HomeMy WebLinkAbout16-17712 - j___ _..�r_......._ _ _ � ` �
� CITY OF ZEPHYRHILLS � '
� .. 'I 533S-8�h Street ,�
(813)780-0020 17�"12 �
� E[.ECTRI�AI. PERMIT `�
f PERMIT INFORMATION LOCATION INFORMA,TION
Permit#:177'12 Issued: 91Q712016 Address: 5'[�3 20TH �T
Permit�ype: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE REPLACEME T Township: Range:
Propos'�d Use: NOT ARPLICABL.E Lot(s): Block: S�ction:
Sq. Feet: Est.Value; Book: Page; 'i
Cost: i� 550.00 To#al Fees: 40A0 Subdivisian: CITY O�ZEPHYRHILLS i
Amount Paid: 40.00 Date Paid: 9/07/2016 Parcel Number: 11-26-21-0010-199Q0-0090 �
CtJNTRACTtJR INFORMATION OWNER INFt3RMATION {
Name: JAMES O MORTON ELECTRIC CO.,INC. Name: BETZEN MICHAEL & DEANNA
Addc: P.O. BOX 1537 1055 GEIGER RD. Address: 5153 20TH ST
ZEPHYRHILLS, FL 33539-1537 ZEPHYRHILLS FL 33542-5217
Phone:l(813)782-7237 Lic. ER QQ02443 Phone:
Wo;rk Desc: CHANGE OUT METER CAN 200AMP
APPLlCATlON FEES
E�ECTFtICA�FEE 40Ad
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INSPECTIO QU1 ED
ROUGH E ECTRIC
CONSTR�CTION POLE �
PRE-MET� _ �`
FINAL II �
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REIN�PECTION FEES:(c)With respect to Reinspection fees will comply with Flarida Statute 553.80 (2)(c)#he
locai government shatl impase a fee af faur times the amaunt of the fee impased for the initia[ inspection or
� first reinspection,whichever is greater,far each such subsequent reinspection.
NC?TIC�: In addition to the requiremertts of this permit,there rnay be additionai restrictions appiicabie to this property that
may b�e found in the pub(ic records of this caunty, and there may be additianal permits required from other governmental
j entities such as water management, state agencies or federal agencies.
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"Wa;rning to owner: Yaur failure ta record a notice af commencement may result in yaur paying twice for
improvements to your property. If yau intend to obtain financing,consult with yaur lender ar an attorney
�� before recording yaur notice of cammencemenfi."
Comp�ete Plans, Specifications and Fee Must Accampany Application. All work shall be perFormed in accordance with City
� Codes and Ordinances.
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CONTRACTOR PER OFFI
I PERMIT EXPIRES IN 6 MfJNTHS INITHQUT APPROVED INSPECTIO
, CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
� PRt�TECT CARD FROM WEATHER
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a��-�eo-ooaa City af Zephyrhills Permit Application FeX s�aasaoa2� �
, Y i Butiding Depa�ttnsnt
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Date Recefvs�i Phone Co tact for Pe snitt�n -
Owner"s Namll � � � �v , Qwnsr Phone Nannber
/ � �Owner's Add, ss . I �'�.� Owner Phone Number �
Fee Slmple TI)Ieholder.Name � � Owner Phane Number r� �
A'�
Fee Simple Ti�I�holder Address �
JOB ADDRESS v � ✓ LOT# �__,��
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SUSDIWSiO PARCEL ID# �
„ (OBTAINED FROM,PROPERTYTAX NOTICE}
WORIC PROPOSED � NEW CON5TR' , ADDIAIT � S1GN �Q [� DEMOL.IBH
,e. INSTALL 8 REPAIR �
PROPC3SE4.U�ISE Q 5FR- Q Ct}MM Q OTHEFt
TYPE OF CON$TRUCTION' Q � BI.00K '" [_] FRAME STEEL �,]
DESCRIPTIO� OF WdRK � �' � � / � U J
II ( -
BUILDING�Sl� �`SQ�FOOTAGE{�, �. „HEIGHT I
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����'�1��' $ J VALUATIONx"tJF TO'fAL CONSTRUCTi . � `�
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li QE� CTRICAi. $ ' AMP SERt110E ��1� � PROGRESS ENERGY [� W.R.E.C.
