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» CITY OF ZEPHYRHILLS
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ELECTRICAL PERMIT f-•'° �
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PERMIT INFORMATION LOCATION INFORMATION �
Permit#:17120 Issued: 3/02/2016 Address: 6616 WIRE RD LOT 56
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE REPLACEME T Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 1,000.00 Total Fees: 40.00 Subdivision: SLEEPY HOLLOW MHSUB DIV
Ar�ount Paid: Date Paid: � �� ��p Parcel Number: 02-26-21-0010-04500-0000
CONTRACTOR INFORMATION OWNER INFORMATION
Name: PATTIE ELEC. & REFRIGERATION Name: SLEEPY HOLLOW MOBILE
Addr: 39111 PATTI RD Address: 38615 LANSING AVE
ZEPHYRHILLS,FL. 33540 ZEPHYRHILLS FL 33542-6312
Phone: (813)782-3319 Lic: Phone:
Work Desc: REPLACE 30 SMP TO 50AMP PANEL CHANGE OUT
APPLICATION FEES
ELECTRICAL FEE 40.00
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INSPECTIONS REQUIRED
ROUGH ELECTRIC _
CONSTRUCTION POLE �
PRE-METER �� �!
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.
"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 commencement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
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CONTRACTOR PER OFFI '
- PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO �
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
4 ��3.�eo-oo�o City of Zephyrhills Permit Application Fax 813-780-007�
Building department .
Date Recetved phona-Cantact for Permittin
Owner"s Name .�`��. f) 4�� '. Y�t -Q �C � Ownar Phane Number
Owner's Address Owner Phone Num6er � �
Fee Slmple Titleholder Name �— � Own�r Phone Number � �
Fee Simple Titleholder Address a
JOB AbORESS F"-Q �� � LOT# ���`'� / I
_��__�
SUBDIVISION PARCEL ID# ���. �-�. �—(��/(j''� `(�JOO(�
(OBTAINED PROM PROPERTY TAX N07tCE)
WORIC PROPOSED �NEW CONSTR ADD/ALT' � SIGN Q C] DEMOLISH
INSTALI. 8 REPAIR
PROPOSED.USE Q SPR � COMM � OTFIER
TYPE OF CONSTRUCTION , Q BI.00K ! [� FRAME � STEEL Q
R
DESCRIPTION OF WORK � f c�C/ cJIJ (C� t/�g
BUILDING SIZE � � SQ FOOTAGE��, HEIGHT-C�� .
QBUlLDING � � `�``'""`�" t''= -.
VALUA710N OF TOTAL CONS'TRUCTION
� - LECTRICAL $ � AMP SERVICE PRQGRESS ENERGY [� W.R.E,C.
� ���d
QPWMBING ��
QMECHANCCA� $ V N F MECHAiVICA�tNSTALLATlON �� ��
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QGAS Q f2{70FING Q SPECIA�TY �� OTHER i ��
, � ��
FINISHED FLOOR ELEVATIONS FLOOD ZQNE AREA QYES NO
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BUILDER COMPANY
SIGNAT'URE REGISTERE� Y/ N FEE CURRE� Y/N .
� Address Cfcense#
I ELECTRiC1AW � COMPANY �t,',,� �u�.`�`
� SIGNATURE REGISTERED Y/ N FEE'CURRE� N
, Addre$s Ucense# '�-r(��`�Q d J �p t"� �
PIUMBER • COMPANY
SIGNA7URE REGISTERED Y/ N FEE CURREP Y/N
Addre�s -License# r� —�
MECHANiCAL COMpANY ��
SIGNATURE REGI$TERED Y•.F N FEE CURRE�- ' . Y/�N','
Addres� License# �� —�
Q'�FIER COMPANY -
SIGNATURE REGISTERED Y/ N , FEE CURRE� , Y•/N.
Addre�s � License# �---��
32ESIQENTIAI.. Attach{2};Plof Rlans;{2}sets ofiBullding;�Plans;`(1)sef of'EnergyYForms;�R-0=W Perrriit for near,canstruc�,on, ,
Minimum,tenr(1,0);working°days after.subr`riittel date. Required onsite,Canstruction-Plans;•Storinwater`Plans w/Silt Fence installed,
Sanitary Eacltifses•&-1..,dumpster Stte�Wor4c.Permitfor,"subi!{vislons/large pro�ect� , • ' -
COMMERCtAi. Attach(3}�coinpfete sets of Suild9ng P1ans ptus a Cife Safeiy Page;(1}set of.Energy Forms.R-O-W Permit for new construction.
� Minimum ten(10)wrorking days after submittal date. Requi�ed onsite,Construction Plans,Stormwater Plans w/5ilt Fence installed,
San(hary Facilitles&1 dumpster.�Site Warlc Rermit for aii neur:proJects.R!i commerciaLrequlrements must meet complfance .
