HomeMy WebLinkAbout03-2035
CITY OF ZEPHYRHILLS
5335 - 8TH SfREET
(813)780-0020
MOBILE HOME SET-UP
2035
ermit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
MOBILE HOME
MOBILE HOME SET-UP
MOBILE HOME SUBDIVISION
Ad ress: 38 R
ZEPHYRHILLS, FL.
Township: 26 Range: 21 Book:
Lot(s):45 C Block: Section: 14
Subdivision: WAYWARD WIND
Parcel Number: 14-26-21-0160-00000-0450
l:l111jm~111111111!I'i;:~:~111111!1~!j!!111111lill:lnil:il1111,llI11111111111i
: Address: 38022 LEONDIAS DRIVE .
ZEPHYRHILLS, FL. 33542
iil'li',j
4/30/2003
3,084.00
3,084.00
4/29/2003
MOBILE HOME SET UP
Phone:
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIF/SUB 99%
SCHOOL IMP FEE/MOBILE 97.5%
. SCHOOL IMPACT FEE/MOB 2,5%
E
60.00 WATER CONNECTION MOBILE He
35.00 MOBILE HOME PLUMBING
932.58 MOBILE HOME TIF/SUB 1 %
1,157.33 WATER METER RES 3/4"
29.67
200.00
40,00
9.42
180,00
[ [ :
REINSPECTlON FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-five dollars ($35.00) shall be made for each trip for each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
~9,..~~~ . ~~
C NTRACTORS SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHlIJLS PERMrr APPIJICATION ~1J:~13
BUILDING UEI?ARTMElN'r 5335 8th S'rREIlI'r ZEPHYRHII,I.S, P'L 33~SO 't .:-- , c;<-15
J?hon~1l B13 -780 - 0,020 :h~ 1813 -780 ~ OO:U Ll- 1(; __ .~
DA'rlll RIllCIlIIVIlJ ~_ ~7?_.02_.
PI,ANS RlllVUl Fall ,.
-.......... - "- - . - - ---
OWIlER' 8 IlAME ___-_m~~ItL M 4~___ _____ _.____ ._______ PHON CON'!'A' "!'!Y0::.~~~.: ";:~'('i
,TOB SITE ADDRm8s,3~Q2~~~.~.L_j;dr_~_._.___.__..________u___. <>
SUSI)IVI S J()tl ~w..9:..1f..d.W{ ~__
PAR""', n< # Jt{ -~ & - JL()jJ<'():J2_Q6 00:9 '-fS:-O__~__!O~TA~N!R(~~-,,~()p~R'rY'I'A~~":~I<"_J__
-~--.------~--~~-
'-f<:)"
IJ81GAL DBJSCRIPTIOll: LOT(8)
SU)(!K
WORK PRUPSElJl ~mw CONSTRUCTION
USHm
[) 1\r)J)I'rION U AI/rERA'I' I ON [J REJPAIR [J INSTAl,!,
[) MOVE [) DElMOI,ISII
[h1UUI'I ~. FAMIl.Y 0# OF UNITS )<n108 II. E l{of~1ll
o INDUS1'RIATJ [JSWltIJMING POO I, [] OTHER
PROPOSED USEI: []SGL FAMILY DWELI,Ilm
[J Cm~MElR(! JAT,
CJ REJ8TAURANT & HEAI,TH DEPARTfIJElNT 1\PPROVAL
IlElSCRIPTION OF NORK Mu..; ;J5:LX':l8...---LJ1Q!QI!.e h.t.J/y1.IL, ,.(L$i~9.4f_~_~___________..~..u___.
SUu'DIN(; S UEl ~~Y.fi_..______
SQUARE FOOTAGEl --.....LL~__
HElIGH'r
REBIDRlNTIATJ I
COI'-1MBlRC!I JH, :
.~.._--_.~- --- --....-..--
A'l"l'1\CH (2) PilOT
A'l"l'AC!H (3) SETS
PROPERTY SURVElY
~IILIJIN(~
ct)
$ __~{!)QO
PTJAllB & (2) SEll'S OF BtJII,IHN(1 PLANS & (1) SEl'r ElNElRI1't'
OF BUILDING PLANS & (1) SElT E:NElR(~Y FORMS.
