HomeMy WebLinkAbout06-5754
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
5754
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:
5754
MOBILE HOME
MOBILE HOME SET-UP
MOBILE HOME SUBDIVISION
Address: 37551 GILL AVE L T 283
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number: 34-25-21-0170-00000-2830
30,000.00
5/05/2006
4,442.58
4,442.58
5/05/2006
MOBILE HOME SETUP
Name: GRAND HORIZON
Address: 37551 GILL AVE LT 283
ZEPHYRHILLS, FL. 33542
Phone:
ACE AIR CONDITIONING & ELEC.
MOBILE HOME PLUMBING
PARK FEES MH
FIRE IMPACT FEE
SEWER CONNECTION MOBILE
WATER METER RES 3/4"
IRRIGATION METER
TRAFFIC IMPACT FEE 1%
40.00
573.73
273.00
808.00
180.00
180.00
...\) 15.88
'~~
/ "rY cl
"< \ '()I
LEC
MOBILE HOME MECHANICAL
POLICE IMPACT FEE
PUBLIC SAFETY 5%
WATER CONNECTION MOBILE HC
IRRIGATION CONNECTION
TRAFFIC IMPACT FEE 99%
35.00
254.00
26.35
209.50
175.00
1,572.12
FINAL
REINSPECTlON 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 inspection 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
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances
0-A ~ ~-.
C5NT~CT - "SIGNATURE -PERMITOFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
QI..J-'tOV-VULU
'-Jll.l VI ...."'1""11]111...- 1 _II...... &1"".....--...--.
Building Department
Owner's Name
Owner's Address I D1B-:5 \
Fee Simple Titleholder NamJ
Date Received
Fee Simple Titleholder Address I
I Lc-\-
I
PROPOSED USE
TYPE OF CONSTRUCTION
I
c=J ADD/ALT D
D REPAIR
D COMM D
D FRAME D
DESCRIPTION OF WORK I 5eJ- . o...tJ fY1l:Sb I ~l--\G1'Y).~
BUILDING SIZE I d <6 X L\CZs I SQFOOTAGE U 8LDGJ I
I . . . I I I 1 I . I I I I I I I I 1 . . I . I . . I . . . . . I . I I I I I . I I I . I I I . I . . . . I I ~ . . I I I . . I . . . . . 1 I I I . . . I I . . I . . I . . . I . . I I . 1 I I I I . . . . . . . . I . . I . . . . I I . . I . . I I I . I I . I . . I I . . I . . . I I . I . . I
9,.~'~
G(~ lA-'
LOT #
JOB ADDRESS
SUBDIVISION
PARCEL 10#1 ~
V" -
WORK PROPOSED
@
D
D
NEW CONSTR
INSTALL
SFR
BLOCK
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN 0 MOVE D
DEMOLIsH
OTHER I
STEEL 0
OTHER I
HEIGHT
o BUILDING 1$ 30 I 00 0
o ELECTRICAL 1$ 1 DOO6U
D PLUMBING 1$ 5DotJO
D MECHANICAL 1$ 1,0000.0
D GAS D ROOFING
FINISHED FLOOR ELEVATIONS I
I
I AMP SERVICE 2m D
I J)ff pu<-1J r{E ftfNL- JJr 0 tAp11- -- ___
I VALUATION OF MECHANICAL INSTALU>.TI~ ~
D SPECIALTY D OTHER ?
I FLOOD ZONE AREA DYES DNO <.
PROGRESS ENERGY
D
W.R.E.C.
VALUATION OF TOTAL CONSTRUCTION
'"..1111,.,....,,11.......111..11..111111.."11"1'..1.........""1"".".1"".11..........1...1111.1..1.,....11.1...111111.......1......11111.....1,1.,
OTHER
SIGNATURE
COMPANY
REGISTERED
~~!R~-!t'L I YIN I I
License # W- ~btx:i)<ZD I
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Ll:?~ lt4~!d I Y IN I I
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Y / N I FEE CURRENT
Y/N
BUILDER
SIGNATURE:
LU D./AJ ~ -"-
COMPANY
REGISTERED
Address
ELECTRICIAN
SIGNATURE
LU.
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~A./'-./~~~
COMPANY
REGISTERED
Address
License #
MECHANICAL
SIGNATURE
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COMPANY
REGISTERED
PLUMBER
SIGNATURE
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COMPANY
REGISTERED
License #
Ac€-
Y / N I
FEE CURRENT
Address
Y/N
Address
License #
I
Y/N
FEE CURRENT
Y/N
Address
License #
II , , , , I I I 111111 111111 I , , 1 I . 111111111111111111111111111 " , II ,. 11111111 ~ II " , I It n . " " 111111111 " , II , . " 11 r r , 1111111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster
COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
All commercial requirements must meet compliance.
