HomeMy WebLinkAbout13-14189 CITY OF ZEPHYRHILLS
, - 5335-8TH SIREET �°"
(si3)�so-oozo 1 4 9
BUILDING PERMIT
Permit Number: 14189 Address: 5051 5TH ST
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-18700-0040
Improv. Cost: 8,400.00
Date Issued: 5/20/2013 Name: STEBBINS, MADELINE
Total Fees: 120.00 Address: 5051 5TH ST
Amount Paid: 120.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/20/2013 Phone: 813-782-2417
Work Desc: INSTALL 7 REPLACEMENT WINDOW/SIZE/SIZE
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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 aomply 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) aondemned work resulting
from faulty oonstruction 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 si�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,wnsult with your lender or an attorney
before recording your notioe of commenaement."
Complete Plans,Specifications Must Accompany Application.All work shall be performed in aocordance with
Ci Codes and Ordinanoes. NO OCCUPANCY BEFO C.O.
CONTRACTO SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
s�3�ea-oozo City of Zephyrhilis Permit Application Fax����so-ooz�
Building Departrnent _�. -- . - ' �
�-_
Date Rec�ived S_ — Phone Contact for Perni in9 �11 — Q �`j
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Owners Name P� �, � � Phone N ��
�b.�e�__ _.. ���_. J-3- g
Owners Address � S t"� S�{ Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple TiUeholder Address
JOB ADDRESS � LOT# �
SUBDIVISION PARCELIDIJ I ` , �"�1� I Q� �
(OBTANED FROM PROPERTY TAX N07N:E)
WORK PROPOSED B NEW CONS?R 8 ADp/,4LT � SIGN � Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSiRUCT10N Q BLOCK Q FRAME Q STEEL Q
DESCRIPTION OF WORK y—C �/�j� � S�"Ly� �
BUILDING SIZE SQ FOOTAGE� HEIGHT �
BUILDING $ Q', VALUATION OF TOTAL CONSTRUCTION
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QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ . /
V �/
Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� �S y u�h S� �
QGAS Q ROOFING Q SPECIALTY 0 OTHER � `�� �r
FIN�SHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO Lt� � L"�,���
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BUILDER � '
I COMPANY A �"-� � �, �°
SIGNATURE REGISTERED N FEE CURREI. Y/N
Address 1� �,� � '}l. Es �� License* v *
ELECIRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREf� Y/N
Address
Lioense s
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N �E c�iaEn Y/N
Address
License#
MECHANICAL COMPANY
SIGNATURE �cis�rtEO Y/ N FEE CURRE� Y/N
Address
Liceitse i1
OTHER � COMPANY �—
SIGNATURE �cisrErtEO Y/ N FEE CURRE7. Y/N
Address License# �--�
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal dffie. Required onsite,Construction Plans,Stoimwater Plans w/Silt Fence installed,
Sanitary Fecilities&1 dumpster;Site Work Permit for subdivisionsAarge projects
COMMERCIAL Attach(3)complete sets d Building Plans plus a Life Safe4y Page;(1)set of Energy Fortns.R-O-W Pertnit for new cansUvction,
Minimum ten(10)working days aRer submiltal date. Required onsite,Co�stniclion plans,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster Site Work Pertnit for aR new projects,,q�l cammerdal requirements must meet compliance
SIGN PERMIT Attach(2)sets of EngineercU Plans.
""'PROPERTY SURVEY required for all NEW oonstruction.
