HomeMy WebLinkAbout05-3754
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3754
Perml umber: 3754
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 3536 PERIDOT LN
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: EMERALD POINTE
Parcel Number:
10,000.00
1/13/2005
212.50
212.50
1/13/2005
12 X 32 LANAI
Name: MR. HOLLINGS WORTH
Address: 3536 PERIDOT LN.
ZEPHYRHILLS, FL. 33542
Phone:
HOMEOWNER
HOMEOWNER
E
PLUMBING FEE
52.50
L IC
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.
REINSPEcnON 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.
~ .fcari--1jc ~ ~
CONTRACTOR-SIGNATURE PERMIT OFF I
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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Lf1
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE lVED
IIfllc7
I
PHONE CONTACT
FOR PERMITTING
PASCO PERMIT SERVICE
PHONE 11-866-824-7894
Toll Fr~e
PARCEL ID #
.
J (lJ/Jes II 0 11/I}MMrllJ
J S- J(P ,!J~ n (/0/ .J L.llI) e
r}J9
~t.J.-J-& -~/- ()o7()- OOO()()- JJ90
BLOCK
OWNER'S NAME
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
SUBDIVISION C/7Um/c/ /l;JtJIe-
"- j/ N,so/'I ,/ ~\ft 5"
10BTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ~NEW CONSTRUCTION
o SIGN
PROPOSED USE: ~SGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
oALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
oMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
J
/tL XJd-- LtL/JCL/
BUILDING SIZE
SQUARE FOOTAGE
3ft/P
HEIGHT
PERMITS REQUESTED
& (1) SET ENERGY FORMS.
FORMS.
12u.~0 1~)C.
Tf;IJ. ~~ li-LiA.
SZ. ~ ?lJNJ6,
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.
rA BUILDING
r5f ELECTRICAL
C/- PLUMBING
o MECHANICAL
$
/(), D(}O. Ov
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
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAo YES ~ NO
BUILDER
COMPANY
hOlA.P- O(OjJ}J"
SIGNATUR~ ,",,-A~Q~,~~ STATE CERT OR REGIST f
- ******************* **********************************************
ELECTRICIAN
COMPANY
~ /U- /JI,().u r
STATE CERT OR REGIST #
******************************************************************
hOM ()t1JU r
PLUMBER
COMPANY
STATE CERT OR REGIST #
**********************
*****************************************
MECHANICAL
COMPANY
STATE CERT OR REGIST #
SIGNATURE
*****************************************************************
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 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".
~c~ ~!L
SIGNATURE: OWNER 0 AGENT
~(1~~ ~{
SIGNATURE: C~TRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this ~day of .7&muuj , 20 OS-
by
(name of person acknowledged)
~o is personally known to me, or
P dl.5c.o
STATE OF FLORIDA r,J
COUNTY OF ra..sc..p
The foregoing instrument wa~acknowledged
Before me this ~ day of ja~~ ' 20 oS-
by
(name of person acknowledged)
~ho is personally known to me, or
~ has produced ~.
(type of identification)
and whoo . d adid not take an oath.
~o
has produced ~.
(type of identification)
~id not take an oath
Sig of pe son taking acknowledgement
,,'~yP'u.'" Suzanne Bahr
Name typed, P~~~;~~~~~im~~~5;6J~
"':;";' . . 'oli,,:: . Bonded Thru
/{ OFr\,; "
'"" ", Atlantic Bonding Co., Inc.
Slgnat re of person taking acknowledgment
,""'" Suzanne Bahr
__~;'~~~.~lJl1;;;',< CQP'P'iooinn 11001';7131
Name t~~~.~fil;~Ml: ~ lSit1i0:l!6ed
--';~~i OF f~O~~'-- Bonded Th~
I'I!!' \\\. ;\tlantlc Bondmg Co., Inc.
~ tlJIl Af
Name
II O//;'/74\f taJrlA
if
J sae; jJ~n \ rft,f LaIJ.
Address
up/u,r Lik Fl JJrz/O
. :/
To Whom It May Concern,
Please be advised that:
Stacie Zullo, & Debbie Dokendorf of Pasco
Permit Service have my permission until further written
notice to sign and pick up permits for me.
