HomeMy WebLinkAbout16-17680 i - CITY OF ZEPHYRHILLS
•�- ' - i 5335-8th Street
� (813)780-0020 17
I ELECTRICAL PERMIT
I PERMIT INFORMATION LOCATION INFORMATION
Permit#:17680 Issued: 8/19/2016 Address: 5152 17TH ST
Permit 1'ype: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRICAL MISC Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: � 1,300.00 Total Fees: 45.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 45.00 Date Paid: 8/19/2016 Parcel Number: 11-26-21-0010-19700-0120
CONTRACTOR INFORMATION OWNER INFORMATION
Name: ,PATTIE ELEC. & REFRIGERATION Name: TURGEON SAM
Addr: ;39111 PATTI RD Address: 5527 16TH ST
�ZEPHYRHILLS,FL. 33540 ZEPHYRHILLS FL 33542
Phone: �(813)782-3319 Lic: Phone:
Wo�k Desc: UPGRADE PANEL
I APPLICATION FEES
ELECTRICAL FEE 45.00
INSPECTIONS REQUIRED
ROUGH ELECTRIC
CONSTRUiCTION POLE
PRE-METER
FINAL I \ /�
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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.
"Wa�ning 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
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813-780-0020 City of Zephyrhills Permit:�Application � FaX-s�saeaoo2�
� , , � Bullding Departrnent , ,
Date Recelv�d ° Phone Contact for Permittln "' "." � —
Owner'a Nam I � ,� I(� (/1/ti Owner Phone Number ,
Owner's Addross Owner Phone Number
Fee Simple Titleholder Name � Owner Phone Number
;�
Fee Simple Titl�holder Address •
JOB ADDFtESS � h LOT# �
SUBDIVISION PARCEL ID# - ��(��� �(�( � '` G��G���
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROP�SED •NEW CONSTR ADD/ALT Q SIGN Q � Q DEMOLISH
B. INSTALL B REPAIR
PROPOSED; ISE - Q SFR. Q COMM � OTHER
TYPE OF CORISTRUCTION Q BLOCK " Q FRAME Q STEEL" []
DESCRIPTIO I OF WORK' � U '� D �jijiL
BUILDING'SIZE' SC1 FOOTAGE C� . HEIGHT� .
OBUIi DING $ VALUATION�OF TOTAL CONSl`RUCTION
L�CTRICAL $ "� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
OPLUMBING $ —
� ����
QME�HANICAL $ VALUATION OF:MECHANICAL INSTALLATION
QGAS Q ROOFING Q SPECIALTY Q • OTHER � � ���
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANIf� � "
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
Addre�� � License# �
ELECTRICIAAFII. COMPANY -„eG (r(L °`" (/�( 'e�-!'/ p
SIGNATURE �` REGISTERED / N FE CURRE��� 'Y/N
AdcYress License# ���.C�U d �� �p�
PLUMBER COAAP.ANY
SIGNATURE" REGISTERED Y/-N FEE CURREn , Y�/N
Addre I .License#
MECHANICW:` COMPANY
SIGNATURE� ' REGISTERED Y./_N FEE CURRE� Y/�N
Address - - � ' - � " � ' , � Ciceqse#
OTHER ' - �- '.COMPAPIY, ,
SIGNATURE -., ' � - � ' - � ' Re�Is7E�o Y/ N,, FeE CUR�n•� Y/N
Address _ License# `
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RE3IDENTIAL: Atta,cFi:(2),Plo.f Plans;a(2)sets:of:Buildi'ng+Plans;'(.1)sef of-Energy=Fonns;�R=O=W'PeRriit for new constrtiction,
;�-Minimum.ten;(:10)�working;ifays_after,�submittal"date.=Required ons(te,�'ConstnictlomPlans;Stormwater'Plans w/Sllt Fence installed,
� ���SaniEary FaGltUes.&;l;dumpster,�Site�Work�P,>ermit;for su6divislon"sAarg"e.pro)ects '• ' ' � �; ` _ �
- COMMEP.�'l�4i. Attach(3)�complete`sets`of Buildirig Pians�plus a Life�Safefy Page;(1)set of Energy Forms.R-O-W Permit for new construction.-
I Minimum ten(10)working days'after submithal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, -
Sanitary FaciUUes 81 dumpster.Site Work Permit for all new projects:All commerctal requlrements.must meet complfance
SIGN PERMIT Attach"(2)'sets of Enginee[ed;Plans:.. : � .. � -
I "'•PROPERTY SURVEY required for all,NEW construction. .. , .
