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Home My WebLink About06-5944 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 5944 ermlt Number: 5944 Permit Type: ADDITION/ALTERATION Class of Work: 434-ADD/AL T RESIDENTIAL Proposed Use: SINGLE FAMILY RESIDENTIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 552517TH ST ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11-26-21-0010-14000-0030 525.00 7/17/2006 52.50 52.50 7/17/2006 Phone: 2 REPLACEMENT WINDOWS - SIZE FOR SIZE Name: Address: BECKMAN, BRIAN & PAMELA 5525 17TH ST ZEPHYRHILLS, FL. 33542 813363-6847 \!}& / \-,,"if \t}~",,f '< ~\ f 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. JrulMJ~CJ ~ ~ CONTRAC OR SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-UU<1U \..Ill} VI ~-"""p.I}I'UI' . -...... -1-1--- Building Department Date Received s+-. I . PARCELlD#lu-~G"'c91 ,.ODlO "~roD" 0)'50 (OBTAINED FROM PROPERTY TAX NonCEI o MOVE 0 LOT_ 13.. ~ SUBDIVISION SIGN DEMOLIsH WORK PROPOSED VALUATION OF TOTAL CONSTRUCTION AMP SERVICE d PROGRESS ENERGY D W.R.E.C. MECHANICAL SIGNATURE I COMPANY REGISTERED Y / N FEE CURRENT Y/N License # Address I OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N License # 11I1 , II , 1111 . 'I "I' I , ' 11III . , r I , I 1 II 1 , I11I 1 II 1 Ill' 1 II1I " I 1 II 1 111111 1 11111111 1 II 1 I 1 II 1 111111111 1 111111 1 II 1 11111111111 . I 1 IIIII rill 1 I' II , III1 1 III' I Address RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) liet of Energy Forms. Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. . 1111111111111111111111111111111111111111111.1111..1111I.I.III..IIIII.IIII..III.llllllllllliiillllilllllllili1IIIIilillllillllilllillllliiililiillii Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (A/C upgrades. over $50(0) 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 AlC Driveways Fences (Plot/Survey/Footage) NOTICE OF ,DEED RESTRICTIONS: The und8rslgn~d understands that this 'permit may be subJect to -deedio restrlctl~ris- . which may be more restrictive than County regulations. The undersigned assumes tesponslblll!y for .Compllance with any applicable deed restrictions.. .. . .. . UNLICENSED CONTRACTORS AND C.oNTRA~TOR RESPONSIBiLITIES:', If the owner has .hlred. a contractor ot cc:>ntractors to undertake work, they may be re.qulred to be I,censed In aCcOrdance wlttl state Bnd local regulations. If the contractor Is not IIc.ensed as required by law, both the owner and con~ractor may be cited fQr a mlsdemeanot Violation under state law. If the filwner or Intended contractor a~e uncertalh as to what licensing reqUirements may apply fot the. Intended work, they are Bdvls~ .t~ contact the P~sco County Building Inspect,on blv!slori-llcenslJ:1g Section at 7'ii-847- 8009. Furthermore, If the owner has hired a contractor or contractors, he Is advised to have the conlratlor(s) sign . portions of the .contractor Bloc~- of this QPpllcatlon for which they Will be tesponslble. If you, as the ownet 61gri as the, . contractor, that;may be an Indication that h~ Is not properly licensed and Is not enllUed .to permitting privileges In Pasco County. . ' ,.. , . , . . . . . TRANSPORTATION I~PACT/UTILlTlES IMPACT AND RESO~ROE REOOVERY FEES: The underslgnedUnderstahds . that Transportation Impact ~ees ~nd 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 humber 89-07 and .. ., 90-07, as amended. The underslgne~ also understands; that such fees, as may. be due; will be Identified at the time of permitting. It Is further ~nderstOod. that Transpo~atlon Impact Fees and Resouree Recovery Fees must be paid prior lo , receiving a -certificate of occupan~y" or final power release. If the project does hot Involve a certificate of occupancy or filial power. release, the fees must be paid prior to permit Issuance.. Furthennotej It Pasco County 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.e., 88 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 thl!lt 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 all Work will be done in compllam~e with all applicable laws regulating construction, zonltlg and land development. 