HomeMy WebLinkAbout04-3496
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3496
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Sq. Feet:
Cost:
Amount Paid:
3496 Issued: 10/22/2004
NEW SINGLE FAMILY DWELLING
101-NEW CONST/SFR
SINGLE FAMILY RESIDENTIAL
Est. Value:
Total Fees:
3,207.21 Date Paid:
Name: TENBRINK & ASSOCIATES
Addr: 36805 SR 54 WEST
ZEPHYRHILLS, FL 33541
Phone: 813782-0678 Lic:
Work Desc: NEW SINGLE FAMILY DWELLING
Address: 4733 5TH ST
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: MICHAEL MANN
Address: 4733 5TH ST
ZEPHYRHILLS, FL. 33542
Phone:
WATER CONNECTION RESIDENl
RADON
419.00 MECHANICAL FEE
17.41 WATER METER RES 3/4"
L
BUILDING FEE
00
'1 '7-- ~;2'
If
C
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."
NO OCCUPANCY BEFORE C.O.
/(/~lJd-~f .:R-.
~ CONTRACTORS SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Tenbrink & Assoc.
4733 - 5th St.
SQ. FEET PRICE
MAIN OR LIVING: 1,741 $ 50.00
OTHER AREA UNDER ROOF: $ 50.00
OTHER: $ -
VALUATION $ 87,050.00
FEE SHEET $ 432.00
ADDRESS $ 30.00
DRIVEWAY $ 30.00
BUILDING: $ 708.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 708.00
ELECTRICAL: $ 103.95
PLUMBING: $ 92.50
MECHANICAL: $ 70.35
SUB-TOTAL $ 9..... Dft
( RADON: .v (.!':. llA1 2)
luTAL $ ~.21
SEWER: $ 1,616.00
WATER: $ 419.00
IRRIGATION: $ -
TOTAL: $ 2,035.00
WATER METER:I $ 180.00 I
IRRIGATION METER. $ -
~..----._._"._--_._.._-~
SUB-TOTAL t ~.,2~~21,V
'P~ at
{!.D.
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
T IF'S: $
99% $
1% $
1 ,588.00
1,572.12
15.88
iLL- ~i {J. 0
TOTAL: $ 6,489.21 I
n ~
~
n
(') (') 103110 E3
C' c' . n n
PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719.7919
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
\1- .55:;0
WATER ACCT. NO.
DATE
lo/.:<;/~y
f
OWNER/
RENTER
~j;;tf~k'
S~~
(
E
A ss 0:::- ,
MAILING
TJ1c .
SERVICE ADDRESS ~7.33 sr-457'
SHUT OFF SERVICE 0
TURN ON SERVICE ~
INSTALL METER cg/
READ METER 0
CHECK METER 0
OTHER 0
4T7
% II
w:i!ir ;ni1t;-
I
,
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WORK COMPLETED BY
& DATE COMPLETED
K
Retain white form in office at all times,
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office.
~ATER
D SEWER
o GARBAGE
~CITY
o OUT CITY
(
_ No. OF UNITS
_ DEPOSIT AMOUNT
_ AMOUNT LAST BIU
_ DATE
_ MISC. CHARGE
ORDER TAKEN BY
/O-.2/-CJV ~
ORDER GIVEN BY
~~&:J
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE IWD
10 IN! 1J(
/
PHONE CONTACT FOR PERMITTING
.
OWNER'S NAME -IYLL(~..h.a.eJ VV\.ll.. Y\V\ PHONE~\:') 78:d-d./4-Cr
JOB AD~'J~; ~ ~~ ~{.
LEGAL DESCRIPTION: LOT(S) ~ BLOCK ~~ SUBDIVISION
PARCEL ID # 14'" ~lR- ~ 1- 0010 - o::,S{){') - no 70 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ~NEW CONSTRUCTION
DSIGN
PROPOSED USE:~SGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
o MOVE
DALTERATION
o REPAIR
o INSTALL
o DEMOLISH
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK b\&. . -=-j \ .. ~ ~ l, r'( ~~ ~e.\^-< e...
BUILDING SIZE SQUARE FOOTAGE '~~I
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 FLORIDA POWER
o
W.R.E.C. ~
* ~~\~
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAo YES 0 NO
BUILDER
cO~qTOR~ECTION
COMPANY -re~ 'Br~ \'\ole ~ A-~5:.E:C. 7..",-,- .
SIGNATURE
/L..L L 2s:>(
,
STATE CERT OR REGIST # CG C D'-t 3.4~J-
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SIGNATURE
COMPANY YY\1-rl-', n Elee-+V-: c... ~#
STATE CERT OR REGIST # Ce... t 3CO \ ~"&' '~
******************************************************************
SIGNATURE
c:..~4~
COMPANY ~.lI\. "5c.-h kM&.", PLu~; ~ C~. ~
~v1ft.o
STATE CERT OR REGIST # C,F"C.O\.f,7~ I -I_pM;
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COMPANY -:SC\..l-"t-heYh ~ V\-L~r+- EY\....{ . .. ~.
