HomeMy WebLinkAbout07-6460
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6460
Book:
11,907.00
2/13/2007
90.00
90.00
2/13/2007
AC CHANGEOUT
HA HMI, HASAN & SALMA
38021 MARKET SQUARE
ZEPHYRHILLS, FL. 33542
Phone: 813780-1543
~-n cA..ad!
(-;)-'-07
CO.-v-
REINSPEcn N FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection
trips are ne ssary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty nstruction c) repairs or corrections not made when inspections called d) work not ready for
inspection w en 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
"Warning to wner: Your failure to record a notice of commencement may result in your paying twice for
improvemen to your property. If you intend to obtain financing, consult with your lender or an attorney
before record ng your notice of commencement."
NO OCCUPANCY BEFORE C.O.
~~
TURE PERMIT OFFI
L FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
I' Jan. 4.
I';,)rll " 22AlA.
L: IJ I : IV'
ZEPHYRHILLS FAMILY MEDICINE
, PKUt'OSAL
~NP-
..CHRIS' Ale
~, COM PAN ,y .
No, 4536 P. 2
CAC05857S
..
, DATa; I ~ ,a,..a.J:,
TO:
NAME:!~I'((~ (~I")Y 1f1t'"I}~~e PHONal: 7S?o "IdA
ADDRESS: $fO~ I y1lt'....,..t.,-,+ 5jilfArf..
Cl1Y: ~krrt...,' Jf~ STATEIZIP: f{. ':?3~.1L
FURNISH.AND INSTALL THE FOLLOWING EQUIPMENT AND MATERIAL,
o r4rrfN 1~"1;" 1Js,.I-&"'I ,Pk(;. fPll't,""<Pt-Ar
U ('AU"; e ( 5' ;r,;;; 'j,j,f,J &&f fK d. 1111 /L &.-1 ~r
~ ~y (A-JCJ-,.r~.. ~~ Apf I.'(J~
'~l~lt ~jhifJ) .
STYLE AND SlZ5AHU BRE.AXER STYLEANP SIZE CONDo BRBAKER
- 1 YEAR PARTS &: LABOR WARR.A.NIT ~, YEAR LABOR WARR.A:NTY ON BQUIPMENT C
. - YEAR COMPRESSOR PARI WARRANTY -- YEAR'5QUlPMBNT ~ONLY PARTS W.ARR.AN'IT
-' 'YEAR OUTDOOR con.. WAR.RANTY ...- S,YEAR DEPENDABlUTY PROMISE
, J,!-
PRICE:, $ IIi <10'? ,
PAYMENr: Y UPONCOMPT.F.TION '
Price good for 30 d
50% ROUGH TN S~ UPON FINAL DR.
s.E'l1JIR ~s 1'm.J! TO SQlJ.wMSNT~A1.S UN1U. PAYMENT IS MADE. IP A PAYMeNT IS NOT MADE AS AOlU!!J), SEI..I.m
ltEMOVEI SAID EQUmtmNTIMATElUAL AI sl.t.um:s BXPJ!NSa. ANY PAMAOE Wut.11N<J PI.OM SAlD REMOVAL SHALL Nor B.l
R.ES1'ONSlBlL1TY Of SBLUIl. BUYSR 'WILL BE SUBJECT TO WTOC1CNG CHAltOE IF JOB IS CANCELED.
, AGREED
CHRIS'
B"(J)rER
DATE I~ /J~/o ~
DATE~
122321U5 HWY 301 DADE CITY, FL. 33525
PH. 352-521~
813-779-~
I
I
Jan 25. 2007
State of
3:37PM "",.ZEPHYRHlLLS FAMILY MEDICINEENCEMENT No. 5293
1".'-' ~ ~'-"'~ '-'~, ,-",'-'lY.11l'.1.
P t1Sa;
P. 4/4
County of
THE U ERSIGNED hereby gives notice' that improvement will be made to certain real property,
and in ac ordance with Chapter 713, Florida Statutes, the following information is provided in
this N oti e of Commencement:
1. Desc 'ption of Property: Parcel No.
OJ. -~~~~l- DOlO - Ot/-()OO -0050
2.
