HomeMy WebLinkAbout11-12438 CITY OF ZEPHYRHILLS f
5335-8th Street ��
(813)780-0020 12438
ELECTRICAL PERMIT
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Permit #:12438 Issued�: 10/12l2011 ��� 4630 WISTERIA DR
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRICAL MISC Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 758.00 Total Fees: 60.00 Subdivision: WHISPERING OAKS
Amount Paid: 60.00 Date Paid: 10/12/2011 Parcel Number: 15-26-21-0160-00000-0330
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Name: ADT SECURITY SERVICE, INC Name: BARNETT, RONALD & FANNIE
Addr: 5471 W. WATERS AVENUE, STE 1000 Address: 4630 WISTERIA DR
TAMPA, FL 33634 ZEPHYRHILLS, FL. 33542
Phone: 813 806-7000 Lic: Phone: (813 779-1722
Work Desc: INSTALLATION LOW VOLTAGE
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ELECTRICAL FEE 60.00
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ROUGH ELECTRIC
CONSTRUCTION POLE
PRE-METER �
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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 aorrections not made when inspection called d) work not ready for
inspection when called e) permit not posted on job site � plans not at job site g) work not aocessible.
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.
"Warning to owner: Your failure to reoord a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of oommenoement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
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-- ONTRACT R PER OF I
�RMIT XPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application ��( Fax-813-780-UO21
. • Buiiding Department I
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Date Received I/� ,� _� f I
v Phone Contact for Permitting 3 �j __ 7�j �
Owner's Name �,v� � n - �� 3 i � �
Owner Phone Number `� 2� �
Owne�'s Address '�1 �� � � C � �
Owner Phone Number
Fee Simpie Titleholder Name �
Owner Phone Number �
Fee Simpie Titleholder Address �
JOB ADDRESS ` � � � p�
, LOT #
SUBDIVISION �IIJ� l S P�(Z (�t.G Q/� �( �, PARCEL ID# � S'L �"' Z( OI b�' OO(�U -� 3 3�
WORK PROPOSED (OBTAINED FROM PROPERTY TAX NOTICE) I
CONSTR ADD/ALT �� SIGN Q Q DEMOIISH I
INSTALL 8 REPAIR
PROPOSED USE � SFR � COMM � OTHER
TYPE OF CONSTRUCTION � BLOCK a FRAME � STEEL �
DESCRIPTION OF WORK �/Cs .� �J� � I Z� V Q C TjC` �' � S � -� � `
s
BUILDING SIZE SQ FOOTAGE�
HEIGHT
�BUILDING $ � �
VALUATION OF TOTAL CONSTRUCTION
DELECTRICAL $ AMP SERVICE '
0 PROGRESS ENERGY � W,R.�.C,
�PLUMBING $
2( I
�MECHANICAL $ �(2,��Jv �
VALUATION OF MECHANICAL INSTALLATION
[�GAS Q ROOFING Q SPECIALTY �� OTHER I
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA
QYES NO I
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BUILDER
SIGNATURE COMPANY
REGISTERED Y/ N FEE CURRE� Y/ N
Address � ----,}.�
License # �
ELECTRICIAN COMPANY ' �
SIGNATURE REGISTERED I
Y/ N FEE CURRE� Y/ N I
Address
License #
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N f
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Address
License #
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� �' /(� I
Address
License #
OTHER COMPANY � S � 7
SIGNATURE �
�� u� � REGISTERED Y/ N FEE CURREP Y/ N
�� r-��ss� � y . 7 '- �� � QA License # `. � � 0 � 1 [ L
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/ Sitt Fence installed,
Sanitary Facilities 8 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 insta led,
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. I
""PROPERTY SURVEY required for all NEW construction.
Directlons:
Fill out application completely.
Owner 8 Contractor sign back of application, notarized �
If over $2500, a Notice of Commencement is required. (A!C upgrades over $7500)
*" Agent (for the contractor) or Power of Attorney (for the owner) would be someone wlth notarized letter from owner authorizing same I
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
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aco ��' CERTIFICATE OF LIABILITY INSURANCE �ATE(MMlDDlYYYy)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER7IFICATE HOL ER.
CER7IFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CER7IFICATE OF INSURANCE DOES NOT CONSTiTUTE A CONTRACT BETWEEN THE ISSUING INSURER(SJ, AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CER7IFICATE HOLDER.
