HomeMy WebLinkAbout05-4824
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4824
Permit Number: 4824
Permit Type: COMMERCIAL
Class of Work: NEW CONST/COMM
Proposed Use: COMMERCIAL
Square Feet:
Est. Value:
Improv. Cost: 438,088.10
Date Issued: 8/16/2005
Total Fees: 3,395.96
Amount Paid: 3,395.96
Date Paid: 8/16/2005
Work Desc: NEW MCDONALDS RESTAURANT
Address: 6042 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Name: MCDONALDS USA, LLC
Address: 6042 GALL BLVD
ZEPHYRHILLS, FL. 33542
Phone:
L P
ACE ELECTRICAL SYSTEMS,INC
MCNATT PLUMBING COMPANY INC
UNITED SHEET METAL & AlC INC
PLUMBING FEE
FIRE PLAN REVIEW FEES
208.00 MECHANICAL FEE
159.16
450.00
N U H EL 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.
&t2_~
CONTRACTOR SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ~J!iJ:'t1.I.t{n.Ll.Il.IO r.l:.l-EU."'.....&. ~......_..._u____.
BUILDING DEPARTMENT 5335 STH St, Zaphyrhills, FL 33542
813-780-0020 FAX:S13-780-0021
DATE RECE IVED
7 / ~/oS
PHONE GONTACT FOR PERMITTING
OWNER'S NAME N\~OlVA\..D~ \JSA} LLC PHONE '81-3.103D. C\193c..\
JOB ADDRESS U'lDL-\'2. N. GfI.\...L. B~"o. (\)5 ~\) ) ZEP\4.'II2\4\LLS. t=L. 33?'-\ I
,O~N'SHtP .
LEGAL DESCRIPTION: ~) SEc:notJ 3 ~ 2(g SOIllR3UBSr:ISHH1 ~ANC,E 2.' E.A$T
PARCEL ID # 0:30- Z-1.9 - 2.\- 00'0 - \\'300 - 0000
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: ~NEW CONSTRUCTION
OSIGN
o ADDITION
o MOVE
o ALTERATION
~ DEMOLISH
o REPAIR
o INSTALL
PROPOSED USE: OSGL FAMILY DWELLING
'i(fCOMMERCIAL
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOM
o OTHER
~ RESTAURANT & HEALTH DEPARTMENT APPROVAL
BUILDING SIZE oNE c::."ToR'/
SQUARE FOOTAGE
ANO U:>NSlR\X:T A tv~ \Y\~~ALOS
LI f ~ J 'f
3<r79 '51= HEIGHT Z, - 9 :r&.\
DESCRIPTION OF WORK \)~\'()OL\S\-l ~\'iI\lIJ<; W\q):)~~\.D~
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL .NEW CONSTRUCTION.
& (1) SET ENERGY FORMS.
FORMS.
M BUILDING
]gf ELECTRI CAL
l8l PLUMBING
~ MECHANICAL
o GAS ~ ROOFING
$ +/- to 31>0 \)OD
,
8oG:>
- [\1\ -\\ . s' soil,
~?)~1
VALUATION OF TOTAL CONSTRUCTION l 4(" 'fJJ. ~
AMP SERVICE 'RJ Progress Energy 0 '- W. R. E. C. ??
-11~/ ~
PERMITS REQUESTED
J
/
VALUATION OF MECHANCIAL
-....--"
$ -+~ " \l.o pOD
o SPECIALTY
/
o OTHER
TYPE OF CONSTRUCTION:bd BLOCK
-~ FRAME
B:l STEEL
o OTHER
FINISHED FLOOR ELEVATIONS _102.13
IS PROJECT IN FLOOD ZONE AREAO YES ~ NO
11iImM~fff~~;~1~j~f;:~I:mR~~lr~1t~~~---~~~ ~,~- t~~, 1'-- --~---~---- - - ~-~l"'r'--;--r~-"~:-~ -~;-"'"T7"lT~~: /1~~::,1 ~:L'if,~1 :-l~rjf;!~~r"
T, I : fl~1 I~::;l I I . I ~ ,I 1/11, III j ~ ~I{,~j ".. J"; I,}\,,~ '1l'i.1T~I;:~![{'rt.!'.!l'r;~:;:~~
~'~L..,-,,-l-.-!.....~.L____~_~______~__~__ ~__ _ _ ~_-:..J...-_,_~~__~,.1 !
