HomeMy WebLinkAbout04-2789
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
2789
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:
2789
SIGN
FREE STANDING SIGN
COMMERCIAL
Address: 6340 FORT KING RD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
4,800.00
3/03/2004
70.00
70.00
3/03/2004
MONUMENT SIGN
Name: DR. K. T JOHN
Address: 6340 FORT KING RD
ZEPHYRHILLS, FL. 33542
I
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Phone:
-REINSPECTI6N~FEES:When extra inspection trips are necessary due to anyone of the following reason~
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
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
--- i'Warning-toowner: Your failure to.record ilnotice of commencement may result in your paying bNice for--
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
- .--------~~.-- ComPlefe Plans;-Specifleations and Fee-MusfAccompa-ny Application.
~11_~()rk~I'1.CJIlbe perfl:)~medJI'l~ccorcji:mce wi!h City_C()cjes a!lcjOrd!ll.cmces_
NO OCCUPANCY BEFORE C.O.
.--------....--------..--.-----.------..-.--- .._-_._-~-------------------,_._._-----...._-----
/ ..;--= etC ~
. ~~TORS~URE _.~ PERMIT OFFI
(---tALL 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 ,1p/~ Y
PLANS REVIEW FEE
JOB ADDRESS
L)~ K, T ;::c Af'!
6 ,3 t.( () r;1l T k i,.; f
PHONE
7f'2-1//L
OWNER'S NAME
/C.:J /J ~
LEGAL DESCRIPTION: LOT (8) Lo; jf) BLOCK
PARCEL ID # () 3~ zt--.7J- q)t/Joo -~()80{) -(jOOO
SUBDIVISION L'T/L €- IlC/ie.f'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: []NEW CONSTRUCTION D ADDITION DALTERATION D REPAIR D INSTALL
~IGN D MOVE D DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING DMULTI-FAMILY DIt OF UNITS D MOBILE HOME
~OMMERCIAL D INDUSTRIAL DSWIMMING POOL DOTHER
BUILDING SIZE
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
/111J Ai \; En t' f"V J /;(/( 6' u ,-v{..() )i ? 4'i
SQUARE FOOTAGE .72 Sf /-r:
HEIGHT
f./ iF
DESCRIPTION OF WORK
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.
'{,~
*1-'
D BUILDING
PERMITS REQUESTED
$
LJ,fIJO,
/
VALUATION OF TOTAL CONSTRUCTION
D ELECTRICAL
AMP SERVICE
D FLORIDA POWER
D W.R.E.C.
D PLUMBING
[] MECHANICAL $
VALUATION OF MECHANCIAL
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
[] STEEL
INSTALLATION tJ2"3
)1qt1... II
l"3 -S ;2
[] GAS
[] ROOFING
[] SPECIALTY
[] OTHER
[] OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[] YES
[] NO
~,QB.~tJi,
'J\<!;;"";""*"<";,-,,,,,,~,_,,,'i'~':'1,, .' .~,;'~IJ~),
SIGNATURE
r-~
COMPANY A::::'<je,-t.J I f;;ro-..
. ,
STATE CERT OR REGIST It
CITY PROCESSING It
{h/S. j
e. 5' o.c 00 ;:{ /7
BUILDER
******************************************************************
ELECTRICIAN ~
SIGNATURE ~ '
COMPANY /~7 {1/.5 I SI,j N (b/i/)
STATE CERT OR REGIST ItE!: 000 0 c..f 17
CITY PROCESSING It
******************************************************************
PLUMBER
SIGNATJRE
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
MECHANICAL
******************************************************************
COMPANY
STATE CERT OR REGIST It
CITY PROCESSING #
SIGNATURE
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
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 responsibil.ity 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 permittipg 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 Bayh~ads, 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 p~otection 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".
/1
/ t~AflYIA.