S1GN PERMiT Attach`(2}�sets of Erigirieer,ed Plans;,,� ,�� - '
"`"PROPERTY SUR1/EY required,for all NEW construction.
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� Diractlons: �
�, Ffll out applicatlon completely. �
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� bwner 8�Cor�iractor sfgn back af apptEcatton,natacized {
', if over E2S00,a Notice of Commencement i�re ulred. A!C u �
q ( pgr�des over y7500) ,
" Agent(for ttie conVacto�)orPowier of Atkot'ney(for.the owster.)would.be.someone with notarized latter trom ownec authodzing same ,
OVER TNE CQUNTER.PERMITTING - (Front of Appllcation;Oniy) . � � �
Reroofs if shingles Sewers Service Upgrades A/C' '. Fences(Plot/Survey/Footage) �
� t. .
Driveways-Not over Counter if on public roadways..needs ROW:..: �_... > ,
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NOT9CE�F DEED RESTRICTIONS: The undersigned und�r.�tands:,th�t this;p�rmit:maybe.subJect to"deed"restrictlons"
whlch may be�ri�or��.restNctive than County:�regulatlons. �TNe undersigned'assumes responslbility for`compliance witFi ai�y
applicabl�deed reatrlctlons. �
IJNLICEPISED. CQPITRACTORS J4idD CAWTRI�CTOR RI�SP�NSI8ILITIES: -If the owner has hired a� contractor or
contractors to undertake work, they.may.be,;eequired,�to,be;llcensed In accordance.with state.and•local r�gulatlons. if the
contractoP•is not Ilcensed as requlred by law, both the owmer and contractor•�m�y be�clfed-for a�misde�n�anor diolatton
under staiQe law. N`the owner or Intended r�ntractor are uncertain as to wh�t Ilcensing.requlrements may apply:�for�the
intended udork, the��are advised to cot�tact'tFie Pasco Cotanty Bullding"Inspectlore Dlvl�lon—Licensing Sectlon at?27-847-
800J. Furth�rmore, �f Qhe owner has�hlred a coratractor o�contractors. he is advfsed to have the contractor(s) slgn
portions of the "coiitractor Block" of thls appllcatlo� for whlch they wlll be r�sponsfble. If you,-as-.#he owne"r sign�as the
contractor, that may lie an Indicatlon that he Is not.properly licensed and-Is not'entltled to perniitting privileges In Pasco t
County.
TFt�4NSPORTA'�I�N,II�IPACT/UTILI'6'IES�INfPAC7'•APIb-RESOURC@ RECOVERYfEES:�The under�(gned understands � �
that�'ransportatlon Impact Fees and.Reco.urse Recove.ry.Fees may applyCo the construction of new,bulldi�gs,:change-of �
use in �xist6ng buildings;�or�expansion:of�ezistiri�g���buildings, as �peclfl�d.ln Pasc�County Ordinance number 89-07 and
90-07, as amendeii. The unders(gned alsa understands, that such fees..as�may_tie�due;::wtfll�:be identified at the time�of-
permitting. I# I� further'understood that Transportatlon Impact Fees and R�source Recove"ry�Fees.must be pafd prlor to
receiving a �certificate of.occupan�y" or flnal�powec-release. :If 4he project does.not Involve.a;certiffcate of occupancy o� '
final power�release�, the�,fees must be patd prior to perrral4 f§suance. Fur:therrv�ore;If Pasco County 1Nater/Sewer-Irr�pact �
fees are due,_Qhey�_must be-pald.prlor to permlt-Issuance-In accordance wtth appllcable Pasco�County o�dinances.
CON�TF3UCTION�ILIEPI"LA9AV(Chapt�r T13� Flor�d��tat�at�s, �s �mendedp: Ef valuatlon of�rork is$2,500.00�or more, I
certify that 9, the applicant, have-been provlded with a copy of the "-Florida Constructlon Lien Lavv:Homeowrner's
Protection Guide" �repared by the Florida Departmenf of Agrlc.ulture and ConsumerAffairs. If the appllc�nt Is someone
other than the�owner", I certiPjr that 0 have.obtained a copy of the above..descrlbed document�and p.r.omise ln,good falth to
deliver It to the="ownec'°�prior•to�coPnmencerr�ent: �
CONTFtAeCTOR°S/�OWN�R'� e4��ID�+VIT: I cecfify.that all the Information.ln this appllcatlon is accurate and that all vvork
will�be don� in con�pllance with all appllcable laws regul�ting constructlon, zoning and:land d�velopment. Appltcatlon Is
hereby made to abtain .a permit t� do. work. and Installatlon as lndicated:-�. `I certify-that no wrork°or (nstallation has
commenced prior Qo issuanc� of a permlt and that.all work will be pertormed to meet_standards of all laws regulating�
construction, Cou�tty and City codes, zoning regulatiQns, and land development tegulations-In the jurisdtction. I aEso
certify that ! u�der�tand that Qhe regul�tions of other gov�rnment agencles may apply�to the intended work, and that it is
my responsibility to identify�what:actions I must take:to be,ln..compllance. S.uch agencles-Include but-are.not Ilmited 40:
- Department o� ��lvironmental Protectibn=Cypres"s. Bayheads; lNetland Areas and Envlronmentally Sensitive
Lands, Water/Wastewat�c Treatm�nt.
