HomeMy WebLinkAbout05-5003
II
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
5003
Permit Number: 5003
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SEir-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 10/11/2005
Total Fees: 4,442.58
Amount Paid: 4,442.58
Date Paid: 10/11/2005
Work Desc: MOBILE HOME S T-UP
Address: 37546 LILLY BEA AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): 242 Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
GRAND H RIZONS
37546 LILLY BEA AVE
ZEPHYRHILLS, FL. 33542
Phone:
E
ACE AIR CONDITIONING & ELEC.
ACE REFRIGERATION INC
E
MOB LE HOME SET-UP
MOB LE HOME MECHANICAL
MOB LE HOME TIFISUB 99%
IRRI TION METER
IRRI liON CONNECTION
POll E IMPACT FEE
PAR FEES MH _ _ f.J.- 6"
r ~\/O
{, (\ \O,d
60.00
35.00
1,572.12
180.00
175.00
254.00
573.73
T
WATER CONNECTION MOBILE HC
MOBILE HOME PLUMBING
MOBILE HOME TIFISUB 1%
WATER METER RES 3/4"
FIRE IMPACT FEE
PUBLIC SAFETY 5%
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 worklresulting 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 m de before any further permits will be issued to the person owning same
Complete Plan I Specifications and Fee Must Accompany Application.
All work shall be rformed in accordance with City Codes and Ordinances
o OCCUPANCY BEFORE C.O.
~.
PERMIT OFFI
CALL FOR I $PE ION - 8 HOUR NOTICE REQUIRED
P OTECT CARD FROM WEATHER
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I I
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
/D-/I) - oS-
~ .
PHONE CONTACT FOR PERMITTING
/'.
OWNER'S NAME ()"OI7C/ H~(i201l
JOB ADDRESS 3 751.1 ~ l_,1 Jj f3ec~ lc t 24 '2-
LEGAL DESCRIPTION: LOT(S) BLOCK
PHONE
SUBDIVISION
PARCEL 10 #
(OBTAIN FROl1 PROPERTY. TAX NOTICE)
WORK PROPSED: 0 NEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY IDWELLING
o COMMERCIAL
DMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~BILE HOME
o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WO,RK _ /fIobd(: ;-IOM€ S~-f' Up
L(2)(3 I
BUILDING SIZE
SQGARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLiT 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 SURVY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
& (1) SET ENERGY FORMS.
FORMS.
~-
( _;)tJtJ~
~
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy []
W.R.E.C.
o PLUMBING
o MECHANICAL
$
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 ZONI<~ AREAD YES 0 NO
BUILDER
COMPANY
SIGNATURE {A-)ep. _ ~ ~?7 STATE CERT OR REGIST ~.
******************************************************************
E~ECTRICIAN ~
SIGNATURE{"A.....J~/?1- Z3 . - ;;p-~"
/!l<'~ .212r---
STATE CERT OR REGIST #
COMPANY ;-1ce.
***************~**************************************************
PLUMBER ~___ COMPANy!3u-Hc~ del
SIGNATURE ~~ /3~ STATE CERT OR REGIST #
*********~**************'**Y?*"****'**"****'****
MECHANICAL : COMPANY m e_ /J?'~l) ~ D j...q.e-
SIGNATURE~- STATE CERT OR REGIST #
*************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The. unde~signed understands that this permit may be subject to "deed restrictions" whi.,'h
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~i6n that he is not prcperly licensed and is
not entitled to permitting privileges in the City of Zephyrhil1s.
C.. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STA~UTES, AS AMENDED)
I certify that Ii 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. -
Appliqation 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 regulationst 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 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 pre~ared 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 la
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. JOaS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
;he foregoing instrument was acknowledged
Before me this _ day of , 2L..
by
(name of person acknowledged)
Dwho is personally known to me, or
acknowledged
t 20_
(name of person acknowledged)
C1ho is personally known to me, or
D who has produced
(type
and wrioD did D did not
of identification)
take an oath.
D who has produced
(type of identification:
and who D did [}:lid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typedt printed or stamped
Name typed, printed or stamped
I I
PA~CO COUNTY, FLORIDA
Permit No. 50D3 ~
I Date Permitted /P - /1- o~?
BUilQerNamelownerNam~ithl>~L 7JfII, Control#.' _
CQunty Parcel No. .3I,L~t- ~/. "'.'70-e..D--;{,/D SubDlv: ~/,~~
Address/Location $1c-j t ~ ~o/j1!"f<;;t2,-A-- (J~ ,~ /J r ~/~!1-
ClassificationlType of Us~ ~~a ...;~~ .
TRANSPORTATION IMPAC~ FEE Rate: Sq Ft Unit:
I
Exempt 0 Yes 'KtNO i How Determined
Impact Fee Amount $ Zone No. T AZ:
SCHOOL IMPACT FEE
Account (056) Single-Fa i1y Detached House
(057) Mobile H me
(058) Other Re Idential
1 3) Collectio Fee
Exempt Yes 0 No How Determined
Amount $
Land Total
PARKS AND RECREATION
Land Account
Recreation Account
Recreation Credit Recreation Total
Zone
TOTAL AMOUNT $
Exempt 0 Yes 0 No
LIBRARY FEE
Land Account
How Determined
Land Credit
Land Total
Facility Account ,,'-'
Facility Credit
Facility Total
Exempt 0 Yes 0 No
How Determined
Total Amount
RESOURCE FEE
TOTAL AMOUNT
,01
ERU
Prepared By
Checked By
NO CERTIFICATE OFIOCCUPANCYWILL B.E ISSUED OR FINAL INSPECTION
PERFORMEP!UNTIL THE TOTAL AMOl)NTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does not 11 ply acceptance of concurrence, but simply receipt of a. copy of this form, placing
the building permit owne~on notice of this assessment and th~ conditions of payment for same.
I
I
DATE
RECEIPT NO.
~it.p ~9- DATE
RE""~BY.
\\. --I 0-05 BY ~~(br-f
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