HomeMy WebLinkAbout06-6193
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6193
111,386.55
/12 -/,--5' - D~ Name: OLD AS MA
516.00 Address: 3749 COPELAND DR
516.00 ZEPHYRHILLS, FL. 33542
12/15/2006 Phone: 813 367-9780
CONSTRUCTION OF CONCRETE PAD & SITE WORK
Address: 3749 CO ELAND DR
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 24-26-21-0010-03900-0000
~p\~~d l~lo5l'()~
<6-10-.07
I~
SLAB
FINAL
N FEES: Reinspection fees will comply with Florida statute 553.80 (2)(c) when extra inspection
ry due to anyone of the following reasons: a) wrong address b) condemned work resulting
nstruction c) repairs or corrections not made when inspections called d) work not ready for
n called e) permit not posted on job site f) plans not at job site g) work not accessible.
NOTICE: In ad~ition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found i 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 0 inspection fees shall be made before any further permits will be issued to the person owning same
nWarning to 0 ner: Your failure to record a notice of commencement may result in your paying twice for
improvemen your property. If you intend to obtain financing, consult with your lender or an attorney
before reco i g your notice of commencement. n
NO OCCUPANCY BEFORE C.O.
.. ~~
SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-760-~020
City ot Lepnyrnllls t"ernlll J-\fJfJlIl;dllUII
Building Department
Date Received
q-lt.\-O~
y~ 'l/S/& ~ WL-
./ OWn.(, Add...., I 3'1 ,1.".u/-".tJr-
Fee Simple Tltleh~lder Name
/ Owner's Name
/
Phone Contact for Permlttln
c,
7-rMY4 R: 131'9~
Owner Phone Number
Owner Phone Number I
Fee Simple Titleh~lder Address I
I ~7~9 ~kd'~
I
E3
D
D
I ~Mh..M:-.f &~L~ 1":: S;b>
I SQ FOOTAGE _ , . 3' _ s
/ JOB ADDRESS I
I
SUBDIVISION I
WORK PROPOSE~
i
I
NEW CONSTR
INSTALL
SFR
BLOCK
PROPOSED USE
TYPE OF CONST~CTION
/ DESCRIPTION OF
BUILDING SIZE
~/.,;-~~ .Ft!- 5~S/f2-
I PAR~L1D#1
LOT#
B
D
D
D
D
D
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN 0 MOVE D
DEMOLISH
ADD/ALT
REPAIR
COMM
FRAME
OTHER I
STEEL 0
OTHER I
i Ddt~
HEIGHT I
'1$
. \ \ \ I D 00, (:) 0
1$
1$
1$
D ROOFING
D
D
D PLUMBI~G
D MECHA1CAL
D GAS
FINISHED FLOOR
BUILDER
/ SIGNATURE
~";r\
Address
ELECTRICIAN
SIGNATURE
Address
PLUMBER
SIGNATURE
Address
MECHANICAL
SIGNATURE
Address
OTHER
SIGNATURE
Address
I
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I
D
I
V,8LUATION OJ: TOTAL CONSTRUCTION
~\ll )6\o.~)
AMP SERVICE D PROGRESS ENERGY
D
W.R.E.C.
f0bL
\~.
VALUATION OF MECHANICAL INSTALLATION
SPECIALTY D OTHER
FLOOD ZONE AREA DYES
VE~ -to PIJ}S'1II'1J6f<,
DNO
sr. 'C.~OMPA~EllI ~M.t1 D"-,, ,.;<; . - ~tv
REGISTERED Y I . FEE CURRENT. I Y IN) I - ~ 'r/
3 "3:5\4 0 License # I . ~D. 6fJ
, .
: r
I
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I
I
I
I
Y/N
FEE CURRENT
Y/N
License #
YI N
FEE CURRENT
Y/N
License #
COMPANY
REGISTERED
YI N
FEE CURRENT
Y/N
License #
Y/N
FEE CURRENT
Y/N
License #
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.
~inimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
II commercial requirements must meet compliance.
SIGN PERMIT Attach (2) sets of Engineered Plans.
!...~PROPERTY SURVEY required for all NEW construction.
lllll'! I1I11I1111I1 n 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1I11111I11
Directions:
Fill out applicati n completely.
