HomeMy WebLinkAbout04-3436
..
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3436
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: INTERIOR BUILD OUT
3436
COMMERCIAL
NEW CONST/COMM
COMMERCIAL
Address: 7813 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
256,220.00
10/06/2004
8,413.23
Name: FASHION BUG
Address: 7813 GALL BLVD
ZEPHYRHILLS, FL. 33542
Phone:
FIRST CLASS ELECTRIC
WILLIAMS (INDIVIDUAL)
SQ"TIatEFlN COMf6RT [rJr. II4e>.-
ELECTRICAL FEE
PLUMBING FEE
MECHANICAL FEE
WATER METER RES 3/4"
150.80 WATER CONNECTION COMMERC
83.50 TRAFFIC IMPACT FEES COMM
260.00 TRAFFIC IMPACT FEES 99% COM
180.00
527.94
37.08
3,671.17
.J~-
I1D. ---
(;, k..
!J _15-D-<'
R 1 T
DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL PRE-METER WATER
SHEATHING FRAME MISC SEWER
MISC INSULATION WALL MISC MISC.
MISC. INSULATION CEILING MISC. MISC.
MISC. DRIVEWAY MISC. MISC.
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.
lJ ~-~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
..
, .
City of Zephyrhllls
Water and Sewer Impact Fe. Calculation
Land Use Type:
Retail
No. of Square Feet
Impact Fees
Within City Limits
$ 527.94
$ 1,311.66
$ 734.58
$ 2,574.18
Water Distribution System
Wastewater Collection System
Wastewater Treatment Plant Capacity
TOTAL
Outside City Limits
$ 660.24
$ 1,639.26
$ 917.28
$ 3,216.78
LOCHRANE
Consulting Engineers · Surveyors
Orlando · Gainesville
February 2, 2005
"c"." r~
....0 ......~.. ~~
'(lJ IN S~~
""J')iv
City of Zephyrhills Building Department
5335 8th Street
Zephyrhills, Florida 33540
North Town Center - Certification of Completion
To Whom It May Concern:
As the Engineer of Record for the above referenced project, I am pleased to certify herein
that the sitework for this project has been completed in substantial conformance with the
City approved construction plans, with the exception of some final grading/grassing in
the westernmost pond,
If we can be of further assistance to you on this matter, please feel free to contact our
office.
Sincerely,
-
Robert J. Lochrane, P.E.
Executive Vice President
-
201 South Bumby AvenUE?' Orlando, Florida 32803
(407) 896-3317' Fax (407) 896-:9167' www.lochrane.com
,BiIIB.urgess
From:
Sent:
To:
Subject:
Sloman, Jeff [JSloman@lpagroup.com]
Wednesday, February 09, 20054:57 PM
Bill Burgess
NorthTown Center- US 301 Site Analysis
Mr. Burgess:
Please let this e-mail serve as a written verification that we believe the area of the
site in question (the north side of the parking lot) that LPA visited on February 7, 2005
appears to have been designed and constructed adequately. Due to the fact that the
parking stalls in question are perpendicular to the drive aisles and the site entrances,
it is our belief that the wheel stops, curbing, and distance of the parking area to the
retaining wall will provide adequate safety for vehicles and pedestrians.
Jeff Sloman, P. E.
Project Engineer
The LPA Group
4503 Woodland Corporate Boulevard
Suite 400
Tampa, Florida 33614
(813) 889-3892
(813)889-3893(Fax)
Confidentiality Notice
This message is intended exclusively for the individual or entity to which it is
addressed. This communication may contain information that is proprietary, privileged,
confidential or otherwise legally exempt from disclosure. If you are not the named
addressee, you are not authorized to read, print, retain, copy or disseminate this message
or any part of it. If you have received this message in error, please notify the sender
immediately either by phone (800-572-1115) or reply to this e-mail and delete all copies
of this message.
1
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
~ //i--[) fL
. "
~.~.
OWNER'S NAME l~o~Jrbe~ Lt (l..
