HomeMy WebLinkAbout03-2138
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
2138
Permit Number: 2138
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 6/05/2003
Total Fees: 3,207.50
Amount Paid: 3,207.50
Date Paid: 6/05/2003
Work Desc: MOBILE HOME SET-UP
Address~ NEUKOM AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
Name: GRAND HORIZONS
L Address:~NEUKOMAVE 31J3tf
ZEPHYRHILLS, FL. 33542
Phone:
BUTTERFIELD MOBILE HO E SERVICE
ACE AIR CONDITIONING & ELECTRIC
ACE REFRIGERATION, INC.
BUTTERFIELD MOBILE HOME SERVICE
MOBILE HOME ELECTRICAL
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIFISUB 99%
WATER METER RES 3/4"
IRRIGATION CONNECTION
SEWER ILE
WATER CONNECTION MOBILE HC 209.50
MOBILE HOME PLUMBING 40.00
MOBILE HOME TIFISUB 1% 14.80
IRRIGATION METER -03 180.00
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REINSPECTION 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
I
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.
vU_S ~ ~~W07~_~
. t...J ~ ~~ ... Cf- (p -
CONTRACTORS ~URE rP PERMIT OFFI
CALL FOR INSPECTION - 8 HbUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8th Street, Zephyrhills, FL 33542
813-780-0020 FAX:813-780-0021
/ _ LL-Q3
DATE RECE IVED fk!. +--
PLANS REVIEW FEE
OWNER'S NAME (,../l.A,vJ JI 011 ;(.0,1.J
.- _ 3~r'/~3'fJ.) I<
JOB ADDRESS L Cl J '-/Y.,.l 'i.) ~,,, "<.'--' ""'"
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
1Ac...J~
SUBDIVISION G--.n~ J /I~,n/:".A.
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
DSIGN
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
o ADDITION o ALTERATION o REPAIR o INSTALL
o MOVE 0 DEMOLISH
DMULTI-FAMILY 0# OF UNITS ~E HOME
o INDUSTRIAL o SWIMMING POOL o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
)VJ,tf
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RES I DENTIAL:
COMMERCIAL:
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o PLUMBING
o MECHANICAL
$
VALUATION OF
o r~--C-\
/ ( '. l") I 19
MECHANCIAL INSTALL4TION etI cJ-..- .-
~ ~/,-,
...,.,.-.,.--.----
o ELECTRICAL
AMP SERVICE 0
FLORIDA POWER
)
//
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES
o NO
BUILDER
SIGNATURE (A.J, o;r-/l~i/
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
******************************************************************
SIGNATURE
w~~
COMPANY /7 c.. <-
STATE CERT OR REGIST #
CITY PROCESSING #
ELECTRICIAN
PLUMBER
******************************************************************
COMPANY o4t
LJ /'_ ~ STATE CERT OR REGIST #
~ CITY PROCESSING #
SIGNATURE
SIGNATURE
******************************************************************
COMPANY ~c.. ---
~ STATE CERT OR REGIST #
VJ l;1 --Ll. CITY PROCESSING #
MECHANICAL
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
****************~*****************************************'*******
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with ,any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may 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 may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, 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 which 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 the 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 Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be done in compliance 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 laws regulating construction, City
codes, zoning 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 work, and that it is my responsibility to identify what 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 Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department 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 "AH or "A,etc.H, it is
understood that a drainage plan addressing a "compensating volumeH will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
A permit issued shall 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 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
six months of issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed 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 period, or the project will be 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. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENTH.
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
2Q_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowle~ed
Before me this _day of ,_
by
(name of person acknowledged)
[1ho is personally known to me, or
(name of person acknowledged)
Dwho is personally known to me, or
D who has produced
(type
and whoD did Ddid not
of identification)
take an oath.
D who has produced
(type of identification)
and who Ddid [}:lid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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PASCO COUNTY, FLORIDA
-~-------.........."'...._--
Permit No. .u_21J_~ TF1--..~-_.
Date Permitted ...J:>.LS,_a.J_
Builder Name/Owner Name --K~1S~.i~.elaLS.._~.___ Control # __._____. .~_.~__~._.~~.
County PalcellJo, ..'~lt.~ 2 S::-_~_~.~..QoJ~-=.__9i&OV- ~_"'''f~ SubDlv: G./:::il.....Il..5?.::'-'..?Ck' '.>
Address/Location ."~.?3_<{1n~ .~rY_e_v., ts:>~"":1_._~_~ ._.._____~_ ._ __.._____.._._
Classlflcatlonll.ype of Use_~_~_~J.e___l.::k-,-~e_~_._._____.._...~~__...._ _.__~___.____.~..~___
TRANSPORTATION IMPACT FEE
Rate:
.. Sq Ft Unit: _____.___ __~___
Exempt [J Yes [7 No How Determined ---~---._--....~~---_...~,..-.__.__~.u_.__u_~_
Impact Fee Amount ._.~.__Jt::L&!-:~:_.~)~.~ Zone No. ~___u~._.____ TAZ: ___._~...~_.__.~.._
SCIIOOI~ IMPACT FEE~'
Account (056) Single-Family Detached House
(057) Mobile Horne
(058) Other Residential
i'12~1 Collection Fee
Exempt [J/Yes LJ No How Deterrnlned
. ~..-..-..._....---~........-...
Amount
$
~_... ..---..".--.....-.. -"'-- -'- --... .-..~..- ..-,..-..... .....,._~'.
-----..~..__.._.___.,_A~ ___.......___~. __...~~
._--..._--._._._---~--~-- .~.._..._.~._..._._-
PAR.<S AND RECREATION FEE
Land AccOllrlt Land Credit
Land Total....
..-....-
F<screatlon Account Recr~g!jGfl.cre-(jlt _____._ Hecreation Total _..___._~___
. .~..---.~--------~------.- -~_..-'.~ -
_/
._-
_.~-----
ZUlle
./.
--.---
TOTAL AMOUNT
...~.._._.._~...- ......--.. ...... .---.--
Exell1l~t.. [JYes [J No
How Determined
':.-- ~
Ii B RAR\lFEE'-.~-~-
Land Account
-----.--.------..-.--.-------..-.--..,..---.-.-.--...-..._---~.~--.._.
.-.------.-..
. Land Credit
--~..-Larid Total
--=::~=---= ----~
Facility Accuunt _.._..__~__._=_..EaeHltYcr~Ztlt _.._~_..~_.._.._.___ Facility Total
Exempt/[-.JYes ./[] No
How Determined Total Amount
------.--- .~--~- -.,...--....-.---..--.--
--
RESOUFi"CE FEE
TurAL AMOUNT
ERU
_._-_..~-_.. - .~._.._--_..---._-~-----..._-.-
-----.. --......-.----.-...-------
....."__'.n.'.............'"--...~..........._.._..~.~.~.,..........,,~.... .
-......a._....__________._
Prepared By ....-.-.-..--....~.-.---~---~.___~m_~~_._ Checked By
__~._.n.______. _____._.______.______.._.__
NO GEFHIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
Pl:RPORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
REGEIPTl:D FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does 110t Imply acceptance of concurrence, but simply receipt of a copy of this form, placing
Il1e building permit owner on notice of tills assessment and the conditions of payment for S8mB.
--"._~... '__"n - '_nO . .._..____._.~_.... ___._.'. -_'__'''_'''__h___~
DATE
.-------_._--.~--_..- -- -.._----~..._..~..._-._-_._--.
RECEIVED BY
RECEIPT NO. L~~~k~-' DATE
BY
.-..-.-. ..._._._--~-- -- .. -_..-.~_.--.---- -..._~.---_.__.....~..__.._.