HomeMy WebLinkAbout05-4129
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4129
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:
4129
ADDITION/ALTERATION
434-ADD/AL T RESIDENTIAL
SINGLE FAMILY RESIDENTIAL
A dress: 38353 IR NWOOD PL.
ZEPHYRHILLS, FL.
Township: Range:
Lot{s): Block:
Subdivision: DRIFTWOOD
Parcel Number:
Book:
Section:
2,643.00
4/20/2005
67.50
67.50
4/20/2005
REPLACING 7 WINDOWS
Phone:
OTE H 1 B
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.
~~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICAT~UN
BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542
813-780-0020 FAX: 813-780-0021 i I ) ~ 05
DATE RECEIVED ~ - -
PHONE CONTACT FOR PERMITTING 81 ~- 'if:> 7-~46'!../
JOB ADDRESS
ICls/J~ ~(jP6JZE, 12e16v1>
I
~5p 5"3 I/Ul/ 1A/I1f]) f?L
PHONE
q,.~1/~~ 7615
OWNER'S NAME
LEGAL DESCRIPTION: LOT(S) BLOCK
PARCEL ID #D2- Ue. Z--! 6Z,/A f50M06 (51),'2---0
SUBDIVISION PYll.}-/tV-i!J
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o SIGN
PROPOSED USE: []SGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
oALTERATION
o REPAIR
Jl(INSTALL
o MOVE
o DEMOLISH
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
121 fL I W '~nvS / ML ~ I ~u~l+ 6f(l:lVlrv~
BUILDING SIZE
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 ENERGYJORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ,r~
{o'7, ~
PERMITS REQUESTED
o BUILDING
$
~b '-(3. fA
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 AREAo YES 0 NO
[~.~_~=~~~i=:~,=_'~,_~.~:.~=~=,~-~'~~~:~:. _~_~~ _ __ __, -- __ _ _ " __ __ _ - :~~~:~~:__~_~~:,~~~_-~~'_:: _-=~~--'~~~~il::~~: I;
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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OTHER (p1l'K/5 l~~J /NL
SIGNATURE /Y~ 1 ~.
COMPANY Uf/l;.€l,S )1rn't ~:wrd J tv!-
STATE CERT OR REGIST # .G/ZL6S-116 f
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 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. 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.
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 be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project ~i11 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: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 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 whoo did 0 did not
of identification)
take an oath.
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
LaWE.S
Com...nleS.nc.
8529 South Park Cr.
Suite 430
Orlando, Florida 32819
Bus. 407/370-2872
Fax, 407/352-6309
#;~j~
Date:
To: City of Zephyrhills Building Department
5335 8th Street
Zephyrhills, Florida 33542
From: Rebeca Alicia Banuelos-Bernard
I hereby authorize the following individual, Michael L. Berkman, to act as my agent to apply for, sign for and pick up permits
under my State Certified Residential Contractor's License, CRC 057468.
Homeowner Name: /45-/}- --;TKo)) lite / ~I>
.3 g ~ ~::s I /2rJ, /;W8]) fl L-
~k;r~j!;)J
/-- 1 flvJ /'vP~ Y
Address of Job:
City:
Type of Work:
Thank you for your assistance.
Sincerely,
~QA';(
'. Rebeca AliCia B elos-Bernard
Regional Installed Sales Manager
Primary State Qualifier CRC 057468
Sworn '0 Md ,ob"riboo ::11:/ cf ~ ofd20rA
No.public
My commission expires
~~~~'ii--V:I;'~;;:.,,.., Rebecca Velez
:'j" .~ ..~;~ MY COMMISSION # DD~76963 EXPIRES
>'~"7..,,"..o January 12, L007
. .c.c;'o;." BONDED THRU TROY FAIN INSURANC~ INC.
:..""