HomeMy WebLinkAbout16-16873 N : CITY OF ZEPHYRHILLS
� 5335-8th Street
(813)780-0020 ,1 $73
ELECTRICAL PERMIT ���
PERMIT INFORMATION � LOCATION INFORMATION
Permit#:16873 Issued: 1/05/2016 Address: 6111 PEARL ST
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: 300.00 Total Fees: 40.00 Subdivision: OAKSIDE MHP
Amount Paid: 40.00 Date Paid: 1/05/2016 Parcel Number: 02-26-21-0020-00300-0010
CONTRACTOR INFORMATION - OWNER INFORMATION
Name: HOMEOWNER Name: SNOKE JEAN S TRUST & DIETERICH P
Addr: Address: 2168 WATERSIDE DR 6111 PEARL ST
CLEARWATER FL 33764-6659
Phone: Lic: Phone: 813-782-3286
Work Desc: REPLACE MAIN METER BOX
APPLICATION FEES -
ELECTRICAL FEE 40.00
INSPECTION E I ED -
ROUGH ELECTRIC
CONSTRUCTION POLE �
PRE-METER �
FINAL �
/
v /
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 property 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.
����
CONTRACTOR PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
� • Building Department .
Date Received �� �� �(j phone�Contact forPermlttin —
Owner's Name G—� kJGi f C� ��r 11 �'i Owner Phone Number `.3
Owner's Address � ' � Owner Phone'Number ��� ��� � 7 7 �
Fe�Simple Tltleliolder.Name � - - Owner Phone Number. '
Fee Simple TItI�holder.Address
JOBADDRESS II Q_Ct C ' S!� �� � �� �� �3�` LOT# �
SUBDIVISION , PARCEL ID# `
. (OBTAINED F.ROM PROPERTY.TAX NOTICE)
WORK PROPOSED �_NEW CONS7R ADD/ALT Q� SIGN Q = Q DEMOLISH
INSTALL B REPAIR - -
PROPOSED�1.USE - Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION �s Q'' ' BLOCK '" Q FRAME � STEEL 'Q
DESCRIPTION OF WORK' Ce i� � `FQ�^ ' � �/(�', � �
BUILDING'SIZE' SQ FOOTAGE � HEIGHT ��
OBUILDING $ VALUATION;OF�TOTAL CONSTRUCTION ' ` '
QELECTRICAL - '_$ � ��'�p � AMP SERVICE •Q PROGRESS ENERGY [� W.R.E.C.
QPLUMBING �$ '
�G��23 . ,
QMECHANICAL' $ ' VACUATIQN OF MECHANICAL IfVSTALLA7'ION
� ' pA��
S
. �
QGAS Q ROOFING Q SPECIALTY.Q OTHER - •
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
BUILDER COMPI4NY` � �
SIGNATURE REGISTERED Y/ N FEE CURREK Y/N
Address � License-# �
ELECTWCIAN; . )� Q��� .�COMPANY `l�IOty�.,� (�N LP�`
SIGNATURE �"�i�y��!�/7��.'�'L �' REGISTERED Y/ N FEE CURRE� ' ��Y/�N
Addre�� ' � , License.# �
PLUMBER `� _ .. � - , COMPANY ��.... .,.- • . ,
SIGNATURE` " :REGISTERED. Y.,/r.N� ' �-.�FEE�CURREK :. Y�/N. : .
Address License,.# �
t,... �: 4� �`, - `
MECHANICAL' �' ' - - , , � . , .C.OMPANY,. , �;_
SIGNATURE� � �' ' ' �r f REGISTEftED , ;,1,.Y./ N, . ._„- FEECURRE�,. Y-/�N -
Addresa'�' ' , : ` l ` � � - ' Licens.e#
OTHER " � u � � �;COINPAPJY , � � .
