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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3084
Permit Number: 3084 Issued: 5/17/2004
Permit Type: NEW SINGLE FAMILY DWELLING i
Class of Work: 101-NEW CONST/SFR
Proposed Use: SINGLE FAMILY RESIDENTIAL
Sq. Feet: Est. Value:
Cost: 109,200.00 Total Fees:
Amount Paid: 6,626.59 Date Paid:
I
6,626.591
5/17/2004,
Address: 5752 DOGWOOD ST
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: DAVID L. CARR
Address: 5752 DOGWOOD ST.
ZEPHYRHILLS,FL. 33541 ZEPHYRHILLS, FL. 33542
Phone: (813)629-4961 ~ic:_____ _____~__ Phon~_______________
--Work Desc: NEW SINGLE FAMILY DWELLING
IN
WATER CONNECTION RESIDENl
SCHOOL IMPACT FEE - 97,5%
BUILDING FEE
96,
419.00 I MECHANICAL FEE
1,651.65 TRAFFIC IMPACT FEE 1%
825.00 . RADON
L
78.801'. SCHOOL IMPACT FEE 2.5%
15.88 TRAFFIC IMPACT FEE 99%
21.84 : WATER METER RES 3/4"
1 . 5
42.35
1,572,12
180,00
~'fW'" [l'J/ff 5)1).'1 ~~ ,rS'1 If
'1 T A
PRE-SLAB , CONSTRUCTION POLE/\/ttlO'ff4., 2ND ROUGH PLUMB DUCTS INSULATED
LINTEL: PRE-METER I WATER : FINAL MECHANICAL
FRAME i MISC SEWER I MISC
INSULATION WALL I MISC Mise, I MISC.
INSULATION CEILING MISC, I MISC. ' MISC,
DRIVEWAY , MISC. : MISC, FIRE DEPT. FINAL
---------~---~-.--.-.----------'-.-----~-.-.-. -- --- ~---.- -______.n__ ____ _____._____________
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
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
-"Warning toowner:-You',. failure torecorda~noflceof commencement maY-result in yourpaying:twice~for--
, improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
JJ_efor't!!~cord!I!9..you_r_l!~tic.!!_~f cC)......_I!!..~n~~"!~nt. "_ ________.____________ _ ____ ____ ____ __
1_ _ ~~ N~ OCCUPANCYlIEFORE C.O__ ~_ __ _ _ _ __ _ ___
'f- CONTRACTORS SIGNATURE- - - - -- - -PERMIT OFF!
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
PHONE CONTACT FOR
DATE RECEIVED 5-1/; 01
PERMITTING 8, J- bJ r~L( 16/
OWNER'SNAME O;V1~~~- AG'Y-(f~(;jji;) PRONE ~15-L~Y-~J
JOB ADDRESS L OjlA/dc'l 1\ ~ 'S:2._
LEGAL DESCRIPTION: LOT (S) Ilb .III '\ BLOCK SUBDIVISION COl-.(,,u1.( f-1 e '1h15
PARCEL ID #i ~ -16'" ).l-t)) ~ 0 \:) ':lOdO '- (/6 () (ORTAIN FROM PROPERTY 'tAX ~O~ICE\
WORK PROPSED: ~EW CONSTRUCTION D ADDITION DALTERATION D REPAIR D INSTALL
DSIGN D MOVE D DEMOLISH
PROPOSED USE: ~L FAMILY DWELLING DMULT I - FAMIL Y 0# OF UNITS D MOBILE HOME
DCOMMERCIAL D INDUSTRIAL D SWIMMING POOL D OTHER
DESCRIPTION OF WORK
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
/!/P/l.-1 j Re>. \1 (P-i:'!l',-( e
BUILDING SIZE ~n:x: ~'-,
SQUARE FOOTAGE ~
HEIGHT
8'\
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS (1)
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 CONSTRUCTIONi
PERMITS REQUESTED
SET ENERGY FORMS.
?L!i
j?,e.
