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Home My WebLink About05-4171 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 4171 Permit Number: 4171 Permit Type: COMMERCIAL Class of Work: ADD/AL T COMMERCIAL Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 38122 12TH AVE ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 4,012.00 5/~/2005 .1 55.0.0 '1' 55.00 5/04/2005 WINDOW INSTALLATION Name: PRILLMAN MIKE Address: 38122 12TH AVE ZEPHYRHILLS, FL. 33542 Phone: FO IC 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. k. ~-. CONTRACTOR SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER JOB ADDRESS CITY OF ZEPHYRHILLS PERMIT APPLICA'1'J.U1't Cvfi!d/ 4';).(-'C~-; BUIWING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 813-780-0020 FAX: 813-780-0021 c2t1 () > (~,t11,M" PE:~TIETTREINCGEIV;;3 - ~ PHONE CONTACT FOR ~.~ ~ fklt..LMIJ11fv1lcJJ~ f} , 3. B I Z-Z / Z-r/.f. IfV PHONE ff/~?gr- ~tf1 OWNER'S NAME SUBDIVISION LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL ID it /1-&10 - 2/- (JD ID- Ds;gD{')- 6 Z1tJ {OBTAIN FROM PROPERTY TAX NOTICEl WORK PROPSED: ONEW CONSTRUCTION OSIGN o ADDITION o ALTERATION o REPAIR o INSTALL o MOVE o DEMOLISH PROPOSED USE: OSGL FAMILY DWELLING o COMMERCIAL OMULTI-FAMILY o INDUSTRIAL O. OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER DESCRIPTION OF WORK c=J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL I~ _ /ZI,IL (JIJIAdJ{1/vS I M C/A~ -/0 ~ (ff!;1) 6f'~/~~ I~ BUILDING SIZE RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGjtORMS. IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~~Z,)- :-------... 0~ "'---~ SQUARE FOOTAGE HEIGHT .fi BUILDING o ELECTRICAL $ Lf; 6{2. rJ PERMITS REQUESTED VALUATION OF TOTAL CONSTRUCTION AMP SERVICE o Progress Energy o 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 COMPANY BUIIDER SIGNATURE STATE CERT OR REGIST . ****************************************************************** ELECTRICIAN COMPANY SIGNATURE STATE CERT OR REGIST . ****************************************************************** PLUMBER COMPANY SIGNATURE STATE CERT OR REGIST it ****************************************************************** MECHANICAL COMPANY SIGNATURE STATE CERT OR REGIST it ***************************************************************** OT.ER LDJ!il'5 UmI~ COMPANY UI'lkS C0^t'9MeJ. If"!- SIGNATURE ~ STATE CERT' OR REGIST it DtLt o~ q / A. NOTIC,E OF DEED RESTRICTIONS The. undersigned understands that this permit may be subject to "deed restrictions" whiph 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~i6n 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, haye been provided with a copy 'of "Florida's Construction lien Law _ Homeowner's ,Protection Guide" prepared by the Florida Department or 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, 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 permtt 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 la 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 LEN DE OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER 2,500 IN VALO 0 N~O RECORD AND POST AifOTICE OF CO NCEMENT". SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT acknowledged , 2CL- STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____day of by STATE OF FLORIDA COUNTY OF ;he foregoing instrument was Before me this _____ day of by acknowledged , 20_ (name of person acknowledged) Owho is personally known to me, or o who has produced (type and wlioO did 0 did not of identification) take an oath. (name of person acknowledged) [1ho is personallY known to me, or o who has produced (, (type of identification) and who 0 did [}: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 SElMINOL.. FORM 408 FLA. '~'17 \.A.Wr;. FS ?1lS.13 NOTICE OF COMMENCEMENT ~::;:~f.~IO'idB.. ,} ,..:.....N ".."...., . 1l~~!