HomeMy WebLinkAbout04-3277
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3277
Permit Number: 3277
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Dese:
4,600.00
8/04/2004
83.92
83.92
8/04/2004 Phone:
SCREEN ROOM AND CONCRETE SLAB
Address: 37415 TEA E RY LP
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: WEDGEWOOD MANOR
Parcel Number:
All E S 0
37415 TEABERRY LP
ZEPHYRHILLS, FL. 33542
o E
PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED
LINTEL PRE-METER WATER FINAL MECHANICAL
FRAME MISC SEWER MISC
INSULATION WALL MISC MISC, MISC.
INSULATION CEILING MISC. MISC. MISC,
DRIVEWAY MISC. MISC. FIRE DEPT. FINAL
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 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."
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
Y':CA1uL lS~ '&.e- ~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IVED
PHONE CONTACT FOR PERMITTING g; 5)'//5-0 7 Jf~
OWNER'S NAME ill-tOLe 6E.t.ClD 5
JOB ADDRESS :5/fi/ ( 5' IE'" bfilUZ-Y 4Jo r
PHONE
Zc:ph\./~' 115 , Fl-
.5-5.s- <J. -z--
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: 0 NEW CONSTRUCTION
DSIGN
PROPOSED USE: ~L FAMILY DWELLING
o COMMERCIAL
~DDITION
DALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
DMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE He
o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
Q,t>....., sTp-u--'- T
X12-EtN Yo1ZGh
J1.N:) G X I ; r/ ~
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
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o GAS
o ROOFING
o SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION'" 3;;2 7 7
o OTHER
o MECHANICAL
$
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
~~~r<"1'"~''''~''''''~-'- -,.......,... ,..'!"t'~~-~,.,.,..,.-."_..,,..... """-,,,,-,~: .--- ----- --- -- ~ ~- - ~-~ - ~,"'''-''' -- ~ -7"-~-"':;"TT ".-_M_......_~ --"7~:;"'7""~1--;-'f7~11;mr
l'I~J~'I;';t:l'!J:!FJt"J~1~'\JlrJ,i/" " 'j; 1",1,',1, ,I'" 'II ,1 I~ I, "1' I J;:11,~11" I ~~~~J!f/':f~i:~~~\/\t1Y~}~:/fp~
~.:~..dd.L.........~~--L..!.l-:~,,"~~_"""'~~...J......'~__~_____ ___ __ ~__ _ _ _ __~ _ __ ~__ _...... ~.-......-..--'-:~~L..).1._.J._"'-"~~~wt..Cl.::..~1 ..,~
BUILDER A~g .
SIGNATURE ~ui:-- () ~
'"
COMPANY
~~
STATE CERT OR REGIST #
******************************************************************
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. 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 pOftions of the "Cohtractor Sections" of this ~pplication 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 conunencement.
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 conunenced 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 conunenced 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 conunenced. 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: CONTRACTOR
SIGNATURE: OWNER OR AGENT
acknowledged
, 2 u..-
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
o who has produced
(type of identification)
and wtioO did Odid not take an oath,
o who has produced
(type of identification)
and who Odid DUd not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
February 17th, 2005
Bill Burgess, Building Inspector
Zephyrhills Building Department
Zephyrhills, FI.
Due to the very unprofessional work done to my home by
Aluminum Residential Works, Inc. I am removing Mr.
Smith from my contract and will contract the work myself
, ~ y
Uk dl-'p-dv!-~
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRBILLS BUILDING DEPARTMENT
I, !~ have read and fully understand and
agree to the provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own dOmicile,. that he or she
actually occupies, or will occupy by said domicile, and same is not for
rent, lease or sale. That he or she shall comply with the following conditions:
1.
That the owner and he or she alone shall act as the builder for all phases of
construction.
That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc., where applicable.
That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourself. You may build or improve a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $25,000.
The building or residence must be for your own use or occupancy. It may not
be built or substantially improved for sale or lease. If you sell or lease a
building you have built or substantially improved yourself within 1 year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your building. It is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your construction must comply with all applicable laws, ordinances, building
codes, and zoning regulations.
)G(lL~
2.
3.
4.
5.
6.
7.
8.
9.
OWNER'S SIGNATURE
ADDRESS
PHONE
~~
DATE
WITNESS
PBRM:IT #
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3277
Permit Number: 3277
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/Al T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 4,600.00
Date Issued: 8/04/2004
Total Fees: 83.92
Amount Paid: 83.92
Date Paid: 8/04/2004 Phone:
Work Desc: SCREEN ROOM AND CONCRETE SLAB
Address: 37415 EABE Y l
ZEPHYRHlllS, Fl.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: WEDGEWOOD MANOR
Parcel Number:
ALICE S lETOS
37415 TEABERRY lP
ZEPHYRHlllS, Fl. 33542
LL
PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED
LINTEL PRE-METER WATER FINAL MECHANICAL
FRAME MISC SEWER MISC
INSULATION WALL MISC MISC, MISC. F I Jo\~l-e4 ~ {3o (0 \- HJb
INSULATION CEILING MISC. MISC. MISC.
