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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4531
Permit Number: 4531
Permit Type: COMMERCIAL
Class of Work: ADD/AL T COMMERCIAL
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost: 67,402.00
Date Issued: 6/22/2005
Total Fees: 645.15
Amount Paid: 645.15
Date Paid: 6/22/2005
Work Desc: REMODEL EXISTING PORTICO ONLY
Address: 5734 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-2600-0250
Phone:
ALL-IN-ONE ELECTRIC
RADON
6.91 FIRE PLAN REVIEW FEES
40.24
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.
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.
~RE - ~M~
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
.,.
DATE RECEIVED
6/13/0f
,
PHONE CONTACT FOR PERMITTING-.3:)2- z.?8-/S""~8
.. c;;oh~ J"" L NC-,
OWNER'S NAM0c~/- 1(4,.-:-57-;-;--'/1) Clf 2/~?,;/r)Au(" PHONE
JOB ADDRESSS7r -::;Lj 6' /)//. .p='LL/,()
LEGAL DESCRIPTION: LOT (S) / / BLOCK SUBDIVISION
. i ~ f:cc'. .
PARCEL ID #i/ 26 Z/ 0C..:J/OV -'J(JZ- .5,-/ (OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: DNEW CONSTRUCTION ~DDITION 01rt,TERATION 0 REPAIR 0 INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION
OF wo.f1
& ijij~T~DEPARTMENT APP~VAL
~'j)j>L i\fnlll-.!..,,- ~I\.TI.L(>)tJ L
c-" . / S(' ti
HEIGHT C. 3 td C
f~l~
SQUARE FOOTAGE
BUILDING SIZE
PERMITS REQUESTED
& (1) SET ENERGY FORMS.
FORMS. ~h.-')'SrJ vvT
fGrL AW)Tr~;\.A"-
e,0-/1I\ 1"'\ r;;,~
~Ti lUL. 16...:.: i -.:V ~J r
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.
ri BUILDING
d ELECTRI CAL
a'" PLUMBING
~ECHANICAL
o GAS ~ROOFING
$
f "l ~ n tJ ~.
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o Progress Energy 0
W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
f1 qS3/
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: ~BLOCK gI FRAME
FINISHED FLOOR ELEVATIONSro()1Cl~ &.IS it tJe"'
~TEEL
o OTHER
IS PROJECT IN FLOOD ZONE AREAO YES
o NO
BUILDER
SIGN~~
STATE CERT OR REGIST # L, GG (!(p/ t~.r:; I
***************~
**********************************************
SIGNATURE
COMPANyfflL - I A! - (')1\ ) E n J7C'ir 'C'_ d
/" .
.. STATE CERT OR REGIST # C, c' / ..J.38 / ./vI:IjC ?
*********************
********************************************
SIGNATURE
~ -
COMPANY LLON l~ . tcu.-rn.h,."l6.
STATE CERT OR REGIST # OFt.! /i./.!)..62- 6~
. .
PLUMBER
SIGNATURE
******************************************tt**********************
COMPANY HlrO r{'y] fh I c.S
STATE CERT OR REGIST # {,,*JC (, <;16o.'::J- 7
MECHANICAL
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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 res~onsib~lity 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 d~y extension of time
may be allowed for the permit with fee charge of $15,00, The extens10n shall b~ requeste~
in writing to'the Building Official. An approved inspection 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
, 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)
[1ho is personally known to me, or
Owho has produced
(type of identification)
and whoO did 0 did not take an oath.
o who has produced
(type of identification)
and who Odid Q:iid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
Zephyrhills Fire Rescue
6907 Dairy Road
Zephyrhills, FL 33542
(813) 780-0041
(813) 780-0044 Fax
~\,-,{Rljl(
rtiti .... .~
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- ~
INVOICE
DATE
INVOICE #
~)
"
6/1612005
05-0004
(.II I'I ,~\'..:....
BILLING ADDRESS
Southern Custom Building
Mary Melfi
P.D- Box 6623
SpringhilJ., FL 34611
PHYSICAL ADDRESS
Southern Custom Building
Mary Melfi
P.O. Box 6623
Springhill, FL 34611
BILLED BY INSPECTOR
LLH KLB
ITEM DESCRIPTION QUANTITY RATE AMOUNT
B1dg Plans Building Plan Review Fees - per square foot 1,006 0.04 40.24
Best Western TERMS
Plan No. 05-0418 Total $40.24
Due on receipt
MAKE CHECKS PAYABLE TO:
CITY OF ZEPHYRHILLS
6907 DAIRY ROAD
ZEPHYRHILLS, FL 33542
ZEPHYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrflills, FL 33542
Fire Chief Robert Hartwig Bus (813)780-0041 Fax (813)780-0044
FIRE SERVICE USER FEES
Occupancy No.:
Plan No.: 0..<:"- Llt{ B
Business Name: "d'r ~Ai
Business Address: S~~ '/
Business Phone No.:
Business Z~.: ;t;;
Contact: ~ ~ M
Owner: S74 ~v .
