BCP2013-09189�
° e rwater
Y
�
U
City of Clearwater
Planning & Development Department
100 S. Myrtle Avenue, Suite 210
Clearwater, FL 33756
Phone: (727) 562-4567
Fax• (727) 562-4576
Building Permit Application www.mydearwater.com
PARCEL NUMBER
J
PROJECT/JOB NAME I
LO ATI N PROJECT ADDRESS �z �� l ��l (��ZIP ���
BUSINESS NAME �-°�S (� ���' PHONE ��
LEGAL DESCRIPTION OF PROPERTY
PROJECT
�
NATURE
OF WORK
(CHECK
ALL THAT
APPLIn
v'��� ��'�'g'� �c���� ���h
[�„B�JILDING
� MECHANICAL
❑ ROOFING
❑ LANDSCAPING
❑TRAFFIC OPERATIONS
� ELECTRIC
� GAS
❑ ENGINEERING
❑ UTILITIES
❑ CLEARING & GRUBBING
o r��� �.
� PLUMBING
� FIRE
❑ LAND RESOURCES
❑ NEAR WETLANDS
❑ OTHER
TYPE OF WORK: N� �ADDITION ❑REMODEL�REPAIR �DEMOLITION ❑OTHER
VALUATION: $ �� v�J (THIS MUST BE FILLED IN, PLEASE PRINT CLEARL`�
PROPERTY
OWNER
(MUST HAVE
PHONE
NUMBER)
PROPERTY OWNER NAME
ADDRESS
!
V
CIN � lG✓ STATE � ZIP ��%f� �
PHONE����� 3 �7 Z'� EMAIL
NAME OF COMIPAI�LY � �l%���
G���
LIC. HOLDER �� t�►�"�� �C�%' / ���HONE � �� � � L �
CONTRACTOR ADDRESS � /�"v /v FAX 7Z-�J � � /� �
(PLEASE
PRINT C�N ��1� D STATE � ZIP %!
CLEARLY) r,,
STATE LICENSE # PCCLB # �V/��
CONTRACTOR EMAII � f�'"C- �, �K S�D�'��' ��- C.- � �
SCROLL DOWN OR SEE REVERSE SIDE FOR NEXT PAGE
cl� ��
z���
� �y�c�
� �rnn�
�?��N
W�N
��o�
=w �
o��
_
�°3
v
D �
�i
y
�
N
�
�
� � ...� -�-- ,
� � �- --�---
h _-�- ��
a % > W„�.F��
�r :?' "'�""°°^.�•°.—.-- e
' -;--
�°�a = � � L.n��w
� ' �
'�'' .: F � �'' �' C�g
:��r, � �
�.� . "��_�'��
�� „ .
'a a�_=1�
-� , � _
C" Y+ � 1 I'
�- e
� Pil a b�—� i
l� � �
� � Y m. �-_._-i
� �.._._:�..: ,_=.�i�' ��L
���..`."W-`-.' ��
OFFICE ONLY
PLEASE ENTER PROPERTY ADDRESS HERE:
NAME
ADDRESS
ARCHITECT/ CITY
ENGINEER
PHONE
EMAII
STATE ZIP
FAX
GENERAL
PROPERTY
INFORMATION
EXISTING BUILDING USE PROPOSED BUILDING USE
NUMBER OF STORIES BUILDING HEIGHT NUMBER OF UNITS
CONSTRUCTION TYPE: I II III IV V VI; P OR U
SQUARE FOOTAGE: LIVING
GARAGE/CARPORT
OTHER
COMMERCIAL
TOTAL
Anyone planning to do excavation work, must notify the one-call "CALL SUNSHINE" Notification Center at 1-800-432-4770 prior to any
excavation work being done, in order to prevent underground damage. Federal D.O.T. Regulation Part 192, Sections 192.614 and 192.707.
Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installotion has commenced
prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction.
CERTIFICATION:
I HAVE COMPLIED WITH ALL THE FEDERAL STATE AND LOCAL ASBESTOS REGULATIONS CONCERNING NOTIFICATION OF THE
PROPER AUTHORITIES OF THE PROPOSED DEMOLITION AND RENOVATION PROJECTS.
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 ATTORNEY BEFdRE RECORDING YCNJR NOTICE OF
CONIMENCEMENT.
