HomeMy WebLinkAbout05-4480
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4480
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:
4480
RE-ROOF
ROOF REPLACEMENT
NOT APPLICABLE
Address: 5737 18TH T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
3,640.00
6/23/2005
50.00
50.00
6/16/2005
RE-ROOF
Name: LEWIS, AUGUSTA
Address: 5737 18TH ST
ZEPHYRHILLS, FL. 33542
Phone:
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
"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.
v~~~ - ~.
CONTRACT R SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
. BUILDtNG DEPARTMENT
DATE RECEIVED
PLANs REVIEW FEE
OWNER'S NAME ~ \l'<J \.1ST f\ k\,,))-s
JOB ADDRESS_S"13i \1;tb fl.
PHONE
PARCEL ID # _ \\L..(.'2..\ \)Ole> t)c:g~~ Ot\\l\
LEGAL DESCRIPTION: LOT(S) BLOCK
SUBDIVISION
~
WORK PROPSED: ONEW CONSTRUCTION o ADDITION ." OALTERATION -' REPAIR o INSTALL
Os I GN o MOVE 0 DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING OMULTI - FAMIL Y DU OF UNITS o MOBILE He
o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER
{OBTATN PROM P8D~ERTY TAX NOTTCFJ
DESCRIPTION OF WORK
~.~
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL:
COMMERCIAL:
ATTACH (2) PLOT
ATTACH (3) SETS
PROPERTY SURVEY
PLANs & (2) SETS OF BUILDING PLANs & (1) SET ENERGY FORMs.
OF BUILDING PLANs & (1) SET ENERGY FORMS.
REQUIRED FOR ALL NEW CONSTRUCTION.
\
i )L(~0 //
( t I //
''''--~
o BUILDING
$
PERMITS REQUESTED
"3 b .1.) 0 ,ltJ VALUATION OF TOTAL C~NSTRUCTION
) -
AMP SERVICE 0 FLORIDA POWER
o
W.R.E.C,
o ELECTRICAL
o PLUMBING
o MECHANICAL
o GAS ~OOFING
TYPE OF CONSTRUCTION: 0 BLOCK
$
D SPECIALTY
o OTHER
VALUATION OF MECRANCIAL INSTALLATION
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE MEAD YES 0 NO
BUILDER
ELECTRICIAN
*******************************************************,~**********
COMPANY
STATE CERT OR REGIST it
CITY PROCESSING ~
SIGNATURE
PLUMBER.
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COMPANY
STATE CERT OR REGIST it
CITY PROCESSING it
SIGNATURE
MECHANI CAL
**********~*******************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING # _
SIGNATURE
OT~ 7z /
SIGNATURE - u f1.r
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COMPANY
STATE CERT OR REGIST ff
CITY PROCESSING ff
SIGNATURE
COMPANY ~,0rn{7 VJ (nn5fru (l i) fYJ+ )nc .
= STATE CERT OR REGIST 1# r ('1(', ~ l.~~, "];"')()<)
CTTY PRnr~~~TU~ il
u, Ul\iLl.Lt;N::it;D 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 c?ntrac~~~ are uncertain as to what
licerising requirements may apply for the intended work, they a~e advised to contact the
City of Zephyrhills Building Department, 813-788-6611. . ",,'
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs as the contractor, Y9u are indicating that
you, rather than the contractor, are responsible for the work: ' .If ~he contractor wishes
you to sign as contractor that may be an indicatiorf'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 someon.~ 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 "o...mer" 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..,cQhstruction, zoning, and land
development.
Application 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, C~Fess 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.'I, 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 allol-Ied 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 FO~ IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCINGr 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 COI'1MENCEMENT".
4~~ENT ~~
STATE OF FLORIDA -~ "'.r (. . ~, STATE OF FLORIDA ~.) l\. A:(I(_,"",
COUNTY OF ~t. :) '- l... .J COUNTY OF .', ,L_---L
The foregoing instrument was acknowledged The foregoing instrument was acknowledged
Before me this --!i-- day of _'UiI'" , >'l:lUU Before me this c-P-day O~{I\..( , ";"Xl.[)
by I)e fr~ ~I''':'' , by f1z 21:i J .'i'''' U '\.-
(nam; 0 person acknowledged) ~. (n me of person acknowledged)
'~hO is personally known to me, or ~o is personally known to me, or
o who has produced 0 who has produced
(type of identification) (type of identification)
id not take an oath. and V{flo Ddid ~id not; take ~n oath
Je l )u
of erson taking acknowledgement
.,P ~~ Angela Helms '
!~ 'f: My Commission 00165587
'e ",,'.j ~aares Jalluo'J 63, 29Q~
typed, ~!r t or stampe
Name
NOTICE OF COMMENCEMENT
State of ~ Lor,;J 1\ C~~~ty of '9 A<:;c..o
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and In accordance wIth Chapter 713, Florida Statutes, the fOllowing information is provided in
thIS NotIce of Commencement:
1. Description of Property: Parcel No. \\ 7J.p 'G-\ bblo O~~ bolO
(Legal description of the property and street address if available)
2. G e n era I Des cri p t i on of 1 m p ro vem en t 'k ~ III"" II"""" 1"11I"" """"" """"" """"""1
2005121041
Rcpt: 894271 Rec: 10. 00
DS: 0.00 IT: 0.00
06/16/05 ---________ Dpty Clerk
3. Owner Information: Name AeJ~ vn-A ~WIS
Address !> 7~'1 \11' Ih... ST. Ci ty "'-91..., t \-;, \)~
Interest in Property:
State FL >"15Y2...
Name of Fee Simple Titleholder:
(If other than owner)
JED PITTMAN1 PASCO COUNTY CLERK -
06/16/05 1 : 23am 1 of 1
OR BK 6425 PG 1459
~~..~".';.~.t 4
-;""i. .
,~
Address
Contractor: Name ~.....-' ~(::)
Address ~,~"2..S- S~ S~
City
State
S. Surety: Name
C i t Y '"'l..c.. ~ '-)4t. ~\'\\ ~
S tat&\... ""1')) 'jl.,.
Address
City
State
Amount of Bond: $
6. Lender: Name
Address
City
State
7. Persons within the State of Florida designated by Owner upon whom notices or other
documents may be served as provided by Section 713.13 (1) (a) (7), Florida Statutes:
Name
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the Lienor's Notice as
provided in Section 713.13 (1) (b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration clate is 1 year from the date
of recording unless a different date is specified.)
Signature of Owner: .:r- t1t rf/0 I ,JipuIJ
Sworn to and subscri ed before me this /_5 ,day of __,_~~, It fl_
Notary Public: ~~-..-J
, 2cxJ::-).
My Commission Expires:
PC93053048/A