HomeMy WebLinkAbout04-3139
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
3139
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 6/07/2004
Total Fees: 3,315.50
Amount Paid: 3,315,50
Date Paid: 6/07/2004 I Phone:
---"Work Desc: MOBILE HbMESEt-UP-_u~---------------------
3139
MOBILE HOME
MOBILE HOME SET-UP
MOBILE HOME SUBDIVISION
Address: 37341 GILL AVE
ZEPHYRHILLS, FL,
Township: Range: Book:
Lot(s): 174 Block: Section:
Subdivision: GRAND HORIZONS
I Parcel Number: 34-25-21-0010-02800-0174
I Name: GRAND HORIZONS
Address: 37341 GILL AVE.
ZEPHYRHILLS, FL. 33542
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'I ACE REFRIGERATION INC
, ACE AIR CONDITIONING & ELEC,
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIF/SUB 99%
IRRIGATION METER
WATER METER RES 3/4"
I
60,00 WATER CONNECTION MOBILE He
35,00 MOBILE HOME PLUMBING
1,572,12 MOBILE HOME TIFISUB 1%
180,00 IRRIGATION CONNECTION
180,00
209.50
40.00
15,88
175,00
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1/rt/o ( / tJ: 'i 3 /JtI~~
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-----..--.-..~-------. ______.....L..._.____.____._ __. _----L____.__ .________..__~,. ___ ,1_.. __. _ __. , .. _. .. ,..
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the followirlg reasons, -a-
I 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~E!_~C!'L'!1.~r1!()f.inspec::t:l~n__f.~es _~~C!l1 be rTlad~!>~or~~n'y furthE!I'J)~rmits \^Iill~E!i!;sl!E!9to the EE!t'~()!!_owning same________
Complete Plans, Specifications and Fee Must Accompany Application.
- _f\II""'()r~h~l:J.E!jJerformE!di~ccordal1ce with City Codes and Or~inal'l_~es __
NO OCCUPANCY BEFORE C.O.
I~', ~~. ~
- ~~RAC~~-ruRE 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 ~ -7.;. r/'Ij,/-
DATE RECE IVED V
PHONE CONTACT FOR PERMITTING 8 ~q 13:s-dS-O
OWNER'S NAME G\~
JOB ADDRESS-3J '3 LU
~~_\LD ~
G. \\ \ A-tJ <e. .
i/L\
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ONEW CONSTRUCTION
OSIGN
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
o MOVE
o ALTERAT ION
o DEMOLISH
o REPAIR
QaNSTALL
OMULT I - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~OBILE
o OTHER
HOME
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
W/~OO flA~.
BUILDING SIZE
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.
PERMITS REQUESTED
~UILDING
l? ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o
W.R.E.~~
/:...._n----.... \
.~ PLUMBING
~MECHANICAL
$
o GAS
o ROOFING
o SPECIALTY
VALUATION OF MECHANCIAL INSTALLATIO
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
SIGNATURE
W~O~
gQ~~:~R'~~:~~~~~QN
........."..~::~D .d:lOAj teA d6
BUILDER
STATE CERT OR REGIST #
ELECTRICIAN , A
SIGNATURE C;.J7--- t?~--r
*********************************~********************************
COMPANY {lJ.J..
STATE CERT OR REGIST #
******************************************************************
SIGNATURE
W6;r-- ~~
**********************************~~~;~~*~~**~*************
(JJ ~_L)~
CCMPANYfi2l-h) l.(! h0
STATE CERT OR REGIST #
PLUMBER
MECHANICAL
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTI~E 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 portions 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 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 2~
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)
Owho 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 D:Hd not take an oath
Dwho 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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f.)AS(;() COlJNTY, FLC)RIDA
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I3llildel/\JC:lllle/qwn811\Jarne -LL~.~~tI.L!d.._-L /1(~.!(!.:J;pL2- Cuntrol #
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ClassificaticJlI/ I YI)8 of l JS8
I) .! /, \ 'i/
/ ,!.A!, )!.L:{c--"'---t"J.Lll1L.K.:.:..__u
THANSPOfHATI<JN IMPACT FEE Hate:
E:X8111pt II Yes l~/NU Ilow Determined
f.jCj Ft Ullit:
I " ,",. '7 N ."A/..'.
Impact Fee /\llIULlI)tJ.//:::1..}{.2,. 'H_ . .::one O. _______._ _..__
.) / 'j i 'I )
"(;--;....-. .......- "'-'~""--"-'",;;'''''''';f''~'C''' J,e.._d.".. <,..,"tl:'-'f..;:;,h.."....,. . ...... ,........ ....."
,,(,11001.. IMPACT FEE I
Acc()ullt (0116) Sillole..Farnily lletat;lJed HOIISA 1\1110 II II ( $
(OIii) Mobile HOllie ._._ ".___
(0513) Otller F<esidential
. jJ2::l) r:ollection 1:8e
Exernpt \(1 Yes L I Nu Ilow Determlned._...._..___
PARj(sANfjF~EimEA'fi6trFf:E... -c..".. ,~'..--
Lalld I\CCOIII II I,alld Credit
".1.......,""".---.., ,.....,_ ~.,..,.' 0 ',.1'"",. .."'- ..._....
..... ......"-;..,,..""'-,.', 0_. "."_,,.....'_, ,. ,...."', .'.,,'~ ", ., ,." "
laml 'j 0181
neel fliililJlI /\CCUllllt
I<ecreatioll Creelil l~ecreatl(J11 Total
IUlle
IOIAL AMOUI\n $
Exelllpt I] Yes !OJ No
T.iBRAf~V'FE(f
L811f1 A( ;(;lJlll II
Ilow Determined
"." ".. ......."" . ..., "'c>,.., "._,_. ......~.._.n...,.._,.. I, " '." ""'_'_". ..,..~, >., .........." ,~...."...,.
Li:lIId Credit
lat)( Ilnlal
Fadlitv /\(:(;011111
Facility Credit
Facility Total
Exempt I I Yes L.J l'-lo
Ilow Determined
Total AlllOllnt
.......,......-,...-_,-,'.......~-.~ ...."... .'''~.-~a'''-_....,_.,.,.-' ""."
RESOURCE FEE
T( ) IN. J\1V10UNl
." :" .~"".,,~, ... . -"~"""-",,..,, ,,,,........~-- ,".., , , ~. .....--~ 0'''':'. '-"'r "'__..,....,., c'... "'". .;.,'~.,,,,",-,,-"''',,,, ,._ "-""~,""'C"",,,,",,, ...... __ .._" '-"U'-~~"_.""_'-'O '., ..... . ......."_t....>.~_~."'--..""",,. "",. '_.,'................_~'"
Em,
PI 81 18rell13y
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Cf lecl<ed By
NO C~:rn'IFIGATE OF OCCUPANCY WILL BI~ ISSUED on FINAL. INSPECTION
PEHFORMEI> UNTil. THE TOTAL AMOUNTS USlJ:D HAVE
BEEN PAID AND
rU:ra:lPn~1l FOR BY A CENTRAL. PERMITTING Ot=PIGE OF PASCO COtlNTY
DATE
Ac:I;lIowledY81I1enl helow does Ilot Imply aGcsplancs of (;OJ\(;tlnsllce, bllt slinply rscelpt ofa(;opy of this fo rill , placlllU
tile hIlI/dillY pellllll OWller (1) lIotlce of tI ~Is assesslllEJnf alld the clJn(~UolIs of PClYII18)1 tor sallie.
// j 3-0.,~G. '
~yp ~CF.jVEn flY
[JAil {"fir~ l! BY
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