HomeMy WebLinkAbout16-17212 F ••
CITY OF ZEPHYRHILLS
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� '� " - 5335-8th Street '
(813)780-0020 �7 2
ELECTRICAL PERMIT
PERMIT INFORMATION � ' LOCATION INFORMATION
Permit#:17212 Issued: 3/30/2016 Address: 6616 WIRE RD LOT 16
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE/NEW Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 600.00 Total Fees: 40.00 Subdivision: SLEEPY HOLLOW MHSUB DIV
Amount Paid: 40.00 Date Paid: 3/30/2016 Parcel Number: 02-26-21-0010-04500-0000
CONTRACTOR INFORMATI,ON OWNER INFORMATION
Name: DOUBLE M ELECTRIC Name: SLEEPY HOLLOW MOBILE MYERS
Addr: 40410 RIVER RD Address: 6616 WIRE RD LOT 16
DADE CITY FL 33525 ZEPHYRHILLS FL 33542
Phone: (813)713-3150 Lic: Phone: (419)962-4674
Work Desc: WASHER/DRYER HOOK UP/ INSTALL 2 LIGHT INSIDE SHED CHNG PANEL
AP.PLICATION FEES
ELECTRICAL FEE 40.00
- � .INSPECTIONS REQUIRED -
ROUGH ELECTRIC
CONSTRUCTION POLE
, PRE-METE
FINAL �
^
REINSPECTION FEES:(c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this properly 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.
"Warnin to owner: Your failure to record a notice of commencement ma result in our a in twice for
9 Y Y p Y 9
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, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
CONT CTOR PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
a�3aeo-oo2o City of Zephyrhills Permit Application Fa�cc 813-780-0021
. ''�~* BuiEding Department �
Date Raceiv�d
. . Ptione.Cantact.for Pa'rm�ttin --
Owner`�Wams � a�F��� � �j� Owner Phone Number
Owne�'s Address ��f� �(l[� 1� L.�/r�L-� G. � ' Ctw�er Phone Number � �
Fee Simple TlNeholder Name � " � "Owner Phone Number � �
''r� . �..�
Fee Slmple Titlehalder Addre�s �'
JaB aoaReSS � �l� �/! . , ,, ,Z�-/yt� f�(�I�L,LS /�G.r � �.oT# ��
SUBDIVISION � � } PAFtCEL ID# - .
. .� (OBTAINED FROM-P.ROpERTY.TAX NOTICE�� '
WORiC PROP03ED ^NEW CONS7R` ADD/ALT C� SIGN" Q- Q DEMOLISH
e� INSTALL _ ,8 ,; REPAIR
PROPOSED-USE . Q SFR � COMM [� ' OTNER° 3 .
TYPE OF CON37RUCTION� � Q BLOCK �` Q FRi4ME Q STEEL �]
DESCRIPTION UF WORK EJ� �./ �S'1��� �~- L l G-N%;� �2, � �X��l� �,-';�,UI��,
BUILDING SIZE �� t�� ,J I�"f' SQ FCIOTAGE�___.�, , HEIGHT..�l�
06UiLD1NG �� ,VAL.UATION O�F�'T�OTAL CONSI'FtUCTIQN
[�EIECTRtCA! $ �G �v AMP SERVICE '� PROGRESS ENERGY C] W.R.E:C.
QPLUMBtNG $ '� , ��,
QMECHAiV1CAL $ VAt.UATIt3N OF MECFfANtCAt INSTAt.lAT10N , �( ��
QGAS Q F200PtNG;._Q SPECIALTY � • OTHE#2 � ��j G/
[
FINISHED FLOOFt ELEVATIONS "� FLOOD ZONE AREA QYES NO
BUI�DER COMPANY ' �
SIGNATURE REGISTERED Y/ N FEE CURREK Y/N:
Address :, L"icense#=� ` �
E�.ECTRICU4N. , :: COMPANY ^ ��C/J��, �' �` ��L/.�G f�f'jC
SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N�
Address 1 (2j �il� , �����j/ �L� � License.#;I; t,�-G'j✓��.�Jf" �`'�� �
PI.UMBER , , , ; GOMPANY<� . - : >, .
SIGNATURE � � vREGISTERED Y f-N FEE cuRrtE� . Y/N
Address - � L�cense#j� �
.t , ..
MECHANICAL „ . , .V . . COMPANY �, -
SIGNATURE � ,. R��isrER�� • � .Y./,_.N � " F��cu�n ,Y/N . ,
Addre�s= � � � � Ltcense.# ( . . �
, . }.