REQUIR'O FOR AI,L NEW eON81'RUC'rHm, vfI ~ ~
FERMITS REQUESTED ~
FORMS,
VALUATION OF TOTAL CONs'rRUC'I'I0l1
l,J--1!TLIllCTRICAI.
----J&QO__ Mlfl? SElRVICEI
G--FI.oRIDA POWElR
[J W , R , El , (; .
[J...1rI,utIfBING
LiHfmc m\.N I C! AT J
oD
$._._/~OO _____ VALUATION OF tIfECHANCIAI, HIS'l'AI,I,ATTON
[] GAS
[] ROOFING
[J 8J?E1C!1AI/I'Y
[] OTHER
'l'YPEl OP' CON8'1'RUC!TION: [J BLOCK
[] FRANE
[] STEElJ
Lq.....eT II El R
FINISHEJ) FI,OOR mrJEVATIONS 113-,2/1 ::.____
18 PRO,TEC'f' IN noon ZClNEl AREA [J YElS ~)
Bur IJnlllR l'otIfPAN y-J;gf..'Y:J1.n~1!1tt.._~:fV/?._..__... ___._____ _._
8"lUATURE __&_=-c)~______ ~'~*~. P~~~~8~;~j~~;~::~:~;~:
*****~**********************~~*******~*************v*** *******~1,r~~~~.K.
ml,lllCTRIC!All . CO!-1PANY _ /-....,/ ~Q~___________....______.._.__ ______
~ STATE e'ERT OR RE~TS'l' #_~-'@-QgJQ>-?,J____.___
81"I1A'I'IIR8 ---,-~,_____ erl'Y PROCE88~K#__-2_1.____~__
~. 1< * * 1< * * 1< " ~ 1< k 1< '" ~ * '" ~ '* * * ~ ~ 1< * * * * * * * ~ * * fr * * * * * * * * *~ * * ~ * "* ~" *" ~ * * ,,* * * * *
PI.l1MBBlR
COt.1 P ANY -.~..lli~'f2-1IJJL~.~0':-?._._.__ ._.....__.________
_J:d ~ STATE CElRT OR RElr1rS'I' # _.;F"1t.!20f2.c}(,)...I...._._.___....
----~_-::~_:--- -------.--- erry PROCE88IN" # ftI?--~~
*"*********************~~~*****************"***c;******"**********
COI'-1PANyJft.__~s '_~"__"__________._ _____
STATE (~ElRT OR REGIS'r # .cttc tJ.L8.'i..(p2._.______.
--------!..-- ---_ .____t!. _..._._____ Cl'1'Y PR()CES~~--L21...-._--..----_---- .._____.
* * * * * * * * * * * * * * * * * '" * * ~ ~ * * * " * * * * * * * * * * * *.* * * * * * * * * a * * * * * * ~ * * ~ * ~ ~ * * *
S WHA'l'lIR m
MBlC!HANICAI,
S IGHA'I'tJREl
O'fnER .------.----.---- .A:21____________ ~~~~:N~ERT OR R~-----..-.-------,_...--. _""______
SWHA'l'UREl ____...___._______ CITY PROCESSING # _____.________._________
****************~****~**********************"**************~***~*
--.-.,---'""""'- -_.._.,-~-------_._-_.......-._._----~._--
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I,
CONDI'l'IONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands th~t this permit may be subject to "deed restriationsU which
may be more restriotive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNI,ICENSED (;ON'l'RACTORS AND CON'l'RAC'l'OR RESPONSIBILI'l'IES
If the owner' has hired a contractor- or contractors to undertake work, they may be l:equired
to 1J8 Ii censed 1n accordance ~~ith state and local regulations. If the contractor is not
l1censed as required by law, both the OvJfler and contractor may be c1ted for a lItisdemeanor
violation under state law. If the owner or intended contractor are ullcerLain as to what
licensing requirements may apply for the intended work, they are advised to contapt the
City of Zephyrhills Building Department, 813-768-6611.
