HomeMy WebLinkAbout06-5572
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
5572
Permit Number: 5572
Permit Type: COMMERCIAL
Class of Work: ADD/AL T COMMERCIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 40420 FRE FALL AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 18-26-22-0020-00BOO-001 A
4,726.90
3/23/2006
160.00
160.00
3/23/2006
INTERNAL ADDITION, 500 sa FT
Name: PRIMARY CARE SOLUTIONS INC
Address: 40420 FREE FALL AVE
ZEPHYRHILLS, FL. 33542
Phone:
UI
FIRE PLAN REVIEW FEES
20.00
lJL c9 It?
. [0 \0
(\ \'" \.0\0-'
DUCTS INSULATED
SHEATHING
MISC.
FIRE DEPT. FINAL
BUILDING FINAL
LINTEL
FRAME
INSULATION CEILING
ELECTRICAL FINAL
PRE-METER
SEWER
MISC.
PLUMBING FINAL
WATER
INSULATION WALL
MISC.
FINAL MECHANICAL
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections 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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
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."
NO OCCUPANCY BEFORE C.O.
('/~~7>(~ ~.
CONTRACTOR ~~~t ;~~EINSPECTION _ 8 HOUR NOTICE REQ~~~~T OFFI
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING.. DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
PHONE CONTACT FOR
S.~Ob
DATl!~ RECEIVED
r1 A t2Yt N 21MtYl€. ({'("\IV)
PERMrrTING ::re(("'i ~ 1\13j--
OWNER'S NAME ~ QI r1A~
JOB ADDRESS .Lj 0'1 20
LAl2--e..- ~ OL\.{T(()'\J S.
V:f ~ ~ L~ A"z..
PHONE
gJ 3 - 77y,.72'1.1o
f-L 3~'-I3
2 E.P (J Y e. H ilLi 1
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 10 # \ ~- 2 <a- d-.d. - 00 Ol.O - 0060b- 00 \ A
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: DNEW CONSTRUCTION
o ADDITION
lxI-ALTERATION
o REPAIR
o INSTALL
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: DSGL FAMILY DWELLING
~COMMERCIAL
DMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
BUILDING SIZE
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
)( ~CJ ~~~ U ~ ~~.
SddARE FOOTAGE .
HEIGHT
DESCRIPTION OF WORK
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.
~. BUILDING
'~ ELECTRICAL
$23 'l~ t. 9.2
,
PERMITS REQUESTED
VALUATION OF TOTAL CONSTRUCTION
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
~ FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
SIGNATURE
~ COMPANY
IV' /4 ~;: Jf/~STATE CERT
,
BUILDER
OR REGIST #
******************************************************************
ELECTRICIANX~. ~~
SIGNATURE ..~~ 7: /f l~
COMPANY
STATE CERT OR REGIST # )(
*******************************************************~,**********
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*******************************************************k*********
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be
may be more restrictive than City regulations. The
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contra.ptors to undertake work, they may be required
to be licensed in accordance with state and focal 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
1f' $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
~/JI(~ 3/<1/0(.,
SIGNATURE: OWNER OR AGENT / I '
supject-to "deed restrictions" "u~
undersigned assumes responsibility for
SIGNATURE:
CONTRACTOR
acknowledged
, 20_
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)
[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 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
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Dollar Amount --1 (0 ?0-
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Square Feet 500
Valuation
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Building
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.---r3~ $146 ," <>
Electrical
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N)A
Plumbing
Mechanical
Connection Fees
Sewer
Water
Meter
/U )1\
. r
School Impact Fee }.J 11}
Transportation Impact Fee AJ lit
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Building' all comply with
the appli, 'ble cqrles of
Florida Fire Pre ntion ,Handbook
NFPA & the City f Zephyrhills
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. BUILDING SHALL COMPLY WITH
ALL APPLICABLE BUilDING,.
ELECfRlCAL, PLUMBING AND
MECHANICAL CODES.
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PROVED
. Marshal of Zephyrhills
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REVIEW DATE:3Jc,It>b '
CITY OF ZEPHYRHILII ~.