OTHER ' ; . � : ,,_COMPANY._ . �
SIGNATURE�� ' ` � � ` " 'REGISTERED Y/ N,_ - FEE CURRE�� Y/N ,
Addre�s . %:,�..°;.�- .` , . . . - �
, . ,License# � � I
�RESIDENTIAL-" s-;sAttach(2);Ptot;Pians;:.(2}sets:iaf 8�ilding°Piaos;�(:1}'sef�of Ene'rgy�Fiirni's;'F2=t3-W`Perrriit farnew ccnsbuc�an, � ..£
� Mlnimum�;ten°'(-1,0)Yworlcing;day,s;after,.subinitkaii:date:!Requiretl.onsite';Gons#rtiotlon=plans;Stomiwater`Plans w/Silt"Fence Installed,
�Sanitaty�Fadil6ies;8��;1�dumpsterSite_Worlc;Recmit#arsutidiVisloctisllargeproJects ��:<:�•�: _ � : t. ..
COMMEitCOAL Attach(3)�oompte#e'sets'of Buiiding`Plans-ptus a Life'Safetji Page;(1'}set of Energy Forms.R-O-W Permit far new construction.
Minimum ten(10)worktng days after submlNal date. Required onsite,Construc8on Plans,Stormwater Plans w/Siit Fence installed,
Sanitary Facllltles&1 dumpster;S�te Wark Permlt for aii new,projecYs:-A!i cammerctal regutrements must meet compllance `
StGN PERMIT Attacti"(2)'s`ets of Eitgineereci•,Plans.;',a . . _ . ,_�. _, - � °� ' , - ` '
•'•'PROPERTY SUR1/EY reguired for all�PIEW_consUuction.
DirectFons: � ... . - ,_ � �
' FIII out appllcatlon ct�mpletely.
4wner 8 Gantractac slgn badc of appltcatlon,notaciz�i
If ovgr S25Q0,a Notice of Commancement Ia required. (AIC upgrades over$7500)
��'' ���'.7:!j���:�,� ., .
!R .,....'� .. _ ._.....r... ... . .
Agent(for th+a cantta�cto'r`)ar'Power of'Attoiitep(fci'the awner)woutd be someone with noterized letter from owner authorizfng same
DV,ERTHE COUNT.ER,RERMITt1NG�-�,����•(Fiant-ofApplication�Only)°•�:,`�:�j�µMf�� ,
,,
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) `
. .�._. �, . '
Drivewaya-Not over Counter if on publfc roadways.:needs ROW ,
.. `,,� -
-.>
NOTiCE OF DEED RESTRICTIONS: The under.signed:under�tands°�.th�t:this�p�cmlt:may.b,e,:subJect.to"deed"restrfcti._ "��``�-�_r .
Cihs
�, � { ,�.: yr,»�.;.�.,- :'�.:;
which may be�more-tesi�ictive��tti�n��Countyrreg�ilatlons�:�Tiie'�unders'lgried assiimes�tesponsibiliiy�for compliance;wlth any
applicable�deed restrlctlons. °.,,:.,,.�;;:„�,�;:_�;;:;,:,.: �, � „ .... .�M.....r.... .<�,... ..�......._ �...;.._- . •
UNLICENSED GC?NTRACTQRS=-AI�1D�-CONTRACTQR.RESPt?NSIBILITI�S:��-�If�tiie°oiinn�er-hasRfiltetl��a��co�ttractar or
cantractors�to undertake work,they maybe�.r.�qt�lred�to�b�.11censed In accocilanc,e:with.state�.and.local�cegulatlons;�.�lf°ttt►es-�r; =---r{ -�
�antractor-ls not Itcensed:;as�reqt�ired'�tiy law, tiath��the:ovmer and�-cont'r"actor`�ma'y tie��cited�°for�a��mis�t,emee�nor vtotatian
under state law. if the owne�or.intended}con�rra�tor;are.;,uncertaln as to wh�t itcensing.requlrementa.;rriay�_appiye�ior;�,tiie�,���::�°-��}r����
intended wotic,they are advised�#o con#act'tlie Pi�scrs_County Buililing'Inspection_�D'Iv1s[on-�,-�:icensi%�g Section at 727-1347-
9009, Furt#�ermore� tf the owner tias hired a contraictor ot ccintractors, he is advised to have tFte contractor{s},.sEgn .
oartions ef the"conkractor @lock" of.4thls a�apllcation for,whtch.they:w1ll.be,ceaponslble...lf you,�,as-:the awrier�'�sign'�as�tiie°."' �:.�`�.'"�
�oMractor, tfiat rnay�be an Indication'�that`he fs not.properfy�licensed�anii'�fs not entiNed`to�perr►iltfl`ng prtvileges tn Pasco ,
County. . ` . . �_. , .. . _:. ._.... .. ..... ;>��.�;_ •�.y. .:.,,,.