I am aware of Florida and Federal Accessibiliry Codes, and 1 certiFy that 1 have met the requirements of both.
I certify that, this application together with any plans submitted is accurate and represents all work being done at this time. All work will be done
in compliance with all applicable laws regulating construction and zoning and if not I realize I am responsible for the removal of any construction
in violation of these laws or regulations. Any deviation From information submitted, unless approved by the Building Official will render this permit
null and void.
IS THI� A�PLI�ATJON Tb4E RESULT OF
A STOP WORK ORDER OR NOTICE OF VIOLATI N? YES NO `C�
� /� / �
' nature of License Holder OR Authorize Personnel
� c
� � � � � � � �n S
Please Print Name Here / rtle in Firm or Homeowner
Date
Revised 8-8-13
I#: 2013297198 BK: 18155 PG: 2574, 09/11/2013 at 01:13 PM, RECORDING 1 PAGES
$10.00 KEN BURKE, CLERK OF COURT AND COMPTROLLER PINELLAS COUNTY, FL BY
DEPUTY CLERK: CLKDUIO
� �����uu�
,� sEp z � ��13
STATE OF FLORIDA-PINELLAS COUNTY
I hereby certiy that the foreyoing is a true
PLANNINty 8, DEVELOPMENT DEPT ar �PY as recorded in e oHiciel records of
Permit NWr►bet * '� Pinellas Counry. I 3
i Thts,�day of 20
NOTI E OF COMMENCEMENT ,I�'�e.";C:`� �e►�ora�� c�a
State of Florida sy!=�"'""'"_ '''�'��
County of Pinellas DeputyCle
THE UNDERSIGNED hereby gaes no6ae tl�at improvements wiB be made to oertan �eal praperly, �d in a000rdence wilh Section 713.13 � fhe
Florida Stah�ies, the foYowing information is provided in tlus NOTICE OF COYYENCEMENf.
i-�SCI��OII Of p10pEfiy �il�l� �lSd�lilOA�: ta �, varry wa1r. Armdnp n�r nro ar Nr rrwdas noora�e in wr mor t�s. vapw �5 rd 1e. Ndie n.00ias d PiWs cn�ry. Fwie�
9) StACt (joa Add1�CSS: 902 Ea�fham Drive
2.General desCtipf1o11 Of ilnproMe111e11tt: �' 8' x 8' tooters, I�fallation af tull pavers 15 x 20' and thin paver over existingT6' x 16' conaete palio
3.Owner MfamaUon or Lesses 6�formadoa if Ifie Lasse� contracted for the improwmeni
e) N�n@ end eddress: Beve�N and Rlchard Smifh, 902 F�1ham Drive, Clearwater FL 33765
b) Name and address of fee simpb tiUeholder (rf �t tl�en Owner Gsted above)
c) Interest in propeny: owne�s
4.Contractor Information c,
a) Neme and eddress: Pe►�dns Corxxete �nc. lj6 / Z- I� J� fJ" v�v, ���so ,�� 3 3 � ��3
b) Telephone No.: 727-531-2545 Fax No.: (aptional)
S.Surety (d appliceble, a oopy of the payment bond is atfached)
a) Name and eddress:
b) Telephone No.:
c) Amount oi Bond:
6. Lsndsr
a) N�ne and address:
b) Teleplane No.:
7. Persons wiMin the State of Fbrida desipnated by Own�r upan whom notioes or other documents may be served as provided by Section
713.13 (1) (a) 7., Fbrida Statutes:
a) Neme and eddress:
b) Telephone No.: ' Fax No.: (aptional)
8.a.ln addition to himself or herself, Owner dasiynates of
to reoeive a copy of tl�e lienor's Notice as provided in Section 713.13 {1) (b1, Fbrida Stad�tes.
b)Phane Number of Person or enfity designated by Owner.
