HomeMy WebLinkAbout05-4015
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
4015
Permit Number: 4015
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 3/30/2005
Total Fees: 4,442.58
Amount Paid: 4,442.58
Date Paid: 3/30/2005
Work Desc: M.H. SET UP
Address: 37331 GILL AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: GRAND HORIZON
Address: 37331 GILL AVE
ZEPHYRHILLS, FL. 33542
Phone:
ACE AIR CONDITIONING & ELEC.
BUTTERFIELD MOBILE HOME SERVICE
ACE REFRIGERATION INC
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIFISUB 99%
WATER METER RES 3/4"
IRRIGATION CONNECTION
FIRE IMPACT FEE
PUBLIC SAFETY 5%
4.
60.00
35.00
1,572.12
180.00
175.00
273.00
26.35
C
WATER CONNECTION MOBILE He
MOBILE HOME PLUMBING
MOBILE HOME TIF/SUB 1%
IRRIGATION METER
PARK FEES MH
POLICE IMPACT FEE
209.50
40.00
15.88
180.00
573.73
254.00
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r: IJln(~ U~ 0 0
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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.
UJ~ EtJ?~ ~~
CONTRACTO IGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME &-l'arlAlJ
.
/-10/2, I "t. OI1V .i
PHONE
JOB ADDRESS '3, J:J/, (,. i If /lu~
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY,TAX NOTICEl
WORK PROPSED: 0 NEW CONSTRUCTION
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
DSIGN
o MOVE
o DEMOLISH
PROPOSED USE: oSGL FAMILY DWELLING
o COMMERCIAL
oMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
tJ MOBILE- HOME
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
BUILDING SIZE :J 7)( .5"(
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 CONSTRUCTION.
PERMITS REQUESTED
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
BUILDER
SIGNATURE W c....y- LJ ----X~
COMPANY
STATE CERT OR REGIST #
******************************************************************
ELECTRICIAN
COMPANY
j1c:..E..
SIGNATURE
w t:-,..- L3~
STATE CERT OR REGIST #
******************************************************************
SIGNATURE
VJC,? ~ 4-A-L/P
COMPANY 11~~
STATE CERT OR REGIST #
PLUMBER
******************************************************************
MECHANICAL
COMPANY
/lc.~
SIGNATURE
VJcy- p~
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTI~E OF DEED RESTRICTIONS
Th~ 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
your 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
p. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES(AS AMENDED)
I certify that Ii the applicant, haye been pl:ovided 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 issuahce of a permit and that
all work wiil 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 extens~on shall be requeste~
in writing to'the Building Official. An approved inspection must be logged during each s~x
month period or the project will be considered abandoned.
WARNING TO O~NER: 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
, 2U-.
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
ackno\.'lledged
( 20_
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type of identification)
and whoD did Ddid not take an oath.
Dwho has produced
(type of identification)
and who Ddid Odid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
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.' ~,,(;O'Cn(JNTY, FLORIDA
Permit No. ,.' '-/0 (5
Date Permitted "j ,~o ~o5
Builder Name/Owner Nama rO~AAeQ ?1rt212frv, control # ' .
County Parcel No, 34- ). 5"-? I - (l MO . 0 ':J..4o j.. 1'7 :1mt,OiV: @, If '
Address/Location 3i 33((;(// HUe, A6'Tl t-r::L-
~to~)I'/~ I~
ClassificationlTYPi:l of Us~
TRANSPORTATION IMPACT FEE, Rate:
Exempt 0 Yes @Nb How Determined
Impact Fee Amount $ I"S?6' ~ Zone No.
Sq Ft Unit:
TAZ:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House
(057) Mobile Home
(058) gther Residential
J:123),/'Collection Fee .
Exempt lJ/Xes 0 No How Determined
Amount $
PARKS AND RECREATION FEE'
Land Account Land Credit
Land Total
Recreation Account
Recreation Credit Recreation Total
TOTAL AMOUNT $.5' 73' 73
Zone
Exempt 0 yes ~/ How Determined
LIBRARY FEE
Land Account
Land Credit
Facility Account Facility Credit --
.------- .
Exempt 0 Yes ~a------~termined
~--- .
RESOURCE FEE ' ,
~,n _ ,01
TOTAL AMOUNT ~
Facility Total
Total Amount
ERU
Prepared By
Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
, BEEN PAID AND
RECEIPTED FoR BY A CENTRAL P~RMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of a copy of thlfi form, placing
the building permit owner on notice of this assessment and th~ conditions of payment for same.
, .
7J!g .'.. RE~
L -.7)$/ tb BY
I
DATE
RECEIPT NO.
q/OJL~ DATE