Furthermol:e, it the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor SectionsH of this application for whiell they
"lill be responsible. If you, as the aI-mer signs as the contractor, YO!,! are indicating that
you, .I.'ather than the contractor, are responsible for the work. If the contractor' Idshes
you to sign as contractor that may be an indication that he 1s not properly licensed and is
not entitled to permitting privil~ges in the City of Zephyrhills.
C. 'I'RANI:lI?Ok'l'ATION IMPACT fEES AND U'l'ILI'l'Y CONNECTION FEES
D. CONS'l'RIIC'l'UION LIEN LAW (CHAPTER '713, FLORIDA S'rATUTES, AS AMENDED)
r certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerU, I cerify that I
have obt~ineci a copy of the above ciescribed Qocument and promise in good faith to deliver
it to the "owner" prior to conunencement.
E. CONTRAC'l'oR' S/OWNER' S AFFIDAVI'l'
I certify that all the information in this appl.ication is accurate alld that all work will
be done in compliance with all applicable laws regulating construction, zoning, and land
development.
Applioation is hereby made to obtaln a permit to do work and installation as indioated. I
ce-!=tify that no ~wrk or installaU.on has conunenced prior to issuance of a permit aud that
all work will be performed to meet standards of all laws regulating construotion, City
codes, zoning regulations, and land development regulations in the j\lrisdict1on. I also
certify that I understand that th~ regulations of otller governmental agencies may apply to
the intended wO.l.k, and that it is my responsibility to identify what actions I mllst Lake to
be in compliance. Such agencies include but are not limited to: *Department of
EnvirowQelltal Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
Lands, Water/Waste\-./ater Treatment
*Southwest ~lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*DepartmenL of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*u.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone qA" or "A,ete.u, it is
understood that a drainage plan addressing a "compensating volumeu'will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
i Bsuance.
A permit issued shall be construed to be a license to proceed with the work and not as
author} ty to v.i.olate, cancel, alter, or set aside any provisions of the tecllllical 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 cocie. Every permit
ie.5ued ahall become invalid unless the WOJ.:k authorized by such permit is cOllunenced Hithin
six montlls of issuance, or if ~-./ork authorized by the permJt is suspended or abandoqed for a
period of elx months after the time the work is cOllunenced. One 90 day eKtension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
j n writing to the Buildi,ng Official. An approved inspection must be logged dudng each six
montb period, or the project Hill be considered abandoned.
WARNING TO OWNER; YOUR FAILURE TO RECORD A NO'rICE OF COMMENCEMENT MAY RESUW' IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'l'AIN E'INANc.;IN~1 ~qNl?UL'I'
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNlJER
$2,50n HI VALUE DO NO'l' NEED TO RECORD AND POS']' A "NOTICE OF COMMENCJillVIEN'l'''.
SlGNA'l'URE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STA'rE OF FLORlDA
COUNTY OF
The foregoing instrument was acknowledged
BeLa e !He this __ day of
by _____.___
(name of person acknowledged)
Dwho is personally known to me, or
'1 (
I ..J..J_
STA'l'E OF FLORIDA
COUNTY OF
'J'he forego.i.ng instrument wae aokllo\-11edged
Before me this --------Jiay of---, 19....-:..~
by ______
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and who[] did 0 did not
of identification)
take an oath.
o who has produced ~_____
(type of identifiQCltion)
and Hho Ddid DUd not t.ake an oath
Signature of person taking acknowledgement
Signature of person taking aoknowledgment
Name typed, printed or stamped
Nan~ typed, printed or stamped
FROM
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(FR I) APR 18 2003 5: 04/ST, 5: 02lNO, 6344811416 P 2
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"
T
PIER SPACING
(SEt NOTES BElOW)
i2-WlDE WlDTU 'UXlMUM G> Q)
SOIL BEARlNC~" R'EQUJRED PIIR FOOTER
CAPACITY (i) W AREA. SQ. I. 4
ICICII lfi
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ZOOO JZ7
t500 212
1000 101
15CIO S3I
ZllOO 404
noo :m
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AND a'-Ir aN CD1II .......
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.'4' MMIUI fIllY tACH hO
*' ID'-o" GN CDfIlR IMXIUUM
(....... PlOt WAQ1Y 5101I)
PIER SPACING
13'-4"-WlD& 1fJMH KAXDlUM <D<D
SOIL BEARDI'C PSF REQUJRlD PIER FO,gTER
CAPACITY. ARRA. SQ. . \:I
'000 11&
I. 471
zaao _
:l5DD .,
\OlIO ..