JOB ADDRESS 78'/3 ~. ') lo~6) 1.1
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL ID * 6t:J - 2.5 - 2J -(Xl/DC. 61100 - QtJ()O 'QR~ArN FROIl PROP~RTY TAX NOTTCE!
PHONE CONTACT FOR PERMITTING
PHONE Lq.~l ') ~'X~- 07-70
335L/o
WORK PROPSED: 6DNEW CONSTRUCTION
OSIGN
o ADDITION
o MOVE
OALTERATION
o DEMOLISH
o REPAIR
o INSTALL
PROPOSED USE:OSGL FAMILY DWELLING
DSlCOMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK ~r\()'\ LorY\p.klinf\ (FI95/1/oJ BtLG- )
BUILDING SIZE j5' .x q?J' '-1" SQUARE FOOTAGE '1,ODQ<!:YfJ- /I HEIGHT J.!!) ,
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.
400
AIO~ f'/rLS
lV~ ,~
~~D I
PERMITS REQUESTED 1f ;:J-f~
VALUATION OF TOTAL CONSTRUCTION y~~///.) /. 'J... &
~/ ~/.Jl /
o W.R.E.C.
AMP SERVICE
o FLORIDA POWER
IS BUILDING
cst ELECTRICAL
$
riI PLUMBING
Gl MECHANICAL $
o GAS "-ROOFING . 0 SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
(16~~~
/1.01/
f) .
TYPE OF CONSTRUCTION: ~ BLOCK 0 FRAME
FINISHED FLOOR ELEVATIONS /57. 5 '
o STEEL
IX1 NO
o OTHER
IS PROJECT IN FLOOD ZONE
~q~J{\,:SECTION
BUILDER
COMPANY
ELECTRIC
*************************************.****************************
COOPANYlxMrUiay 1orcl. f' Jpt'-I.nr_
STATE CERT OR REGIST # tt Dab t51 ()
STATE CERT OR REGIST # C6C DLQ,g 1?J
SIGNATURE
PLUMBER "
SIGNATURE \\( <
~':~,<
~ \",
_..~.,...- '\ ,,--," ,
**********************************************
C,",PANY_~l1n (~ L. Wi 1l'4ms PIl.!.rYJb, fig
STATE CERT OR REGIST # C9C 1<-/2'S tooL
'p ^-
------
MECHANICAL COMPANY
SIGNATURE < ~ Q.. d ~. STATE CERT OR REGIST * Ct1fJ ~lg
;.1~~ ~~~**************************************************************
*******************************************
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 responslbil.ity fqr
compliance with ?ny 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 l~w, 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(sJ 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 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE F CO~MENCEMENT".
C-' ~< 4,
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this _ day of , 2U-
by
(name of person acknowledged)
Owho is personally known to me, or
o who has produced
(type of identification)
and wooD did Ddid not take an oath.
SI AT CONTRACTOR
STATE OF FLORIDA (? 6' ,
COUNTY OF .. ~ 6:)
The foregoing instrument. was c~wledged ~
Before this (5"' day , 2012-
by
ame of person acknowledged)
is personally known to me, or
Signature of person taking acknowledgement
..~
Sig~at~re 0 person taking acknowledgm t
,..~-:r.~:'&:". Bobbie SwetlOnd .
t;r .')1' MY COMMISSION # 00268763. EXPIRES .
Name typed, printed or stamped
Name t~,
pr~T~~~I~Wti
------- .
I.
Sandy Development
7813 Gall Blvd.
SQ. FEET PRICE
MAIN OR LIVING: 7,000 $ 35.00
OTHER AREA UNDER ROOF: $ 50.00
OTHER: 13,200 $ 0.85
VALUATION $ 256,220.00
FEE SHEET $ 951.00
ADDRESS $ 30.00
DRIVEWAY $ -
BUILDING: $ 1 ,456.50
CREDIT: $ -
BUILDING LESS CREDIT: $ 1,456.50
ELECTRICAL: $ 150.80
PLUMBING: $ 83.50
MECHANICAL: $ 260.00
SUB-TOTAL $ 1,950.80
RADON: $ -
TOTAL $ 1,950.80
SEWER: $ 2,046.24
WATER: $ 527.94
IRRIGATION: $ -
TOTAL: $ 2,574.18
WATER METER:I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
4,704.98 I
: I
10~. ?-5
,) '5 q ~?, " 1 S
fl' t(J I ;). '1 .
