HomeMy WebLinkAbout05-5026
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
5026
5026
Permit Type: ADDlTION/AL TE 1llON
Class of Work: 434-ADD/AL T RESI
Proposed Use: RV PARK
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 3434 TOURMALINE DR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
30,000.00
10/17/2005
376.00
376.00
10/17/2005
LANAI ON EXISTIN
Name: KENNY & NANCY GRIFFIN
Address: 3434 TOURMALINE DR
ZEPHYRHILLS, FL. 33542
Phone:
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DUCTS INSTALLED PRE-SLAB
DUCTS INSULATED LINTEL
SHEATHING FRAME
MISC INSULATION
MISC. INSULATION
MISC. DRIVEWAY
REINSPECTION FEES: When extra in
charge of Thirty-Five Dollars ($35.0
CONSTRUCTION POLE 2ND ROUGH PLUMB
PRE-METER WATER
MISC SEWER
MISC MISC.
MISC. MISC.
MISC. MISC.
ction trips are necessary due to anyone of the following reasons, a
hall be made for each trip for each trade:
(a) Wrong address (b) Condemned wor r~sulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for i ~pection when called
(e) Permit not posted on job site (f) Pia s Inot at job site (g) Work not accessible
The payment of inspection fees shall be a e before any further permits will be issued to the person owning same
nWarning to owner: Your failure to r rd a notice of commencement may result in your paying twice for
improvements to your property. If y intend to obtain financing, consult with your lender or an attorney
before recording your notice of com ncement."
Complete Pia ,Specifications and Fee Must Accompany Application.
All work shall be rformed in accordance with City Codes and Ordinances
o OCCUPANCY BEFORE C.O.
~~
PERM IT OFFI
PECTION - 8 HOUR NOTICE REQUIRED
TECT CARD FROM WEATHER
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CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
101-/05
D~~~Mll ~ERVICf
PHONE CONTACT FOR PERMITTING-866-824-7894
Toll Free
OWNER'S NAME PHONE
BLOCK
SUBDIVISION
EY"nerCL\d.
0['(\ e
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
PARCEL ID #
WORK PROPSED: ~EW CONSTRUCT dN
o SIGN
PROPOSED USE: ~L FAMILY DW LILING
o COMMERCIAL
o ADDITION
OALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
OMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
c:J RE TAURANT & HEALTH DEPARTMENT APPROVAL
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
DESCRIPTION OF WORK
IOJ. '
RESIDENTIAL: ATTACH (2) PLOT
COMMERCIAL: ATTACH (3) SETS
IF SIGN PERMIT ONLY (2) SET
PROPERTY SURVEY
plLANS & (2) SETS OF BUILDING PLANS
qF BUILDING PLANS & (1) SET ENERGY
pF ENGINEERED PLANS REQUIRED.
RIEQUIRED FOR ALL NEW CONSTRUCTION.
& (I) SET ENERGY FORMS.
FORMS.
o MECHANICAL
$
PERMITS REQUESTED
~
VALUATION OF TOTAL CONSTRUCTION
~UILDING
~ECTRICAL
~LUMBING
o Progress Energy 0
W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALT
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
ELECTRICIAN
***********************************************
ikwl.AJV~ .LJ 5' .~o
COMPANY
SIGNATURE
STATE CERT OR REGIST #
PLUMBER
~-* * ** *** ** *** **** **** ** ***** * ** ************* ** ** ~
I COMPANY ~(JV-//lf'r ~'b I iU'~
SIGNATURE
STATE CERT OR REGIST #
************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
****************
**********************************************
SIGNATURE
COMPANY
OTHER
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 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 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
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
~
SI-6N TURE: ER OR GENT.
STATE OF FLORIDA ~
COUNTY OF .Q-.$to
The foregoing instrument was acknowledged
Before me this ~ day of r;c+Oloer , 2005""
by
(name of person acknowledged)
Dwho is personally known to me, or
~ has produced-.TIJ"..