(Legal description of the property and street address jf ~Vailable) .
Gene al Description of Improvement c.J.a.n.(!/'_ OJ, a.. c.. S !jS--/-e.n-..
Intere t in Property:
Name of Fee Simple Titleholder:
( f other than owner)
~ Y\') a..
3. Own Information: Name
Addr 55 350,;;) I M
Addre s
City
CJu.~ I AIr.- Cn':f:dt
u..S tAwLf. 301 City. - OJy
State
Rcontr ctor: Name
Addre s t~~ .3~
State t=L 336.;;}b
5. Surety Name
Addres
Amou t of Bond: $
City
State
Addre s
1111111111111111I1111I11111111111111111111111111111111111111
200702e288
6.
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:
City
State
N"ame
8. In addi . on to himself, Owner designates
9.
to receive a copy of the Lienor's Notice as
in Section 713.13 (1) (b), Florida Statutes.
on date of Notice of Commencement (the expiration date is 1 year from the date
ing unless a different date is specified.)
Signature 0 Owne~:
Sworn to an subscribed before e this c::9-~~'
Notary Publ c: (~~.J"C~:>-..~) ". C,Q'>.
My Commis ion Expires: -=+ \ \ ~ \.C:fl
,,,,,,,, L Let
PC93053048/A i~'tt>'l.J.~~ aura . ar er
:.:tIJ!~ Commission # 00451773
" ~k. l~ Expires July 17 2009
'l1,iYi , Bonded TIlII Flln "Inlutlnce, Ino 100."5.701'
Rcpt: 1073126 Rec: 10.00
DS: 0.00 IT: 0,00
02/12/07 Dpty CI.rk
dayof ~ .....-....1...)..0 'a--'
. 20.Q:::b
-'~--
JED PITTnANA PASCO COUNTY CLERK
02/12/07 1" : 39pm 1 of 1
OR BK 7383 PG 1384
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
Date Received
Owner's Name
JOB ADDRESS
I
:;%D;Al
DESCRIPTION OF
E3
D
D
I
NEW CONSTR
INSTALL
SFR
BLOCK
Mar ktt ~ U/,l% e.. ,I LOT # I
I PARCELlD#1 O~-:J.h-~I- oOtO-oLfooo --0050
(OBTAINED FROM PROPERTY TAX NOTICE)
[==:J ADD/All D SIGN D MOVE D DEMOLISH
D REPAIR _--' '--- L
D COMM ['?] OTHER rTllQl ~ Ale s~~~r.
D FRAME D STEEL D ~ _
I
SUBDIVISION
WORK PROPOSE
PROPOSED USE
TYPE OF CONSTR CTION
BUILDING SIZE
SQ FOOTAGE I
HEIGHT I
D BUILDIN
D ELECTRI
1$
1$
1$
1$ III t1 D '1 . 00
D ROOFING
I
I
I
I
D
I
AMP SERVICE
D
PROGRESS ENERGY
D
W.R.E.C,
VALUATION OF TOTAL CONSTRUCTION
D
m
VALUATION OF MECHANICAL INSTALLATION
D GAS
FINISHED FLOOR
SPECIALTY D
FLOOD ZONE AREA
OTHER
DYES
DNO
Address
COMPANY 1
REGISTERED YI N FEE CURRENT Y/N
License # I
COMPANY I
REGISTERED YI N FEE CURRENT Y/N
License # I
COMPANY I
REGISTERED YI N FEE CURRENT Y/N
License # I I
COMPANY I 0+;1; ~ It {f 1::!.,'rIf-~i I I
REGISTERED
License # I GACoS-g515 I
I
Y/N FEE CURRENT YIN
License # I
BUILDER
SIGNATURE
ELECTRICIAN
SiGNATURE
Address
PLUMBER
SIGNATURE
Address
MECHANICAL
SIGNATURE
Address
OTHER
SIGNATURE
Address
RESIDENTIAL
ttach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
inimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wi Silt Fence Installed,
anitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
ttach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
lnlmum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
anitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
ttach (2) sets of Engineered Plans.
