HomeMy WebLinkAbout04-3145
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
3145
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
----Work Desc: M.H:-SET UP
3145
MOBILE HOME
MOBILE HOME SET-UP
MOBILE HOME PARK
Address: 6130 RID EWAY DR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: ZEPHYR RIDGE
Parcel Number:
Name: GEORGE MERCER
Address: 6130 RIDGEWAY DR
ZEPHYRHILLS, FL. 33542
6/10/2004
4,147.51
Phone:
R
JORDAN (INDIVIDUAL)
JORDAN (INDIVIDUAL)
BAHR'S PROPANE GAS & AlC, INC,
IL
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIF/SUB 99%
SCHOOL IMP FEE/MOBILE 97,5%
WATER METER RES 3/4"
60,00 I WATER CONNECTION MOBILE HC
35,00 MOBILE HOME PLUMBING
1,572.12! MOBILE HOME TIF/SUB 1%
1,157,33 SCHOOL IMPACT FEE/MOB 2,5%
180,00
51~f(l(, ~
tJ{Zf 0
FINAL
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1__ _ ________._______ ~._______._ _______
I REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
I charge of Thirty-five dollars ($35.00) shall be made for each trip for each trade:
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(a) Wrong address (b) Candemned wark resulting from faulty canstructian (c) Repairs ar carrectians nat made when
inspectian called (d) Wark nat ready far inspectian when called
(e) Permit nat posted an jab site (f) Plans nat at jab site (g) Wark nat accessible
Th~"paYI'l1~I1_t ,?fil"l~pectian. fees shall be 1"1!C!~e befare any furthe~Fern:!its will be issued to. the e.ersoQ.. awning sam~__.
Camplete Plans, Specificatians and Fee Must Accampany Applicatian..
u _______AII wEr~shall be perfarm~!!!..accardance with Cit'f_<::E~es and Ordinances R-e5-,-R::r(, .J-S.sw
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NO OCCUPANCY BEFORE C.O.
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CONTRACTORS SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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t i- .'~;,:',-;:/.'7/~.~{'I!'J/ ~'~
APM.~H~OIPlfolfJi~T
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
DATE RECEIVED ~ - / - Of
PLANS REVIEW FEE
,.
o\>JNER' S !'JANE Ge 0 rc;\ 'e.' QJ Q f' Ce r- PHONr-?? 120 7! '1-9 y~_
JOB ADDRESS ~ / $IJ _ E,'dseUJCUf 'J) r.
LEGAL DESCRIPTION: LOT(S) 39 BLOCK SUBDIVISION ~~r P/d8~
PARCEL I D H 0 ~ - d (0 ~ rl. I - 0 I ~ 0 - DOOm- 0:3 9 ~BTAIN FROM PROPERTY TAX NOTICE)
vWRK PROPSEU: ONEW CONSTRUCTION
o ADDITION
OALTERATION
o REPAIR
Ii2rINSTALL
Os I GN
o MOVE
o DEMOLI SH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
On OF UNITS
o SWIMMING POOL
~BILE HOME
o OTHER
BUILDING SIZE
o
fJ.ew
dSY S (j-
RESTAURN~T & HEALTH DEPARTMENT APPROVAL
mOb/\{-e fiome ~pkemen+
SQUARE FOOTAGE 1.1.f5(P
HEIGHT
DESCRIPTION OF WORK
RESI DENTIAI.:
COMJvf~~RCIAL :
ATTACH (2) PLOT PI..J\NS & (2) SETS OF BUILDING PlANS & (1) SET ENERGY F'ORMS,
.il\TTACH (3) SETS Ol" BUILDING PLANS & (1) SET ENERGY I"ORMS.
PROPERTY SURVEY RF~QIJ I RED E'OR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
AMP SERVICE
o FLORIDA POWER
W,R,E.C. P'3/Lj5
Ii BUILDING
o ELECTRICAL
oIPLlJMBING
~ MECHANICAL
$ 3S DOD/(X)60
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VALUATION OF TOTAL CONSTRUCTION
'0
$
/500. DO
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOF'ING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
rif'O'l'HER
FIN1SHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES
(S;(NO
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C()~TQJt;:Sj:~~I~
BUILDER r~
SIGNATURE ~ ~
COMPANY ~r TFa.n sfvr'f-
STATE CERT OR REGIST n, :r:ifOOOO t.lCt 7
CITY PROCESSING n
***********.********.*********************************************
ELECTR!CI~~
SIGNATURE . Yf1~
COMPANY :SorJo V\..