Billing Address:
Billing Phone No.:
. Billing Fax ~.:
~/.g!:7 ' Contact: ~5?-) ~- ~.I'
INSPECTION FEES ~ PERMIT FEE FALSE ALARM FEE
Annual NlC'p 1;3~ t t A 3 1st AIann NlC
1 st Re-4nspection $25 2nd Alarm NlC
2nd Re-inspection $50 5 ~ rL 3lft II 3fd Alarm N/C
3fd Re-4nspection $125 ~ tJ1..J ~.~-I 4th AIann $25
4th Re-Inspection $250 ~ r 5th Alarm $50
5th Re-Inspection $500 6th AIann $75
Construction $15 7th Alarm $100
Commercial $25 8th Alarm $150
9th AIann $200
10th Alarm $250
'Db' ....
PLAN REVIEW FEES
~ Site Plan NlC
Building Plans .04 sf
Revision .06 sf
STANDPIPE SYSTEM
o Per Riser $25
SPRINKLER SYSTEMS
B 0 - 25 Heads $30
26 plus Heads $60
FIRE PUMP
o Per Pump $100
FIRE ALARM SYSTEM
B 0 - 25 DevIces $30
26 plus Devices $60
SUPPRESSION SYSTEMS
~ w. $35
Dry $35
C02 $35
Other $35
GREASENENTILATION
o HoodIDucts $35
PlANS TOTAL I LIt;, 20/
SPRINKLER SYSTEMS
Hydro Undergrounds $45
Hydroslalic System $45
w. Acceptance $30
Dry Acceptance $45
Hydrant Flow $25
FIRE ALARM SYSTEM
B Syslem.Acceptance $50
Recall Acceptance $50
OTHER
Fire WalllSmoke Wall $15
LP Gas $25
Natural Gas $25
Fuel Tanks $25
Tent $15
INSPECTION TOTAL c::=J
SPRINKLER SYSTEMS
o Automatic $15
FIRE PUMP
Fire Pump $15
FIRE ALARM SYSTEM
o Detection $15
OTIER
~ LP Gas
Natural Gas
Fire Works
Fuel Tanks
$45
$45
$25
$45
GREASENENTlLATION
B Hood/Ducls $15
Kitchen Suppreuion $15
PERMIT TOTAL I
FALSE ALARM
TOTAL I
GRAND TOTAL 5 ~2.1/~
I!!n ~ h:~~ :..", ,,~.Jd bf: ~a"Ca
v-'rrrl ~~ 4S5<:::5'!~ pJ1 .bv/ld <:JvI- fvk,'.SS/~AJ .
Comments: h~ JHj~LJ ~ Iy
IJdd:h '?~ IlL.e--S
Date: tit, tr
Inspector: {lfHo./ ~
nlh I
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f)G- ~I L~P--~1)iLfJ'
573 '-I G-1J"}L~ f~{D-
Square Feet
jOulo
Donar Amount \01 ji>>EJ
Valuation 07, '-fG L
,
Building ~Z~ ,:.> -j
;3 LDG.
!?fJDD,v -
00
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h,yl
,:;-.,
Electrical 7 {j . 'oJ ~
7J ,(fi 1'-'1
R~lIlf4J FEE LJ /J, ,')d
FD. ::; '/v.~7
Plumbing rJ 1ft r1 r 1ftl~ T''t''f-'
..... ....-
( .. .~s'Q
-~...-
Mechanical ~'n tv\)~
~Do~ _Jolql
Connection Fees
Sewer
Water
Meter
rr-J,^ f) I '--r! ) ,)'rr -
~ ~ )W)f-_
School Impact Fee ~ PI
Transportation Impact Fee
foJ Jrr frr '}T}() liME
t
Park Impact Fee
N)fl
Public Safety Impact Fee
Nit} AI m)~ 'fi ttli-.
.
