HomeMy WebLinkAbout08-8175
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
8175
ermit Number: 8175
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 7,700.00
Date Issued: 8/11/2008
Total Fees: 6,965.58
Amount Paid: 6,965.58
Date Paid: 8/11/2008
Work Desc: MOBILE HOME INSTALLATION
Address: 7922 KAY MARIE A V
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 34-25-21-0010-02800-0305
Name: CARLSON, CHARLES & SHIRLEY
Address: 7922 KAY MARIE AVE L T#305
ZEPHYRHILLS, FL. 33542
Phone:
ACE REFRIGERATION INC
ACE REFRIGERATION INC
BMI LLC
M
MOBILE HOME PLUMBING
SEWER CONNECTION MOBILE
WATER METER RES 3/4"
WATER CONNECTION MOBILE HC
POLICE IMPACT FEE
PUBLIC SAFETY 5%
TRAFFIC IMPACT FEE 1%
L
40.00 MOBILE HOME MECHANICAL
1,005.00 WATER CONNECTION MOBILE HC
220.00 IRRIGATION METER
266.00 PARK FEES MH
254.00 FIRE IMPACT FEE
26.35 TRAFFIC IMPACT FEE 99%
36.32
. 0
35.00
320.50
220.00
573.73
273.00
3,595.68
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MOBILE HOME ELECTRIC
MOBILE HOME AlC
MOBILE HOME PLUMBING_
FINAL
REINSPEcnON 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 inspection 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
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
~,~ nodau- ~
6NTRACTORS SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
City of Zephyrhills
BUILDING PLAN REVIEW COMNIENTS
Site:
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Date Received:
Permit Type:
Approved wino comments:D Approved withe below comments! Denied withe below comments: 0
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be kept with the permit and/or plans.
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(Required when comments are present)
813-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
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Date Received
Owner's Name
Owner Phone Number
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Owner Phone Number
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Owner's Address tv 0 ~'k \od~ W '19 <8 ~ ~(p
Fee Simple Titleholder Namel
Fee Simple Titleholder Address I
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rJ1 NEW CONSTR D ADD/ALT D
5J INSTALL D REPAIR
PROPOSED USE [KJ SFR D COMM D
TYPE OF CONSTRUCTION D BLOCK D FRAME D
DESCRIPTION OF WORK 1rY'1C'b'\'I~' \k-frY1e.-'rn~+v I~+-tcr(\
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LOT #
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JOB ADDRESS
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WORK PROPOSED
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MOVE D
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BUILDING SIZE
HEIGHT
D BUILDING 1$5;006 I VALUATION OF TOTAL CONSTRUCTION
D ELECTRICAL 1$ (000 I AMP SERVICE D PROGRESS ENERGY D WR.E.C.
Alrt!---
D PLUMBING l$loCYl I fJ/
D MECHANICAL 1$/,500 I VALUATION OF MECHANICAL INSTALLATION
D GAS D ROOFING D SPECIALTY D OTHER
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES c;tINO
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RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy FDrms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) cDmplete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new constructiDn.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Sift Fence installed,
Sanitary Facilities & 1 dumpster. Site WDrk Permit for all new projects. All commercial requirements must meet cDmpliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
'-"PROPERTY SURVEY required for all NEW constructiDn.
11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 II 11I11111111 j 111111111I11111 i
Directions:
Fill out application completely.
Owner & Contractor sign back of applicatiDn, notarized
If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
Agent (for the cDntractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front Df Application Only)
Reroofs Sewers Service Upgrades NC Fences (PlotlSurvey/FoDtage)
Driveways-Not over Counter if on public roadways..needs ROW
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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
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 ~aid 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 "An 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) 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 YOU NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 1 03)
CONTRACTOR
Su scrib d and sworn tO~ffirmed) before me this
~ ~ 0 i- by MPF I..Xl.tD \r
~ is/are personallY known to me or has/have produced
~ON"'''a.\f' K~,..J as identification.
Name of
Notary Public
Notary Public
Commission ND.
FY.
NoIary PublIC . S1ate of FIodCIa
Ole l,2DllI
CommIIIIOn # DO 376090
........_NaIIanaINl*IYMn.
Aug 08 08 09:30a
Lisa Booker
8137837891
BMI LLC
39838 Stewart Rd.
ZephyrhWs, FL 33540
5/ w j d-I-'f!
t~ I/z;y,~~
~
Phone 813-714-9508
Fax 813-783-7891
FAX TRANSMITTAL FORM
To: City Of Zephyrf1ills
Name: Jackie
cc:
Phone: .
Fax: 780-0021
From: Usa Booker
Date Sent08/08I08
Number of Pages: 2
Message:
Workman's Comp.