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QFLUMBINti $
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E Q{t+tEGHANlCAL $ YALUATlON OF.MECNIWICAI.INSTALLATION.
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'k C]��S 0 aooF�N� _0 sp�cx�.�r � 01'HfR -
� FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA �YES NO
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; BtlI�D�l3 � GOMPANY` `
SIGNATUREi REGISTERED Y/ N �eE curt�n ' Y/N _�
j Addrea� � , �L:lcense�#
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�� �t�c�c�.' t�� t -coM�,a� �' _ ' � U r� l;
SIGNATURE� �' � �� REGI3TERED Y/ N FEE CURRE�` Y/N
Addre� - _ . � License# � . � �
I PLUNIBER '� - COMRANY ,
� SIGNA"I'URE� ' REGISTERED Y./:N: . �Ee cu�En ' Y-/N. -
I Addre � License,# � -�
MECNAPIIC ' ", _ � COM,P,ANY . . ,
SIGNATURE� � � REGISTERED Y,/ N FEE CURRE� Y/-N
Addrss� ' � AF J� - ` - � � License#
OTHER � � ',COMPANit, ,
SIGNATURE °- � `' `' ` � ' REGISTEREyD ' Y/ N . FEE CURREh Y/N
Addr � .. l . _ ' _ � "licerise# �� �
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RESIQEN _�� �.f : �Attacti'{2)APIo#%P-,lans;<(2)§efs_.ofiBulliling�Plao's;`(1}'set af'Energy=Forms;`'R=0-W Perisilt far new cxinstruaUan, '
� � MinlmumNten,(,1,0);worlcing;daygyafter.:submittafdafe.'�:Requlred onsite;:Constrtrcdon'P..Ians;Stortnwater Plans w/Sllt Fence installed,
. ������ �Sanitary Facllidess&;1;,dumpste,r,-$Ite-Wo►1c,,Permif;far subdlvislons/iarge projects;,.'�h_;._,. ' - � �
COMMERCld41. Attach{3}�oainptete's�#s of Building�Plans pius a Llfe Safefy Page;{1)set af Energy Faims.R-O=W Perrt�it for neuv construc�#3on.
Minimum ten(10)wartcing�days afke�subirilkhalFdate: Required onsite,CanstrucNan Plane,��Storitiwater Plans�w/Silt Fence instatled,
Sanitary Facilitles 8�1 dumpste�.Site Work Permtt for all new projects:All commercial requlrements must meet compliance
St�N PERM T Attacti{2}sets of Eriglneer.ied�Plaris.,:� ��.^ - � , -
i ""'PROPERTY SURVEY reGutred for aII,IVEW constructlbn.
Dlrectlo�s:�) ;� , �
Ffll out;applicaHon completely.
Owner!�Contrector stgn back of applfcaUan,natadzed
if aver;3�500.a NoUce of Commencement la rfequired. (AlC upgrades over 57500)
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'" Agent(for the cantractor)'or Powe�of Atfarney(for�tFie ovimer)would be someone with notarized letter from owner authorizing same
t�VER THE��OUNTER PERMiT'i1NG ..__,.(Front af•AAPiication O�ly}-
Reroofs if s�ngles Sewers Service Upgrades A/G Fences(PIoUSurvey/Footage)
Drivew ya•Rtat over Counter if an public rasdways..needs R(3W
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fVOT10E OF D�ED RE3'PRICTIONS: The undersigtaed undergtands;th�t_this::p�rmit.may.b�.subJect:to.;"deed".restrictions" .,��, _ _�'
which may�be=more�restir:ictive=th��Counfy��regulatfons: The��under�lgned��ssuriies�resp6n�itifltty�`for'compilanee witfi any`'"�� �� �
applicable deed reshictions. ,•: � �..,� - • " ,.. � ._ : : • � �' ~
UNLICENSED CONTRACTORS �AND CONTR�►CTOR�RESPONSIBILIYI��: °if°tfie �wner h��° hired°��"contractar or
contractors to undertake work, titey.may.be�r�qulred..to:�bevlicensed ln�accordance.with:atate.and�local,,regulations:t�lf°the�k.� =
contractor ls-not Ucen�ed�as'requlred�tiy lainr� both�the'ou+mer and"conUactor��rriay be°�clfed�'for a�iriisd'emeanor violatton
under state law. IF the owner or tntended>oon,,.tractorare,;uncertaln as to what Ilcensing,;requirements,5may-.apply���or:�the��� �- •��.� °
Intended work,'they a�e�advised to i:oritact the Pasco County,Bullding;Inspectlon Division�-l:tcensing Section at 727-847-