9. Fxpinfion daie d nadce M commeeoen�nt (tl�e e�'retion date mey not be betore the compbtbn of crostruc�ion and fmal payment � the
conhacbr but wil be 1 yeer trom 1he deie of raoo�ding � a ditlerant dete is apecified): .2�
WARNING TO OWNER ANY PAYIAENTS YADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMYENCEMENT ARE
CON8IDERED IIpROPER PAYIIENTS UNDER CHAPTER 713, PART 1. SECTION 713.13, RORIDA STATUTES, AND CAN RFSULT IN YOUR
PAYING TWICE FOR fYPROVEYQITS TO YOUR PROPERTY. A N0710E OF COMMENCE�NT YUST BE RECORDED AND POSTED ON
THE .�B SYTE BEFORE THE FIRST WSPECTION. � YOU INTEND TO OBTAW FlNANCING, CONSIRT WRH YOUR LENDER OR AN
ATTORNEY BEFORE �OMI�NCING WORK OR RECORDING YOUR NQTICE OF OOMMENCEAIQIT.
Under oenelN o# aeriurv. I dedere that I have read Ihe foreAOiqA notice of oommenoem�t and tl�st the iacls stated therein �e true b tl�e best of my
Q.
or �essee, or �wner's or
'� . tl..-,.�� .� -�a .� su- �-r "��ti..►_ �
(Print Name and Previda Sigmbys Ti ow --s�-
The forego'rg instr�unent wes adcnowledged before me Ihis 3 fD day of SG/�T , 20 l 3
bY It ieltAti� * Be.ve,ecv A. SJrI �'!� o e.� a e� cn� or�y, e.g. �. �, �r ��►1
for , �
(Name d Person) (tYPe of autlwrity,... e.g. officer, Vustee, aCorney in fad)
for (�me ot psrty on behaN of irhom instrument Yras exewted).
Persor►aly Known � Produced ID ❑ �
Type of IO Notery Signeture �� - ��%�i'"'��
rint name �e. � � -�-���
IN�I
,�� r i �• � /ARtARA A. TOOKER
$i Notuy Pullk - St�M of florld�
•� My Conw�. Expirq ylay 1. 201i
.,��, �'= Commiabe I EE 791�7
,.°; : Y� `��,
BoMM TMauph NNbnY Nef1�� Affn.
C�'�
`�0
�
�
1
��
�
�
�
�
�
�
„ , .
. . . ' 1.30
• � LOT 46
CC?LLEGE NI LL ESTA�TES
TRACT �;A�� P, $, 64, P6,4Q 6' VINYL SUBDIVISIOi�t FENCE
LANDSC.APE BUE'E�[2 & 4�AI�I, 050 . o � , .
/ FENCE TRACP Drm �N 003235 E 7000� �r> Frs_ azo PLAT BOUNDARY
yF�� � F:��It� �n i ,r_ 10' FENCE & MAIN'd'F..xVANCE
� �rzs�a �z
�O -'”- -� EASIINENT (PRIVA
. O °- '.
vi — �— � Q ��X�� PER F�'4A
� M � �ei OF MAP REVISION
� � CASE.� 10-44-1358A, DATED
��j .. ��• FLORIDA� PIATE'LL�AS CJBUD]TY.
�, _ �
� � , ..�.s • ,�, �, r,
~ '� r . , �
�� -� . � ,��. .
b ''t
� � O PLAT � S RY
OUSE
� n �j ARX � a�'o # 902
,� � �. � � . LdWEST FIAOR
p. a2 nl . EGEV=31 . 54'
� °
rn ti
'4' 4fi o, 70
ro � i� w' »s.5 � �voe ' o
�� � � '� �� ' . �� ..
� � � a�o ' ��` : ;:. , D!
i � W r�J U�'
— 2 —
Z /� � � i ,
. /t
G�,
13
BEARING EASIS: �^9MON
�: � PROPERTX LINE OF L�C7PS
ca• � 1, & 2 BEING.S 89°59' 14�E
' •4 �al .
N � Q � .
yi �
,:� � �
..� �
/ J�`� ��
� v �I -�
� �
���'� � l�
� �er
3�e D � ! .
