HomeMy WebLinkAbout11-12517 CITY OF ZEPHYRHILLS �,/
5335 - 8TH STREET 12517
(813)780-0020
• BUILDING PERMIT
Permit Number: 12517/12518 Address: 7800 GALL BLVD
Permit Type: SIGN ZEPHYRHILLS, FL.
Class of Work: WALL SIGN Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: ZEPHYR COMMONS
Est. Value: Parcel Number: 35-25-21-0130-00000-0050
Improv. Cost: 9,850.00
Date Issued: 12/13/2011 Name: SF ZEPHYR COMMONS LP
Total Fees: 187.50 Address: MARK AM ON CANADA L3R 5R7
Amount Paid: 187.50
Date Paid: 12/13/2011 Phone:
Work Desc: INSTALLATION 3 DIRECTIONAU4 LANE /2 CLEARANCE
NW SIGN INDUSTRIES
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ELECTRICAL ROUGH
FINAL
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 � 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.
"Warning to owner: Your failure to record a notice of wmmencement 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, Specificatio ust Accompany Application. All work shall be performed in accordance with
i Codes and Ordinances. NO OCCUPANCY BEFO C.O.
- � ,
CO CT IGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
� ,�n �" (� ��
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 �=g' �' �
Building Department � r � I � ]''7
�� � i �_
Date Received Phone Contact for PermiKin � 2 �- ✓` :� �� ��.{�
TT__f_f"T-� � 1 � 1� �
Owner's Name J r Z� �Owner Phone Number � �
Owner's Address � 5 I ��"'�OWner Phone Number �
Fee Simple Titleholder Name � Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS � D OG V� ' LOT # �
SUBDIVISION PARCELID�1 35-25 �05�
(OBTAINED FROM PROPERTV TA% NOTICE�
WORK PROPOSED e NEW CONSTR B ADDlALT Q SIGN � Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR � COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK FRAME Q STEEL Q
DESCRIPTION OF WORK � A � �S C ��� SI v' 'S
V
BUILDING SIZE SQ FOOTAGE � HEIGHT
�BUILDING $ � VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�PLUMBING $ �--�+,�
/ "
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION / ' 1 G
L (/ /
��
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
rJ ,
BUILDER • � • y COMPANY • • • • • ` • • ••
SIGNATURE � REGISTERED Y/ N FEE CURREN Y/ N
Address � License #
ELECTRICIAN � O• COMPANY N� S �
SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/ N
Address L I License # E 2
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREI: Y/ N
Address License #
MECHANICAL � COMPANY
SIGNATURE REGISTERE� Y/ N FEE CURRE� Y/ N
Address License # �
OTHER � COMPANY � �
SIGNATURE REGISTERED Y I N FEE CURRE� Y/ N
Address License #
1111111111111111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-0-W Pertnit for new construction,
Minimum ten (10) working days attar submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster, Sile Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans pius a Life Safaty Page; (1) set of Energy Fortns. R-0-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, ConsWCtion Plans, Stortnwater Plans w/ Silt Fence installed,
Sanitary FaaliUes 8 1 dumpster Site Work Permit for all new projects. All commercial reqwrements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
'°'PROPERTY SURVEY required for all NEW constr�ction.
1 1 1 1..1 1 I I�L I�i�l..l -
Directions:
Fill out application completely
Owner 8 Contractor sign back of application, notarized
If ovar 52500, a Notice of Commencement is required. (A/C upgrades over 57500)
" Agent (for the contrector) or Power of Attomey (for the owner) would be someone with notarized letter trom owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
• NOTIC,E 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 ihey 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 IMPACTIUTILITIES 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 expaRSion 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 refease, 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 amendedi: 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 "owne�' 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 instailation as indicated. I certify that no work or installation has
comme�ced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
consiruction, 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 Engi�eers-Seawalls, Docks, Navigable Waterways.
- Department of Health 8� Rehabilitative ServiceslEnvironmental 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 perrrqtted 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 affeci 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 permii 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 ihe Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued sha�l 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 abando�ed
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 FIN NG, CONSULT
WITH YOUR LENDER OR AN ATTORN BEFORE RECORDING YOU EMENT.