Owner & Contra tor sign back of application, notarized
If over $2500, a otice of Commencement is required. (AlC upgrades over $5000)
Agent (for the co tractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authOrizing same
OVER THE COUNTE PERMITTING (Front of Application Only)
Reroofs ewers Service Upgrades AlC Fences (PloUSurvey/Footage)
Driveways-Not ver Counter If on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to Udeed" 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 accordanc'e 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 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 not 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 new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 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 not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if 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 Statutes, 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 all 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 also
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 not limited to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterlWastewater 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 offill 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
ucompensating 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 UA" 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 not 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 ~hat a s.eparate perm~t may ?e requir~d for elect~ica.1 work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically 1n?luded.ln the application. A
permit issued shall be construed to be a license to proce?d with the work a~d not as authorl~Y!o vlolat~, cancel, alter, or
set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the Building OffiCial from there.after
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 o.f permit issu~nce, or if work authorized. by
the permit is suspended or abandoned for a period of six (6) months after the time th~ work IS commenced: An extension
may be requested, in writing, from the Building Omcia~ for a period not t~ exceed n1n~ty ~90) da~s and 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 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.
FLORIDA JURAT (F.S. 117.03)
CONTRACTOR
Subscribed and swom to (or affirmed) before me this
by
Who is/are personally known to me or has/have produced
as Identification.
OWNER OR AGENT
Subscribed and swom 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
"
Permit Application Review Comments
BJy: Bill Burgess
Date:
IO-d.-5-Q<O
i'
No Comments
A~dress:
TyPe:
37Y~ Onro-l~ryQ ~.
C('fY'\(lj~O PA\') /S~t~ (DcJt\c
I
.
Page 1 of 1
Karen Miller
----,
,
From:i Billy Poe
Sent: Thursday, September 14,20063:34 PM
To: Karen Miller
SUbjett: RE: Old Castle-Matt Stone - 3749 Copeland Dr
approve~
!
From: K ren Miller
Sent: Th rsday, September 14,20062:01 PM
To: Todd Vandeberg
Cc: Billy oe
Subject: Old Castle-Matt Stone - 3749 Copeland Dr
I
Todd and{Or Billy:
We have ~ permit in our office for site work/construction of a concrete pad (3.36 acres). Can you advise if your
dept has ,pproved this project or if you have outstanding issues on this. Thank you.
Karen I
9/15/2006 I
NOTICE OF COMMENCEMENT
~
State of
fi4hal'P-
County of
~~
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,
and in acpordance with Chapter 713, Florida Statutes, the following information is provided in
this N otiae of Commencement:
1. Description of Property: Parcel No.
R3.
I
I
2. Genetal Description of Improvement
c.:.+re.k; pnr.L ..f!... s~
ownJ Information: Name t:7j,1t:A.$~
QJd~fA~+i.L ~e. J.hJct~, ~
" 5A/ _ , _ I_
roperty and street aadress if available)
5. ~ w/J~JC ~ &~4t.uaf,.~,^ dl-
/0,.039(J()-.c,t1c
1111111111111111I111111111111111111111111111111111I111111111
2006189952
Addr~ss 9()1J9 ~""k_-t- ~~ a...
, I
Intere$t in Property: ~~.IU9-.S
I
Name Jof Fee Simple Titleholder:
qf other than owner)
Addre~s
~1I_'f-hH~ 44 ~
City -Z;/,a..
~L"
State
FL- 33(P3f
4. Contr~ctor: Name
Addre~s gD ~ 3
5. Surety~ Name
.::r V ~MlI~Jl
:J.g~ S:I.
~/t-,.;"S/~
State FL
Addre*
Amourtt of Bond: $
City
State
6. Lenderi Name
,
I
Addres~
City
State
7. Person within the State of Florida designated by Owner upon whom notices or other
docum nts may be served as provided by Section 713.13 (1) (a) (7), Florida Statutes:
Name
City
State
,
I
of t to receive a copy of the Lienor's Notice as
provide1 in Section 713.13 (1) (b), Florida Statutes.
9. Expiratipn date of Notice of Commencement (the expiration date is 1 year from the date
of recor~ing unless a different date is specified.)
I
Signature of ~wner: ~;
I - ''I ,l\--if /
Notary Publit: ,----. ~~ CJ (} -1-- _
M:y commissfon Expires: '3 -(1--D! _
PC93053048/ A
day of
S-e ~+-
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. "lUI",1. I\Ir.w:Il:J'Q. T t. .
