HomeMy WebLinkAbout04-3402
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
RESIDENTIAL SWIMMING POOL
3402
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost: 35,155.00
Date Issued: 9/28/2004
Total Fees: 385.00
Amount Paid: 385.00
Date Paid: 9/28/2004 Phone:
Work Desc: NEW FIBERGLASS POOL WITH SCREEN ENCLOSURE
3402
SWIMMING POOL RES.
POOUNEW
SINGLE FAMILY RESIDENTIAL
Address: 39697 MEA 0 0 LP
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: MEADOWOOD ESTATES
Parcel Number:
Name: JOHN MICHON
Address: 39697 MEADOWOOD LP
ZEPHYRHILLS, FL. 33542
BARRIER REEF LS OF FL RIDA
ROGERS ELECTRIC
BARRIER REEF POOLS OF FLORIDA
BUILDIN FEE
PLUMBING FEE
ELECTRICAL FEE
POOL STEEL POOL DQCK 8t FqoTER
POOL PLUMBING/PRESSURE_ FINAL V '2 / !iL.tlS...
1/1
REINSPEcnON 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
~-~
CTOR PERM IT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
PHONE CONTACT FOR
DATE RECEIVED 9 -1.3 -or
PERMITTING 7€j-l SS'::'-J
(8/J) ~-
PHONE 779- ~'f;r J.
OWNER'S NAME
j4An .( 111 i~b1tl
3Cj~l}7 ~c:dotOood lp
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # , J -aCo- dJ.. 0.40 . E>VOOO -D~c=tD
WORK PROPSED: ONEW CONSTRUCTION
Os IGN
o ADDITION
(OBTAIN FROM PROPERTY TAX NOTICE)
'"Poo I
OALTERATION 0 REPAIR 8-1NSTALL
Wl,,,,",,- ~
o DEMOLISH ~O~~
o MOVE
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULT I - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
CJ RESTAURANT & HE~TH DEPARTMENT APY..gy1:' 35' tu/ 8 I w4lU
DESCRIPTION OF WORK -:::}.~ crool ~~""- Id/ s..u.IlJ;;.d f Jfl.LiCbuA.J......
BUILDING SIZE SQUARE FOOTAGE HEIGHT
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.
o BUILDING
o ELECTRICAL
'2.. c::. i)4J
$ I-^.). \ 55.
PERMITS REQUESTED
& (1) SET ENERGY FORMS.
FORMS.
?,~~LI)~
f ~ -. l j?\"~ (J.
'~)-, ~l. f5..1ji..,L .
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o FLORIDA POWER
o W.R.E.C.
o PLUMBING
o MECHANICAL
o GAS
o ROOFING
o SPECIALTY
'O~
VALUATION OF MECHANCIAL INSTALLATION >>. ~v{
o OTHER
$
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
CONTltACTORyiSECTION I
BUIIJlER J ." e~PANy-iu"i~ ~r.J~ ~~dD.
SIGNATURE~*:*:~~************.*::~:~*~~~:*~~*~~~::*:*~:*~"7L3
ELEeTlUC~ . A ", ~
SIGNATURE ~~~"" STATE eERT .
*****~*~**********************************************************
COMPANY
PLDMBER .. ~ .. COMPANY~M~.~:~7DO!) ~ ~~
SIGNATURE~ STATE eERT OR REGIST # ~/<l567J.l
******************************************************************
MECHANICAL
COMPANY
SIGNATu:RE.......t.C~.. ..?,;,,-:~,,J,w.. :,~~....,}..N.f. .; S'T~~. ,,~'E '0R ..~~if#..,~.' '.';'.~~""
"~,,,,,,h f"~.f l"<l,;t~"'~"~l._'" .' ( "{'.'.""'" _ ""1",-,.""
