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HomeMy WebLinkAbout09-9192 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9192 BUILDING PERMIT u'., ° s<`°.z~.. r . : . , a . , . t , , e ,. 4 , , , si i w,. .. : r , m ,_ —. ,.: -< F t E b' fo ik -0 Permit Number: 9192 Address: 5953 GALL BLVD Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 10- 26 -21- 0020 - 00000 -0030 Improv. Cost: 11,435.00 A t Date Issued: 6/03/2009 Name: ZEPHYR LLC Total Fees: 287.14 Address: 7162 READING RD #730 Amount Paid: 287.14 CINCINNATI. OH 45237 -3845 Date Paid: 6/03/2009 Phone: Work Desc: INTERIOR REMODELING . 1 Oa ' { r JOHN L SMITH CONSTRUCTION INC BUILDING FEE 135.00 ELECTRICAL FEE 35.00 FIRST CLASS ELECTRIC INC PLUMBING FEE 35.00 FIRE PLAN REVIEW FEES 82.14 CHRIS BAHR PLUMBING 1 Ci r 14-11 li° ort S-7-2--o f FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING 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 any one 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." i ---9 -. _ / CONTRACTOR SIGNATURE PERMIT OFFI rR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER , • •••• •.• vmmrm••••• •■ • ••••at ...,•••.^••--,• Mort • •,1, ••••,•■ •• ,lat•rWynrrY1 CITY OF BUILDING ZEPHYRHILLS liNIOTICEII DEPARTMENT OF ADDITION OR CORRECTION DO NOT REMOVE ADDRESS DATE PERMI ( 1 . 0 THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be ma before the will be accepted. - C c Wrir , + I AMMIWir = I/ 4/' -A11111111111/11111r 111111111111111111%., 111111111EVAL MEW I :7 ‘p -111111V /--4 I MBIONIUMMIWAM &CM Irlatirrani 41111 It is unlawful for any Carpenter, Contractor, Builder, or • er persons, to AFTER C • - • NS ARE M cover or cause to be covered, any part of the work with flooring, lath, 'arth or other material, until the proper inspector has had ample time to approve 780-0020 FOR RE-INSPECTION the installation. OFFICE HOURS 7:30 AM - 5 PM MON.-FRI. INSPECTOR CITY OF . / / NOTICE" BUILDING ZEPHYRHILLS DEPARTMENT OF ADDITION OR CORRECTION DO NOT REMOVE ADDRESS DATE PERMIT # ' 25-. (:) '' . Li I, lei 6 119 -- 2- THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job will be accepted. q-AS17:- 1 - k\ 111--' p■\A- p_,T • ---\ i CA ( � �� 5 ( t c 4,s I ( ,art , ,R..t r2. (),10-1_1- l moo it .gz)5k) F-L %% OtL &Q)-77-)/A) t or (Ac,i- of `, A 6, 'le , M A._ ti 1 usA 247t--1— ,&- ‘./.\.)(d.. O g'C" Tom- z›f 1 if' i - I4Sc..- -- TriAiNt Vi-u- It is unlawful for any Carpenter, Contractor, Builder, or other persons, to AFTER CORRECTIONS ARE MADE CALL cover or cause to be covered, any part of the work with flooring, lath, earth or other material, until the proper inspector has had ample time to approve 780 -0020 FOR RE- INSPECTION the installation. OFFICE HOURS 7:30 AM - 5 PM MON. -FRI. INSPECTOR PASCO COUNTY BUSINESS TAX RECEIPT 2008-09 Issued oning or othe subject . This se be posted conspicuously n place of business. September with 0. Mike Olson TYPE OF BUSINESS A ACCOUNT NO: 002799 TAX COLLECTOR TYPE CONTRACTOR SIC CODE 1541 pASCO COUNTY FLORIDA •••., T HE ST ••• LOCATION: ADDRESS .,,x ...1f+ ° 4240 COATS ROAD W T- z ZEPHYRHILLS JOHN L SMITH CONSTRUCTION INC :;•`r a 4240 COATS ROAD '.,. DATE RECEIPT AMOUNT • ZEPHYRHILLS FL 33541 -7144 HCOp yE 10. •- 09/30/08 558588 31.25 isdimii..1.issi,d„diimisio oiniekshistnined i 4> STATE OF FLORIDA AG1 , 0 2 ;=i "" 8 ,, DEPARTMENT OF BUSINESS AND .. 