8009. Furtliermore, if the owner'has hlred"a�contracfor or contractors, he is advised to have the contractor(s),sign.
portions of the°cvntractor Block" of this_application�for which.,they wilL.be�,resp.onsible.�.�{f:you;�as;#he owne�sign"�as`the ' "`� `
cont�actor, that�may be an indication that'he-is not:prope�ly ilcensed-and-ls'not �ntiiled 4o per�viitting privlleges in Pasco ,._
County. ' , �. � • . ; : ,: , ... �,�
TRa4NSPORTATION.IMPACTIUTILITIES'rMPAC'�ANb RE$OUitCE RECOVERY FEES: The undersigned-understands
thatTransportation Impact Feas and.Reco.urse Recove.ry.Fees rriay��appiy�,to�tf�e_construction:of new._bulldings,;change�of==,''���� F`
use in exis8ng buildings, or,expansi�n�-•of�existin�g:�butid(ngs� as specifled.in Pascv County Ordinance number 89-07 and
90-07, as amended..,�'he, undersigned also=urtderstands, that�such fees;;as�may=be:.due;�wlll;;be identified at the=#ime`:of��--�" ��
permitting. it is furtiier'understood that Tra�sportatlon Impact�Fees and=Resource.:Reco�ery-`Fees..must be paid prior to
receiving�a °certiflcate of�occupancy"�or flnal�power.release. :If`the.proJect,.does�not involve�a�:certfftcate of occupanoy_°or`��'�' • <<r;''
flnal powec release, the.fees mu�t tie"paid;p�for to.permft issuan'ce. Ft�IGthermore;•ff Pasco,County'llVater/Sewer,;lmpact -;.,.
fees are due�,they must.be�pald-pNdr to permit=lssuance=:in_accordance.wltF�:applicable:Pasco'.County'ordinances. •
CONSTRUCTION�GEN'LAW�(Cfe��ter 773� Florlda S@atute��as amended,; If valuadoni of,work Is$2�500:00�or more� l�� :� -.�, .
certify that I, the,applicant,:-have.been provided with.-a=�copy�of:.:the�"Flo�ida°�Constructlon� Lien :Law—Homeouvner's
Protection Guide" prepared by,tfie Floiida DepartmenC of Agriculture and ConsumertAffa(rs. If the applicant is someone ..
other than the"owner", I certify.that I;;h�ve,obtaJned�a�eopy.of.the`=above:.described'tiocuii�ent:and;p.r..omise.in;good#aith to �.;
deliver It to:the"owner"�p�ior:to�commencement:'�'. - � -� ' . - � - • , �
CONTRACTOR'SlOWNER'�AFFIDAVIT: I.certlfy°that•.aI).the,Inf.ormation:ln:thi� application is accu�te�nd that all work
v►►ill'be done in compliance with all.appltcable laws regulating.construction� zoning and�land�development. Application is
hereby made to obtaln .a.pecmit�:to :do.,�:w.ork:;and:liistallatlon••as indlceted:�.��=:I� cerfffy that no work��or Installatton�Fias
commenced pPlor to Issuance of'a permlf""and thaE�.all��work wlll be perFormed to meet�.standards-of all laws regulating-,
conshuctlon, Caunty and City codes, zoning regulatlQns, and land development tegulatlons�in the ,Jurlsdtctlon.- I al'so _
certlfy that I understand that.the regulatlons of other�government agencles may�apply�to the Intended work, and that it(s
my responstbllity to identify�what.act(ons I must•take to besln�cotr�pllance;_,.S.uch.agencles lnclude-but are.not Ilmited to:
- Department of E�1v(ronmental°Protection=Cyip�e§s'�Bayheads, WeNand Areas and Envlronmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management .Distrlct:Wells; Cypress.Y+�Bay�eads; Wetland Areas, Altering
Watercourses. - : �, , � • � -
- Army Corps of Engineers-Seawalls��Docks, Navlgable Waterways.