I50D 510
2OCIO tU
2500 354
3.4' MAIIUI flIII EAQf DID
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(tIIfIIIIUM 'IJI CM'AaTY .,."
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PIER. SPACING
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FROM
(FRI)APR 182003 5:04/ST. 5:02lNO,6344811416 P 6
r
t8~' X 22'o;;~R 3~OJ~.~NfP ACIN~~.
MAXIMUM I-BEAM PIER SPACING
FLOOR MAXIMUM PIER SPACING (SOIL SEARIN ~ CAPACITY)
wtDTH 1000 (PSf) 1500 (PSf) 2000 (PSF) 2500 (PSF) J >00 (PSI=') J~OO (PSF
120- \MDr "'... I.) 1/1' , '!O ,no sa Nal( ,. m:~,. IU. N01r ,. m N01t ..
144" WD[ n,ODlt.. ~- .. 1" 'Il" m HOlt I' i[[ 1I0Ti ." IiU IiIOlt II
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..... PO C_IoCl1'Y Z74., '" ., ~I '" 519. &.IS "'I La '212 "II HI' LIS
~O" X 2a'~':;:R 4&gol~~NrPACINGS.
MAXIMUM I-B6AM PIER SPACING
FLOOR MAXIMUM PIER SPACING (SOIL 8EARIN( CAPACITY)
WIDTH TOOO (PSF) 1500 (PSF) 2000 (PSj:') 2500 (PSF') J 00 (PSf') 3500 (PSF)
lJO" -or tlOOlt... .. 1/"- 101 In' . !IOJl .. SEr N01! ,. S :I IfOlt I' 5f,t HOlt '4
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..". PC. CAIIAan 2771 LIS. .117 1.15- -ws. ,~. U1S. ~I l8S. "l2 LIS.
MOlt: \lilli' WDntS InH II IMCl.UllU A .' Ol/PHAIiIG ON 1O'Itt wn UAlIMI,I
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I. llC ............ ,... .. ..'JUD ... TIC ~ ( '1~ '\ , ~ l:JPROVEO BY
----.""..-, :. - :
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FROM
(
FLOOR
WIDTH
I ZOo WlIIC FlOOll..
,..- WIDr: rl.OClll..
160' WIllE nCICIII..
11." _ ~.
.... "1Clt UlM:J"
. FLOOR
WIDTH
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,.... ..Of 1'\.0ClII.. .
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loIN, "'tit CAPACITY
(FRI)APR 182003 5:04/ST, 5:02lNO,6344811416 P 7
!S" X lS" PIER FOOTER SPACINGS.
(MIN. 256 SO. IN)
MAXIMU~ I-BEAM PIER SPACING
MAXIMUM PIER SPACING (SOIL BEARING C "PACITY)
1000 (PSF') 1500 (PSr) 2000 (PSF') 2~OO (PSf') .1000 (~SF) J500 (PSr)
,." 11 'IJ" u ./1" 110" sa NOl It sa ..Oll ,.
3,)" 53: 7J I/Z' 13 l/r III 'J~' It:[ N01[ "
>>. .. 1/3" ff III" U' 103' 5[[ NOTE "
~, '/2"
,n. UJS
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to II .
un I.'
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X ~IV2;4~lEt54F~~~~ SPACINGa.
MAXIMUM I-BEAM PIER SPACING
MAXIMUM PIER SPACING (SOIL BEARING CJ PACllY)
1000 (PSF) 1 SOO (PSF) 2000 (PSF) 2500 (PSF) 3000 (SF) 3500 (I'SF')
,. I/Z" ... \17 . fl" 5([ NOTI: 14 XI: NO" It Sf.C NOT[ ,.
4." 7;,' , llO" 5([ NO'll II s(E IIOT, It SEE NOlE I'
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EOR TYP~~L PIERS SEE PAqE SU-Ol 0021
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.....lICUOlI M1~_ .~ ... I('[T 111( __
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Ir 1-.-1 CJ4" _ .... DIIIn
_JACOBSEN HOMES
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.... (IIJ) 121-11.