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Directlons: I .,��:: :, u -
F(II out applicadon completely. ;
Owner 8� Contractor sign back of appltcatlon,notarized �
If over�2500,a Notice of Commencement is required. (AIC upgrades over 57500)
" Agent(I r the�contractor)or Power of Attomey(for tFie owrner)would be someone with notarized letter from owner authorizing same '
DVER THE�OUNTER,PERMITTING - - �(Front ofiApplicatlon Only) - -
Reroofs if sh�ngles Sewers Service Upgradas A/C Fences(Plot/Survey/Footage) -
Drivers I ya-Not over Counter if on public roadways:.needs ROW
NOT1�E OF DEED R@STI�ICTION�: The unde�rs�gned under�t�r�ds�:#h�t,thl�,°p�rmit.mayb�.sub)ect fio"deed"res#rtcttons"
whlch may be•:more�r.est�ictive-thaFl County regulatians: �Th�underslgned�assumes�responsftiillEy�for"compliance with"a'riy
appltcable deed-resttictions. �
_UNLICENSECI- CONTRAGTORS -ANL9 CONTRACTOR RESPANS181LITIES: -if the �wner h�s��hired a contractor ar
contractors to undertake work�they may b,�;r,equlc�d•.to-:be:.Ucensed Irt accordance.with state.and�Iocal regulattons. {f�khe
contractor Is nat Itcensed as�required=by law, both #he own�r and contractor•may be-cited-for a misderneanor violatian
under state law. If the owrner or Intendeds,cantracto� are,;uncertaln as to what Iicensing.requlrements may�apply:�for the
�:_,.
intended"wark,they are advlsed to contact tlie'Pasco Courity Building'lnspectlori.Dlvis#on--Llcensing Sectton a#727-84T-
8009. Furthermore, if the owner has hi�ed a contracfor o� contPactors, he Is advlsed to have the contractor(s) sign
portlons of the "conkractor Block° of thls appllcat[on.for which they wil� bs responslble. If.yo�, as_ihe ouuiiie�'slgn'as'the
confraafar� that inay be an indicatlon that�he is not.properiy licensed and`�is nmt ent�ied to permitting prirrileges in Pasca
County.
__ 'a'?�dl11!��?+��x�Tf��3-d�"tB���T�6�r 6�:��'6c�9�Fi�►�-i��A�1�=r�E��i�9�t��"iRE�a`�Ef��'�EES: The underslgned unders#ands
� , that Transporkation Impact Fees�and.Recourse Recave.ry.Fees may::apply:ta�the ctmstruc�6on of new bulidings,-change�of
use in existing building�, or�expartsloet�of=ezisti�i�°�liuildings, a� spectfled !n Pa�co Gounty Oedlnance number 89-07 and
90-�7, as amended., .,"Ghe undersigned atsa;understands, that:such fees,�:as�may:�ie�:due;:•wilh be id��nti�ed at the�#irr�e�crf�
permitting. It Is iu�kher understbod that Tracrspoe�atlan Impact�'ees and�Re�ource Reco�ery�Fees must be paid prior to
reaeivir�g a °cerElficate-of�occupancy"or flnal-power-.release. :I��the.prr���ct�d�es tto�irnrotve=a:certifica#e of occupancy.or -
flnal power-release;the fees mu�t be pai� prior to permR Issuance. Fu�thermore,•if:-Pasco,County�V1latedSewer�Impact
fees are due,they�.must be�pald.prlor ta permlt lssuance-ln accordance witli appttcable�Pasco'.County acd3nances. �
CONSTRUCTit3N CIEN'LAW(Ctispter 713� Fi�Nda Statute��as smended): if vatua�on of wark is$2,500.00-or more, t
certify tha�t I, the applicant,. have.been provlded �with a-copy of 4he� °Flarida Constru�tion Lien l.au�—Homeowner's
�'rotectian Guid�" prepared by the Florida Depa�tmer�t of Ag�lault�re and ConsumerRfFairs. If the app[icant is sameone
other than the"owner", I certify th�t I;h�ve.ok�t�ined>a�cop�r of the;above..des.cribed`�locur�en��a�d.promise�in,good faith ta
deliver it to.the."owner",p�ior.to�cornmericement: ` - � ,
CORITRACTOR'�/OWNER'S AFFIDAVIT: i.ceeti�jr�th;at�ali�,the,lnf.ormatlon in�thls appllcatlon is accurate and that all wark
will�be done in compliance with all apppcable laws regulating�onstructlon� zon(ng and land developrnent. AppUcatlon is
hereby macfe ta obtaln .a permit to do. work_.and inst$Ilatlan �s tndE�efed:. °I certffy that no work-:or instaltation has
cammenoed prio� ta Issuance af a perm(t and that �II work will be pertormed�4o me�t standards of ali laws regulating�
construc#�ar�, County and City cades, xoning reg�la#ians, and land develapment r.egulaft�ns:ln the Jurisdfctlon. ! al'so
cer�liy that I understand 4hat the regulattons of other governmenk agencles may�apply�to #he Intended work, and #hat 1t is
my respa�slbAity#o ldentifjr.what��cttons!musk•take:to be,in:-cQrt�pllar�ce. S.uch agencfes Include but are.not Ilmited ta:
- Department of Et�vironmental Protection=Cypre�s.8ayhead�, We�and Areas and Envlronmentally Sensitive
Lands, Water/Wastewater T�eatment.