IMPORTANT: Ii the certiflcate holder is an ADDI710NAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subJect to
the terms and conditions of the policy, certain policies may requfre an endorsement. A statement on this certificate does not confer rlghts to the
certiflcate holder In Ileu of such endorsement�s).
PRODUCER
NAME:
Mal'Sh USA IfiC. PHONE FAx
1 166AvenueoftheAmericas A/C No Ex :(212� 345-5000 A!C No:
New York, NY 10036 ADDRESS:
INSURER AFFORDING COVERAGE NAIC /
INSURED INSURER A. AGCS Marine Insurance Company (Allianz) 22837
INSURER B: CHARTIS CASUALTY COMPANY 40258
ADT Security Services, Inc. INSURER C Commerce 8 Industry Ins Co. �gq�p
32100 US Hwy 19 N INSURER D� Illinois National Insurance Co. 23817
Palm Harbor, FL 34684-3727 INSURER E. NaYI Union Fire Ins Co. of Pittsburgh, PA 19445
United States INSURER F• New Hampshire Ins. Co. 2��
COVERAGES CERTIFICATE NUMBER:934148 -A REVISION NUMBER:
THIS IS TO CERTIFY THAT 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 qNY CONTRACT OR QTHER 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
��R TYPE OF INSURANCE POLICY NUMBER POLICV EF POLICY %P
F GBJERAL LIABILIN MM! M! LIMRS
GL 2449607 (Primary GL) 10J1/2011 10/1/2012 EACH OCCURRENCE $ $2,000,000.00
X COMMERCIAL GENERAL LIABILITY
CLAIMSMADE X❑ OCCUR PREMISES Ee ocaRence 3 $1,000,000.00
OWNER'S S CONTRACTOR'S PROT
MED ExP (Any one person) $ $10,000.00
PERSONAL $ ADV INJURY $ $2,000,000.00
GENERAL AGGREGATE $ $4,000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER
X POLICY PR � LOC PRODUCTS-COMPlOPAGG $ $4,000,000.00
AllTOMOBILE LIA81LfTY $
E CA3506468 (Vq) 10/1/2011
E X CA 3508484 (AOS) 10/1/2011 10/1/2012 Ea accident $7,500,000.00
ANY AUTO BODILY INJURY (Perperson) $
E AlL OWNED SCHmU�ED CA 3506465 (MA) 10/1/2011 10/1/2012
F nU70s ,aUTOS Cq 3508466 H
X HIRED AUTOS X NON-0WNED M)(Primary ,qL) 10/1/2011 10/1/2012 BODILY INJURY (Per atadent) S
AUTOS
Pe�eccident AMAG $
UMBRELLA LIAB X NEW HAMPSHIRE CSL $ $250,000.00
OCCUR
F x EXCESSLIAB aAIMS-MADE CA3506467(NH)(ExcessAL) 10/1/2011 10/1/2012 EACHOCCURRENCE $ $5,500,000.00
GL 2449608 (Excess GL) 10/1/2011 10/1/2012 pGGREGATE PROwCrs - g $11,000,000.00
DED RETENTION $
B WORKERS CoMPENSAT1oN C 0158840 5( T,GA,PA,SC NEW HAMpSHIRE (CSL) ; $7,250,000.00
APD EMPLOYERS' LIABILITY � 10/1/2011 1 O/1/2012 X W S A U- H_
C Y! N wc o� 5ssaoos �F��
ANYPROPRIETORiPARTNER/ExECUTIVE WC015884008 10/1/2011 10/1/2012
D OFFlCERlMEMBER E:-:CLUDED9 � N! A (MI} E L EACH ACCIDENT $ $2,000,000.00
E (Mantletory in NH) WC 015884004 (CA) 10/1/2011 10/1/2012
F If y es, destribe under WC 015884007 (MA, ND, OH, WA, � 0/1/2011 10/1/2012 E L DISEASE - EA EMPLOYEE $ $2,000,000.00
DESCRIPTION OF OPERATIONS below wl 10/1/2011 10/1/2012
E L DISEASE- POLICY LIMIT $ $2,OD0,000.00
A Builder's Risklinstallation/Contract Works OC & OCW 9112ggpp 10/1/2011 10/12012 USD $1,000,000.00 perjobsite
A Rental Equipment/Contractors Equipment OC & OCW 91128600 10/1/2011 10/1/2012 USD E1,000,000.00 perjobsite
A Blanket Transit OC & OCW 9112g600 10/1/2011 10l1/2012 USD $1,000,000.0p per conveyance
DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES (Akach ACORD 101, Addklon� Rsmvks Seheduls, If more apace is requintq
Jo6 Number: town 174 Customer Number: town 174 Town Number: town 174
Please refer to attached ACORD 101 for further remarks.