,
STATE CERT OR REGIST # C-.Ae.- \ i J 357<7
PLUMBER
SIGNATU
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OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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 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 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 indication 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.
Application 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 r~gulations, 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 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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
~~ SIGNATb~~T~CT~ /L ~
STATE OF FLO~A
COUNTY OF c:..['O
The foregoing instrument w()0~owledged
Before !}Ie \ this ~ay oflX' ~Y" , 20 Cf-l
by '("'y\ I C-IfYA. e.- Y\ h
. ~name of person acknowledged)
~ho is personally known to me, or
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
acknowledged
, 20_
(name of person acknowledged)
C1ho is personally known to me, or
Owho has produced
(type of identification)
and whoO did S--did not take an oath.
-=r::~~Cb ~
Signature of person taking acknowledgement
o who has produced
(type of identification)
and who Odid Diid not take an oath
Signature of person taking acknowledgment
YY\1V+~~
Name typed, printed or stam
TABmfAMARTlN Na e typed, printed or stamped
MY COMMISSION # DO 297031
EXPIRES; March 7, 2008
Bonded Thru NoIIry P\tlIc Ilndenmters
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~ ~ ~$ NtiTiLE OF COMMENCEMENT
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~ .a ~ -.:.. Building Permit No.
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o 0 0 "::.f'Q
:t:! ~ ~ ~ I. STATE OF FLORIDA
f-o 0 .0 r---1"
a lE"- \.~c:::-" COUNTY OF Pasco
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2004188210
Rcpl: 821566
OS: 0.00
10/07/04
Rec: 10.00
IT: 0.00
Dpty Clerk
Tax Folio No. 14-26-21-0010-03500-0070
., '
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.
JED PITTMAN PASCO COUNTY CLERK
10/01/04 03:44pm 1 of 1
OR BK 6058 PG 1128
THE UNDERSIGNED hereby gives notice that improvements 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.
1. Description of Property:
(legal description oflhe property, and street address if available)
Lot 7, 5th Street
Zephyrhills, FL 33542
Lot 7, and the South 19.66 feet oflot 6,block 35, Moores First addition, PB 1, P 57,
2. General Description of Improvements: Single Family Dwelling
3. Owner Information:
a. Name and Address:
Michael L. Mann
39151 Woodland Drive, Zephyrhills, FL 33542
b. Interest in property: FEE SIMPLE
c. Name and address of fee simple titleholder (if other than owner):
4. Contractor:
(Name and Address)
Ten Brink & Assoc. Inc.
36805 SR 54 West, Zephyrhills, FL 33541
5. Surety:
a. Name and address:
b. Amount of bond:
Lender Information:
a. Name and Address:
First National Bank of Pasco
13315 Highway 301
Dade City, FL 33525
b. Designated Contact: Ralph W. Cumbee. Amv Pollock. or Taralee Morehouse
7. Persons within the State of Florida designated by Owner upon whom notice or other
Documents maybe served as provided by Section 713.13(1)(a) 7., Florida Statutes:
(name and address)
First National Bank of Pasco
13315 Highway 301
Dade City, FL 33525
8. In addition to himself, Owner designates Ralph W Cumbee. Amv Pollock or
Taralee Morehouse of First National Bank of Pasco to receive a copy of the
Lienor's Notice as provided in Section 713.13 (l)(b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is one (1) year
from the date of recording unless a different date is specified).
Other expiration d:;J..te: _____
~~..
N/A
N/A
STATE OF FLORIDA ,- :...... ~'.';. C'(/"
COUNTY OF PASCO-." (i,. "/'
THIS IS TO CERTi8?'THArtHE'FOJfeGO~G IS ~ ('
TRUE AND CORRECT CQP:ti)F:rH~. DOCUMEN.'tO~L& 9 f
OR OF PUBLIC RECORD .'tt. TItlS OFFICE~~TNESS 'MY. :>;
HAND A~FICIALS~L'.!H,rS DA~C)-~,
~u~) 2*," ."" i
JEO PITT~L ilF. t:1Il9'f" SO...r ,"i'
BY "L/,-"",. '< 'DEPUTY CLERK
6.
Sigriature of Owner
Signature of Owner
Signature of Owner
STATE OF FLOEJl)A
COUNTY OF {),q.StJD / . ' s-I / (7" J
The fore~?il).g inst~jent was acknowledged before me this L) e-It.,!b-&v' / ;?(jv'~
by I ,1 ( 11 Q<.f'. . L, m{}.ln n who are personally known
to me or who have produced FLD C as identification.
/l? M1Y~ ~~
,"""". MARY G. CASTRO
/~Wl:.UI~\ MY COMMISSION #.0 D020111
~.~ ::~ EXPIRES: April 28, 2005 .
-:~;.;.....i..~~ Bonded Tnru Notary PublIC Underwnters
.'r",'lf,,~'t\'....