'Application Is . . hereby made to obtain' a permit to' do work and Installation as Indicated. I certify that ho work or !nstallatlon has commenced prior to Issuance. qf a permit and that all work will be p~rformed to meet standards of all laws regulating construction, County. and City codes, zoning regulations, and land development regulation!! In the jutlsdlcUoh. I also ,certify that I understand that th~. regulations of other government agencies may apply to the Intendt:ld \Nork, 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 Ptotectlon-Cypress Bayheads, Wetland Areas and Environmentally Sensitive . Lands, Wi\lter/Wastewater Treatment. . .. . Southwest . Florida Water Management Dlstrlct-Weils, Cypress. Bayheads,. Wetland Areas, Altering. Watercourses.. . .. ., . . . Army Corps of Englneers-Seawalls, Docks" Navigable Waterways. . .. .. . Departm.ent of He~lth & RehabilitatlveSe..vlces/Envlronmental Health Unlt-Wellsl Wastewater Treatment, , .Septlc Tanks.. . ..' . . US Environmental Protection Agency-Asbestos abatement. . Federal Aviation Authority-Runways. I understand that the folloWing res~rlctlons 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 .uged In Flood Zone "'N, It Is understood that a drainage plan addressing a . .compensatlng volume- will be. sub'TIltted 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 lill 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 a~versely 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 ~ondltlonsset fo~h In this affidavit prior to commencing , construction. I, understand that a separate permit may be required for electrical wor~, . ' . plumbing, signs, wells, pools, air conditioning, gas,. or other InstallaUonsnot specifically Included In the application. A . permit Issued shall be construed to be a IIcens.e. to proc.eed with the work and not as authority to violate, c,ancel, alter. or set aside any provisions of the tec~nlcalcodes, nor shall Issuance of a permit prevent the Building Official frQm,t~erea~er requiring a Qorrectlon of errors in plans,cQnstructlon or vlolatlons,of any code~. Every permit lssu~d 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 ab,andoned for a period ohlx (6) months after the time the w~rk Is commehced. . An extension may be requested; In wrltlng,from the Building Official fora period not to exce,ed hlnety (90,) days..and WIII,dem~nstrate justlflal:Jle cause for the extension. if work ceases.for ninety (90) consecu,tlve days, the Job Is conslde~ed abandoned. . . . WARNING TO OWNER: YOUR FAiLURE TO RECQRD A NOTICE OF COMMENCEME;NT MAy i:tE~ULt IN YOUR. . . ., ' PAYING TWICE FOR IMPROVEMENTS TO VOUIt PROPERTY. IF VpU INTENP TO. O.BTA~N F~NANCINGI OONSUL T WITH YQUR LENDER OR AN ATTORNEV BEFORE RECORDING YOUR,.NOTlCE OF COMMENCEMENT; . FLORIDA JURAT (F.S. 117.03) TRA TOR . . OWNER OR AGENt ' . CON C.. . Subscribed and sWam to (or afflrm!'d) before me this. Subscribed and sworn to (or amrmed) before me this , . ~ ., . ~ . Who Isla~ personally known to me or haBlhave produced . Who Is/are personally known to me or haslhave produced . . as IdeoUflcaUon. . as IdenUflcaUon. Notary Public NolarY Public Commission No. Commission No. Neme of Notary typed, printed or stamped Name of Notary typed, printed or stamped 07/13/2005 23:23 7273757332 PAGE 01 STATE OF FLORIDA DIVISION OF WO~Ke~S' COMPENSATION BUREAU OF COMPLIANCE EMPLOYER EXEMPTIONS REPORT Employer 10: . Eoo007407 Name: ACKERMAN CONSTRUCTION INC Slnet1: 8420 ULMERTON ROAD #434 Street2: City: LARGO FEtNlSSN: 593369225 Zip: ~rl~ State: FL ();:h;~ ~/3' 7t~ - OD2/ ~~; ~. ~a, 07/1312006 07/13/2004 01/0112004 07/1412002 07/1212000 01/0911998 01/0112004 07/1312002 07/13/2000 01109/1998 05/1512003 01/1611998 07/1212008 07/1312006 07/1312004 12/31/2003 07/1212002 12/31/1999 07/12/2004 12/31/2003 07/13/2002 12131/1999 1213112003 12131/1999 CONST~UCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION CONSTRUCTION PROCE8C'~ gr." -II ~ta6--fYh ;0 ~'f) :;n-J-~~;S- 07/13/2006 23:23 7273757332 NOTICE OF ELEcnON TO BE EXEMPT - Page 2 PAGE 02 SECTION 2. You must identify tile workers' compensation insurance carrier business. Carrier Name: 4-- '~:'.