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Fire Chief Robert Hartwig
ZEPHYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrhills, FL 33542
Bus (813) 780-0041 Fax (813) 780-0044
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Occupancy No.:
Plan No.:
Business Name:
BusinessAddress:
Business Phone No.:
Business Fax No,:
Contact:
PLAN REVIEW FEES
~Site Plan N/C
. Building Plans 'CS'
. RevIsion 1ffisf
FIRE SERVICE USER FE~
Owner: r~:J C'poc ~ ('~l~"a~
Billing Address:
STANDPIPE SYSTEM
D Per Riser $25
SPRINKLER SYSTEMS
n 0 - 25 Heads $30
D 26 plus Heads $60
FIRE PUMP
D Per Pump $100
FIRE ALARM SYSTEM
D 0 - 25 Devices $30
D 26 plus Devices $60
SUPPRESSION SYSTEMS
~ Wet $35
Dry $35
C02 $35
Other $35
GREASENENTILATION
D Hood/Ducts $35
PLANS TOTAL ~
Comments:
417
~ ~TO~L
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INSPECTION FEES
Annual N/C
1 st Re-inspection $25
2nd Re-inspection $50
3rd Re-inspection $125
4th Re-inspection $250
5th Re-Inspection $500
Construction $15
Commercial $25
SPRINKLER SYSTEMS
Hydro Undergrounds $45
Hydrostatic System $45
Wet Acceptance $30
Dry Acceptance $45
Hydrant Flow $25
Hood / Booth $30
Grease Duct $15
FIRE ALARM SYSTEM
B System Acceptance $50
Recall Acceptance $50
OTHER
Fire Wall/Smoke Wall $15
LP Gas $25
Natural Gas $25
Fuel Tanks $25
Tent $15
INSPECTION TOTALC]
Billing Ph~O.:
Billing Fax .: tCI ~up~
Contact: . all. .h t
PERMIT FEE
FALSE ALARM FEE
1 st Alarm N/C
2nd Alarm N/C
3rd Alarm N/C
4th Alarm $25
5th Alarm $50
6th Alarm $75
7th Alarm $100
8th Alarm $150
9th Alarm $200
10th Alarm $250
Non Compliance $150
"Affidavit of Service/Repair"
SPRINKLER SYSTEMS
D Automatic $15
FIRE PUMP
D Fire Pump $15
FIRE ALARM SYSTEM
D Detection $15
OTHER
~ LP Gas
Natural Gas
Fire Works
Fuel Tanks
$45
$45
$25
$45
GREASENENTILATION
D Hood/Ducts $15
D Kitchen Suppression $15
FALSE ALARM I
PERMIT TOTAL! TOTAL.
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Date:
Inspector:
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Building shall. comply with
the applicable codes of
Plorlda Fire Prevention Handbook
NFPA & the City of Zephyrhills
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APPROVED
by Pire Marshal of Zephyrhills
with e~.'.__~ -. ent~s R'lOvided with plants)
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, BUILDING sHAL UILDING,
ALL APPLlCABL~ING AND .
ELECTRICA.L, PL .
MECRAN1CP-:l CODES, ..
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REVIEW DATi.:......... ,- J~\..
CITY OF ZEPHY~ Jl,
BUILDING, O~~CIAL-f-k~L2VO'7
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FLA, 1877 LAWS
PS 713.13
SEMINO!.E FORM 408
N.OTICE OF CO'MMEN,CEMENT
~~:~t:f o:JOrida , } IPR~P-ARE IN DUPLlaA~EI ~~~~~llll~ll]1I1111ll11111111l11111ll11ll111l1111111
The undersigned hereby informs all concerned that improvements will_ be made to cfilrtain real property, and in accordance
with sfilctlon 713,13 of the Florida Statutes, the'following information is stated in thi.!i NOTICE OF COMMENCEMENT.
, .
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Description of property... fJ:J.fJ.t!.<< F.Ag.t0&.1.~.tf:-:" .~A:r:../, '~.(!i..""""""""""""""""""""""
...'. .....,.. ...~F.F I. C/:. :. ,-:...?:O.Y.... .-r:':} , . E.~,...., .1?~f}#T.,~., .~.~PP..., ~9,'J.T.::.",.........,
. ..l.~... .'. .2.&..~ ..~~ .~. ..601.0 ..~,Q .~.7.@..~ ./JO'!' D., .......... .,.........,.......,."....,."..
General description of improvements.. ."!?-!. r.~ ~!'!. ~ .~.... .~C?~.. ~.9; .;::r.... .tf. ~ ,~.'""!),. ,ti.7)'-:J/ ,i.;r. Q N..."., '.'...
6vt.~:::~/~, .~~:-:.~~".. .t~(/!7A tf{ ..C.11.4k. .S/?{-.<< 7/iJ.~,~,.: .:;r;:~((-;:'...,.,...............,....."..,.,."...,
R Address.. y.~. Y..-!: ~...F.f!/2.~..F.IJ,~::-:.,~l~'I""~ ~.f.(:I.;/tf./{!~, ?:,~,., F..~,.... .:3..? .-?.,!:, .~..,
Owner's interest in site of the im~rovement . . . ,~.t;. ;:r~4#,~. , . .. ~.. . .-. ,., . , ,. . . Repl: 976442 Ree: 10.00
. Fee Simple Title holder (If other than owner) . OS: 0.00 IT: 0.00
03/08/06 Dpty Clerk
Name....... .a'. .:...:~..~: ~~~............... ..... ... ...... .... ..... ....... ... .............'