4 PROFESSIONAL REGULATION CBCO59519 08/08/08 080081879 CERTIFIED BUILDING CONTRACTOR SMITH, JOHN L . JOHN L SMITH CONSTRUCTION IS CERTIFIED under the provisions of Ch. 489 18s >ispiration date: AUG 31, 2010 L08080801498 STATE OF FLORIDA I DEPARTMENT OF FINANCIAL- VICES f DIVISION OF WORKERS' COMPENSATION : : , r CONSTRUCTION INDUSTRY - : - .1 CERTIFICATE OF ELECTIOM TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 11/24/2008 EXPIRATION DATE: 11/24/2010 PERSON: AMIN L SMITH FEIN: 270071702 BUSINESS NAME AND ADDRESS: • JOHN L SMITH CONSTRUCTION INC 4240 COATS RD ZEPHYRHILLS, FL 33541 I SCOPE OF BUSINESS OR TRADE ; 1- CERTIFIED BUILDING CONTRACTOR A c ® CERTIFICATE OF LIABILITY INSURANCE DATE I O 3 IDONY) PRODUCER Bauer 8 Associates THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 12210 US Highway 301 ONLY AND CONFERS NO RIGHTS UPON THE CERTFICATE HOLDER. THIS CERTFICATE DOES NOT AMEND, EXTEND OR Dade City, FL 33525 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (352)567 -3702 Fax (352)523 -0434 INSURERS AFFORDING COVERAGE NAIC I1 INSURED JOHN SMITH DBA/ INSURER A: AUTO OWNERS INSURANCE INSURER B: JOHN L. SMITH CONSTRUCTION INSURER C: 4240 COATS ROAD INSURER D ZEPHYRHILLS, FL 33541 INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE USTED 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. INSR ADO'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRD DATE (MMIDDNY) DATE (MWDDIYY) GENERAL LIABILITY EACH OCCURRENCE 300,000 [J COMMERCIAL GENERAL LIABILITY 20632794 05/01 /09 05/01 /10 PRawSESEaErrerce) 50,000 Ci ❑ CLAMS MADE [r] OCCUR MED EXP (Any one person) 5,000 A ❑ ❑ PERSONAL 8 ADV INJURY 300,000 GENERAL AGGREGATE 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 600,000 [I POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT O ANY AUTO (Ea accident) ❑ ALL OWNED AUTOS BODILY INJURY ❑ 10 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 LIABIUTY EACH OCCURRENCE El • OCCUR E.:1 CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND ❑ WC STATU- ❑ OTH- EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT OFFICER / MEMBER EXCLUDED? It yea, describe under E.L. DISEASE - EA EMPLOYEE SPECIAL PROVISIONS below E.L. DISEASE - POLICY UMIT OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS BUILDING 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 WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO BUILDING DEPT. 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. Au p ZEPHYRHILLS , FL 33542 1 FAX @813- 780 -0021 TH EPR TAT ` / NNE dr y / 7 3 O ACORD 26 (2001/08) QF ®ACORD CORPORATION 1988 T00 21 '3NI 'DOSSV '8 HafIVEI t£60EZSZSE XVd L£:ST 600Z/£0/90 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780 -0020 9192 BUILDING PERMIT Permit Number: 9192 Address: 5953 GALL BLVD Permit Type: ADDITION /ALTERATION ZEPHYRHILLS, FL. Class of Work: 434 - ADD /ALT RESIDENTIAL Township: Range: Book: Proposed Use: COMMERCIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 10- 26 -21- 0020 - 00000 -0030 Improv. Cost: 11,435.00 a _ 0* :0 i. :773S0�� Date Issued: Name: ZEPHYR LLC Total Fees: 287.14 Address: 7162 READING RD #730 Amount Paid: CINCINNATI. OH 45237 -3845 Date Paid: Phone: Work Desc: INTERIOR R E MODELING JOHN L SMITH CONSTRUCTION INC BUILDING FEE 135.00 ELECTRICAL FEE 35.00 FIRST CLASS ELECTRIC INC PLUMBING FEE 35.00 FIRE PLAN REVIEW FEES 82.14 CHRIS BAHR PLUMBING . c le ep Liab, (Jo( , s 4 cooyi FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILING 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 any one 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." CONTRACTOR SIGNATURE PERMIT OFFI FR PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER NOTICE OF COMMENCEMENT STATE OF FLORIDA COUNTY OF PASCO 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 : Description of Property: Parcel No. 10 26 - 0020 - 00000 - 0030 Street Address: 5953 Gall Blvd. Zephyrhills, FL 33542 General description of Improvements Interior Remodeling PINE GROVE PB 2 PG 15 COM SW COR LOT 10 TH NO2DG 02' 12 "W Owner Information: 313.00 FT FOR POB TH CONT NO2DG 02' 12 "W 306.96 FT TH N88DG 25' Name Zephyr LLC 13 "E 59.58 FT TH S38DG 43' 06 "E 140.00 FT TH N88DG 25' 13 "E 150.00 Street 7162 Reading Rd. # 730 FT TO WEST R/W LINE US 301 TH SELY ALG R/W 273.41 FT TH S88DG City Cincinnati, OH 45237 28 05"W 482.54 FT TO POB OR 4341 PG 1041 Interest in Property: Owner 111111111111111111111111111111111111111111111111113 Name of Fee Simple Titleholder ( If other than owner ) 2 00 009073582 Contractor: JOHN L. SMITH D/B /A JOHN L. SMITH CONSTRUCTION 4240 COATS RD. ZEPHYRHILLS, FL. 33541 R ; 1/200495 279 R ee : 10 � �.