HomeMy WebLinkAbout05-4122
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4122
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:
4122
RE-ROOF
ROOF REPLACEMENT
SINGLE FAMILY RESIDENTIAL
Book:
8,390.00
4/19/2005
75.00
75.00
4/19/2005
RE-ROOF
Name: WILLIAM VIVAN
Address: 39035 1 OTH AVE
ZEPHYRHILLS, FL. 33542
Phone:
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
"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.
~~
URE PERMIT OFFI
LL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS !:'.I!i}(M.L ".L" fi.c"' r.LI.L'-'.n.... .....,...
BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME W \~\j\N\ ~ J\JIA-N
JOB ADDRESS 39osS"' /1J-fh, Ave...,
0f. ~\~ ~\s
'2 r"'~I\h.yrlJJ ~
1
PHONE
\=\
33 ~'1 .2.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I ~ # /:J. - ;;l.~" ;2 1- O;)"f.,O. 00 5 (56 - 0 '{ ~
(OBTAIN FROM PROPERTY TAX NOTICEl
o SIGN
o MOVE
o ALTERATION
o DEMOLISH
o REPAIR
o INSTALL
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOMI
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
~E ~C~..r
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.
lFy /;2 ;).
PERMITS REQUESTED
o BUILDING
$ 83'10.00
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
o PLUMBING
o MECHANICAL
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 AREAD YES 0 NO
::::::R~...~::::!~..:.::~~~~:;~~~~:~:.:~~~~
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTIC,E 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. CONSTRUCTOION 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 b7 requeste~
in writing to 'the Building Official. An approved inspect10n must be logged dur1ng 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
, 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
acknowledged
,20_
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
o who has produced
(type of identification)
and wnoO did Odid not take an oath.
o who has produced
(type of identification)
and who Odid Diid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
(f,3 c1D
State of
rlO'(c\A
11111111111111111111111111111I111111111111 11111 11111111111I1
'< -'+ - ~ 2005074401
'c""r,., 5e,,-'
NOTICE OF COMMENCEMENT
County of ~ SCD
THE lmOERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following infor~ation is provided in this Notice of Commencement:
1.
Description of Property: Parcel No.
12-26-21-0260-00500-0430
39035 10th Ave.
(Legal deser1pt1on of the property an street a
General Description of Improvement tfE -'Koo..(7
2 .
Rcpl:875496
os: 0.00
04/19/05
Rec: 10.00
IT: 0.00
Dpty Clerk
3. '*'
O\mcr Information: Name "'-I; IL'~i'Y' D4.V\S ~ Yiv\(\\\ C. Dav/S
r.ctdrcss s%?5 10+)., Av<;, City ~htrh; \~..,
Sta te -FL
3!.54;)..
Interest in Property:
Name of Fee Simple Titleholder:
(If other th~n owner)
JEO PITTMAN, PASCO COUNTY CLERK
04/19/05 08: 59am 1 of 1
O~ BK 6327 PG 476
Address
City
State
~ Contractor: Name
Address 3B..~{)8
State+ t ,
S3slt =t.
5.
Surety: Name
Address
City
State
Amount of Bond: $
6. Lender: Name
Address
City
State
7 .
Persons within the State of Florida
notices or o~her documents may be
713.13(1)(a)(7), [,lorida Statutes:
designated by Owner upon whcm
served as provided by Section
rJt:mc
Address
City
State
8. In addition to himself, Owner designates
C). fxp.i.rf'lt .I.'Jn d..,te Ot rlot.iee of Comm~ncement (the
from the ~~tc of rc~or~ing un~~ss a diff;rent
, --=-' ,.Jv'-\.; 1M'\. .~
~ Si<J:1ature of Owner: y~
Sworn to and subscribed before me this q day of
20 0,--)'
of to receive a copy of the
Lienor's Notice asprovlded In Section 713.13(1) (b), Florida Statutes.
expIration d~te is 1 yedr
date is specified.)
(h,qJE:.eh
NotLlry Publ ic :
Qli.r.l~\..c.A' ,0 .Jjn\A~
My (::J;T],;1i ssion Expires:
~~~ CHARLENe D. GOUCHER
W: :~ MY COMMISSION' DO 063562
'. . = EXPIRES: OcIober 25, 2IlO6 ,
. BondedThru P!cIlMI__~
PC93053048/A
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