HomeMy WebLinkAbout10-10688 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 10688
BUILDING PERMIT
Permit Number: 10688 Address: 37 &, h*I R ' v Ai EY B� VD 3g 'alak
Permit Type: PARK MODEL SETUP ZEPHYRHILLS, FL.
Class of Work: PARK MODEL SET -UP Township: Range: Book:
Proposed Use: RV PARK Lot(s): Block: Section:
Square Feet: Subdivision: MAJESTI • K
tj - 0690 Est. Value: Parcel Number: 24-26-21-3V" •-; , : i ; -otee
Improv. Cost: 2,300.00 ; , s f �_�r , .
Date Issued: 7/12/2010 Name: MAJESTIC OAKS LLC
Total Fees: 175.00 Address: 8818 PC
Amount Paid: 175.00 ZEPHYRHILLS, FL. 33542 -- Tru
Date Paid: 7/12/2010 Phone:
Work Desc: PARK MODEL REPLACEMENT 14 X 36
1111Z11°
, `„A' . `' M t1 Cis ;, , 7 '.. - � : e t' w :- i
P TER •N •N MH IN - A - KM•• LELE I 40.00 PA='M•DEL- U -ING 40.00
CRANDALL, RICHARD PARK MODEL MECHANICAL 35.00 PARK MODEL SETUP 60.00
PETERSON CONST & MH SET UP, INC
BAHR'S PROPANE GAS & NC, INC.
PkCt-
(—)
PA M•D L -UP
PARK MODEL PLUMBING
PARK MODEL ELECTRIC
PARK MODEL MECHANICAL
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."
-
,
CO TRAC •PSIG TURE PERMIT OFFI
PERMIT 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 Rued IINPTNIMIIIII
Phone Carat for • , , , ...167/ 1 ' • - ■. CO # / 616 6
0..... N. Q �c (^ t� i Owner Phone Number I
Owner's Address' (a 1 1 l Coi .S rk riff 3(�I (p 4h Owner Phone Number 1
Fee Simple Titleholder Name In / yi
- i 4 O Owner Phone Number 1
'Y
Fee Simple Titleholder Address l (� kO ( Q 0 / 2 a CA. a
JOB ADDRESS - 1 ! � ! TX._ 1 •Iii /.7lyVIE , & LOT, 1 1)1 I h
SUBDIVISION I Mq P ( (. ()I/CZ) 1 PARCEL ID, bar! j F - �_' AJ, l 7 " It� A L 2 (I - 26 -
k (061M W FROal PROPERTY Tex NOTICE) 0 V n / 00 -6090
R ]
WORK PROPOSED NEW CONSTR 8 ADD /ALT r ---, r ---, SIGN Q ri DEMOLISH
INSTALL REPAIR 3/� �
PROPOSED USE SFR COMM OTHER ✓ 'J
TYPE OF CONSTRUCTION = BLOCK FRAME I STEEL m' i PI (J� C
DESCRIPTION OF WORK 1 I 3U pCikk / / x,J� ( I 10511 BUILDING SIZE I / ' k 1 SQ FOOTAGE MN HEIGHT 41) ? T1 I t � 1
r �BUILDING 18 1 SOD VALUATION OF TOTAL CONSTRUCTION (;) 3 V Ca
r1ELECTRICAL 18 300 AMP SERVICE )6 0 PROGRESS ENERGY = W.R.E.C.
niPLUMBING IE 1 00
r1MECHANICAL 18 (.Jj'o I VALUATION OF MECHANICAL INSTALLATION
=GAS r i ROOFING Q SPECIALTY r-] OTHER
FINISHED FLOOR ELEVATIONS I FL000 ZONE AREA nYES NO
BUILDER COMPANY m.2_2_14, 1 _ . �r1► . _. 11 _ .:.. 12
SIGNATURE .ice . , ,..„ s : _ - ,.. ® c*RRa,
P .
