HomeMy WebLinkAbout04-3537
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3537
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:
3537
ADDITION/ALTERATION
434-ADD/AL T RESIDENTIAL
RV PARK
Address: 39644 AMET YST WAY
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: EMERALD POINTE RV RESORT
Parcel Number:
22,000.00
11/01/2004
297,50
297.50
11/01/2004 Phone:
RV PORT ON EXISTING SLAB & PLUMBING
Name: BERNIE & PAT ETHIER
Address: 39644 AMETHYST WAY
ZEPHYRHILLS, FL. 33542
HOMEOWNER
HOMEOWNER
E
PLUMBING FEE
52,50
U
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.
UiAC~ NL ~~
CONTRACTO~IGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE 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
/Cd~-CY
PHONE CONTACT FOR PERMITTING
LEGAL DESCRIPTION: LOT(S)
~ P a.:f F ..J-I..u- r
4h.LH., ~I t<J~
~/ 6l- BLOCK
PHO(r 18) 77'1- Jr'VtJ
OWNER'S NAME (3LrrJ~
JOB ADDRESS .j fu 'Ill
SUBDIVISIONCIlPrL!J '/lOtA.. ~
(OBTAIN FROM ~Kp~o;t t'o~E1
PARCEL ID #
o SIGN
PROPOSED USE:,oSGL FAMILY DWELLING
o COMMERCIAL
rA ADDITION
o MOVE
o ALTERAT ION
o REPAIR
o INSTALL
WORK PROPSED: 0 NEW CONSTRUCTION
o DEMOLISH
DMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE He
o OTHER
BUILDING SIZE
o RESTAURANT
k!.r /J()rf
PIe- SltI'1I'g->~7::'s
, . ,
& HEALTH DEPARTMENT APPROVAL
u{€.-6 -I- jJ~6/~q
, '-'"
SQUARE FOOTAGE 680 F
.
.IL ~ l(f.) I AS
DESCRIPTION OF WORK
HEIGHT
/4 '-f"f
PERMITS REQUESTED
& (1) SET ENERGY FORMS.
FORMS.
2J()I~~ I~L:S)~'
QC;-'O'::':> ~.
5z..';~ /Lil.'\ l,.
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF EUILDING PLANS & (1) SET ENERGY
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
r/;J BUILDING
Ii ELECTRICAL
~ PLUMBING
o MECHANICAL
$
(yJ
~J 000.
.
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o Progress Energy 0
W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
~ FRAME
o STEEL
oJ-OTHER tA-!Ulrn,iYlU"'" t'oof2
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
***t!~~tf***~/i\'f~*******************************************
COMPANY
otVU-r
ELECTRICIAN
SIGNATURE . STATE CERT OR REGIST #
PLUMBER **~1fi***~***j*~~***********:::::::****:~*;:*;*...*........
SIGNATURE ~ STATE CERT OR REGIST i
11 L r() r'" l: t-i..ur .
****y**** ~*********t********************************************
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.
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 d~y extension of time
may be allowed for the permit with fee charge of $15.00. The extenslon 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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF MENCEMENT. JOBS UNDER
$2,500 IN VALU DO NOT NEED TO RECORD AND POST A "NOTICE OE C M CEMENT".
SIGNA
OR AGENT
SIGNA
STATE OF FLORIDA ~
COUNTY OF ia. $Lo
The foregoing instqlment was acknowledged,
Before ~e th~s I~d~y of (}>+oIoeL, 20o<-t
by l~~n,e~\-er
(name of person acknowledged)
Dwho is personally known to me, or
It!who has produced D, L .
(type
~did not
STATE OF FLORIDA ~
COUNTY OF l C1.5(O
The foregoing instrument was aF~owledge?
Before meJ:his. ~c;J,p.:i of O::'~f" , 2r:f!2!:L
by !:1 e nll1> r,....J+11 er
(name of person acknowledged)
C1ho is personally known to me, or
lX.who has produced D, L. .