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1~;O>~". .4/ "\f Ji/_ /r,'i~S.";~i ;1~",';0~" 'A~')':~'
OTHER:, d;i - /fIU-11 IV'" . f-IlJJ 111 . cot~J(~k~~3!:~l:~~-t~
STATE CERT OR REGIST #.~~y~
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 assu~es resp~nsibilitj' 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 und~~ state law. If the owner or intended contractor are uncertain as to what
licensing: req~i~ements 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 fo~the work. If the, contractor wishes
you to sign as contractor that may be an indicat;ion that h'e 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. GONSTRUCTUION 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 ce~tifytha~ all the information in this application is accurate and that all work will
be done in.c~mplian~e with all appliqable laws reg~lating construction, zoning, and land
deve16pment: ''I', " ,",
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 fora
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 TQOWNER: YOUR,FAILU,RE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBT,AIN FINANCING, CONSULT
WITH YOUR LEND~R OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE,Q ,COM~ENC&MENT. JOBS UNDER
$2,500" IN 'VALU DO NOT NEED TO RECORD AND POST A "NOTICE oF"co ENCEMENT".
STATE OF FLORIDA'~ .J
COUNTY OF ~,
The foregoing instrument was~cJnowledge~. J
~~fore m~~~\t~ of <:;l<UIf-' 2QjL,
~~name of person aC~edged}
,who is personally known to me, or
STATE OF FLORIDA ~. ,
COUNTY OF r-aac..o
The foregoing instrument was~~kfoWledge~l
Before me this ~day of , 20~
by
(name of person acknowledged)
~ is personally known to me, or
o who has
ent
~:~'
Sign i(~". ~ 't'a*l~~ dgment
":l), '< ".' ~,T,t,mlSSion #1)024113970
',,,,,,, Bonded IlvNq......-.
'''''''U 'k:'\',l,ar..
Name typed, printed or stamped ,:"";
of identification}
ae an oath
, "
Name typed, printed or stamped
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POOL WORKSHEET
BARRIER REEF
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Phone 779 - ;;J V.22
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Job Description
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G:'My Documc:ntslBanitrr Rc:efPools llfFloridalPool Worksheet 070903.doc
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RESIDE~tTJ8J..,__SWIMMJNQJ~QQh~_QPA ANO/Of{ HOT TUB SAFETY ACT
NQTICE.OF HEQUIREMENTS----.--- .---.--
-" , - __ - __ - - n__ __.. _.~_ . __. .. _ . _.. __ _.. _ __ ._ _. ___.___ _".. _ ___
I (We) acknowleclqe that a rww sVJilllrllinq pool, SPd 01 hot tub will be constructed or installed 8t
- 5>6? J $..e.~~C..am._6/_ _.. ._....., ,Hld Iler eby <lHirrll 1I1<1t one or the following
fPI~il~1! Prinl Strp.el ^dd".'~~)
methods will be lIsed to Ineel the requirPlllpnls or (;hClptel ~"j, Florida St;Jtutes
+~..n";I;~~~:::r';,~d~:V~:"~I'~~:~ I""n 'JCcess In Ihe h",ne hV on endus",e Ihall1Jeels Ihe poul ba"ler
requlrerllenls of f-Iorlda Statute GIG 29,
TI1~'pool will be equipped witl1 8n Clpproved safety pool cover that complies with
ASTM F1346-91 (Standard Perforrnallce Specifications ror Safety Covers for Swhnrning Pools
Spas and Hot Tubs), ,
All doors and windows providing direct access "UIII II". :!'IIIl! lu the pool and located within the
enclosure/fence required by fhe Pasco County L,Hld Ueveloprllenl Code, Section 530.-1(D), will
be eqUIpped WIlli ,111 eXI' ;1I,lt111 Ih;:11 h,~s rl Illillirlllllll SOlll1d pressure rating of 85 decibels at 10
