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Home My WebLink About04-2992 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 2992 Address: 38250 A AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS . Parcel Number: i Name: ZEPHYR HAVEN NURSING HOME I Total Fees: 350.00 I Address: 38250 A AVE l Am;:t~t :aal~: _ . 4/26/2~~~OO .. --".hone: ZEPHYRHILLS~FL 3354~_ . _ Work Desc: 2-ADDITION 12 TON PKG. EER 10,HEAT & ELECTRIC Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: Date Issued: 2992 ADDITION/ALTERATION ADD/AL T COMMERCIAL COMMERCIAL 119,684.00 4/26/2004 1 PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED LINTEL PRE-METER WATER FINAL MECHANICAL FRAME MISC SEWER MISC INSULATION WALL Mise MISC. MISC. INSULATION CEILING MISC. MISC. MISC._ DRIVEWAY , MISC. I MISC. FIRE DEPT. FINAL -REINSPEcTI:ON-FEES: -\Nh-en extra inspectIOn trips are necessary due to-anyone of the- following rea-sons~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 inspect ion fees shall be made before any further permits will be issued to the person. owning same .. ' --"Warrnng-to owner:Yourfillfure to recorda 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 bef~re ...~cor~il'lg .YCtLlr._l1otice_C)! cOl!1mencem~l1t. "___ _____ __ . .. _ Complete Plans, Specifications and Fee Must Accompany Application.- ----- ---.. --- --- Ail work !5.h_~1I ~~ per!~r-.IT1.~ in c3ccordan~~~lth City Code!5. C3!!.C!.()!~l1anc~~__ __ __ i- ---- _NOO~CU~~N~~~EFQ.RE _c.()._______________ ___ __ ...y--_.._---_..._--~- ---- -~- TRACTOR SIGN . U PERMIT OFFI CAL Ii INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER vC CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 DATE RECE lVED ~~ PHONE CONTACT FOR PERMITTING J/{)1- i/13 -1" ~ () LlJ603 VWn 'IA .<t PHONE ~ OWNER' S NAMELerhILo~f) JOB ADDRESS 38250 A tJlJ'~;'1lJ' I-/OMt3 Aliff 2~~/kll.., fl. 33?'11 LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # WORK PROPSED: [JNEW CONSTRUCTION [J SIGN [J ADDITION [J MOVE DALTERATION o DEMOLISH [J REPAIR INSTALL PROPOSED USE: [J~L FAMILY DWELLING I)(COMMERC IAL [JMULTI-FAMILY [J INDUSTRIAL [J# OF UNITS [J SWIMMING POOL [J MOBILE HOME [J OTHER o RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK .2 AJJi~()- 12 TOn PQ~JDCjP/ EER. 10 ) rIeur EkLln'c... ,k!lJ II < 3 BUILDING SIZE SQUARE FOOTAGE HEIGHT ./...,.----." &/t 1) SET ENERGY FO~. FQBM8. \ . f. ' ~.. Jz /) O~ // / TOTAL CO STRUCTION ~.~ /' (~- "/ --P_.._-~:_~-~<:':.~ -~ RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. ,.../ PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRU~~ PERMITS REQUESTE I $-1L <i ) 68 tI. 00 VALUATION OF [J BUILDING [J ELECTRICAL AMP SERVICE [J [J YLUMBING g'MECHANICAL [J GAS [J ROOFING [J SPECIALTY VALUATION OF MECHANCIAL INSTALLATION [J OTHER .t:f) 71/-- $ -5AMe TYPE OF CONSTRUCTION: [J BLOCK o FRAME [J STEEL [J OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREA[J YES [J NO CQ~CIJ.'QR<SEC'rION . " , -,'" BUILDER COMPANY SIGNATURE STATE CERT OR REGIST # * ** * ** **! * * ;*Kh.1>* *** ** * * * * * * * * *** * ** ** ** *** ** * * * j* * * * *'*?:* ****j? __ T P' COMPANY f11a r-f-I Y, C U c::r;-./ C ., ~ C ~ STATE CERT OR REGIST #EC./3DO).3~3 ******************************************************** PLUMBER COMPANY SIGNATURE STATE CERT OR REGIST # OTHER ...... .................. .....*....:...:...;7f*. 1:0 fJ1 L COMPANY LiM,. 6e(I),Cf>~_ STATE CERT OR REGIST # GNG 1-:;2.tf qJ{IO MECHANICAL ~c;~s_::;:;:~:~~_"'~.'- * ************************************************** 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 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 "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 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". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR acknowledged , 2CL- 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 Odid not take an oath o who has produced (type and whoD did 0 did not Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped I N~T~\.A-Ti-::'rJ (3 f 2- ttMf ~i) ~N\\) 12 To(\l~ ~ Square Feet Valuation I J q I b ~lf. Q~ Building Electric ? 5 !3-!!