HomeMy WebLinkAbout04-2977
.1
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
2977
Permit Number: 2977
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 4/20/2004
Total Fees: 3,315.50
Amount Paid: 3,315.50
Date Paid: 4/20/2004
Work Desc: M.H: SET UP-
Address: 37433 LILLY BEA AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
. Lot(s): Block: Section:
i Subdivision: GRAND HORIZONS
! Parcel Number:
I Address: 37433 LILLY BEA AVE
I ZEPHYRHILLS, FL. 33542
I
Phone:
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIF/SUB 99%
WATER METER RES 3/4"
IRRIGATION CONNECTION
WATER CONNECTION MOBILE HC
MOBILE HOME PLUMBING
MOBILE HOME TIF/SUB 1 %
IRRIGATION METER
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-REINSPECrION FEES: When extralnspection trips are necessary due to anyone-of the fojlowing-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
I (e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
I
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Th~ paYl'T!ent()f inspe~ion f~s sh~~ be l'Tl~de be~ore any furthE!r permits w.~1I be is~ued to the per:.s().I'!.ow.l1i.!lg sa_I'T!E!____
Complete Plans, Specifications and Fee Must Accompany Application.
____, All w.~k sh~IU~~e~rforl'Jl.E!d in accordclnce w!!h CitxCodesand Or:.clinan~E!s
NO OCCUPANCY BEFORE C.O.
~~i~ATURE- ~MITOFFI-
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
4t/c
C-~ 11-1<.1 o( I/o ~ / 2.0,.U5
7645 Green Slope Drive Zephyrhills, FL 33541 (813) 782-1866. Fax (813) 782-3966
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
9'- / 7 -t;y
PHONE CONTACT FOR PERMITTING
OWNER'S NAME
{ ')-fl...II,., J /'10 If( 1<' (J N ~
37'-133
PHONE
JA7fje~ five,.
SUBDIVISION
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
PARCEL ID # :J'-/- :2/;~ d-.J - cC'!Oj VdJ~V .ki,;lc/
BLOCK
(ORTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: [JNEW CONSTRUCTION [J ADDITION [JALTERATION [J REPAIR [J INSTALL
[J SIGN [J MOVE [J DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING DMULTI-FAMILY [J# OF UNITS ra MOBILE HOME
[J COMMERCIAL [J INDUSTRIAL [J SWIMMING POOL [J OTHER
DESCRIPTION OF WORK
CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL
PH. 11
BUILDING SIZE 27 rY<o ~
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.
[J BUILDING
[J ELECTRICAL
$
PERMITS REQUESTED ~c(ll
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
[J FLORIDA POWER
[J W.R.E.C.
[J PLUMBING
[J MECHANICAL
$
[J GAS
[J ROOFING
[J SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
[J OTHER
TYPE OF CONSTRUCTION: [J BLOCK
[J FRAME
[J STEEL
[J OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES [J NO
C. .ONTRACTORSECTION
',',',' ,,_' --'0" ....._.. -""'.. d", .. -, .._
.. .. ." "...... .. '."
BUILDER
SIGNATURE W ~ JtJ~L,EjjJ
COMPANY B.I 1~
STATE CERT OR REGIST #
******************************************************************
ELECTRICIAN
COMPANY
/Tit ~
SIGNATURE
vJ~
Ll:J ~
STATE CERT OR REGIST #
******************************************************************
SIGNATURE
W'7
o~
COMPANY n~ ;tL~
STATE CERT OR REGIST #
PLUMBER
******************************************************************
MECHANICAL
SIGNATURE
LJ~'p~
h ~""--
COMPANY
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
, 20_
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
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid QEd not take an oath
D who has produced
(type
and whoD did D did not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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PASCO COlJNTY, FLORIDA
t....~........'''' ,...,J....,.......-.......-..-.......nc--...,..,.". ."""'....."'..."..,-,-.._"",............'~-....,.....,......-."~,---... """""""''''"''~~,,......."',,. .....,.., "'.'........ _'":-,~. .,..,.......'""".,.", ~.......,..-.~.. _.~,..,,,............ .'....~.., ".."""l'n..t>...... ~........."..,
~') 41 /7'7
Perrnlt I\ll).__._.:.:~~,./. / __._____.
Date Permitted ---7.:'~':'.="~~..:_".L~
Builder ('Jallle/Owner Narne ._~~~:I~f':Le_j)~~(,<Z(IL~.,_.._ Control # '___'__.......
C<HlIlly l)alc;81 ~Jo.
,5';-/ :.'.';'; s '~)/"~'~!(!_" t:~/L('-i~:!..~'~;}~'(. SubDlv:
Addle8s/Locaficlt I ~j '/~:/).) <~/!y- _/_L~~~.\..._<(~~~.'..__._...__ .____.. '-.. .n..____..,
Classlflcatloll/lype of Use.. 6IL)kJd.C_.l0'lL.\I__ __.__.___ .._n.___~_._....___.___..__, _...._____._
THANspon rATION IMPACT FEE
Hate:
_. --. ,.- -..--.-.----------.... ..,.--
Sq Ft Unit:
Exempl
[I Yes '''+No
I low Detennlned
1"'PEwt Fee AIl1()untl..{_~!i~'.~:..