- Southwast Ftor�da W�ter Management .C�Es#riic#-Vitells; Cypres�.''Bay�eads;- Wettand Areas, Atteri�g
VlCatercaurses. .
- Army Corps of Engineers-Seawa!!s, Docks� idavlgabie Waterways.
- Deparfinent of Heaith�'8 Rei�abiiitafive Services/Envitonmenfal Health Unit Well.s, Wasteumtater�Treatment,
Se�tic Tanks. � _
- US Envlronm�ntal Protectian Agency-Asbestos abatement,
- FederaFAvlatton.AutMority-i�unways:
!understand th�t the..Bollawing.restrlciions apply 4a the use o#fllt:�
- Use of fill is nat atiowed in F1ood Zone"V"unles�s expressly permitted.
- if the fill material�is to b.e used: in �flaod Zane. �A", (t. is understoad that a drainage ptan addresstng a
°compensating votume"wltl be submltted at#me ot p�rmitting wfiich is prepared by a prmfessional engineer
Iice�sed by the�tate af'Florida.
- If the f�El materlaf Is Ep be used in Fload ��ne 'A� in!c�nnection�w1th�a permttted bnitdtng using stem vuall
� construction., I cenify that flll•:wall:b.e used only.to.flll the area within�the stem�wali. �
- !f fill rnaterlal ls to be used in any are�, I �ce�t�jr tha# .�se of such flH wfll not adversely afFect adjacen4
properties. ifi use�of fill 1s found #o adversely:�ffiect adja�eat��praperties,.tha owner may be cited for violating
the condllions,of_the building:permit�issued.under the attached,permik applfcation; for:lots.less�than.ane (1�
acre vw�i3cti are elevatect by f�lt;a�t englneer�ed dralnage plat�ts requlred. .
If!am th��►GENT FOR THE OIMNER, I;'Qromise In,good falth to inform the owner of�the permitting.conditlons set forth in
this affidavit�prior to commencing constructlon. i unilerstand that a-separate permit may be requtrad for etecfrlcal work,
plumbing, signs, weHs,.poots; air conditioning,.gats,;or othec (nstall�tlon� nat�spec�icatty indu�isd-in.#he application. .A
pe�mit issued shall be coristrued to 6e a�Itcense to•pr.oceed wlth th�wark and nok as:authoNty�to:violate;cancel, alter, c�r
set aside anjr'provlsions of#lie:techntcal cades;�nor shatl tssuance�of a.permit.prevent the Bc�lldlrig Of�falal from thereafter �
requiring a corcection af.er�a�s�inwplans; construction c�r vIol�Uons of�any codes. :Every'perm(t issued-shall beaome invalid
unl�ss the work authorized�by suoh permit.�s.commenEed•wtthln.sfic manths ot perml# lssuance, ot if wark authorized by
tfie permit is.suspended�or,abandoned.�far.a:perlod of six�f8)monti�s..after the time the�work(s c�ammen�ced. An extension
may be reque�ted� In wciting,�from the�Building,Oiflclal for a period':not to exceed�nlnety�(90)-days a�d wil! demonstrate
justifable,cause fbr.fhe extansiar�. If work ceases:for ninety.{90)cans.ect�tive:day.s,..the�ob�is.constdered aba�rdoned,
WARNlNG TQ t�WNER; YOUR..FAI!lJRE-7A,R�ECORD A NQYIGE.tJF-Ct�M19�EMCEMEMT�.MAY RESUkT IM Y4UR
PAYING TWICE;�OR.IMPROVEMEN.TS�TO YOUR:PR'I�PERTY: �IF�YO.U=1N'�EEr+11D?T�'OBTAIN��FIN�►w�1NG;'CONSULT
W!T U D O N O OR��. -Q� �:! OU ' . :+� 'Ct � ���' E �E �
Ft.ORIQA JURA�{F:3:1.17!.03) ' , � - �j� , . .
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OWIdER OR�►OEIdY . COAITRAG7Q1t
Subsc►ibed and swom to{or aftirmed)befare m�fhis Sut�scrlbed snd'swram=ta(pr rmedpbefiore`me�ii� �
by �b / � �
Wfio!s/are personally known to.me.or:haslhaae produced ,UUtto.lslare na y ta.me,ar.haslhave•produced �
as IdentlBi��an. ` _, as iden8ficatian.
Nokery Publlc Natary Publlc
Commisslan No` C rt�lss R!a
(Vame ot 1Vatatry iyped�Printed or stamped R�ame af Notary iype , p�d,.■.r„�
,�Qti� "�-, JACQUEL.INE BOGE
. _•• R= Commissian#FF 95Q422
- � � � ;�,�P: Expires becember 12,2018
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ay Fain Insuranca 800-385�7019