~~~I:.tr.. ,. i$~;' t AFFIDA;VIT OF APPLICANT: I hereby certify that the information contained herein is true and eorreet t~"tliiCbest of my knowledge and belief; that this election docs not exceed exemption limits for corporate officers, including any affiliated corporations as provided in ~440,02 Florida Statutes; and that any non-exempt employees of the corporation or limited liability company (LLC) identified in section 3 of this notice are covered by workers' compensation insurance. ~~~ / YO I g33~ SOCIAL Sf'..cuJUTV NUMRER. 7 -L5-0'~ DATE SIGNED NOTARY STATE OF FLORIDA, COUNTY OF Hi\\"!:o~c>,.oo\"" ~. Swom to and subscribed before me this~ day of :r v \... , '2.Do," , by J')o.....i~ \ k. A c.\c......._ Personally Known OR Produced Idcntification~ Type of Identification Produced fc.1:l L ,A)..w ~.f71.4' ')~'-Q NOTARYSIGNATURBU ~ My Commission Expires Plea."le submit this completed form, along with any attachments and a $50.00 BppUcadon fee (construction jndu$tl'y appHc:ants only) payable to the DFS WC Administration Trust Fund, to the District Office Ustcd below that is closest to your place of business. 4415 Metro Parkway '11 N. Davis St. 401 NW 2nd Ave. Suite #300 Building B, Suite #250 Suite #32.1 South Tower Ft. Myers FL 33916 JacksonnIle, FL 3ZZ09 Miami FL 33128 Telephone (239) 938-1840 Telephone (904) 798-5806 Telephone (305) 536-0306 2686 Chapman Dr. 400 West Robiolon St. UlI NE 2.5'" Ave. Panama City FL 32405 Room #111 North Tower Suite #403 Telepbone (850) 747~5425 Orlando FL 32801 Ocala FL 34470 Telepbone (407) 245--08;6 Telephone (352.) 401-5350 610 E. Burgess Road 499 Northwest 70th Avenae TALLAHASSEE Pensacola, FL 32504-6320 Telepbofte (850) 453-7804 Suite #116 SUBMITTERS Plantation FL 33317 3111 Sonth Dixie Hwy. Telephone (954) 321-2906 Wlllk-in $Ubmi8~ns: Suite #123 2012 Capital Circle SE West Palm Belich FL 33405 1313 N. Tampa St, Sutte #102 Hartman Bldg. Telephone (561) 837-5716 Saite #51)3 Tallahassee FL 3Z399.2161 Tampa FL 33602 Telephone (850) 413-1609 1718 Main St. Telephone (813) 211..6506 MIIJI in submissiolJ$: Suite #201 Barasotu FL 34236 200 ERSt Gables Stroot Telephone (941) 329-1120 Tallahassee FL 32399-4228 Teleph(lne (150) 413.1609 18..."................".........., ftICHARD M, WOY'; ':.:ICH . _ camrr;.o: OIJC;;38a~3 i ~ 7n112OO8 ; . . 8andw thnl (eOO)0432.<l2~! H..~~~~.~.~.&~.~i :::;1:,:: .'-f.: : '~~~:(J.. '.:.;, Effcetivc/Issuc Date: 7/13/6& Expiration zc: c:! dr. /6 <:( 120001tf.oL Postmark Date: Received Date: P-q JUL 1 $ 'Z.ooa UREAU OF COMPUANCE TAMPA Payment Number: DWC 2GO, NOTICE OF ELECTION TO BE EXEMPT - REVtSED :moo4 1V.;! THIS APPLICATION IS CONTINUED FROM THE REVERSE SIDE 07/13/2006 23:23 7273757332 PAGE 03 T~t & ll--WJ NOTICE OF ELECTION TO BE EXE~ ~rsowiJ!DJ Please refer to tlte enclosed instrudions before completblg tIIis fonn. JUl 1 3 2006 SECTION. ): I am applying for ~emptjon as a (please check only one box in this section): TAMPAMPUANCE CONSTRUCTION INDUSTRY "C~PO~TE <?BICER" ($50 APPLICATION FEE REQUIRED) 9l Officer.of a Coxporation (Title): rFlJ!.:> i T:).l!,rJ. ( ) -OR- 0 Member of a Limited Liability Company (LLC) NON-CONSTRUCTION INDUSTRY "CORPORATE OFFICER" (NO FEE REQUIRE~ o Officer ora COIJloration (Title): ) ~ An officer ejecting au e:l:emption under chapter 440 Florida Statutes is not entitled to bene SECTION 2. To be eligible for an exemption, the corporation of which you are an officer or the limited you are a member must be registered with the Division of Corporations of the Department of State. For applic' officer of a corporation, you must be listed as an officer of the Corporation with the Division of Corporations of State. Please lis..t....the registration number c.docU9lent number shown on your UnifODl) Business Report) on filc with the Corporations. t::. 