~d"!IIQ~
[g"BUILDING
I!:rELECTRICAL
$ Y s: (\0 J. 0 0 VALUATION OF TOTAL CONSTRUCTION
~. (J 0 AMP SERVICE ~LORIDA POWER D
~:E:
KJ"PLUMBING
~ECHANICAL
$
:2 So f) 0 0
,/ \..' -
VALUATION OF MECHANCIAL INSTALLATION
o GAS
~OOFING
o SPECIALTY
D OTHER
TYPE OF CONSTRUCTION: ~ BLOCK
o FRAME
o STEEL
D OTHER
FINISHED FLOOR ELEVATIONS
,ki
IS PROJECT IN FLOOD ZONE AREAD YES .9-NO
CO~CTO;R ',SECTION
SIGNATURE
a~~~
v
COMPANY en 1'V~ Cd:\J/Pvcfi2.l '\ 5~C.5.
STATE CERT OR REGIST # (. (;C o.{. 0 G Ll6
BUILDER
******************************************************************
ELECTRICIAN
SIGNATURE 6~y"f ~AI'>f
COMPANY CU~ ( Ik &:.eclit'L
STATE CERT OR REGIST #
******************************************************************
PLUMBER
L~~
COMPANY e G .'1 ~{\~(.-ft<.tA. ~I.:.,_t~
-
STATE CERT OR REGIST # CF~ II{) b /6)
SIGNATURE
SIGNATURE
*******************************************~*******************
.II COMPANY J,I.._/~ { ,!t('_"-
.de ~ STATE CERT OR REGIST # eACo5g51~
MECHANICAL
*************** ******~**************~**************************
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 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 "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 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~~O~CORD AND POST A "Not23~~
SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
STATE OF FLORio~ ~ STATE OF FLORIDA /~-
COUNTY OF . L tJ<3~) COUNTY OF < UL54)
~:~oregoing instrument w acknowledged // The (OE oing instrument was
~~~ m this I . d ~ '7 , 2001" ~;f~e this~ da 0
(name of peYson ac nowledged) (name of person acknowledged)
~s personally known to me, or ~personallY known to me, or
owl edged //
, 20 e.t:
D who has produced ~-----
_/ (type of identification)
and~,hOD dl ~JLrdid .,'tf,ot pke a, n O,~,th. ,-
'~JIZ_'~~7J~~
SieJnature of person taking acknowledgement
Name
Signature of person taking acknowledgment
'" 8clttitSwetkJnd
. tM~NISIQN' DMAA7A-~ FXPlRFS
Name - ' , printtet:lfdarp22, 2IGlBm ed
. ", . .~,,~., BONDED THRU TltOY fAIN INSUIWlCt ~c.
. ,
Carr Construction Services
5752 Dogwood
SQ. FEET PRICE
MAIN OR LIVING: 2,184 $ 50.00
OTHER AREA UNDER ROOF: $ 50.00
OTHER: $ -
VALUATION $ 109,200.00
FEE SHEET $ 510.00
.
ADDRESS $ 30.00
DRIVEWAY $ 30.00
BUILDING: $ 825.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 825.00
ELECTRICAL: $ 107,95
PLUMBING: $ 96,00
MECHANICAL: $ 78.80
RADON: $ 21.84
TOTAL $ 1,129.59
-
'1/ D-/.'7 5
SEWER: $ 1,616.00
WATER: $ 419.00
IRRIGATION: $ -
TOTAL: $ 2,035.00
I
I
WATER METER:I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
3,344.59 ,
SIF'S: $ 1,694,00
97,5% $ 1,651.65
2.5% $ 42.35
T IF'S: $ 1,588,00
99% $ 1,572,12
1% $ 15.88
TOTAL: $
6,626.59 ,
396766
~~
PERFORMANCE 3USINESS PRODUCTS, :NC. 313-7~~008 FAX 313-7~9-79t9
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CITY OF ZEPHYR HILLS
ZEPHYRHILLS, FLORIDA
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WATER ACCT. NO.