DRIVEWAY MISC. MISC. FIRE DEPT. FINAL
REINSPECTlON 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 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."
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
~.
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
~
5-;"- -d~
5~~
~7ifl:;- )
~~. ~.7P'
./~ JUL.tJ
333-4:2-.
-------.
~1)j-~{) Prf/
/
fJ - .
- --" - - {
LJRT OF THE SIXTH JUDICIAL CIRCUIT
R PASCO COUNTY, FLORIDA
~:~o~~: ~5-SC.133~S ~." ~
~,4- /'r" /J ),~ ~
( ~ ~ I, 7 I ?cJ.:5
((If)O
SUBPOENA FOR TRIAL
f! 11t~
, /V:5'1/
THE STATE OF FLORIDA:
TO: BILL BURGESS, BUILDING OFFICIAL, CITY OF ZEPHYRHILLS
5335 EIGHTH STREET
ZEPHYRHILLS, FL 33540
c',' 1:-:':
YOU ARE HEREBY COMMANDED to appear before the Honorable WILLIAM G, SESTAK, Judge of the
said Court at the PASCO COUNTY COURTHOUSE 38053 LIVE OAK AVE DADE CITY, Florida on August
12,2005 at 1 :30 P.M., to testify in the above styled cause, If you fail to appear, you may be in contempt of
court.
You are subpoenaed to appear by the following attorneys and unless excused from this subpoena by tile
attorneys or the Court, you shall respond to this subpo9na as directed.
WITNESS my hand and seal of said Court on July 8, 2005,
JED PITTMAN
CLERK OF CIRCUIT COURT
. (seal) ~y: ~ ~
. ,Dep Clerk
AUCE"SELETGS .
~?415TEABERRY{OOP
ZEP~RH-lbL-S;'FL 33542
Name and Address
FOR PROCEEDINGS BEFORE THE COURTS OF PASCO COUNTY
IF YOU ARE A PERSON WITH A DISAPBILlTY WHO NEEDS ANY ACCOMMODATION IN ORDER TO
PARTICIPATE IN THIS PROCEEDING, YOU ARE ENTITLED, AT NO COST TO YOU TO THE
PROVISION OF CERTAIN ASSISTANCE. WITHIN TWO (2) WORKING DAYS OF YOUR RECEIPT OF
THIS SUBPOENA FOR TRIAL PLEASE CONTACT THE PUBLIC INFORMATION DFEPT., PASCO
COUNTY GOVERNMENT CENTER, 7530 LITTLE RD. NEW PORT RICHEY, FL. 34654 (727) 847-8110
(V) IN NEW PORT RICHEY; (325) 521-4274 EXT. 8110 (V) IN DADE CITY; VIA 1-800-955-8771 IF YOU
.. ARE HEARING IMPAIRED. NOTICE: PROPER DRESS IS REQUIRED FOR COURT, or you may be held
in contempt or refused admittance. NO shorts, tank tops, undershirts, etc.
Issued: 0 Sheriff of Pasco County
o Sheriff of County
[8J Ret'd Pltt/Def
o Ret'd Atty
o Ret'd Process Server
SUBPOENA FOR TRIAL R091603
.'
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3277
Permit Number: 3277
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
4,600.00
8/04/2004
83.92
83.92
8/04/2004 Phone:
SCREEN ROOM AND CONCRETE SLAB
Address: 37415 TEABERRY LP
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: WEDGEWOOD MANOR
Parcel Number:
All LETOS
37415 TEABERRY LP
ZEPHYRHILLS, FL. 33542
L ALL
PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED
LINTEL PRE-METER WATER FINAL MECHANICAL
FRAME MISC SEWER MISC
INSULATION WALL MISC MISC. MISC,
INSULATION CEILING MISC. MISC, MISC.
DRIVEWAY MISC, MISC. FIRE DEPT, FINAL
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 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. n
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
~~~/b- ~~
CONTRACTOR SIGN URE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CiTY OF ZEPHYRHiLLS PEmaT APPLiCATiON
BUILDING DEPAR'DmNT 5335 8ft St, zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED '1/2.~/Q 'I
PASCO PERMtr SERlff<
CONTACT FOR PERMI'l'TING r - cglCCc - g}..l.{- - 7 g q tj
PHONE
OWNER'S NAME A llC.~ S eLe.. to s
JOB ADDRESS c ~ 74 I 5 T ea.ber r 'j Loo p
PHONE
LEGAL DESCRIPTION: LOT(S)
SUBDIVISION We~ewa:xd.