- Southwest Florida Water Management District-VVells, Cypress. Bayheads, Wetland Areas, Altering
Watercourses. .
- Army Gorps of Engineers-Se�walls, Docks, Navlgable WaQenways.
- DepartQnent of Health & ReMabllitativ.e Sen►lces/Envi�onmenfal Health Unit-Wells, Waste�►ater Treatment, '
Septic Tanks:
- US Environmental Protectlon Agency-Asbestos abatement.
- F�deral Aviatlon_Authorl�r-Runways.
I understand that tFue followring�restrlct�ons apply to the use of flll:•
- Use of fill Is not�Ilowed in Flood Zone°V"unless expressiy permlQted.
- If the iFll material is to be usetl_ ln Flood Zone_ "A", It I� understood that�a drainage plan addressing a
°componsating volume" vvill be submltted at tirroe of permltting which is prepared by a professional engineer
Ilcensed by.#he Sgate-of Florlda.
- If ihe fill materlal.is.:.4o be used In Flood Zone °A" in�connection�wi#h.a pecmitted building u§ing stem wrall
constr�ction, I certify lhat fill�:wlll:be-used only.to.flll the area withln the stem wall.
- If fill rriatePlal is to-be'used in any area, I c��tlfy that .use of�such-iill will n�t adversely affec4 adjacenf
propertfes. 9fi use of f�ll Is found to adversely.�6fect adJacenQ�properties, the owner may be clt�d for violating
the coridltion� of the�buildfng:permit lssu�d�under Qhe atfacFied permit applicatfon, for�lots 9ess than one (1)
acre whlch are elevated�by flll, an engtneered dralnage plan is r�quired. ,
I' If I aen the AGENT FOR YHE 01MtdER;I,�promise In good fai4h Qo inform the owrner of the:permitting conditions set fort� fn
, this affidavtt prlor tc� comrnencing constructton: I`uraderst�nd that a,sep�rate permlt may be required for elect�ical work, ,
plumbing, signs, w�lls, pools; alr cond(tioning, .gas, or-othec In'stallatfons not,specifically included-in.the application. .A
perm0t issued shall be eonstnaed to be a license.to-proceed writh the work and not as authortty to,violate,cancel, alter, or
set asld� any provi�ions of the technical codes; nor shall Issuance�of a.permit.prevent the Bulldlrig Offictal from thereafter ��
requiring a correctivn �fi errors In plans, consfructlora or vlolatlons of�ny codes. Every permlt Issued shall become invalid
unless the work authorized.by such permlt�s_comonenced�wlthln six months of permlt Issuance, or If work authorized by '
� the permit is suspeiided or abandoned for a:period,of slx(�)months-after the tlme the�work Is coroimenced../An exten�ion
may be requ�sted, In writing, from the �uilding,Official for a perlbd-not to exceed�nlnety(90) days and will demonstrate ;�
�ustifiable cause for.the extension. If work ceases.for ninety(90)consecutEve days,..th�job is consider�d ab�ndoned. � �
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WARNING TO OIIV'fdER: Y�UR.FAILlJRE.TO,REC.O�tD �►:NO�1�� OF•COMWIENCEMENT wIIAY�RESULT IN YOUR �
PAYIIVC;'T�MICE F�R IIVAPROVEAAEN.T3 T�YOUE�;PltOP@R�(.,:IF°YO.t��IMTEI�D�'T0=0BT'AIIV�FIIetANCINC�'COR1SUfl.'T '
WITH YOl1R E. D� O �1�4 ATTORNEY�� FORE-RECOlt�� G`YOU = � �C 'OF" .•IiPf � E CE � EIdT:
FLOF2iUA J11�1Y(F.�.59�.�D3j - � - --- - -- -— - -�- - =-i' ——
DWtdER 018 AGEN7 CONTR6�CT0
3ubscrtbed and swom to(or a�lrmed)before me thls Subscrlbed and'swam to r rmedpbe re me thts
� bY %�-Z-/
Nho lslare personally knovm to.me or has/haye produced Who Is/are .ersonally own�to me or hasiheve•produced
es Identlflcatlon. as IdendRcatlon.
Not�ry PubOc ix � Notary Publtc
�ommisslon No. •- ______ ' Comml on.N .
,� .
;=g•• '�`�s
_*: ':.= Commission#FF�150422
Vame of Notary lyped,piinted or stamped Name of Nota 't �
�,,pp f�,� Bonded Thru Troy o n neuranae 000�385•7019
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