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HomeMy WebLinkAbout09-9983 CITY OF ZEPHYRHILLS 5335 -8th Street (813)780 -0020 9983 ELECTRICAL PERMIT 1Q 2 / Permit Number: 9983 Address: ' : 13TH AVE Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL. Class of Work: ELECTRIC SERVICE REPLACEMENT Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Contractor: EAST PASCO ELECTRIC, INC Book: Page: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11- 26 -21- 0010 - 03200 -0200 Improv. Cost: 200.00 [ �., = ` # < ° E Date Issued: 1/12/2010 Name: LAND TRUST 130608112621 JACKMAN Total Fees: 35.00 Address: PO BOX 669 Amount Paid: 35.00 ZEPHYRHILLS, FL. 33539 Date Paid: 1/12/2010 Phone: Work Desc: SERVICE INSPECTION /DAMAGE METER PROGRESS REQUIRED B4 RELEASE POWEF r n:- W Q ,', £.. , ,;.` E a rt..: ELECTRICAL FEE 3 irit ROUGH ELECTRIC CONSTRUCTION POLE PRE -METER (0 1314& FINAL 'Z -(U -[b "O. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one 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. "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." Complete Plans, Specifications and Fee Must Accompany Application. All work shall be perform in a o•dance with City Codes and Ordinances. 1 662- filr itr', ANII A.4 C NTRAOOR PERMIT OFFI - ERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813 -780 -0020 City of Zephyrhills Permit Application Fax - 813-780 -0021 Building Department Date Received r� �t( � Z- Phone Contact for Permitting Owner's Name 1,, %/Ir Owner Phone Number ; .dW Owner's Address Owner Phone Number r �� Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS .?/D 2- / 3 ��� /J %� LOT # SUBDIVISION PARCEL ID# /1 !2 - Z� 6'47/0 . "- e/ 2--e d Zl (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN n MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE I I SFR 1 I COMM I I OTHER I TYPE OF CONSTRUCTION 1 BLOCK I I FRAME I I STEEL I I OTHER I DESCRIPTION OF WORK " - Acre - 4 - Z —�1/� BUILDING SIZE SQ FOOTAGE HEIGHT 1 BUILDING $ VALUATION OF TOTAL CONSTRUCTION I 4/1 $ AMP SERVICE fa ROGRESS ENERGY I 1 W.R.E.C. I I PLUMBING $ I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS 1 1 ROOFING 1 1 SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES 1 INO BUILDER r COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I Address 1 . ` . License # I ELECTRICI 41111 m�r � � COMPANY SIGNATURE ' If REGISTER D I Y/ N I FEE CURRENT I Y/ N I Address /J 7 � / �= /, z 1' 1 AP _ , i41 9 7� License # l 30-0 30 4, 2' PLUMBER OMPANY SIGNATURE REGISTERED Y/ N I FEE CURRENT I Y/ N 1 Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N . 1 FEE CURRENT I Y/ N 1 Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address 1 License # RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C 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 A/C Fences (Plot/Survey /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 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, 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 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 Official for a period not to exceed ninety (90) days 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 TICE OF COMMENCEMENT, FLORIDA JURAT (F.S. 117.03) OWNER OR AGENT CONTRACTOR Subscribed and swom to (or affirmed) before me this Subscribed and sworro -(er rmed) ore me this by b y (0)' Who is /are personally known to me or has/have produced Who is /are personally known o me has /have produced as identification. as identification. Notary Public otary Public Commission No. Commission No. Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped Pasco County Parcel: 11- 26 -21- 0010- 03200 -0200 001 Page 1 of 2 Search Again Map Generalized Building Schematic Frequently Asked Questions Estimate Taxes Other Parcel Cards: 1 1 2 1 3 1 4 Other Agency Data: Tax Collector School Board Supervisor of Elections Data Current as Of: Weekly Archive - Saturday, January 09, 2010 Parcel ID I 11 26 -21- 0010 - 03200 -0200 (Card: 001 of 004) Classification 12 - Stores, Office, SFR Mailing Address Property Value LAND TRUST 130608112621 Ag Land $0 JACKMAN SCOTT SUCC TRUSTEE Land $68,320 PO BOX 669 Building $213,148 ZEPHYRHILLS, FL 335390669 Physical Address - See All 8 addresses (First Shown) Extra Features $180 38102 13TH AVE Market Value $281,648 ZEPHYRHILLS, FL 33542-3435 Assessed (Save Our Homes) $0 Legal Description (First 4 Lines) See Plat for this Subdivision 1. Taxable Value $281,648 CITY OF ZEPHYRHILLS PB 1 PG 54 LOTS 20 -24 INCL BLOCK 32 OR 3830 PG 233 I Land Detail (Card: 001 of 004) I Line II Use IlDescriptionl) Zoning II Units II Type II Price II Condition II Value 1 1200 STORE 00C2 7,000.00 SF COMB $5.26 1.00 $36,820 2 1200 STORE 00C2 10 500.00 SF COMB $3.00 1.00 $31,500 I Additional Land Information I Acres II 0.40 I Tax Area II 30ZH II FEMA Code II X °Commerical Code° M6ST2AA I I Building Information - Use 08 - Multi Family (4 or Tess Units per Building) (Card: 001 of 004) Year Built 1968 Stories 1.0 Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 None Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle Interior Wall 1 Drywall Interior Wall 2 None Flooring 1 Terrazzo Monolithic Flooring 2 None Fuel Electric