HomeMy WebLinkAbout07-6851
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6851
Permit Number: 6851
Permit Type: ADDITION/ALTERATION
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 38741 54 EA T L T
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: SLEEPY HOLLOW MHSUB DIV
Parcel Number: 02-26-21-0010-05000-0030
8,000.00
Name: NICKERSON, AMOS & SHIRLEY
Address: 38741 SR 54 EAST L T # 62
ZEPHYRHILLS, FL. 33542
105.00
105.00
7/18/2007 Phone:
10 X 32 SCREEN ROOM & ROOF OVER
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FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC. .
CONSTRUCTION POLE FRAME MISC. MISC.
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."
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CONTRACTOR SIGNA TU PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
_______+____-----.--o------~o o~. ....0
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City of Zephyihills
BUILDING .PLAN REVIEW COMlv1ENTS
. Date Received:
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3B7t(f . ot 5</'
JD,,32-stral\ .~/l'l1~~.
. Contractor/Homeowner:
Site:
Permit Type:
. .
ApprovCd wino cdnnnents:D Approve,lwlthe below comments: '1. Denied withe below comments: .. 0
M 'Gk35 . WI~J8tAJS
AJo })(u). [(e Crr/'.f::-
. AyJ~mfu7~~~;mp~~~~~k0
(Required when comments are present)
813-780-0020
City of Zephyrhills Permit Application
Building Department ()
rasco
/3
Date Received
Fee Simple Titleholder Name
Owner Phone Number
r Phone Number I
Owner Phone Number I
Owner's Name
Owner's Address
e
Fee Simple Titleholder Address I s ~ R-
!3E51'1J ~tv;!~ /Df~,~/~ 7L339/;;C I LOU 102-
I SkerJ 7Ji;/ [ntJ I PARCELI..16~ ~;(6-';V -0016 -0iJM- ti136
(OBTAINED FROM PROPERTY TAX NOnCE)
~ NEW CONSTR CSZJ ADD/ALT D SIGN D MOVE D DEMOLISH
~ INSTALL D REPAIR
PROPOSED USE D SFR D COMM D
TYPE OF CONSTRUCTION D BLOCK D FRAME D
DESCRIPTION OF WORK I ..5cl'eeJt.. Room 01-- /200? - 0 ve r
liD ~ 3:z. ,5.1<'-. I I
BUILDING SIZE 1/ x 3..2.. RcoF SQ FOOTAGE ~ 7 :<
TII""IIIIIIIIIIIIIIII."'II"')I""'III"""'IIIIIII111111""'1111111111111"'"'11111'0011111111111""..."111111'.'...'1111111111'"',111111111
JOB ADDRESS
SUBDIVISION
WORK PROPOSED
OTHER I ,i .
STEEL ~
~
OTHER I /-:/"-;..,..........
HEIGHT I
0- BUILDING 1$ JI/ ()OO.OO I VALUATION OF TOTAL CONSTRUCTION
D ELECTRICAL 1$ I AMP SERVICE D
D PLUMBING 1$ I
D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
D GAS D ROOFING D SPECIALTY D OTHER ~NO
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES
4l t Oty
Add'... L7f/ CK ~ W62, ~'f'tt~;L
ELECTRICIAN COMPANY I
SIGNATURE REGISTERED
License #
BUILDER
SIGNATURE
Y/N
FEE CURRENT
Y/N
Address
License #
PLUMBER
SIGNATURE
COMPANY
REGISTERED
YI N
FEE CURRENT
Y/N
Address
License #
MECHANICAL
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
Address
License #
OTHER
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
License #
111I1111111111111I1111111I111111111111I1111I1111111111111111I1I111111II1111111111111111111111111111111I111111IIIIIIIilllllllllllll
Attach (2) Plot Plans; (2) 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
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.
Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
1111111I111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111
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
Address
111111111111111
RESIDENTIAL
COMMERCIAL
SIGN PERMIT
Fences (PloUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
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 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
~~ '
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE JtECOVERY 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, 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 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 proce~d with the work a~d not as authori~y !o viol~t~, 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 th~ work is commenced: An extension
may be requested, in writing, from the Building Officia~ for a period not t~ exceed nln~ty (.90) dars 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 INYOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER 0 N ATTORNEY BEF RE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) I a. I ~ ~~
OWNER OR AGENT ' CONTRACTOR
~u~~~~andb~~~!~~e=s:o~, s~scribedJ_y m;3~m;aA~t;r~~th~ r:
Who is/are personally kno~to me or haslhave ~oduced ~~ r::J:e personally known to me or haslhave produced
as Identification. as identification.
,
~c:dh\ S, ~~~ I".,"'Y P",,",
Commission No.
co~J~~wm::"'YP"~I'
/' '\ Suzanne
Name of Notary typed, printeW . mission #DD6011l0
"":'''''''~' Expires: NOY. 15 2010
BONDED 1HRU ArL "',lIe BO:--iDING CO., Il\C.
Name of Notary typed, p nt~ ,State of Michigan
County of Grand Traverse
My Commission Ex Ires Jul. 13, 013
Acting in the County of
SLEEPY HOLLOW MOB~E ESTATES, INC.
38615 '--. Avo
. 7ApIJyddUs, PI. 33542
813-782-1111
813-783-7611
~.COIIl
This is a n:quest 10 the Boerd of 'DiRdors as called :tOr in our Prospeetus to make the
1bIIowlugaddllioD....ll~lD my home"'~
I wish to u.d7 /l a:.- .<:'--;n/ ~rJj,) q .d /U:{ ()Ve,)
_~~..r---n./,~ c.t <..1Q--n1~
{)ate of Request 03 - <6" - 0 7
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To Whom It May Concern,
Please be advised that:
Stacie Hartwig and Deborah Dokendorf of Pasco Permit Service have my
permission until further written notice to act as my agent to sign and pick up
permits.
n..t ' Sin. cerelY,..
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Signature
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Date
NOTARY
STATE OF FLORIDA, COUNTY OF PASCO
The foregoing instrument was sworn to and subscribed before me this ~ day
of ~~ ' ~QQiJ.
Personally known ~or Produced identification
PATTY S. BREITHAUPT
Notary Public, State of Michigan
County of Grand Traverse
My Commission Exp res Jut 13. 2 .3
Acting in the County of
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Commissioned Stamp
and Expiration Date
. D:ISCLOSURB S'l'ATBMBlrr FOil OWJIBR
~Q~ OP ZBPImUIn.t.s 8IJXI.DDIQ DIlP_
J:, ~ fr1 1/. have read and fu1l.y understand and
agree to the provisions 0 this instrument.
The undersigned states and affizms that he or she is desirous of CODStructing,
renovating, adding to or reroofing his or her own dom:i.cil.e, that he or she
actual.l.y occupies, or wil.l. occupy by /1- 07 said dom:i.cil.e, and same is DOt for
rent, l.ease or sal.e. That he or she shal.l. comp1y rith the fol.J.ow:i.ng CODditions:
J.. That the owner and. he or she al.one sbal.J. act as the buiJ.der for al.1. phases of
construction.
2. That the owner wi11 compl.y with a11 provisiODS of the City of Zephyrhil.1s
omi "'mees and codes pertiDent to the bui1ding.
3 . That in the event various phases of construetion are subcontracted, he wi11
engage only properly licensed subcontractors. and. wil.l. personally supervise
such work..
4. That in the event the Buil.d:ing :Inspector sbal.l. require correctiODS to be made,
the owner wil.l. assume ful.l. respOlUlibiJ.ity to insure they are made, and upon
compl.etion wi11 cal.l for a reinspect ion before proceeding with the buil.ding.
5. That the owner sbal.l assume ful.l responsibi1i ty for the construction and will
not expect supervision of his work from the City of Zephyrhill.s Buil.ding
Depart:ment.
6. That prior to final inspection any additiODaJ. fees, incl.udi:a.g reinspection
fees, must be paid in ful.l.. A written request from this office shal.l
ccmstitute an official. notice to pay additio:a.al. fees.
7. That the owner sbal.l comply with &1J. City, State and Pederal. l.aws in regard to
social. security, workman's compensation, 1ien 1aws, etc., where app1ioable.
8. That the owner shal.l comp1y with a1l. the s~ety codes issued. by the P10rida
:Industrial. COD1IBission.