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for ali NEW construction.
I I I I I I I I I I I II II I II I I I I I J I I I ~ I I I I III I II II III I III I I II I I II '. I I I I I I II III II I I . . . ~ I I. ~ ~ I . I I I I II I i I II I I I i I I I I I I I I' i II I I I i I i I I 1111I1 II I I I ~ I II i I ~ i i I I II i I Iii
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000)
.. Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades NC Driveways Fences (PloUSurvey/Footage)
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
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 hlay 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 Pasco County Building inspection Division-Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for Which they Will be responsible. If you, as the oWner sign as the
contractor, that may be an indication that he is not properly licensed and is hot entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of heW buildings, change of
use in existing buildings; or expansion of existing buildings, as specified in Pasco County Ordinance hUhlber 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due; will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final poWer release. If the project does hot involve a certificate of occupahcy or
final power release, the fees must be paid prior to permit issuance. Furthermore; if Pasco COl,Jnty Water/SeWer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statu~es, as amended): If valuation of Work,is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify 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.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and, that aii Work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application 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, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I aiso
certify that I understand that the regulations of other government 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 hot limited to:
Department of Environmental Protection-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.
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the folloWing restrictions apply to the use of fill:
Use of.fill is not allowed in Flood Zone "V' unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will hot adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
. acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
. plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application.. 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 codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced., An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) daysan~ Will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEM~NT MAy RESUlt INYOUR
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.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT '
Subscribed and sworn to (or affirmed) before me this
by ,
Who is/are personally known to me or haslhave produced
as Identification.
CONTRACTOR
Subscribed and sworn to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as Identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
11111111111111I1111I111111111I1111111111111111I1111I1111111I
2006092009
. n HancE OF COMMEN~
state 0'"'' ,W C\.... C \ '.... fi., ,/\
. aumy of - ' ~l.L
THE UNDERSIGNED her ivea nOli . '. '.
Chapter 713.1-1ofida Sta1~ ~ fOlIcw~ngl~:o~':::~~pnlitow.'d'l be. ~. . .~ ?6nall1 f~al prQ~ITy, aoo in accordance with
' . I" eel ,n u'l!! ,..orlCe of Commet)C<!lrrJenJ:
1. DesenPlion of Property: Parcer No. 3!1- Q ~ - Q J - (J I J{)- Q!10C()- :J 8 36
f~"
2. ===;:'::::~' lA,(1-~'e (f,t~
3. , ;:.......,~-'" "!"'" Gn.~ j 70 ^' 5 .
3/~5LEWl AVE _ c~ht.trtl-Ill~
~~ ~
L-
E
$~
irnerest III Property;
Rcpt: 995320
OS: 0.00
05/05/06
Rec: 10.00
IT: 0.00
Dpty Clerk
Name of Ft!!e Simple TidetlOlder:
fl1..e.1l!an owner)
R ~~rs~[;k ~€-~~U1C-{
. . 36'~ . _ CAoh4rhAL) yo L .. ~'S'\O-
~'ee c~ ~. J
5.
Surety: Name
cit)>
JEO PITTMAN PASCO COUNTYrC1ERK
05/05/06 09: 54am 1 10955
OR BK 6971 PG
Ad~s
Amotmt of BOfld: S
6. Leil~r: Nama
Aiii~n
SIaIc
City
7. F'erson$ WIthin the Slare of Florida designated by Owner upon whQm notices Of oltJer doclJments may be sen.-eel
as ,roYided b)l Section 713.13(1 )(3)(7), Florida S1alules: .
Name
Ad.r$l;~
.~-
City
B.
In addition [0 1lUn&eft. 0IAfler Cl.ig~
of
Noti<;e as provided 111 Seolion 713.13(1J(b), Florida Sla[ules.
to reoeive EI copy of !he Uenor's
9. expiration date of NOIIce of Comrnencemenr Is
~D0J
o..~ \_~
STATE OF Fl6RIOA .<::::::....f' 0
COUNTYO~~~
or'il9oi ng ins1ruo dgecl
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'V'
fi"om tile date of recording ~ a different dare ~
(name of person acknowl.edglng)
(type of idenlilic8tion)
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