SIGNATURE: OWNER OR AGENT
<_..-
, ../"
STATE OF FLORIDA )r.-f. - . .J I (;
COUNTY 0 F LI re rv' ( (V.::'"
The foregoing instrument was acknowledged
Before me this ~day of . /VJI1A.(A , 20.2...!l
by jGrt c ,,, r E'.' -Z;- L k
~/""-(name of person acknowledged)
~who is personally known to me, or
;r-.".5~
Owho has produced
(type
and whoO did 0 did not
of identification)
take an oath.
//
L
acknowledgement
~ My Commission 00043649
Expires July 22, 2005
~
SIGNATURE: CONTRACTOR
STATE OF FLORIDA, ~
COUNTY OF ~--I GA ;V ;'JrVfY ()
The foregoing instrument was ackn~wledged
Before m~ this. ) ~ day of />1..1/1.,( , 20 d
by ~()6{ /lr I-~ /(!tJ yE/I:5
.~ (name of person acknowledged)
l3Iho is personally known to me, or
o who has produced
(type of identification)
and who Odid O:iid not take an oath
acknowledgment
J'~ ~ Ru sell S Muli
. ~ .; My Commission 0004364Q
~ Of ,,"do' Expires July 22, 2005
CITY OF
ZEPttYRHILLS
IINOTICE"
OF ADD.ITION OR CORRECTION
BUILDING
DEPARTMENT
DO NOT REMOVE
I ADDRESS . DATE PERMIT .,. I
(,3iu FDA ~;,,~ Rl ib-doy 27H .
THIS JOB HAS NOT BEEN COMPLETED, T~e following odditiqns or corrections shall be made before the job
will be accepted.
u"'~~'( to de.\-tr I"\,/\e
40 I~~"/:~ ed~oe (Jf
_J:.,r e I ^ I'e. (J, /'1
,
f!-!3!.flj+.t li^~ -t,r S-' ~e+ - baLk
"S'1.. M~t ~ ff{)l'(/'~rJ:/\(S and ~tI
It is unlawful .for any Carpenter, Contractor, Builder, or other persons, to
cover or caulle to be covered, any part of the work with flooring. lath, earth
or other material, until the proper inspector has had ample time to approve
the installation.
AFTER CORRECTIONS ARE MADE CALL
780-01N7PECJ"ION
INSPECTOR ,~
OFFICE HOURS 7:30 AM - 5 PM MON.-FRI.
101 DANIEL AVENUE · 13ROOKSVILLE, FL 34601
PHONE (J52) 799-192J · FAX (J52) 799.6994
LETTER OF PERMISSION
Date: 02-23-04
To whom it may concern:
I Robert Rogers give my permission for Jerry Zack to act as my agent to apply for and
pick up the following sign permit for the locations listed.
Dr.KT John
6340 Fort King Rd
Zephyrhills, FL
In the County of Pasco
Robert Rogers
State of Florida
County of Heman do
The foreg. i
, by
ent was acknowledges before me this -L- day of ~~
~om is J2.ersonally known to me or has produced
as identification
sell S MuU
; My Commission 000043649
~df Expires July 22. 2005
~
Rogers' Sign CarR.
SALES · SERVICE · INSTALLATION
101 DANIEL AVENUE · OROOK5VILLE. FL 04601
PHONE (J52) 799-192J · FAX (J52) 799-6994
Letter of Permission
DATE -ldl/1 Iv?>
To Whom It May Concern:
This is to certify that Rogers' Sign Corp., Inc. of 101 Daniel Ave., Brooksville, FL has
our permission to pull a permit to install a sign at our address at:
k. T: J:04~, M.]),
':5 'iQ F(I}A.ft K I '4 lCofJ~
ZGpj.V~/,I({ 5 FL S"55L/Z--
v' "
?/}5c. 0
In the County of
Yours Truly,
The foregoing instrument was acknowledged before me this
l) ~~y,'o"€..r , 200 ~by -.J< .1- J ohi))
~who is personally known to me or _ who has produced
^ j 4./'iv../1! /J , as identification,
YfI' (t;~ I ~ ~"...~ SHARON L. BARBER
~ Totary i 16 Notary .PUbliC' State of Florida
N Seal: My comm. expires Mar. 9, 2007
No. DD 191150
1-, \J.h
M.~<
day of
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Ernest S. Silcox, PE0008161
Silcox Engineering, Inc.