CERTIFICATE HOLDER CANCELLATION
City of Zephyrhills
5335 Eighth Street SHOULp ANY OF TNE ABOVE DEBCRIBED POLIpEB BE CANCELLED BEFORE
Zephyrhills, FL 33540�312 7'1�E EXPIRATION DA7E THEREOF, NOTICE WIIL BE DELIVERED IN
United States ACCORDANCE WITN THE POLICY PROV1810N8.
AUTHORIZED REPRESENTATNE
'i �
�M�� INC. BY� ��� � �
Lynthis IGm, Cawelty Pmgrsm Frenklin Ndlock, GbbA M1�me
Trenai[P nm
ACORD 25 (2010/05j The ACORD name and logo are registered marks of ACO D ORD CORPORATION. All rights reserved.
Pasco County Parcel: 15-26-21-0160-00000-0330 001 Page 1 of 2
Data Current as Of: Weekly Archive - Saturday, October O1, 2011
� Parcel ID 15-26-21-0160-00000-0330 (Card: 001 of 001)
Classification 01 - Single Family
Mailing Address Property Value
BARNETT RONALD C& FANNIE L Ag Land t, , I $p
4630 WISTERIA DR Land �����,+�,K�Y� �n"'�'�' ��'� 1f $22,261
ZEPHYRHILLS FL 33542-5648 Building �''�''�/ � �� ~� y y � ��-� �s4,9so
Physical Address � ��� ��"'��'�����. L. !_
Extra Featurp.� � � � $Z,g71
4630 WISTERIA DR E""LHN� ��`f��r"���'�j��w � J
ZEPHYRHILLS FL 33542-5648 Market Value $110,112
Assessed (Save Our Homes) $99,59g
Legal Description (First 4 Lines) Homestead 196.031 -$25,000
� Non-School Additional Homestead Exemption - $25,000
See Plat for this Subdivision �t"'
WHISPERING OAKS Non-School Taxable Value ��g,��$
PB 14 PGS 86-87 LOT 33 School District Taxabl�ij�Q�{ SHALL COMPLY WI �
OR 4395 PG 1106 Warning: A significant taxable vp �������N
Click here far details end infa. r '��������D
Land Detail (Card: 001 of OOi�ITYOFZEP
Line Use Description Zoning Units Type Price Condition Value
� 0100 SFR OOR2 6,000.00 SF $3.20 1.00 $19,200
�_� 0100 SFR OOR2 9,875.00 SF $0.31 1.00 $3,061
Additional Land Information
Acres 0.36 Tax Area 30ZH FEMA Code � Residential Code WISPLPI
Building Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1980 Stories 1 0
Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 None
Roof Structure Gable or Hip Roof Cover Metal
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Cork or Vinyl Tile Flooring 2 Carpet
Fuel Electric Heat Forced Air - Ducted
A/C Central Baths 2.0
Line Description Sq. Feet Repl. Cost New
� 1 � BAS � 1,536 $92,744
2 UEA 240 $7,246
� 3 FGR 400 $9,661 �
Extra Features (Card: 001 of 001)
Line Description Year Units Value
1 DWSWC 1980 770 $645 �
z CON PTO 1987 396 $535
3 SCRN-AF 1990 620 $558
4 � UDU-M �� 1990 1
$685
5 DCFENCE 2006 300 � $448
Sales History
Previous Owner WAUGH ROGER M JR & GLORIA A
� Year � Book/Page Type Amount
2000 � 06 4395 / 1106 WD $78,500
199z �4 3013 / 0359 WD $65,000
1986 � 11 1564 / 0818 WD $55,000
http://appraiser.pascogov.com/search/parcel.aspx?sec=15&twn=26&rng=21 &sbb=0160&b... 10/6/2011
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: l �� �'�C�j
Date Received: `� — � ��
Site: _ "�`� - `�(,�t�>�i'i� �!�—
Permit Type: (•`��`�
Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
�
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Ka1 n S ' z lans Examiner Date Contractor and/or Homeowner
(Required when comments are present)