Heat Forced Air - Ducted A/C Central Baths 1.0 Line II Description II Sq. Feet II Repl. Cost New I 2 U FOP II 1,026 $94,146 II $1,009 Extra Features (Card: 001 of 004) I Line II Description I Year II Units II Value 1 II UDU -M I 1988 II 1 II $180 I Sales History I Previous Owner I FARRINGTON PERL V JR TRUST Year II Month I Book /Page II Type II Amount 1997 10 I 3830 / 0233 II WD 0 $150,000 1991 I� 10 I 2058 / 0880 II Q II so 1979 II 11 I 1036 / 1621 I $123,700 http: // appraiser. pascogov .com /search/parcel.aspx ?sec =11 &twn= 26 &rng =21 &sbb= 0010 &b... 1/12/2010 CERTIFICATE OF LIABILITY INSURANCE 1 l nz /2 010 Producer: Lion Insurance Company This Certificate is issued as a matter of information only and confers no rights upon the Certificate bolder. This Certificate does not amend, extend or alter 2739 U.S. Highway 19 N. the coverage afforded by the polities below. Holiday, FL 34691 Insurers Affording Coverage NAIL # Insured: South East Personnel Leasing, Inc. Insurer A: Lon Insurance Company 11075 2739 U.S. Highway 19 N. Insurer 8: Holiday, FL 34691 Insurer C: Insurer D: Insurer E Coverages he ties of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement. term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions. and conditions of such poi cies. Aggregate limits shown may have been reduced by paid claims. INSR ADDL Policy Effective Policy Expiration Date LTR INSRD Type of Insurance Policy Number Date Limits (MM /DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence $ Commercial General Liability Damage to rented premises (EA Claims Made Occur occurrence) $ Med Exp $ Personal Adv Injury $ General aggregate limit applies per: — _ D Policy ❑ Project ❑ LOC General Aggregate $ Products - Comp /Op Agg $ AUTOMOBILE LIABILITY Combined Single Limit Any Auto (EA Accident) $ '., Bodily Injury All Owned Autos '■' (Per Person) $ Scheduled Autos - Hired Autos Bodily Injury Non -Owned Autos (Per Accident) $ Property Damage (Per Accident) $ EXCESS /UMBRELLA LIABILITY Each Occurrence I Occur ❑ Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2010 01/01/2011 x I WC Statu I 1OTH- Employers' Liability tory Limits ER Any proprietor/partner /executive officer /member E.L. Each Accident $1.000,000 excluded? E.L. Disease - Ea Employee 51.000.000 If Yes, describe under special provisions below. E.L. Disease - Policy Limits 51,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocationsNehicles /Exclusions added by Endorsement /Special Provisions: Client ID: 19-57-205 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company ": East Pasco Electric, Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. active employee(s) , while working in Florida. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: FAX: 352 -521 -3845 & 813 -780 -0021 / ISSUE 01 -12 -10 (TD) Begin Date: 12/9/1999 CERTIFICATE HOLDER CANCELLATION CITY OF ZEPHRYHIL LS Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shat impose no obhgation or liability of any kind upon the insurer. its agents or representatives. 5335 8TH STREET ZEPHRYHILLS, FL 33540 / ; ,' _ J r � . 44C OR. CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD"") PRODUCER Bauer & Associates THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 12210 US Highway 301 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTFICATE DOES NOT AMEND, EXTEND OR Dade City, FL 33525 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Phone (352)557 - 3702 Fax (352)5230434 INSURERS AFFORDING COVERAGE NAIL N INSURED EAST PASCO ELECTRIC INC. INSURER A: AUTO OWNERS INSURANCE CO. INSURER 8: ANTHONY LEGER INSURER C: 4771 ALLEN ROAD INSURER D: I ZEPHYRHILLS, FL 33541 INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADM T YPE OF INSURANCE POLICY NUMBER DIWI POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRD DATE DATEIMMIDD/YY1 GENERAL LIABILITY EACH OCCURRENCE 1 M I L ❑/ COMMERCIAL GENERAL LUIBIUTY DAMAGE TO RENTED 20692036 50 000 20692036 12/14/09 12/14 /10 PREMISES (Ea ourenca) 00 CL� IMS MADE fir] O CCUR MEO PCP (Any one person) 5,000 A ❑ ❑ PERSONAL b ADV INJURY 1 MIL ❑ GENERAL AGGREGATE 2MIL GEM_ AGGREGATE UMIT APPUES PER: PRODUCTS ' COMP/OP AGO 2MIL 0 POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 M I L ❑ ANY AUTO 41 -455- 947 -00 05/14/09 05/14/10 (Ea accident) ❑ ALL OWNED AUTOS BODILY INJURY A ❑ I i SCHEDULED AUTOS (Per person) ❑ HIRED AUTOS ❑ NON OWNED AUTOS BODILY INJURY (Per accident) ❑ — PROPERTY DAMAGE ❑_ _ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAN EA ACC ❑ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION S WORKERS COMPENSATION AND ❑ WC STATU- ❑ OTH- EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT OFFICER / MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LMT OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ELECTRICAL CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL CITY OF ZEPHYRHILLS 30 DAYS WRITTEIf NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 5335 8TH STREET OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ZEPHYRHILLS , FL 33542 �T REPREWITAT� 1 FAX©813- 780 -0021 � ACORD 28 (2001/08) QF m ACORD CORPORATION 1988 TO . ONI DOSSV '8 2INI1Vg b£b0EZSZSE XVA 81' :OT OTOZ /ZT /TO