HomeMy WebLinkAbout03-2557
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
2557
Permit Number: 2557
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 12/09/2003
Total Fees: 3,315.50
Amount Paid: 3,315.50
Date Paid: 12/09/2003
Work Desc: MOBILE HOME SET UP
Address: 37352 NEUKOM AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
Name: GRAND HORIZON
Address: 37352 NEUKOM AVE
ZEPHYRHILLS, FL. 33542
Phone:
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
IRRIGATION METER
WATER METER RES 3/4"
TRAFFIC IMPACT FEE 99%
ILE
60.00 WATER CONNECTION MOBILE HC
35,00 MOBILE HOME PLUMBING
180.00 IRRIGATION CONNECTION
180.00 i TRAFFIC IMPACT FEE 1%
1,572,12 I
I
8 .
209,50
40.00
175.00
15,88
(J, [) t
I ff !:2!j!r3 8-:13 {;/o/(/' U-
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REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the followi rea ns, 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 .notlOa e wln~,e
inspection called (d) Work not ready for inspection when called K J-.-7 .
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible J \ V '
. J1'1.~payment of inspection fees shall be made before any further permits will be issued to the person owning sa~e
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in acc~~dance ~ith City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
.j (cJ ~L7J2! ~
--~C-6NT~CTbRS~N~TURE 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
813-780-0020 FAX:813-780-0021
DATE RECEIVED
PLANS REVIEW FEE
JOB ADDRESS
/....AA/jJ
o373;r2
/1"'/112 ','~'""-~
11) ~ <. .. !\ '--~ Ilt, ..~
PHONE
OWNER'S NAME
/...\.'j""/I
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOT1CEl
WORK PROPSED: ONEW CONSTRUCTION
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~LE HOME
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK )t/, /I'
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
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 ELECTRICAL
A~1P SERVICE
o FLORIDA POWER
o W.R.E,C.
o PLUMBING
o t-'lECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
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 AREAO YES
o NO
SIGNATURE
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- /'
COMPANY /)}=__LI. --/ {;/'
STATE CERT OR RE-CIST #
CITY PROCESSING #
BUILDER
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ELECTRICIAN
SIGNATURE
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COMPANY /9,',--_
STATE CERT OR REGIST #
CITY PROCESSING #
******************************************************************
SIGNATURE
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;;
, ,
COMPANY 0.: 1.( ;/ 1:. t
STATE CERT OR REGIST #,
CITY PROCESSING #
PLUMBER
SIGNATURE
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COMPANY /7.... "--
STATE CERT OR REGIST #,
CITY PROCESSING #
L'
, - '.1-./"
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MECHANICAL
*.~***************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
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*****************************************************************
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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, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign po~tions 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 indica~ion 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 som~one 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 AFF'IDAVIT
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 "A" or "A, etc.", it is
understood 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: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 20_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
20
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
Dvho is personally known to me, or
of identification)
take an oath.
Owho has produced
(type of identification)
and who 0 did []did not take an oath
Owho has produced
(type
and whoO did Odid not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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Pelllllt r\lD, :< .55' '7
Date Pennllled ,Jt?:,~qJ',:':Lh__
Blinder 1'lallle/Owl1er Name ~~.-^':'LdL.I(Yu:?fClr,._ ,_.. C,,"trol #
.'L" 'II
(:Ollllfy 1)81(;811 J(),.34 -~,s--- .;:{ L:,_a(u('):~q;;1.ji:qC) ,.c hullUlv:
A( idI8Ss/l()( :r:it!OII . ,31Z3.l),.:)." ,j'V..Q~~CJ.~?t)x.s::~_,___.
CIEl8siflc:811ollll'yps ()I' Use ,_ n'__
"-..".. ____.._ '_M' .__.._____._ .' .__~_.__~..__..._ ___.
TFV\N8POHI'AlIUN IMPACT J~EE
Hale: Sq Ft Ut i1t:
E:x8111pl I I Yes IJA'lt')
Ilow Oelen nlned
Il11l'nr:l h:m /\IIIOlllll ~t
. /'~ ('"" (7 (~t)
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lrllls Nu,
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'~mi i <1f)L-IrIl!f.'AC fFEE'"'' ".~",..... ".,'.. -.. ~" . "'"
AC(;(J1 II II
1::)(8111\)\
(05fl)
(Ill')/)
(()f51) )
Cl /}'j
I t\{")/ e s
SlilUle..Farnlly Detached 110\188
Mobile Ilul11e
Other F<esldel Itlal
Collection Fee
'--']1\10 Ilow Uetennlned
Amount
~H
'PAR l<sA'N f) r~eCREATi()tTFEEr"
1.81 It.l/\( ;C:Ollllt I.and Credit
---
Land Tut81
F~e(;1 (-'l"Illull 1\I;COl lilt
r<ec:reatlon (;redlt
I<ecreat!on Total
ZOlle
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E: XGJJJftt/ I I '/8S II t'lu
TOTAL AMOUNT
l,
llow r >etermllled
Lif3RAhV h::if
Lalli! /\1;(:(1\1111
. "-,, "',' "',,. ...... -' " . .. ",.'~,.~ .:-"......-.-.. -' ,.' .-.~,"
LHIHI C;l8dit
I.and lotHI
Ff:1dllly /\(;C;()lllll __<::-,-:', ..,,__ ,
/~.
E)(8IjJPl..-" 1.1 Yes 1.1 t\jo
.~r~
Facility Credit
Fanlllty lotal
Ilow Uelernlltled
Total Amoullt
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..... ,". ".".,"" ~',"" "'-'-."-, ~~,...
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Pml181ArI Hy
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Checked By
.- --.- ..~.__...._-_.---._-_.--.._~--._._-
NO CEHTIFIGATE or: OGCUl'ANCV WILL 61: ISSUED on FINJ\!.. INfWP.GTION
Pl:IU:OHIVlEU UNTIL TilE TOTAL AMOlJNlS L1STl::D HAVE
BE~N PJ~I() ANlJ
rH:Cl:IPTI~U t::un BY A CENTRAl PEI~MITTIN(; Ol:::PICE OF PASCO COUNTY
Acl(lII I\VIBdWliIlent bHlow does 1I0t Illlply acr.eptance of concurrence, but sllllply rer:elpl of f:l I;OPV of thlR fOllll, placlnu
the htllldlnu pellllll owns, Oil Iwlles of this asseSSlllent alld tile Gondltlulls of paYll1811t fIll sanle,
r~H~r:lfll 1-10,
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DATE