SIGNATURE
~
COMPANY SmAhFl1 f /U)j) f ~EV..V'
STATE CERT OR REGIST # O,8C/ZS//Po4-
BUILDER
*************************************************************~**** ~ ~~
ELECTRICIAN .' I /J c: COMPANY ArE E!ECI//{Ci! >~e:H5 JQ
SIGNATURE f7~ :;t ~ STATE CERT OR REGIST # ~l)e() 13~'
******************************************************************
PLUMBER n n~
SIGNATURE~ ~
******************************************************************
MECHANICAL COMPANY l/tVl1&; ~J.I7#/7t. ; Ac.
SIGNATURE -# ~ STATE CERT OR REGIST # CAt!o/6~<t7
*****************************************************************
OTHER
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STATE CERT OR REGIST #
A. NOTICE 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
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 indi9ating 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 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall b~ requeste~
in writing to'the Building Official. An approved inspection must be logged dur~ng each s~x
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 "~E OF COMM':::;:T".
n ,m W 'Ri>1Z. ~~\...Oi USJ:.\ \...\..C: .-?
~J:T~ OWNER OR AGENT' SIGNATURE: CONTRACTOR '-
o who has produced
(type of identification)
ot take an oath.
STATE OF FLORIDA <; ,
COUNTY OF f/MC'()
The foregoing instrument was~ack~9~ledgeonc
ttp' .a' dja)l'-?f /-U(bIL.Yr 20 u--J
~~for~dld --5;ryiu~'~-r . c1 ,-
(name of person acknowledged)
C1ho is personally known to me, or
~o has produced 4. ()~/()cte.S ;; ~
( ype of identification)
o did id not take an oath
STATE OF FLORIDA
COUNTY OF .BiL.\.S6012OU:.'\.l
The foregoing instrument was a~knOWledge~
Befor~ me this 2- day of"X. t.I , 2~
by JRMESI<U~T:(;-
(name of person acknowledged)
~whO is personally known to me, or
Name
\Tl1lv'lcl3 q-"/l..(..€SP/E
typed, printed or stamp~~ Jenloe GK'"
. ~ j My ComrnlMiCJn 00231528
~./:I EltpirM October 10. '2tJJ7
() e
....,
p S .
'_ CaMlDOCMI1'" I
.......... I
......... (100)4....,
.................~.~~..~.I
McDonalds
6042 Gall Blvd.
SQ. FEET PRICE
MAIN OR LIVING: 4,558 $ 90.00
OTHER AREA UNDER ROOF: $ 50.00
OTHER: 32,786 $ 0.85
VALUATION $ 438,088.10
FEE SHEET $ 1,497.00
ADDRESS $ -
DRIVEWAY $ -
BUILDING: $ 2,320.50
CREDIT: $ -
BUILDING LESS CREDIT: $ 2,320.50
ELECTRICAL: $ 258.30
PLUMBING: $ 208.00
MECHANICAL: $ 450.00
SUB-TOTAL $ 3,236.80
RADON: $ -
TOTAL $ 3,236.80
SEWER: $ -
WATER: $ -
IRRIGATION: $ -
TOTAL: $ -
~ I
SUB-TOTAL ~ ~3,236.80D ~
PARK IMPACT FEESI $ _ ~
WATER METER:I $
IRRIGATION METER $
PUBLIC SAFETY IMPACT FEES
POLICE $ -
FIRE $ -
5% $ -
TOTAL: $ -
SIF'S: $ -
100.0% $ -
1.0% $ -
TOTAL: $ -
I
I
T IF'S 'I $
99% $
1% $
: I
TOTAL: $
3,236.80 ,
ZEPHYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrt1ills, FL 33542
Fire Chief Robert Hartwig Bus (813)780-0041 Fax (813)7~
FIRE SERVICE USER FEES
33g/J
=:::.YNO'05_~
Business Name: fd {"
Business Address; ,bo _ - , :e.JI
Business Phone No.:
Business Fax No.:
Contact:
PLAN REVIEW FEES
~Site Plan NlC
. Building Plans .04 sf
Revision .06 sf
3 CfJ'j
I
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
~ Wel. $35
Dry $35
C02 $35
other $35
GREASENENTlLATION
DHoodIDucts $35
INSPECTION FEES
Annual N/C
1 st Re-inspection $25
2nd Re-inspection $50
3rd Re-inspection $125
4th Re-Inspection $250
5th Re-Inspection $500
Construction $15
Commercial $25
SPRINKLER SYSTEMS
Hydro Undergrounds $45
Hydrostatic System $45
Wel. Acceptance $30
Dry Acceptance $45
Hydrant Flow $25
FIRE ALARM SYSTEM
B System Acceptance $50
Recall Acceptance $50
OTHER
Fire WaHlSmoke Wall $15
LP Gas $25
Natural Gas $25
Fuel Tanks $25
Tent $15
Owner: /~ ~ tH4 aL
Billing Address: .