� / & ��
Address 1 al. -! . • T ) i fl //r.9 License, ( 111 ObI/ 3Sll 1
SIGNATURE C. q M , 1 6 i /())I , � I Cl
Address 1 3 1 S / ' .W� A L ` SIC (J✓� 19 c t License, ( f4 0)/a910 a91() 1
PLUMBER SIGNATURE /' 4,./ , / :�� REGISTERED I Y / N �� Y / C
Address 1 . _i /0, ' _�. ft'T IS rrtpuc Liicensee, II ) II / r. tI I
SIGNATURE L • � r : �(� qcthic EEC LA E/. I Y/ / c 1 r
Address ' I i9' Otel n Id 7 -hit .) Fi 3341y Lim, Icy OD ( •/3 yLg I
OTHER COMPANY
I
SIGNATURE REGISTERED C Y/ N I FEE cuRREA I Y/ N I
Address 1 I License I I
II III IIIuuI IIIIIIII1II I1I1IIIII,IIII11111I11I11
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/ Sift Fence installed,
Sanitary Facilities & 1 du npster,, Site Work Permit for subdivisionsAai ge 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) wooing days after submittal date. Required onafte, Construction Plans, Stornwater Plans tin Sift Fence installed,
Sanitary Facilities & 1 dumpater. Site Work Permit for WI new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW construction.
1 1
Directlons:
Fill out application completely.
Owner & Contractor sign bads of application, notarized
N over S2500,1 Notlu of Commencement is required. (NC upgrades over $7600)
•' Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing sane
OVER THE COUNTER PERMITTING (Front 01 Application Only)
Reroofs if shingles 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.
UNUCENSED 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 buiktings, 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 UEN 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 goverment 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 inoude 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, 1 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 YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR . .. � � r ;
Subsaibed and sworn to (or affirmed) before me this Subscribed and = • to (or : ' • me this /
by . , A •• Js IP' Or
Who Is/are personalty known to me or falhave produced • Is/ are • known • me or has/have produced
as identification. ��/ / / /��, ��_ {)/n as identificalbn.
Notary Public Minn Sn ( / ' / (// Notary Public
Commission No. Com - - • No. / -
Name of Notary typed, printed or stamped N: : of Notary typed, pri ed • - 7!'.`:'
kotari. o,, Ntic :state of Florida
CO : tW 752576
0 ..r: s u1r27F201.7
Pasco County Parcel: 24- 26 -21- 0030 - 00000 -0000 001 Page 1 of 2
I Data Current as Of: Weekly Archive - Saturday, June 26, 2010
I Parcel ID 24- 26 -21- 0030 - 00000 -0000 (Card: 001 of 001)
I Classification 77 - Clubs, Lodges, Halls
Mailing Address Property Value
NHC -FL115 LLC Ag Land $0
6991 E CAMELBACK RD STE B -310 Land $23,782
SCOTTSDALE AZ 85251 -2493
Building $343,365
Physical Address Extra Features $50,112
3751 LAUREL VALLEY BLVD
ZEPHYRHILLS FL 33542 -8408 Market Value $417,259
Legal Description (First 4 Lines) Assessed (Non - School Amendment 1) $417,259
See Plat for this Subdivision •-` Taxable Value $417,259
MAJESTIC OAKS COMMUNITY -
PHASE ONE
PB 35 PGS 107 -112
TRACT C
I Land Detail (Card: 001 of 001)
Line Use Description Zoning Units Type I Price 1 Condition Value
1 7700Q CLUB t OPUD 1 1.88 , AC $12,650.00 1.00
I Additional Land Information
Tax Acres 1.88 Area [3ozH ( Cie --
I Residential Code 3ZHR.A1 Commerical Code RRVPCL4
Clubs, Lodges, !! • 001 of 11
Year Built 1998 Stories 1.0
Exterior Wall 1 Average 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 Sheet Vinyl Flooring 2 Carpet
Fuel Electric Heat Forced Air - Ducted
A/C Central Baths 4.0
Line Description Sq. Feet Repl. Cost New
2 'FOP 1,492 $26,181
3 tIffkl 440 $7,714 1
-i A !SOWN i r4 _Qp i : cif QQ 1) rr
Line Description Year Units Value
1 PAV CON 1998 1,952 $3,416
2 1 TENNSCT 1998 12,960 $22,680
3
CLFENCE ,
1998 4 560 1
4 POOLCON 1998 640 $10,240
5 FIRE PL 1998 1 $2,100
6 I SHUFFLE I 2001 3,744 1 $3,510 I
7 UDU -M 2003 1 j $495 I
8 ' CANOPY 2003 1
840 $6,064 I
Sales History
Previous Owner 1 MAJESTIC OAKS RESORT LLC I