� Surety: N/A Ds : 0 .0 iT :0. 00 0 0 Name 05/28 - - Dp�y Cl Street City PRULR S. O'NEIL, PASCO CLERK 6 G01IPTROLLER Amount of Bond 0 O R8 6 K9 81 1 PG Lender: N/A Name Street City 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 Mike Prilliman Realty, Inc. Street 38122 12 Ave. City Zephyrhills, FL 33542 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. Expiration date of Notice of Commencement to be 1 year from date of recording unless a different date is specified Signature of Owner: ,.4.ee,e2, as agent for Zephyr LLC Sworn to and subscribed before me this 51 -7 b ? day of J}t 20 b`j . Notary Public: �1 -�& E, ' My Commission Expires : NADINE L. SEELY MY COMMISSION k DD$72352 C EXPIRES: March 19, 2013 1. 100.3- NOTARY R. Newsy Discount Awe. Co STATE OF G ERT R IFY A TH T THE FOREG !tA ►S A THIS IS TO TRUE AND CORRECT COPY OF THE DOCUWNT ON FILE OR OF PUBLIC RECORD I SEAL T -t S. E A ______ S MY HAND ANh i AY OF' �� . OLLF . O'NEIL, Cl... ," 4 Y +` � LERK BY �� ._ .� • 1-------IN i ® 9 Y t C ® 6 v oUBMITTED PLAN(S) HAVE BEEN REVIEWED i BY ZEP 1 � ' S HAL' S OFFICE 0 1 t Reviewer: t z /, / 7' V Q ,, d\ + c., ( LYWIZHA , D ad o MINNO aSIINAIC O O�DAB� lip G l ES, C CO _ D AN j D pR�VA�L CO ➢ ELES 01011\10C ES j COpE �i1 L ® �a�c- ? ; i (Alp/ \)e,‹ _____ _... Proposal Date May 24, 2009 John L. Smith Construction, Inc. 4240 Coats Rd. Zephyrhills, FL 33541 (813) 782 -0470 CBC 059519 Proposal Submitted To Work To Be Performed At Name Mike Prilliman Reality, Inc as agent for Zephyr LLC Street 5953 Gall Blvd and Sharon Burnett Street 38122 12 Ave City Zephyrhills, Fl City Zephyrhills, FL Date of Plans Telephone # 788 -4849 Architect We hereby propose to furnish all materials and labor for the completion of remodeling of unit at above listed address to specs of attached plans. All material is guaranteed to be as specified, and the above work to be completed in accordance with the drawings and specs submitted for above work. All work and materials to meet local industry standards and existing codes in effect at date of this proposal. The above work to be performed for the sum of Eleven thousand, four hundred thirty five and 00 /100 Dollars ($ 11,435.00 ) with payments to be made as follows: See attached sheets. Any alterations or deviations from the above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, wind and all other necessary insurance required upon above work. Workers Compensation and Public Liability Insurance to be taken out by builder. Cost of collection and attorney's fees in the event of any default by the Owner and in the event that the Builder must initiate any collection proceedings or must engage attorneys for any purpose whatsoever relating to this agreement, including but not limited to seeking the enforcement of its terms and conditions, the Owner acknowledges, agrees, confirms and warrants, that they are responsible for all costs and attorney's fees incurred by the Builder. Respectfully submitted �. Per John L. Smith Cokt.fl ction This proposal may be withdrawn by us if not accepted within 10 days Acceptance of Proposal We, the undersigned have read this proposal and do agree to the terms and conditions as listed above and to any attachments, if included. We authorize you to do the work as specified. Payment will be made as outlined