HomeMy WebLinkAbout04-3068
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
3068
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 5/12/2004
Total Fees: 3,315.50
Amount Paid: 3,315.50
Date Paid: 5/12/2004 L Phone:
-Work Desc:MOBILE HOME SETUP---- --
3068
MOBILE HOME
MOBILE HOME SET-UP
MOBILE HOME SUBDIVISION
Address: 37337 GILL AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
GRAND HORIZONS
37337 GILL AVE
ZEPHYRHILLS, FL. 33542
I IL
MOBILE HOME SET-UP
- MOBILE HOME MECHANICAL
MOBILE HOME TIF/SUB 99%
IRRIGATION METER
I WATER METER RES 3/4"
i
I
4. I
60.00 WATER CONNECTION MOBILE HC
35.00 - MOBILE HOME PLUMBING
1,572.12 MOBILE HOME TIF/SUB 1%
180.00 IRRIGATION CONNECTION
180.00 I
I
209.50
40.00
15.88
175.00
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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
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
I_Thef>~'yment of il1~ecti().!!.fees shall be ma~~b~()r~_i:l_ny ..further permits ~iII~!ssued to the person ()~I1.!ng same__ ___
Complete Plans, Specifications and Fee Must Accompany Application.
-------- ________~Jw().rk shal'-beperfor~~.lJ1.accon:lanc~~ith City CodE:!~~Ordina~~_~________ ___
1- n__ - - -- __un ____NO OCCtJPANCYJlEFORE C.O__ ___ _ _ _______
il -L>c'O~~URE - - -~MrrOFFI
I CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
L PROTECT CARD FROM WEATHER
'::-:;:::-200.:1 1 1 : 3.:1Ar1 FROr1
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX:813-780-Q021
PHONE CONTACT FOR
DATE RECEIVED S -{ l-oC[
PERMITTING(~
OWNER'S N~rn-rc1 tJOVGlLO)\:5
JOB ADDRESS OI'?=>3/ Gill~
LEGAL DESCRIPTION: LOT(S)~ BLOCK
PARCEL ID #
PHONE )1'?Jq7~.5d50
SUBDIVISION
(OBTl\IN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
OSIGN
o ADDITION
OALTERATION
o REPAIR
')5 INSTALL
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~OBUE HOME
o OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
~ QA1_~ Q JiYJu'oll-e_
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAlJ: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
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
L__________
c~::~~;+~~~-_-_-J
STATE CERT OR REGIST #
BUILDER
SIGNATURE W O-:7------r:7~,tfIJ
******************************************************************
ELECTRICIAN
SIGNATURE
tJ'~ ,.:-...{~;1
COMPANY /J ~ c.-
STATE CERT OR REGIST #
********************************************************,~*********
SIGNATURE
W~e6~
COMPANY fr~
STATE CERT OR REGIST #
PLUMBER
MECHANICAL
******************************************************************
COMPANY
.J1?;:::.. ""'-'
SIGNATURE
w~<Li~~Q
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 udeed restrictions" whicll
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 Zephyrhil1s Building Department, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the uContractor 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 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 uFlorida'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 Uowner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the Uowner" 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.
Application 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 UA" or uA,etc.", it is
understood that a drainage plan addressing a ucompensating volume" will be submitted whicll
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 i'lOrk authorized by such permit is commenced vlithin
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 uNOTICE 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
, 2CJ
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
of identification)
take an oath.
Owho has produced
(type of identification)
and who Ddid DEd not take an oath
Owho 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
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Permil.I,lll. ,'c; (I'
I late Penllillecru ---~.--~Z'ldi;;/:::
Builder "'Janle/Owner Narne _(~-" __I ~(C._ Lb !!l '/)\_ ___ Control if.
II
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Addttt8S!locRtlon-' ~:) -- 1_> :~-l _ (:;""_)1. I ,i-
Classlflcatlon/ Iype of Use
TRANSP(m rATION IMPACT FEE
I~are:
Sq Ft UIIII:
EXeltlpt [_ ] Yes I ~J No
Ilow L)etennlned
II npac! Fee Alllcllltlt $ I -; ~'<3"
--- ,-- -- r--;-- -- ----
IUlle No.