SiGNATURE° `-`a � , •'= • , , � . � ";
� 'REGISTERED' Y/ N:r.. FeE CuwtEn . Y I N
Addreas °•`,� � -• " � � � Cicense#
E,-. ....5� .. .� •5..,: ,, ;. .... ... ' . /' - � ' .. '^ .. ' .
RESIDENTIAL'•}�-.Attaoh(2),;Plot�.P.,laris;:_(2)�'setscof<Bullding+Plaris;'(1)'se't of Energy�Form'sC'R=0-W Perrnit for new construction,
, ;.s r.Minimum.ten�(•1,0);working�cfays;after,°submiftal`date:'�Requlr"eiJ onsite;-Constiucdon:Flans,Stormwater"Plans w/SIItFence installed,
__ _ ' �Senilary'Faplllti;es&:_1;dumpste_r,�Site,Work;Permitforsubdivist�ns/Iarge.proJects ,;; ,:= � �" ' -
COMMERCIAL Attach(3)'iioFnpiete seC§`tif'Buittltng Plans"plus a Ufe$afety Page;(1)set of Energy Forms.R-O-W Partnit for new construction.
Minimum ten(10)working days'after submittal date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilides 8 1 dumpster.Site VVork Permit for-all new�pro)ects.All commercial requl[ements.must meet compllance � � '
SIGN PERMIT AttacF�'(2)"sets of'Engineer.edsPlans.; , �.� • _. : _ ` � � •
"••PROI'ERTY SURVEY required for all NEW_construction.. •
D)rectlons: •- ,._ . � � � � � `
Ftll out applicatlon completely.
Owner 8 Contractor sign back of applfcaUon,notarized �
If over 52500,a Notice of Commencemenf Is required. (A/C upgrades over$7500) ',
, :�,;,m,•.;-; - ° . ;,�,..�..,.��,._:,_...�:-.,•,.�
" F�qent(for the-contractor)orPower'of=Attomey'(fo�the'owinerj would tie someone with notarized letter irom�owner authoniirig'same. _, a
DVER�THE COUNTER.PEiiMITTING-����-�v>�-_(FroM�of dlpplication�Only�.:.,......�; '' �� � ii � � �=�.-'r.�-:•sz I, ' - " ;,
Reroofs if shingles Sewers i Service.Upgrades.�A/G� •Ferices(PIoUSurvey/Footage) � - , , ,... �:�`-- � - � �
Drivewaya-Not over Counter if on'public roailways.�n`eeti"s ROW,",�, �:� � .;- -... _.� � ,.'..`.�`��.l��f. µl;'. P.J -, .
. ..,_..��.�...... � ...�.,......�.,,.r. .. p::���...f:
� � �
WOTICE�F D��D RESTItICYIOR�S: The undersigned,understands��,th�t-.this,-.p�cmit.may__be.subJect to,°deed" restrictlons" �.. � ..
