HomeMy WebLinkAbout13-14581 CITY OF ZEPHYRHILLS
5335-8TH STREET
, ' �sis)�so-oo20 14581
MOBILE HOME SET-UP
Permit Number: 14581 Address: 7836 KAY MARIE AVE LOT 314-315
Permit Type: MOBILE HOME ZEPHYRHILLS, FL.
Class of Work: MOBILE HOME SET-UP Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: GRAND HORIZONS
Est.Value: Parcel Number: 34-25-21-0180-00000-3150
Improv. Cost: 13,100.00
Date Issued: 10/02/2013 Name: DEREXSON, ROGER& NANCY
Total Fees: 7,226.76 Address: 35604 WINTERSWEET LN
Amount Paid: 7,226.76 ZEPHYRHILLS, FL 33541-5046
Date Paid: 10/02/2013 Phone: 813-780-1862
Work Desc: INSTALLATION OF MOBILE HOME 40 X 49
JAMES O MORTON ELECTRIC CO.,INC. PLUMBING FEE 40.00 MECHANICAL FEE 40.00
BMI LLC SEWER CONNECTION MOBILE 1,005.00 WATER CONNECTION MOBILE HC 320.50
BAHR'S PROPANE GAS&A/C, INC. WATER METER RES 3/4" 348.09 IRRIGATION CONNECTION 266.00
IRRIGATION METER 348.09 PARK FEES MH 573.73
POLICE IMPACT FEE 254.00 FIRE IMPACT FEE 273.00
PUBLIC SAFETY 5% 26.35 TRAFFIC IMPACT FEE 99% 3,595.68
TRAFFIC IMPACT FEE 1% 36.32
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MOBILE HOME ELECTRIC
MOBILE HOME A/C
MOBILE HOME PLUMBING
FINAL �
REINSPECTlON 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 inspection called d)work not ready for
inspection when called e) permit not posted on job site t) 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 pubiic 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
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
� �
CONTRAC IGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS
UTILITIES WORK ORDER
WATER ACCOUNT NO.: DATE: Oct 1,2013
OWNER/RENTER/BUSINESS:Roger&Nancy Derexson CONTACT PERSON: BMI LLC
MAILING ADDRESS: 7836 Kay Marie Ave lot 314-315 PHONE NUMBER: 813-714-1476
Zephyrhills FI 33542 EMAIL ADDRESS:
SERVICE ADDRESS: 7836 Kay Marie Ave
SHUT OFF SERVICE ❑X OX WATER
TURN ON SERVICE ❑ ❑ SEWER
INSTALL MEfER ❑X ❑ GARBAGE
READ METER ❑ ❑X IN CITY
CHECK MEfER ❑ ❑ OUT CITY
OTNER ❑
DESCRIBE OTHER: 3/4 irrigation
NUMBER OF UNITS
DEPOSIT AMOUNT
AMOUNT LAST BILL
DATE
MISC. CHARGE
METER: FULL
IIRRIGATION 3/4 I
WORK COMPLETED BY&DATE ORDER TAKEN BY: Jackie Boges
COMPLETED
_ ��
ORDER GIVEN BY: �
Revised 9l2010
CITY OF ZEPHYRHILLS
UTILITIES WORK ORDER
WATER ACCOUNT NO.: DATE: Oct 1,2013
OWNER/RENTER/BUSINESS:Roger&Nancy Derexson CONTACT PERSON: BMI LLC
MAILING ADDRESS: 7836 Kay Marie Ave lot 314-315 PHONE NUMBER: 813-714-1476
Zephyrhills FI 33542 EMAIL ADDRESS:
SERVICE ADDRESS: 7836 Kay Marie Ave
SHUT OFF SERVICE X❑ OX WATER
TURN ON SERVICE ❑ ❑ SEWER
INSTALL METER X❑ ❑ GARBAGE
READ MEfER ❑ ❑X IN CITY
CHECK MEfER ❑ ❑ OUT CITY
OTHER ❑
DESCRIBE OTHER: 3/4 meter
NUMBER OF UNITS
DEPOSIT AMOUNT
AMOUNT LAST BILL
DATE
MISC. CHARGE
MEfER: FULL 3/4
IIRRIGATION I
WORK COMPLETED BY&DATE ORDER TAKEN BY: Jackie Boges
COMPLEfED
ORDER GIVEN BY:
Revised 9/2010
°"-'tl1-"u`� c:ity of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received i 2 %�
Phone Contact for PeRnittin �� / __ / ��
Owner's Name ��'� ��' Owner Phone Number �. - C - I ���
Owner's Address �
Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number r
Fee Simple Titleholder Address
JOB ADDRESS � (�� ] LOT# �Cy-31r
SUBDiVISION 7 r PARCEL IDA� � �j , 1 (�i Q � �
(OBTAINED FROM PROPERTY TAX NOTICE)
1NORK PROPOSED � NEW CONS7R 8 ADD/ALT �� SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE � SFR Q COMM � OTHER
7'YPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK ��-� Q l` (�����, ��'�����
BUILDING SIZE ) � SQ FOOTAGE I� � HEIGHT ��
QBUILDING S�l , VALUATION OF TOTAL CONSTRUCTION
�/ �UQ
�ELECTRICAL a ' � ��� AMP SERVICE ��� [� PROGRESS ENERGY Q W.R.E.C.