STATE CERT OR REGIST
CITY PROCESSING #
E lec-kl\ c..
ne-p.ooO .8-7
****.************.~*****************************k*****************
PLUMBER ,r\.
SlGNATUR~~
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QlCLr-eI'\.c.e.. Tord 0 h..
COMPANY R WI':J..3 e.:-
STATE CERT OR REGI ST # F &0
CITY PROCESSING It
********************~*~*******************
l~CHANI
~ Y!7~
COMPANY
STATE CERT OR REGIST
CITY PROCESSING II
SIGNATURE
******~***************~********.,****~****************************
OTHER
COMPANY
STATE CERT OR REGIST n
CITY PROCESSING n
SIGNATURE
.*~**********~***~-****~*~**********k*.****k*k**********k*********
i:OND1'l'10NS r.'!;' PEi'.Ml'(' !\FFID.'\',;:~,'
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perini!:. may be sU~Jec': to -"deed r:eslri,:t.lons''- '"l:\.clo
may be more restrictive than City regulali':;>ns. Th~ undersigned asswnes respon:s~_L;.J.i ty for
compliance with any applicable deed rEstrictions,
B. UNLICENSEp CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertak~ work, they may be required
to be licensed in accordance with state and local regulations. If the contracto~ is not
licensed as required by law, both the owner' and contractor may be cited for ,1 rnisdemecliloJ.
violation under state law. If the m-mer or intended contractor a.l:e uncertain '::'s to tJl;:I1:
licensing requirements may apply for t:le intended wor1:. they are ad"i~ed te, contact the
City of Zephyrhills Building Department, 813-78(,-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have t-:be
contractor(s) sign portions of the "Contractor Sections" of this application fo~ which the~
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 contrDcLor WiS)10S
you to sign as contractor that may be an ir:dication that he is not_ properly licensed c,nd '~E
not entitled to permitting privileges in the City of '!.ephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTII.ITY CONNECTION F'EES
D. CONSTRUCTUION LIEN LAW (CHAPTf~R 713, FLOP-IDA STI...TUTE:S, AS AMBNDED)
I certify that I, the applicant, have been provided with a copy of "Flo~ida's Ccnstructjcll
lien Law - Homeowner's Protection Guide" prepared by the Florida Depa rtment ef l\gricul ture
and Consumer Affairs. If the applicant is someone other that the "owner". r (~eri t',' that I
have obtained a copy of the above described document: and promise in ,;ood f:d. th tn (le.L ver
it to the "owner" prior to co~nencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is
be done in compliance with all applic<lble laws .regt:lating
development.
Application is hereby made to obtain a permit to do work and installation as indicated.
certify that no work or installation has comm.~nced prior to issuance of a p~rmit ar:d l:!Jat
all work will be performed to meet standards of nIl laws regulating construction, C5.ty
codes, zoning regulations, and land development regulations in the jurisdiction, ] ~lso
certify that I understand that the regulat ions of other governmental agencies may appl~/ to
the intended work, and that it is my responsibility to identify what actions I R~st t~ke to
be in compliance. Such agencies include but are not limited to: *Department: Qf
Environmental Regulation-Cypress Bayheads, 'tletland Areas and E!'lvirornnenta.lly Sensi I:i 'I",
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypr:ess Bayheads, ~'ieLla,;d Areas,
Altering Wat.'rcourses
*Army Corps of Engineers-Seawalls, DOCKS, Navigable Waterways
*Department of Health & Rehabilitative Servic~s, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to b~ used in F'lood Zone "A" or '"'.n..,etc.", :it is
understood that a drainage plan addressing a "'conpensating volume" will be submitted T'lhj ch
is prepared by a prof~ssional engineer regist~red in the State of Florida prior to pe[rr~t
issuance.