���� 1��
�`D�"
�� Q 1 �"'Iz •� . ;�,. N s-- T 0 UTILITSC EASII�7ENT
Qi � '• �k2T�L � �:�.?'.�:. �.:':�.. .f r•�L lF15�i ���I�.'� � Cj
�� Q �. 7r,, �, �'��t. �s. -.:.: 4� WALK '5:,� ��
� 0 �. • ` =.:: ��: � ..��r- 2 � �� . . ;: �.ti� �'�,� `J`�`{ �C-\'G
^p ;�' ' '� r ' z5 ov �p� ' i`- 25,OOiP� �, �,, �� -`'� � ,.� Q F �
U �� � t�,i�'� ;,� �a��'��t,5.
a � �,�p � ��.p�.l,.� . . . � �,,N..:L }.;4� ��� �.� ��
� � ����' � � f, `��� !AA � � {'��,.
m 000�� . EARLHAM ORI�� � , ��: 't, � N�a ° -� ����
� �
>+ �P �K """�, 5 0 � R'O W ( PUBLIC ) �; `'�``� �,��`•,� ���. ' �', .
ue.ac�s J � ��'� �ic�e,wC�"` -
V rM�w�tG (ASPHALT) «..O 'v ,
CII2TIFIID T0: M/I HOMES OF TAMPA, LLC. �';y.-�' `�ir�`� .
M/z Fziv�vcz�, m�or��oiv ���\�
M/I Z'ITLE AGIIVCY, LTD:; L,C. BENC[-IINARK: NORTfi RIM OF.SANITARY
LAWY�2S TITLE 1NSURANCE CORPORATION MANFiOLE AT VARSITY DRIVE AND
JON L. CULP OBERLIN DRTVE. EL�E'�/ATION - . 7'
N.G.V.D. 29. ��'
� R.��. J
DESCRIPTI�1: LAT 1� VARS22'1' ESTATFS� ACCORDING •TO Ti� MAP OR PLAT Tf�REOF, A�S �T�.i. .-��3
IN PLAT BOOK 136� PAGFS 45.AN�D 46, PUBI.IC RECORDS QF PIl�1EC�LAS COUNTY� FTp�tIDA�.� ,� �-- �,,
SECTIQN _ 7,_ TOWNSHIP _ Z9 S, RANGE �6 E PfNELLA S
0 y
,' NUM9kR� ' ..
r PIR FOU�J� IRON ROO , 84 E ` �
YG O! FIP FOUND IRON PIPE M.O.I. � MORE OR LESS � � , p
� N.6.V.0, NAT'� OEODETIC VERTICN. DA7UM MI �
.FCM FOUND�p�.��R6TEMONUMENT NTS . NOTTOSCA�E
•SVfiVEYEb PRM PERMANEN7R@FERENCEMONUNENT (R) qqp�q�
11-5-09 I�P PERMANENTCOji7ROl�PdNT cl CEN7ER-IINE,�,
FNQ � FOUN� PI, PROpERTY LINE
, DEPT. DEPARTMENi �R.O.W. RKiM-OF•Wqy
RGVISION:' �� S��,Y ���� 11=18-09 RECbRD SURVEY
_ Y SURVEY FINAL 9-25-10 •
BOUNDAF2Y SURVEY' . ' ,-- - •.�
SVRVEYISSUBJECTI(OAiITl,ESENiCHFOR � ,�������"-�" � �
MATTERS OF RECqRO EFFECTWO'THE � �^`
PROPERTY. BA$f$ QF BEARING.ARE PUT. �:�`.'.....'
UN�ESS O7'HGRWIgE NOTED NEREON, ryp TI OTN R +
�UNDEttpRp�p.p�ry�pqdyEMENT5.v2E SHOWN ��` FLA. REO. SURVEYO Np, 6088
I�IEREON. , (NOt VALIO WIT7iWT THE S NATURE AND TME
� ORIGINAI,Rp1SEpSEAlOFAFLORIDAUCEtiSEO
sunverore nrio n�a�ea�
ia � , I ����-
rx . � �, \�-r
� � . I� f;= -
rr� :;; ��-
�`D.�RILYd � _
P .
8
E
w'
,MARSIiAS,L-PEIRCk; AND 'ASSpCZATES INC •
:iURVEYORS .AND MFIPP�BS
2199 MA.IN ST. SiJI:TE L
DUr�DTN, rL. 3468:6
PHONE:727-73t3-0321 ,FAX.: 727-738-83�11
0
m
�
N
�
�
�o
� Q
�
f� V / �
a �w
= p� O
J o0
� M=
a�~>
WN�m
c�aw�.�
Qi mdt�N