HomeMy WebLinkAbout04-3507
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3507
Permit Number: 3507 Issued: 10/26 2004
Permit Type: NEW SINGLE FAMILY DWELLING
Class of Work: 101-NEW CONST/SFR
Proposed Use: SINGLE FAMILY RESIDENTIAL
Sq. Feet: Est. Value:
Cost: 104,000.00 Total Fees: 3,332.75
Amount Paid: 3,332.75 Date Paid: 10/26/200
Name: GLOV NCO C NSTRU TION INC
Addr: 11506 SHIMMERING SHORE PL.
TAMPA,FL. 33624
Phone: Lic:
Work Desc: NEW SINGLE FAMILY DWELLING
Address: 39784 MEADOWOOD LP
ZEPHYRHILLS, FL.
Township: Range:
Lot{s): Block: Section:
Book: Page:
Subdivision: MEADOWOOD ESTATES
Parcel Number:
RAFAEL HERRERA
39784 MEADOWOOD LP
ZEPHYRHILLS, FL. 33542
Phone:
WATER CONNECTION RESIDENl
WATER METER RES 3/4"
N
419.00 MECHANICAL FEE
180.00 RADON
L
76.45 BUILDING FEE
20.80
~ ..I,D!'
y~ \,
,\0
11 J~-f)
fGV^ L1/0'
..(}s;
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.
~ .
SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
I!!!I PETE ALFONSO JR.
I. ARCHITECT LLC.
APRIL 15, 2005
REF: PERMrr # 3507
39784 MEAD WOOD Loop
ZEPHYRHILlS, F'L
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ZEPHYRHILLS BUILDING DEPARTMENT
ZEPHYRHILLS, F'L
To WHOM rr MAY CONCERN
I HAVE REVIEWED THE BEAM STRAP (SIMPSON HSULC) AND I HAVE DETERMINED
THAT THIS STRAP IS ADEQUATE TO SUPPORT THE TRUSS AND ROOF ASSEMBLY
FOR THE ABOVE MEN110NED PRO.JECT.
IF YOU HAVE ANY QUESTIONS PLEASE CALL ME.
9720 N. ARMENIA AVE. TAMPA, FL. 33612 PH. (813) 933-5800 FAX. (813) 933-5810
05/04/2005 10:59
8139339565
ASER4U
16 ' ~Lb
-FR.vm: y /)(}11 fJ.e.--
P.# 3507
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PAGE 01
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FILL CELL WI CONe
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FILL CELL WI CONe t
llOS (TYP)
EPOPXl GROUTED
ItoITO EXIST CONe.
EXIST. BLOCK
I-lALl.
... PETE ALFONSO dR.
I. ARCHITECT
uc.._
'l72o N.. __... A~ TAI'lPA, fU'IllPol. _1:2
(8&) -.seao F-'X (*S) _-&a1O
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE lVED
lo(~/o'f
PHONE CONTACT FOR PERMITTING
OWNER'S NAME ~.J!. 1-+ " <r~Q. P~ONE
JOB ADDRESS '~ ?Yl~4.c!)~~ C)Q'Q. ~ J -t:!)(!J{J ,
LEGAL DESCRIPTION: LOT(S) 601.u BLOCK i3 SUBDIVISION
727 7~'(7ZfCt.(\
, '. '. ..'~. .-".' ".
W. e,-l)tJ~ 06 Jt
PARCEL 10 #
WORK PROPSED: urNEW CONSTRUCTION
(OBTAIN FROM PROPERTY TAX NOTICE)
o ADDITION
o ALTERAT ION
o REPAIR
o INSTALL
DSIGN
PROPOSED USE: ~GL FAMILY DWELLING
o MOVE
o DEMOLISH
o COMMERCIAL
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DMULTI-FAMILY
BUILDING SIZE
o
IJ~CAJ
/ & S-15
RESTAURANT & HEALTH DEPARTMENT APPROVAL
l~ ~-e-
DESCRIPTION OF WORK
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.
o ELECTRICAL
AMP SERVICE
BI Progress Energy 0
43, 501
~-
,/'"
W.R.E.C.