Billing Phone No.: 8'J-1-~;;; .....~63~
Billing Fax No.:
Contact:
PERMIT FEE
FALSE ALARM FEE
1 st Alarm NlC
2nd Alarm N/C
3rd Alarm N/C
4th Alarm $25
5th Alarm $50
6th Alarm $75
7th Alarm $100
6th Alarm $150
9th Alarm $200
10th Alarm $250
SPRINKLER SYSTEMS
o Automatic $15
FIRE PUMP
Fire Pump $15
FIRE ALARM SYSTEM
o Detection $15
OTHER
~ LP Gas
Natural Gas
Fire Works
Fuel Tanks
$45
$45
$25
$45
GREASENENTlLATION
B HoodIDucls $15
Kitchen Suppreuion $15
FALSE ALARM
PLANS TOTAL~ I~ INSPECTION TOTALc=J PERMIT TOTAL I I TOTAL I
c.......... f'I/l/1 tulC,,) L 7~~J J g~'tf J ;y 47~,{///f;. r/
Date: "7 /'2-1 ~,--
. , ,
n1h Inspector: f{~1 ff/h2Pe'~~ /:4
~\..>>
~~ L j)-U/'i ~5
bt; i 2 N, GftLi- j~UJj).
Square Feet Lf5S .g
,?'1-th I..
Dollar Amount q(}. \:>Cl-
I' 1--3'5'
Valuation
Building
+-- ~7S1o"" ~I::.-til--
Electrical
r?<:'\. Q :st.
Plumbing ~ () '-
Mechanical f50\~7J
~Do~ f'\)~ lffi~-r;~ b
Connection Fees
Sewer
Water
CM~
FH f-1 ~ '}11 f>L-
"<
4
School Impact Fee
!X )\7- fi:IJ ~.,-
Transportation Impact Fee
f'{ ) 17 ~ 5firI i.J
.
Park Impact Fee
N/f
Public Safety Impact Fee
~}p. C-YJ)1i Nt-
,
Prepared by:
James M. Kurtz, Area Construction Manager
McDonald's. USA, LLC
10150 Highland Manor Drive #470
Tampa, FL 33610
1111111111111111I111111111111111111111111I1111I1111I11111111
2005161304
NOTICE OF COMMENCEMENT
Rcpt: 910617
DS: 0.00
08/09/05
Rec: 10.00
IT: 0.00
Dpty Clerk
PERMIT NO.
TAX FOLIO NO.
~i90;~TT5MAN1'4PASCO COUNTY CLERK
o 0'. 3am 1 of 1
OR BK 6517 PG 1854
STATE OF FLORIDA
COUNTY OF PASCO
The undersigned hereby give Notice that improvements will be made to certain real property, and in
accordance with Section 713.13, Florida Statutes, the following information is provided in this Notice of
Commencement. This Notice shall be void and of no force and effect if construction is not commenced
within ninety (gO) days after recordation.
1. Description of the property: 6042 N. Gall Blvd.. Zeohvrhills. FL 33541
pA1ZefL. ~ 03. 2.".ZI-OD'O' l \31>0. ot>DO
2. General description of the improvement: Demolish existina restaurant and construct a new
McDonalds Restaurant
3. The owner: McDonald's USA. LLC
Address: 10150 Hiahland Manor Drive #470. Tamoa. FL 33610
Phone (813) 630-9634 Fax (813) 621-4073
Owner's interest in the site of the improvement: [fee simple]
5. Contractor:
Address:
Phone
Stansell Prooerties & Develooment. Inc.
