HomeMy WebLinkAbout04-2668
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
2668
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost: 1,800.00
Date Issued: 1/23/2004 Name:
Total Fees: 175.00 Address:
~~~!~t;a~~~____.1 /2~!26~~O~_______~________ _L__Phone:
Work Desc: MOBILE HOME REPLACEMENT
2668
MOBILE HOME
MOBILE HOME SET-UP
MOBILE HOME PARK
Address: 6116 ROYAL ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
WILLIAM ZACK
6116 ROYAL ST
ZEPHYRHILLS, FL. 33542
GATOR T T
ENVIROMENTAL CONTRACTORS
ENVIRONMENTAL CONTRACTORS
I
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-----,----....-.-----,----._____.._.....1__. .__,__. ,--..-....__..__..__...1__. ___,__,----'--____.__. _.__ '_. '_"__,, ".
REINSPECTION FEES: When extra inspection trips are necessary due to any one of thefolfowTngreascins;-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
_T.I1E:! pa.'t.'!I_ent gf.~rlsR~~~!!l~s shallbeI'1'19debe~()re Cinyfurther permits ~lI!.be issu~Q._t()...!I1~erson olJVning ~~Ill~ _
Complete Plans, Specifications and Fee Must Accompany Application.
.._ _~III,IIJ~rkshall beperforl'Tl~_in accordance with City codesand O!dinanc~~_
__..______n_____.______________.__________.___ __ ______..____
NO OCCUPANCY BEFORE C.O.
"
~~ ~
-d~'G-NAfURE - PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
DATE RECEIVED ;-021-01
PHONE CONTACT FOR PERMITTING 1/1./-1~f
OWNER'S NAME (d,'i/;rtrn I~. ZAcK PHONE (gI3) 78;)-;2.{)/:?
JOB ADDRESS1/~t:5ew-~ :l~pI:)lrh,Jis /"1 3dS7'~
],EGAi 'i{.'fCRI ~N: ~S) ulll. BLOCK R"'1fl ~SUBDIVISION {)fiKSioe YlnH P
PARCEL 10 # tJ~- ~,,- ..;l/.. ()Dd()- OD300-()DIO (QB'{'AIN FROM PROPER'I'Y TAX NOTICE)
CITY OFZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX:813-780-0021
WORK PROPSED: [JNEW CONSTRUCTION
[J SIGN
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERC IAL
o ADDITION DAI,TERATION o REPAIR ~ INSTALL
o MOVE 0 DEMOLISH
DMULT I - FAMILY 0# OF UNITS fgj, MOBILE HOME
o INDUSTRIAL o SWIMMING POOL o OTHER
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
~1'1 I t/ / ., /
BUILDING SIZE Q'L 1\ -4...
SQUARE FOOTAGE
~6,J'/
q~'1.
HEIGH'
[, (1) SET ENERGY FORMS.
FORMS.
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
o GAS
o ROOFING
PERMITS REQUESTED
$ 1300 ()O VALUATION OF TOTAL CONSTRUCTION
J5(J AMP SERVICE ~ FLORIDA POWER 0 W.R.E.C.
'j (JO 40
$ VALUATION OF MECHANCIAL INSTALLATION
,
o SPECIALTY 0 OTHER
!8f....BUILDING
~, ELECTRICAL
~'" PLUMBING
, MECHANICAL
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
[J STEEL
f!:l. OTHER
FINISHED FLOOR ELEVATIONS
IS PRO,JECT IN FLOOD ZONE AREAD YES jg. NO
L._____.L_________.___.,.
CONTAAc~!t;;iS~S~,tON ]
c c. . c ",'.""',.,'1"""'-"."""".'_, _____...._ __________ ,__
COMPANY (j..",[;;. 1(-0It'\5fO<""T;..r\J s..e)-ut Ih('-
STATE CERT OR REGISi5l~\,A/-/ ~ 0 at) 'lei ?
BUILDER L d
SIGNATURE , ~
//" ' C7
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ELECTRICIAN
COMPANY f AJ iJ I fa It) i1 e A:JT JJ-L fLe> JJT I et..-
SIGNATURE & JIg^'! ~1/~~ @. STATE CERT OR REGIST # E I!..ool 3 5 f'--.:, J/"
(tJ/{f'J {J(),~t/II?/ '{?M~ 1C1 I~"-"
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PLUMBER
COMPANY u.~for 7~~t)~fo(f A",J .k-J-uf II'} e-
STATE CERT OR REGIST # :tJl OlJ60 7~ ?
MEC
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SIGNATURE rlv,'''1 ~~ _ @
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COMPANY r; It) iJ j R. 0 It.J M c I/T ff"L
STATE CERT ~#
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OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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('SIGNATURE:
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 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 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 someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faitti 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 \'wrk 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 ml1st 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 reql1iring 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 conunenced 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 r~quested
in writing to the Buildihg 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, CONSUI.T
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR l'WI'ICE OF COMMENCEI'1ENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "N~;;J'E OF COMMENCEt-1ENT".
I / / '
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~GNATURE: CONTRACTOR
~" STATE OF FLORIDA I,~
COUNTY OF -::::7"- u# 5'eU
The foregoi og instrument was cknovl1 edge(~ //
Before 'this .:;;t//'o ay of 0.-+-' , 20~
by
vI (name of pers
[1ho is personally
~hO has produced F/.'j)j... LU,t.5'& -/l11-7:1-00J- 2-
of identl\~~ ~;/~::"",,__,___,_ (type"of identification)
take a~~~V) .....RO~ -a'-nd who CJ;-iid ~tl~dJ"~take~n 0 h
.i~.'~~\SS'O^,;;;..~~ \ \, /~! tlO ' ,. "F -;( /J I
~ C).. "a ~~e{ 19,<, '%:!\ ~\ _,_ .~ ~ / ,~/~
Signa'ture of pe~son taking acknovvledgroent
STATE OF FLORI~)4 (0
COUNTY OF ~
The foregoing instrument was acknowledged
Before me this ~ day of M/~;y, pl'ft-., 20.o.2J
by
(name of person acknowledged)
Owho is personally known'to me, or
Owho has produced
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ALl WORKSHALL OMPLYWlTIiALL
PREY AlLlNOOOD FLORIDABUUDlNC
CODE. NA nONAL ECI"RlCCODEAN
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