HomeMy WebLinkAbout06-6162
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
6162
Permit #:6162
Permit Type: ALUMINUM
Class of Work: ALUMINUM PACKAGE
Proposed Use: MOBILE HOME PARK
Sq. Feet: Est. Value:
Cost: 20,000.00 Total Fees:
Amount Paid:
Address: 3544 MALINE DR LOT 266
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: EMERALD POINTE
Parcel Number:
lA, THOMAS M
3544 TOURMALINE DR LOT 266
ZEPHYRHILLS, FL. 33542
Phone: Lic:
Work Desc: LANAI 12 X 42
Phone:
cw
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 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."
\Jia:{'~ {~ ~ ~
CONTRACTORS SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CI~Y OF ZEPHYRHILLS PERMLT A~~~~~A~~U~
BUI'LDING DEPARTMENT 5335 a'J:H St, Zephyrhills, Fl. 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
70/6/0b
PHONE GONTACT FOR PERMITTING
ThaOl fA. ~ {'a ,I-(1;'a.
JOB ADDRESS J5Lflf T()u/[ /1l.~lL,(e
LEGAL DESCRIPTION: LOT (S) ,;){c~
cJt/- tJ4 - 02/ --00 P () - () 6(X)O ~ ~(}
OWNER'S NAME
PHONE
.. :....... .\ ~ !..... '"'. "". ;'"
, . . _ ~ __ . ..., c
1J1/tt('
BLOCK
SUBDIVISION Iii E/x_im/lk
/JollL
(OBTAIN FROM PROPERTY TAX NOTICE\
PARCEL 10 #
WORK PROPSED: ~NEW CONSTRUCTION
o SIGN
PROPOSED USE: DSGL FAMILY DWELLING
o COMMERCIAL
o ADDITION
o ALTERATION
o REPAIR
o INSTALL
o MOVE
o DEMOLISH
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOt-'
o OTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL
I u.. I) a.. /
BUILDING SIZE
Ie). )( YaY
SQUARE FOOTAGE
s-o'li
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
& (1) SET ENERGY FORMS.
FORMS.
PERMITS REQUESTED
",0 Q. V
If ~I~V
J!\I BUILDING
}4 ELECTRI CAL
ta PLUMBING
o MECHANICAL'
$
v.o 000. (YJ
I
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o
Progress Energy
o
W.R.E.C.
$
VALUATION OF'MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
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COMPANy04J.I-lr- J!Lomq,f reilY/a.
STATE CERT OR REGIST #
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ELECTRICIAN
'2 _<;;>,0
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COMPANY {J/~ - lit OwrA S cr a::c.-rc l e:....
SIGNATURE tJWItDz.
STATE CERT OR REGIST #
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PLUMBER .~ 5' 0/ b':>
SIGNATURE t9tcntvrJ
COMPANY t9t~- 7h0Pt1.45 0a..rr{~
STATE CERT OR REGIST #
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MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A.' NOTI~E 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 contrq~tors 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 maybe 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 pOftions of the "Contractor Sections" of this ~pplication 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 indication 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, hay~ 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 corrunencement.
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 corrunenced prior to issuahce of a permit and that
all work wiil 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 inolude but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetiand 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 certity that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a;:'compensa,ting 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 corrunenced 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~SO ~~ ~:&:: TO RECORD AND pOST :;;~O~:EL
~RE: ~~NER OR AGENT SIGNATURE: CONTRACTOR
STATE OF FLORIDA n .In
COUNTY OF .ra'JLtJ.
The foregoing instrument was acknowledged
Befo~ me this ~d'ay of ~ , 2~
by I nolMA.s. ~.-z:I;""" .'
(name' of person acknowledged)
Owho is personally known to me, 'or
)LiwhO has produced D L-- .
(type of identification)
and Odid not take an oath.
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
Before me this ~ay of J.<<tZ'V_t...... ., 200;..
by -rJ\D~~ ~a:.rc.( L .
(name of persor acknowledged)
[1ho is personally known to me, or
fJ eN (0
~ho has produced p.L-.
(type of identification)
~idnot ta e an oath
f person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
I, ThPrtuJ (;a..r{'/a.. have z'ead and fully understand and
agree to the provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own c.omicile, that he or she
actually occupies, or will occupy by saic. domicile, and same is not for
rent, lease or sale. That he or she shall comply ~'ith the following conditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of constructie.n are subcontracted, he will
engage only properly licensed subcontractors ar..d will personally supervise
such work.