--~l --:./1,
-1' (;{)
~11,/~
91 Z~ '3, ~
/ Z -; :;/7- 08"
SI"S:I $
97.5% $
2.5% $
TI F'S: $ 14,833.00
99% $ 14,684.67
1% $ 148.33
TOTAL: $ 19,537.98 I
S i~\.f V 6\1 lit i,r{ t,'I/uENI"
'7'b'~ ~'- iSLvd.
. ,htSt~ 1-:o.N hu &
!?JL)/V) D0T
Square Feet
Dollar Amount
7, aC ()
J 0,2-00
3S,O\;,
, <{")-
Valuation
Building
Electric
Plumbing ~?5" c
Mechanical 2 <D o. '.J C
Radon tJ J 11
Connection Fees:
Sewer
2, D,-/l:); L'i
5Z7, qL/
I eo. 00
Water
Meter
School Impact Fee: N J A
Transportation Impact Fee:
I. 0 X- Z, I )C) . o~
1)
/ '-Ij 33'?=>, 0 c
P.Ol/Ol
. '
TRANSACTION REPORT
SEP/l5/2004/WED 03:26 PM
RECEIVER
817278157000
TYPE/NOTE
OK
'CO
"
5335 - 8'IH Street
Zephyrhllls, FL 33542
City of Zephyrhills
Building Department
Fax
10:
FronG Bobble Swetland
Judy
Pasco County addressing
F-= 727-815-7000
pages: 2 Including cover sheet
Phone;
Date: . 09115/2004
Re: Address requests
cc:
D Urgent
D For R.mew 0 Please Comment X Please Reply D Please Recycle
Dear Judy,
I would like to request addresses for the following six (6) commetclal buDd-outs:
Parcel 1.0. #34-25-21.0010-01700-0000
Units will front GALL BLVD.
Page 2 has lay-out of units.
If any questions, please give me a call 813-780-0020 or fax 813-780-D021.
Sincerely,
G ri&u./
SG3
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919
Y-55)~
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
WATER ACCT. NO.
DATE
/o/? 10</
f
OWNER/
RENTER
s~ j)eve(op ~
'2 '3.0 3 ~d' ~rJl
U~~ ~ ~ ) yz:J 5 3 ~.:1.S-
SERVICE ADDRESS 7 i ( ? 0~ b /vd
MAILING
~--f
SHUT OFF SERVICE D
TURN ON SERVICE ~
INSTALL METER wi
READ METER D
CHECK METER D
OTHER D
~WATER
D SEWER
D GARBAGE
ijJI';N CITY
D OUT CITY
--1- No. OF UNITS
_ DEPOSIT AMOUNT
~II
_ AMOUNT LAST Bill
w~~
_ DATE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
Retain white form in office at all times.
Send pink & yellow forms to Water Service .
Water Service Dept. to sign yellow form & return to office.
FROM ; SRNDYDEl)ELOPMENTCOMPRt~Y
. 10/e7l:2004 13:38 6854522
, ,
FRX NO, :3525675686 Oct. 11 2004 04:27PM P2
DYKF-S JOHNSeN ARC~IT PAGE O~
OCT-n-2004 15: 2J
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2004/WED 04:09 PM
ZEPHYRHILLS BUILDING FAX No. 813-780-0021
CITY OF ZEPBYRRILLS PBRMcrT APPLICATION
BUILDING DIPART:HIN~ 5335 8~ St, Zephyrhille, rL 33!42
813-780-0020 ~AXIB1~-180-0021 AI/
DA~1l RIlClllVllD (/-;<.. ~/- ~ 7
P ~O' 1
I,"' J.