~~III\IIIIIIIIII'IIIIIIIIII11II~mllll The undersigned hereby informs all concerned that Improvements will bE! made to oertain rearpropBrtY~8n~ci in accordenco with seetfon 713.13 of ttle florlde Statutes, the following Information It; ~tated In this NOTICE OF COMME.NCEMENT. D?:~Of ;roPB"Y; . ~L;-r~...0.,(~~. H 11. t;;;&.. ~f? 472': :::,.. ~f ~ ~;.. .F-i.' "".,..', ,Wj/{,).I.l,..,.. "" .e~T........, ,'r.?...I." ..~~. 51". ,7ft:,...,..". ..t),lJ, ,,7'" p"" 711~0. .M/ :;;1).~, !!.....4.4-.~~/,-:~/9. .7.~~8~. ,-:/?,~.(.~".."...~ ',',.',. ':"..."" p"",,".... General description ofimprovements.. K'.~fI-JlC~, ..aJ/.NDauJ. 5.,.".."..""....".",.., ....,.".. ......" Owner. .4?7(~IJAE4-.... d.'.'.?~/I...f:...?J'XI.A.J.......",.."........ ,,"" ,',."..".",."",."""""",.""".. Address., .~, <f/ ??:,..,.!.~ ,1:~,. .Zsf'./I!I&.#.t?:':-.~'A. E4.""" ,J~,~ ~~" ,'""""""..".. Owner's interest in site of the improvement. , . . , . , . , . . . ' , , , . , , . . , . , , , . , ' , , , , . , . . ,: ~~~l~ ~J~089 R~~ ~ ~~ 0:0 Fee Simple Title holder (If other than owner) , '04/11/05 Dpty Clerk Name '.,. /J/'/A-". ,." " , , . , . , , , ., , .. ., , '.'" "". . ...... , ':.,., ." .., , .' .' , "_,,, , , , , ,.,'..,.. " ' ":~:~,n~:,',~~,n,,,~,,_,:,~,,~, , " , , Address .. I ,".,.. _.. .0........ ....... 1,.,". ..... .... ,.. ....._.... ..... .11"-" ..... .... '0 0.... .._" I'- ... ._..... ,_.. OM .... r 0' ._---. R ! II' LlYy) , Contractor ,....A:J\fl/k J ~~\ e~ ,/'" L. Address ,7~ ;'\""i ';;;;. .~'~~'~,., ~'h~;'i~;1~ ~,'~" ';~ ;"1'" ('C'T~~'~'i;f'~'hi ~ ~"~.~~ ').; i'.".'" .."'.."""'..,.,..,.,..,.)."""........"""'.....,.,.,.."",',.".,.",.",..",."".""""".",.2",.", Surety (jhmy) . ..... ............ 11.0.. _.____ _._..... I... ......... .11 It. _...0.. .... '"I.'... "......, ...... ---......... .... '" Address :,."""",..,..,. " , . . , , , , . ' , , , , , . . . , , . , . . . . . . . , , , . , . . . . , . , , , , . . . , . , . , . . . . , ' , , . , , , , , , , ,Amount of bond $ , , , , , . , . , ' , , ' , , Any person making a loan, for the construction of the improvements: /1014- Name ." ,'/ /:. , , , . . . '. , , , . , . , . , , ' , , . , , . . . . . . . . , . ' , . , . . , . . . . . . , , . . . , . , . . , . . , , . . , , , , , . , , , , ' , . , . , , , . , , ' , , . , , , . , , , , ' ' , , , , . , , , , , , , ' , , Address ',.".,.,.,',""""",.,..,.,..'.'..".......,'"..,",.... .'" . , , , , , , , . , , , . , ' . , , , , , , , , ' , . , , , , , . , , , , , ' . , . , , , , , , , , , , , , , , , , Person Within the State of Florida designated by owner upon whom, notices or other documents may be served: Named/'&'., d~ uu u"",.: U U H"" U H H'"'''' ~~~~~!~;"2~CO 1 :~~TI CLER~ Address. , . .n___3lSu n 281 . I . . . ,. I........................ ' ._-_._.._.._..._~---~--- In addition to himself, owne,r de$ign8t~'~ th'~ 'f~'li~~i'~g .~~~~~~. ~~' ~~~~i~~' ~. ~'~~~'~; '~h~' i.i'~~~~;~ 'N~;i~~' ~~' ~'r~~i~i~d' i'l~ 's~~~i~~ .,' 713,13 (1) (hI. Florida S.tatutes. (Fill in ftt Owner.s aption),'; ~> .,-Name . . , . . . . , . .. . .. . ....... . . . ... . .. . .....~_._~ .--......_. ... _. . . . ... " . . _.. . _.. . .......... .. ... .. . . .. . . .. .. . .. . I . .. .. . .. . . . .. . .. .... . . Address "'"""",",..""."""""",.." . . ;j;2 THIS SPACe FOR RECORDER'S USE ONLY , ,. ." ,.,""""",...,"":.,""',.".,""""'" ""':""'" ',.. ...... '" , " ,~~a,. ,~'''' Owner Sworn to aild subscribed before me this , . , , ' , , , , , . , , ' ' , , , , ' , , ' , , , , , ' , , ;~~daYOf .. ,4;;4/....,. .fJ.'. ';. .",.~05 ~~ NAD. 0&"~1!' ,'....,..", ~ MYCOMMlSSI #DD394264 Notary Public ",OF:; ,EXPIRES: h 13. 2009 I J~3-NOTAltY FL Disco:mt Asooc:. Co, 1./1. d H::9L 20-~O-~002 - The Sunshine State - LICENSE N..MIER 8625-552-52-448-0 -=-~ LOUIS IEIUCIIAN tt2M TMlMUAVBIUE pan RICHEY, R. 1_ IIGO _OlIn: _ H81', _, BlDORllE. 12.... . 647 -- ....... EllNES f~ lU'UQI\n: --- ORGAN DONOR SAFE DRNER .. .... Opeowlion d. _ """icIe c:on.tibD& ~ '" eny 80briety _ requiIed by.... ./