PERMITS REQUESTED
o BUILDING
$
?61~6~
:l 0"0
VALUATION OF TOTAL CONSTRUCTION
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
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
FINISHED FLOOR ELEVATIONS
BUILDER
COMPANY
ELECTRICIAN
COMPANY
MI\c1--.(
CI3<=- o~'iJ g~ 2.
CA.,,'''' ~
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
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. 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 pOftions 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 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 iof 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".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
,20_
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)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did D did not
of identification)
take an oath.
D who has produced
(type of identification)
and who Ddid 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
Givenco Canst. Co., Inc.
39501 Meadowood Loop
SQ. FEET PRICE
MAIN OR LIVING: 2,080 $ 50.00
OTHER AREA UNDER ROOF: $ 50.00
OTHER: $ -
VALUATION $ 104,000.00
FEE SHEET $ 492.00
ADDRESS $ 30.00
DRIVEWAY $ 30.00
BUILDING: $ 798.00
CREDIT: $ -
BUILDING LESS CREDIT: $ 798.00
ELECTRICAL: $ 123.00
PLUMBING: $ 99.50
MECHANICAL: $ 76.45
SUB-TOTAL $ ( 1,096.95
RADON: $ -ZU:80
TOTAL $ 1,117.75
-7
SEWER: $ 1,616.00
WATER: $ 419.00
IRRIGATION: $ -
TOTAL: $ 2,035.00
WATER METER:I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
3,332.751
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
}cf~
] ~-t- C~)
TI F'S: $ 1,588.00
99% $ 1,572.12
1% $ 15.88
TOTAL: $ 6,614.751
TRANSACTION REPORT
FEB/28/2005/MON 05:09 PM
P.Ol/Ol
RECEIVER
99689652
TYPE/NOTE
OK
ECM
Glvenco Const. CO., Inc.
39501 'Meadowood Loop
SQ. FEET PRICE
MAIN OR. LIVING: 2,080 $ 50.00.
OTHER AREA UNDER ROOF: $ 50.00
OTHER: $ -
VAlUATION $ 104,000.00
FEE SHEET $ 492.00
ADDRESS $ 30.00
DRlVEWA'V $ 30.00
BUILDING: $, 798.00
CREDIT~ $ -
BUILDING LESS CREDIT: $ 798.00
ELECTRICAL: $ 123.00
PLUMBING: $ 99.50
MECHANICAL: $ 76.45
SUB-TOTAL $ ( 1,098.95
RADON: $ "2Ir.80
TOTAL $ 1,117.75
SEWER: S 1,818.00
WATER: $ 419.00
IRRIGATION: $ -
TOTAL: $ 2,035.00
i
I
I
SUB-TOTAL $
3,332.7Sl
WATER METER:I $
IRRIGATION METER $
180~00 f
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
TIF'S:I$
99% $
1.588.00 I
1.572.12
-7
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~~~~~[IJ~ 1~1 I1I1I 11I11II1I111II11I1I111I1I 1I111II1
NOTICE OF COMNffiNCEMmNT
Rcpt:826797
os: 0. 00
10/28/04
Rec: 10.00
IT: 0.00
,_, Dpty C jerk
State of FLORIDA
County off;;5CO
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.