feel,
All doors providinq. direct ;:1Ccess frolll the home to the pool and located within the
enclosure/fence required by the Pasco County Land Development Code, Sectloll 530.-1(0), will
be equipped with self-closing. self-latcl1inq devices with release mechanisms placed no lower
than 54" above the rloor or deck,
I UNDEHSTAND AND AGI~EE TI fAI NOT I fAVINC; AT LEAST ONE 01: THE ABOVE INSTALLED AT
THE TIME OF FINAL INSPECTION, or~ WilEN lHE POOL IS COMPLETED FOR CONTRACT
PURPOSES, WILL CaNST" UTE A VIOLATIOI\j OF C"APTEr~ 5" 5, F.S. AND WILL BE
CONSIDEHED AS COMMlrTINC A MISI)EMEANOr~ OF TlfE SECOND DEGREE, PUNISHABLE BY
FINES UP TO $500 AND/On UPl () (3() DAYS It'J JAIL AS ESTABLISHED IN CHAPTER 775, F.S,
I FURTHEr~ UNDEr~s rAND AND ,l\GI~E[ THAT THE Q.wNEB-At--JQ/0R.J;DlUBA.CIOB WILL
COMPLY WITH THE FOLLOWING REGULATIONS CONCE~f\JJN(r~WJMMJf:.JGl'Por..',--SPAAND/OR
HOT TUB ENCLOSURES, IMMEDIATE!. Y UPON COMPLETION OF TIlE SWIMMING POOL, SPA
OR HOT TUB, IN COMPLlAr,ICE: WI I II ~';ECTIUI\j 5:30 4(U), PASCO COUI\/TY LAND DEVELOPMENT
CODE:
, ~ ~c("\;onSIIUcl a,ou"d Ihe sW;'''''';''y pool, spa 01 hol !lIb a MiNI. MUM FQ!Jr-,RFOPJ J!LqJI FENCE with self-
; clOSing, self-latchll1g gales 1 he fence musl nol have any qaps, openlngs,lndentallOlls, protrusions, or
i structural components that could allow rl young child to crawl under, squeeze through, or climb over the
! fence Gates must open cll;lward away frorn pool area The releasinq mechanism of the latching device
must be located on the pools ide of the gale and so placed that il cannot be reached by a young child
over the top or through any opening 01 gap hlo opening in Ihe fence may be large enough to admit a
four-inch sphere
7
Construct a screen enclosure aruund the swimming pool, Sp<1 or hot tub with self-closing, self-latching
screen doors Latches on exterior screen doors must be rninlrnulll 54 Inches from the exterior access
standing surface All screen enclosures require 8uildinq Permits.
Provide and utilize an approved safely, swimming pool, spa or hot tub cover that complies with ASTM
F1346-91 (Standard Performance Specifications for Safety Covers for Swimming Pools, Spas and Hal
Tubs), Such cover Inus! be capable of being securely fastened over the swimming pool, spa or hot tub
when not in use
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I FURTHER UNDERSTAND AND AGREET I fAT one of the enclosures described above will be completed prior
to final inspection of the pool, spa or hol tub
ADDITIONALL Y, , FURTHER UI\lDERSTAtJlJ AND AGREE THAT the owner will require his/her pool contractor
and his/her screen enclosure contractor (if applicable) to request and successfully pass a final inspection
immediately following the completion/installation of the swimming pool, spa or holtub.
IF THE S!Gt--J^.TUF~E of the Contractor, acting as agent for owner, appears below, the Contractor prolllise~ In
good faith to make the Owner awar e of the above-descr ibed r equirerncnts ~md penalties before cOlmnenclng
construction
SWORN AND SUBSCRIBED BEFORE ME! IllS
//"" ,DAY OF A~_____..__, 2012"(
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\ J In j 0 A'.f,
.------~~O~~~~Gn7\ftJr~E:
dr.~ I/~~ K.J
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r'LE^SF lYPE 0 RINI N^ME ^80VE
#-.".y,~ JUDITH L. SCHAPER
\w.# MY COMMISSION # 00010092
It D"\'~ EX PIRBS: June ~ 2005
1-8Q0.3.N(\1'.'~ . !. i'10'iW '1erv1ce & BancIng. Inc.