FROM
r.o
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WIDTH
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I..' lIAIlE 'LDllll..
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IS." .. '1.CIDIt..
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-FLOOR
WIDTH
lH" .lor "-oaII.,
IH" .or F\.DCIIl..
110" 111IO[ J'LOCIl..
II" lllIll n.Glllt..
'lllll. ~'" CAllag TV
(FRI)APR 18 2003 5:05/ST, 5:02/NO,6344811416 P 8
17 3/16" X 25 3/16" PIER FOOTER SPACINCS.
(MIN. '432 7/8 so, IN)
MAXIMUM I-BEAM PIER SPACING ..
MAXIMUM PIER SPACING (SOIL BEARING CA ~ACITY)
1000 (PSF) 1500 (PSF) 2000 (PsF) 2500 (PSF') 3000 (P ~F') 3500 (PSF)
. '10 '/2" 110 11'l" sa ~01r II ![[ ..011: ,. sa: NOn:. sa: NOli: ~.
&9 lIZ' .3 1/2" In /tOn; ". SEE NOW: '4 su: NOT" IU: HOtt: '1
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sa ltO'It .
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SEE NOW: ,.
SEE NOl[ ,.
102'
1001 L8S.
7SU LiS.
24" X 24" PIER fQOTER SPACINGS.
(WIN. 576 SO. IN)
MAXIMUM I-BEAM PIER SPACING
MAXIMUM PIER SPACING (SOIL BEARING CAI ACITY)
1000 (PSF) 1500 (PSF) 2000 (PSF') 2500 (PSF') 3000 (P F) 3500 (PSF)
" 'IZ" sa: ..Dyt I' III ",ft ... SQ; MOlt I. SI:[ NOrl ~ sa: NOT': "
I!' sa: ~01C ,. $Q; a101t II m; NO" I' 5[( lfOTl 14 sa: 1lI0TE '4
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,~" '0'" sa: HOyt ,.. srt NO'll: 'f set NOlt. sa NO'" '4
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"Oft; loINl .0,.., .," .. INCWOn A .. OIIOMANO CJ.lI 1G1lt 51DrS UAlIMUU,
FOR T~ICAL PIERS SEE Pf'.CE SU-Ol-0Q21
~'l-...~:zt01
~=~1fD""'_ .,.... At. _...." IllIC CIICllIlf ";$~Ti~7!."" ,......'S-::7""t;~ ". "\
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... (ltl) 711-". ..-...''''''- SU.O -002~
..
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f'
(FRI)APR 182003 5:05/ST, 5:02lNO,6344811416 P 9
FLOOR
WIDTH
28" X 26" PIER FOQTER SPAC[~yS*
. (WIN: 676 SQ. IN)
MAXIMUM I-BEAM PIER SPACING
MAXIMUM PIER SPACING (SOIL BEARING APACITY)
1000 (PSF) 1500 (Psr) 2000 (PSF) 2500 (PSF) 3000 PSf') 3500 (PSF)
lt3 ,/t" SU NOn: ,. sU NUl[ ,. sa IICJ1( ,. srr N ,. 5[[ NOT[ ..
. 'fl' Kt IIIOft ,. srI NC)1l I. SEE -otI ,. I' III IIOlt ,.
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FOR TYPICAL PIERS SEE PACE SU-Ol- OO~J
M JACOB~~ ..HOMES
wt" ...... ~ Jet"
. .... (It" !.".
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II" 1'" a.. .... ,., ~
'Ku~d-~;
Accu Title Agency
14445 7th Street
Dade City, FL 33523
PREPARED BY/RBl'URN 'fO:
~~'l>TI<i'"
~~ ~
,"i?r.;;.1jt
~'~""-'t'n
t'~~ t1\li
Jill Lewis, Tri.Star Lending Group
1500 LEE ROAD
ORLANDO, FL 32810
(4071578-2000
LOAN NO.: 132018282
NOTICE OF COMMENCEMENT
I 111I11 11111 11111 11111 11I11 IlIIi illlllllll 111I1 1111111111111
2003077647
Building Permit No,
Rcpl: 676985 Rec: 6.00
OS: 0.00 IT: 0.00
05/01/03.________ Dpty Clerk
JEO PITTMAN PASCO COUNTY CLERK
05/01/03 04: 30pm 1 20f571
OR BK 5339 PG
STATE OF Florida
COUNTY OF 1a$co
. '. . 100 not ""rite in this blank area. .Reserved for recordiIUl.JJu!1?os~J)l1ly..l. .