PHONll COmAC!1' I'OR PJ:RMI'.rTING
OWNER' S NAM~
f15hIO'F)
?gj3
/3t~
blf.!/
PHONE
JOB ADDRESS
-
/iLt//)
LEGAL DESCRIPTION: LOT(S)
BLOCK
SOBDIVISION
PARCEL 10 t
(Oa~AIN FROM PftQptRTY,TAX NOTICEl
WORR PROPSED: []WEW CONSTROCTION
DSIGN
o ADDITION
o MOVE
OALTEMTION
o DEMOLISH
OREPAt~
o INSTALL
PROl?OSF~D USE: DSGL Ii'lWILY DWELLING OMOLTI-FAMILY
~ERCIAL . CJ I!3DOSTRIAL
",
O. OF UNITS
CJ SWIMMING POOL
o MOB I LE HON8
o
OTHER
0' RESTAURANT & HEALTH DEilARTMENT APPROVAL
DESCRIP:UON 01' WORK /N~7/f// ~ L/J/-nA/ /It:l/-t qL /t-/,/'L
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS or BUILDING PLAMS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS.
IF SIGN PERM~T ONLY (2) SlTS Of ENGINEERED PLANS REQOIREO.
PROPERTY SURVEY REQUIRED FOR ALL .NEW CONSTRUCTION.
PBRN2TS REQUBSTED
o BlJI,tDING
:;I
VALUATION OF TOTAL CONSTROCTION
o ELl!:CTRIC.l\L
AMP SERVICE
o PrOare5$ Energy 0
W.R.E.C.
o PLUMBING
~ANICAL
$~~1-. o~ _ VALUATION dr MECHANCIAL INSTALLATION
o GAS 0 ROOP'ING 0 SPECIALTY
o OTHER
TYPE OF CONSTROCTION: 0 aLOCK
o FAAME
o 9T&:&:L
'0 OTHER
FINISHED FLOO~ ELEVArIONS
IS PROJECT IN nOOD ZON&: ARE.l\D YJi:S D NO
. . . I I
f , "
~..:.., .:...:........~~' ~ ~ 1......L............~. -~:- M - ....... - ~-- _ _ __ __ _ '__' _ M............ ___. . ~t ,~~
BUILDER ..
CQNPAN'l
S IGNAT ORE
STATE CERT OR REGIST .
***+**~.****~*.*._......*.***********.*******~********************
ELECT:P.ICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST i
.**.***+..*....****.*******.*******~********'*.*****...*..**....~~
PLTJHSiU\
COHPANY
SIGNATURE
STATE CERT OR REGIST t
SIQ1.tATURE
.**.****~**..*.._..*.*.******.***+****++.***-***
COKFAWY .Ll/tRJ)~ /J Ie CON,Dr //o..//IIIG //l./c
_ STA'!'&: CERT OR REGIS'? # CIte OJ''? t;3 3
MBCHANlCAL
*.************.**._.*.***w******+*++.+~***.*+***..***...***
OTHER
COMPANY
SIGNA'1'ORE _
STATE C~RT OR REGIST t
_, _ _ .:: ,::, ~ 'j,:, '-, ~ :' M ilYHl k.H 1 L:..J~) t:..Il L:J lI'~u
;' n.l\ '.1, 0 ~ ::.. :~J ,....1 - .::J... ~
~. NOTI~E OF DEED RESTRICTIONS
,The undersigned understands that thi~ permit may be eubject to "deed restrictions" which
may be more restrictive than city reguh,tions. The undersigned assumes respongibllity tor
compliance with any applicable deed reetriction~.
B. ONLIC8NSED CONTRACTORS AND CONTRACTOR R~SPONSIBILITIES
If the OHnQr has hired a contractor or contractor~ to undertake work, . they may be required
to be 1iceneed in eccordance with state and looal regulations. If the contractor :_~ t\C.t
licensed as required by law, both the owner and contractor may bQ citQd for a misdemeanor
violation under s~ate ~aw. If the owner or intended contractor are uncertain as to what
licensing requirements may apply tor the intende~ work, they are advised to contact the
City of Zephyrhil!.s BuHdinq Department. 813-780-0020.
