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Home My WebLink About05-4004 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 MOBILE HOME SET-UP 4004 Permit Number: 4004 Permit Type: MOBILE HOME Class of Work: MOBILE HOME SET-UP Proposed Use: MOBILE HOME SUBDIVISION Square Feet: Est. Value: Improv. Cost: Date Issued: 3/23/2005 Total Fees: 4,442.58 Amount Paid: 4,442.58 Date Paid: 3/23/2005 Work Desc: M.H. SET UP Address: 37436 LILLY BEA AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): I/'O Block: Section: Subdivision: GRAND HORIZONS Parcel Number: Name: GRAND HORIZON Address: 37436 LILLY BEA AVE ZEPHYRHILLS, FL. 33542 Phone: H ACE AIR CONDITIONING & ELEC. BUTTERFIELD MOBILE HOME SERVICE ACE REFRIGERATION INC 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% .0 60.00 35.00 1,572.12 180.00 175.00 273.00 26.35 ILE WATER CONNECTION MOBILE HC MOBILE HOME PLUMBING MOBILE HOME TIFISUB 1% IRRIGATION METER PARK FEES MH POLICE IMPACT FEE 209.50 40.00 15.88 180.00 573.73 254.00 ( ;;{~i / ,I r/5/0;? ~\~ r1'-' .6Ch{t ~I ;7 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 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. cAJ~~ ~_. CONTRACTOR SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8~H St, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 DATE RECEIVED }/z/H PHONE CONTACT FOR PERMITTING OWNER'S NAME (r~",...J JOB ADDRESS 3 7Y;J (, - H 0 "17.. C1"v L '/(. I ..,. PHONE 8e,,-(. I1J~ L.., 1ft tJ , LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # WORK PROPSED: DNEW CONSTRUCTION o SIGN (OBTAIN FROM PROPERTY TAX NOTICEl o ADDITION o ALTERATION o REPAIR o INSTALL o MOVE o DEMOLI SH PROPOSED USE: DSGL FAMILY DWELLING o COMMERCIAL OMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK fe1 \ It BUILDING SIZE SQUARE FOOTAGE HEIGHT 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. PERMITS REQUESTED -t 4001 o BUILDING $ VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL 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 AREAD YES 0 NO COMPANY STATE CERT OR REGIST # ****************************************************************** ELECTRICIAN COMPANY n c... ~ SIGNATURE w~~~ STATE CERT OR REGIST # ****************************************************************** SIGNATURE w C!y--7:J-A.k~ ~.. .-n //JJ.1 COMPANY L::>~ PLUMBER STATE CERT OR REGIST # ****************************************************************** MECHANICAL /!,~ COMPANY SIGNATURE w.,.. ~~ STATE CERT OR REGIST # ***************************************************************** OTHER COMPANY SIGNATURE STATE CERT OR REGIST # A. NOTI~E OF DEED RESTRICTIONS The. undersigned understands that this permit may be subject to "deed restrictions" whicfl may be more restrictive than City regulations. The undersigned assumes responsibility'f9f 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 "Cohtractor 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 Ii the applicant, have been provided with a copy of "Florida's Construction lien ~aw _ 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. Appliqation 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, wetiand 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 a~andoned.for \a period of six months after the time the work is commenced. One 90 day extenS:LOn of t~me may be allowed for the permit with fee charge of $15.00. .The extension shall b~ requeste~ in writing to'the Building Official. An approved inspect~on must be logged dur~ng each s~x 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 ackno..1J edged ,20_ 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) C1ho is personally known to me, or Owho has produced (type and whoD did 0 did not of identification) take an oath. o who has produced (type of identification) and who Ddid [}:lid not take an oath Signature of person taking acknowledgment Signature of person taking acknowledgement Name typed, printed or stamped Name typed, printed or stamped ..."".._~___>._~".._ . .,.__.o_......_.""__...,,'"_>...___...'..~"--~.....- /tJt) 6A--sc/J?c.uT f1' 't' toT /~ () 370/30 t:/f.{r- dc~ ~IfD cl !loR I 2LJ ~ ..J' ~ '.tM. S e1 ~ ~'1 . . d~ f uI'l. -ell( Pdt". . fifil) I r. /eft A':. jJt,O OJ ,1 *'" j J /15/ ~' UtJ ~~ iF I ~ . ( I . . 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County parcel No. !YI- ').. !;- 1. I - tH) 90 - Cl;J. '1 tJ j. I[uqolv: (] ( H. Address/Location 3'1 '13& J.. II ~ &c_ AJe, ,,( tJ T / to D Classificationrrype of Us~ yYl.oVJ i Ie. t~- TRANSPORTATION IMPACT FEE, Rqte: Exempt 0 Yes ~o How Determined Impact Fee Amount $. ! _5 S S' Zone No. SCHOOL IMPACT FEE Account (056) Single-Family Detached House (057) Mobile Home (058) . Other Residential J.:l2JY' C~e~on Fee ' Exempt l.[YYes ~o How Determln~d Sq Ft Unit: TAl: Amount $ PARKS AND RECREATION FEE' Land Account Land Credit L~nd Total Recreation Account Recreation Credit Recreation Total DYes ~ TOTAL AMOUNT $ 5-73',73 Zone Exempt How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Facility Credit Exempt 0 Yes :::--- . RfsoORCE FEE ' '?JJ1. q \ TOTAL AMOUNT J ___-Faclllty lotal Total Amount ERU Prepared By Checked By NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOl!NTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PJ:RMITTING OPFICEOF PASCO COUNTY Acknowledgement below does not Imply acceptance of conc~rrence, but simply receipt of a copy of thll? form, placing the building permit owner on notice of this assessment and thQ conditions of payment for same. . ' DATE RECEIPT NO. Dlo7~S DATE -=t -2-) rlb BY 8'~'