HomeMy WebLinkAbout05-3996
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
3996
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:
3996
ADDITION/ALTERATION
434-ADD/AL T RESIDENTIAL
RV PARK
Address: 3506 PERIDOT LN
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: EMERALD POINTE RV RESORT
Parcel Number:
15,000.00
3/18/2005
255.00
255.00
3/18/2005
LANAI
Name: HARRY BOWLES
Address: 3506 PERIDOT LN
ZEPHYRHILLS, FL. 33542
Phone:
HOMEOWNER
HOMEOWNER
PLUMBING FEE
E B 1
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.
'~ ~[>.~. ~/'( t'~~.
. ~ CONTRACTO SIGNATURE 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
PHONE CONTACT FOR
3;1p5
PERMITTING '1 Of-{ - 1l/1( / l./2.fti
DATE RECEIVED
LEGAL DESCRIPTION: LOT(S)
PHmP~SCO PERMIT SERVICE
1-800-824-7894
Toll Free
SUBDIVISION cme r~1I '!V//Jk
,el/ ~.[()/'f
(OBTAIN FROM PROPERTY TAX NOTICE)
OWNER'S NAME )/a..-fY'!j I3rJttJ/N
JOB ADDRESS JS-~ P-tI'L'r4f ~IJ e
PARCEL 10 #
rJ.47
~'I." ~& -&1-/- (X) 70- O()aX) - J.-'I7 ()
BLOCK
WORK PROPSED: ~NEW CONSTRUCTION
o SIGN
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
PROPOSED USE: ~SGL FAMILY DWELLING
o COMMERCIAL
OMULTI - FAMIL Y
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
}~ )l-J~ LIL/JCLi
BUILDING SIZE
/61 )( 3rL
SQUARE FOOTAGE
.3/'1 f
HEIGHT
PERMITS REQUESTED
& (1) SET ENERGY FORMS.
FORMS.
/57, 5'> ~lOL
/} ~ >..;::. ~U;L
57 . ~'''' pl.r1\ (;
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.
'Fp BUILDING
o ELECTRICAL
$
Is-. COO . Of
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o Progress Energy 0
W.R.E.C.
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
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDER
/ SIGNATURE 11...') -:?J. .8~
COMPANY
()t{))J r
STATE CERT OR REGIST #
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ELECTRICIAN
-SIGNATURE :zI.7 11113~
COMPANY
() CUM r
STATE CERT OR REGIST #
******************************************************************
alUM r
PLUMBER
SIGNATURE .-:2/...7- 1/ ,8~
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 portions 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.
Applic: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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGe~ 1!,~1~NT
STATE OF FLORIDA ~
COUNTY OF r'ttS'O
The foregoing instrument was acknowledged
Before IJl~ this~day of ty)ttr{,.f", , 2005"
by t:M.r,.'1 1~1.:!l.1, ~
(name of person acknowledged)
~o is personally known to me, or
. ~ ?/~--A-
SIGNAT~ CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was ack~OWledged _
Before me ~is ~dale of 11)0..('1" l , 20 00
by I ('r"j tAl t'$
(name of person acknowledged)
[tho is personally known to me, or
Fksco
Owho has produced
(type
Odid not
of identification)
take an oath.
Owho has produced
(type of identification)
~id not take an oath
person taking acknowledgement
Name typed,
\1t1111
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Name
:f.~i1;';YO~06 Suzanne BahI
tY~J~~:!~~SI~~~~r,ted
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(, I'ry
NOTICE OF COMMENCEMENT
j19t
State of
;:: I(Jl' t (la..,
County of
fJ tc\f{'(?
TH~ UNDERSIGN~D hereby gives notic~ that improvement will be made to certain real property,
and m accordance wIth Chapter 713, Flonda Statutes, the following information is provided in
this Notice of Commencement:
1. Description of Property: Parcel No. ..) if -(:1 (P - J-I- Or) 7()- ()O()(JJ - ,;2 tj),j
L {' I ..,L fj 7 EN rfl: /1 /b;;6--- ;e t/ 13JO /' I ,] S- a:~ l?e /' ;c4! LcZ ~
(Legal description of the property and street address if available)
") General Description of Improvement J 1Y.. J. -3 iJ L (i. /7 it /
11111111111111111111111111111I111111I11111111111111I11111111
2005050843
~~;'i.~ Owner Information: Name /I <<-/'/'!J
M- Address 3YO{; I/~ FL.tiJ/- Ia.1..f..
l3a:t,' Ie.[
City
-;> . II..