FLORIDA JURAT (F.S. 1 .
OWNER OR AGENT CONTRACTOR
Subscribed and swor to (o ed) e this Subscribed and swor (or ir ed be e thi .
f� f�_by �%/ by
ho lare personal y nown o me or as ave produced o is are personally known to me or has have produced
as identification. as identification.
Notary Public Notary Public
C mission No. Q mmiss�on N. '� � 'O p
.l�r, Jcnr,; r L Jo
Name of t�d4 , pn ����— Name of Not�rti jya$�, printe � A, IV11'C1t L��N
* MY COMMISS{ON # EE 1310�4 N` t�v
* :� '����' c * MY COMMISSION 0 EE 1310Y4
EXPIRES: Octaber 2, 2015 * EXpIRES: October 2, 2015
sT1 r FOF F���\oc �d Thru Budgd No1ary Services
���'oF c�o°'��' B�ded i�t Bu�d Not�Y ��ces
2851 John Street, Suite One, Markham, Ontario L3R 5R7
Main 905 477.9200 Fax 905 477 7390
SF ZEPHYR COMMONS GP LLC
October 7, 2011
City of Zephyrhills
Building Dept.
5335 8 St
Zephyrhill, FL 33542
Re: Sign Permit for Chase Bank — Zephyrhills Kossik — NBD # 22501
To Whom It May Concern:
This letter shall serve as authorization for NW Sign Industries to sign any necessary documents
for permit obtainment and also to fabricate and install signage for Chase Bank located at 7800
Gall Blvd., Zephyrhill, FL 33542 per attached plans.
Sin e ly,
Robe . Green
Manager
L �
Sworn to an su scribed before me this � 1 day of �C�ObC� , 20�, personally
appeared for me who is personally known / produced a
valid dri ers' cense as identification. �
Notary Pu lic (Seal)
My commission expires: � � �
�����
�
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: Gf1 �J; C���L���' �f
Date Received: `� � Z �j ' l/
site: �7��1J �i�--f% /..�/l/1�
, ,/ �,, ' �-
Permit Type: �� � � }2(� 7� ���
Z ) C e ��,
Approved w/no comments. Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment shee�ha be kept with the permit and/or plans.
�����
Kalvin — Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
123467 07:46:12 a.m. 11-10-2011 3l5�
v' � OP ID: NC
'`�� CERTIFlCATE OF LIABILITY iNSURANCE °";; �„°; ""'
THi3 CER7IFICATE IS ISSUED AS A MAITER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLbER. THIS
CERTiFICAiE DOES NOT AFFlRMATyVELY OR NEGATIVELY AMEND, EXTENO OR ALTER TNE COVERAGE AFFORDED BY THE POLICIES
BELOIN. THIS CERTIFICATE OF IN8UR/WCE DOE8 NOT CONSTITUTE A CONTRACT BEIWEEN THE IS9UING INSURER(S�, AUTHORfZED
REPRESENTATIVE Ott PROdUCER, AND THE CERTIFICA7E HOLDER.
IMPORT/WT: If the wAHlcate holder Is sn ADDITIONAL INSURED, the poiieypes) must De endoned. N SUBROGATION IS WM/HD, subj�et to
M� tstms and conditlont of !h� policy, c�riain polides may roquiro an sndors�ment A stabmerN on tMs ceAMcats dots not confer ri
phb to the
osrtlfleab holdsr in Ilw o( such endonem s.