- Department of-Health�_$,.ReMabllitaflve,Sen►.Ices/Environmen#al:.Health-Unit Well.s,.Wastev+tater�Tre�trnent,
Septic Tanks:. " . � � - . ,
- US Environmental Protectlon Agency-Asbestos abatement.. '
- Federal Avlatton:Aulhodty-Runways. '
I understand that the.following:restrlctions apply'to the use of flll:•
- Use of fill Is not alloinred In;Flood=Zone"V"unless expressly.pennitted.
- .If the,:�11-tnaterlal�;ls��,to`be used:.�ln ';Flood;Zone. "A"� It Is understood, that:,a�,drainage plan addressing a
''"compensating voluine".will.be�.submltted_at�tlme of�;permitting which Is prepa��d�by.,a'pr�fessf�nal engineer
Ilcensed by�he�tate of;Florlda: ` - � .
- -!f ih� flll-materlal°.Is-'to�be used In Flood �one 'A" In�'connection�Hrlth�a�permitted building using �tem wall _
� construction, I certify th,at flll�:wall:b.e used only.to.flll the area wlthln�the�stem�wall.
- If flll mate�al Is to be used In any area� I �certlfy that .use. of`such flll wfll not adversely afiect adjacent
propertles. If use of flll ls found_to.adversely:�ffect ad)aeent��properties,.the owner may be clted for vlolating
the condlfions.of the building:permlt�lssued�under the'atEacfied permlt epplicatlon; for�lots:less than.one (1)
acre wlitcii a"re elevated�by flll,a�englneersd dralnage plan Is requlred. . ��
If I am the AGENT FOR.THE:OVYNER;.I?.promise In,good falth to Inform the owner of the permltting condltlons set forth In
this aifidav(t�prlor to�commencing construction. �I understand that a�aeparete petmlt may be requlred for electrlcaf work, .
plumbing, signs, wells,.,pools; alr condltloning,-.g�s, or-othe� Ins#all�ttons nok spec�lcally lncluded�tn.the appltcation. .A �
permlt Issued shall be construed to b`e:a'Ilcense�to'proceed wlth`tNe;work_and�not•as:authoHty:to:vlolate,�,cancel; alter, or
set aslde any provls(ons of ttie.technlcal codes;�nor shall Issu�nce of a.permtt.pcevent the Bulldlrig Officlal from thereafter
requlring a correctlo�Af enors In ptans; consfructlon.oc vlolations of�any codes. .Every�permlE'Issued shall beaome invalid
unless the work authorized.by such permlt:ls.commenced•wlthtn sfx m.onths of permlt Issuance. or tf work authorized by
the permlt Is suspended�or.abandoned,for.a�:period:of:,�slx,f�)�monfFis.after the tlme the�work��fe commenced. An extenslon
may be requested, In wrfting,f�om ttie�Bullding,Offlcfal-for a perlod�.:not.-to exceed=nlnety(90)`days a�d will demonstrate
justlfiable cause tor.�the extenslon�. If work ceas�s.for nlnety(90)cons.ecutive day.s,..the)ob:is.consldered aba�doned.
WARNIMG TO OWNER: OUR.FAILURE.TO..R�EC.ORD.A��NOTIGE:OF:°COMMENCEMEMT:MAY=RESULT IN YOUR
PAYING TWICE;FOR 1. . . OVEMEN�3:,TO,X0�.I��:PROPER7Y:=�I�°YO.UaI�'F � ��i09TA1N��FIN�1t�E G;'CONSULT
WIT D � � AMATTO N � RE�R AR� ��� OIJ ' � �'Q�`. :�, � _- - _-----
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OWNER OR AOENT �� CONTttACTO '
Subscxlbed a�d ewo to(or aflirmed)before me thls Subscribed and' m-to(ot atflrmed)�befot+e me'ffilg.�
by � �
Who Islare person y knovm to.me or heslhave.produced Who.ls/are p.ers ally lmown•to me�or heslhave:produced • �
as Identlflcatlon. as Identlflcaflon.
Notery Publlc . Notary Publlc
Commisslon No: Commleslon�No. •
Name oI Notary typed,pHnted ar stamped Name of Notery typed,pdnted or atamped