HomeMy WebLinkAbout15-16453 CITY OF ZEPHYRHILLS '
5335-8th Street '
_ � 1,6J453
(8�.3)7$0-0020
. ELECTRICAL PERMIT
PERMIT INFORMATICIN � LOCATION lNFORNIATION
Permit#;16453 lssued: 7/21/201 Address: 37815 SR 54 WEST
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRICAL MISC Township: Range:
Proposed Use: NOT APPLICABLE Lo#(s): Block: Sectian:
Sq. Feet: Est. Value: Book: Page:
Cos#: �oa.aa Tatai Fees: 40.00 Subdivision: CITY 4F ZEPHYRHlLLS
Amount Paid: 40.00 Date Paid: 7/21l2Q�5 Parcel Number: 10-26-21-4010-1260Q-0020
GONTRACTOR INFQRMAT.ION OWNER INFQRMATION
Name: MARTW ELECTRlC Name: EVERS CINDY LAWSON & BURGES AMB
Addr: P.O. BOX 437 Address: 34132 SAINT JOE RD
DADE CITY, FL 33525 DADE CITY FL 33525-7846
Phone: (352)521-3319 Lic: Phone: 813-263-2366
Wark Desc: INSTALL NEW LEFF FROM PANEL BOX
' APP tCATIC}N FEES '
ELECTRICAL FEE 44.Q0
lNSPEC. IONS REQUlRED �
ROUGH ELECTRIC
CONSTRUCTION POLE
PRE-METER � �
ELECTRICAL F1NAL�
REINSPECTION FEES: Reinspec#ion fees will com�ly with Florida Statute 553.80 (2)(c)when extra inspection
trips are necessary due to any one of the followi�g reasons: a) wrang addres�b) candemned work resulting
from faulty construction c) repairs or carrecti ns not made when inspection called d)work not ready for
inspecEion when calted e) permit nat posted on job sife f) plans not at ja6 site g}work nat accessib{e.
NOTICE: In additian ta the requirements af this permit, there may be additiana( restrictions applicabfe to this property that
may be faund in the public recards of th9s caunty, anc�there may be additional permits required from other governmental
entities such as water management, state agencies ar federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice far
improvemenfis to your property. If yau intend to o6tain financing,consult with yaur lender ar an attorney
before recording your notice of cammencement."
Complete Plans, Specifieatians and Fee Must Accompany App{icatian. All work shafi be performed in accordance with City
Codes and Ordinances.
t
�
NTRACTOR PER OFFI
ERMIT EXPIRES IN 6 Mt?NTHS WITHCJUT APPROVED INSPECTIO
CALL FOR INSPECTT�?N - 8 HOUR NQTICE REQUIRED
PR#aTECT CARD FRt�M WEATHER
I
8�saao-oo�o City of Zephyrhilis Permit Application Fax-s�aasaooz�
Buitding Department
,
Date Recelvad Phone-Cantact for Rermlttin
Owner's Name�t � Owner Phone Number � �� f �U�
/ Y + ! , , ) .
Owner's Address � �/ �� � � �� Vv Owner Phone Number
Fee Simple Titlehalder Name � � 4wner Phone Number � �
Fee Simple Titlehalder Address
J09 ADDRESS �� � • / J~ � V �� LOT# ��
SUBO1ViStON �� � PARCE a�D#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK Pt20POSED NEw CONSTR ADD/A� � S1GN CJ C] DEMtJLISH
INSTALL REPAIR
PROPOSED U8E Q SFR � COMNI' Q QTNER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DE$CRIPTION OF WORK
BUILDING SIZE � `� 8Q FOOTAGE HEiGHT C�� �
QBUII.DiNG � � VALUATtON OF TQTAL CONSTRUCTiON
QEl.ECTRICA� ��a-��',.f..� � AMP SERVIGE Q PROGRESS ENERGY Q W.R.E.C.