F1.Jrthermore, if the owner hilS hired a contra.ctor or contraotors, he is advised to hS'9'6 the
contractor(s) ~dqn po!:,tions or the "Contractor sections" of this application for which they
will be responsible. If you/ as the ownex aigna as the contractor, you are indicating that
}~u, rather than the contractor, are responsible for the work. If the contractor wiehes
you to sign as contractor that may be an indica~i6n that he is not properly licensed and i$
not entitled to permitting privileges in the City of zephyrhills.
C; TRANSE'ORl'ATION IMPACT E'EES AND UTILITY CONNECTION FEES
D. CONSTRUCrUION LIEN LAW (CHAPTER 113, FLORIDA STATUTES, AS AMENDED)
I certify th9t Ii the applicant, haya been provid~d with a copy'of "Florida's Construction
lien taw - Homeowner's.~rotection Guide" prepared by the Florida Department or Agrioulture
and Conswoer Affairs. I f the applicant l!! someone other that the "owner"" I cerify that I
have obtained a oopy of the above described dooument and prorn1se in good faith to dellver
1. t to the "owne:c" pri,~r to commencement.
E. CONTRACTOR'8/OWNER/S.AFFIDAVIT
:r; certify that an thl9 iriformation in. this application is accurate and that all work will
be done in complianoe with ,all applicable laws regulatino constn\ction, zoning, and land
dQv~lopmQnt.
Appl.:i.qation is hereby made to obtain a permit to do work and instalLation as indicated. I
certify that no wo~k or 1netallation h&$ commenced prio% to issuance of a permit and that
~11 work will be perro~ed to meet standards ot all laws regulating con3truction, City
code~, zoning regulations, and land development requlatione in the jurisdiction. I al~o
certify that r .understand that the regulations of other gover.nmental agencies ffiay apply to
the intended work, and that it is my reeponsibility to identify what actions I must take to
be in compliance. Sllch agencies inolude but are not 111111ted to: *Dcapartment of
Environmental R&gulation-Cypress Bayheads, Wetland Areae and Environmentally Sensitive
Landa, Water/Wastewater Treatment
*Southweat f10rida Water ManaQement District-Wells, Cypress Bayhead5, Wetland P.reas,
Altering Wateroourses
*Army Corps O! Engineers-Seawalls, Docks, Navigable Waterways
"Department of Health << Rehabilitative Services, Environn\l~ntal Health Unit-Welli!l,
Wastewater Treatment, Septic Tan~s
*U.9. ~\vironmental Protection AQency-Asbestos abatement
I also oertify that, if fill ma'buial is'to be used in Flood zon~ "A" or "A,Qtc.", it is
understood that a dra.inaqe plan addressing a. "oompemusting volwne" will be submitted wnich
if! prepared by a professional engineer registered in the Stata of Florida prior to pe:t'mit
issuance.
A permi.t issued shall be donstrued~o 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 p~event ~he Building Official from thereafter requiring e
correction of errors in plans, construotion, or violations of any ~ode. EVClry permit
issued shall become invalid unless the work autho~ized by such permit is commenced within
Bi~ months of issuance, or if work authorized by the permit is suspended or abandoned for 'a
periC?d ot SiR months after the time ,the "'ark i9 commencCld. one 90 day extension of time
n~y be allowed for the permit with fee charge of $15.00. The extension shall be requestad
in writing to'the Buildir\Q Of.ficial. An approved 1n9pection must be IOQQed durinQ each six
month period, or the project will be considered abandoned.
WARNING TO OWNER, YOUR FAILURE TO RECORD A NOTICE OF OOMMENCEMtNTMAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO ANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE Q OMMENCE T. JOgS UNDER
$2/500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOT! OHMiNC TH.
S!GNATURE: OtiNER OR AGENT
CONTRACTOR
ST t O~ FLORIDA P U.J......