r�aoucea 610-2T9-855Q
The Addis Group. inc. � F
2500 Rsnaissanoe Blvd. Sts 100 610-�79-8 ,� �:
Kiny ot Prussla, PA 19408-2772 � ss:
Gary W. Warron, CPCU, ARM NWSIG-1
s �FOao�we carenr►ce wuc r
��� NW Sign Industries, lnc iNSUaER�:Zurich American Insurance Co. 16535
360 Crider Avenue �awees e. Travelers Pro Casual �g�4
Moorestown, NJ 08057
wsu�a c :
INBURER D :
INSURER E :
URER F :
COYERAGES CERTIFICATE NUIiABER: REVI410N NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE lNSUREO NAMEb A80VE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REpUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR �THER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN tS SUBJECT TO ALL THE TERMS,
EXCWSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
� TYPE OFIN6URANCE
POUCY NUNBER LIMIT6
GENERAL IIABIUTY
EI1CH OCCIlRRENCE S 1,000.00
A X co��cuw��qn�uneiuTV L08196415 03101H1 03/01112 M� Fq a nen s SOQ,O
cwMS-wuoe QX occuR �o exr �a�r a+e oana+l s 10.00
r�HSOwu a nov in�xrar a 1,000.00
GENERAL AGGIiEGpTE S Z,OOO,OO
c,�►r�. Acc�care uMrr AaPUES a�: �aooucrs • cotiwroP Acc S 2�000,00
aoucv X P R 0 ' �q� _
AUTOMOBILE LIA8ILITY COA�INEO SINGLE 11M17 s �,OOO,OO
A X e,NVquio BAP6198415 031fl1h1 p3fO1H2 (E'accid�n�
X AI.LOWNEDAUT0.S
BoDtt.r �wuRY (ax Peraanl S
SCHEOULED AUTOS
BOOILYIWURY(PeraxideM) S
X HIRED AUTOS ��� ��'� s
{Pbr ictiOsM)
X NON-0WNEDAUTOS =
j( :250 Comp 500 COLLISION s
UMBRELLA LU8 X��R �cH occu� s 25,000,
EXCEE8lU18
B 01UN Ko64o�s66 oarou�� o�ov,s "��`TE s ss,000,00
oeoucne�
a
EM1
S
WONIIER6 COMPENBATqN WC STA7U. OTi+
ANO EMPLOYER3' LIA6ILT' X ,
A � � CEWMEb6EREX�CLUp E p?�� VE Y �N N1A C8196497 03J01H1 03/01H2 �.�.�,�� a 1,000,00
�� °a°D1r rn �� E.�. asFwse - en �ore s 1,000.00
H dasaiba under
Po �� °��_'"� " °M' el.asEwse.apucvw,rr s 1,000,00
q P�operty 12776 01l09N1 01101l12 elank�t
/� onbacWn Eqpbnt 12776 z7,1S8�18
o1ro1H1 o1ro1H2 uwucc. zs,00
DESCRIP7qN OF OiERATIONS I LOCATIONS! VEHICLES (Atucn ACORD 101, AdWtlond Ramrks SeAWW�, H mon �c� Is raqulnd)
CERTIFICATE HOLDER CANCELLATION
COFZEPH
8HOULD ANY OF T1iE ABOVE DESCRlBED pOLICIES BE CANCELIED BEFORE
City of Zepbyrhillg THE EXPIRA71pN DA?E 7NEREOF, NOTICE WiLL BE OELIVERED IN
5335 Btl1 Subet, ACCORDANCE WITM THE POLICY pROVISIONS.
Z�phyrAQls, FL 33'342
AUTHORIZED REPRE9ENTATNE
�t� o.."' �,/ • C../ �.,s.,1�
� 1988-2009 ACORD CORPORATION. All rigf►ts reserved.
ACORD 23 (2069/09) The ACORD name and logo are registered marks of ACORD
1
07:46:03 a.m. 11-10-2011 2/�—
123467
NW i N DUSTR! ES
BETTER FASTER SMARTER
2416 Sand Lake Road,
Oriando, FL 32809
Phone (407} 251-931 I Fax (�0� 25l-9351
www.nwsi�r 'nduscries.com
I, Ronsld Brndie, License Number 512040224 hereby authorize the foliowing to act as my
agent(s) in obtaining permits in the _� of' Ze� rhi pS , Florida.
Name of AgenNsl
��' jQ1 � ri C1uPZ
..�
Iaob Florid
l.ance W; Iscr�
This aut6orization shall remaiu ln effect untll cancelled in writing by the undersigntng license
holder.
Lianse d ' ignature
State of Florida
County of Orenge
Sworn to and subacribed before me this CJQ , day ot , 20 / by
��'t� *.�'�UU-.C�+ , who is personally know to me or produced
as identificstion.
�]�er�n��er L• •�t�r1 seai
Name of Notary Printed
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