1. Description of property: Parcel No. S f3 T 2 (2, !;urn 1? 2/
(legal description of the property and street address if available)
!;6 ()otJtJtf) Bb:..oo/tJ lor /
j,1ftL.J
f'1 i:m IX) CV'OO f> Dv'" Z E'P h Y 12. fI iLl.., s~ j F t SCO COUNT! CLERK
i~&~~l~lM~~f~ lpGo1.683
2. Gen~ral description of improvement:
J""li(<.-I C:"/J Sr/2.C/C77 01-1
3.0wnerinformationName Pf2,9-ncl5Co r!o IllS l 2IJ-Pfl t?L- Ij6f2-1Z~1t
A<{dress. j{,;o_3 L.A-i->y WELL Cr City kle5Le-yOvlOdState R ::J::,\C;Ji 3
Interest m property:
R
Name of fee simple titleholder (if other than Owner):
Address City
C) d GiDVenco)
4. Contractor Name 1\ of L (..() v 41 ?o ~::> /.
Address I ( ). D (..5),., I '- ...... t'~'(""'~ SLc"Citv r ~ f <-
5n\(YI~ri l\S hqt?- ~lc\'c(..
L'l./.l2.s { ~ r,.J <: J r. L, .
City
State
5. Surety Name
Address
Amount of bond: $
r:-
-I-- A./c...
State rL ..
3 j <:.. l ~
-
s, ~~
State
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 C'A:-r L crl \j J oL<4~",- L"'v> r. Q;,
Address ,{ <(b ~ S".. <-v.. "'-".., l '54_ (> (City rr-~ f A.--- State t=-i.... J S c I Y
8. In addition to himself or herself, Owner designates Y V 0 n 1'1 e }). -lvn IJ- r ro 1'1
of !' I w;fA- m It.. It , T F L 3 to receive a copy of the Lienor's
Notice as provided in Section713.13 )(b), Florida S es.
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
Sworn to and subscrib~ before me this
/(dl
20 () y
NotaIy Public, State of Florida:
My Commission Expires:
CARLOS MELARA
STATE OF FLORIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING IS A
TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE
OR OF PUBlIG REGORD IN THiS OFFI~ESS MY
HAN NO FFICIAL SEAL THIS DAY OF
2~
JED MA, ,. D CIRCUIT COlRT
BY DEPUTY CLERK
PASCO
CENTRAL PERMITTING OFFICES
· Dade City: (352) 521-5144 FAX (352) 521
13852 17th St., Dade City
· New Port Richey: (727) 847-8126 FAX (7
7530 Uttle Rd., Rm. 210 New Port Riche
· land O'lakes: (813)929-1266 FAX (81
4111 land O'lakes Blvd. (US 41),land
THIS APPUCATION MUST BE TYPED 0
AND IS VOID IF NOT PERMITTED WITHIN 6 MONTHS
is rn,s-;PPLiCATiQi:jTHE-AESULT -OFA-ST~-woiiK -ORDER OR- NOTICE-OF VioLAnoN?- - - - - y-=:'- i-jC - - -- - -- - ---.
.R'S NAM~ R <l: f 'I", \ ~ .-.-" c, PHONE I 1'27) 7.< 'I. '7~. L/
CATION: 3 '7<) c 1 (J.A.. e .:. c!) 0..,.;) oM i ' SUBDIVISION: (Y'(c~::::-\t....~-~! --.)( (,6
EL 10#: S --LL T ~ A ~ SUB~ ; LOT 0C!2- PROJECT # Tftl. _ LOT SIZE _X_
ER'S PRESENT ADDRESS: / (.. (') 3 L 4 J11 w ~.ll.. c {' CrrY: L.u ~ "i l-eo 1 STATE: I':::c. ZIP:.5 ? S <.. /.J
:;: CIA..... r <:. I
e FEE SIMPLE TITLEHOLDER'S NAME (if other than owner):
address M applicable): CI1Y: STATE: ZIP:
PERMIT#:
II III IV
BY:
V
VI
DESCRIPTION OF WORK:
G LIVING AREA: i (.. 5'Y PATIO: GARAGE: ENTRY: TOTAL UNDER ROOF:
9 # BEDROOMS --L- # BATHROOMS ~. _ TYPE CONSTRUCTION: ~LOCK 0 FRAME 0 OTHER:
m FILL Y _N.L.