PARCEL ID * 'O-~c,-D1.I- OI.;l.O-()(;)(;)(X)-Ol70 (OBTAIN FROM PROPERTY TAX NOTICE\
WORK PROPSED: ~W CONSTRUCTION jJ( ADDITION OALTERATION 0 REPAIR 0 INSTALL
o SIGN 0 MOVE 0 DEMOLISH
PROPOSED USE: 9'GL FAMILY DWELLING OMirLTI-FAMILY 0* OF UNITS
o COMMERCIAL 0 INDUSTRIAL 0 SWIMMING POOL
BLOCK
o MOBILE H<MI
o OTHER
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK Sc..re",Y'\ RQ)rvj ~ rDn~e.te 6la..b
U:r ' f " .J,.,
BUILDING SIZE --1.J X q -(n SQUARE FOOTAGE ~
HEIGHT S{!"e l.:Jiet.4t;,.
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
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 CONSTRUCTION.
(l( BUILDING
o ELECTRICAL
$ .J-/ ~ O{) . ()O
PERMJ:TS REQUESTED
& (1) SET ENERGY FORMS.
FORl-JS .
)/ - ~
~ 2, ~ '-.) 1-J-i)6.
1,4-1- /l1+J)~~
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
OGAS
o ROOFING 0 SPECIALTY
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDER
SIGNATURE ~ ~W~I b-
~~~~-'~{~g~~~ ;/
,
COMPANY.AlLunI'hLA.m. Re~ldet'\tt~( Wor~
Ric.htlr-e;\ S~i+1--
STATE CERT OR REGIST *
******************************************************************
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST *
******************************************************************
PIamER
COMPANY
SIGNATURE
STATE CERT OR REGIST *
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST *
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTIGE 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 the
will be responsible. If you, as the owner signs as the contractor, you are indicating tha
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 i
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 ~owner", 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.
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 t(
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'c
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 si~
month period, or the project will be considered abandoned.
WARNI~G 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, CONSUL1
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
STATE OF FLORIDA "/:)
COUNTY OF ~U!)
The foregoing instrument was acknowledg:~d
Before me this ~day of ,T LA1~ ' 2\LQ.:r
by -5tac.t~ Zullt>
(name of person acknowledged)
~hO is personally known to me, or
o who has produced
(type of identification)
Odid not take an oath.
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged~,1
Before me this ~ay of .::fw'1 ' 20 Q:r.
by St'~CI ~ ---ziZ[lo
(name of person acknowledged)
~hO is personally known to me, or
o who has produced
(type of identification)
~id not take an oath
Pa.sC..o
Name typed,
f person taking a,~.knowlf~ement
,,". :-,uzanne
,~~,l'v~"~</" C'ommission #DD157\31
,,~ '"~ C> - . 2066
printe~ 0 , :~MiNOV 15,
____-:;~~, , ' ,<l',~ Bonded lOrn
// III~~ \V'~ \,' Atlantic Bonding Co., Inc.
Name typed,
erson taking acknowledgment
;.ev;i', ,~)uzanne Bahr
; ,,"(/ _ COllUllissislI #00157131
pz.:tnh&i~~~~pi~~A, 2006
-"'-,. 0' ,'-O~>' Bonded Thru
.,', Atlantic Bonding Co" Inc,
NOTICE OF COMMENCEMENT
State of -EI 0 ri d CL
County of _p ~S CD
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:
1111111111111111I1111I1111I111111111I11I111111I111111111111I
2004143414
Rcpl : 803807 Rec: 10.00
OS: 0. 00 IT: 0. 00
07/30/04 __ '______ Dpty Clerk
3. Owner Information: Name-AI ir.~ Sp- ~to5
Address ..374 15" ~f'rr'f L("){jp
Interest in Property:
City Zephyrbills State FI. 3354.;t
JED PITTMAN, PASCO COUNTY CLERK
07/30/04 01: 49~ 1 of 1
OR BK 596:) PG 795
Name of Fee Simple Titleholder:
(If other than owner)
Address City
A Contractor: Name -A1 L..Lrh i nu..rY\ Re.s ide n+, '0..1 W 0 r k~
Address 37Q, LSp("in~dcJe Rd. City Zeph'(rhi ILs
5. Surety: Name
State
StateE]. 335~o
Address
City
State
Amount of Bond: $
6. Lender: Name
Address
City
State
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 in Section 713.13 (1) (b), Florida Statutes. '
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date
of recording unless a different date is specified.)
