HomeMy WebLinkAbout04-3512
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3512
Permit Number: 3512 Issued: 10/26/2004
Permit Type: GENERAL BUILDING PERMIT
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Sq. Feet: Est. Value:
Cost: 4,000.00 Total Fees:
Amount Paid: 110.00 Date Paid:
Address: 38741 CR 54 EA LO 5
ZEPHYRHILLS, FL.
Township: Range:
Lot{s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: HOMEOWNER
Addr:
Phone: Lic: Phone:
Work Desc: ROOM ADDITION WITH WINDOWS AND SHED ON EXISTING SLAB
Name: FRED CHATTERLEY
Address: 38741 54 EAST LOT 5
ZEPHYRHILLS, FL. 33542
H E G
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.
~ ~
RACTORS SIGNATURE PERMIT OFF I
CALL FOR INSPECTION - 8 HOUR NOnCE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
/ (J - ;~j - (J L/
,
PHONE CONTACT FOR
~ecrtJERMIT SERVICE
1-866-824-7894
Toll Free
PHONE
PARCEL 10 #
,cre-I c.ha..-Ikrl"
j
JI7lfl e .I<.~ S"1 &.
S
o OJ.. -J..~ -rJ/ - ()O/o -as-OOO - 0030
OWNER'S NAME
JOB ADDRESS
SUBDIVISION S !.et.py . JId//av JL
(OBTAIN FROM PROPERTY TAX1NOTICEl
LEGAL DESCRIPTION: LOT(S)
BLOCK
OSIGN
PROPOSED USE: ~GL FAMILY DWELLING
o COMMERCIAL
~ ADDITION
o MOVE
OALTERATION
o REPAIR
o INSTALL
WORK PROPSED: ONEW CONSTRUCTION
o DEMOLISH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
* MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
\S~J ~
~^
.
I'Od/K ruI rftl-/ OIl a/ tL ~ 'J k
JL't. I cS H/i r; '-S'&L6 J... I
SQUARB' FOOTAGE .3l/0 I HEIGHT
~ //1 rlPtoJ
BUILDING SIZE
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.
& (1) SET ENERGY FORMS.
FORMS.
-1 - ;;)~
I ~.
'2.' " ~~
l J.
.r~b.
fi-JJLC. -
PERMITS REQUESTED
I1J BUILDING
~ ELECTRICAL
o PLUMBING
$
<f@. 00
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
" FRAME
o STEEL
'" OTHER aIu.m
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
FINISHED FLOOR ELEVATIONS
BUILDER
COMPANY 0fJJ /.A. r- PJe...t1 Cl1.o.....JJ...r0
_ SIGNATURE
~
STATE CERT OR REGIST #
******************************************************************
~SIGNATURE
~@r~
COMPANY O/VUr - j: teAL CJ.,L./krly
STATE CERT OR REGIST #
ELECTRICIAN
********************************************************k*********
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 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.
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 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".
p~
SIGNATURE: OWNER OR AGENT
.~
SIGNATURE: CONTRACTOR
STATE OF FLORIDA ~_
COUNTY OF ~Go
The foregoin? inst~~ment wa~a~knowledged~/J
Before meJhls ~ay of Vt ~r, 20t.2:z.
by Cred rMfre.r(J
(name of person aCKnowledged)
C1ho is personally known to me, or
~o has produced P L..
(type of identification)
~d not take ~
son taking acknowledgment
.""'"'' Suzanne BahI
," :'i.t-?'.Y.p'u(J '_... ..
_-".0. '.v,,'_ (QlllD'l~",gR #ODI57],
Name t yped, =_~~~~<!X~fes~NM1~sl:O'\'
..,~, c, ",0"" Bonded Thru
, ^(I~nl:\(' Bond!ng (\\
STATE OF FLORIDA R
COUNTY OF ~Lo
The foregoing insts~ment was ar~nowledge~,1
Befor~me this /Q'h:1ay of Ocfnh(r, 20b
by t::r~d CL-t~r:f,
(name of person acknowledged)
Dwho is personally known to me, or
~s produced Y. L-.