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1-91-19950:14AM
FROt-1
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in ~~fR;gr'ess Energy
INVOICE
I Cv$t~;;r Representatives Name
i JOHN K. MICHON
I AddreS5 -"- Clly State /z.
39697 MEADOWOOD LP ZEPHYRHILLS FL 33542
Work DeScription
I
COST TO RELOCATE A PORTION OF A SINGLE PHASE, 3-WIRE. UlG S:RVICe FOR INSTAJ.LATtQN Of A POOL AT 39697 MEAOOWQOD LP, I
ZEPl-fYRHILLS
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I Re"'bucsemeot Charg.. $406.50
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IX] Work A\.IthorizlItion
o Job Order
WR' rn~~#'$~F""l
. l.c,~:..._::r~.., ;~..:,~i~",,':"".
CIIST~
I Billing Method Terr.ls of Payment
I 00 Cl}fltr"act Pri~ $ 406.50 o Cost o Cost pJl.I$ 15% On 0( before 20 daY6 after Otl1e"
~ In Advance o Completial of project o Explain below
rOther ~ em'lt; of Paymenf - -
Ownershi;> of oomplet.eCl .,roject Oate Payment Received
L lKJProgI'Q$$ Energy DCuston".er
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AGREEMENT
The Customer is respol'Isible for the cost, repair or replacement of (1) sod, tree&. shrubbery or ~r plants damaged in the norma' course of
performing or gaining access to the above work, anCl (2) dam;ge 10 non.Prog~ss Enetgy undergl'O\.lndwirQOl, conduit, Pipe3 or Olner utJJit~ iacjfjtJe$
that haY6 NOT been $taked or located by own9r 0/ the fadlili... Contract price and terms of payment bQcome inwllCl jf ~e si;Jned agreement i~
not received by Progress Energy on or before .... 30 DAYS.
"T"he unQ'GfSlgne(;l hereby al,ltl'lorizes and employs Progress Energy to perform the above jOb and to fIlrnish labor, necessary facilitie$ or
equipmetll and 1 or materials for the above Job and egrees to pay if) accordanoe with the terms of payment as noted abOve.
I :~'~~Of \1 C~_~Ob'"
Il\Iame (?i4>aSe 4"::;;ype)
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AUTHORIZATION
I Date
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i Date
:CF"l~ Or"il"l'f VtIr fIn ""J'IT~
~~4-001
Barrier Reef. c;PooC5 ~of P[orUfa
8949 Gall Boulevard, Zephyrhills, FL 33541
Local (813) 788-1555 Fax (813) 7154875 FL Lie #CPC1456713 www.banierreefpoolsusa.eom
Customer I John Michon
Addre~-39697-~~~-~~~~-~-~~-~~~~:~-~~~~~-~-~~~'~-~~~-~~~:~~~"
City L.~............... Sta~ Fl . Zip ~ 33541
e..... .... .... ..........: ~..............
Salesperson
Richard
_~"_~_1o~"'-_1o_"_lo~__~"'_"'1olo~
Phone 81~~2422
...~
Date ~ 05-07-04
P......................................................
MODEL:
13 Included
Included
Included
Included
Included
Sorrento
Permit
1 HP
#125 CartJid e Filter
Salt Water Chlainator
Tile C. 2 - Tile S1andard)
COLOR:
Included
Included
Included
Included
.-Peeilic- 0t.E0. V\
standard Electrical Connection
Instala1ion
start- Chemicals
Hand OVer E .