TAl:
srTn6()riMPA(~TFEE-''''-''~'''''--'''''"- .
m" "-"" -, .."~.." ,.,..,." ",..-" "._~, .",.",..,_,~ .""""'....a "., .~,.
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Exempt
lllnqle..Farnily l.Jet8clJed House
Mohile HOll1e
()tIler F<esl! lential
Collection Fee
I.--J ,,10 Ilow Deten nlned
AtllOUlI1
$
-'-"'-'-_"'__'U' _ .____..
. J') Ah'i<fr,Wi f'i' f~ F:iffiE Afl() t.fFE fro<' .., -.. -"..~".. '-" ._c..._. . -"~""'" .------."- --" --__ ~ __._.,..."._
Lalld AceIJI till Land Credit Land Total
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.. ~. ~..-~.".,..''''<..._-,.."..............~....- ......'.... -. p" ".--....."'.........
nor:I!~alil)1l ACCUllIlt
HeCleatinll C;FfH.iil
HecleatiollTotal
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n.>TAI. I\MC)UNT
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d
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Exelllpt / I I Yes [] 1'10
llow Uetermined
...' , f-f:~;, ",..." ...''"..........' '_' ......_ ..;..- ."'.....".,
LlBnARY FFE
I.alld AI;COI II II
-. "-.----'-"--'" - ,-_. .-. ...--., -..-.-. ..-.------.--.. '-'-... -.----.-.--. "--'-
.,ft..' ',.,-..~ ~. U' ".~.' "."....,.~,-_..._,.".~..., ",.,'"...,.~~".."_.,._ _ . _._,..''''...,......_.,., '-:u... ,,.,,-'c.......,,.,, .....-"-....---._..u""......, .."'.~~.,_~. .,.,__.,_~"".......,....".."...__....."......".......___.~..,,"'-....
Lalld Credit
.-'--"..:.------....-,..---...--..-.. ."
Lalld TntHI
Foeilily J\CCOltlll
'-. ..- ~-"'--" ----. ..~--._._-. -..~-....
""----...-._...~-. --
I::adlity C:n'ldll.
Facility Total
EX8111prJ I Yes '-_I I'Jo
Ilow Uelellllllled
Total AlllOllllt
_....-.~x:;::.. ..... '''~'''''''''''_''''" "....""........".",.,
RESOURCE FEE
lUIN AMUUHT
, ",' ,..- - ... ~~,,,.~ r_..
"""".r '-..,.,.....,..""--" ..,....,.Il..".""-..... ~~'.., ...-.... "" ..-.,..,.~,.".~,.....-,,.......,,,,,,,,,, ..'.. e.'," '_"-.~"', n... .......-.w_.... ..~,.. ""-''''''_'''''''_n. ...'.~~'L'-......-n........."J,.....~~,.___,~.......".,_....... ".-~,..._,.w.
ERU
. ...,........,~.. '..''''.........,'' ....,.-.,-
PIFJIH_"lled HV
. CI18cked By
NO Cl:HTIFICATF. ()F OCCUI'ANCY WILL Bf~ ISSUED on. FINAL INSPECTION
PEHF()RIVlf:U UNTil. 'f HE TOTAL AMOUNTS LISTED HAve
BEEN PAil) AND
HeCr.IP'n~n FOR BY ^ GENlRAL PERMITTING OI~FIGE OF PASCO COUNTY
N:kn()wl(~duelnp.nt hp,low does Illlt hnply 8cneptanc8 of C0I1Cllll8nc8, bill simply receipt of A copy of this fOllll, plal;lnq
the hulldill(.l permit owner Iln notice of tills assessment and the condit/OilS of paY1I1A1l1 for sarne.
DATE
~-.._---- - -----. ....-. ___... '._h___ _
I ~ECEI\lEr) BY
HECE/f'r I.l( ,_
(IAll:
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