3675 S. Westshore Blvd. #154. Tamoa. FL 33629-1864
(727) 372-0781 Fax (727) 372-0366
"'l: W >- ...
~~:e 0 ~
C!lZ~>- Lu
zOw C c:3
5~~~O !r~.
fD ~ i ;:) ;:)
I?;:)..; 8 &
...,g5,? .~' l- 0
:ro:tu:> 3
o-wo-~(..)
0- ::r ::r '\l a:
O"'l:o-U:>I-N-
< i!:....X-l (..)
gi6~~;;~ 15
a: ~Q..-(I) ~
'Ooc(a::OO-l a:
...JQ..~~g:! ~,
lL.lL.o~~~ ~
IL 0 ;;; a:: a: ~
0:>- -g2 0
f- ~uiit 0
~zi!:i~~
i!5 ~~~
00 ~g ~
4. Fee simple title holder (if other than owner):
Address: N/A
6. Surety: N/A
Address: N/A
Phone: N/A Fax: N/A
Amount of Bond: N/A
A Copy of the payment bond (if any) is attached hereto as Exh:b!t "S". N/ A
7. Lender (Persons or entities making a loan for construction of improvements):
Address: N/A
Phone: Nl8 Fax: N/A
8. Name and address of person within the State of Florida designated by the owner as person
upon whom notices or other documents may be served as provided by Florida Statute Section
713.13(1){a){7):
Name:
Address:
Phone:
James M. Kurtz. McDonald's USA. LLC
10150 Hiahland Manor Dr.. Tamoa. FL 33619
(813) 240-6707 Fax: (813) 741-0200
9. The owner has designated the following person, in addition to himself, to receive a copy of the
lienor's notice asprovided in Section 713.13(1){b) of the Florida Statutes:
Name: Harold Stansell. Stansell Prooerties & Develooment. Inc
Address: 3675 S. Westshore Blvd. #154. Tamoa. FL 33629-1864
Phone: (727) 372-0781 Fax (727) 372-0366
10. Expiration date of Notice of Commencement: (the expiration date is one (1)
year from the date of recording unless a different date is specified):_The
recording of this Notice of Commencement does not constitute a lien, cloud or
encumbrance on the described real property, but gives constructive notice that
claims of lien may be filed under Chapter 713 of the Florida Statutes.
By:
Name:
Title:
The fore~oing IPstrulT)ent was acknowledge before me this day -..t... of -Au-~ ,2005,
by ~ "-L.t.k-" -t- who is/are personally known to or who has~ave produced as
identification and who did/did not take an oath.
Instrument Prepared by:
My Commission Expires:
~ '" Janice Gnletple
. ~ . My Commission 00231528
~ Of ",'" Expirea October 10, 2007
OGT/!4/20DS/?~I 01 ~'PM ZEPTfRffILLS aUiLDfNG
FAX N~, 813'-780-0021
P. OO~
CITY OF ZEPHYRBILLS PERMIT APPLICATION
~UILnl~G OEPA.'TMEN~ 5J35 s~ at, l~phyrh~118, FL 33542
813-780-0020 UAX,813-780-0021 h~'.'~.__
DME HECJ;1nD"'& '
Ellon CONTACT !!'OR PlliIMU'rIHG ~-'1ti.J. ~r
o:mF;l\' s fUIM~:FtJ.rl'{)C-fAk.- ft iffIY- ()1~tJOIZlI1UJ {' (2'09 /C~fcfj _~_,_---'--_
JOil~J:$S~zoa-. (lALL &VLJ 2-/:;]J11YJt.tiL~~21
LI:OAL DES'CElJP.'I'IOl'i: LO'1::IS;__-'- EE..c'CK._____ SUECIVISI0N -
e;l>.RC&:L!D. O'?'-~6=-2J-Oo)o-lfdOO-()oa:J~~~~w:r:.:..~L-
WORK P~CfSiDt~~EW ~)NST;DCT!ON
Os [GN
o ACD:I'::CN
DA!!tEILr..'l'ION
a RE:P~.:rR
o Il'!llTAU
DWWf
o DtJ-r.:JLI8M
PROPOS:;';) tlSF.: lJs:;: fAlr;!:l OW!:I.LING
~GW1gl'C:i\.L
O~ro;:'11 - C'i'.Y.!L Y
o IlIDUS'i'lUAT..