18,700.00
Included
Included
Included
Included
Included
Included
HEATING OPTIONS
ical h120
35 If
WATERFALL OPTIONS
3 'Waterfall in Tile
DECK OPTIONS
Ac Iic Deck wI Concrete 257 S Ft
SCREEN ENCLOSURE
Screen enclosure 23 ' x 35 ' with 8 . walls Bronze
Su er Gutter with 2- On S uts
2 - Screen doors with ke ed locks
Aluminum Pan Roof 6 ' x 35 '
Shuttle Dig
15,655.00
~;~~W1.i~ti~11~ltlmJt~<<f~ll}wwtflil~ff:{?!I~fr_*~If:')i1Wff~
)1gi1~lW;Wi1rtwl~1t;l*~f~~tj~~L~%.MMi*t4ti~~Rt~~_lm~~t~1j
PAYMENT
SCHEDULE
Retainer ##
10%
40%
40%
8.58%
Balance ##
800.00
m,15S.00
$0.00
'$3,516.00
. $14,062.00
$14,062.00
$3,015.00
$500.00
Finand
ent 1- due U on D SheS & FiItra1ion
Tie Beam 'n Fonn
SCreen & Deck
Handover E .
DELIVERY of is scheduled for
ITEMS NOT Electrical Service; Rock Excavation; lJndergroW1d Water or problems caused by Stann Water.
INCLUDED Relocation of Service Lines; . of removed debris.
ClIent hereby agrees that BARRIER REEF POOLS OF FLORIDA Is not responsible (but aU care taken) for any damage to concrete,
driveways, paths, gardens, ooderground dnms, ~es. etc., or any plant life on or near the route of access and around Pool Area.
Price valid for 30-days. CoUection costs if any. together with interest shaH be added to the contract price if payment defaul occurs.
Cancelation of the contract after the 72-hour grace period shan incur a nominal fee.
BA~RI F~POO OF RI CUSTOMER ACCEPTANCE I
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DATE I
.sIll to (,(
I
RRP .Inhn Ui,.hnn nM71\4
STATE OF FLORIDA
COLJNTY OF PASCO
THIS IS TO CERNY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
OR OF PU IC RECORD IN THIS OFFi~'E I~ i 5S MY
HAN D OF. IAL SEAL THIS DAY OF
2Al2
J PITT K OF CIRCUIT COURT
'~fP"NOTICE OF COMMENCElVIENT
111111111111 11111 11111 11111 IIIIIIIII! \1111111111111111111111
2004138922
Rcpl: 801970
OS: 0.00
07/23/04
Rec: 10.00
IT: 0 . 00
Dpt.y Cl",rk
State of Florida
County of
JEO PITTMAN. PASCO COUNTY CLERK
07/23/04 0.3:1~m 1 of 1
OR BK 595b PG 265
(3;..5- c cJ
Hk-
Permit No.
"'1 I A-
Key No.
THE UNDERSIGNED hereby gives notice that improvement will be made to certain
real property, and in accordance with Chapter 713, Florida State Statutes, the following
information is provided in this Notice of Commencement:
1. Description of Property: Parcel No. /;3 - lye; --;l/ - o/yO- c>(?c>c?e> - 07'20
2. General Description of Improvement ,~o / tf E:r.,'?hjcc".e~e.
3. OwnerInforma~ion: ~ame vk~/V ~, //J./cAo,u
Address ..396 9/) f11;,~"o(uo City .A-/A.~rz-L//.> State p/
Phone No. 8\3.'..nq.a'-fiI-J. Fax No. ~/A-
.
\4. Contractor: Barrier Reef Pools of Florida, 8949 Gall Boulevard, Zephyrhills, and FL
" " 33541
5. Surety: Bauer & Associates, 14427 ih Street~ Dade City, FL 33525
6. Lender: Name/Address:
^ItA-
7. Persons within the State of Florida designated by Owner upon who notices or other
documents may be served as provided by Section 713 .13(1 )(b), Florida Statutes.
8. In addition to himself, Owner designates Barrier Reef Pools of Florida, of
8949 Gall Boulevard, Zephyrhills, FL 33541 to receive a copy of the Lenoir's
Notice ~s pr'Jvided i!l Se-:ti('!l 7!3.!3(1)(~)(7), F1ar:d~ St:!.t'..l!~~.
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the
date of recording un! s a differctnt ate is specified.)
