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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3021
3021
Permit Type: ALUMINUM
Class of Work: CARPORT
Proposed Use: NOT APPLICABLE
Sq. Feet: Est. Value:
Cost: 2,800.00 Total Fees:
Amount Paid: 82.50 Date Paid:
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82.501
4/29/2004 i
Address: 5829 12TH ST
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-03700-0090
Name: HILL'S CONSTRUCTION
Addr: P.O. BOX 490324
LEESBURG, FL 34749
Phone: (352)424-0249 Lic:
Work D-esc:HCARPORT 24 X 20
HABER TED
5829 12TH ST
ZEPHYRHILLS, FL. 33542
Phone:
I
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_____________ ..________________ ._____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
i 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
-"Warning to owner: Your-failure tOl"ecord a-notice of commencement may result in your paying twice for
j improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
i before recording your notice of commencement."
I.-~-----..--------.----------~.. ---.---___________.u._________._______.. _ ----- ____
-----------
.~~~. /
L __...____________ _____ _ ..________ _________
CONTRACTORS IGNATURE PERMIT OFFI
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 L-!' ~ 4~/
DATE RECEIVED /~ 7 07
p()( SG-d rp~vn I 'cs/i/
PHONE CONTACT FOR PERMITTING .S~/i_u:e'~i~9Y
OWNER'S NAME -led ~bp.f PHONE I~hh- f1z1f:.7b'1f
JOB ADDRESS 5".g :Jq ./2 -M 5:JrP.c-c-) ~ ~ / Is, R.- 33C;Z;()
LEGAL DESCRIPTION: LOT (S) -9 ..{ 10 BLOCK SUBDIVISION
1\ ~X ---:2/-00 I D---D 37 cJ () -D::)cr~AIN FROM PROPERTY TAX NOTICE\
WORK PROPSED: ~W CONSTRUCTION
PARCEL ID #
o ADDITION
o ALTERAT ION
o REPAIR
o INSTALL
OS~
PROPOSED USE: ~L FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
OMULT I - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK C;Q, rpD.t
~4 i'd-D SQUARE FOOTAGE
Ifflj) i-
BUILDING SIZE
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.
~UILDING
o ELECTRICAL
$~()~
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATIO
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDER
~~~
cQ~Q!t'():R;SmCTI01i{
- COMPANY Hi lis (~n6iY(jc:h D (7
STATE CERT OR REGIST # tfZC, D5J 3(0 /
..~-:' SIGNATURE
******************************************************************
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
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 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 GuideH prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "ownerH, I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "ownerH 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 volumeH 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 COMMENCEMENTH.
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71J l~
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA ~
COUNTY OF raGlC
The foregoing instrument wa~ac~nowledged
Before~e this ~day of.1.:!fn \ ,200~
by ay-{- 1-\ i \(
_/' (name of person acknowledged)
UYwho is personally known to me, or
STATE OF FLORIDA ~~(O
COUNTY OF I C.
The foregoing instrument wa~ac~owledgedIJ
Before mn t_hi~ ~~7"day of I prr , 20~..l.
by ~r'-r- I I
~ (name of person acknowledged)
~ho is personally known to me, or
Dwho has produced
(type
o did not
Dwho has produced
{type of
Odid not t
Name typed,
person taking acknowtedgement
,",,,,,, Suzanne Bahr
," ~VPlJ.~"
.f!~~;>_ Commis~ion #00157131
pn~e .~E~lla~~ 1:l,:'wu6
....;7 OF f~O~,,> .Thru
"."", Atlantic Bondmg Co., Inc.
Name typed,
erson taking acknowledgment
,"""" Suzanne Babr
,,~vp(J. 'I
::'~~'~~;'__ Commission #00157131
prirl~ed ~i~ E~pj~~v 15,2006
....,::~ OF f~O~~ ,.... Bonded Thru
I,,,,,,, Atlantic Bonding Co., Inc.
Sig
4LLS (GN'>I.
5'1> Lei i2+k S-\--,
fQif1- <'~DIN \r
1 SQ. FES PR:Cc
MAIN CR liVING AREA Q1JU :$ 10. ()~
OTl1E~ AREA UNDER ROeF S
CTHE~
VALUATION S If ~a),
,
BUILDING:' $ }{L, SO
C~EDlT: '5
ELECTRICAL: $
PLUMBING: ;$
MEOfANICAL 'S
i
J~ADCN' S
TL"'S ls
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PL 365dil
NOTICE OF COMMENCEMENT
State of --I::1 0 l{ l dCi - County of (1 S (j)
THE UNDERSIGNED hereby gives notice lhat improvement wi II be made to certai n real propel1y,
and in accordance with Chapter 713, Florida Statutes, the following information is provided in
this Notice of Commencement
1. Description of Property: Parcel No.
C,<) "'7 q . 'lW S:.L.
Q () ,;7\ I l."", -:'I ( I ,} ~
(Legal description of the
2. General Description of Improvemenl
Interest in Property:
State
FL c -J-;;S-t(C-'
3. Owner Information: Name -reel
Address \5C6:~,q I~fi ~Sfre0t- City
o tUner
SLl V'n-€-
Name of Fee Simple Titleholder:
(If other than owner)
.~,:&: ""~
Address
Address
City
Hi / Is (['-hy;H/X;:hiJ"
13Lfifr:7 uS 3D I_City 1),1, Cukf=s...e
(.
State
4. Contractor: Name
5. Surety: Name
Address
City
Slate
Amount of Bond: $
6. Lender: Name
Address
City
State
7. Persons within the Slate 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
Cily
S lale
8. In addition to himself, Owner designates
of to receive a copy of the Lienor's Notice as
provided in Section 713.13 (I) (b), Florida Statutes.
9_ Expiration date of NOlice of Commencement (the expiration dale is I year fromlhe dale
of recording unless a different d.lle is specilied.)
Signalure of Owner:
.L0.(:". ,:L.. { I
OJ,to <1"'-
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,
Hprr I '
.20.J2!i
day of
Notary Public:
\,\\1'/1/.
'O"'\..'.~(/
;:~'~'.:":~ Com,mission #DD157131
~'!l'. ~I:...: Rxpmt~. No" 15 2QQ6
-',;;i oiFcc,J}' Bonded Thru'
. '" """ Atlantic Bonding Co., Inc.
My Commission Expires:
PC93053048/A
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