
CUSTOMER /LIAA/C/ I41ILlL/t..
Address: ~t?y.."2_ "P/-LAS:AA}!' ~T '
City: Z!:E,t/t'l/!./h;/A."-.'> State
'CONT'. NO. /~SOI28
Phone # (<;;13) 7')'1 . 3t~23
../
~ (-- Zip 3 -?5<J 2- Lot #
Unit To Rear
'1'
9'
1. Flash to Pan; bothisides
2.. Level Off Cap,seepic1ure t6r
3. Build Up??? - See:Cap picture \It
~2 < F. t~ah'cyj~'i~1;rtreet
6042 Pleasant Ave.
Zephyrhills, FL 33542
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:USTOMER Signature
EVERYTHING PROMISEDAS PARTOFTHISCONTRACTISCOVERED iN THEABOVE.
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JAMES B USHD USE, F.E.
BOCA llA rON. FL.
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COMM. NO.
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PHONE: (681) 4,.,-3SfU 2./20102...
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ADVANCED MOBILEflOME SYS:
'4/ $,11'. Slh Slrul
Pompuno Deac"- Florida 3306'-002/J
Permit No. --1cgf,a
..Farce 1 1.0. No ;J--J-6-J-/-Oot:H;>-..CJo..s"v -cJOU>
1111111 111111111I11111111I1 11111 1IIIIIIrII 11111 IlIIrllllllll
2003033560
NOT ICE QE COMMENCE.1,.(ENT
Rcpt.:657955
DS: 0.00
02/25/03
Rec: 6.00
IT: 0.00
Dpty Clerk
/
State of Florida
County of
JI:r//J/Tlr'~:2~~colCOU~TfY fLERK
OR BK 5250 PG 1839
~E UNDERSIGNED hereby gives notice that improvement will be made to
Cel ain real property and in accordance with Chapter 713, Florida Statutues~
thf following infor.mation is provided in this Notice of Commencement.
1. Description of property (legal description of the property and street
address' if available) 6042 PLEASANT ST "Z.../HtHJ
2. Ceneral descr iption of improvementMOBILE HOME ROOF-OVER NO GAS
NANCY MILLER .
3. Owner information 6042 PLEASANT ST Z/HILLS 'f-( 33542
a) Name and address
b) Interest in property
c) Name and address of fee simple titleholder (if other than owner)
r:.t:
/'In CHA!:L MURRA','
13764 W.RENA ST
Contractor (name & address) rL 3~C~1
AMS TIi\MJil'A
LARGO
. "-
s. Surety (name & address)
6. Lender (name ~ address)
=
~c :__-:,
7.. Persons within the State of Florida designated by owner upon whOm
notices or other documents may be served.' as provided by Section' 713.13 (1)
. (~) {7l, 'Florida Statues (name & address)
8. In addition to him~elf, owner designates
of to receive a copy of the
Lienor's. Notice as provided in Section 713.13 (1) (b), Florida Statues. .
'9. Expiration date of Notice of Commencement
(the expiration date is one year from the date ox recording unless a
different date is specified). YJ ~ 0. 712,)hAd.
Sig~ of Owner
. /' t~ .4 /~ //
Sworn to and ;;:Ubs~/ed before me this {/ .. day of -f,;tl:Mlk/1J
Personally known -"-- or fJ.roJ':;ed [.D. Type of 1.0.
.. . 4~;(~~/4!Jr~41 flj':-~:_
;- NOTARY. PUBL Ie . " i ....:1:.Iff.:;~ _ .-.Ip1ded-IhrQJgh.. _
. : (800....32....254) Florida Notary Assn.. Inc. !
.... .... II............. ~ Ill... ill ell I ............. ............
I997
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