Civil Engineering
Post Office Box 8574
Tampa, Florida 33614-8574
(813) 988-3181
~~-S-' S"ltirf-"l
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STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTI~V THAT THE FOREGOING IS A
TRW AND CORRECT COP', OF THE DOCUMENT ON,FILE
OF' OF PUEUC RECOR~.iJ r~;iS_ OFFI~ITNESS MY
Ht,ND 0 r)FFICii\L ohl!. 1 HIS. _ DAY OF
2.~
~1_ERi<~;F CiRCulf CQURT
DEPUTY CLERK
A'1.
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Permit No.
Key No.
NOTICE OF CO!\'[!\'[ENCEMENT
State Of
FL~/C let "
County OF
A~G'D
The Undersigned hearby gives notice that improvement will be made to certain real property. and in
accordance with Chapter 713. Florida Statutes. the tollowing information is provided in this Notice 'of
Commencement. "
I.
Description of Property Parcel No. tJ.S '- 2 t -21 ~.' CtJ'IO - b()cf' 0/- ot)Q 0
(Legal Description of the Property and str~et a~dress if available) /;"3 '-f ~ {.-- \, Klr'7 If(},
. 4tf)() ;., -J' (--. 1 I ,,- J
General Decription of Improvement~.lf.~ ;) t 7 fV .- ILL J '" I r" 4/ &,
2,
3.
Owner Information: Name k. Y r; t...) ( fY' ]) Address: t '5 <( tJ pr;)(i ("'1 [J.
City: Zc;ft.;iA /-.., ((..f State: ~L- 'E? '3 -; 'i z
Contractor Name: ;(t')J{-;('f r I:lj~ (!o/l~' Address: I~I j)qc-/(cd Ave.
City 13/l.{J.!J k: >tlltle- State: ;::- L 7f6~ /
Surety Name:
Address
State
City
Amount of Bond: $
Lender Name:
City
Address
State
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: Address:
City: State:
In Addition to himself. Owner Designates
of to receive a copy of the Lienor's Notice as pro.ided in
Section 713, 13(l)(b), Florida Statutes_
9 Expiration date of Notes of Commencement (the expiration date is I year from the date of
recording unless specified):
Signature of Owner:
'XQ:~
, 0_ Who
as identification
The Foregoing instrument was ac . wledged before me this ,1,-\-1"1 day of-.bE. t::
is ~ Personally known to me or (~ who produced
and who U did or Udid not take an oath,
.,/,',,1, ("."\' a ,- C<i.l~. 1,/\ .I
" IF! ;-o.~, ('.'Y' .u'^-'C, ..c..:....
\.. f"'. v..' l tJ '-"
Signature of Notary
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SIGN REMOVAL AFFIDAVIT
.:
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K. T J; I- rJ. 1"1. P.
Please Print :Same
~ ov.ner of the pro"e:ty
lo~d at 0 J L( () n: J.Cf tV I ,.eo It cA . hereby certi~ that
Address of Property
~$L<:J ,.,
I have read and UDde~~d the L J! County Land Use Regulations conce':'!.itlg sj~
and agree tbat my existing sign is in violation of the those regulations. .1 agree to :ercove
the existing si~ an my propeny within ten (10) days of the final inspeocn of the new
sign. I understand that if I do not comply withm ten (10) days, the resuh' eould be a citation
and possible fine of up to five hundred dollars ($.SOO.OO).
SigIJarore: ~
The loregoing irL~eUas aeknowledged before me this \ 4th
Date: ~~
'"" (' .
d a~ Q f <-V<:!------
i9:m~ by
)<,:\ ~f\) m.\:)
, whQ is person!;ily .or who
has produced
as identific~tioll.
Nc~ry Signature:
Prilu Notary Name:
SHARON l. BARBER.
Public, State 01 Flonda
My comm. expires .,
No. DD 191150
My OJmmisslO!1 E7:pires:
(Se31)
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