HomeMy WebLinkAbout04-2966
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
2966
Permit Number: 2966
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 4/16/2004
Total Fees: 3,315.50
Amount Paid: 3,315.50
Date Paid: 4/16/2004 j
----Work Desc: . MOBILE HOME S-ET UP---~
Address: 37501 LILLEY BEAAVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
GRAND HORIZ NS
37501 LILLEY BEA AVE
ZEPHYRHILLS, FL. 33542
Phone:
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
WATER METER RES 3/4"
IRRIGATION CONNECTION
MOBILE HOME TIFISUB 1%
4.
60.00
35.00 MOBILE HOME PLUMBING
180.00' IRRIGATION METER
175.00 I MOBILE HOME TIFISUB 99%
15.881
I
1
P ljJ4''tt <;(;40 'i 2 -35 Dol< f4 k,f-
..~
FINAl ,L I
l t U-j(;!
I ,
--,--,------,---.-----1,___,_, ,-.1_,___ _'_.___.,.______,_..__,
REINSPECTION 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
Ih~paym~'!..of ir:1spection!ee~shall be made before any furth~l'.permi~ will be jssued ~ the ~rso!!.Ewnin9 same____
Complete Plans, Specifications and Fee Must Accompany Application.
---- ______~'-"^'ork shCllLbe performed ir:1 accordance with Ci!y Codes and....Qrdinan~es_______~__
_...__.__..._--.._-..,~-_..._._._----,--------_.-._----"'-"-- --..----...-----..----~,.--,~--~-.----.---.-..-.--- '_ ..___ ___0' n_.. _ _____,_______
NO OCCUPANCY BEFORE C.O.
~~~IGNATURE -- ~MITOFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
J,-01-1995 1! : ! dPM
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IWD
~'l/o,/
PHONE CONTACT FOR PERMITTING
OWNER'S NAME V-1l-/7"v }
JOB ADDRESS Lo 'j
1(0 I'- /"'l..0..J
205 3750./
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
"L.."f
J4-~S-;;;lI- O()!O-eJ ~RoO- ~O~
Lit / ~
SUBDIVISION
(3~~
~
live.
,
PARCEL ID #
(ORTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: []NEW CONSTRUCTION [] ADDITION []ALTERATION [] REPAIR [] INSTALL
[]SIGN [] MOVE [] DEMOLISH
PROPOSED USE: []SGL FAMILY DWELLING []MULTI-FAMILY []# OF UNITS ~ILE HOME
[] COMMERCIAL [] INDUSTRIAL [] SWIMMING POOL [] OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
)H, If /0\'>>f
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
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
[] ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
[] FLORIDA POWER
[] W.R.E.C.
[] PLUMBING
[] MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
[]GAS
[] ROOFING
[] SPECIALTY
[] OTHER
TYPE OF CONSTRUCTION: [] BLOCK
[] FRAME
[] STEEL
[] OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[] YES [] NO
BUILDER
SIGNATURE (,.Icy-- A~/~
******************************************************************
C9~qIJ!QR<$:&:CT:ION
" , .-.-r- . I. //
COMPANY 8v-//<..-/7 L if
STATE CERT OR REGIST #
ELECTRICIAN
SIGNATURE
vJ c-.r--LLo/JR
COMPANY J?1 ~ ~
STATE CERT OR REGIST #
******************************************************************
PLUMBER
SIGNATURE
U-J~~
COMPANY ~-7Z~h ~''(0/
STATE CERT OR REGIST #
MECHANICAL
******************************************************************
COMPANY
Hc~
SIGNATURE
LJ ~-r-- ad.Jr! P-----_
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 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 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 "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 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 "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 2~
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)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did D did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid OEd not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
~'. I "
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PASCO COUNTY, FLORIDA
. .~".. '-"-"-"'".~"",,^,...,,, .,-. ".'-'--,~,"""",,, '''~'"'~-~"..".., .' ""'-'-~"""--"'" ',"'.. ot,,_ .".._'... ',."..,...._.. ,.~.".~
,) .' , "
Perflllt 1\10. , " ()//,(>
- --.-----........ -0.
r J8te Pel milled ._.-,IL_.j~.:(V-
81111der Nallle/Owner Nallle -~:'c,\" "\&~_MI:'~I'}r"~' "_~_~~ ~. Control #~.__~_~~
C;OlJl lty Palcel No.:3l.j..._~![~;;'L~ 09,~~-" ~?:~o --3.~;-:;', Subl )Iv: ,Q ilL.