OPLUMBING $ �"� , j[���/
V � � 1
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
�a�� DC�
QGAS Q ROOFING Q SPECIALTY 0 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES CO%
S GNATURE ' _������1`�"-'` COMPANY �J �� �
REGISTERED Y/ N FEE CURRE� Y/N
Address � � � �� `L— �' 2 h �IS ��J� License# T��� �C� j J ��
n p�
ELECTRICIAN � � r� lr� COMPANY ��
SIGNATURE 1 �"�/'��� REGISTERED Y/ N FEE CURRE� Y/N
� c � Ylf 1 � License# �-�C_� ��lp�-�_
Address �' �
PLUMBER ! COMPANY ����- C�.�
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address , _ `�I� License# �:µ ��� -�'j� ��
MECHANICAL � COMPANY � �
SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
Address � YL. 11 �'V ( I �J � License# �,{���-�'��� I
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# C
RESIDENTIAL AtNach(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 instalied,
Sanitary FaciBties 8 1 dumpster;Site Work Permit for subdivisionsRarge projects
COMMERCIAL Attach(3)complete sets of Buflding Plans plus a Lffe 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 Pians w!Silt Fence installed,
Sanitary Facilities 8�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 tor all NEW c�nsVuctlon.
Directions:
Fill out application completely.
Owner 8 Contractor sign back of appflcatlon,notarized
If over 52500,a Notice of Commencement la required. (A!C upgrades over 57500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Appiicatlon Oniy)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PioUSurvey/Footage)
Driveways-Nof over Couhtet N onpubiic 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
cont�actor is not licensed as required by law, both the owner and conVactor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what Iicensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Fu�thermore, 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.
7RANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned �nderstands
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 buiidings, as specified in Pasco (;ounty t�rdinance numbe� 8�-t�7 anci
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 Transpo�tation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "ce�tificate 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
othe�than the"owner", I certify that 1 have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'SIOWNER'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, Wettand 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, f 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�II is found to adversely affect adjacent prope�ties, 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 fo�th 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 spec�cally 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(90j 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 T�OBTAIN FINANCING, CONSUL7
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTfCE OF COMMENCEMENT.
FLORIDA JURAT(F.S. 1'N.03) �
OWNER OR AGENT ' ���.�� CONTRACTOR___�����/�`-'
, i�
Su sc►ib d and sworn or af�ned)before me is u scrib�a�nd swo o(or a rme )befqre me this
by � ��ri'�'a'�,('_' �' 1� 1����F�aF' — by C �`��C't �,�<,C'` � �
o isl re personally known to me or has/have produced o e persona►ly known to me or haslh aen�fication.
as identlflcation.
y - i' �,� 7 ', � Notary Public `` �'�4 -���. ��L 4y'� Notary Public
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Com sfon No. Commission No.
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,;.,.��P`...,, E : r� .