C NTY or 0
The forcaqoing ini;ru:ent wa~~OWledged
:Before me, this ay of. ~ 20 Q..::i.
by ::r - Td'c\{'\TH 'I ~ '. t 'c.-
____ (name of person acknowledoed)
~ho is oQrsonallv known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledQed
Befor!! me this _ day of , 2L
by
(name' of per~on acknowledoed)
o who i8 1:>ersonallv known to me, or
I
o ""ho has produoed
itype of identification)
and whoO cUd Ddld not take an oat:h.
o who has produced
(type of identification)
and who ~ OUd not take an oath
S.iqnature of pI!lrson takino- l!lcl<nowled~ement
,-~cL.. V-.. ~ ~ ~
Big-natura of person taking aCknowledgment
S. ALL~J
printed or stamped
.s~~1)(l.~
Name typ.d,
~ame typed, printed or st~ped
,,~V';~ Sandra S. Allen
{j'j;;:\), MY COMMISSION # 00067031 EXPIRES
~:.~.~ff November 27, 2005
"1,X;;.;....W~ BONDEO ll-t1lU TROY FAIN INSURANc~ INC
'filnl"
WARDS
AIR CONDITIONING
CAC 057633
865 CREATIVE DRIVE
LAKELAND, FLORIDA 338'3
PHONE {863} 646-0020
FAX {863} 70'-9025
e~e~
tf'iRCe' (967
11-18-2004
I, J. Timothy Rice, contractor license number CAC 057633 hereby authorize
the following to act as my agent in obtaining permits for the City of Zephyrhills.
Name
Barton E. Goodison
Wayne R. Adams
Michael D. Inzer
Ronald Rodgers
License Number
G325-065-48-449
A352-896-55-027
1526-544-59-098
R326-736-42-344
This authorization is to remain in effect indefinitely, unless canceled by
me in wri .
Sworn to subscribes to before me this l~ day of ~O\l..(..yT\'a..-.- , d..c>o1-
by J. Timothy Rice who is personally known.
~ 11'.tL.~..A ~
Sandra S. Allen
"\"'V't",,
,,'<p;.tI\"l:~, Sandra S. Allen
~..(/f;;."\..~ MY COMMISSION # DD067031 EXPIRES
~~i%i November 27, 2005
'.Rf,.;:-.." BONDED TH~U T~OY fAIN INSU~ANCE. INC
My Commission Expires:
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PASCO COUNTY, FLORIDA
Permit No. .;3 ~a~
Date Permitted ~ - ~ - ()Lf
C~ner Name V &/?~ Q~t- Control,#
County Parcel No. ...31/-:2 !}-:J /"-O{)/tJ-O/P7tJ{J -000 U SubDlv.
Address/Location 7f/3 ~~. CilM.
/7 ' /' /"C) .,.,,, /l -+ \' -L/. ,~~ / '7). "
ClassificationlType of Us~ (_:'it?'J?A1ldA(!tdt/ \~~ Vile rrr'S"lIlurv. ~G16
TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: -'1 dO{)
Exempt DVes ~N~;~~~~lned
Impact Fee Amount ~ Zone No.
TAl:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House
(057) Mobile Home
(058) Other Residential
J:123) Collection Fee
Exempt U Yes D No How Determined
Amount
$
b'il
.
PARKS AND RECREATION FEE
Land Account Land Credit
Land Total
,
I
Recreation Credit Reereawo
TOTAL AMOUNT $;'
Recreation Account
Zone
Exempt DYes D No
LIBRARY FEE
Lan9 Account
How Determined
Land Credit
/ Land T atal
life
1/1 ,. IIIty Total
/ I Total Amount
Facility Account
Facility Credit
Exempt DYes D No
How Determined
RESOURCE FEE
TOTAL AMOUNT
Prepared By
J}~.lfll G'lt)
Checked By
ERU
NO CERTIFICATE OF OCCUfiANCYWILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of a copy of this form, placing
the building permit owner on notice of this assessment and the. conditions of pa me.
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rl J RE
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RECEIPT NO.