Year Month Book /Page Type Amount
2006 1 01 6825 / 0087 WD ; $0
http: // appraiser. pascogov. com /search/parcel.aspx ?sec= 24 &twn= 26 &rng =21 &sbb= 0030 &bl... 7/6/2010
J� DATE (MMIDDIYYYY)
coir CERTIFICATE OF LIABILITY INSURANCE OP ID CM
PETER -3 07/01/10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTE OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hillcrest Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 1364 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Mount Dora FL 32756
Phone: 352 -383 -8164 Fax: 352- 383 -5899 INSURERS AFFORDING COVERAGE i NAIC #
INSURED INSURER A. Auto- Owners 18988
INSURER B: Owners Insurance Company 32700
Petersons Construction &
Mobile Home Setup, Inc. INSURER C: Southern Owners Ins. Co. 10190
P 0 Box 108 INS S URER D:
Ferndale FL 34729
INSURER E:
COVERAGES
THE POLICIES 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
POLICES. AGGREGATE LMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS,
1 LT MNSRC R I N POLICY (MMIDDIYYTYY DATE (M Y)
LTR SRC TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
U At IJ I<=
B X COMMERCIAL GENERAL LIABILITY 72688080 08/24/09 08/24/10/47 MI ence _ s 300000
CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10000
PERSONAL & ADV INJURY $ 1000000
X Non - Owned/Hired C GENERAL AGGREGATE s 2000000
GEL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2000000
POLICY d LOC
AUTOMOBILE LABILITY
COMBINED
A X ANY AUTO 4101977201 08/24/09 08/24/10 aacderlq NGLELIMIT $ 500,000
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS (Per Perms)
HIRED AUTOS
BODILY INJURY
NON -OWNED AUTOS (Per accident)
-.- -_ ___ -_ -_ -- __ - - - - - - -_ PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
C ANY AUTO 4101977202 08/24/09 08/24/10 OTHER THAN EA ACC $
X G $100,000 AUTO ONLY: AGG $
EXCESS/UMBRELLA UABILTTY EACH OCCURRENCE $
OCCUR (. - CLAIMS MADE AGGREGATE $
$
__ -- DEDUCTIBLE $
RETENTION $ / $
WORKERS COMPENSATION NJ WC S I AI U- O (N
AND EMPLOYERS' LUIBILRY X ITORY LIMBS 1 __ I ER
A o ER IETO ECUBV 72 68 8 081 08/24/09 08/24/10 EL. EACH ACCIDENT $ 100,000
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 100,000
If yes, describe under
SPECIAL PROVISIONS below EL. DISEASE - POLICY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
William Peterson # IH00O0354
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITYZEP DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Zephyrhills REPRESENTATIVES.
5335 8th St. AUTHORIZED REPRESENTATIVE
Zephyrhills FL 33542
ACORD 25 (2009/01) CORD CORPORATION. All
registered rights reserved..
The ACORD name and logo are Istered marks of ACORD
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2009/01)
Peterson Construction &
Mobile Home Setup, Inc.
Po Box 108
Ferndale, Fl 34729
407 - 469 -4366
407 - 469 -5518 Fax
City of Zephryhills Building Division
July 6, 2010
I , William Peterson, authorize Jama Peterson, to act as my
agent and sign on my behalf for all permits. I also authorize
her to register my license. Please call if there are any questions
@352-516-2312.
Thanks,
William Peterson
A n Ge I (p
Notary Public S ` of Florida
Teresa K Yenor
P • INy C 4�mmission DD752576
b pd" Exp /27/2012
•
1 AND AIC INC. )
C PROP
£rce 7988 813-782-5013
4441 Allen Road — Zephyrhills, FL 33541
July 1, 2010
CITY OF ZEPHYRHILLS,
BUILDING DEPARTMENT
Dear Sir,
Effective immediately, the following individuals will be permitted to sign and pick up Permits
for Kevin J Bahr of Bahr's Propane Gas & A/C Inc. State License #CAC043948, City #17.
Lenny Bahr / Jama Peterson
Sandy Bahr/ Stacey Hartwig./
Bobbie Burke' Debbie Steve v'
Jaime Misener f Misty Easler v
Donna Moon v Suzanne Bahr "
Thank you,
e______.//, Z
Kevin B
State of Florida
County of Pasco
Subscribed and sworn before me this 771 day of 4)4 O 2010.
,..4,,,,-, ce ,
/ %Lk
Notary Public 1
NO'PARY PUBLIC -STATE OF FLOP I' ■
Sylvia A. Campbell
-,,: Commission # Dll883699
Expires: JULY 19, 2013
BONDED TIIRU ATLANTIC BONDL\G CO., INC.