- ~}" 'Z7 ,- v~ J. NIp., Plumbing Mechanical Radon Connection Fees: Sewer N}p, ,J}f\ tJ}A Water Meter School Impact Fee: JJ J A Transportation Impact Fee: ~ 111 L, N L ~iL-Vl<-0 ~ ~L~'C It AV J2- .2~) 1~'iJL j~VHN N\Jltjir<tr 1+\!.."I\\~ Dollar Amount tine service line Service Company 4150 Church St. Suite 1000 Sanford, FL 32771 -..^---.s... Date: March 30, 2004 TO: City of Zephyrhills Building Department Re: Mechanical Permits Mark Hagerman - Qualifier Mechanical License #CMC I 249410 Subject: Zephyrhaven Nursing Home Gentlemen: Please accept this letter as my authorization for Susan or Lucas Young to apply for and pick up the Mechanical Permit on the above subject, in my absence, as I am the undersigned state certified license holder for Linc Services, LLC. Hagerman Vice President/General Manager Mechanical License #CMC124941O Linc Services, LLC STATE OF FLORIDA COUNTY OF SEMINOLE The foregoing instrument was acknowledged before me this'?D1!t day o\.JAo.,rd- , 2004 by Mark Hagerman who is personally wn 0 me and who did not take an oath. W el- My commission expires: ~l 201 OS "'m~~;J:;~~::i:",," DEBORAH It WARD/CARTER .:'~ "b'" ~. J Notary Public - State of Florida \~ ~f My Commission Expi"es ~ 20, 2llO5 "':f,,'ff,r.r't'" Commission II 00026372 SANFORD - Phone: 407-323-5455 Fax: 407-324-8699 . TAMPA - Phone: 813-621-0032 . ~"'.'..:.............~..............,......;' , . ".' . --,' i";,,:. <~,,~,:. ..~" ~."'):~' - r'le Sunshine State _ UCSlsE 1UIBeR. Y520'-S35-79-100-O LUCAs PATRIcK YOUNG 11407 CR 581A MlNNEOlA, Fl. 347&6.4000 IIIR1J.r ~TE SEX IiGT REsT. ENDoRSE 03-20-79 M s.os ~ .' 'SlUm EXPIRes '-..;,; 03-25-87 O3-2D-Ot '1.:,"://1 11, _'....."" ,1:::.:.,1" rf/ '~'i ;~, 7 ~;! ..", ~" W!Il!l" GlI7010425ODl14 ~ at a -"""""" consIiIutes consent 10 any SOIlfietytest reqUIred by law /JlJPUcATE (N.,25-41 8137831586 ~4i;5/2~~4 13:37 8137831585 ._M_'__..._m._. .. ... / Pr~PtJred /3y,' Apr 15 04 12;47p LiNe SERVICE ifliCJ (JtvrJ., ~ 'I. ~Dt1}, F/. 3277' ZEPHYR HAVEN (407)324-0699 11111111111111111111111111111111111111111111111111111111111I 2004079744 1\ Florida StatUte n 3 is the Construction Lien Law. The owner needs to b.1amltiar with alllts passages, At a mlnlmum. me a Notice of Commencement, protect. your rights by obtaining a partlal.or complete HRel.e888 of uen" prlOf to any payments and obtain releases from aU provkter8 before making the final paymenL . Rcpt: 778840 Rec : 6 . 00 DS: 0.00 IT: 0.00 0~/03/04 Dpty Clerk NOTICe.OF COMMENCEMENT.: -Ill : : . i~~0~~~1"Ari : .':;0 fOUNT:, C~ERK OR 8K 5833 PG 1960 Pennit No. Tu Folio No. Tl'l. undM'llgned hereby aiV.. notice. that I~t will tM made to certain real pIOpel'lY. and in accoitd.nce wilt! Cha~t 113, F1orld. StatLl.... the following lnfonTIalion IS provided in . thIS NotIce of OOmmencem.nt.. : . (1) Lea-t OescrlpUor\: )825'0. .,4J~ A. ~e'/'''1r4JI If rl 3?5""(f! (2) Gen.r.1 DNCrlptSan of Il"nPrcwement: V6G~01e .un"""" 1k (3) Owner InformetkH'l 7e..pkvlh ? N' II ' 8 A A (a) Name and add.....:~ I. t11K;..fJJ"5I,' Ho/Nte- I 3 250 rnJe. . '2eohy (t,,'II-s 'F L- "3 ~3St(1 (b) 'nterest in PrOperty. . - V ..J .' . (e) Name and addrete ~ fee almple titleholder: Contractor (Name and Addr..>ir/ ~ ~Y()t'ce? 1//,0 CAVfJ,. St.. Suroly jT!3. It:{) <)0" "F( ':3277/ (8) NatM and Addm-= . R (4) (5) (b) Amount of bond: S (6) Lender (Name and Addroas): (7) Peraons wtthln the S1af18 of F1crtda d&al~ by' Ow\"'~ upon wt1~m !'lO~C~~ or other docpenta m6 ~ as Provided_~ Section 7'3.13 (1) (a) 7,. Florida Stalues: f\ev'+tJ ';~.s (,0" G.~.:~!'h'lkP ~h ~te~ . (Name and Address) 6~-f,\-Ndc I FL .6 .i<ti6' .(8) In addition to himself. Owner designated./g<f f1I\~~Al~~ .of -;2i!'(t....;lwetJ PC to r.c.lV8 , he ' SeCtion 71~,'3 (1) (b). Florida Sta~~PY 0 t LIenor & Notice .a pfOlllided In (9) expiratIon dale of nota of oommencement (the explra date is 1 )'ear f,om the . date of recording unless I different cMl& 1$ - too tIl r............... : OeBORAH.......~ : "" M. SWOfII I ~~ Com""DO~>lllin Owner) : 'i~ ,; Ii ~ ullMl2Cio7 E "",,~oFp.rt1 .....hu(~! Swom an !Subscribed before me this 1.....Z~~~:..__~~.1nc ,. . . / ~.. of IJAI.{ 20 ~,"t.1 ........ (J' .J..l,.;{" \' (/".?,) . ~' ~,-~ '. ;;?(,.. . . . c. ~,~---, XY.:l Z'Z:'n IlII.L ~oo i ~ !