Thank you
Lisa Booker
(813) 714-1476
,
p.1
Aug 08 08 09:30a
Lisa Booker
8137837891
p.2
04-17-2008
ALEX SINK STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 04/17/2008
PERSON: BOOKER
FEIN: 204474712
BUSINESS NAME AND ADDRESS:
BIIII LLC
39838 STEWART RD
ZEPHYRHILWS FL 33540
EXPIRATION DATE: 04/17/2010
LARRY
W JR
SCOPES OF BUSINESS OR TRADE:
1- MOB! LE HOME TIE DOWN (8400)
IM.ORTANT: "'suant 10 Daple. 440 . Q51141. F.S~ an of/jeo. .f . e.rpora1i.. wh olocu ......llon from l~is eb.p10. bV lilill9 . eerliliale 01 Ilecli.. "_1' Ihis
slldi_ m." .., rec:oul .....IIIs. .r co.......... ..... .his c.....er. Pune...t Ie Clllprlf .48~a5CI2.L f.S.. Cenilir.es D' cl.'U_1I ID be ..'WI,I... Ipply Dnly willlin tile
ICDpe .. II. ''''IISSO' Ind. 1i1l.4 01 .h ...ice or .ledi.. 'D b. ._L 'urs."1 10 ClIoflOf 440.154131, F.S.. NOliees 01 .leeUDo '0 bl e......1 .._ cor:i'ical.s 01
oIleUOI ... H ..e....' ...11 h lallj..' I. '...e....n iI, "' IOY Ii.. .r.Of ... II Ii", DI I.. llDliee or I.. i.I...c. .r lh clnil;call. '.e person n..... on lh '.Iitt or
clrtiliclI. wa ...ger 11I"'$ the relluil....11S ., Ibis SKli_ tor illUllCe 01 . cI"ilicale. TIle d.p......enr 'llll uvoke I ceni'.cal-e II any titRe for f.ihre of Ibe pcrs..
..._ OIl t" tellihClle to meel die r.q..i.....ts of lIli'S _ctiM.
DWC-252 CERTIFICATE OF ELECTION TO BE EXDJI>T REVISED 09-06
QUESTIONS? 185m 41]-1609
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR fUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS. COMPeNSAnoN
CONSTRUCTION lNDU$TRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS COI'M9SATION LAW
EFFECTIVE: 04/17/2008 EXP1RATlDN DATE:
PERSON: LARRY W BOOKER .JR
FEIN: 204474712
BUSINESS NAME AND ADDRESS:
IIMI lLC
31838 STEWART RD
ZEPHVIl..lS. FL 33540
~
W'
F IMPORTANT
o Pursuant to Challler 440.051141. F.S.. an officer of a corpor~ion who
elects exemption from this chapter by filing a certificate of election
Lunder 1his section may not recover benefIts 0' compensation unlier this
D chBpter.
H Pursuant to Chlpter 440.05(121. F.S.. Certifica1es of election 10 be
exempt.. IIlplV onlv within the scepe of lIle business or trade listed on
E the notice of election to be exempt.
R
E PurSll8llt to Chapter 440.05(131, F.S.. Notices of electior. to be exemPt
anti certificates of electien 1e be exempt shall be subject to rel/Oc/ltien
if. lit ...y lime after 1he filing of the nOlice or tile iSSuance of the
certificate. Ihe person named on the notice or certifiCllte no longer meets
the requirements of this seetion for issLlllnce of a certifiCllte. The
department shall revoke a certifica1e lit any time for failure of the
person named on 1he certificate to meet the requirements of thIS
section.
04/17/2010
SCOPE OF BUSINESS OR TRADE
,. Mone HONE TIE DOWN 16400)
QUESTIONS? 185D) 413-16D9
CUT HERE
· Carry bottom portion on the job, k_p upper portion for your records.
OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-D6
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Permit No. ,. ~ l 75
Date Pennltted' (S', 11- 0 B.
auilder Name/Owner Name DAI- LLc..., .' ~Clntrol# .
. County Parcel No. 3<<{ ~ 20'-2(. 001 o..()~ Sa> :'D'3()S SUbD~V:
Address/Loc~tion "712 z- ki4}- 'M~;~. ~ l ~r!- 1F B~
"'.0_; D,....I n 'S.I~. k :-I,.. I~~ .
ClasslfioationIType of,Us~ '(D::> .AeA'l-. cc.Jt - ~ 9
Sq Ft Unit: I~S 7
TRANSPORTATION IMPACT FEE. ' Rate:
~xempt 0 Yes 0 No . H~ p~1emilnecl
Impact fee Amount $.3 (g3 2- Zone'No. .
TAZ:
SOHOOL IMPAG'r FEE' . . .' '"
Account (056) Single-FamilY [}eiachad House 7. AmOU!1t $.
. . (057) Moplle Home' . : .'.
(058) . Other Residential. , .
. . J.:l23)' Collection fee' . . .
ExelTlpt .U yes 0 NQ How DBtannln~d ,&.... .. .
PARKS AND' RECREATION FEE -.
Land Account . Land Credit
41nd Total
Recreation Account
Recreation Credit
Rfilcreati~n Total
Zone
TOTAL.AMOUNT: ~ . $' 573, 73"
1
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Exempt 0 yes 0 No
LIB~RY FEE'
Land Account. .
riilcllijyAccoLlnt
Ho\V.PBtermlneq
Wind Credit Land Total
Faclnty Tota!
. Total Amount
~xempt 0 Yes . 0 No
'RESOURCE FEE ' . ER.U
TOTAL AMOI,JNT
PreparedBy ~~~ Che~By ..
NO OeRTIFICATE Of OCCUP..A.NCYWlLl. BE; ISStJED OR FINAL INSPEcTION
pERfOR.Mt:D U._NiI~ THE TOTAL AMOlfNTS LISTED HAVE
. B5EN PAID ANP. .'.
Rj:CEIPTEP FOR BY A OEf'JT~A.L f!!=fU\lI!mNG OFFICE. OF PASCO OOUNTY
Acknowladgement palow dollS not Imply Bccep~ of Co/lO!lrranll&l. .burBimply rElll&llpt oh coPy of thk; form, placing
. .' the building permit oWT!ar on noljGs oflhl6 B8&IlSSIllen! ~ thEl condltloru; of paymant fur sarna.
:.
PATE
R.ECEIPT NO.
RECEIVED BY
DATE
BY
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