~ IF MOBILE HOME OR RV: MAKE YEAR SIZE ,-> L FEES BLOCK
a: WORK CODE PlANS ON FILE? 0 NO 0 YES PAE-PAlD PLANS FEES: $ (o(Q PLANS FEE: $
u __
* "m-'7-~-~-~~-~-~~:~~~:~----m-__mm~~~E~~~~J0_~_J5-zbo1fLLDING S _._
BONDING COMPANY:
::.::: ADDRESS: - CITY: STATE: _ ZIP:
u
e
~ ARCHITECT/ENGINEER:
cc ADDRESS: CrrY: STATE: _ ZIP:
w
:%:
l-
e MORTGAGE LENDER:
ADDRESS: CrrY: STATE: '_ ZIP:
--------------------------------------------------
---------------------------------------------------------------------------------
,CTOR: IOU e. VI.. ~ Q 4-..".,.. 5 1'- c~ -t--"v <..
URE: '/ ~ PHONE 1/ (gol.> ) -<&f II ?C ;Y-L('
ESS: I (j, . r__... 4-~ .'.... j-~ t' (CITY: /' / ~ STATE: ~ Z: .s C I <;y
CD UC 1/ (if applicable) - <.. : L , PASCO CO COMPUTER 101/: C) f..L/ I;) <'5 r+-
~ ~ AA. S. ~ ~ cz:h ELECTRICAL
~ ELECTRICAL CONTRA :' " I (}, 'L I' ~ ~-z:;J C- '-...... FEE: $
u SIGNATURE: PHONE 1/ Ei2... l i? ~ - rJ~ 1-.
g ADDRESS ~. - :ift!.2!. CITY:~*-!-~S:TE~Z1P~",.~/..,..
5 STATE UC 1/ (if~pllcable) tF C. 1300 I G.," (' PASCO co COMPUTER 10#:
U POWER CO: '7JJA:) G pi2 c;; c;. (U ( SAWPOLE: t; t!) ~ Y? AMPS:
MECHANICAL CONTRAC
SIGNATURE:
ADDRESS: ~,
STATE UC # (if applIcable)
~ NEW 0 ALTERATION
PlUMBING~O CTOfl-~ ~(1tAJO flauti:,Y06 tY/z
SIGNATUR . _t<~ _ HONE' j}J.L) H12- 9/33
ADDRESS: 47i.r.- M (jJ.lc.therf A1e- CITY: 7~,Q.. STATE: B- ZIP: ~~f
STATE U.C' ~f ipP./icable) I.C -CD.c'Tnr PASCO CO COMPUTER 101:
, FIXTURES: 'II SEPTIC PER , SEWER:!.... WATER: J WEl..L;
'"' ~ MECHANICAL
M< FEE: $
-=s 3<:'''74
PLUMBING
FEE:
$
OTHER
. BLDG.
FEE:
$
OTHER CONTRACTOR:
S~NATURE ~E'(____)
ADDRESS: CITY: STATE: _ ZIP:
STATE UC , ~f applicable) PASCO CO COMPUTER 10#:
TYPE CONTRACTOR: VAlUATION: S
~~;;;;;;;;-~\\--e:------~~;;~i-j;:)-------;~~;;;-=_12------------
fpennit form 10191)
_NS OF THIS FORM RElEASED BEFORE 1191 ARE OBSOlETF AND Will NOT BE Acx.'t.t'I~u BY CENTRAl PERt.lmNG STAFF
PC93043032JG ftICDl
....NOl1CE....
