HomeMy WebLinkAbout05-4789
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4789
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:
4789
RE-ROOF
ROOF REPLACEMENT
NOT APPLICABLE
Address: 6614 FOXM OR D
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: SILVER OAKS
Parcel Number: 03-26-21-0120-00000-0560
6,000.00
8/05/2005
60.00
60.00
8/05/2005
TEAR OFF & RE-ROOF
HA YCRAF, OP A
6614 FOXMOOR DR
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.
~ '1Z_~
U~~ ~
CONTRACTOR SI NATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECE lVED
g-S-D::S-
PHONE CONTACT FOR PERMITTING
1/ 1/
OWNER'S NAME .5l?r'Hr/1 (!;c.:.'rrIJ
,
h ;</11..~ to' te
LEGAL DESCRIPTION: LOT(S) ~~~~(,
JOB ADDRESS
a"tt(
/1/7- ve~.4p r
j).~.
PHONE
7&'~ - ~:J..Yo
.
BLOCK
SUBDIVISION
s; Iv t' /' (J /-!-- /C ~
PARCEL 10 # t:3 -, Jrb' 21- (.V.Jo '{i'bt1tJ,,1 -os~o
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
DALTERATION
A REPAIR
o INSTALL
PROPOSED
DSIGN
USE:~SGL FAMILY
o COMMERCIAL
o MOVE
o DEMOLISH
DWELLING
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
D RESTAURANT & HEALTH DEPARTMENT APPROVAL
tI> kCi, trII -t- l-e ~ (~i /'~S' (" chh C' ~:-
.'3~o
3CJfr ;;:/;~~/-C-J
,
DESCRIPTION OF WORK
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
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.
& (1) SET ENERGY FORMS.
FORMS.
AMP SERVICE
o Progress Energy 0
1169
PERMITS REQUESTED
o BUILDING
$
6,000
,
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
W.R.E.C.
o PLUMBING
o MECHANICAL $
o GAS jiROOFING 0 SPECIALTY
TYPE OF CONSTRUCTION: 0 BLOCK
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
ELECTRICIAN
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST # ~ I~
", Ii':;; ()
***********************************************************~ ~ ~
OTHER /?~t'~/ A.J(7 COMPANY 'MII'U- {kc(,J,1,1 I?ctJ'~fJ(,l<t /N'(- .
SIGNATUR~ ?( ?fJ?/
STATE CERT OR REGIST # a:.l:.DC(Q37D
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 portions 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 indication 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 corrunencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be aone 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 corrunenced 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 corrunenced 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 corrunenced. 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: 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
of identification)
take an oath.
o who has produced
(type of identification)
and who Odid D:lid not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
· NOTICE OF COMMENCEMENT
I HEREWITH GIVE NOTICE IN SECTION 713.13 FLORIDA
STATUTES THAT IMPROVE!);fE~TS, DESCRIBED AS
If€'- R..OO,ci~/Q" KBIl')CAILC. "
WILL BE COMMENCED WITHIN 30 DAYS AFTER RECORDING OF Tms
NOTICE UPON THE REAL PROPERTY SITUATED AT THE FOLLOWING
ADDRESS: t,h/&/ r:-~XA?ctJR te.2~"h'f"h://~ . Pi . -p~-Vo
PERMIT # ,
FOLIO # fJ:3 -:;)t,.; . ;;U - &/;20 - 61atpo - o..s-~o
LEGAL DESCRlPTIQUOR SAID PROP.ERTY BEING ~ FOLLOWS: ""7'
s,):;~ O:!s. l-ha~G- ~A-e :~ ~ P6 ~'- Lt#~~
..,. --- {J _c Ib.( _~ Lo r ~__ ~
OWNEDBY ::Jof'Hf4 Berry HAV~R",pr
ADDRESS AtI?t1~ //5 PL .Y3S-VO
NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER (IF OTHER THAN OWNER):
A//A-
,
//11111111111111I1111111111111111111I11111 ~lInllllllllllll
2005160762
Rcpl: 910373 Rec: 10.00
DS: 0.00 IT: 0.00
08/05/05 Dpty Clerk
JED PITTMAN PASCO COUNTY CLERK
08/05/05 02:0!pm 1 of 1
OR BK 651D PG 644
R
THE FIRM MAKING SAID IMPROVEMENTS UNDER DIRECT CONTRACT(S) IS:
CONTRACTOR'S NAME: 77?1f'LE f~~ ~~I'J(J~ /A/L.
CONTRACTOR'S ADDRESS: :17~.~ ( ~ /JelL''' s-y Zrhy"~ '//.,5 rL :1sSY2.
THE NAME AND ADDRESS OF THE SURETY ON THE PAYMENT BOND IF ANY AS P~OVlDED UNDER SECTION 713.13
FLORIDA STATUTES IS: AYIIJ-
AND THE AMOUNT OF SUCH BOND IS $
THE NAME AND ADDRESS OF THE LENDER IS
A/~
"
COpy OF NOTICE TO OWNER AND OTHER DOCUMENTS AS PROVIDED IN SECTION 713.13(1)(A)7 AND SECTION
713.13(1)(B) FLORIDA STATUTES IS ALSO TO BE SENT TO:
AS DESIGl'IATED BY OWNER.
EXPIRATION DATE OF NOTICE OF COMMENCEMENT:
(1 YEAR FROM DATE OF RECORDING UNLESS SPECIFIED DIFFERENTLY)
-Lt;fN~F~iti:;a;) 1*'10Vi.y(
SOfJl-l11 (3J::'TrY' J./I't ye(Ar-T,
PRINTED NAME OF 0 R
b~/t/ MXJt1{)O~ /Je2~J1't(", /h R. 3~s"Y'O
ADDRESS OF OWNER I'
.."l.~'jJ~;. ';"'~ .'
STATE OF FLORIDA
COUNTY OF ~ -WI" P&e.O
SWORNTOANDSUBSCRIBEDBEFOREMETIDS IcrJ- DAYOF Jttl V. , ;:lO()J-
BY SbP;jJ4 "J4-r~/(/1-n- WHO IS PERSONALLl:' KNOWN TO ME OR WHO HAs PRODUCED
~ IDENTIFICATION.
~~CLERKOFClRCUlTCOVRT ~~ .., L
SIGNATURE OF DEPUTY CLERK SIGNATURE OF NO