�
QPt�UMBING �>�
QMEGHANICAL �y—� VAE.UATION QF MECHANIGAL INSTALUITION
QGAS Q ROOFING Q SPECt TY � OTHER
FINISHED FLOOR ELEVATIONS �� FLOOb ZONE AREA [�YES NO
BUI�DER '"S' ` C�M �
SIGNATURE RE ISTERED Y/ N FEE CURRE� Y/N
i
Address L(cense# I �
ElECTRICtAN C�1MPAFtY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address � � License# � �
PCUMBER Ci�MFA1+IY
SIGNATURE � REG�.�ISTEREp Y/ N FEE CURRE� Y/N
Address License# � �1
MECHANICAL COMPAl�tY
SIGNATURE RE�ISTERED Y/ N FEE CURREP Y/N
Address License# �� �
OTHER C�AIIPAHY
SIGPIATUR� RE�GISTERED Y/ N FEE CURRE� Y/N
I
Address � License# �� �i�
RESlDENTU4� A#tach{2)Ptot Plans;(2}sets of Bullding Plans;{1)se of Energy Forms;R O-W Fermlt far new cansUvotion,
Minimum ten(1.Q)woricing days after.submittal date. Ftequired ansite,Construc8on Plans;Starmwater Plans w/Silt Fence installed,
Sanitary FaGllUes&.1.dumpster,Slte Wc�ric•Fennit for subdivisionsAarge proJects
COMMERCIAL Attach(3}compiete sets of Bultd3ng Plans pius a life Safety Page;{1}set of Energy Forms.ft-O-W Permit for new constructton.
Minimum ten(10)working days after submittal date. Required onsite,ConsUuct(on Plans,Stormwater Plans w/Silt Fence installed,
Sanitary FaciliUes&1 dumpster.Site Work Permlt for�all new praJects.All commercial requlrements must meet compilance
StGN PERMIT Attach(2)sets oE Erigineered Ptans.
"""'PRQPERTY SUR1/EY required for all NEW cons ctfon.
Dlractlons:
FIII out applicadon completely.
Owner&Contractor slgn back of applicaUon,notarized
if aver�2500,a Natice af Commencement is required. {1�UC up rades over�7500)
'• Agent(for the cantractor)or Pawer of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
dVER THE COtlN'FER PERMITTING (Front of Appllcation Only}
Reraofs if shingles Sewers Service Upgrades A/C Fenc s(PIoUSurvey/Foatage)
priveways-Not over Counter if on pubiic roadways..needs ROW
. � .
NOTICE OF DEED RESTRICTIOWS: The undersigned under�tands;th�t.this..p�rmit.may be,subject to°deed"restrlctions" '
which may be�more�r.estrictive than County regulatlons:�The undersigned-assumes responsitiiltty for compliance with any
appllcable deed restrictions. � '
UNUCENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner-has�hired a cont�actor or
contractors to undertake work, they may be>r�quired.,to be:ltcensed in accordance.wlth.state.and•local regulations. �If the
conhactor ts not ifcensed as�requlred'by law, both the owner and contractor-may be cited for a misdemeanor violation
under state law. If the owner or Intended�contractor,are�uncertaln as to what Ilcensing.requirements may_apply.�.�or�the
intended work, they are advised to�contact the Pasco County Bullding Inspectlon Divislon—Llcensing Sectlon at 727-847-
8009. Furthermore, If the owner has hired a contractor o� contractors, he is advised to have the contractor(s), sign
portions of the "contractor Block" of this application for which they wlll be responsible. If you, as.the owner slgn'as tfie
contractor, that may be an indication that�he is not.properly Iicensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION-IMPACTIUTILITIE$�IMPAC7 ANb RESOURCE RECOVERY FEE3: The underslgned understands
that Transportation Impact Fees and.Reco.urse Recovery.Fees may��apply-to�the construction of new buildings��change of
use in existing buildings, or.expansion=of��ezistin�g`�6ulldings, as speclfied in Pasco County Ordlnance 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 Resou�ce Recovery`Fees mu�t be paid prior to
rece�ving a °certificate of occupancy" or flnal powec-.release. :I€the project�does not tnvolve a,certificate of occupancy o��
final power release, the.fees must be paid prtor to permit issuance. Ft�r.thermore��If Pasco County-Water/Sewer-Impact
fees are due, they�must be�paid prior to permit Issuance-in accordance with applicable Pasco�County ordinances.