.-.--.-------..--- .._---...~-~..-._....- '. .----...--.---..--..--. -.-. "'-'-
Zone No,
s ci"i{jf)L~'I MPAC'T 'FE'["-'''- ._--". .'.... .~...-,.''''',.",... ..... ...._,,-._~'... ,....~'.."'..-..~._, ....."...''"-_.,_, ..v.,__,~___..... ......',..... _~....,_."..
-.. "'-'-"'-'-~_.... --~_._-._....- '--~----'----",-
TAZ:
Account
(056)
(051)
(050)
{'I 2 3)
!l],Ves
Slnqle-Farnlly Uetached I'louse
Mobile Horne
Other Residential
Collection Fee
GrrzrQ Ilow Determined
Arnount
$
------.. '-'... '--"-'''."-'~'---_._.-. -- '~'--"-" -....--.-...--.
-'-~_.. -"""-'-.--... -----.-.---.....-
'-.- --_.-. -.-.--....----...-.---..---.-
E)(empt
-.------..----.-- -.--~..__..h_.
- -. --._~"...~.._.-._~~_...-. _. _. '-. --"-- -...
PAffi(s'AHfj'RECREJrfION FEE' ....,-_._..,_...._.__._.._._""-_.....~._--_._-_..._...~. "m...~_.__..~_.._".
LAI Hi I\Ccollnt L.and Credit '_._._._... Land TO.!gL.
necle8fiun ACCOl" 1t
--...-----..-.-......- .....-...-...--....
"-'-'''--_.'''''__n...__..._ .._
n~.cre8t1ofi'Credit
Hecrealion Total
ZUlle
----.-..-- ._-._".... -- ---. '---"-"-.'
TOTAL AMOUNTL___H....._______.
EXelllpt [J Yes I'] No
Ilow Determined
IiBRARy.FEE........ ""
Lallel I\CCOlllll
.----~_.--.. .---.---- .....- ...---.-____ __'__m_.._._ _.___~__.~.._..._. '_"._. __'_
.." .,. ." ".".~.~. -""'n'..",-,-_, .." -~. '. ..- "-"~"''''~'~'",''~'' ._"..,,.,..,.......~.._ ,..." ,.._..,.,,, -."'e......... .. ...."...,..".,......,' "'-~_'~. "'" ~. ..."..,,0>.,..... '.C",. ~ ..'.....".".....1 .._.. .__"_~,~'..._....,,.. '~11 . ". ".,'"-,--",,,
Land Cledit____._-===-__=::-,~_=__:_.. I 811d '1 ntal
Facility AC(;(JlJllt
,.-
---..- _._----.._-_.._----~--".
--"
Exempt LJ.Yes/TJ No
.J.~dnfY(:;redlt
-- ...~_... ....--.-...-...- '_..:.;,,_r.:'
. .-..--------+----.--.---. -.~.._,
Facility Total
.. ...~._--..--"..__.. ----..-. ._--_.-.~
._.._~..; m_.,_"... .._.__""'''' '~"......"....", ........__ '~__,..___. _..'.,,_,__. '''.._....._..____,._"'"...__..,_._..~,~.__.._.,_..._. .....__.._~_",_......._......'__
.,RESOURCE FEE ERU
TOTAl.. Afv1C)UNT
How Detenllined Total AnlOllnt
------_._.--..._~.... .-~_.._~ -..-.------... --'-''''..--. ._. ----_._-~.
..---. - ---..-,,- .. - '--'--.--,,_ __ __ "U. '_._.._._. . __ _____
..- .- _._...~~..-.._.._.--...-....--._._.~.
.,...,.. " ,,... "'-N", ~_,., .
Pmpamd Hy
...'........, ,',....,...".' ".. ...~.,-','" -..., ....', .....,,',,",........, ....,.......'.........,..'.. "'" ..... ,,-". ......w..,_...~.. .~"".... _" ".......,..... ...."...,'......",.., .'.,,'.......'.
_ ~_._..._. Checked By
..".- . ~-------..~__ ..__ __n___..__.. .__ _ ____
NO CErrnFIGAlE OF OGCUPANGY WIL.L 81: ISSUED OR FINAL INSPF.GTlON
PEUr:ORMED UNTIl. THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID ANn
I~EGF:IPn:n FOH BY ^ CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Ackllo'lvledgAl1I8l1t Ilelow does lint hllply acceplclllce of concurrence, but simply receipt of a copy of this form, placing
Hw Ilulldlllg permit owner 011 no lice of tills 8SSeSSI11ent and tile conditions of payment for same.
'h___._.___."__.___. ....~...."
DATE
._~_..._-_._- ...------..--.
nECEIVEI) BY
---- -_..~_..._....._-......_-_. ----....
1',ECElfJ r NC),
. -------.----.-.. .- ----... .--..-...-......
DATE:
._n.....___..._._..______.._ _
BY
- ---..-.-----.--- --".- ...'"._---_.__._~._-