HomeMy WebLinkAbout05-3940
. ,I
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813}780-0020
MOBILE HOME SET-UP
3940
PermIt Number: 3940
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 3/03/2005
Total Fees: 4,442.58
Amount Paid: 4,442.58
Date Paid: 3/03/2005
Work Desc: MOBILE HOME SET-UP
Address: 37413 GILL AVE.
ZEPHYRHILLS, FL.
Township: Range: Book:
cPjUs): 179...) Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
Name: GRAND HORIZONS
Address: 37413 GILL AVE.
ZEPHYRHILLS, FL. 33542
Phone:
I ME ELE
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIF/SUB 99%
WATER METER RES 3/4"
IRRIGATION CONNECTION
FIRE IMPACT FEE
PUBLIC SAFETY 5%
60.00 WATER CONNECTION MOBILE HC
35.00 MOBILE HOME PLUMBING
1,572.12 MOBILE HOME TIFISUB 1%
180.00 IRRIGATION METER
175.00 PARK FEES MH
273.00 POLICE IMPACT FEE
26.35
209.50
40.00
15.88
180.00
573.73
254.00
PE
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REINSPECTlON 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
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.
Ji?~ c P
CONTRACTORS SIGNAlj
CALLFO
~~
PERM IT OFFI
I N - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATIU~
BUILDING DEPARTMENT 5335 8TH st, Zephyrhi11s, FL 33542
813-780-0020 FAX:813-780-0021
DATE RECEIVED
3/3~S
PHONE CONTACT FOR PERMITTING
IIO/f-/"2.c;.,;N
I.:J &. ~(( vA-
LOT (S) /1r BLOCK
PHONE
SUBDIVISION
PARCEL ID #
WORK PROPSED: 0 NEW CONSTRUCTION
(OBTAIN FROM PROPERTY.TAX NOTICEl
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~ HOME
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APpROVAL
m)/ "C; / !J?
I -,.I ,
BUILDING SIZE ,1 rt sf
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 CONST.ROCTION/? .
. l /Jml t~ fI\lIJLiL )
PERMITS REQUESTlw S ~~;;~
VALUATION OF TOTAL CONSTRUCTION ',--
o GAS
o ROOFING
o SPECIALTY
AMP SERVICE 0 Progress Energy 0 w"..R:1::' c'~
VALUATION OF MECHANCIAL I NSTALLAT'c ~~10
"-'-
0 OTHER
$
o BUILDING
o ELECTRICAL
o PLUMBING
o MECHANICAL $
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
SIGNATURE
COMPANY
(..0 "7----p:J..~ STATE CERT OR REGIST I
************* ****************************************************
BUILDER
SIGNATURE
{~~/J~
COMPANY jtfC- <L-
ELECTRICIAN
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
~;M
SIGNATURE
.{.-u 7-- 4- ,. STATE CERT OR REGIST I
******************************************************************
MECHANICAL
COMPANY
J4C2-~
,
SIGNATURE
lJoJ ~
--~
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The. unde~signed 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:J:'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, haye 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 conunencement.
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.
Appliqation is hereby made to obtain a permit to do work and instaliation as indicated. I
certify that no work or installation has commenced prior to issuance of a permit and that
all work wiil be psrformed 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 inolude 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 conunenced 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 conunenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requeste~
in writing to "the Building Official. An approved inspection must be logged during each S1X
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: CONTRACTOR
SIGNATURE: OWNER OR AGENT
acknowledged
, 2~
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)
[1ho is personally known to me, or
D who has produced
(type of identification)
and wnoD did Ddid not take an oath.
o who has produced
(type of identification)
and who Odid [):iid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
I
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
5- v Cfer?
WATER ACCT. NO.
DATE S -:3 -D.:)
OWNERI
RENTER
~","L ~~
MAILING
SERVICE ADDRESS r$7J/i3 ~.d.0 {k. At' r /71
0 ~ WATER
SHUT OFF SERVICE
~ 0 SEWER
TURN ON SERVICE
t( 0 GARBAGE
INSTALL METER
xJ
0 IN CITY
READ METER
0 0 OUT CITY
CHECK METER --'- No. OF UNITS
OTHER 0
_ DEPOSIT AMOUNT
f0.~
_ AMOUNT lAST BILL
_ DATE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
3-:$--06
ORDER GIVEN BY
LJ
Retain white form in office at all times.
Send pink & yellow forms to Water Service Depl.
Water Service Depl. to sign yellow form & return to office.
~
PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
(; - <:::> '19 Y
WATER ACCT. NO.
DATE 3-.-::]-05
OWNERI
RENTER
~~ GY~~
MAILING
.:::3 6. t.;t
.--:- I'
/I ~';i;L07V.ffi?_
SERVICE ADDRESS ..:3 7'11-'1
SHUT OFF SERVICE 0
TURN ON SERVICE 'x1
INSTALL METER ~.
READ METER 0
CHECK METER 0
OTHER 0
l
WORK COMPLETED BY
& DATE COMPLETED
~/t1~ tk-, i"r /1'9
)z{ WATER
o SEWER
o GARBAGE
'WIN CITY
o OUT CITY
-L No. OF UNITS
_ DEPOSIT AMOUNT
_ AMOUNT lAST BILL
_ DATE
_ MISC. CHARGE
ORDER TAKEN BY
Retain white form in office at all times.
Send pink & yellow forms to Water Service Depl.
Water Service Depl. to sign yellow form & return to office.
,A..-0
t' (,'1
Permit No. . ~ '1"1D
Date Permitted :;-Ij-D5:
~ner Name {2,,7.bAI';;/ 7J1Ij: r control,#.. . Qi1.'
. County P areel No, 3 L( - ?.~. do J - ,,0'10 - {) ;},.'I'O I 7 7 subDlv, cJi;, ~ ",.I . · if f7J1 S
Address/Location r-37.1//3 ',c1f..l/-!' 0/1-(, LoT' 7'1
ClassificationlTyp~ of Us~ ~?da~ Qi8"J'" ~-
TRANSPORTATION IMPACT FEE. RClte: Sq Ft Unit:
Exempt 0 Yes 54 No How Determined
Impact Fee Amount $. 1.5}f;J /;( Zone No, TAl:
. ffJd .9- '1-0 t)
SCHOOL IMPACT FeE (/ .
Account (056) Single-Family Detached House Amount $
(057) Mobile Home
(058) Other Residential
W~) Collection Fee
Exempt ~:5 0 No How DetermlnE;ld
PARKS AND RECREATION FEE
Land Account . Land Credit L~nd Total
PASCO COUNTY, FLORIDA
Recreation Account
Recreation Credit
R~creation Total
Zone
TOTAL AMOUNT
$ , f1g. 1:3
J~ J-/f-D5
.
Exempt
o yes ~ No
How Determined
LIBRARY FEE
Land Account
Land Credit
Land Total __--------.
Facility Account
Facility Total
No
How Determined
Total Amount
RESOURCE FEE
TOTAL AMOUNT
. .
~~.3D
ERU
Prepared By
Checked By
I
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOl,fNTS LISTED HAVE
. BEEN PAID AND
RECEIPTED FOFt BY A CENTRAL PERMITTING OfFICE OF PASCO COUNTY
Acknowledgement below does not Imply acc~ptance of concl,Jrrence, but simply receipt of a copy of thll! form. plaolng
. the building permit owner on notice of this assessment af!d th~ conditions of payment for same. .
DATE
RECEIPT NO. ~ DATE