HomeMy WebLinkAbout04-2839
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
2839
Permit Number: 2839 Issued: 3/18/2004
PermitType: GENERAL BUILDING PERMIT
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Sq. Feet: Est. Value:
Cost: 2,400.00 Total Fees:
Amoun Paid: 67.50 Date Paid:
Address: 37402 DERBYSHIRE DR
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: WEDGEWOOD MANOR
Parcel Number:
Name: A.J.'s CONSTRUCTION
Addr: 10332 NEWSOME RD.
DADE CITY, FL 33525 I
Phone: (352)567-0026 Lic: I
Wol1k Desc: SCREEN ROOM ON EXISTING SLAB
WILLIAM CLAGUE
37402 DERBYSHIRE DR
ZEPHYRHILLS, FL. 33542
Phone:
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FOOTER IN
PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED
LINTEL PRE-METER WATER FINAL MECHANICAL
FRAME MISC SEWER MISC
INSULATION WALL MISC MISC. MISC.
INSULATION CEILING MISC. MISC. f MISC.
DRIVEWAY , MISC. ! MISC. I FIRE DEPT. FINAL
-- ------.-----..-______-L:" ._.._ _ _~~_-"--___..______..______
REINSPEcnON 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
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
I "Warning-to owner:Your failure to record a notice of commencementmay result in your paying twice for-----
! improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
I_~~~ing YoUrnoti(Ufcom:::~~ANCY ~FO~E C~. ~_. -=--_~_
t/.,-~~ss!~ PERMITOFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
3-/7' ({IV
PHONE CONTACT FOR PERMITTING
OWNER'S NAME -1A.) j ll; tlVY\ C (a5 ~.:e_
JOB ADDRESS 37J.fOJ... Dp-r6ish,;"'e..,. 'D..
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL 10 # 'D-~b-,;1I-0l;;W-COO'XJ-10l{O
WORK PROPSED: (JNEW CONSTRUCTION ~ADDITION
PHONE
SUBDIVISION t.u e~eu..y:~.)&..
(OBTAIN FROM PROPERTY TAX NOTICE)
(J SIGN
PROPOSED USE: ~GL FAMILY
(J COMMERCIAL
o MOVE
DALTERATION
o DEMOLISH
o REPAIR
o INSTALL
DWELLING
(JMULT I - FAMILY
o INDUSTRIAL
(J# OF UNITS
o SWIMMING POOL
(J MOBILE HOME
(JOTHER
DESCRIPTION OF WORK
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
/Sr'f'pen RoiJ7"n 60 !::~X-lc;.T/fj~ SLA~)
BUILDING SIZE
~)('5
SQUARE FOOTAGE
I d-.O
HEIGHT ~ec,. Pel... ~
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: 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.
PERMITS REQUESTED
~BUILDING
(J ELECTRICAL
$ Z- c;oo , Of)
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
(J FLORIDA POWER
o W.R.E.C.
o PL~ING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: (J BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
SIGNATURE
~)h~M
CON'rRACTOR....SECT..ION
i,.....:.:'..:, , ',_, .,....:.::._,;:...:..(..._....:.,..._., ,_....'_, .
A--i
COMPANY .J . 50
COY\.S.t'Ue-f, D"'-'
BUILDER
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY.
SIGNATURE
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
MECHANICAL
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COMPANY
SIGNATURE
STATE CERT OR REGIST #
********************************************************~,********
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictionsH 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 SectionsH of this application for which they
will be responsible. If you, as the owner signs as the contra'ctor, 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 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 "AH or "A,etc.H, 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 fora
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 "NOTI~E O~MENT".
sf!/f1bE:!:;:.?f/ SIg;~It;:::~
STATE OF FLORIDA ,~~{"
COUNTY OF {/
The foregoing instrument was acknpwledged
Before w,e t/1is -15.:!.-ctay of rYlt<,/,c.t1. , 2~(/
by Vi r'f11t,tt' ~tk
~ (name of person acknowledged)
~ho is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was ackn~wledged /'
Before me.., thf~ ~day # m?l fr"....... , 20~
by F'7Y VI u.. -("4.. ~
A/ (name of person acknowledged)
~ho is personally known to me, or
r:b s c c.>
Dwho has produced
(type of identification)
and ~d not take an oath
O~ '~~
Dwho has produced
(type
R-did not
of identification)
take an oC!,th.
?'
of p rson taking acknowledgement
,'~W'III Suzanne Bahr
:.:'~~:; Com!TIis~ion #0015713]
typed, ~'p'.+:l ~#iE~e@l:~d~ct2006
"~~ oFf~(F,/ Bonded Thru
1111111\\' Atlantic Bonding Co" Inc,
and
Name
Signat re of son taking acknowledgment
"'"'''' Suzanne Bahr
,"~t-P-.V.P'I.JI{"'''' . .
~J'~"~'-:. CommIssIon #DDI57111
Name t~~d~,~irerlNDr Is,tlOOp>ed
",~"i' , , 'o~ ,,- Bonded Thru
11(1~~t\~\..... Atlantic Bonding Co., Inc.
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