Name of Notary typed, d, e r�f�mpe Name of Notary typed,p nf8d S,�Q�ped
- = MY COMMISS�ON#FF046058 • € MY COMMISSION#FF046058
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�407)398-0153 FloridallotaryService.com (407)398•0153 FloridallotaryService.com
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�'�'OTl(:E UF CUA9MENCEMENT 2013168096
Penn�tNo R�pt:1552964 Rec: 10.00
DS: 0.00 IT: 0.00
Tax Fol�o No _ ,� � ���1 Q^�:��SC-� 09/27/13 E. Munguia, D t
P v Clerk
TNE tJNDERS7GNED hereby grves not�ce that improvements wiJl be made to cenain real properry,:uid�n accordance with Sect�on
'I13 13 of the Flonda Statutes. the followmg mfonnation is prov�ded in this NOTTCE OF COMMENCEMENT
I.Descnpt�on of property(legul drscriptiun):��-�j{�,i�; • --_ ��..��3 G, + _��G
a)Street(job)Address: ��i ' � n ' __���� ��
2 General description of improvements: _ �!���'-3��
---°--- -��-`t�
mnn� ����a�_���+�( a-F�--��r,v -- —
3 Owner Infonnation ,-, ----
a)Name and address: '�C� =f �I}- �Q � � " � ,� " 1`v�JPr t-�i't % �'{�, ��c�
b)Namc and address of fec s'vnple tit)choldcr �f othtr than owner) ����� r
c)interest in property i'�,,,�.n.e { - �3��-�-1 �
�Contractot Infom�ation
a)Name and address:� � � � _
1 �
b)Telephone No.. _�t �'7/1-1— l �] lo Fax No.(UP� ) �1? 7�1— �]
5_Surety Information
a)Name and address.
b)Amo�mt of Bond:
c)Tclephone No.: Fax No.(Opt.)_
6.L,ender '�
a)Name and address:
7 Identi of Pbone No.
ty person within the State of Florida desibmated by owner upon whom notices or other doc�unents may bc seiyed:
a)Na�ne and address:
b)Tclephone No.: Fax No.(Opt)
S.In addition to hunself,owner designates the fo]lowing person to receivc a copy of the Lienor's Notice as pmvided in Section
713 13(Ixb),Florida Statutes:
a)Name and address:
b)Telephone No.: Fax No.(Opt.)
9.Expiration date of Notice of Commencement(t6e ezpir9tion date is ooe year from t6e date ot recording unless a different date
is apecilied):
�1'ARNING TO OWNER: ANY PAYMEN7'S MADE BY THE OWNER AFTER THE EXPIRATTON OF THE NOTICE OF
COMMEIVCEMENT ARE CONSIDERED II1SpRppER pqyMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,
FLORIDA STATUTES,AND CAN RESULT IN YpUR pAyING TWICE FOR IIKPROVEII�NTS TO YOUR PROPERTY,
A NOTICE OF COMMENCEMENT MUST'BE RECORDED,U�TD ppST�p ON THE�OB SITE BEFORE THL�FIRS�'
UISPECTION. IF YOU IIVT'END TO OBTAIN FIN.a11VCING,CONSUL7 YOUR LENDER OR AN ATTORNEY BEFORE
COMMETICING WORK OR RECORDIlVG YOUR NOTICE OF C011�NCEMENT.
sr�rE oF r�.oxro� -� 0` G��
covxrr os ,
� igoyaturc of Own or Owner'a Au�horizrd Officer/Direcbr/Paetnc/Managv
1 V 0.,�'li�L 1 ���"e.�i� ':�1��.
Prim Name � —
The foregoing instrument was aclmowledged betore me this��da of�� �) v �
Y C 1_J��i ''t° 1'� ,20,�i,by
d(r, � h a-�-�._��� ;
(type of authority,e.g,olTicer,trustee,
�cto*oey�o r'�r�ror 1 f\� t t `� ��'I��`- (name ot party onbe6alf o!w6om instrument was eYecuted).
Personally ICnown�OR Produced Identification_ �� ;���� ��� � ,i
Notary Signature -�
Type of Identification Produced Name(print) : y...--��
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Verification pursuant to Section 92_525,Florida Statutes. Under penalties of perjury,I declare that]have read tbe foregoing and that
the facts stated in it are trve to the best of my knowledge and belief.
Fw`MS °G�."�Bea CRYS7C�l GROVE � �JL�/��
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�fo«.�P'�' EXPIRES August 15,2017
�RULR S 0'NEIL,Ph D PASCO CLERK & COMPTROLLER
(407�398-0153 FlondallotaryService.com 0g/27/13 02��� 1PG° ���
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: (� !"�U— L-L�
Date Received: �—Z�-- j�
Site: � U�3� l�C�i./ �Gtrr� �
Permit Type: /l/�'(1�i �� � `�Gt p
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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Kal n Swit — ans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
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