THE UNDERSIGNED hereby gives notIce that Improvements will be de to certa1ll real property, ana 111 accoroance willi c.naJ1,er I u, f'londa
Statutes, the following inform3tion is provided in this Notice of Commencement.
I) DESCRIPTION OF PROPERTY: PARCEL NO, 142621016000000450
(legal description of the property, and street address, if available)39022 LEONDIAS DRIVE. ZEPHYRHILLS. FL 33541
Lot 45, Wayward Wind Mobile Home Subdivision, as _per plat thereof recorded in PLat
Book 28, Pafes 61 and 62, Public Records of Pasco County, Florida.
2) GENERAL DESCRIPTION OF IMPROVEMENTS: Construction of Single Family Residence
3) OWNER INFORMATION: JOHN MICKLE
a) NAME AND ADDRESS: 3745 COURT STREET, ZEPHYRHILLS, FL 33541-
b) FAX NUMBER (OPTIONAL, IF SERVICE BY FAX IS ACCEPTABLE):
c) INTEREST IN PROPERTY: FEE SIMPLE
4) CONTRACTOR:
a) NAME AND ADDRESS:
b) PHONE NUMBER:
c) FAX NUMBER (OPTIONAL, IF SERVICE BY FAX IS ACCEPTABLE):
CITRUS HOMES
5) SURETY
a) NAME AND ADDRESS:
b) AMOUNT OF BOND $
c) PHONE NUMBER:
d) FAX NUMBER (OPTIONAL, IF SERVICE BY FAX IS ACCEPTABLE):
G) LENDER
a) NAME AND ADDRESS:
b) PHONE NUMBER:
c) FAX NUMBER:
PINNACLE FINANCIAL CORPORATION
1500 LEE ROAD, SUITE 200
ORLANDO, FL 3281
ATTN: CONSTRUCTION-PERM DEPT
(407) 578-2000
(407) 578-9005
7) PERSONS WITHIN THE STATE OF FLORIDA DESIGNATED BY OWNER UPON WHOM NOTICES OR OTHER DOCUMENTS
MA Y BE SERVED AS PROVIDED BY SECTION 713. 13(1)(a)7" FLORIDA STATUTES
a) NAME AND ADDRESS:
b) PHONE NUMBER:
c) FAX NUMBER (OPTIONAL, IF SERVICE BY FAX IS ACCEPTABLE):
8) IN ADDITION TO HIMSELF, OWNER DESIGNATES THE FOLLOWING PERSON(S) TO RECEIVE A COPY OF THE LIENOR'S
NOTICE AS PROVIDED IN SECTION 713. 13(1)(b), FLORIDA STATUTES
a) NAME AND ADDRESS: ~~~8~'6t't~I~~6R~J>:1~~~of.~'Wr~~~6~~~AKELAND, FL 33868-
b) PHONE NUMBER: (407) 578-1121
c) FAX NUMBER (OPTIONAL, IF SERVICE BY FAX IS ACCEPTABLE): (407) 578.9005
9) EXPIRATION DATE OF NOTICE OF COMMENCEMENT:
(The expiration date is one (1) year from the date of recording unless a different date is specified here).
~- // 1/
lI~k /
LE
cV 1/;/ J',C7 .5
(Date)
/
(Date)
Sworn to and subscribed before me by ~~ l1~eL/~
personajly:, known to me ~h9 h1Ij produced L. '
this ~ day of VlA-i ---=:::::': Vl02()Q,3
~li:: idpntifir::atinn ~nd whn did
(Date)
who is
t.".. .n oath,
Signature of Notary
Printed/Typed Name of Notary
Commission No.lExpiration
SEAL:
,'l~l;ilj~~A'::~I!:~~
,-:,'q'!i\Y, f!~__ CHEFlYL O. HOE ]
~ ~;( ~ ):~ MY COMMISSION # CC 999117
'::J.~;f.,"ifbW EXPIRES: February 5, 2005
! ...::::!1!~~:"_~d9d Tin" NOlary Pub!>c Undel\'lrilers
W"J.\'I\!;l"""~~~~l'jI _
Lender Support Systems. Inc, PIN.26,PIN (04/99)
Permit No.
