HomeMy WebLinkAbout04-2756
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
2756
2756 Issued: 2/18/2004 i
Permit Type: GENERAL BUILDING PERMIT :
Class of Work: SCREEN ENCLOSURE
Propos$d Use: MOBILE HOME PARK
Sq. Feet: Est. Value:
Cost: 500.00 Total Fees:
Amoun 52.50 Date Paid:
I
52.501
2/18/2004
Address: 6616 WIRE RD
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Lic: Phone:
----~---~- SCREEN ROOM UNDER. EXfSTINGCARPORT
JIMMIE PERRY
6616 WIRE RD
ZEPHYRHILLS, FL. 33542
r- .~J 4f)/O'l fffo
/-, IV'
PRE-SLAB
LINTEL
jFRAME
INSULATIO~ WALL
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
inspectiorj 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
- "Warnlnj 'toowner:Your-failure-to record-a-rioticeof commenc:emenfmayresultfriyoi'-..-paYirigtwlce -for ..-- --
improve....ents to your property. If you intend to obtain financing, consult with your lender or an attorney
be~~I'~o~ing you!, no!ice of co~ml!'_enc~mel1t. "-_ _____~__________ ____~_ _____ ___ ______
i--
NO OCCUPANCY BEFORE C.O.
- --------- .. ...~
CTORS SIGNA UR PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
/J - JPJ. -- .-."1
DATE RECEIVED ~ ..::.;- u
PASCO p~RMtr SERif"
PHONE CON'1'ACT FOR PERMITTING (-'!Sw(O-'B;l.L{-7g9tf
OWNER'S NAME
PHONE
JOB ADDRESS
LEGAjr. DESCRIPTION: LOT (S) 7 q
PARcEL ID ,. 6;"- ;z,-~- OOI/) - OStYJD- 0630
(OBTAIN
WORK PROPSED: ~W CONSTRUCTION
[JSIGN
PROPOSED USE:~GL FAMILY DWELLING
o COMMERCIAL
[J ADDITION
OALTERATION
o DEMOLISH
o REPAIR
[J INSTALL
[J MOVE
OMULTI-FAMILY
[J INDUSTRIAL
[J,. OF UNITS
[J SWIMMING POOL
[J MOBILE HOMI
[J OTHER
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
JO()(h (J ndef e.XiS+'0J
SQUARE FOOTAGE ~
C-41~r-b
DESckIPTION OF WORK 5cr-e.en
7'/ "", 17""
BUIL1HNG SIZE '" ~ _ ~
HEIGHT
RESIllENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMJkERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF! SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
lQ. BUIJ!,DING
o ELEGTRICAL
$ S-OD ~
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
[J
W.R.E.C.
[J PLmfaING
[J MECItANlCAL $
o GAS [J ROOFING 0 SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
[J OTHER
TYPE iOF CONSTRUCTION: 0 BLOCK
[J FRAME
[J STEEL
o OTHER
,
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES [J NO
SIGNATURE
... .. -'.-' ",' . --, . -, " ...... - .-- .
~~~,~~-'t~~li:9~tQ1i
COMPANY 0 Wn.e",r
;1-.--.. .; I P 7 STATE CERT OR REGIST #
**********~*************~***************************************
BUILI)ER
ELEC*CIAN
i
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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PWMBJ:R
COMPANY
SIGNAtURE
STATE CERT OR REGIST ,.
MEC~ICAL
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COMPANY
S IGNAfURE
STATE CERT OR REGIST #
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OTHER
S IGNA1-too:
COMPANY
STATE CERT OR REGIST #
A. NOTI~E 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 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.
Appli~ation 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 '.
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 sil
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, CONSUL'
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".
si2"&~: '-=E~ otffrt ~IGNATui7:0:;:;;:; ~
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged./
Before ~~ th.is~"o.ay of Fl!-bn".4~', 2~
by ,"""""I....~ ~J
(name of person acknowledged)
[Jwho is personally known to me, or
~o has produced 1?~.
(type of identification)
Odid not take an oath.
At see;
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me th~s .~ay of rebrltA.'), 20 ~
by , T'r"H''''' err'j
(name of person acknowledged)
[1ho is personally known to me, or
~sco
d-who has produced P. L .
