HomeMy WebLinkAbout05-4896
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4896
4896
Permit Type: ADDITION/AL TERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 3524 P OT LN
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: EMERALD POINTE
Parcel Number:
4,000.00
9/07/2005
110.00
110.00
9/07/2005
LANAI EXTENSON & SHED
JA S WA LACE
3524 PERIDOT LN
ZEPHYRHILLS, FL. 33542
Phone:
HOMEOWNER
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.
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
"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 ~rformed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
'-l~~ Jis/[ ~.
CONTRACT R SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PR.OTECT CARD FROM WEATHER
OWNER'S NAME
I
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 0- 17/0S-
813-780-0020 FAX: 813-780-0021 &11
pA~(JftRMIT SERVICE
PHONE CONTACT FOR PERMIT~f~6-824-7894
_I Toll Free
(j'i.f1C <<- .
PHONE ([/3) f97-///7
f<.; all ~ C-L
hl"y_'rkf
LEGAL DESCRIPTION: LOT(S) ~1~
~'/- J~ -,;)j- 0070- OO()O:J- ~l/J-()
JOB ADDRESS
T fU)t.f.J
3S ;tlj
~M
SUBDIVISION c/1....tIaIJ IV/flit
jJjS
BLOCK
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ~NEW CONSTRUCTION
oSIGN
o ADDITION
oALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
PROPOSED USE: []SGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
/ ~o~i .e y.f.e-fJ<S tot--
f-
'S-11c1
~O,p
HEIGHT
BUILDING SIZE /0 y: Id
10 x/()
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.
SQUARE FOOTAGE
PERMITS REQUESTED
rj;J. BUILDING $ 1, 000. UJ VALUATION OF TOTAL CONSTRUCTION
9( ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C.
o PLUMBING
o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION
o GAS o ROOFING o SPECIALTY 0 OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAo YES 0 NO
SIGNATURE
COMPANY
()(Uur
75 .~~
BUILDER
o--v-.
STATE CERT OR REGIST #
ELECTRICM
S IGNATUr "fit,,'u- f' (,(! (1.. ,;.' rZ~
/
*******************************************************~.**********
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/op-
QtLJ,ur
COMPANY
STATE CERT OR REGIST #
PLUMBER
(1.-1?
p!U~/tj
COMPANY
(93:>',u J/>
SIGNATUR
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
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 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 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 som~one 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.
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, 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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
STATE OF FLORIDA ~.$(O
COUNTY OF r 0
The foregoing i15trument wa~~cknowledged
Before me this ~day of ~("II , 20~
by
(name of person acknowledged)
owho is personally known to me, or
~ has produced p./-,
(type of
o did not ta
...:o~/
taking acknowledgement
"~'V(lnne Baht
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6.t,;sti'litlpedV' :- luut
Name typed, print$p
i.',,~~:,
EOlVJi;'J~
lnc
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31 ATURE: CONTRACTOR
RsUJ
STATE OF FLORIDA
COUNTY OF
The foregoing instrument wa~~c~nowledged
Before me this ~'f(-day of--p:ff"("l ( , 20 Q2
by
(name of person acknowledged)
[1ho is personally known to me, or
~o has produced 'J). L- .
(type of identification)
Odid not take an oath
taking acknowledgment
.., i.n:nne Ham
;'IQll #1)P1571;
Name typed, printed .R~;. !'IltiVlIpP'~C:1
;"nd<~d ~L J'..
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:. : \l\lLlNG CODES, FLORIDA BUILDIN(
,ODL. NA 110Nl\.L E~EcrRlCCODEANI
CITY OF ZEPlfYRHILLS ORDINANCES
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CODE. NA TIONAL r~ECTRlC CODEA.'\.
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To Whom It May Concern,
Please be advised that:
Stacie Zullo, & Debbie Dokendorf of Pasco
Permit Service have my permission until further written
notice to sign and pick up permits for me.
Sincerely,
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rai ture
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WaLk:., c1-~CL
NOTARY
STATE OF FLORIDA - COUNTY OF PASCO
The foregoing
subscribed before
Personally known
Suzarme Bahr
#D01573i
\!)!"~s. Nav 15,2006
Bonded Thn;
'"ldntic Bondmg Co., be.
instrument was sworn to and
me this <g~ day of ~rj f
or Produced identrlication
, 02.00~ .
L--
Commissioned Stamp
and Expiration Date
N
Page 1
DXSCLOSURB ~ ~ OWBD.
crrY OP ZBPBDuI:r:I.Ls BD'XLDDIG DBPUT.IIBIr.r
Ja/X.tJ' (i.)tL!/(i{' <-
agree to the provisions of this iDst2:'tlllatmt.
1:,
have read and fuJ.~y understand and
The UD4ersigned states and affirma that he or she is desi.rous of constructing,
renovating, ......i'rig to or reroofing his or her 0IfD a.c.ici~e, that .he or she
act~~y occupies, or w:l.~~ occupy by said ~ci~e, and same is not for
rent, ~eas. or sal.e. That he or she shaJ.~ cOlllp~y w:l. th the f0110wing CODdi tions :
1. That the owner and he or she al.one shaJ.1 act as the bui1der for al.~ phases of
constxuction.
2. That the owner wi11 ~~y with 81~ provisions of the City of Zephyrhi~~s
or(J'; "'vnrces and codes ~inent to the buildi.ng.
3. That in the event various phases of construction are subcontracted, he wi1~
engage onl.y proper~y ~icensed subcontractors and. wi~~ personal.~y supervise
such work..