which Pnay be�more-re'striettve-4h��a County fegula�fons. �Th��:uiede�igne�'assumes'r�sponsibility'for"'compliance vdttti a�iy � " "
applicable.deed•restrlctions. � �
UNLIC�N�ED� COIV7RACTORS AND CONT�►CTOR RE�PONSI�ILITI�S: (f=the=�wner has��'h(red a:contractor or
coe►tractors 4o undertake work, th�y may:be;ceiqutred�to=be-:licensed In.accordance.with state.and;local-tegulatlons. �If�the -�� "
contractor Ps not Iicensed�as� re'quired�tiy lavm, both the owner and'conU�ctor�enay be�cBted�for a misdemeanor vdol�tion
under state I�w. If th� owner or OnQended�.contr�ctor;are.;uncert�ln as to what Iicensin�.,requlrements.;may�apply:-��for:the =
intended"inrork, #h�y are adviseii to,contact tfie�Pasco County�uliding'inspectton_,:DlvOslon—Licerasing Sectton at 727-847-
�009. Fu�thermore, tf the own�r fias�'h9Ped`a cont�actor or cor�trac4ors, he�is �dvised to have th� contractor(s),.sign _ _
portlons of the "contractor Block" of..thla application:for�nihich they.wll�.be responsible. If::you;=as�.#he owner'sign"as th�� � �
contractor, that in�y'be an indication that'ti�`is not:prop�rly flcensed a�i� 0��not entitl�d to perrviiQting prOvlleges In Pas�
County. ��" �
TR�IN�PORTA7'ION.�IMPACT1lJTILIT'IES`IMPAC7'ANb�ItESOURCE RECO�IERY FE@S:�The und�rsigned understands
that Tr�nsportetion Impact Fees.�nd.Recourse F3ecove.ry.Fees may�apply�to the:congtru�tion of new.buildtregs��change��of' - � �=
use in exBsting buildings, or,expansi�n:�of ezisfbng�buildEngs, a� speclfled.in Pasco Gouroty Ordinance number 89-07 and �
90-07, as a,mended,...Th� undersBgned also;und�P�tainds, ttoat:�such fees,:;as�may_be�du�;:wlll:�be ident(fled at the�time°�of��' ����
permitting. It Is fu"rtlier understood that Transport�tion Impact Fees ac�d'Re�ource..Recovery'Fees.must be paid prior to
receiving-a °cerEi�cate of�occupancy" or flnal-.power:release� :Bf�the project..:does.not involve�a=�.certificafe of occupancy-or�'��
flnal power-rele�se; the fees�or�u�t b� paid.prior to permft Is�uance. Ft��thermore,•if Pascv,.County"INater/Sewer�:lrrepact : ��
fees are due,.lhey_must be,pald.pelor to.permit iss4ance=ln accordance wiitti.applicable-_P�sco�County�o�ditoances. •
CONSTRUCYlON"LIEN LAV��(CIi��4�r 713� �I�rlda�t�tut�a��a am�n�ed): If valuatEon of work is$2,500.00:or more,.I� : , �
certify that I, �he. applicanQ, have.been provided�v�rtth a copy- of the �Fiorida� Construction� Llen.:L'avir--Homeowner's
Protectfon Guide" prep�red by tti� Flo�ida Dep��ment of Agric.ulture and ConsumerAff�irs. If the applicant I� someone ,- ,
other than the"owner", I certify thaQ I h�ve,obtained}a'copy.of.the�above:.describeddocui�ent°and.promis�In,ggod:faith,to
deliver It to.-the"owr�er"�.p�ior�:to�cornmenceme�iE:" - �
CONTRACTOR'SlO1MNER'�AFFIDAI/IT: I.cerQify th;at�Bl.Qh�;lnf.ormatlon::in�this appl�catlon is accurate�nd that all vvork
will'be don� in compliance with all.applicable laws regulating constructlon� zoning and l�nd development. Applic�tion is
hereby made to obtain .a perenit�30 ,do wotk;.,and�In�tallatlon as Indl�aRed:.� :i cer�ify Rhat no work-or Installation fias
c�mmenced prior to issuanc� of�a perrriit and that.all work wtll be performed�to meet standaTds of�ail laws regula�ing�
construction, County and GBty cod�s, zoning regulatlans, and land development t�gulations�in the jurisdicQton. i al'so
certify that I undersfand that the r�guiations of other governmen� ageneles m�y�apply�to the intended work, a�d that it Is
my responsibili�to identify.wh�t,act(ons I must t�ke:to.be<In:.complia�ce,.,Such:agencies Include b�af are.not limited to: �
- Depa�tment of Er�vironmental�Protectiori-Cypr�ss.`Bayhead�, 10!l�aand Are�g and Envirorameretally Sensitive
Lands,W�terMlastewater T'reatment.
- Southwest Florida !lV�t�r Management .Di�trEct-I�/elis, Cypress.'�Beyhe�ds; �VVetland Areas, Alter3ng
W�tercourses.