BOTH THE OWNER AND CONTRACToR OF RECORD (Ucense Holder) MUST READ AND
SIGN THE REVERse SIDE OF THIS APPUCATION
A. NOTICE OF DEED RESTRJCTION~
The .'"'e",,,,,,,,,, '-"and!hat thi, """'" may be "'~ect.IO"deed _'0"" ""'" may be mO<e ,,'lnctive fhan CO.OI, '""""""". Th,
undersigned assumes responsibility fCJr comphanceWlth any applicable deed restnctlons,
8. UNLICENSED CONTRACTORS AND CONTRACT0R RESPONSIBJLlTII;,S
If !he 0_ h" ~""" oont,ecto' 0"""""""" 10,,__, fhe, "'" be """'''''' f, lie h"n"" '" an_ W'th ~"e and IooaJ ,",,"
'abo",. If !he 0"""",,,, " "OI'~en"" " ~ iJw:'bolh fhe OW"" ..., 00"_ me, be oiled I", , m_,,,,,, w""",,," .""" ~"e
"w. If fhe ow"" '" '''u"""" 0""""'",... ."""~,, '" '0 Whef'<"'."9 ""''''''menf' mey ""'" "" the ,_ _, the, '" ",,,,,"" 10
contact the Pasco County Building Division -LIcenSing seCtion ~t.(727) 847.8009.
F'Menne". ,I !he own.. h", h,,,,,,, '"".anfo, 0' """","oii:... """''''''' 10 h,,, fhe 0""'''''0''" .9" PO",o", of Ih, "'""tranto, B'oo'" 01
fh" _10""" 10' whlOh they ..." be "_"ble If '0', '" fh, OW"" "9" "fhe 00"""'0' "0' '" ''''''0'''''9 fhe. '0'. '''h<u fh", th, oom"o
10'. ." "'P"""b'e 100th, ""Ii<. If the ""f""o, ...,.... '0' 10 "9" """'f""o'. thet mey oe '" '''O~et'o" thet h, "not propert, h"""" ,"0
IS not entitled to permitting PriVileges In Pasco County,
C. TRANSPORTATION IMPACTIlJTILlTlES IMPACT AND RESOURCE RECOVERY FEES
The 'nde",,,",,,, ."d"~and Ihet T"""""'etlO" 'moaot F... '"d R"o.", Rano"" Fee, m" 'ppl, 10 th, OO"~"'''IO' ol",w b.lld"9'
ohenge of.,", '" "'''''9 build"9" 0' ".....0" 01'''~'''9 bu'd,,,",, "'_u"" " Pesoo Co.nty ""''',"" ".m_ B9-07 '''d 90-1)7. "
""'''d"". The """""'."" "'" ""d"'fand" fhe! '""" lees, "may be due, ..." be 'denh,,,,, et fh, "me 01 p"m",,,'9 It" '.rth" """"'fooO
fhe! T""""",,,IO" 'mpo" Fee, '''d R"",,",e R""""" F... m.~ b, P'''' P"OIIo "'''''''''9' '"""",, 01 oO'"P,oo," 0' ,,,,' po"" ",..'"'
If th, "'- doe, "01 ""~"e, "",',," 01 000.""",,, 0' 'ne' pow" "Ie,,,, the Ie" m,,, be P"d p"o"o oe""" '''_e. F'"h""""""
p,,,,o Co,,,ty Wet"/Sew" '"'Peel tee, ete due, fhey m,~ be P"d P"O. fo Delm" ''''''''00. ,,, =0",,,,,, w,," 'PPl~etile P"oo CO'OIy O'd,-
nances,
D, CONSTRUCTION LIEN LAW (Chapter 713, FlOrida Statutes, as amended)
If """''''''' 01 wo" " $2500.00 o. mOl' , ,,",ty thet 1 the 'P~~'''t heye bee' P<OWoed W'fh , '"P' 01 "Flo"d, C'",,"',,'O, li", L,w _
Homeow""., O<ofeof,,,,, 9"'de" P"P"ed by the Flo,,", Depenmen, 01 Ag"",",,, eod Co""m" AN"". 11th, ",P"oeol " "'meone oth" theo
the "OW"".' I o.."ty fhet , h,,, obf""", , oopy 01 the el,,,,, de"'''''ed d"'me'" eod P<om"e '" 900d lOIlh to del",,, " 10 the "o~".. PlIO' to
commencement,
E, CONTRACTOR'S/OWNER'S AFFIDAVIT
, ,,",ly thel "'the IOIo<m",o" '" th" 'Opl"'''on " '00'"" '''0 fh" '" wo<' .,,, oe dO"e 10 oomp","" w'fh ", 'PP''''~e "ws ''"'''''''" "n.