4. That in the event the lSui~diDg :In8pector shaJ.~ require corrections to be made,
the 0WDer wi~~ as8'Wle fuJ.~ responsihi~i ty to insure they are made, and upon
cClllp~etion wi~1 cal.~ for a rainspection before proceecling with the bui~ding.
5. That the OIfDer shaJ.~ assume fuJ.1 respons:lbi1i ty for the construction and wi~~
not expect supervision of hi. work from the City of Zephyrhi~~s Bui~ding
Depart:lllsJ1t.
6. That prior to fiaaJ. inSpection any additional. fees, incl.wti.ng reiDspection
fees, DDUlt be paid in ful.l.. A- written request from this office shaJ.~
constitute an official. notice to pay additiaaaJ. fees.
7. That the owner shal~ cOlllp~y with 81~ City,. State and Pederal. ~aws in regard to
socia.l sec:u.ri.ty, wor~' s COIIIpensaticm., ~ien ~_, etc., where app~icab~e.
8. That the owner shaJ.~ CCIIIIp~y with 811 the safety codes issued by the P10rida
I:DdustriaJ. c:o.ai.ssion.
.9. 8tate ~aw requires cODiltruction to be done by ~icenaed contractors. You have
app~ied for a pexmit under an exemption to that 1aw. The exemption al~ows
you, as the owner of Ydur property, to act as your own contractor w:l.th certain
restrictions even t:hou9h you do not have a ~icenae. You must provide direct
onsi te supervision of tIhe construction yourse1f. You may bui~d or improve a
one-fami1y or two-fa.i1y residence or a fazm. outbui1ding. You may also bui~d
or improve a c~ial. bui~diDg, provided your costs do not exceed $25,000.
The 1)u:i..~diD.g or resideDice JDIUIt be for your own use or occupancy. Xt may not
be bui~t or substantia.llly improved for sal.e or 1e..e. Xf you seJ.~ or 1ease a
,bui~ding you havebui~t or substantial.~y iJIlproved yourse~f within 1 year after
the construction is call1plete, the ~aw wil~ pre8Ullle that you bui~t or
substantial.~yimproved :if for sal.e or 1eaae, which is a v:i.o~at:f.on of this
exemption. 1(ou may not h:i.re an lIDl.iceused person to act as your contractor or
to Supervise peop~e worJd.Dg OlD. your bui~diDg. 1:t is your responsihi1ity to
make sure that peop~e 8llDP1oyed by you have ~ic8DSes required by state ~aw and
by COUD.ty or DlUDici~ licenaiD.g ordiuances. You may not delegate the
responsihi~ity for sup~is:f.Dg work to a 1:f.cenaed cOlD.tractor who is not
~ic8D8ed to perform the work being done. Any perSOlD. workiDg on your building
who is not licensed aust work 1JDder your direct supexvisiOlD. and aust be
emp10yed by you, which .ana that you DlUSt deduct p.x.e.A-. and withho1ding tax
and provide workers' c__....-ation for that emp~oyee, a.l1 as prescribed by ~aw.
Your constructiOlD. DIWI OIIIp~y with iLLl. applic:ab~e 1aws, ordinances. bui~ding
codes, and zoning tions.
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NOTICE OF COMMENCEMENT
11111111111l1~11111111111111111111111111111111111111111III1
2005175788
State of
P tOIL~
County of
fJ (( if {!&
THE tmoERSIGNED hereby gives notice that improvement will be made to c~rtain
real property, and in accordance with Chapter 713, Florida Statutes, the
following infor~ation is provided in this Notice of Commencement:
1. Descr iption of Property: Parcel No.
3502Y P.g(,L~f UJ-e
(Legal descr~pt~on of the property
2 .
General Description of Improvement 10 ~ /0
/O:l /0 ~LeJ
L-llJI tL/ .L If .j.t.JM to-i
Rcpt: 916633
DS: 0.00
08/25/05
Rec: 10.00
IT: 0.00
--------- Dpty Clerk
3R O\...ncr Information: Name 7iJ../lJfJ'
llddress .J YeP! P..efL'dof UM.. City
tL^tt 1/ tt t f1
Z)~4~4!t
StateF/ d3Jyd
Interest in Property:
Name of Fee Simple Titleholder:
(If other th~n owner)
Address
City
State
4.
Contractor: N~me
Address
o {.O).-R r
City
State
5. Surety: N~rne
Address
City
State
Amount of Bond: $
JED PITTMAN1 PASCO COUNTY CLERK
08/25/05 1 : 02am 1 of 1
OR BK 6550 PG 1232
6.
Lender: Name
Address
City
State
7 .
Persons within the State of Florida
notices or o~her documents may be
713.13(1)(a)(7), florida Statutes:
designated by Owner upon whcm
served as provided by Section
tJtlmc
Address
City
Sta.te
8. In addition to himself, Owner designates
of to receive a copy of the
Lienor's Not~ce as provided ~n Section 713.13(1) (b), Florida Statutes.
<). f"xp.i.rnt i 'In d~te ()f tlutlce of Commencement (the expIratiun date is 1 year
tr~m the d~te of recording unless a different date is specified.)
Si.g;1a t ure of Owner:
Sworn to and sub~bed before me this. R'fL day of ftpr; {
2oD~. ,f7_
Notury Public, 'rA~A44v
My C :J:T1;;1.1 55 1.0n Expl.res :
76~
""\~~;.~~s,....... . ~'~-~~~(~rh_H;; Balli
::'~~. .::o~ Commission /in 01 S7 J '? i
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PC93053048/ A