HomeMy WebLinkAbout05-4949
I II
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
4949
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:
4949 !
MOBILE HOME RV/~ARK
MOBILE HOME SET+UP
MOBILE HOME PARK
Address: 3852 LAUREL VALLEY BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: MAJESTIC OAKS
Parcel Number:
Name: MAJESTIC OAKS
Address: 3852 LAUREL VALLEY BLVD
ZEPHYRHILLS, FL. 33542
9/23/2005
175.00
175.00
9/23/2005
PARK MODEL SET
Phone:
CRANDALL, RICHARD
BUTTERFIELD MOBILE HOME SERVICE
BAHR'S PROPANE GAS & A/C, INC,
or
REINSPEcnON FEES: When extra in pection 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 worktresulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for i spection when called
(e) Permit not posted on job site (f) Plan not at job site (g) Work not accessible
The payment of inspection fees shall be de before any further permits will be issued to the person owning same
"Warning to owner: Your failure to rd a notice of commencement may result in your paying twice for
improvements to your property. If y u intend to obtain financing, consult with your lender or an attorney
before recording your notice of com encement."
Complete Plan , Specifications and Fee Must Accompany Application.
All work shall be rformed in accordance with City Codes and Ordinances
o OCCUPANCY BEFORE C.O.
~~
PERM~
SPECTION - 8 HOUR NOTICE REQUIRED
OTECT CARD FROM WEATHER
CONTRACTOR SIGNATURE
CALL FOR I
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CITY OF ZEPHYRHILLS PERMIT APPLICATION .
BUILDING DEPARTMENT 53.35 8TK st, Zephyrhills, FL 33542 ~~ __
813-780-0020 FAX: 813-780-0021 t,2105
DATE RECE IVED
PHONE GONTACT FOR PERMITTING
OWNER'S NAMEMajeS11'C Oats .~
JOB ADDRESS j2S2- L.o{),V'ef! Yolfe) Lo 1 J'1
LEGAL DESCRIPTION: LOT (S) I BLOCK
PARCEL 10 # 2tj-2<O-21-0cqO-06/00- 0090
I .
WORK PROPSED: ONEW CONSTRUC!TION 0 ADDITION
PHONE
SUBDIVISION
(OBTAIN FROM PROPERTY TAX NOTICE)
o ALTERATION
o REPAIR
o INSTALL
DSIGN
PROPOSED USE: 0 SGL FAMILY DWELLING
o COMMERCIAL
o MOVE
o DEMOLI SH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~BILE HOME
o OTHER
BUILDING SIZE
c=J ~ST~URANT & HEALTH DEYARTMENT APPROVAL
[l\~ V\~~J( .ki{1 Jr .
/ 'I x.3 to SQGARE FOOTAGE
DESCRIPTION OF WO~
HEIGHT
i
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SE~S OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERMIT ONLY (2) S~TS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVBY REQUIRED FOR ALL NEW CONSTRUCTION.
& (1) SET ENERGY FORMS.
FORMS.
dt y"i(j1
PERMITS REQUESTED
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o MECHANICAL
o GAS
o ROOFING
o SPECIAnTY
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
$
TYPE OF CONSTRUCTION: 0 BLod:K
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
_~~~~~~~~~~~~~W~--:-~~~-;TI;:~~~~V~~rrB~*~~~!1t ~ ,
1:iB'ilI1~f~~'\~J'1Ji;t'!J;!lt!';,,~,~fC"' 111!ij ~b,?il'."f.~ '",!Jl, ~ri,'~!'il'hll,T;L '" I"," \ 'I' /, - I "]f' \" , ; ; I' ,id'ti,Jh'1m,\!b;q;;;~'M;d~,.,,-:;(,!,',rf!Jll1:"h.lf\1 '~'!,w.re 13, oj
~~~~~..t2.::.Lte~L~_J..~_~~_~~_--.J_~_____~_~~~~~2'2::+-iill:J~~I:~ ,d)!~~ ~r"F~ ~~ "t It, "
BUILDER
I
SIGNATURE WI)-_ Z$. ~
**************1*************************************:************* ~
EU;CTRICIAN . I COMPANY ~V(J/Id(ll ./ ~ Lf
/~,_~_-Z ~ ~L'c:.-'
SIGNATUREU~7-~ L-,--<.~ 0- ~ STATE CERT OR REGIST # ,..}l' ,
******************************************************************
COMPANY
STATE CERT OR REGIST #
PLUMBER COMPANy.f3LA ttc~f,e..J J
SIGNATURE STATE CERT OR REGIST #
***************************************************
MECHANICAL COMPANY BohY5
SIGNATURE' STATE CERT OR REGIST #
************** **************************************************
OTHER COMPANY
SIGNATURE STATE CERT OR REGIST #
A. NOTIC.E OF DEED RESTRICTIONS
The. undersigned understands that this permit may be subject to "deed restrictions" w.hich
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 raw. 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 cipplication 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 Ii the applicant, haye been provided with a copy of "Florida's Construction
lien Law _ Homeowner's,pr6tection Guide" prepaied 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. .
Appli~ation is hereby made to obtain a permit to do work and instaliation 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 inolude but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Watei 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 pre8ared 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 la
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. JO~S UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
ackno\-1ledged
, 2~
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrlment waR
'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
and whoO did 0 did not
of identification)
take an oath.
owho has produced
(type of identification:
and who 0 did [}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
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