Directions:
Fill out application completery
Owner&Contractor sign badc of application.notar¢ed
If over 52500,a Notice of CommencemeM is required. (AIC upgrades over s7500)
" Agent(for the coMractor)or Pwaer af Atfomey(fa the owner)would be someone with notarized lefter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Applicadon OMy)
Reroofs ff shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footape)
Driveways-Not over Counter'rf on puWic roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The urxiersigned understands that this permit may be subject to"deed°restrictions"
which may be more restrictive than Courriy regulations. The undersigned assumes responsibility for compiiance 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 accordanoe with state and local regulations. If the
contractor is not licensed as required by law, both the oHmer and contractor may be ated for a misdemeanor violation
under state law. If the owner or irrtended contrador are uncertain as to what licensing requirements may appty 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 conUactor or coMractors, he is advised to have the contractor(s) sign
portions of the"contrador Blodc°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 prope►iy licensed and is not entitled to permitting privileges in Pasco
County
TRANSPORTAl10N IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impad Fees and Recourse Recovery Fees may appy 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 furlfier understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final p�ver release. If Uie project does not involve a oertificate of occupancy or
final power release,the fees must be paid prior to permit issuance. Furthertnore, 'rf Pasco County Water/Sewer Impad
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,FloNda 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 Construdion Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"oNmer",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 commencemerrt.
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 consVuction,zoning and land development. Application is
hereby made to obtain a pertnit to do work and installation as indicated. I certify that no woiic or installatio� has
commenced prior to issuance of a perrr►it 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 govemment agencies may appy to the iMended work,and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies indude but are not limited to:
- DepartmeM of Environmental Protection-Cypress Bayheads, WeUand Areas and Environmerrtally Sensitive
Lands,WaterNVastewffier Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, WeBand Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Dodcs,Navigable Waterways.
- Department of Heafth 8 Rehabilitative Services/Environmental HeaRh 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 certiy that fill will be used only to fill the area witt�in 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 buildirg permit issued under the attached permR 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 OYVNER,I promise in good faith to inform the oNmer of the pertnitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate pertnft may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically inGuded 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,atter,or
set aside any provisions of the technical codes,nor shall issuance of a pertnit preverrt the Building Offiaal from thereafter
requiring a corredion of errors in plans,construction or violations of arry codes. Every pertnil issued shall become invalid
unless the work authorized by such permit is commenced within six months of pertnit issuance,or'rf work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is corrwnenced. 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 eutension. 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 COMMENC MENT.
FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT ��.
Subsaibed and swom to(or affirmed)before me this Subscribed and swan to(or alfirtned)before me this
by �,
Who is/are persanaly knoMm to me or hasRiave praduced
as identifica6on. �,: ,.
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Notary Public Notary Public
Commissfon No. C
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Name of Notary lyped,printed or stamped N ,�
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Professic�nal ProductApproval
USER:Public USer
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� Product Aooroval Menu>Product or Aoolication Sear h>Aool¢a[ion list>Appliution Detail
, 4
"f FL# FL5167-R13
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'������'":;•` . . , � t.� Application TYpe Revision
Code Version 2010
Application SWtus Approved
•Approved by DCA.Apprwals by DCA shall be reviewed and ratified by the POC
and/or the Commission if necessary
Comments
Archrved
Product Manufacturer Simonton Windows
Atldress/Phone/Email 1 Cochrane Ave
Pennsboro,Wv 26415
(800)746-668� EM 2329
tlRany_davies�simonton.com
AuMorized Signature Tiffany Davies
tiffa ny_davies@simonton,com
Technical Representative Tiffany Davies
Address/Phone/Email PO Box 1646
5300 Briscce Road
Parkersburg,WV 26102
(800)542-9118 EM 9329
tiRany_davies�si monton.com
Qual�ty Assurance Representative qqMp
Address/Phone/Email 1827 Walden O�ce Square
Suite 550
Schaumburg,IL 60173
(847)303-5664
webmaster�aamanet.org
Category Windows
Subcategory Double Hung
Compliance Method Certifiwtion Mark or usting
Certification Agency American Archikectural Manufacturers Association
Validated By American Architectural Manufacturers Association
Referenced Standard and Year(of Standard) �ndard Year
AAMA 450 z006
AAMA 450 2010
AAMA/WDMA/CSA 101/1.5.2 A440 Zpps
Eqmvalence of Product Standards
Cert�fied By
Product Approval Me[hod Method 1 Op[ion A
Date Submitted 02/20/2013
http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqtZM1u87qOKm... 5/13/2013
Florida Building Code Online Page 2 of 5
Date Validated 03/27/2013
Date Pending FBC Approval
Date Approve0 04/02/2013
'�Summary oP Products -- - -------- ---�---- -------------- --
i
!FL# Model,Number or Name Degcriptbn
�5167.1 07-09,07-10 and 07-20 Reflections 5500,Pnsm Platinum,Sears 9300,Amcraft Grand Estates �
Premier Vinyl Double Hung
i Limits of Use rtlficatbn Apenq CertNlwte i
� Approved for use in HVHZ:No FL5167 R13 C CAC 07-09 DH 36x63 R50 odf �
I ApproveA for use ouWde HVH2:Yes FL5167 R13 C CAC 07-09 DH 37x76 R65 odf
j Impact Resistant:No FL5167 R33 C CAC 07-09 DH 37x84 R60 odf
1 Desiqn Pressure:N/A FL5167 R13 C CAC 07-0 DH 44x64R50 odf
1 Other.48x80(+/-25 PSF),56x84(+/-25 PSF),53x76(+/-50 PS�, FL5167 R13 C CAC 07-09 DH 47x71 R50 odf
�36x63(+/-50 PSF),44x64(+/-50 PSF),47x71(+/-50 PSF),37x84(+/- FL5167 R13 C CAC 07-09 DH 48x80 R25 odf
!60 PSF),37x76(+/-65 PSF) FL5167 R13 C CAC 07-09 DH 53x76 R50 odf
FL5167 R13 C CAC 07-09 DH 56x84 R25 otlf
FL5167 R13 C CAC 07-10 07-20 waiverto 07 09 otlf I
� uality Aswrance Contract Expiratbn Date �
07/28/2013 �
,� Installation instructbns �
' FL5167 R13 II IN0066 07-09 07-10 07-20 DH 1X odf
� FL5167 R13 II IN0067 07-09 07-1D 07-20 DH 2X odf
�167 R13 II IN0554 07-09 07-10 07-20 DH 37x84 2X odf
Verified By�American ArchiteUUral Manufacturers ASSOCiation
Created by Independent Third Party�
Evaluatbn Reports
FL5167 R13 AE P R 0 07-0 07-10 07- 0 DH 1X odf
Created by InAependent Third Party:Yes �
%5167.2 07-09,07-10 and 07-20 Reflectlons 5500,Prism Platinum,Sears 9300,Amcraft Grand Estates �
Premier Vinyl Double Hung with Transom
j Limits of Use Certlflcaqon Apency CerUficate
� Approved for use in HVH2:No FL5167 R13 C CAC 07-09 PW ov r DH 37x107 R65 odf �
� Approved for use outside NVH2:Yes FL5167 R13 C CAC 07-09 PW over DH 53x107 RSS.odf �
; Impact Resistant:No FL5167 R13 C CAC D7-10 07-20 warv r to 07-0 odf
i Desipn Pressure:N/A Quallty Assurance Contract Erzplration Date
i Other:53x107(+/-55 PSF)&37x107(+/-65 PSF) 04/14/2013
InstalWtbn Instruc[io�s
FL5167 R13 [I IN0063 07-09 07-1D 07-20 DH w-Transom 2X odf
FL5167 R13 II IN0464 07-09 07-SO 07-20 DH with Transom 1X odf
Venfied By•American Architec[ural Manufacturers Association
Created by Independent Third Party
Evaluatbn Reportt
FL5167 R33 AE PER 1647-07-09 07-10 07-20 Double Huna with
ran m 1X. f
Created by indepentlent Third Party�Yes
:5167.3 07-20(Nailing Fin Installation) Retlections 5500,Prism Platinum,Sears 9300 Vinyl Double Hung
�Limits of Use ertlflcatlon Apenq Certlrycate
� Approved for use in HVHZ:No
� FL5167 R13 C CAC 07-20 DH 37x76 R65 odf
I Approved for use outside HVNZ:Yes FL5167 R13 C CAC 07-20 DH 53x76 R50 odf j
' Impact Resistant:No FL5167 R13 C CAC Sim 07-20 DH 56x84 R25 odf
� Desipn Pressure:N/A Quality Assurance Contract Expiration Date
�� Other.56x84(+/-25 PSF),53x76(+/-50 PSF)&37x76(+/-65 PSF) 07/28/2014
Installatbn I�tructions
FL5167 R13 II SND129 07-20 DH 2X odf
Venfied By�American Architec[ural Manufacturers Assxiadon '
Created by Independent Third Party• �
Evaluatbn Reports �
� Created by Independent Third Party
i 5167.4 42-19 ProFinish Brickmould 600 Vinyl Double Hung
;Llmits of Use Certlficat{pn Aqmq CertMcate �
� Approved for use in NVHZ:No F�5167 R13 C CAC 42-1 DH 36x63 R50 odf
Approved tor use outside MVHZ:Yes FL5167 R13 C CAC 42-19 DH 36x74 R50 odf
j Impact Resistant:No FL5167 R13 C CAC 42-19 DH 46x80 R 5 odf
i Desipn Prc.sure:N/A FLS167 R13 C CAC 42-19 DH 52x71 R35 odf j
� Other:52x71(+/-35 PSF),48x80(+/-35 PSF),36x64(+/-50 PSF), uality Assurance Contract Expiradon Date
�36x74(+/-50 PSF) KJ/14/2014
Installatlon Instructbns
FL5167 R13 II IN0148 4Z-1 DH 2X odf
Verified By•qmerican Architectu2l Manufacturers Assxiadon
Created by tndependent Third Party�
Evaluatlon Reports
' Created by Independent Third Party•
�i 5167.5 42-19 ProFinish Brickmould 600 Vinyl Double Hung Twin '
Limits of Use Certlflcatipn Apenq Certlflcate i
i Approved for use in HVHZ:No FL5167 R13 C CAC 42-19 DH Twin 73x63 R35 odf
�Approved for use outride HVHZ:Yes FL5167 R33 C CAC 42-19 DH Twin 73x76 R50�df
;� Impact Resistant:No FL5167 R13 C CAC 42-19 DH Twm 8q 3 R30 odf
Desiqn Pressure:N/A FL5167 R13 ar az-1 DH Twm 7x80 R 0 odf '
Other:89x63(+/-30 PSF),97x80(+/-30 PSF),73x63(+/-35),73x76 Qualfty Assurance Contract Expiratbn Date �
(+/-50 PSF) 10/OS/2014
InstslWtbn Instructbns
FL5167 R13 II INOS50 42-19 DH Twin 2X odf
Verified By�American Architectu2l Manufacturers Association
Created by independent ThirA Party•
Evaluatbn Reports
Created b Inde ndentThird Party �
;5167.6 42-19 ProFinish Brickmould 600 Vinyl DouWe Hung Triple �
�Limits of Use rtlficatlon Apency Certllk�ate �
ApD�aYed for use in HVH2:No FL5167 R13 C CAC 42-19 DH Tnole 109x74 R35 odf
i Approved for use outslde HVXZ:Yes ualky Assurance Contract Eupiration Date
i Impact Resistant:No 10/OS/2014 �
I Desipn Pressure:+35/-35 InstalWtbn Instrucqons
; Other.109x74 FL5167 R13 II INOS51 4Z-19 DH Tnole 2X odf
Venfied By•American Architectural Manufacturers Associatlon
Created by Independent Third Party� i
http://www.floridabuilding.org/pr/pr app_dtl.aspx?param=wGEVXQwtDqtZMlu87qOKm... 5/13/2013
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2013083839
Rcpt:1519904 Rec: 10.00
D5: 0.00 IT: 0.00
05/13/13 L. Serin, Dpty Clerk
Permit Number
ParcellD Number i� • '� _ � PRULA S 0'NEIL,Ph D PASCO CLERK & COMPTROLLER
� C'�' � �-� 05/13/13 10:35am 1PGof 1
NOTICE OF COMMENCEMENT OR BK ��71, 2585
State of Florida
THE UNDERSIGNED hereby gives notice that improvements will be made to ce�tain real property, and in accordance with Section 713.13 of the
Florida Statutes,the foi(owing information is provided in.this NOTICE OF COMMENCEMENT.