structlon, zoning and land development
ApP"OOllc" " he",y m.o, fo obt", , "'''m,. " 00 wo,k '''0 '''''''''lIc'' "IOd'''''a 'ce",,, 'h" '" '"Plk PI '"""''','' "" "mmended
P"o< '0 '''''''''' of , oe",," '''" thet '" w""' w", be peno"""" to meet ''''0''0' PI ""'w, co, ""no "'''''''''' Coo,,,y OOd". '""'''9 "9.
"et,o"" '''" ""0 de"'""meOl ''"'''lIc" '" the """d''',o" ''''0 "Oily fhef' '''O'''''''d thet ",e "9"''''0", of Oth" go""'me", ,"en""
m,y ",ply fo the ""nd", Wo". '''" fhet " " my ",po""bil'ty fo 'den"'" whet ""0", , m,,, ;eke '0 be" Oomp"",,, Suoh 'go",,", ''''''''''
but are not limited to:
· Dep,"me", 01 '''""o''meOl'' P,otan"o" . CYP"" B'yl,,,O', W"""" A"" end E'",o"men,,", Sen"""" Le"o,. Wet""''''ewet" T"etme",
· Southw"f Flo"d' Wet" M''',oeme", O"f",. - WeI!" OYa"" B"'heod'. Wef",," A"" Alle""9 W,,,"O"',,,
· Armv CorDS of Enolnee~ - Seawalls, DOCKS NaVJ,:?ilbl-: Waterways
.D
nVlronmental Health Unit - Wells, WastewatEr Treatment, Septic Tanks
. US EnVironmental Protection Aoenf:i - Asbestos abatement.
. Eederal Aviation Authonty . Runways,
I understand that the fOllOWing restrictions apply l::l tt~p. Lise of fill,
· Use of fill IS not allowed .n FlOOd Zone "V" unless expreSSly permmed,
" II '" mete"" " fo be "'''' '" FlOOd ZO"e "A" " " '""",fOOd th" . O'''nage P'''' ''''''''''''9 , -oomoo'''''''9 ~,"me .,11 be ""'m,"'" et
lime of permitting which IS prepared by a ProfeSSional engineer IIcensea by the State of FlOrida
· II 1,,, me""" " fo be '''d '" F'ood Zone 'A" '" 00""""00 w,th , pe""'''ed b""dlO9 '''''9 "em w,1I ao""",,,,o,,. ,,,",ty thet fiI' """ be ''''''
only to fill the area Within the stem wall.
· It "" me""et " to be ''''' 10 ,,,y eteo. I ""iIy thet '" 01 "'''' "" w,1I 'Of 'd"""e1, ,Nect edlOO"" 01000"", II '" 01 fill " 10'''d 10
"''''''''y 'lfeof '~""'f P<OPert,"" the OW"" m,y "e ""d IPI ",0"""9 the oO""f,o", 01 fhe b""d',," pe",," '"'''' '''"''the '''''''ed pe"""
application, for lots less than one (1) acre wn'Ch are elevated by fill. an engineered drainage plan IS reqUIred,
It, 'm the AGENT FOR THE OWNER, , P'o""" " 900d letfh fo ,,,to,,,, the 0_ PI the """""'''9 oo"d'",", "flo"h '" th" ,md"', P"o< to
commencing construction
I."""",,,,, lhel , """,,, p"m, mey be ..qw."" 101 e1eof"", wo", PI,mb"9, "9"', wel", po~" '" "''''''''''''',,", ""', 0' ""'" """"'''''''
not specifically Included In the application,
A """" ""'ed """ be "''''frued 10 be , ,~- 10 P<ooeed WIth the _ and nof OS "'lhonty to ","""e. "'''e1, _, '" ... __ '"Y p<ow_