in this proposal. Date O Zo a Rde:deet.1 )66ut..,occ-- 813 - 780 -0020 City of Zephyrhills Permit Application J Fax -813- 780 -0021 Building Department T Date Received 2,413 Phone Contact for Permitting / i T U -- ,5 y /3 Owner's Name 2 6 i /, L // L G , Owner Phone Number Owner's Address 7/ 1 h e e a' � H/ / 1 / Ci • /c ',v v 1 ©y Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address /� / ,, / JOB ADDRESS / q �A l-r // a / 1 1 LOT # SUBDIVISION PARCEL ID# /d --g6--c / - ®Dbs O - dOdO D - c2e (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT SIGN n MOVE I DEMOLISH INSTALL REPAIR PROPOSED USE r SFR I>L_I COMM n OTHER I I TYPE OF CONSTRUCTION I><1 BLOCK I I FRAME I I STEEL I OTHER I I DESCRIPTION OF WORK L A/ T Le /C / ` d /, E L v _/ E /,` A / Q BUILDING SIZE SQ FOOTAGE 1 HEIGHT I I BUILDING $ l VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY rI W.R.E.C. I I PLUMBING $ ' pc. v I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION jeI' ./7 & s v I I GAS n ROOFING 1 1 SPECIALTY n OTHER brrv FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA r1YES 1 INO L. 6 ,t if, a. A BUILDER / � COMPA J ' x/ �. �z� Gt A.c %/ J / ✓ .2 SIGNATURE /� ` REGISTERED Y N FEE CURR I Y/ N I q dk i- Address o) ,v e d d 7 ,� CI Z ,` r `/ ('/ /�� 1 License # 1 G G ©,( —��� / 1 %z (c r 7b2 ELECTRICIAN a ` � COMPANY Cam( �( j� � C SIGNATURE / t' _00 1 REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address IIML' . M License # , -- -cam ()0041-76 I PLUMBER / v 1 COMPANY qii6 £ 'M i Pi. U /Z/t h, � SIGNATURE �.. i2- ' ' ` REGISTERED / N I FEE CURRENT I Y / N I Address I S729 4- /( /L,p,Q License # RFC /X-.2_ 6'5i2Z. I MECHANICAL COMPANY SIGNATURE REGISTERED I Y / N j FEE CURRENT I Y/ N I Address 1 License # I OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address 1 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 NC Fences (PIot/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 Tess 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 - NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 11 ) / ' OWNER OR AGENT �—� - 1 J CONTRACTOR RACTOR 1 ' Subscribe and swo o for affirmed) Wore m his Su crib -. a • / worra t x(�npr affi ed)pe�fore rin this 5747 r by P/ n �� rr o i .r e personally kn wn to me or has /have produced VW% is/ re ersonally known to me or has/have produced as identification. F/... 1 n r',. a %i S A r (.' as Identification. .a 0 i x '- ) i IL_ 1 --1 2 / L, >� C Notary Public /t r j, ` - : i 4 I No P �C � �C { , 7 Co mission No. q / / 9 / .21 c / ) Com ssian No. V I /9.1 Name of Notary` ` y . ; . " '' ' -' EELY Name of - mi ∎ - • , -.. - - • Y MY Ct • : , 9SSION # DD872352 MY COMMISSION # DD872352 [ . ∎: EV: : March 19, 2013 EXPIRES. March 19, 2013 ` FI. Na�yDuwwM Co 1- W O•l•NOTARY fl. �m Notary Di" Awe. Co. 1 A00.1•NOTANY ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Keith Williams Bus (813)780 -0041 Fax (813)780 -0044 FIRE SERVICE USER FEES Occupancy No.: k� ( n Plan No.: G7r, Contractor: •; ov s Business Name: � `1 c w ` t-�.c Billing Address: Lo " Business Address: -/{- ,i k - - 2i /A 1L1 d. 335 - 2 Business Phone No.: Billing Phone No.: 7e:- 3 --5 -Z Business Fax No.: Billing Fax No.: Contact: Contact: PLAN REVIEW FEES _ INSPECTION FEES _ PERMIT FEE _ FALSE ALARM FEE Site Plan N/C _ Annual N/C _ Sprinkler $50 _ 1st Alarm N/C / J s ' Mufti FamilylCommercia 06 s _ 1st Re inspection N/C ` Standpipes $50 _ 2nd Alarm N/C (Minimum Charge $25.00 _ 2nd Re- inspection $100 _ Fire Pump $50 _ 3rd Alarm N/C Ei Plan Revisions DBL _ 3rd Re- inspection $250 _ Hoods $50 _ 4th Alarm $100 — 4th Re- Inspection $500 _ Fire Alarm $50 _ 5th Alarm $150 _ SPRINKLER SYSTEMS (Business closed until — LP Gas $50 _ 6th Alarm $200 _ 0 - 25 Heads $50 violations corrected) _ Natural Gas $50 _ NON COMPLIANCE $150 26 plus Heads $100 SPRINKLER SYSTEMS — Fuel Tanks- per tank 550 STANDPIPE SYSTEM Hydro Undergrounds $45 _ Sparklers $100 0 Per Riser $50 Hydrostatic Test $65 per system _ Fire Works $500 FIRE PUMP Acceptance Test $45 persystem _ Camp Fire $25 ❑ Per Pump $100 Hydrant Flow $75 _ Controlled Bum $100 _ FIRE ALARM SYSTEM — Hood/Duct $50 0 - 25 Devices 550 FIRE ALARM SYSTEM ` Place of Assembly $50 Annual _ 26 plus Devices $100 System Acceptance $50 _ Fire Protection $25 _ SUPPRESSION SYSTEMS Recall Acceptance $50 _ Flammable Application 550 Annual Wet $50 _ OTHER — Waste Tire Storage $50 Annual Dry $50 _ Fire WaIUSmoke Wall $15 p er w all _ Generator < KW $100 CO2 $50 _ LP Gas $25 per tank _ Generator >30 KW 150 Other $50 _ Natural Gas $25 per system — Bio Waste $100 Annual KITCHEN EXHAUST _ — Fumigation Tenting $50 0 Hood/Ducts $50 _ Tent 10"x10' or greater $15 per tent — Torch Pot/Applied $50 OTHER _ Fire Pump $45 _ Haz. Materials $100 Annual — LP Installation per tank 5 50 _ Fire Suppression $30 Fuel Tank Installation $50 System Acceptance ^ (Per Tank) $50 _ Exhaust Hood/Duct $30 Ei Natural Gas Installation $50 _ Re inspection DBL (Per System) (other than annual) II Spray Booth $50 [3 Inspection scheduled DBL El , , and cancelled less than _ 24 hours _ Construction Insp. N/C _ Emergency Vehicle Aa $50 FALSE ALARM PLANS TOTAL 8,1, 'y INSPECTION TOTAL PERMIT TOTAL TOTAL r GRAND TOTAL WM f W' Comments: Date: 6 d i _.— Inspigctor: Zephyrhills Fire Rescue 6907 Dairy Road, Zephyrhills, FL 33542 Fire Marshal Bus (813) 780 -0041 Kerry Barnett Fax (813) 780 -0044 E -mail: kbarnett@fire.zephyrhills.fl.us Plan Review #: 09 -0042 Project: Interior remodel for Mercantile Occupancy Number of Pages: Single Page June 2, 2009 I have received and reviewed the single page plan for an interior remodel located at 5953 Gall Blvd. This project will be allowed to move forward with comments made below. Paying for permit, contractor acknowledges complying with the following items below. Be advised no revision fees were charged. Should anyone have any questions, please do not hesitate to contact the Fire Marshal's office. 1. Certified fire extinguishers shall be installed in accordance with NFPA 10. Extinguishers shall be located in front and rear of unit. 2. Employees are required to have training on the use of fire extinguishers. Zephyrhills Fire Rescue may be contacted for the training. 3. Firewalls shall be maintained on each side of the unit. Any penetrations to the walI(s) shall be properly sealed. 4. Unit shall be addressed both in front and rear. 5. The secondary egress consists of two doors. One of the doors shall have either a hotel latch or panic hardware. 6. Install emergency light in restroom, if not one present. Inspections Required: 1. Final KE ' ',' : ARNETT, FIRE MARSHAL ** *Please be advised this review of plans submitted is a cursory review to assist the contractor in compliance with applicable fire safety codes. This review is not intended to be a final approval of the submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance with all applicable NFPA codes and local ordinances. In the event that further examination or site inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure to be in compliance with all applicable NFPA codes and local ordinances. •1 `. ` City of Zephyrhills BUILDING PLAN REVIEW COMMENTS Contractor/Homeowner: 4Ufl J ° c;')')/ Date Received: 5- 2 5-09 Site: 51 Gibli ZH Permit Type: ����CT`'' i r C-- ede_D Approved wino comments: Approved w /the below comments: ❑ Denied w /the below comments: ❑ This co ent sheet sh be kept with the permit and/or plans. ,_)_, ay( Kal in Switzer — Pl xaminer Date Contractor and/or Homeowner (Required when comments are present)