1.Description of property(legal description): iQ' 1 � V� S � ,j" Q��� cl
a)Street(job)Address: S p S� S -�� � Z ° p�����,��� i�� �:r` ' �S i%�-
2.General description of improvements:
�`�.Q�l.c.��►.�+.� Wl�Sl�c�c.+S
3.Owner Information or Lessee informaUon�f the Lessee contracted for the improvement:
a)Name and address: �h c��1,�i..i� �C 7 d��•� � �c7� 1 S � �1 '�..4.�1�1�i��i 1 L�� '��. ����y�--
b)Name and address of fee simple 6tleholder(�f drfferent than Owner listed above)
c)Interest in property: (�j�;J�..
4.Contractor Information /�
a)Name and address: -R��j��__+`cc .�o �4�t U 1 C�.�9 ` �� ���L�k� �.r', --�M�'�fl � ��'� ��
b)Telephone No.: `7�7 • `
�b`i-� �7 O� Fax No.:(optional) �a"'�.. (vY 1 �i 3-)`I
S.SuretSr(if applicable, a copy of the payment bond is attached)
a)Name and address:
--- --- --- ------- ----
)Telephone No.:
--- ---------------------------------- - --- - --------
c)Amount of Bond: $
6.Lender
a)Name and address:
b)Telephone No.:
7.Persons within the State of Florida designated by Owner upon whom notices o�ofher documents may be served as provided by Section
713.13(1)(a)7.,Florida Statutes:
a)Name and address:
bj Telephone No.: Fax No.:(optional)
8.a.ln addition to himself or herself,Owner designates of �
to receive a copy of tfie Lienor's Notice as provided in Section 713.13(1)(b),Florida Statufes. •
b)Phone Number of Person or entity designated by Owner:
9•Expiration date of notice of commencement(the expiration date may not be before the completion of construc�ion and final payment to the
contrador,but will be 1 ear from the date of recordin unless a d�ferent date is ' ed: y�
� WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
` CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,S,�CTION 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR
� PAYING TWICE FOR IMPR011EMENTS TO YOUR PROPERTY.A NOTICE OF COMAAENCEMENT MUST BE RECORDED AND POSTED ON
; THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTENO TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
; ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMEMT.
Under penalty of perjury, I declare that I have read th oing notice of commencement and that the facts stated therein are true to the best of my
knowled e a �
���.,.�.� -- � � IW p��B I ;�L S i�� ,,ps
Sign af r or Le see,or Owners or Lessee's(Aufha¢ed OfficedDirectodPartnedM�ager) M Name and ProNde na ��,'v
The foregoing instrument was acknowledged before me this � � �{i _ day of ( � �''s rde�ot�ce)
' � � --- -�t----
` , i
bY �`!��►.p'�.1,_�:�� .J��`Oh�rb as �,r�►��__ �
fOf -- _ --� -------------- (h�Pe of autho"ty.e.g.oificer,trustee,attaney in fact)
--------------------�-�- 1.�—__------- ,as
(Name of Person) (type of authority,...e.g.officer,trustee,attomey in faG)
for (name of paRy on behalf of whom instNment was executed).
Personally Known Q- Produced ID .�,.�.���� �,
—� �------- — -
Type of ID - ---- �� _°.. .°��' �Y � ION����51�
-----. -- --..��--------- Notary Signature
Print name -� '; � �� , ,
---�---- ���
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y . ' T}�l:E AiJi�C.:��n'f��.;T Cu�=..r C�F��!E. C)C1rUft�F�l�(
�, �c C�PJ �IL��R�F PUi��.l;;RECCJ�[� is�J T?-!�`�UFr ICE
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�c . �887 .
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� City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
, �
Contractor/Homeowner: !!J Qvt e'�? ���� ��S l �
Date Received: � ��--� ,3
site: L5 D �.�^l LS�' ��
Permit Type: 1� ' 1�LL i'1'1 P�'1 r �� � 'S �
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.
�� �
�% � �� ��
Kalv Sw' —Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)