JEO PITTMAN, PASCO COUNTY CLERK
03/08/06 10: 03am 1 of 1
Address ......;.................:.................................................. OR BK 6873 PG 1761
Contractor ..4.'-:? .:?/..~.{3;. S:5.". .q0.':'!.~.' R.............."....... ........,.,:................:............,.....,...
Address
. .
...... ....... .......................... .............................. .... ......... ......... .... ... ... .... ... ................
Surety (if any) .,........,.,..... '. . . , , . . . . . . . . , , . . . . . . . . . . , , . , : . . . . . . . . . .. . . . . .- , , . , , . . . . . . . . . . . , . . " ' . , . . . .- . . , . , . . , . , , . . . . . . . . , ,. ,
Address .:.... .....- ......... ,.. .,. "... ,:....... ,..., ...., .... ,... ,... ........,,:, ..,. ...". ...,. .Amount of bond $.",."., .....,
Any person making a loan, for the construction' of the improvements: . .
Name . ..~II}... .......,...........,..................,.. .....,..... ~.., '.'.'....-.........."....."....................-...........
Address ..,...,.... '.., ",....,..,.",.,..... ,....,. .........;. ~.,.."'...... ,. ,.."" .. . ,,'. " . ...' ,... , ...... ,..,.,......,.. , ,.,.
Per;on within the State of Florida designated by. owner upon whom notices or other documents may be served:
Name .................,.....,."."...,.,.............",...,......",...,.......,.....,.,....",.....:,...,.........,..,...,."
Address ....".", ... , . . " . , , . . . , , ., , . . , . , .. . . . . .. . . , . . , . . ..' . , , . .. . .. . . . . .. . , , . , .., .. , . . , , , . . . , . . . , '. .- . . ... ,. , . . . , ., . , . . , . , . . . . .
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Sectioll.......:
713,13 (1) (h), Florida Statutes. (Fill in at Owner's option),--.----.--------- - 9 V'
.' ~Uil", ~ . "TT")I'~I" L In'~''':'O''1 ' .
,~. ~"'n' ,.~ rf;.. i n '.,Jl""~ . vr-~\"f...; Ili \r
. Nam.e :.."..."".,. _, . . .. .~ .~.~_ . . . . .. . , . , . . . . . . , . , , . . . , '.' , , . , , . " . ?';L;J ~.'" . /iff,q~~:':!~~~<?t.J :.~ ?~;~.:_~~~' .......,..,
,. ,'( Ct ij\fJ,,~ EXi"l'j""i,:':'S: CGtober 6, ",~,.1...'U
. . ./) H3(^c,~ri'JTARY FL No\~1Y SeNioa & C<:<<I."". inc. .
Ad~ress T~I~' ~~~~~ .;~~.~~~.~~~.~~,~. ~~.~ ~.~~~' ....... . ,.. ,. , ......, ...-.i~::e ;;:-'Hi~~':-:-;~-'~~'-" , ....... . .
- ."..........,.,',.,",........~.....,...,......
Owner
STATE OF FLOFlIDA
COUNTY OF PASCO
THIS IS TO CERTIFY THAT THE FOREGOING I
TRUE AND CORRECT COpy OF THE DOCUMENT S A
Of! OF PUBLIC RECORD IN THIS OFFIC~;lTN~~F~~
HAND AND OFFICIAL SEAL THIS. D.AY OF
(r) It R 2 00 t' .'
JED ~AN, 'MRK RF C,RCU;COURT
BY r, ~D
. , .D~PUTY CLERK
}c-.( ~()J:Or ':J4J
Sworn to and subscribed before me this.. ./':t. ft.~.c;.H.. ,l~.. ... , . ,. " , . .
........................day of .., ,., , , . . , . , , . . . .' . . , , . . . . . . . , , . . , . . . . . . . . . .a9..Ql$:.. .
..... p..~. ~;;;:.:;;-~.......................
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PI"ilnary Care Solutions, Inc.
40420 Free Fall Avenue
Zephyrtlills. Fl. 33542
Phone; (813) 779-7225
Falf' (R13) 71~4D84
To Whom It May Concern
ThilO lener will certil)r thaI Ronald L. Maddix, Vice President &. Director of Operalionll
for Primary Carc Solutions, Inc. is an operating partner in ownership of Primary Care
Solutiolbl. Inc
Sincerely,
~4--
Stephen B. Harrington
PrcWent
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