.- 01 th, I""",,,, 0_, "0< "'''' "",""" of , """" """""' the BuildlIt9 0ffidaI from th_ ._""" , 0""'"",,, 0' ""'" ,,, Plan,
""-"''''''''''' , '" ""'u,,,,, 01 any OCd",. E""" Pennlt "'"'" "'''' betxtme """"d un~" the _ ""honzed by '"'" penn, i, """me,,,,,,,
-,,, .. mo"th, 01 pem" '''''''''e, '" it """ "'th"""" by fhe penn, " "'_Oed o. "'- "" , _ of ., mo"'h, _the I"",
lhe - "",""""",d, An """'S~" m.y be """''''''', " Writing, from the B,''',," Qffio'" "" , ","od not 10""0"'" "'""Y (90) _ eod
""" detnon~"'e iu~m_ 0"'", to, lhe """"on ,,_ ""'" fo, ",nety (90) 00"""""" _, the lob i, """"""'" _"",
CATE
WARN'NG TO OWNER YOUR FA'LURE TO RECORD A NanCE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
'MPROVEMENTS TO YOUR PPOPERTY 'F YOU 'NTEND TO ~'NANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECOROl YOUR NonCE OF COMMENCEMENT \,0 ) '~, ,"
SIGNATURE ' , S'GNATURE (;~ f( __ I~, ')
..........
S' - 2 0 - 0 '--(
DATE
NOTARY AS TO
OWNER OR AGENT
NOTARY AS TO
CONTRACTOR
MY COMMISSION
EXPIRES
MY COMMISSION
EXPIRES
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PERFORMANCE BUSINESS PRODUCTS. INC, 813-719-8008 FAX 813-719-7919
CITY OF ZEPHYRHILLS
ZEPHVRHILLS, FLORIDA
y-55:}L(
WATER ACCT. NO.
DATE
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OWNER/
RENTER
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Iit/ WATER
;G-r-/
SERVICE ADDRESS
37 S6/
SHUT OFF SERVICE
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o SEWER
TURN ON SERVICE
READ METER
o
o GARBAGE
~CITY
INSTALL METER
CHECK METER
o
o OUT CITY
-I- No. OF UNITS
OTHER
o
_ DEPOSIT AMOUNT
_ AMOUNT LAST BIU
)/11
ILf -
/;J~ ~
_ DATE
_ MISC, CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
lo-:<~-er
ORDER GIVEN BY
;cr-
x
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,
TRANSACTION REPORT
JAN/06/2005/THU 09:29 AM
P.Ol/Ol
RECEIVER
99339565
TYPE/NOTE
OK
ECM
CITY'OF ;ZEPHYRHILLS
5335 -:8TH STREET
(813)780-0020
:BUILDING :PERMIT ' SINGLE :FAMILY,REsIDENTIAL
3507
~_ _ _ __.7':17 -'-.-r ~C~:-:~;~'?::i~.~~-:~t:f'l. _ ~ --------..:- ~~'1~,_:'.-'~~~ :\' ~1~l~L .~_ ~--------.:
Permit Number: 3507 Issued: 10/26/2004
Permit Type: NEW SINGLEFAMIL Y DWELLING
Class of Work: '101.NEW CONST/SFR
Proposed Use: SINGLE FAMILY RESIDENTIAL
Sq. 'Feet: ESt. Value:
.Cost: 104,000.00 Total Fees: 3,542.7
Amount~Paid: 3,332.75 Date Paid: 10/26/200
Name: GLOVENCO CON U ION INC
Addr; 11'506 SHIMMERING SHORE PL.
TAMPA,FL. 33624
Phone:.Llc:
Work Desc: NEW SINGLE FAMILY DWELLING
Address: 39784 MEADOWOOD LP
ZEPHYRHILLS, FL.