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SERVICE ADDRESS -:) '.> ..~
SHUT OFF SERVICE 0
TURN ON SERVICE Q.--/
iNSTAll METER 0-/
READ METER 0
CHECK METER 0
OTHER il
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a-WATER
o SEWER
o GARBAGE
g IN CiTY
o OUT CiTY
_ No, OF UNITS
_ OEPOSIT AMOUNT
- AMOUNT LAST BIU
--,
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<........~L...::.//
_ DATE
/~
\--,--(..~.f/
_ MISC. CHARGE
WORK COMPLETED BY
.1 DATE COMPLETED
,,JRDER TAKEN BY
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ORDEFl GIVEN BY
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=leta," white rorm in office at ail times. .<
3ef1d pInk 1 yellow forms 10 'Nater ServIce DeDI.
Neier ServICe Depl.:o .sIgn yellow 'arm ,.; --alum DJtfice.
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NOTICE OF COMMENCEMENT
County of Va -' ( '0
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statutes, the following information is provided in
this Notice of Commencement:
1. Description of Property: Parcel No. ll. - J..-~ - 2.. 1 '~v ).. 60 -. (1-'2- (j G '-1/ _r: (;
S'-; "')-...1 00- VVL'~ J 57ft" r.' 2'2 / (~'i(J L.
(Leg a description of the property land street address if available)
2. General Description of Improvement IV~.A./' /r 12..5:df!A\. c e
11111111111I111111111111111 111111111I11111111111111111111111
200409098!5
{Juv vi)
0/
',\lj"
) ,6 ~
_ LG- t7
3. Owner Information: Name
Address 33 U 0 (V~'\t\
City .'2e~1 tYII{.lU
, ,
State
~'
IL
Interest in Property:
C';Hl~- /{iv,'!t/le r
Name of Fee Simple Titleholder: Lljt,/~ ~l ;~!'~J LlI\.JL<..
(If other than owner)
-I
L.c.~ (;/'
~_.
((lAM)
"~
Contractor: Name ( (I yY-
Address
5. Surety: Name
Address
C/>/l
City State
({(, {\S/r~/[jfd'l J(.,'(.5 .-:hi C_ /L:l1 VI L l C6c J t-
City 'z."f} 1\ ",( /41 fJ State ,;?-'l .33S-c..; 0
I I
Rcpt: 783337 Rec: 6.00
OS: 0.00 IT: 0.00
0S/18/04 Dpty Clerk
State
JEO PITTMAN PASCO COUNTY CLERK
0S/18/04 08: S6am 1 of 1
OR BK 5858 PG 274
R4.
Address '73JQ f)rUIJ6' !2j
City
Amount of Bond: $
-1//' ,/-1
/' ,~ T A
1.. /;.',?
'/ '
// / / ( City
State
6. Lender: Name
Address
7. Persons within the State 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
City
State
8. In addition to himself, Owner designates
of. . . to receive a copy of the Lienor's Notice as
provIded m SectIOn 713.13 (1) (b), Florida Statutes.
9. Expiratiop date of Notice of Commencement (the expiration date is 1 year from the date
of recordmg unless a different date is specified.)
S,/l ',.;'- /~ Gi.. 'of' / ,
'" /,/ '=---7 C~
Signature of Owner: 10;,tAr-:{ C- (f (.,t;t " I] 1 -t y', .to" -v
,'\:":hf' ...) :.~..:
Sworn t~>j7~d,SUbS~~Ofi~ before me tJs / Y
Notary Pll:bllc:' " _~ 'l~::/I' .-."'- -"-'"
day of
/hH
/'
J,/
20 f} .;-
,~.
,
My Com!l1ission Expir~,s;
'~<)., ,;,'] ~,~,
PC93053048,.1A .
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~ .",arT" CARMAN HA
~9~ M/COMMI RTZOG
, EXPIRES' A 085
L l'aoo.3-NOT~,RY. . uguS! 27,2006
"'---------... !-L Norarr Service & BonN'
LJlng, Inc
08/31/2004 02:27 8132348810
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O'RIORDAN COMPANIES
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