HomeMy WebLinkAbout05-4675
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813}780-0020
MOBILE HOME SET-UP
4675
Permit Number: 4675
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 7/13/2005
Total Fees: 4,442.58
Amount Paid: 4,442.58
Date Paid: 7/13/2005
Work Desc: M.H SET UP
A dress: 37627 GILL AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
Name: GRAND HORIZON
Address: 37627 GILL AVE
ZEPHYRHILLS, FL. 33542
Phone:
ACE AIR CONDITIONING & ELEC.
BUTTERFIELD MOBILE HOME SERVICE
ACE REFRIGERATION INC
IL
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIFISUB 99%
WATER METER RES 3/4"
IRRIGATION METER
PARK FEES MH
POLICE IMPACT FEE
60.00 WATER CONNECTION MOBILE HC
35.00 MOBILE HOME PLUMBING
1,572.12 MOBILE HOME TIFISUB 1%
180.00 FIRE IMPACT FEE
180.00 IRRIGATION CONNECTION
573.73 PUBLIC SAFETY 5%
254.00
209.50
40.00
15.88
273.00
175.00
26.35
./
1: 3~
P E $" - 3 .-05 lJj.J. J-/5A- p-
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
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.
~.
CONTRACTORS SIGNATURE PERMIT OFF I
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 53.35 8TH st, Zephyrhills, FL 33542!1f I
813-780-0020 FAX: 813-780-0021 7 05
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME Ci( aYlcJ t-Io, ( Zb Y)
JOB ADDRESS 3 "7 ~Z 7 ell J. A ve. [of 28<1
PHONE
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 10 #
WORK PROPSED: ONEW CONSTRUCTION
/OBTAIN FROM PROPERTY.TAX NOTICE\
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o SIGN
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLISH
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~OBILE HOME
o OTHER
DESCRIPTION OF WORK
2/;<51
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
M8
~A
~
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 ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$
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 AREAO YES 0 NO
BUILDER
SIGNATURE W~ IX ~pt ~
COMPANY
STATE CERT OR REGIST #
******************************************************************
ELECTRICIAN
SIGNATURE h~ 1~e'-A..oC;;>
COMPANY ALL
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY !3u-f+e-rl'd d
SIGNATURELJ'/ r -.L3.JC ~.L.../4 ~ ~. STATE CERT OR REGIST #
******************************************************************
MECHANICAL COMPANY Ac e..-
SIGNATURE Ur /? Gr ~ STATE CERT OR REGIST #
*****************************************************************
OTHER
SIGNAT"RQ~~
~
COMPANY
STATE CERT OR REGIST #
A, NOTIC.E OF DEED RESTRICTIONS
Th~ 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
cohtractor(s) sign po~tions of the "Cohtractor Sections" of this ~pplication 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, haye 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,
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 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 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
, 2CL-
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)
C1ho is personally known to me, or
(name' of person acknowledged)
Dwho is personally known to me, 'or
Dwho has produced
(type of identification)
and wrioD did Ddid not take an oath.
Dwho has produced
(type of identification:
and who Ddid [)did not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
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I: ~::,~UE OFF J CE:: D
m::CEIPT NtJi"iBF,:: ('0:34I.U,:,0
OFF 1 CE : Df~'tDE CITY
~CCNT
:1.1.4
TOTAL. f:~IT\ClUNT::
COMPNY ACCOUNT CENTER
B450 - 363000 - 2
:1.0 ..~57
f~MCH..INT DES;:::I:;: I PT I DN/PEWYiT DfitT f~) DI:UCI:;:
18.57 ****** SULID WASTE FEE 60
:~ECE I VEl) BY
--------..-- . -........,-..,
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~
PASCO COUNTY, FLORIDA
Permit No. ~ f 7 s
Date Permitted 'l-/~~5
Builder Name/Owner Name r:;~ ~
~~o-r-
County Parcel No, 3f/-JS:';lI-"I"()~-Iil'IO ;;.. ~q
Address/Location 31 ~ ;;27(2,111 /l <.If' .
ClassificationfType of Us~ ~;(~ ~
Control #
SubDiv:
G'rfl
TRANSPORTATION IMPACT FEE
Rate:
Sq Ft Unit:
Exempt 0 Ves~' How Determined
Impact Fee Amount $ /58' g Zone No.
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House
(057) Mobile Home
(058) Other Residential
J.:123) Aollection Fee
Exempt ~ 0 No How Determined
TAl:
Amount $
PAR AND RECREATION FEE
Land Ac unt Land Credit Land Total
Recreation Credit Recreation Total
Zone
TOTAL AMOUNT $
Exempt 0 Ves 0 No
LIBRARY FEE
Land Account
Land Total
Facility Account
Facility Credit
Facility Total
Exempt 0 Ves 0 No
RESOURCE FEE
TOTAL AMOUNT
How Determined
Total Amount
Prepared By
Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement ~elow does not Imply aC,ceptance of concurrence, but simply receipt of a copy of this form, placing
the building permit owner on notice of this assessment and th~ conditions of payment for same.
BV RE~ BY- .
tJ/;)qI05 ~
DATE
RECEIPT NO. 811 J ~O
DATE