0* CF (lNUS
o Slm1L'1ING ?Oo~
o lolceIU, 1l0ME
o c'tHER
)6 RSSTA%At,'l' , fltALTll D6:PAfl'l'MEN'f l\F.r..OVI\;, . .
DI!I8CRU'UON OF WOItK -T1!XLdJ-~...t2.L. t2c/;e,~/IO/l1 ;;..q -Ule; &1lJ.f ,;O~ W;fl./G/MS
iJrJILDnll, SlZB
SQ,lAl<.E :motAGE
HE:GHT ____
RESIDEN~~Al,' ATTACH (~; P~~T PLANS & (2) SETS OF aUILOING PLANS & (1) SET ~NERGY FORMS.
COIrJl.lEl>.Cn,L: .1\T'tltCll (3: SETS OF BUll,nH;Gi?I.AlIS ~. (1) sn E:~)ERG'i i'Ol'iY.o$.
IB' 9!Gl, l?El'.MIT ONL.,. (2: SETS 0,' E"GINE:i!:~.E:D ~LANS REQUIRED.
PROFE~TY SURVEY REQUIP~D rc~ ALt~tw CONSTROCTION
PERMITS_~~UES~ED
o bUIWlh7'3
$
VAL!JATIOll Of' T01'...L COHZ'l'l'.UCT!Oll
o ::;:'EcrRICAL
A~J? SERVICE
d. Proqre~$ Enor7Y 0
W.R,li:,C'.
o PLOMB!NG
ft('ME-CHF.NlCAL
o GAS 0 Roof'ING
$--1.t. )oqg
VIlLOA'rI(\l~ o. MECAANC!AL H1S'f.I\LLATION
o SPECIALTY
o 01'HER
TYPE OF CONSTFWC! T.O~:, [l 8LC<:K
o i'RA.'l.!:
o S1'O:EL
. 0 OTHER
FINISH~C fLOOR 11EVAT!0KS
IS PROJECT IN .'LooO zOlll:: AREAO YES 0 No)
["",., :.,.~ '1:,,~,.~~..'~'tt;<J'1~\:;,.~,,;?~~r\ ~~)\;:t~:"/~Tii,'" r~ ~~J '. . '.,', .'"1 .J{1[\';.I/ I~.";' , f"f,;~f~\l;\\~!..~i\ ~.\l;}r.
,"!'i~..,_~_f,;L~~iL'~~'~~;>~ ;"I-~lr"'JI~~I.,~",.r.,r,""f-,"~ 1"..1 ;',,' I l .1. 'I"'~'JC)~." ''\~~'JJ~J.ljlj ':/'J./t,.\'l'" 'JJ~'~~.'"()l"~~
........,-'" ~"'" ___" ~....' . ) ~ _ r _~.w_ ._' ~,," '- r~ t:-_ ~-<...... ,. > ~
liItJIWla
CQHPANY
SIGNATURE
. "
oTATE CERT OR R~GIST t
'II.. * .ir:* ir *.. *.."* It *"" * w.. *,;,,'Ii....,.. ..."..... * ~,.. i,. ~...... ..........1r'-***... * 11" -. 'if ** **'...'* ..ll:.....*. '* 1;.",- ~-
SIGNATURE
CO~1PAN;:__
STATE CElt'; OR REGIS'l' t --------.--
ELECTRICIAN
...*.~.*.*k****.*,*..**'~*k*x**.*._*t**w*~*~~~~~*t~.~.~.*wi*....~+.
PLUMBIlR
C<)t~PAt-l,(
SIGNATURE
/G~CHAN~
SIGIUl'rU;l.li
STATP CERt OR REGIST i
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. OHfMIY ..:d{d.~ L. -' -
,,'" . OR REGISl' 11 ~ - -"Lt-.
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C0t,j? AN'L-....-
SIG~.h'.!'URF., .____._~-',....-_____~~....._:____"_____ ST'~TE CERT OR REGIS'I'
OCT!14/20Q~!FRI 01:32 PM
ZEP3YRHILLS ~JILDING
'AI No Bij-~8U-UU~1
r. Ul.'j
A. NOTIGE OF DEED RESTRICTIONS
The Und131::~1.9"li>d undllr"tar,da that tbi.. pern:it may b.. subject t,.,"deed r<ilstrictio:ms" ~'hlc.h
ma~' be more lielltd.ctiva than' Ci1:y rSg\llatior.e. The "ndEl.t5ig'''!'C S1l5Lrme9 respOfwib:.lity fox
cornpHanc", I.dth a:11 applicable deed re"uictJ.ons.