(type of identification)
did ~ot tak an oath.
Si of person taking ackn.o~ledgement
\\11"" suzanne Bahf
~~t:'~'~~~<i', Commission #DD 15713:
Name typed, piint~:.6Ex~tfa~l), LUU\)
:'~'.'~'c R;~Xed Thn;
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D:ISCLOSlJRB S'l"A'.rBIIBIr.r :POll. OWIIBR
crry OF ~.IlX~ATT.T_CI BmLDJJIIG DBPUTJIlDr.t
~~e to ~:~sf~~~s instrument. have read and fully understand and
'!'he undersig:ned states aDd affixms that he or she is desirous of constructing,
renovating, ad.... ftg to or reroofing his or her o.n daaicile, that he or she
actually occupies, or w:l.ll occupy by said domicile, and same is not for
rent, l.eaae or sale. 'l'hat he or she shall comply with the following conditions:
1. That the owner and he or she alone shall act as the builder for al.l. phases of
construction.
2. 'l'hat the o.ner w:l.ll ccmply with all provisions of the City of Zephyrhills
or..i ftaJ1("es and codes pertiDeu.t to the buil.ding.
3. That in the event various phases of construction are subcontracted, he wil.l.
engage ODl.y properly licensed subcontractors and will perscmal.ly superv1.se
such work..
4. That in the event the Building :ID8pector shall require corrections to be made,
the owner will. assume full responsibility to insure they are made, and upon
cOlllpletiOll will. ca11 for a reinapectiOll before proceeding with the bull.ding.
5. That the owner shall. assume full. respousibil.i ty for the construction and wil.l.
not expect supervision of his work from the City of Zephyrhil.l.s Building
Department.
6. 'l'hat prior to fiD.aJ. inspection any ac:lditicmal. fees, incl.uding reinspection
fees, must be paid in full.. A written request from this office shall.
constitute an official. notice to pay additicmal. fees.
7. That the owner sbal.l. compl.y with all. City,. State and Federal l.awe in regard to
social security, workman's compensation, l.ien l.aws, etc., where appl.icabl.e.
8. That the owner shall. compl.y with all. the safety codes issued. by the Fl.orida
Industrial. Calamission.
g. State l.aw requires cODStructiem to be done by l.icensed cemtractors. You. have
appl.ied for a permit UDder an exeaption to that l.... '!'he exemption al.l.ows
you., as the owner of your property, to act as your own cemtractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervisiem of the ccmatructiem yourseJ.f. You may build or improve a
one-family or two-fami1y reaidence or a faza outbui1diD.g. You may al.so build
or :i.JDprove a c~cial. building, provided your coats do not exceed $25,000.
The bai1ding or residence aust be for your own use or occupancy. :It may not
be bui1t or substantially improved for sal.e or l....e. Xf you sell. or 1ease a
. bai1ding you have built or suhstantial1y improved yourself within 1 year after
the constructiem is comp1ete, the law wi11 presume that you built or
substantiall.y improved if for sale or lease, which is a violatiem of this
exemptiem. You may not hire an 1Dll.icensed persOn to act as your contractor or
to supervise peep1e 1IO%'kiDg on your bail.diD.g. Xt is your respcmsibility to
make sure that peep1e emp10yed by you have licenses required by state law and
by county or DlUDicipal. 1icenaing or-'iftaD.ces. You may not de1egate the
respcmsibil.ity for supervising work to a licensed contractor who is not
1icensed to perfoZ1ll the work being done. .Any persem workiDg em your bui1diD.g
who is not licensed aust work uncler your direct supervisiem and must be
eapJ.oyed by you, which -.afta that you must deduct P.:I.C.A. and withho1diD.g tax
and provide workers' compensation for that emp1oyee, al.1 as prescribed by law.
Your constructiem must ccmpl.y with al.1 appl.icabl.e laws, ordift.1tces, bui1ding
codes, and zoning~. attiionsons..
. O1IlGIR' S S:IGIIATDRB ~ DATE I~ - 1'0 - (] y
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