Date Permitted
r Na!ll~/owner Name ~,v:";1'//,? )1/1!--:5.i/(p Control #
/4/- ;1.'''- ~/- :;'~0D -OC'c.'t.f)[; -//'~5USubDiv:
~ "'. .,..,,., .~ - / . ~f j
~ :( -:;.J ~ /1 ~~c..~ l '/ //1 ..
- .
'-------"/'"}~! '" ~. /
Classification/Type of Use / //~..b; yx~
J COUNTY, FLORIDA
,;, t" ~ <-
.--,<. v -='_)
~/ '31' /.c~
'I /
/) . ' ,
" l /'/.i-ljlL/~~ 0~~
-f
/
~
TRANSPORTATION IMPACT FEE Rate:
Exernpt 0 Yes 121 No How Determined
Impact Fee Amount $
SCHOOL IMPACT FEE
Account
(056)
(057)
(058)
1:123)
[.J Yes
Sq Ft Unit:
E)<empt
C;L/~~
,~,' ;
'/""'0 Jl jj./-:2'I.r.~
/..' . 'f' ",,- -'---,
,/,' ..
Zone No.
TAZ:
=
Single-Family Detached House Amount
Mobile Home
Other Residential /lc.1.... I"", / j ~
Col/ection Fee I JI/.7 ~
1ST No How Determirred .. '
$
1. ' /2.. /'""'7'. --
j ,... '/
.r " :; ,
PARKS AND RECREATION FEE
Land Account Land Credit
Recreation Account
Zone
Exempt
Land Total
LIBRARY FEE
Land Account
Recreation Total
TOTAL AMOUNT
$
DNa
How Determined
Land Total
Facility Account
--------
~ DYes DNa
Facility Credit
Facility Total
How Determined
Total Amount
RESOURCE FEE
TOTAL AMOUNT 2;L. g 7
Prepared By
ERU
Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement bt::low does not imply acceptance of concurrence, but simply receipt of a copy ot th;::> torm. olacinn
thl:! buildina oermil mAlnAr r-.n n^H~" ... +l-.:~ ~_ _ _
"', ,'" .... ~ " .,. .......... ... '. . ."
...... .. .". . .
::-: ::::; i. .:;' .:: CJ;.J () '1"Y" 1 . 1... I I) (:,
. (:1I.j!: ';
, L.:
C Lli..ff F: (IC::-UJ F: A:: 0"1 O.-:V:.H?
NAME= IHOMAS G
ADDR: 410 ADAMS RD
i...:./j!:: t'dJDUh:NDtd..,F
::'~'):...n:: ~.y.. r"
:t)
>.T E: f--.,! h~ :I
,..:'...'....1
j(:CEI"T
il.Jiiij:h: :
:) "::l~:.~.;:.:,:; ::.:.:::? ..:!.
(JF:'F' _i'_ '::: E:;: ))(:':'!:O;:::
I "~"y
j..
. ................:
....'.,..1'......:..'. '
r:' C) F~~ :;
CHE:. (::1< H ;.?p.<.!.:L
F:F':;,iJ1..JPC:C FEE: FC)F: :.(....HI L.L:::; PFF:i...'lI1 l;~;::.:)()::;;.:..i
CO(')fF~(:lc:'rUh~ :: ():L O..:j.()()
TDTt'lL f~'livi(:)f..H-,.rr::
::? ::.? .. :.:,~.;'.::r'
(::1 C: c: (.1 'r
11,':.[
CUNPI'\IY (1CC:UUI)T
c: l::'. (..!r E:~ h:
(:lI-ii(JU(.!r DcnC::h:IF:'TIU(.i/'PFF:iviT D{:lT('1 DF:../CF;;
22.37 ****** nUL.ID WAS1E r'LL 60
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