(type of identification)
and who ~id not take
re of p taking
',"'''''''' :Suzanne Bahr
"o,\~Y.~lJ& ""
_-,~,:,;,:~,,_ C'Qm.miEEisR HOD IS7\J]
typed~;;pr ,~~~~s:~rqJg~06
-<;~ OF fCo'!':':--' Bonded Thru
'" "", Atlantic Bonding Co" Inc
Sigu~ture 0 person taking acknowledgement
"~~\."'" Suzanne Bahr
'~~~'-:' Commission #00157131
Name typed, ~i:ri ,'~lijlj,fe!8~rl~&006
'.~1jioP'co~,,' BondedThru
" , I ""' AtlantIC Bondmg Co., Inc,
Signa
Name
111111111111 11I1111I111111I11111 111/111I1111111111I111111111
2004200066 '
NOTICE OF COMMENCEMENT
1= to /'Ld lc.,
/J at,{ eo
County of
State of
THE lrnDERSIGNED hereby gives notice that improvement will be made to c2rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following information is provided in this Notice of Commencement:
1.
2 .
R3.
4.
f!J'I-~' -~/_(JI)StJ - OalV - tY.-/J-,O
Lal e)../<Y.- C/1.LHLId /Jou:A ,ep 4rJ/'r iJh\U c3 J9~ if'! 4n.J--h~ul- t./jw
(Legal description of the property and street address if availabl) J
12// pt/rf t/A ~K~ul-/,i'l ~b
v
Rcpt: 826101
OS: 0. 00
10/26/04
Description of Property: Parcel No.
General Description of Improvement
?'
pknLbl/J1
v
Rec: 10.00
IT : 0 . 00
__~___ Dpty Clerk
Owner Information: Name (; Lrnu
Address .3 9('l/l.j 41U.f.-4ul- ~City
Interest in Property:
-r PILI E J-A IL r
UpA.,,,UJ PI
Stat~3S-~~
JEO PITTMAN PASCO COUNTY CLERK
10/26/04 12: 16pm 1 of641 5
OR BK 6081 PG 1
Name of Fee Simple Titleholder:
(If other thgn owner)
Address
City
State
Contractor: Name
.
OtuMr - /j-e./'/Jtl
E-li /tr
Address
City
State
5. Surety: Name
Address
State
City
Amount of Bond: $
6. Lender: Name
In addition to himself, Owner designates
of
. to receive a copy of the
Llenor's Notice as provided in Section 713 13 1
. ()(b), Florida Statutes.
~xpl.rl1t_.io~ date of Notice or Commencement (the expiration date is 1 year
Lr0m the date of recording unless a different date is specified.)
Signature of Owner: ~
,. V'
Sworn to and subscribed before me this /q'it. day of O{,fv her-
7.
8.
9.
Address
City
State
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
Address
City
State
~ d.COtf.
Notary Public:
,,\~~:;~/I, Suzanne Bahr
{~"'.'''''~<f\ Commission #DD157131
~~. ,..i?"':::::: Bonded Thru
''''/~Of.f.\.o,\"
'1,,,,,,\ Atlantic Bonding Co., Inc.
,ak-
My Commission Expires:
PC930S:3048
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
t3e-m i e
agree to the provisions of this instrument.
t.J. hI i:r
have read and fully understand and
I,
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile, that he or she
actually occupies, or will occupy by said domicile, and same is not for
rent, lease or sale. That he or she shall comply with the following conditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
4. That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc., where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourself. You may build or improve a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $25,000.
The building or residence must be for your own use or occupancy. It may not
be built or substantially improved for sale or lease. If you sell or lease a
building you have built or substantially improved yourself within 1 year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your building. It is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensat' for that employee, all as prescribed by law.
Your construction must com 1 w h all applicable laws, ordinances, building
codes, and zoning regula
OWNER'S
ADDRESS
PHONE
DATE
/ tJ ~J-I-()Y
WITNESS
PERMIT #
-Wi
Tn ~
....
0<
~
T 1001111 i
....
ts
Q.
~
ts
i
\\"~
~
>
:t
;
,.....
.-
III , ,
II I
II III
I I
III
~
-
I
~
~
t=
0<
i1'i
id
w
fj}