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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
5086
Permit Number: 5086
Permit Type: MECHANICAL
Class of Work: AlC NEW
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Name: KELLER, ALLEN H.
Address: 5943/5945 20TH ST
ZEPHYRHILLS, FL. 33542
6,000.00
1 0/31/2005
60.00
60.00
1 0/31/2005
NEW CENTRAL AI
Address: 5943/ 5945 20TH ST
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-04500-0010
Phone:
HEAT SYSTEMS *ELECTRICAL EXISTING
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REINSPECTlON FEES: When extra in ,ction 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 i ~pection 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 e before any further permits will be issued to the person owning same
"Warning to owner: Your failure to r ord 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 e cement."
Complete Plan ,!Specjfications and Fee Must Accompany Application.
All work shall be . rformed in accordance with City Codes and Ordinances
OCCUPANCY BEFORE C.O.
.~ ~-~
CONTRACTOR SIGNATURE i PERMIT OFFI
CALL FOR I $PECTION - 8 HOUR NOTICE REQUIRED
POTECT CARD FROM WEATHER
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Parcel Information for: 11-26-21-0010-04500-0010 Card: 001
Page 1 of2
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I ParcellD I 1-26-21-0010-04500-0010 (Card: 001 of 001)
I Classification I 08 - Multi-Family - Less than 5 units
Mailing ddress Assessment (totals)
KELLER LLEN H Ag Land $0
5945 N OTH ST Land $10,119
ZEPHYRHILLS, FL 335423839 Building $28,074
Ph sical Address e All 2 addresses Extra Features $262
5943 2 TH ST
ZEPHYRH IWLS33542
Le al Descri ti n (First 4 Lines)
CITY OF ZEPHYR ILLS PB 1 PG 54
E 1/2 OF LOTS 1 & 2 & E 1/2 OF
N 1/2 LOT 3 BLOCK 45
OR 6498 G 1976
L d Detail (Card: 001 of 001)
Use Descri ton IZoningl1 Units I Type
0100 SF 00R2 00.00 SF
100 SF 00R2 . 0 SF
Total Assessment $38,455
Save Our Homes $0
Taxable Value
$38,455
ditional Land Information
Acres 0.16 30m ~~~: I x I Res Code !ZHLHLP21
Buildin Informatio - Year Built 1930 USE 08 - Multi Family (4 or
less U i s per Building) (Card: 001 of 001)
Ext Wall Tile or Wo d Frame Ext Wall N
1 Stucco 2 one
Roof Str Gable or H p Roof COy AsshPhallt or Composition
Inge
Int Wall 1 Drywall Int Wall 2 None
Flooring Flooring
http://appraiser. pascogov. oml search! offline.asp?Sec= 11 &Twn... 10/31/2005
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CITY
I I
OF ZEPHYRHILLS PERMIT APPLICATION
DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542
813-780-0020 FAX: 813-780-0021
I
BUiLDING
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DATE RECE IVED
/ Vn/ /0 S-
.
PHONE CONTACT FOR PERMITTING
OWNER'S NAME
'1k,.,
PHONE ~3-~79~
JOB ADDRESS
BLOCK
SUBDIVISION
LEGAL DESCRIPTION: LOT(S)
PARCEL ID ""
/'-076 -<:t:) V&'-
o NEW CONSTRJCTION
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WORK PROPSED:
o ADDITION
o ALTERATION
o REPAIR
;8(: NSTALL
DSIGN
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING ~ULTI-FAMILY
o COMMERCIAL 0 INDUSTRIAL
~ OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
BUILDING SIZE
DESCRIPTION OF WORK
RESIDENTIAL: ATTACH (2) P
COMMERCIAL: ATTACH (3) SE
IF SIGN PERMIT ONLY (2) S
PROPERTY SURV
T PLANS & (2) SETS OF BUILDING PLANS
S OF BUILDING PLANS & (1) SET ENERGY
TS OF ENGINEERED PLANS REQUIRED.
Y REQUIRED FOR ALL NEW CONSTRUCTION.
& (1) SET ENERGY FORMS.
FORMS.
PERMITS REQUESTED
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
o PLUMBING
~MECHANICAL $ ~~ VALUATION OF MECHANCIAL INSTALLATION
o GAS 0 ROOFING 0 SPECIA TY 0 OTHER
AMP SERVICE
o Progress Energy 0
W.R.E.C.
TYPE OF CONSTRUCTION: 0 BLO K
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
_~~t=~}~=-;',~lli~~~:~~~'~_~~'.~~~.~l u ---~- - ,-- - _.~_ ~~~ :;,~::~~:~~~',~~"-~R~':'::r~';~:; 1;:~i~~~~~~~r;
BUILDER COMPANY
SIGNATURE STATE CERT OR REGIST ""
************** ***************************************************
ELECTRICIAN COMPANY
SIGNATURE
I STATE CERT OR REGIST ""
I
**************~***************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST ""
SIGNATURE
***************************************************************::.~* ~~
COMPANY .... ?~/f'v~ /4/1
STATE CERT OR REGIST # c:. A-co51J'Y7&?Z
MECHANICAL
**************************************************
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 contr~ctors 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".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
acknowledged
, 2U--
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
,20_
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
o who has produced
(type
and whoO did 0 did not
of identification)
take an oath.
o who has produced
(type of identification)
and who Odid DUd not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
II
State of
76r/c1~
NOTICE OP COMMENCEMENT
County of
1111111 11111 IIlIItllll 11111 11111 11111 11111 111111111111111111
2005229644
~6CO
TUB tmoERSIGNED hereby g'ves notice that improvement will be made to c~rtain
real property, and in a cordance with Chapter 713, Florida Statutes, the
following inforr.lation is provided in this Notice of Commencement:
l\ddress
-5'9113 J-.59~
(Legal descr~ptlon
1.
2. General Description of
An 0/ ,&-~/.
~'6'*H1 "
3. O\>'ncr Information:
State ;:L 3J:>~2
Name of Fee Simple T i leholder:
(If other than 0 ner)
Address
City
Stilte
--
R4.
Contractor: N<lme
Address
5 .
Surety: N.:llne
State ~ 3.3.5~
'/
Address
6. Lender: Name
Address
City
State
---
7 .
Persons within the State of Florida
notices or o~her d cuments may be
713.13(1)(a)(7), F10 ida Statutes:
tJ,:.mc
designated by Owner upon whcrn
served as provided by Section
fi93~~~~M~~:~~~COICO~~Tl CLERK
OR BK 6666 PG 286
Address
City
State
8. In addition to himse1 , Owner designates ;11 /4
of 1VL:J4. J to receive a copy of the
Lienor's Not1ce as p~ovided 1n Section 713.13(1)(b), Florida Statutes.
'). fxp.irflt J.'Jn dl'1te of ?lCJ lee of Commencement. (the explratiun d.3.te is 1 year
ir~m the d<lte of recording unless a different date is specified.)
2oL.
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Sig:1ature of Owner:
Sworn to
Not<lry Pub} ic:
My C:J;i"1',;1j 55 .:Lon Expires:
PC93053048/A
,"""'" EHUS
f.;,~' . ~~ MY COMMISSION II DO 284918
\:!i:~ ~ j EXPIRES: JanuaIY 26. 2008
~..w.... . ~ IloncIed Thtu Notal\l Public Und8rwItleIs