: ~yp CornmIIIIan.DD0191337 i
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i OI"'~ Bonded through :
: ."". FlorIda Notary Alan., Inc. :
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J.}!::L-r::>-2006
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N.do"cJ M...,~,.
S"ciflhJ, UlUlttf'Writillg UIIU, NmiolUll ACC()lUIlS
lUG Risk Ma".Z.JII.t, IIIe.
DINCr Dial; 212.oUa.329)
FIX NCI. 21204>>-3."
debra.dalvUiW.It.CO(D
-RISK
fUIII MANAGEMENT
175 W.... StIc<< - JItA n.",.
N~ Ywk, No I. lion
LEITER OF ASSUMPTION
Date: 12114/06
Name of Employer: Paycbex Business Solutions
Name of Carrier: New Hampshire m.urance Company
Carrier's Policy Number: WC7656672
Policy E~iration Date: 611/07
Type ofInsuran~: Workers' Compensation and Employers Liability lnsUl1lDCe
To Whom It May Concern:
This is to certify that il$ of 12110/06 IV FlolMell PaVini. Inc. is insured for W orktr! I
Compensation under the above policy number.
By my signature hereundtr, I certify tha.t:
1. r am a duly authorized employee or agent of the Carrier named above; and
2. The carrier named above has entered into a contract of Workers' Compensation
and Employer's Liability Insurance with the Employer named above, subject to
the details of Coverage described above.
Sfgn.Jf\(}JJ.Ut91..hv.J~
Date:_12/14l06
Name: Maria Vordonis
Title: Underwriter
TOTAL P. 02
CERTIFICATE OF llASILlTY INSURANce
.:=..u....J..J
ITAU ANO n:SURANCE
l"!l'AI.IJUt INSOJAN'CE
P. O. B K 18425
~. 33679-8425
Phone:S 3-&77-'7g9
IIIIIIURl!D
SIlB,"ICES
Fax;S13-S77-SB77
T HI
A
FOUcv NIJ""RIl
04/15/05
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IlOC... TlON. , VEl1/CLQ I DCLUSIONS IIODEO J;V VlDORtiEMENT ! Sl'EOIAl PRCMelONS
CUT/F/CAn HOltlER
-----..
EACH OCCUAAENcE
04/15/06 PlleMfaES EQ~
~ED exp fA.'!)' one l*a<Irti
I PERSONAl. lo ~ 1"-i1lA.,
f';!N!RAL AGGREGATe
~lI:OtxJCT;f . COIolPIOI' AGe;
_J
I COIlSINeD S'NGu; liMIT &
(I!.~nll
IIOCIL.,. INJUI'lV
(Per Jler!CWlI
I DOOIL YINJURy ,
' (Per 1a:dIInt!
r PROF'E'AT'r DAW.G;---t~
(P",~) ,
s
AIJ'TO ONLY. eA ACClDfNT $
&AIICC .
AOC I
5
OT~ THAN
~o ONLY:
eACH OCCURRiNCE
~EQATE
$
S
,
$
--
e.L. EACH ACClDIiNT . ,
e.l a~'EAEiII'L~S--
E.l O~81! - ~:JlIC)' ~"';T I ,
e.Pbyrh.illlJ
~aZ't;m.nt
Street
1.. n. 33S42
CANCELLATJON
6HOla..o ANY OF THE AROve DUeRao P(lUCII8 BE CANcnL!tl BeFOrUi Ttfl ~1IOH
DoIlTE 'l'Mlfte0lr, Tlfl! IQIiING fN:lllJWt WILL eNDhVOIt TO Atu. !2-. DA'I1l ~TTIN
~c; TO THIi CEATIF/O,IITE tlOl..DI!It IlAIII!D TO THE I.En, IIUT FAILURE m IlO SO SHAu.
'MPOSE /.10 OSl.lOA11QN OR UAlIUtv OF ANY KINIl UI'ON TliI U;aulf~. ITS ~ Oil
/tel"I'II!HJiTA 7lVlill.
Il.l.ITliOItiZ ,. EllENTA
Ci.ty o!
BUildng
5335 8th
Z.phyz-h.i
CIno!,z
ACOAo 25 (2001/0ll}
~
<!t ACORD CORPORATlON 1988
TOTAL P.01