Township: Range:
.Lot(s): Block: 'Section:
Book; 'Page;
Subdivision: MEADOWOOD ESTATES
Parcel 'Number:
RAFAEL HERRERA
39784 MEADOWOOD LP
ZEPHYRHILLS,FL. 33542
'Phone:
PLUMBING FEE
WATER CONNECTION RESIDENl
WATER METER RES 314-
RedTsg
RedTsg
FOOTER SO
DUCTS INSTALLED
DUCTS INSULATED
SHEATHING
MISC
MISC.
MISC. DRIVEWAY MISC. MISC.
RElNSPEcnON fEES: When extra Inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty,;.F"lVe 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 Ins ctIon fees shall be made before an further permits will be issued to the person ownin same
"Warning to owner: Your failure'to record a notice of com'mencement 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.
r.nNTRAr.TnR~ ~1~NATIIRF
~-~
-PERM1T'OFFl ' ,
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3507
Permit Number: 3507 Issued: 10/26/2004
Permit Type: NEW SINGLE FAMILY DWELLING
Class of Work: 101-NEW CONST/SFR
Proposed Use: SINGLE FAMILY RESIDENTIAL
Sq. Feet: Est. Value:
Cost: 104,000.00 Total Fees: 3,542.75
Amount Paid: 3,332.75 Date Paid: 10/26/200
Name: GLOVENCO CON TRUCTION IN
Addr: 11506 SHIMMERING SHORE PL.
TAMPA,FL. 33624
Phone: Lic:
Work Desc: NEW SINGLE FAMILY DWELLING
Address: 39784 MEAD D LP
ZEPHYRHILLS, FL.
Township: Range:
Lot{s): Block: Section:
Book: Page:
Subdivision: MEADOWOOD ESTATES
Parcel Number:
RAFAEL H RRERA
39784 MEADOWOOD LP
ZEPHYRHILLS, FL. 33542
Phone:
WATER CONNECTION RESIDENl
WATER METER RES 3/4"
RedTag
RedTag
N
419.00 MECHANICAL FEE
180.00 RADON
35.00 RedTag
35.00 RedTag
1,6
76.45 BUILDING FEE
20.80 RedTag
35.00 RedTag
35.00
798.00
35.00
35.00
DUCTS INSTALLED PRE-SLAB /.;2h7/,G'! tI.TD CONSTRUCTION POLE II 2 ~' 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL L~2d. -l2..5 'ii.:ru 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.
CONTRACTORS SIGNATURE PERM~
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRE~
PROTECT CARD FROM WEATHER
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PASCO COUNTY, FLORIDA
Permit No, 350'7
Date Permitted lO-a<o -aOOLf
Builder Name/Owner Name ('..,.. \ O.J e.. n (' 0 0cJY"\C::S+< uc\-I (.')--"Control #
County Parcel No. ',3 ~;;)(p - dl-61'-tO - 000 6 <J --Co 1 0 SubDiv: rneo..d ou..)o<::,d Lf>
Address/Location 3 C1"7<iS '-\ ~Qd.CSl--Uoocl L,o
ClassificationlType of Use S/"c tD ~~~ Qp<,\c\eVl(,,~
'..)
TRANSPORTATION IMPACT FEE Rate:
Exempt DYes 0No How Determined
Sq Ft Unit:
Impact Fee Amount $ 15 '675. crv
Zone No.
TAZ:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House
(057) Mobile Home
(058) Other Residential
.J:l23) Collection Fee
Exempt U Yes f.ZJ No How Determined
Amount $ \<.0 qL.\. 0-0
PARKS AND RECREATION FEE
Land Account Land Credit
Land Total
Recreation Account
Recreation Total
Zone
$
Exempt 0 Yes 0 No
LIBRARY FEE
Land Account
How Determined
Land Credit
Land Total
Facility Account
Facility Total
Exempt 0 Yes 0 No
How Determined
Total Amount
RESOURCE FEE
TOTAL AMOUNT
ERU
Prepared By
Checked By
NO CERTIFICATE OF OCCUPANCY WILL 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 payment for same.
DATE
RECEIPT NO.
RECEIVED BY
DATE
BY