CON�TRUCTION LIEN LAW(Chapter 713� Florlda 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 Constructlon: Lien Lav�—Homeowne�'s
Protection Guide° prepared by the Florida Department of Agriculture and ConsumerAffairs. If the appllcant is someone
other than the"owner", I certify that I�have,obtained a copy,of..the above..rJescribed 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.lnf.ormation in this appllcation is accurate and that all work
will'be done in compliance with all.appiicable laws regulating construction, zoning and.land development. Application is
hereby made to obtain .a permit Co do work:and Installation as indtcafed: `I certify"that no work 'or installat(on has
commenced pr(or to issuance of a permlt-and that.atl work will be pertormed to meet standards of all laws regulating�
construcNon, County and City codes, zoning regulatlons, and land development cegulations-tn�the jurisdtction. I �also
certify that I understand that the regulatlons 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 agencles-include but are.not Iimlted to:
- Department of Er�vironmental�Protection-Cypress.'Bayhead�, Wetland Areas and Envlronmentally Sensitive
Lands,WatedWastewater Treatment.
- Southwest Florida Water Management �Distrtct-Wells, Cypress. Bay.heads; Wetland Areas, Altering
Watercourses.
- Army Corps of Engtneers-Seawalls, Docks, Navigable Waterways.
- Department of Health� & Rehabilitative Servlces/Environmental Health Unit-Well.s, Wastewater�Treatment,
Septic Tanks. � .
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviativn Authority-Runways.
I understand that the following.restrictlons apply to the use of flll:�
- Use of flll is not allowed in Flood Zone"V"unless expressly permitted.
- If the fiil materfal is to be used�in-�Flood Zone. "A", ft. 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 Flor(da.
- If the f111 material is to be used in Flood Zone 'A" (h�connection�with.a�permitted building using stem wall
construction, I certify that fill�:wJll:b.e used only.to.fill the a�ea withfn the�stem wall.
- If flll materlal is to be used in any area, I �certlfy that .use of such flll will not adversely affect adJacent
properties. If use of flll is found to adversely:�ffect adJacent properties,.the owner may be clted for viofating
the conditions of the building,permit issued�under the attached permit application, for lots less than_one (1)
• acre which are elevated by flll, an engtneered drainage plan is required. .
If l am the AGENT FOR THE OWNER, I,�promise in good faith to inform the owner of�the�permitting conditions set forth in
this affidavtt prior to commenctng construction. I undersfand that a-separate permit may be required for elect�ical work,
plumbing, signs, weils, pools;_ alr conditioning, .gas. or other installations noE•spec�ically included�in.the application. .A
permit Issued shall be constcued to be a Iicense to proceed with the work and not as:authority to.violate,cancel, after, or
set aside any provisions of the technical codes; nor shall issuance�of a.permit.prevent the Bulldirig O#flcial from thereafter
requiring a correction.af errors In plans, constniction or violatlons of any codes. Every permit issued shall�become invalid
unless the work authorized.by such permit.•Is-commenced•withtn sGc months of permit lssuance, or if work authorfzed by
the pe�mit is suspended or abandoned for a:period of six f8)montF�s.after the time the�work is commenced. An extension
may be requested, in wrtting, 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 day.s,..the Job�is considered aba�doned.
WARNING TO OWNER: YDUR.FAILURE�TO..REC.ORD A NOTIGE OF�COMMENCEMEMT MAY�RESULT IN YOUR '
PAYING TWICE.FOR IMPROVEMENTS TO YOUR PROPERTY. .IF�YO.U�IN'FEND�`TD�OBTAIN�FINANCING��CONSULT
WITH YOUR LENDER OR AN ATTORNEY�B�FORE°RECOR�f)ING~YOUR�NOTICE'OF�`COMMENCE'�ENT�
FLORIDA JURAT�(F.S. 117.03) - _ -- - - - - - _ ---,--- — - -
OWNER OR AOENT CONTRACTOR �
Subscribed and swom to(or aflirmed)before me this Subecrlbed and'swom to(or aflirmedpbefore me'ffil�
by ,bY
Who is/are personally known to.me or-has/have produced Who ts/are personallyacnown�ta-me or haslheve produced •
as Identlflcatlon, as Idendflcadon.
Notery Public Notary Publlc
Commisslon No. ComrJ�Ission No.
Name of Notary typed,printed or stamped Name of Notery lyped,printed or stamped
I