Add res s/Lola tlllnf L 'C' 1/ ; (Ic'l Be, l) ,) (
Clasf3ific;:jt!ollllype of Use fH ".., ~.) ( \s -._..ji})~ \"~' '___
TRANsporHATION IMPACT FEE
E)(ell'pt [1 Yes I~JNo
Rate:
Sq Ft lIlllt:
Ilow [letermlned
Impact Fee Amount --~"--,,L~,~:S
, or:'
~---._- ._-"._-~..._--~-.,-,,---, - . --.-..---- -.-'-.-.--..--.--- . '--', .---'-- '..----.
Zone No.
'sCn()CirrMPAGT 'F'EE'''-'-'-'''- "'." ....,.,. "'" ,'.,,,.--.-_._,w," _A>_._....",',...., ,_,
Accuul1t (05G) Sinqle..Fatnlly 1J(~tached HOl/se AntOl/tit
(DGl) Mobile Home
(mil3) Other f'"<esldenlial
JI2:3) C~llectlon Fee
Exempt r~1 Yes L J No How Uetennined_____ _.'._______.
------------.....--.-....-
TAZ:
'''~.-'''''''''';'~,"'" ....,;.,........."',4....~_,..,.,. ""'''~""'''''''._,.... '.'
$
" -."........ -. --._.... -~..
u ... ___.___. ___.. ___....__ _..._.._._.
PARi<s7\Hfi -R.ECREATf6NFEE....'.'.._'~...,_. ._'"--_."-._-_.>O~"..._._~__ .'.'.w.."'....,_.___...._. _.'....__...___..__.
L1:lIld AceOlllll Land Credit Land Total
. .-...--.-.....-..... ---_.. -'-'--~- ~---._---.
'. ---..-.----..--.
.--..----.... _"h.__, ~
neCIAr:'ltlutl/\C:C(lllltl
necreation credit
l~eCleati(Jn Total
l< It 18
Exempt r I Yes [J No
TOTAL AMOUNT ,l..,.. _"'_'_,
110w Deterrnlned
IIBRA'i~,Vf.F. E'''........,."........, '>"-'"' ...--..---, ".,. ...,....,_...._-'~...."--_.,,~_-.,_..._'~_._._..~.....__._...___...'_'''___...__.,._
LatHJ /\(;CUI H It Land Credit_.__ Land Total
_._.-._._-----~_._---._--_._...__._._-------_.._-_......--..--------.-.'"
Facility ACc:ollllt
._"'._-~-------~._.- ...-----.-.
Facility C;reeJit
.--. .-. --...----__.n._____..__..___.._
Exelllpt r -,I Yes [] Nfl
... --. "-'-'-'--. '.-- - ----
Facility Total
--'---"--'--.- .""'..,., ---.._---_.~~
..-....~,,-. .... ..~'<....._--.~. "'''' '''-'-'"~~.,. """,, ".....~... -"-'.,._"..~., "'''r~..""..._"". '",,_' "_~_"_,,"',,_, ...."...._ "___.''''''__.,_.._.."~,......,~~___,,.._"...,..____
How Delenllined Tolal Amount
..--~-,----. ----.....----"..-~...- "--"__0_...__ _.. . .._.___.~.
RESotJrWE FEE
TOTAL. AMOUNT
ERU
.--..- .-.. -.-. -........ "'__~'.n_._ _ ....._____._....__._..
.---.---. --'.- '--.- -".~- _._...__._--~..
'_'~""''''''''''''''.-..,-.......-.,.,.,,,,....,,
Prepared By
.. "--"'-'---....-. ,. - .--.-..----
Checl<ed By
--.---.- -...--..----..--
NO CI~lnIFIGArE OF OCCUPANCY WILL 81: ISSUED on 1~IN^t. 'NBPI~GII()N
PEru:OJ~MEU UNTIL TilE TOTAL AMOUNTS LISTED IIAVE
BEEN PAID AND
I~EGEIPTE[) FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement helow does lIot hnply acceptance of concurrellce, but simply lenelpt of a copy of this form, placlnU
the IllJlltllng pennlt ownel ollnollce of this assessment and the conditions of payment for same.
DAIT=
'--'~n_ .._..__.._._._ '___"__"""_
Pr:CEIVED BY
HECEII'T r'Jo.
DAlE
BY
... --. . ..---.--....... -_..-.~--..m~..--__._.___....__..n.._.._