9. State 1aw requires construction to be done by l.ice:a.sed contractors. You have
appl.ied for a permit under an ~tion to that law. The exemption al.l.ows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You DlWIt provide direct
o:a.site supervision of the co:a.struction yourse1f. You may buiJ.d or improve a
one-famil.y or two-famil.y residence or a fiUDl outbuil.ding. You may al.so buiJ.d
or improve a cc:xmmercial. buil.ding, provided your costs do not exceed $25,000.
'rhe buil.ding or residence DII1St be for your own use or occupancy. :It:may not
be buil. t or substantial.l.y improved for sal.e or J.ease. :If you sel.l. or l.ease a
. buil.ding you havebuil.t or substa:a.tial.l.y improved yoursel.f w:i.thin 1 year after
the construction is comp1ete, the l.a. wiJ.J. presume that you buiJ.t or
substanti.aJ.J.yimproved if for sal.e or J.ease, wh:i.ch is a viol.aticm of this
exemption. You may not hire an UDl.icensed person to act as your contractor or
to supervise peepl.e working on your buil.ding. :It is your respODSibil.ity to
make sure that peopl.e eapl.oyed by you have l.icenses required by state l.aw and.
by county or municipal. l.icensing ordinances. You may not del.egate the
responsibility for supervisiJ:Lg work to a l.ice:a.sed contractor who is not
l.icensed to perform the work being done. Any person worldng on your buil.d.i:a.g
who is not l.icensed must work UDder your direct supervision and must be
eapl.oyed by you, which means that you must deduct P.:I.C.A. and wit:hhol.d.ing tax
and provide workers' compensation for that eapl.oyee, al.l. as prescribed by law.
Your COl1Struction must compl.y w:i. th al.l. applicab1e l.aws, or"; nances, buil.d.ing
codes, and. zoniJ1g regul.atio:a.s. Q.f,~a,~.%-,~
OIIIIIIR'S "-X ~ T:xJ3:, j,"J~,DAD 8-.2 f- 07
ADDUSS ~'Z7t/ ~/~ ~~ __~
PHOlIB ~31- ~1 - "1ft - _ 1_ ~ _ ~ I
WITIlBSS ~ ~ . ~ ~
,
State of
NOTICE OF COMMENCEMENT
. RDfrdtt,; County of fa<)L6
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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. ().J.-;(h -- J-I- {)()/(j- O!:J7JbD - 003[))
I-f { oa c wf t,:( fL 3~~
(Legal descriptio of the property and st eet address if av. '1 Ie)
2. General Description of Improvement 5ereeh.. 1200"", 0/- Roo {' - Ot/e,-
1111111111111111I1111I111I1111111111111111 11111 1I1I1 11111111
2007121742
3. Owner Information: Name }mffi+ShJY~ Af,'ck..efS6h
AddresdmLfI C. R, 9!e-.,' LotJJ 6::L City t~ 1//"5
Interest in Property: () /)j h er-
N ame of Fee Simple Titleholder: Sam e.
(If other than owner)
State FL33gj;;G
Address City State
R Contractor: Name D()) fJf!.r
Address City State
5. Surety: Name
Address City State
Amount of Bond: $ Rcpt:1115084 Rec: 10.00
DS: 0.00 IT: 0.00
07/17/07 Dpty Clerk
6. Lender: Name
Address 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.
Signature of Owner: ){
9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date
of recording unless a different date is specified.) JED PITTMAN, PASCO COUNTY CLERK
07/17/07 10:34am 1 of 1
OR BK 7570 PG 1714
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dayof ~_
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Sworn to and subscribed before me ~his . .ex;
Notary Public: <V<.mu ~ .~~
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My Commission Expires: ~ - \ ~ - \ ~
PC93053048/ A
,20~.
. EITHAUPT
N~ Public. State of Michigan
~unty of Grand Traverse
Actin My Comm/slfon Jul. 13 20
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ALL WORK SHALL COMPL'i Y\llTR I\LL
PREVAILING CODES, FLORID:\ B\JlLD~rS
CODE, NATIONAL ELEC1RIC CODE AN~:
Cl1Y OF ZEPHYRHILLS ORDfNANCES
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