'-.-<2/) i.'Jj.~h!t[
, v
Rcpt: 865628
os: 0.00
03/18/05
State/i, J35Y()
Interest in Property:
Rec: 10.00
IT: 0.00
Dply Clerk
Name of Fee Simple Titleholder:
(If other than owner)
Address
City
State
JED PITTMAN~ PASCO COUNTY CLERK
03/18/05 1~:0lrm 1 of 1
OR BK 627D PG 1475
State
4. Contractor: Name OiL) iLf (~
Address
5. Surety: Name
Address
Amount of Bond: $
6. Lender: Name
Address
City
City
State
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
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the Lienor's Notice as
provided in Section 713,13 (1) (b), Florida Statutes.
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 oJ Owner: >:%7'?!' ~.J.<-
Sworn to and SUbSCFib befQre.mt?this 07'8~
Notary Public:
day of ty)CLYcdJ.....
, 20 OS-.
PC93053048/ A
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DISCLOSDltB STA'f'BMBII'1' I'OR 0IIlUm
CITY OP ~Uxw1nT.T.A BUJ:LDDiIG DBPUT.MID1'l'
I, }/d-rrlf 13()(L)/.eJ have read and fu1ly understand aDd
agree to ~ provisions of this instrument.
The undersigned states and affi%ms that he or she is desirous of constructing,
renovating, .~~i 'rig to or reroof:I.Dg his or her own domicile, that he or she
actually occupies, or w:l.ll occupy by said domicile, and same is not for
rent, :Lease or sale. That he or she shal:L ccxaply w:l. th the following conditions:
1.
That the owner and he or she alone shall act as the builder for alJ. phases of
construction.
That the owner will ccxaply with all provisions of the City of Zepl:t.yrhi11s
ordi """"""'es and codes perti.DeDt to the buildiDg.
That iu the event various phases of construction are subcontracted, he wi11
engage only proper1y licensed subcontractors and rill personal.ly supervise
such work..
That in the event the Bui1diDg J:xuIp4lctor shal1 require corrections to be made,
the owner wi11 assume fu1l responsibility to iDaure they are made, and upon
comp1et:1on rill call for a redDepection before proceeding with. the building.
"l"hat the owner shal1 assume fu1l respcmsibi1i ty for the construction and will
not expect supervision of his work from the City of Zephyrhills BuildiDg
Depart:meDt.
That prior to f:inal inspection any additional. fees, iD.c1uciing reinspection
fees, must be paid iu fu11. A written request from this office shall
constitute an official notice to pay additional. fees.
That the owner shal.1 comply with all City, State and Pederal. laws in regard to
social security, workman's cOlllpeD.Sation, lien 1aws, etc., where app1icable.
That the owner shall ccxaply rith &11 the safety codes issued by the P10rida
J:ndustrial COIIIlBission.
State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption al1cnrs
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a 1icense. You must provide direct
onsite supervision of the CODStruction yourself. You may bui1d or improve a
one-fami1y or two-family resicieuce or a faxm. outbui.1diDg. You ~ also bui1d
or improve a cOllllll8rcial building'.. provided your costs do not exceeci $25, 000 .
The buildiDg or resicieuce must be for your own use or occupancy. J:t may not
be bui1t or substantially improved for sale or 1eas.. If you sell or 1ease a
. buildiDg you havebui1t or substantially improved yourse1f within 1 year after
the construction is COIIIp1ete, the 1aw will presume that you built or
substant:1allyiDlproved if for sale or 1ease, which is a violation of this
exemption. You may not hire an unlicensed persOn to act as your contractor or
to supervi.se people working on your building. It is your respcmsibility to
make sure that people elllp10yed by you have 1iceuses required by state law and
by county or JIlUDicipal. 1icensing or~i""ances. You may not delegate the
respOlUlihility for superv:i.s:I.Dg work to a 1iCeDaed contractor who is not
1icensed to perform the work being done. AD:y person working on your building
who is not 1iceused must work 'UDder your direct supervision and must be
employed by you, which means that you must decluct P.I.C.A. and withholding tax
and provide workers' compensation for that eaployee, all as prescribed. by law.
Your construction must comply with all applicab1e 1aws. ordi-"aD<:'es, building
codes, and zoning regulations.
5mBM"ORB ~ ~ ~
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OWJIBR.' S
ADDRBSS
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PBRKIT #
PASCO PCRMIT SEnVICE
1-866-824-7894
Toll Free
I/o. r-rYj /jOfL/.e~
Name
350& ~tL/c1- lAM
Address
Zef0rkl/I P/' 3JSlO
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,
~~ ~ t;...A-
signat er
NOTARY
STATE OF FLORIDA - COUNTY OF PASCO
The foregoing instrument was sworn to and
subscribed before me this ';(f~day of fY1~ , 0U)0'!i' .
Personally known ............... or Produced identification
"""'" Suzanne Bahr
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FAX NO,
Jan, 08 2005 03:45AM Pi
8717 N. NEBRASICAAVe:. TAMPA. FL33604 (813) 932-5893
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