...PROPERTY SURVEY required for all NEW construction.
COMMERCIAL
SIGN PERMIT
Directions:
Fill out appllcatl completely.
Owner & Contra tor sign back of application, notarized
If over $2500, a otlce of Commencement Is required. (A1C upgrades over $5000)
Agent (for the co tractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTE PERMITTING (Front of Application Only)
Reroofs Service Upgrades A1C Fences (Plot/Survey/Footage)
Driveways-Not ver Counter if on public roadways..needs ROW
f:'
I
I
.. I...... ... . . ..... .... ....... ...... ....
\1'l~.!9.~." "~.~~D RESlRICTIONS: The undersigned understands that thts permit may ~sl!~jedJ? .~~."!'~!t!\s\\Ii;\ion.~"
!'t.r~l~:;t:t:~"e than County regulatkms. The unders~ned assumes resPQn~lbllity fortam}li~:;:mi~.!1X
.. , ':__':' '$~Q.c;q.t:l~TRACTORS AND CONTRACTOR RESPONSIBILITIES:. Ifthe.o\\1ner..has.Nfe.a.ayontf~btQf of
'-':,~ ..~ "~~rtake work, they may be required to be licensed in accordance.Wlthst~,~,~~~J()?~Lf~~41~ti?iiSLJtthEi
'licensed as required by law, both the owner and contractor m~Yb.e9it~~fdt:~Iij.I~d~tri~~B~tVlpiatl~~
:,:I.fthe owner or Intended contractor are uncertain as to whatIi9t)iisin~,it~~u.ir~T~rl~:TaYa~(JIY,f~ftRe;
'e.yare advised to contact the Pasco County Building Inspectlol'l [)ivi~i()n";UCe~~i6g..~.~a.ti61i~II?7;'81t-
9~~' if the owner has hired a contractor or contractors, he IsadvisedJbh~ye~hep6~tt~cldHs).Sigti
. (jntractor Block" of this application for which they will be responsible.. Ifyou,asthet>wn~rsigry aslhe
e6Jr~9tg"~'1 be an indication that he is not properly licensed and is hot entitled to pefi'l1iUingptllJiieges ih Pasco
'hly".:.,'> .... ,..
..~tI~~~ .. 'iJ.!"Il IMPAllTIUTILmESilMPACT AND RESDURCE RECOVERY FEES; Th~ uhder~lgn~d uhderslahds
)tM~,-t~i1.. '. . "Impact ~res and Rec?urse Recovery Fees may apply to the cohstruction of new bUiidings, change of
;j9~~m:~~i~ti ..... ...... )Igings, o~expansion of existing buildings, as specified in Pasco County Ordinance~u.mber89~07 and
!~9:-0has~me9.pe9' The undersigned al~o understands, that such fees, as may be due, will be identiped at the time of
. p;~r~iWr1g.!;I~"t~ity~her understood that Transportation Impact Fees a~d Resource ~ecovery Fee~ must be paid prior to
re~elvlng a~peftlficate of occupancy" or final power release. If the project does not Involve a certIficate of occupancy or
fin~1 powerreie~~~, 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 7.13, 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; 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 not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may beeited 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 Officia~ for a period not t~ exceed nin~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 (ES. 117. ) All ^ II AA.# ~
CONTRACTOR dV Lt:/r~
Subscribed and sworn (or affirm ,d) be e me h
2-13-0'7 by ~ Ail
Who Is/are personally kno to me or haslha e produced
as identification.
Notary Public
E BOGES
;'" ..~j Expires December 12, 2010
~~iif::':"\~"'''' Bu,~ T'Il1U [IVY 1Icd111:mtultlfIW ~/Ull:f
Notary Public
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
J5~O- gl b --It; /--0'7 ~-O