(type of identification
~id not take an oath
and
..c...-
person taking acknowledgement
__'',i(~:':~11 Suzanne Bahr
:~~~': Commission#DDl57131
pr~te . .~h=JPXjt!'Mil~@~15, lUUo
;;"~~OFf\.O~-:'':- ~on ed.Thru
I"" " " Atlantic Bondmg Co., Inc.
Signature f erson taking acknowledgment
,""," Suzanne Baht
_"~~PIJ,,", . . 57\3\
_,.p....... . '. .v~'_ rnmmlSSlon #DD \
Name ty~~~t~~s:o.mvs-6~ed
".;;..: OF ,~o~'... _-- Bonded Thru
I, , , , , , " Atlantic Bondmg Co., Inc.
Sig
Name typed,
Permission To Pick Up.txt
:r; ,;, m J~.- PUrL{
Name J
C,"11o W,r/!/ ~d
Address
~1rlll/ls I FL ?,85'fO
To Whom It May Concern,
Please be advised that:
Suzanne Bahr and Debbie Dokendorf of Pasco Permit
Service have my permission until further written
notice to sign and pick up permits for me.
Sincerely,
~. -
_t.1~ .)
sig ure
~
NOTARY
STATE OF FLORIDA - COUNTY OF PASCO
The foregoing instrument was sworn
subscribed before me
Personally known or
,~Oot/.
----
Type of I..D. . p,-.
"'~~~Y4;',, Jeffre~ T~da R~utiwlllllJ
:o'~~~'~':. Com.mlsslOn #DD I 59234
~;:. 'Ij).::~ ExpIres: Noy 15,2006
"~~..' 'o~"'.." Bonded Thru
'""~~,~~,,, Atlantic Bonding Co., Ine.
~ 7ilclR-*~
N ~gnature
Commissioned Stamp
and Expiration Date
Page 1
D:ISCLOStJRB STATBMBR"l' POR. OWNBR
C:In OP ZBPBYRBl:LLS SU:ILDDIG DBPUTJlBNT
:I, :It Vl1 ~ i:e.~ P e.r r~ have read and ful.ly understand and
ag2f-ee to the Jfrovisions ~f this instrument.
~ undersigned. states and affirms that he or she is desirous of constructing,
r~ating, adding to or reroofing his or her own domicile, that he or she
acUually occupies,' or will occupy by said domicile, and same is not for
r~t, lease or sale. That he or she shall comply with the fOllowing conditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed. subcontractors and will personally supervise
such work.
4. That in the event the Building :Inspector shall require corrections to be made,
the owner will assume ful.l responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from. the City of Zephyrhills Building
Department.
6 - That prior to final inspection any additional fees, including reinspection
fees, must be paid in ful.l. A written request from. this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's Compensation, lien laws, etc., where applicable.
8. That the owner shall comply with all the Safety codes issued by the Florida
:Industrial Commission.
9. 'State law requires construction to be done by licensed. contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsi te supervision of the construction yourself. You may build or improve a
bne-family or two-family residence or a farm outbuilding. You may also build
lor improve a commercial building, provided your costs do not exceed $25,000.
~e building or residence must be for your own use or occupancy. :It may not
~e built or substantially improved for sale or lease. :If you sell or lease a
. ~lding you have built or substantially improved yourself wi thin 1 year after
~e construction is complete, the law will presume that you built or
pubstantially improved if for sale or lease, w~ch is a violation of this
~emption. You may not hire an unlicensed person to act as your contractor or
~o SUPervise people working on your building. :It is your responsibility to
1pake sure that people employed by you have licenses required by state law and
1y county or mun.icipal licensing ordinances. You may not delegate the
esponsibility for superviSing work to a licensed contractor who is not
icensed to perform the work being done. Any person working on your building
he is not licensed. must work under your direct supervision and must be
~loyed by you, which means that you must deduct F.:I.C.A. and Withholding tax
td provide workers' c~sation for that employee, all as prescribed by law.
our construction must comply with all appliCable laws, ordinances, building
odes, and zoning regulations.
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LOT: 78
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