An Equal
Opportunity
Employer
Watson L Haynes II
Chair, Pinellas
Heidi B. McCr_
Vice Chair, Hillsborough
Judith C. Whitehead
Secretary, Hernando
Talmadge G. "Jerry" Rice
Treasurer, Pasco
Edward W. Chance
Manatee
Thomas G. Dabney
Sarasota
Maggie N. Dominguez
Hillsborough
Ronnie E. Duncan
Pinellas
Ronald C. Johnson
Polk
Janet D. Kovach
Hillsborough
Patsy C. Symons
DeSoto
David L. Moore
Executive Director
Gene A. Heath
Assistant Executive Director
William S. Bllenky
General Counsel
Southwest Florida
Water Management District
2379 Broad Street, Brooksville, Florida 34604-6899
(352) 796-7211 or 1-800-423-1476 (FL only)
SUNCOM 628-4150 TOO only 1-800-231-6103 (FL only)
On the Internet at: WaterMatters.org
'-
Bartow Service OffIce
170 Century Boulevard
Bartow, Florida 33830-7700
(863) 534-1448 or
1-800-492-7862 (FL only)
SUNCOM 572-6200
Lecanto Service Office
3600 West Sovereign Path
Suite 226
Lecanto, Florida 34461-8070
(352) 527-8131
SUNCOM 667-3271
Sarasota Service OffIce
6750 Fruitville Road
Sarasota, Florida 34240-9711
(941) 377-3722 or
1-800-320-3503 (FL only)
SUNCOM 531-6900
Tampa Service OffIce
7601 Highway 301 North
Tampa, Florida 33637-6759
(813) 985-7481 or
1-800-836-0797 (FL oniy)
SUNCOM 578-2070
February 14, 2005
Mike A. Carpenter
Archiplan International, Ltd.
955 North Plum Grove Road, Suite E
Schaumburg, IL 60173
Subject:
Project Evaluation - Permit Not Required
Project Name: Best Western - Building Addition
Inquiry Number: EX 1696
County: Pasco
Sec/Twp/Rge: 11/26S/21 E
Latitude/Longitude: 28014'26.00"; 82011'08.00"
Subsections 40D-4.021 (1) and 40D-4.041 (1 )(a)(b), Florida Administrative Code
Reference:
Dear Mr. Carpenter:
The District has reviewed the information you submitted for the project referenced above and has
determined that an Environmental Resource Permit (ERP) will not be required for the proposed
building addition over existing impervious surfaces.
The information received by the District will be kept in the Brooksville Service Office to support the
District's determination regarding your project. The District's determination that your project does
not require an ERP is only applicable pursuant to the statutes and rules in effect at the time the
information was submitted and may not be valid in the event subsequent changes occur in the
applicable rules and statutes. Additionally, this notification does not mean that the District has
determined that your project is permanently exempt from permitting requirements. Any
subsequent change you make in the project's operation may necessitate further evaluation or
permitting by the District. Therefore, you are advised to contact the District before beginning the
project and before beginning any activity which is not specifically described in your submittal.
Your timely pursuit of this activity is encouraged to avoid any potential rule changes that could
affect your request.
This letter constitutes notice of Final Agency Action of the project listed above. A request for
hearing must: (1) explain how the substantial interests of each person requesting the hearing will
be affected by the District's action, or proposed action, (2) state all material facts disputed by the
person requesting the hearing or state that there are no disputed facts, and (3) otherwise comply
with Chapter 28-106, F.A.C. Copies of Sections 28-106.201 and 28-106.301, FAC. are enclosed
for your reference. A request for hearing must be filed with (received by) the Agency Clerk of the
District at the District's Brooksville address within 21 days of receipt of this notice. Receipt is
deemed to be the fifth day after the date on which this notice is deposited in the United States
mail.
Permit No.: EX 1696
Page 2
February 14, 2005
Failure to file a request for hearing within this time period shall constitute a waiver of any right you or such person
may have to request a hearing under Sections 120.569 and 120.57, F.S. Mediation pursuant to Section 120.573,
F.S., to settle an administrative dispute regarding the District's action in this matter is not available.
Enclosed is a "Noticing Packet" that provides information regarding the District Rule 40D-1.1010, FAC., which
addresses the notification of persons whose substantial interests may be affected by the District's action in this
matter. The packet contains guidelines on how to provide notice of the District's action, and a notice that you may
use.
If you have questions regarding this matter, please contact Wojciech M. Mroz, P.E., at the Brooksville Service
Office, extension 4329. Please reference the Project Name and Inquiry Number in future communications
concerning this project.
Sincerely,
o..\fJ2--
-----
~
Henry Rob Lue, P.E., Director
Brooksville Regulation Department
HRL:WMM:mej
Enclosures: Noticing Packet (42.00-047)
Section 28-106.201 and 28-106.301. FAC.
cc: Inquiry No. EX 1696
US Army Corps of Engineers