B. GNLIC~NS~D CONT~~TOR9 ANO OCNTRACTOR RE3"C~B1BtLITLES
1;'; the OHI1U has hired a contractor or contrach'ra to undertake work, tho:1 IIlllY be requiX'9c!
t., b~ liceneed in accordance with state and iQOul re9ul"tions. If the e?Atractor ia ~ot
ll<!lens..d as rElquired by law, bot:~ the owner and Clontractor may Oil ci1:ed fo;c Q ",illdl!!meAao;::
viol~tion a~d$r 2t~t~ law. If the owner or lntA~~d oontrac1:or arQ uncertain QS t~ what
lio,sMlng requiret\...r,ts ~!<y ilpply for the intand~d wJr<, t.hey are advl"'ld to oonC,act tillil
City of Zep~,yr!'.i:Us Building r:AlfJartment, B13-7<lC-0020.
l'u::therm6rEl,. if tr..~ o<lner he.oS r.ired a contrll.ct"r or "'olltr;;.~to",,,, he i.. ad,.'i"ed t<, 11...,.." t""
=cr.tractor t~: sigr, porti~n= of 1;1\6 'Contrao,::or Se-otior,." of this epplioati"" for '"hier. tr,ey
wl11 be reel?"n~ible. If yC)U, ".s the owher ~i~lI as the eorltrao~or'l Y'J'~ !ilra indicating t)-."t
~lOl1, r8.ther tharl. tbe 'con~r:a.ctO:t, are re.spone1,ble for th~ work. .If thp. contractor vli!hlOS
yr.ill to !liQn a.s C~L.,nt::a2tc= that may !;,Q t.n indica~i,'n t.hat' he is :'l\lt properlY J,.i.c~~n:i.d and is
net entitbd to permitting privilege' in the Ci-::y cf Zepllyrhilla.
C: TPJ\NSl?ORTArIOtll IMPACT FE:ts AIm OT::LI~Y CONN"CTION niES .
O. CCiilSTllJ1C'rUION LZEN L...a (CHQ'rtR 113. FLORIDA STATUTES, AS ?MENDED)
~ oertify that I, th~ appli~n~( have b$en'prcvid~d ~it~. oopy'of ~florida/$ ~oll~tructicn
!.i19n taw - Homeowne::' ~. Pro'cection r:=uideh" prapl9l.~...d by th& Florida. Oe;:;l~,-rt'rte;ot c:: Aq.ri~\.\l1:.l.:!.re
~nd Ccr.awner ~f!airs, If th6 .!L1'1plicatlt is 8Dt!':eon~ othu trLa't, tit' "c.inerll; I. cer:'..f'y th~t I
have obtained a oopy of the ~'ove deecr1b9~ doc~nent and pro~ise in ~ood faith to C~liver
it to tfie ~owne.rN prior to comw,~ncement.
E. CONTRACTOR'S/OWW~R'S Al'rI~~VIT
1 certify th,t all the i~formation in this applicati~n'is accurate ~nd that ail work w:ll
be dOM 1n compLance with all apJ.:.licable laws requlating cons'.:.ueUcr" zoni'1q, and land
dllvelo~ent. .
Appliqation is hereby made to obtBi~ a permit to do ^~rk and installation as indic.ted. -
certify th..t no .work or installation Mil COll1Jll.lonced prior to inu:sil':e c.! a permit Bnd that
all work will be pertorm.d to meet standaLds of Lll laws requlating construction, City
0[)<.lra5, zoning re\1ulatione, and la.nd d""el"pmelit l::e9uli\1:ior.s J.n tt.Iif jurisdiction, I else
cQrtify that I .~,ders~"ne t~"t the regulations of oth~r g07er~reantai aqenciea ~y apply t~
the intended work, and th3~ it is my ree90nsibility to identify what aotio"~ I m~st ta~e to
be 1n cOnlp'liance. Such aq8r,nJ.es include but an n,~t IL'l[ited to: 'Oep..r-:.me'ot of
inviro~.mQn1:al ~.egulation-CyprseB 3ayhwads, Wetla1d A~eaG and Envl~o~~nT.ally S~nsitivQ
La.Tlds, Water/Wastewater TrQat~ent
'Southwe~t Florida NitGr ~.nag.ffi~nT. Diat"ict-Wells, Cypre~$ BayhQ"d3, Wetland ArSDS,
Alt~ring Wateroourses
'A~my Corps bf Enqineere-Sea~alls, tooks, Navi9~~1. Wate:waye
.De~ertmen" of Health & Rehabilitative Servioes, En~ironmQntal Health Unit-Wells,
Wastewater Treatwent, Septic T~nks .