(type of
Ddid not t
Si
Name typed, printeci'or,stam~d
. \....s/ u..ic. tJli
SIGNATURE: , TRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument wa()(a~wledged
'~..J r--
Before me this -1.::U--"'Uay of , 20 O!;>
by
~(name of person acknowledged)
~o is personally known to me, or
Pas (.0
o who has produced
(type of identification)
~id not take an oath
taking acknowledgment
, . 3 ",.i'Tiil'i\a"" ~ -t:r~~')1'
Name typed, p~.tnted orstamp"fdj'
'.1',
; '3.!(~
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DISCLOSlJRB STATBIIEln' FOR OWNER
CITY! OF ZBPBYRBJ:LLS BUJ:LDDIG DBPARTIIBHT
I,
agree to the provisions of this instrument.
have read and ful.l.y understand and
The undersigned states and
renovating, adding to or
actual.l.y occupies, or wil.l.
rent, l.ease or sal.e. That
affirms that he or she is desirous of constructing,
oofing his or her own domicil.e, that he or she
qccupy by said domicil.e, and same is not for
l:\.e or she shal.l. compl.y with the fol.l.owing conditions:
l..
That the owner and he
construction.
That the owner
ordinances and codes p
That in the event vari
engage onl.y properl.y l.
such work.
That in the event the
the owner wil.l. assume
compl.etion wil.l. cal.l. f
That the owner shal.l. a
not expect supervision
Department.
That prior to final. i
fees, must be paid in
constitute an official.
That the owner shal.l. c
social. security, wor
That the owner shal.l. c
Industrial. Commission.
State l.aw requires con
appl.ied for a permit
you, as the owner of y
restrictions even thou
onsite supervision of
one-famil.y or two-fami
or improve a commercia
The buil.ding or resid
be buil.t or substantia
. buil.ding you have buil.
the construction is c
substantial.l.y improved
exemption. You may no
to supervise peopl.e wo
make sure that peopl.e
by county or municipal.
responsibil.ity for sup
l.icensed to perform th
who is not l.icensed mus
empl.oyed by you, which
and provide workers' c
Your construction must
codes, and zoning regul.
~ she al.one shal.l. act as the buil.der for al.1. phases of
2.
3.
l.y with al.l. provisions of the City of Zephyrhil.l.s
Jttinent to the buil.ding.
~s phases of construction are subcontracted, he wil.l
densed subcontractors and will personally supervise
4.
.l.ding Inspector shall. require corrections to be made,
~l. responsibi1i ty to insure they are made, and upon
zt a reinspection before proceeding with the bui1ding.
~ full responsibility for the construction and will.
df his work from the City of Zephyrhills Buil.ding
5.
6.
to
8.
additional. fees, incl.uding reinspection
~l.l.. A written request from this office shal.1
~otice to pay additiona1 fees.
l.y with a11 City, State and Pederal. laws in regard
, s compensation, 1ien laws, etc., where app1icabl.e.
l.y with all the safety codes issued by the Plorida
7.
9.
ction to be done by 1icensed contractors. You have
r an exemption to that law. The exemption a1lows
ujr property, to act as your own contractor with certain
h! you do not have a license. You must provide direct
iB construction yourse1f. You may buil.d or improve a
y! residence or a farm outbuil.ding. You may al.so buil.d
~uil.ding, provided your costs do not exceed $25,000.
cjra must be for your own use or occupancy. It may not
1y improved for sal.e or lease. If you sell. or lease a
or substantia11y improved yourself within 1 year after
~ete, the law wi11 presume that you built or
i~ for sal.e or 1ease, which is a viol.ation of this
~re an unl.icensed person to act as your contractor or
ng on your bui1ding. It is your responsibil.ity to
loyed by you have 1icenses required by state law and
~censing ordinances. You may not de1egate the
ising work to a 1icensed contractor who is not
~rk being done. Any person working on your buil.ding
I work under your direct supervision and must be
ans that you must deduct P.I.C.A. and withh01ding tax
ensation for that emp1oyee, all as prescribed by law.
~1y with a1l appl.icable laws, ordinances, building
tio~.
WITNESS
OWNER'S
ADDRESS
PROBE
DATE
-
/11--/3 -OJ
PBRHJ:T #
To Whom It May C
sor
Please be adv $ed that:
Stacie Zullo & Debbie Dokendorf of Pasco
Permit have my permission until further written
notice to si and pick up permits for me.
Sincerely,
NOTARY
STATE OF
COUNTY OF PASCO
The foregoing instrument was sworn to and
subscribed before ~ this I.~"'" day of Ocj-:
Personally known or Produced identification
-
, 6ZDO':J .
Commissioned Stamp
and Expiration Oat
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