NOTARY STAMP
Plan Review
Modular Home Set -ups and Aluminum Packages
1) All property markers shall be exposed and clearly marked at time of first
inspection.
2) All set -backs shall be met.
3) All garages shall comply with section 309.2 ( Fire separation ).
4) Access shall be made available at time of inspection.
5)Manufacture specification manual, approved plans and permit shall be available
at time of inspection.
6)No electric, plumbing, mechanical or framing is to be covered without
inspection and approval first.
7)R.O.W. Use permit required for driveways on public streets.
8) At least 10' separation between other units.
9) All work shall comply with the 2007 F.B.0 and the 2008 N.E.C.
R.O. W. - Right Of Way
F.B.C. - Florida Building Code
N.E.C. - National Electric Code
Richard Crandall Electric, Inc.
395 Louise Drive
Zephyrhills, FL 3354
($13) 788 -3146
July 6, 2010
City of Zephyrhills
Building Department
RE: Building Permits
Effective immediately, the following individuals will be permitted to sign and pick up
permits for Richard Crandall Electric, Inc. State License # ER0012910
Stephen H. Crandall -
Richard P. Crandall
Jaime L. Misener .1
Misty Easler .,
Kevin Bahr
Jama Peterson.;
Thank you,
f Cali m / L
Richard Crandall
Richard Crandall Electric, Inc
STATE OF FLORIDA
County of Pasco
The forgoing instrument was acknowledged before me this Co day of 3A -t f 2010.
Personally known to me ✓ .
� s scorrAJOI
• M MY C N DD 744203
Notary J EXPIRES: January 27, 2012
, ." Banded TMuu Notary Public unwmvtrers
. ,,si �;t IY
ti,�
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: AieVSeY) dYc,Suc%
Date Received: / -7 / & //1
3 38/ 6 4per
Site: � ,� �. • ''
Permit Type: / /�G' ' %'/C 3(
Approved w /no comments: ❑ Approved w /the below comments: 71 Denied w /the below comments: ❑
eke SL/
This comment sheet shall be ept with the permit and/or plans.
7 - 7 7-T
�� /iii
Kalvin z — Plan xamine Date Con actor and/or . • eowner
(Required when • mments are present)
BOB MGKEE 2009/2010 ACCT NO. 787
LAKE COUNTY TAX COLLECTOR LAKE COUNTY BUSINESS TAX RECEIPT RECEIPT NO. 2250000014
STATE OF FLORIDA EXPIRES SEPTEMBER 30, 201C
FACILITIES/ ROOMS SEATS EMPLOYEES RENEWAL
MACHINES $30.00
1
TYPE OF CONTRACTING
BUSINESS
ORIGINAL TAX $30.00
BUSINESS PETERSON WILLIAM W
18745 THIRD AVE
FERNDALE, FL 34729 AMOUNT $30.00
WILLIAM W PETERSON TOTAL $30.00
PO BOX 108
FERNDALE, FL 34729 -0108
PAID - 6004917 08/17/2009 30.00
2089 4911k4010
WO** VAVINgt 0101411.
Lam:
i " rr ar
License :
10 -1 -09
State of Florida - Dapartmant of Highway Safety and MOter V McIsa - DtWYion of Motor Whit Ns
Jul 06 2010 2:56PM HP LASERJET FAX p..a
, :., KE '" . 2000/203A •ACCT''NO1 ." 787
LAKE COUN'ty,1 x COLLECTOR• LAKE coup pS" AXtRECErip
:FACla
S TATE Dlr *LDRICfA : FLL -CEIPT f0 ��SOLk00Q14
iES/ EXPXREs S MEM�'30., 2010
MACHINES ROOMS SEJ4TS PLCYLYEE5
,• EM REN.EVV/ L $30 00
*PE OF CONTRA . r \t 11#0"...-..!4-,,,,:* ` ti \ BUSINESS
:BUSIN PETER�40N WII.,LIAM N► , :...„.L t . ,, 74 9 a
th
• AL TAX $30.00
QRI G I IY
Y'8�4TN�tD �v 1
, FERIi1D4LE, FL 34 5 \ •*' . f
aNILLIi W `PETERSON
P O BOX 1 T1TAl S30it0 3.
FERNDALE, FL 34729 .-0108
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