- ArPny Corps of Engineers��awalls, Docks, N�vtgatil�W�terways.
- Department of Health:'.8 -ReY�abllitat(ve�ServEcesfEnvironm�r�t�9 Health Uni�VV�II.s, VNast�v�ter�Tre�trn�nt,
Septic Ta►oks. � �
- US Enviroromental Protection Agency-Asbestos abat�ment. �
- Feder�l Aviatlon_Authori,ty.-Runvvays. -
I understand that the following;restricllons apply'to the use of flll:•
- Use of fill Is not allowed in:Flood.Zon�"V"unless expressly pe�naitt�d.
- if the fill mat�rfal is t�"be us�d,ln.�Flood Zone. "A", IG is understood that � dratnage plan addresstng a
ycompensating volume" will be submltted at time of;p�meifting which Is prepared by a professional engin�er
Iicensed by the�tate of;Florlda: - �
- if the fill materlal is to :be,used in Fl�od Zbne '�d" In�connection�with�a peemitted building using stem wali
construct(on, I certify.that fll�:wall:be-used only.to.fill the ar��withtn the�stem�wall:
- If flll rro�terial is to be us�d ln any �rea; I c�rtlfy tfiat .us�. of such flll will not adversely affect adjacent
properties. If use of flll Is foa�nd to �dversely.,�ffect adJaEen��propertles,.the owner may be c04ed for violating
the condFkions.of.the building'.permlt i§sued under 4fi�.attached_.permit application, for:lots�.less than.one (1)
acre whtch are elevated�by f111,a�t engfn�ered draln�ge plan Is required.
If I am th�e4GEPIT FOR TM@ OWNER; I��iromise In good fa0th�o inform th�owner of the p�rmitttng condi�ions set for�h tn
this affod�vit'prior to commencing construction. I uniler�fand that a,separate permit m�y be required for electrical vvork,
plumbing, signs, welis,.pools;, alr conditioNng,..gas,, or"other in�t�ll�tfons nol�spec�ically Included�in the appl6a�tion. .A
permit Issued shall be canstrued to be�� Iic�n�e'to proce�d vvlth the`vvork and not as�authoNty to.violate��-cancel, alter, or
seQ aside�ny provistons of the teclinlcal codes; nor shall issuanc��of a.permit prev�nt th�Bulldirig Of�iclal from thereaf4er
requiring a correctlon af errors I¢�:plans, const�uct6on.or violat�ons of�•any�c�des. Every pi��mlt Issued sfiall become indalid
unless 4he work author(zed.by such permit:�s-coFnmenced•wtthln sfx m.onths of permit Issuance, or if uvork authorized by
the perrnit is�uspended�or:ebandoned:for a:period of:six:(8)montfi�.�Rer-'the time the�wo�k�ts commenced. An ext�nsion
may b� requested, In writirig,from the�Buildtng,Of�cial for� p�rlod noQ to ex�eed:nine�r�(90) days ai�d-will demonstrate
justifiable cause for.�the exten�ion�. If work ceases:for ninety(90)cons.�cutive days;..th\Job�is considered abandoned:
�lARMING TO OVVRIEFl: YOUR.EAILURE.�TQ..PdEC.OttD,A::t�OTIGE.OF,�CONiME(dCEh�lENT=NiAY�RES�JI:T IRl YOUR
Pe4Y1N(�TWICE.FOR�INIPROV�IVIENTS�TO.Y�UE�::PROPERTSY. I�°.YOUr91d'F��:TO��O�TAIN;FINAI��ING;'CON�IJL�'
—�1i�6�-��40R LEi1�D�R 0�A�54-r$�4'OR�J�Y���OR�'��Ic�O�3�1P:�-'7Q41�'�T-�rC�'O�`�OM�lE�lC�i��R9'f—`-
FLORIOA JURA�(F.S.1.17.03) � _, - • .