4. That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to iZ:.sure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the Ci t.y of Zephyrhills Building
Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, Stat:e and Federal laws in regard to
social security, workman's compensation, lien laws, etc., where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that: law. The exemption allows
you, as the owner of your property, to act as i'our own contractor with certain
restrictions even though you do not have a licE!nse. You must provide direct
onsite supervision of the construction yourself:. You may build or improve a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $25,000.
The building or residence must be for your own use or occupancy. It may not
be built or substantially improved for sale or lease. If you sell or lease a
building you have built or substantially impro,'ed yourself within 1 year after
the construction is complete, the law will preElume that you built or
substantially improved if for sale or lease, wlLich is a violation of this
exemption. You may not hire an unlicensed perElon to act as your contractor or
to supervise people working on your building. It is your responsibility to
make sure that people employed by you have licElnses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibili ty for supervising work to a licenlled contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct: supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that emp:.oyee, all as prescribed by law.
Your construction must comply with all applic~)le laws, ordinances, building
codes, and zoning regulations.
OWNER'S
ADDRESS
PHONE
~
DATE
(J -,.). tj--()t,
WITNESS
c/)~
PE~:r #
j-!JOf)IO..r {/(I't/a.
Name .
3 jt.Jf(7;)tt,1/lla.&u /)11/:e
Address I '11 1
Ze,p /1j r ~ IN P, ..3JJrd
To Whom It May Concern,
Please be advised that:
Stacie Cross, & Debbie Dokendorfof Pasco
Permit Service have my permission until further written
notice to act as my agent to sign and pick up permits.
Sincerely,
~ Ro.... fr}~d~~~
s~gnature
-3 ~ :;2lj -O~
date
NOTARY
STATE OF FLORIDA, COUNTY OF PASCO
The foregoing instrument was sworn to and
subscribed. before me this c2L/rf? day of f11an~
, c;2Cl::X.e
Personally known
or Produced identification 1//
Commissioned Stamp
and Expiration Date
~~re ~
Page 1
NOTICE OF COMMENCEMENT
C' '~1 C f Z -;.J( /11
State of
F- Ct r{ ~'-
County of
/J tlSC('
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statutes, the following information is provided in
this Notice of Commencement:
1. Description of Property: Parcel No. r::Jtj- ;L~'-62I- OOfO -oaJ(V-c2&(g()
L oJ- 02 (p I.r /~ E /IJ /'&.. {/ /iJ L ~k . j( F f!ttf.-/J" I
(Legal description of the property and street address if available)
2. General Description of Improvement I CL /}Ci.... ;'
\ \\\\\\ \\\\\ \\\\\ \\\\\ \\\\\ \\\\\ \\\\\ \\\\\ \\\\\ \\\\\ \\\\ \\\\
200608Ql011
3. Owner Information: Name Tom (;a.ffl/'k
City ~/4 r Ll !r
Address (rSLjt;Tt)ldm~lL ~ f){,
Interest in Property:
Name of Fee Simple Titleholder:
(If other than owner)
Address
4. Contractor: Name O{J)/.,(r
Address
5. Surety: Name
Address
Amount of Bond: $
6. Lender: Name
Address
State;:-l JJJVd
Rcpt: 990298
os: 0.00
04/20/06
Rec: 10.00
IT: 0.00
Dpty Clerk
City
State
City
State
City
State
~~~~~~T6MA0N~'2P4ASCO COUNTY CLERK
~ . am 1 of 1
OR BK 6945 PG 946
City
State
7. Persons within the State of Florida designated by Owner upon whom notices or other
documents may be served as provided by Section 713.13 (1) (a) (7), Florida Statutes:
Name
Address
City
State
8. In addition to himself, Owner designates
of to receive a copy of the Lienor's Notice as
provided in Section 713.13 (1) (b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date
of recording unless a different date is specified.)
Signature of Owner: ~""=' me"... ~ _
~Vf,c day of
t/2if-t;l~
Sworn to and subscribed before me this
~~-(~ ei. t! (~
m &.A..f' A
,20 a,.
Notary Public:
My Commission Expires:
PC93053048/A
NOTARY PUBUC-STATE OF FLORJDA
~ St::lriP. r.ro~~
Comrmsslon # DD510984
Expires: ocr. 16, 2009
Bonded TI1ru Atlantic Bonding Co., Inc.
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