Signature of Owner: ~~\.fi.~.,I} ~
Sworn to and subscribed before me this 0?'8'%- day of
~
CT~
,20~,
Notary Public:
\\11/
, ~
My Commission Expir
PC930530481 A
L~~':t~ Com.mis~ion#DDI57131
:_~. 'il.9c Expires. Nov 15,2006
....:~OFf\.o~\" . liondt;d Thru
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A L TE'Rf'JATt KtJEt WALL FODlll'Jc;
fDR. 6CR.EE tJ OR- GL-A-6s Roo M-,s
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It!"" ~~\.
4# 3000 PSI CCJlICRETE SLAB \/ / 6x6-10/lOWM
tR nBERMESH ,
OVER 6 MIl POl YF"ILM \// EDGES LAPPED 6'
a. TAPED OVER a.EAN CtlFACTED TERMlTE TREATED SOIL
\// tOU.ITHIc\o".x \~'" FIG. \/~r)15 REBAR aJrT.
ON CHAIRS I 4' o.c. MAX
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@ CORNERS &EACH SIDE or JDJR IlPENDIGa.8' o.c. MAX
J't)~CP15'
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I hereby CePMlf'y 'tho."t I helve J>>rf'ONIed a.nd rttv..ed 1:hIs plo.n a.nd found
Ii: i:o' be In COPIpUcanc:e wtth design recp.r.....ts for 110 "Ph wind load
per section 1606 oF tiw F'LtIUDt\ aID 1I'Ni ODE., 2OD1 eell tkNt.
Do""d W: SlItf+h P~e:.
A L TtRt0ATE' KtJEt WALL FODlltJC::,
"FOR. -SCREE rJ OR- GL.A-6S 'Reo M6
16 CIlNC. BlOCk
kNEE VALl
4' 3000 PSI ctN:RETE SLAB V/ 6x6-10/1OWM
DR FIBERMESH .
OVER 6 MIL PI1 \TILM V / EDGES lAPPED 6'
.. TAPED OVER a..EAN Cl:lFACTED TERMITE TREATED SOIL
V/ MlNJUTHIC 16'x!2' fiG. V/2 15 REBAR aJrT.
ON CHAIRS .- 4' o.c. MAX
e VERTICAl.. REItFfR:EMENT V /STD fDJ( IN GR[lJT FILLED CElL
. CORNERS &EACH SIDE IF DIXIR 0PENlNGtr8' D.C. MAX
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I hereby c:eriWy 1iho:t I helVe ..,.farMd a.nd Mrvle.ed this plo.n unci found
It 1:0 - be In cOPtpUclnc:e with design re~PIerrts fPor 110 "Ph wfncI loGd
per section 1606 of' -the F'LIJUDA aJII..DING OJ:JE. 2001 eel tfan.
Dct-iAd W, S'PIIH+t P.~.
SCAEBI ROOM
EXJS'TN)
HOUSE
I is
BACK aEVA TION
E>CIS'Jt4G
HOUSE
:J" coqlOSie penets
wIh O.sB. for shi1gIes.
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SI)E aEVA TION I
9'8"
I
City of Zephyrhills
Building Department
5335 Eighth Street
Zephyrhills, Florida 33540
(813) 780-0020
Fax(813)780~1
w. A. "Bill" Burgess
Director of Building
Licensing & Zoning
Alice Seletos
37415 Teaberry Loop
Zephyrhills, Florida 33542
Ref: Screen Room Addition
Permit #3277
Aluminum Residential Works
To Whom It May Concern,
I was contacted around September/ October of 2004 by the property owner. She
had concerns about the construction that was being done at her home. I
conducted a brief inspection and found some deficiencies. I told her she had
legitimate concerns, I also told her that the project was still under construction
and that corrections could still be made.
I assume Ms. Seletos contacted her contractor because I received a call shortly
thereafter from Richard Smith. He wanted to know why I had inspected the job
because he had not called me to do so. I told him Ms. Seletos requested me to
look at the project because she had some concerns. He implied I didn't have the
rite to do so. I assured him that is exactly what I should do when someone has a
concern about work that is being done within my jurisdiction. He asked me what
the problem was. I told him he was not constructing the addition according to the
engineering that he submitted. I also expressed my concerns about the wall
flashing that he installed. I told him the flashing should be installed under the
shingles and either be cut into the abutting wall or installed under the siding. Mr.
Smith told me Ms. Seletos no longer wanted him to finish constructing her
addition. I told him that was something that he and she would have to work out.
Sincerely
b~ /;~S
Bill Burgess
Building Official
City of Zephyrhills
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Ernest S. Silcox, PE000816J
Silcox Engineering, 1m.
Civil Engineering
Post Office Box 8574
Tampa, Florida 33674-8574
(813) 988-3181
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