'U.S. Environmental Protection AgeGcy-Asbestos abatemen,
T alao certify thl>t, if till ml.'teriaJ. h to be used in Fl'Jod Zone ~A" or ~A, etc.", .It 1$
und6rstcod that a drainage j;llan a'idres~ing " "c''Jmpensatir.g' volume" will be submitted wh1ch
is pr6?aredby ~ prof~ssional enginQ~r'registered in the State of F~orida prior to permit
La:nJ.anoQ.
A permit iBs'led shall.'oe UOllstr"-ed to blio a license to pJ:or:lled wit.i1 the \<tork 6,nd r.ot as
a~tho~ity to ~iolate. oanoel, alter, or Qet asideeny ~~ovi$iQn$ of the technical codes,
~c.r ~hall. hsuar(~" or " ~rmi t prevent tna Build~.ng Officia.l trOlll thereafter riilquiring "
eor~sctlon or 9~ror8 in plans, 'oonstruction, or violations o~ any oode. Eve~y permit
is~u"d shall become ir.7alid unless the work authorized by :such permit is (J~c~enc~d within
sl~ montha ot ia9u~no9, or if work authOrized by the pennit is suspended or ab~~doned fvt 'a
p.oric>d of six month" after the time .the ,,"ork is cooC!\ence(;\. One 90. da.y ext..nsioll of ti;n.e
may be e.llowad !c= the ;:>ern.it ",i t~. tee cb.arq" of $15. QO. 'fh<l ext<<nsion shall be "eques.ted
in writinQ' to'tt,e Building Official. An app.co<;1'''' iMpecti,,~ must be legged -:J\::t:ing each six
mOnth period. 0: the proj~et will be ocnsid..red 4bandoneo.
WARNING TO OWNE~: YOW'R FAILURE TO REG~RD A SOTIeE OF COMMEHC4MENT MAY ~S~~T IN 10U~
F.,YING TWr::t FOR' IMPf"OVEMENTS 1:o.YOCa P~.OI?ER'r'Y. !F YOU IN']," 0 OiO'Il\.IN FINANCING, e:'NSCI.T
WITH YOUR LENDER OR Abl AT'l'ORNE~' Bn'OI'.E RECOROING 'fOaR NOTICE COMMENCF.wEN~. It
$2)500 IN VALUE DO NOT NEED TO RECORD A.~b POST A ~NOT~ct.O OMMENCEMEN~H
SIGNATURi.t OWNER OR AGENT
STATE .or FLORIDA D. A I ~Ll41 S'
eOCNTi' OE' -LLfV'6
T):,EI fCl'\qoing i~~f9nt "'a,}ih:{~dged..-l"-.
Before....me. th.ls d7-tO:! ~O'-'O .
by l'-fCJlltaiJ__ V~If7?'JtU. __
"'\of (nillne ot p..rson a ckno",le':iged)
!""4;ho i!l personQ l'!. i' k..""low:r: .to "tnl!! ~ 0.('
o who h~S
STATr. OF ,'LORIOA
COUli'rY OF
The foregoing in~tru~ent was acknowladged
B~fore IDe this ;._ clay' of ___. 2CL-
by
(n8.If.e ot person acknowledgcdi
o who ie per8on~11y kI:OWll to me, . or
o \Vh" ha,; produced
(tYpe or iti..ntifioationl
and "'hOcj die Odic! not take an cath.
Signature of per_~cI, t.:!k:inq ~c;kno~iledqenlEn-:.. ~J
Nc.me tYl,ed# printed. 0).." $t:ampe.d
~_..- W;'C .,<., '::~-I
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