TRANSPORTATiON�IMPACTJUTIG1TiES��MPAC'1'�AND�RESOUItCE RECOVERY�FEES:��The�un�erslgned uiiderstands
that Transportatton lmpac#Fees:and.Recourse.Recave.ry.Fees.msY,��Pp�t��to;,tha cbnst�vci�on,of new,butidEngs,�ahange°of�°F�' "{-"y`:';�'` `
use in e�sting bolldings,.or:�expansl�n{of=��zls#i�ig,<bulldtngs; as sper�€Ied.1n Pasco Counky Ordir�ance number SS-07 and
80-07, as amended....,Tlae,undersigned �lso,urtdersta�da; th2it'�suoh fees;-,as��y�tnay�,�e�tlae„>w11F::6e identlfied at#he�tiFrieAof��-�° , ,�'"� �
permitting. It is furtiie�understood that Tra�sportatlon�fmpact`Fees and��-Resoucce,..Recovsry�RFees:.mus#be pald priar to
rece�ving.a "cerENicate�of�occupancy"or flnai-.power�.:reliease. :If�the proj�ct;fdaes:not`�lnvoive�a�.certiftcate,;of occupancyy'o��'��.�`�=��'-°���
�nal power reiease;-the:fees-.mu�f�-be p�id pr�ortta permit issuance. F��t�iermore;-'if�Pasco3C,aunty�Water/Sewer,:tmpact� �� . � .
Fees are dt�e,:they=must..be;pald�pr�or.ta permlt��lssya%ice-:in.,accord',a_nce..wi#h applicatile;Pasc�r..Coun#y.ardinances.
CQNSTRUCTION LIEN"!A1l1t(Ch�pter 793i Elorlda Statutes�as amende�!); !f valuatian of work is$2�l500.00aor>mare;,,}. � <; ; :.;��
certify that I} the�applicant�..have:.beea_provlded-with-a�-copy� of�=the�-"Elorida��Constructlon_.Llert',L:av+r=-Nomeowner's
Protectlan Guide" prePared by the Floi�lda Departmer�t of Agric.ulture and Consumer.Affairs. If the applicant ts someone, „ �., �
uther than#he"owner", i cert�y_.th�t_i�have.obtalnedta3copy.of.,the�abvve..describedtiocui�ent;and�pror�ise�in.qgood:.faith�_to.; _ .�. �
deliver it ta the bwner'�.,p�iot�to;camrrtericeme�it:=',`�., °°, - ,� ° � . . � - . .
CQNTRACT4R'SIOWNER'S AFfIDAViT: 1 ce�t�y;;that=alE.:the;lnformatlorn lnYthl�-appllcatfon is ac�urate.and that al#work _
,,�,,..
wlli�be done in campllance with ell.appltcable fainrs:regtilating construa#lon, zoning and��tand-devetopment. Applicatlon is
hereby made to obtain�:a�:pe�mit._ta..do.,wot�;:�and >InsCellation as I�dt+�afed:�•::�I�ceK4fy�that no work:or lnstalla#�n' has•' �
cammenced prior to issuance of aNpermit'�'antl that';all�wark will be perFarmed�to meet standards.of-ai! laws regulating-
cans#ruction, County and City codes, zoMng regulatians, and tand deveiopment cegulattons-ln"'the Jurisdtctlon. � I:al'so�
certify that 1 understand that fhe regulatians of other govemm�n#agencies may•apply�to.#he intended work, and that it is
my responslbiflly to fdenti(y�what.acttons 1 must.take:to be.it�:.cotrtp�tance;Such agenctes include bt�#are::nof timited to: -
- Departfient of E�vlranmenta{>rP�tiectton-Cypress:'Bayt�eaiis;`Viletland Areas and Envlronmentralty Sens3tive
Lands,WaterlWastewater Treatment. �
- Southwest Florida Water Management°:District-Wells, Cypress. �ay,heads; Wetland Areas, Altering
Wateccourses. . �
- Army Carps of Engineers_Seawalls,Dacks,Navigatile VVatetways.
- DepaKm�nt of Heaith=.8� Ret��bflltative�,.SetvfcesiEnvitanmetik'a! NealEh U'ttit:We![s, Wastewatar�Trea#ment,�
Se�tic Tank�: '` � _ i � � � .