Sincerely,
:~ r,~~o~\\",19'\:tl
\ ;- SIgnature
NOTARY
STATE OF FLORIDA - COUNTY OF PASCO
The foregoing instrument was sworn to and
subscribed before me this .J.j..p.. day of Jayut.c..r
Personally known or Produced identificatfon
,,'~~::t"l Suzanne Bahr
~~~~~~;). Com.mis~ion #ODI57131
:",' \ii....~ Expires. Nov 15,2006
'<:;:;.: . . . .,l,,:: Bonded Thru
//III~~t\\\\' Atlantic Bonding Co., Inc.
, ;:ZOO!)
---
Commissioned Stamp
and Expiration Date
~~~
Page 1
DJ:SCLOsmtB STATmlBR'l' B'OJi. OWRBR
cr.rY OJ!' ZBPBnB:ILLs B1T.[LJ)DIG DBPARTIIBII1'1'
Ja-m~J !lO//I~"ot{)or/-A
agree to the provisions "&f th:i.s instrument.
I,
have read and fu11y understand and
The undersigned states and affirms that he or she is desirous of constructing,
renovating, addiJig to or reroofing his or her O'WD. dcaici1e, that he or she
actua11y occupies, or wi11 occupy by said c:lomici1e, and same is not for
rent, 1ease or sa1e. That he or she sha11 comp1y with the fo11owing cOD.d:i.tions:
1. That the owner and he or she a10ne sha11 act as the bui1der for &11 phases of
construction.
2. That the owner wi11 comp1y with a11 provisions of the City of Zephyrhi1ls
ordinances and codes pertinent to the bui1ding.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will perscmal.ly supervise
such work..
4. That in the event the Bui1ding J:nsp8ctor sha1l require corrections to be made,
the owner wi11 assume fu11 responsibi1ity to insure they are made, and upon
completion wi11 ca11 for a reinspection before proceeding with the bui1di.ng.
5. That the O'WD.er sha1l assume fu11 responsibility for the construction and will
not expect supervision of his work from the City of Zeph.yrhills Building
Department.
6. That prior to final. inspection any additiona1 fees, including reinspection
fees, must be paid in fu11. A written request from th:i.s office sha11
constitute an officia1 notice to pay additional. fees.
7. That the O'WD.er sha11 comp1y with a11 City, State and Federa1 laws in regard to
socia1 security, workman's compensation, lien laws, etc., where app1icable.
8. That the 0WD.er sha1l comp1y with all the s~ety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by 1icensed contractors. You have
app1ied for a permit under aD. 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
ensi te supervision of the construction yourse1f. You may bui1d or improve a
one-fami1y or two-fami1y residence or a faxm outbuilding. You may a1so build
or improve a cOllDerCia1 bui1di:a.g, provided your costs do not exceed. $25,000.
The bui1ding or residence aust be for your own use or occupancy. It may not
be built or substantia11y improved for sale or lease. If you sel1 or lease a
. building you have built or substantia1ly improved yourse1f within 1 year after
the construction is camp1ete, the law wiJ.1 presWlle that you bui1t or
substantia11y improved if for sue or lease, which is a vio1ation of th:i.s
exemption. You may DOt hire aD. unl.icensed person to act as your contractor or
to supervise people working on your building. :It is your responsibi1i ty to
make sure that people employed by you have licenses required by state law and
by county or DlUDicipa1 J.icensing ordi-qances. You may not delegate the
responsibili ty for s-upervising work to a J.icensed contractor who is not
1icensed to perfOrDl the work being done. Any person working on your bui1ding
who is not 1icensed DlUSt work under your direct supervision and must be
emp10yed by you, which :means that you DlUSt deduct F.:I.C.A. and withhoJ.di.ng tax
and provide workers' compensation for that emp1oyee, a1l as prescribed by law.
Your construction must comply with a1l applicab1e laws, ordinances, building
codes, and zoning regu1ations.
OWHBR.' S
ADDRESS
PROBE
DATE
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