, ,t-
'* Signature of Owner: , ~I
Owner Printed Name: ~c i.dv I~ /l}, 'LAc /v
'" ID:N),.2 b 7795 C:/? Personally Kno"'TI
Notary Public:
(Type, Print, or ~
~/
204
~.".YP(J~ JUDITH L. SCHAPER
~ V '" MY COMMISSION # OD010092
"1'OFft,.<ft'''' EXPIRES, June 6, 200~
t~.~.~ .~fJ1:)~~.~~.~~~__.~~,~~~~~~~ry, :.~~::~. ~C"'!~~~'.,I~:1.._
Building Permit Application Affidavit of Intent
CY.,..,J,. SJ,,"fPr, do hereby state that this building
Contractor
Permit application for 3969,7 ~4?c:?~~ for a
Location '
New custome . AeJ--1../ or is a Spec unit.
I also will have the building permit application picked
up within 3D-days of notification that the application is
Ready. I can be contacted at ~'3~J83'- 3d-3o or
Phone
j\~<Q.. ~~~U)n~-f-rw.--k~.( tI,,\ I further understand that
E-maIl
in order to pick up the application and have the permit
issued I will need, as a minimum, to bring the
Following: ...
1. Deed showing ownership of th~ lot
.? f\Jnr ("\r ~ffi~'::l' ,if ........,-.. Ii..",,"'! h" C" ~ ~.L: _ _ -, A,.., .--, _' _'._
-. . - - -" ""'. ....... ...........".1. I v'1 UIl ClU U Y uC;vLIUII I 10, r lUlIUd
Statutes
3. Utility Receipt or where applicable the Septic
Permit from Health Department
Signature:
Name:~~
Contractor No.: C?C. I'IS&; t 13
PRIVATE SWIMMING POOLS & SPAS
REQUIRED INFORMATION FOR
INSPECTIONS & POOL APPLICATIONS
424.2 FBC-2001
011 January 1,2002 the Applicant became responsible fOl' conforming to all
appropriate sections of 424.2 F.B.C.
Specifically, Building Inspectors will be checking for the three levels of anti-
entrapment protection that you ar~ required to provide and issues of safety
protection.
1. ANTI-VORTEX COVERS, Mfg. ~ ",n4~ik~ModeI No. JF2"
2. LOCKING COVERS on all suction inl~ts, Mfg. t'f~c<I"";(/). Model No WYOO~
3. TWO MAIN DRAINS separated a minimum of3 feet
4. VENT or VACUUM release device, Mfg. -.- .(x;; #lee"": '(bvj Modcl No.
5. SAFETY BARRIERS, Mfg,. ~-'f.Io"t ./l-4~ j\iJodcl No.
6. ALARM SYSTEMS for windows and doors, Mfg. Model No.
Applicants will be required to provide a layout showing
1. The pool with a Complete Plumbin2: Plan and location of all mechanical equipment,
show dimensions, pipc sizes, flow rates, suction and pressures.
2. The spa with plumbing plan
3. The dcck with sizc, shape and relationship to house
4. Location of windows and doors that have access to pool fl'om house
Appli,cants will be required to provide the following information with the above
1. Site specific drawings showing the len2:th, width, dcpth, shapc and pool C2:ress
2. Volume ~cYc) Gallons
3. Pump Mfg. ..2.,/~A./'e Model No.f!lI.+Jf<- Hp. --'-- Turn Over Ratc , 6 C)
4. Filtcl' Mfg. ~ '~d'-e Model No. R,IL erZ..r GPM. 60
5. Pool Heatel' Mfg. Mode(No. -Typ~
6. Skimmer Mfg. ~ -f.'1o-~~ Model No. J..' ~f)c;p ~Jr6J
Applicants will be required to provide CERTIFIED ENGINEERING design to
424.2 Florida Building Code 2001 and ANSI/NSPI-5, 1995
* The applicant will provide two copies of all requested information; this information is
supplemental to the normal permitting material necessary at intake