- US Environmental�Protection Agency-Asbestos abatement, •
Federal Aviatton.Authorliy-Runways�� -
1 understand tfiat the foltariv�ng:restrictlons'appiy to�the use of flll:
- Use of fitl is nat�afiovved 3n:Flood:ZorEe"V"uniess expressty permitted.
- If the fill materlal=ls'�to:;6.e'�,used;j�ln.��lood Zone. "A". {t, !s understoad that a draEnage plan addressing a
"compensating�volume"wll! be submttted at�ime of permt#(r:�g whlch Is prepa�ed by a professiona! e»glneer `
licensed by theti,State�of'Florida: � `
- if#h� fiil mafer�af:ts.#o_be::used tn Fiodd �one 'A" in�connection,�with.a��►ermitted"building using stem wall
� cons#ruc#ion, i�srt�yr that fill,!wi1l.b.e��used oniy.to fitl the area within.the��s#e�n.�wati. � �
- !f ffil mate��l�is #o� be used in=any area, F certliy that .use. of such fllt w11t not adversety afiect adjacsnt
propertles. .!f use of flll Is fonnd ta adversely,:�f[ect adJace�t��prope�ties,.the ownef may be clted far via(ating . -
the conditions of the buiiding:pe�mit Issi�ed�under the attacfied�ermit�pp((ca#lor�, for�lots less than:one {9)
acre�wNich are elevated�by flll,a�r engineered dralnage plan Is required, .
If I am the AGENT.FQR.THE�CiWNER, I;:promfise in goad faith to Inform the�owner af-the:permltting condit�ons set forth In
lhis affidavi#'pr'ior to co�nmecictng constructtan. '1 understand that_ja�separate permit may be required for elecMcaf work�. - 4
Qlumbing, slgns, weffs, poals;.afr conditloning�.gas�-o�.ot�ier !ns#al�atlons�,nat.spec�icafly inEluded-In.the applicatlon. .A :
aermit Issued shalf be conshued to b�e°a�license to_pr�ceed with ttie'woik�and not-as:�uthori#y to•violater•cancel, alter, or ,
3et aside any provlsions of the technlcal.codes, nor shall Issua�ce�of a permit.prevent the Bulidtrig C)#ticla!from thereafter
�equiring a aorrection;.af errars tn�plans; constnictlon.or vlolatlons of any codes.:�Eve-ry permit lssued shall�become-invaNd
�Mess the work autharF�ed.by such permit:�is.commenced�within �;�t,,martths of�p�rrnit Issu�nce, or if work authorized by
ihe perr�►It!s suspended or.�bar�doned;f.or a;period of slx�(�)morittts:.after:the tli�e the�wartk>{s commenced,:An extension
�nay be requested, !n wrltlrtg,.ftom t#�e:Building Offi�ial for a perlod;°not to ex�eeid.�nfne#�(90) days a�d�wilt�demonsEraEe
usti�able cause far.�the extension: If work.cease�:for ninety(90}con�ecutive:days,..the�ab�is consldered aba�tdoned:�'
A/ARNiNG TO'OINNER; YOUR.FAiLiJRE•TC1.,�R�ECOEtQ�A.�NOTIGE.OF-COMMEMGEMEN?.�nIFAY�-RESUI:T IN:YOUR �
-�A1f1NG TW1�E,FOR<iMPROV�MEIV:�SMTZI,.YOUi�:�PRt�PER�TY.:.I��.YCi.t1�tF1�TEND�:`?I'a°OBTJ�'iN��FtNJ�M�1Ti�,�C.ONSULT
IT OU D fl AI+I�� �'TO N � � G�� � � � t�>�wp � ;' - :� �� x_ � .
'LORICIA JURA'�(F.S.11�.03) - � � - �- , ., . _. .- . - � :_ . - .
?WMER OR At�EN7 �CdNTRAG30
�ubscribed and ewom M(or aflirmed)before me lhls Subsalbed'and'swo ot afflrmedp " re�me dil � -
by
Nho lslare perscar�lly known b.me.or.ha�tltave produc�d Wfio` re.per�onaliy#cno �tc�nte or:hasthave•praduced �
`as Identl�catlon. " `�. as IdendNcaqon.
,:_ ,
, �
Nntery Pubitc . Notary Public
�ommtsalon No. ^ ` Con1 s �
,�,...,,
,,�:�n:ev��,+ JACQUEL4NE�t1t�iES '
�
�iame ot Notary typed,p�inted ar atamped Name of d,g��i�d�p��Y�2p18
�'�:;,va;°a'�� 3unac�thn�iroyfsicii�§iaarce3C4;565•TOf9