HomeMy WebLinkAbout03-2446
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
R ~ '3/J If o'J"
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2446
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
2446
RE-ROOF
ROOF REPLACEMENT
MEDICAL
Address: 7050 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: -Cl.TX..o..f, ZEfJ1~~LS 0000
. Parcel Number: ;3Q...1&~-OOOO: -QQft:@-
95,845.00
10/23/2003 1--- Name: EAST PASCO MEDICAL CENTER
464.00 I Address: 7, 050 GALL BLVD.
464.00 ZEPHYRHILLS, FL. 33542
10/23/2003 Phone:
REMOVE EXISTING ROOF & INSTALL NEW THERMAL PLASTIC SYSTEM
I
I
L
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
uJ~~_P9Y!T'ent.c>f inspection fees shall be made before any further permits will be issued to the person owning same
"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."
--- -------ComplefePlans, Specifications and Fee Must Accompany Application.
______~lI'.'ork sh~_bep~rf'o_rll'l~ in accordance with City C:()~~~_C1nd Ordinances
NO OCCUPANCY BEFORE C.O.
~
.~&~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8th Street, Zephyrhills, FL 33542
, . A
813-780-0020 FAX:813-780-0021
DATE RECE IVED
PLANS REVIEW FEE
OWNER'S NAME
EAS'1 ft:JSCv
m~A,(<-,l
PHONE "iS1'?. - 'l<{3 - L:/ ~-q
JOB ADDRESS .7050 &~ LL- 1)1 v()
2e.-p~'1rhl(15 -' it.., 33<;;1..( I
LEGAL DSSCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
35- ;;)s - ;) I . 00 i 0
;030,:;..... OF.:..
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
o INS'l'ALL
o SIGN
o MOVE
o DE[vJOLISH
PROPOSED USE: DSGL FAMILY DWELLING
o COlvJMERCIAL
DMULT I - FAMIL Y
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK ~v~z
(:..,,-.-;4 ''') IU(,~-
,,-
lf1stAI\
"<\oJ th~r ...." l P\"", ~, I...
~ '1 ~A <.""
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COMlvJERCIAL:
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.
o BUILDING
6s, '('IS -"~
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL $
o GAS ~OF'ING 0 SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
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
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
********************************************************1~*********
ELECTRICIAN
C0f'.1PANY
STATE CERT OR REGIST #
CITY PROCESSING #
,
SIGNATURE
********************************************************,,*********
PLUMBER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
********************************************************,~*********
MECHANICAL
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER ~.~~
SIGNATURE~ ~ ~~
COMPANY (eAT'Me".. l<'--
STATE CERT OR REGIST #
CITY PROCESSING #
***"k*************************************************************
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" whic~
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, 813-780-0020.
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 FE:ES
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
*O.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.n, it is
under~tood that a drainage plan addressing a "compensating volume" 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 COMMENCEMENT".
~~~
SIGNATURE: CONTRACTOR
STATE OF FLORIDA P If 5 C. ()
COUNTY OF
The foregoi.ng instdment wV~Wledged
Befoke. me this~~ .day of LV , 20.12;?
by I c-haxd ::>. 8y~, p id J
, (name of person acknowledged)
J8-who is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The toregoing instrument was
Before me this _day of
by
acknowledged
, 20_
(name of person acknowledged)
Gho is personally known to me, or
Dwho has produced
(type of identification)
and whoO did j1(did~ tak~ ao ,oath.
l~/f~ '-~ tUJ7~
Signature of person taking acknowledgement
Dwho has produced
(type of identification)
and 'r,ho Ddid [}Hd not take an oath
Signature of person taking acknowledgment
Name
Name typed, printed or stamped
CENTlIfII.'IIK
THE MA'RK OF EXCELLENCE IN ROOF SYSTEMS
October 14, 2003
To Whom It May Concern:
Please be advised that I, the undersigned, hereby give my Power of Attorney to
the following persons, Robert Rostocka, Florida Drivers License #R232-761-72-
186-0 and Eufemio Vazquez, Florida Drivers license #V220 21649044 O. This
gives my authorization, under my contractor's license #CC048169, for the above-
mentioned person to sign a Building Permit for the City of Zephyr hills, state of
Florida.
If you have any further questions regarding this matter, please feel free to contact
me at (954) 677-9195.
Thank you for your attention to this matter.
Fowler
Project Manager
State of Florida
County of Broward
Sworn to and subscribed before me on this ~ay of O~.. 2003.
-"'.~.,. .
C-'...
t--.. . L
Notary Public - Heather Wentworth
CENTINlARK CORPORATION
5370 N. W 35th Terrace, Suite 109 · Ft. Lauderdale, FL 33309
954-677-9195. Fax 954-677-0821
Florida State License Number CCC048169 Fully Insured
· Nationwide 800.558.4100 · www.CentiMark.com ·
State of
NOTICE OF COMMENCEMENT
County of - ~~~IJlllll!~!111II11111111111111111I111111I111I111111I1
THE UNDERSIGNED hereby gives notice that improvement will l?e m.ade to ce~tai~ real pr.opert.Y'
and in accordance with Chapter 713, Florida Statutes, the followmg mformatIon IS provIded m
this Notice of Commencement:
1. Description of Property: Parcel No.3s ,25, 2;' DOI~' i.;:,~oo - OCX)O
-701-0 6 l BivD 2e h hI II FL ~ 33~- J
(Legal description 0 the property and street address if available)
2. General Description of Improvement TeAr c"pp eJl.I';)t.I')~) ro."? J~('\d 1."'\~llAII
f)~w
T. Po
C J
-'.> yST cfV\
Rept.:724234
DS' 0.00
10'/14/03
Ree: 6.00
IT' 0.00
. Dpt.y Clerk
3. Owner Information: Name t:A sJ' PAS G\~ (Y) €d I C f\ L
Address7D50 GI1~L BIll!)
Interest in Property: DwlVt!..~
City ZEPHyrhl(/5
State FL. ;3':)t; l.j I
JE9 ~ITT~~. PASCO COUNTY CLERK
10 14703 .:}J.~ 1 of..1S5 -
OR BK IS~ PG {
Name of Fee Simple Titleholder:
(If other than owner)
Address
City
State
R4.
'... .
Contractor: Name C e{)1 I mAt" K
AddressSZ 10 ~~ I t)1erLAl{€.. ~\
City LA~tLAnl,)
f-L .:;>' c.'
State 'J'~){~(:;<)
5. Surety: Name
Address
tV/A
City
State
Amount of Bond: $
6. Lender: Name
iV/A
,
Address
City
State
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) (a) (7), Florida Statutes:
Name N/A
Address
City
State
8. In addition to himself, Owner designates /1.,'/ A
of. . . to receive a copy of the Lienor's Notice as
provIded m SectIOn 713.13 (1) (b), Florida Statutes.
9. Expiratio? date of Notice of Commencement (the expiration date is 1 year from the date
of recordmg unless a different date is specified.)
Signature of Owner: ~
Rlelfl~f2(~
,)
i) YFlf LD
Notary Public:
day of ((/iit5- I;.~ ~
STATE OF' FL.ORIDA
COUNTY OF PASCO
. _....~-'..i (~..
, 20 t\ :; .
My Commission Expires:
i:i . "'~;~ MY COMMISSION # CC 947172
PC93053048/ A %'j;;.. ./,~.l EXPIRES: June 19, 2004
",f,,'ift~~'" Bonded Thru No rlY Public UndelWriters
RIiGOING IS A.
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
OR OF PUBLIC RECORD IN THIS OFFICE, WITNESS MY
. F