A permit issued shall be construed to be a License to pI:oceed \-lith the work c;nd nr:;t as
authori ty to violate, cancel, alter, or set aside ar.y provisions of ;;.he technical cod",s.
nor shall issuance of a permit prevent the Building Official from thereafter requiring CI
correction of errors in plans, construction, or violations of ~ny code. Every permll
issued shall become invalid unless the work authorized by such permit is cG~r.enced \o/ithin
six months of issuance, or if work authocized by the perrot is suspended or aba!1deoned tOl: i1.
period of six months after the time the work is commenced. One 90 day exten:=:ion of time
may be allowed for the permit with fee charge of $15.00. The extension shall. be requestt'.d
in writing to the Building Official. Jm approved inspection must be logged during each si.:'.
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD .1\ NO'rICE OF COM~tENCCi"!ENT MAY RESULT } N YOUf"
PAYING TWICE FOR IMPROVEMENTS TO YOUF l?ROPE1l.TY, IF YOU INTEND TO OBTAIN E'IlJAN(;ING, CCiNSUl,'!'
WITH YOUR LENDER OR AN ATTORNEY BEFuRE RECORDING YOUR NOTICE O~ COMMENC&~ENT. JOB~ UNDEP
$~O IN VALUE DO NOT NEED TO RECORD AND POST A~TICE OF Crn~ENCEMENT".
C /L'/, 1. A Gh~ _ L h,.. 07 J
~ x:::/rfflL.{W-- .tbr~______.
SIGNATURE: OWNER OR AGENT
acc'Jrate and that il.U
c01IstructioI1, 2')ni nq 1
10W r;; ....' i. ..1
and lauel
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SIGNATURE:
CONTRACTOR
S'l'ATE OF FLQRI ~A
. COUNTY OF I--b..S CJ) .
The foregoing instrument was acknowledged
Before me this a,S'00-day of ~ ' ~~t)l{
by DOh /1\ ,^, 1"1'l f) () I"-
~ (name of person acknowledged)
bdwho is personally known to me, or
STJ.\'J'I~ OF r'LOIU I.lli--
COUNTY OF _L~ S CEO -.----..-
The foregoing instrument was acknowledged
Before,.lQe this ;!S~ay of fYlC<.( , ~ :}LJtJy
by D OV"l KC"-~^-o_
/ (name of person acknowledge-dl
L~O is personally knOlro"I1 to me, or
o who has produced
(type of identifjcationl
and whoD did Ddid not take an oath.
~~,-,~
o \-Jho has pr0dllc;ed___.____.______.__
(type of identjfic~t;on)
and who Ddid [}.:lid nct ti11~e an onth
~ ~~~~~<1
Signature of person taking acknowledgement
Signature of i'.~.cson t'1kinq acknOlo/ledgrne;:t
~ p'7 I /,'
uS~ H-n It. La-VCL-(/ee
Name typed, printed ar stamped
r:m'-"";)t~'i"';;"' ..',' ' ---"
; gt~ ,'%, SUSAN ANN LAVALLE:: .
.~ "."Ii<.;" .S Nofcry Pubfc - Stab of F\,,~.dc
1 ~~':'_ rB My Comm. B:p:-c3 Jun 13. ~"U4
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PERFORMANCE BUSINESS PRODUCTS., INC. 813-719-aOOll FAX 813-719Q9lg.
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CITY OF. ZEPHYRfllltS
ZEPHYRHIl!.t.S; FLORIDA
WATER ACel: NO~
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DATE
OWNER;
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SERVICE ADDRESS
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Q- ~ATER
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SHUT OFF SERVICE
o
13"/
cr/
o GARBAGE
TURN ON SERVICE
o SEWER
INSTALL METER
READ METER
o
!:y'" iN CITY
CHECK METER
o
o OUT CITY
OTHER
o
--L- No. OF UNITS
_ DEPOSIT AMOUNT
---
//:-
L....- .5c. <...",//
_ AMOUNT LAST BILL
/J~;
-+
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_ DATE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
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Retain white form 10 office at all times:' " -
Send pink & yellow forms, io \Nater Service !Jepl.
Nater' ServICe Dept to sign yellow Torm & return to office.
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ORDER GIVEN BY
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