OYdPIER OR/At3�M4�LfS/CM��� GON�CTA �'�K���
Su scrlbed and swo tosor Pflrtned) efore me th(f Subscrlb and' (o aflirm��e/d)�befc�te me QPi�y@'`
- � by � C fJ('i./� �CL'^/I�.LI �c�'� .by- ' ��i,t)Q�CS� �-�`� l � 1�C�S•
Whq.F�/are,personaily_knowm to.me or h�slh�ve produc d Who.I��Pe,p.erson�lly�Cnc�vu�to me:or hesfieve�produced •
__ I-'L.., 1J►4-s1�s l�c� ae ldentlAc�tlon. _ -r/, '�:ul�-� �ctr4L2� �s ld�ndflcadon.
r a � Notery Publlc f �--�. Note�ry PubIIC
�ti��Pj:&�. JACQUEII
Commi slon °�' �: BOGES Co mission o.
� : : sion 150422
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=;;. ,P; Expires December 12 2 ,,,•:;��.r, . JACQUELINE BOGES
Name of Pdoi� �a�a8W�3A5•7019 Name of Notaty @d�= t�o
I ;. •,: xp r ember 12,2018
I ��.;;ul��?�'� Bo�d Ttw Troy Fdn Insuraae BU0�385d019
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DISCLOSURS STATEMENT FOR OWNBR
CITY OF ZEPHYRHILLS BIIILDING DSPARTMENT
_. have read aad fully understand and
agree to the provisioas of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovatiag, adding to or reroofiag his or her own domicile, that he or she
actually occupies, or will occupy by said domicile, aad same is aot for
rent, lease or sale. That he or she shall comply with the followiag coaditions:
1. That the owaer and he or she aloae shall act as the builder for all phases of
coastruction.
2. That the owaer will comply with all provisions of the City of Zephyrhills
ordiaances and codes pertinent to the building.
3. That in the event various phases of constructioa are subcoatracted, he will
� engage oaly properly licensed subcoatractors aad will personally supervise
, such work.
4. That in the eveat the Suilding Iaspector shall require correctioas to be made,
the owaer will assume full respoasibility to insure they are made, and upoa ,
completion will call for a reinspection before proceediag with the building.
5. That the owaer ahall assume full responeibility for the constructioa aad will
aot expect supervision of his work from the City of Zephyrhills Buildiag
Departmeat.
6. That prior to fiaal inspection any additional fees, iacludiag reinspection
fees, must be paid in full. A writtea request from this office shall
constitute an official aotice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owaer shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be doae by licensed contractors. You have
applied for a permit under aa exemption to that law. The exemptioa allows
you, as the ovaner of your property, to act as your own coatractor with certaia
restrictions evea though you do aot have a license. You must provide direct
onsite supervisioa of the constructioa yourself. You may build or improve a
one-family or two-family resideace or a farm outbuilding. You may also build
or improve a commercial buildiag, provided your costa do aot exceed $75,000.
The buildiag or residence must be for your owa use or occupancy. It may aot
be built or substantially improved for sale or lease. If you sell or lease a
buildiag you have built or substantially improved yourself within 1 year after
the constructioa is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violation of this
exemptioa. You may not hire an unliceased persoa to act as your coatractor or
to aupervise people• workiag on your building. It is your respoasibility to
make sure that people employed by you have liceases required by state law aad
by couaty or muaicipal liceasiag ordinaaces. You may aot delegate the
responsibility for supervising work to a licensed coatractor who is aot
licensed to perform the work being done. Any person workiag on your building
who is not licensed must work under your direct supervisioa and must be
employed by you, which meaas that you must deduct F.I.C.A. aad withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your construction must comply with all applicable laws, ordinaaces, building
codes, aad zoaiug regulatioas.
OWNER'S SIGNATURE DATE �'� � �
ADDRESS � / �
PHONE
WITNESS PFsRMIT #