't If 0 00 0 ~ J.. 3. X. SECTION 3. This exemption application applies only to the Derson signing the application, the Corporation/LLC that is listed below, and the scope ofbusinesl oli !rz1~li$te.r!: I/). . 127. Corporation OJ' LLC Name: 1:t.~4n1ltr' /,.(J"fV~~ .IPkJN:SCJ .33~'1Z2>TeJephonc: l.(~lJ~i 'f9".3. I BusinessMailingAddress:[1531 P~/ZA:fn11> DIZ. City:OOOSA State: & zip:3~ County: lASe.[) . &1I1t...t;;JIrJf. Scope of Bns1ness OJ' Trade of Applicant: 1. ~ 2. 3. 4. SECTI. ON 4. Please list aU ~ed or registered licenses issued to the applicant pursuant to Chapter 489, F.S. (Contractor's License)--.C:..e.C O~ O~I . SE ON. i~. D.oes the county or municipality in which your business is located require an occupationa1license for your business? DYes .No IF YES, A COPY OF A CURRENT OCCUPATIONAL LICENSE MUST BE ATTACHED. SECTION 6. Axe you affiliated with any corporation (including LLC) other than the corporation (including LLC) to which this application ~lies? o Yes ~No IF YES, PLEASE LIST THE NAME(s) AND FEIN(s) OF THE AFFILIATED CORPORATION(s) OR LLC(s): NAME: . _.. ... FEIN: SEC'IION 7, If your corporation or LLC is engaged in the construction industry, you must provide the required proof of ownership in the corporation or LLC. A. To be eligible for a construction industry c:xemption as au. officer of a corporation, the applicant must be a shareholder, owning at lea..~ 10% of the stock oftbe corporation. A COPY OF A STOCK CERTIFICATE EVIDENCING THE REQUIRED OWNERSHIP MUST BE ATTACHED. B. To be eligible for a construction industry exemption 8S a member of a limited liability company (LLC), the applicant must confIrm ownership of at least 10% of the company. THE REQUIRED OWNERSHIP MAY BE ESTABLISRED BY PRODUCTION OF DOCUMENTATION R.EFLECTJ.NG 1llE REQUIRED OWNERSHIP, ORBV SUBMITTING A NOTARIZED STATEMENT ATTESTING TO THE REQUIRED OWNERSBIP. SECTION 8. FRAUD NOTICE A. Any penon who, knowingly and with intent to injure, den'and, Or deceive the department or any employer or employee, in~lu'ance company or any other person, files a notice of election to be eJ:empt containin~ any false or misleading information is goUty of a felony of the third degree. D. =- .hP~ z.; aOW'l lIlat I .... r.... ..d.....ODd ODd .-...ledge th. foregoing ~ ~SIGNATVJU!: OF APPLICANT . tHIS Af!f!LlCA TION IS CONTINUED ON THE REVERSE SIDE . owe 25D, NOTICE OF ELECTION TO BE EXEMPT - REVISED 312D04 TV-2 07/13/2006 23:23 7273757332 PAGE 04 . DEPARTMENT OF FINANCIAL SERVICES TOM GALLAOmm. O!IBP FD-IANCW,. OmCB.'R EXEMPTION APPLICATION RECEIPT ,,- f., This receipt ONLY confirms that the applicant listed, below has sabmitted an application for exemption froni, the provis,jons of the workers' compensation law to the Division 'of Workers' Compensation. THIS RECEIPT DOES NOT CONSTITUTE PROOF THAT AN .EXEMPTION HAS BEEN ISSUED TO TH.E APPLICANT. AN EXEMPTION S~ALL BECOME E.FFECTIVE'ryEN ISSUED BY THE DEPARTMENT. DATE RECEIVED: 7 /13/6~ APPLICANT'S NAME: VAil/fEZ k !lCKEfCm&,J BUSINESS NAME: lIeKE. .7JtJAl Receipt comp-Ie,ted by: lAIc Exemption applications a e p cessed in the order It was:received. The Division of Workers' Compensation has !Q. day~ to Issue the application after it has I;>een received or notify you that it is incomplete." . The exemption applicatlon,was received at the following Division of Workers' Compensation office: Bureau of Compliance ~~~ 1313 Tampa Street JUt 1 32008 . SuIte #503 . Tampa, FL 33602 BUREAU OF COMPUANCE Telephone (813) 221--6506 . TAMPA To check status of your exemptIon, go to www.fJdfs.com/wc/ then click on the proof of coverage database. . DlVlSION ClF WOll.lClllS' ~AnON . BtlJUIAU OF COMPLIANCB 1313TAlDAST1Ul8T, stm#S03. TMQ'A" n.33602 . (BI3) 221-6506' (813) 233-3741 Ml'lmlatlvo ADdcm I Bq1i.1 Op,port=lly JlGIplonir . c) c i j~ ~ ,~ ~ . ~ . ~ ~J~ ~ \.~ ,~ ~ w. ~~ ill i i j hi=- ~ ~:jt ~ ~ Jj~ F- ~ ~ JI.JI JI ~ ~ ~ ~ IJL_ ~ tH!% g ! ~~ 0 8 t::J . ~ ~n! ~ ~ \1).et~ :;. ~ .~ z U- ti !h~ illS i! (J) ~ .... ~ ~ i ~ c ~ ~ '- 00 ~ it ~ e"r- l r-~ ~ ] ~. 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