HomeMy WebLinkAbout16-17890 CITY OF ZEPHYRHILLS
�� � � 5335-8th Street
' (813)780-0020 17890
ELECTRICAL PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit;#:17890 Issued: 11/04/2016 Address: 38741 CR 54 LOT 103 ro (b�
Permit�Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE REPLACEME T Township: Range:
Propos�ed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: j 250.00 Total Fees: 40.00 Subdivision: SLEEPY HOLLOW MHSUB DIV
Amount Paid: 40.00 Date Paid: 11/04/2016 Parcel Number: 02-26-21-0010-0500-0000
CONTRACTOR INFORMATION OWNER INFORMATION
Name: ';EAST PASCO ELECTRIC, INC Name: SLEEPY HOLLOW MH PRK
Addr: i10411 CONNERLY RD Address: 38741 CR 54
IDADE CITY, FL 33525 ZEPHYRHILLS, FL 33542
Phone:',(813)782-8622 Lic: Phone: 813-782-1111
Work Desc: REPLACE METER POLE
APPLICATION FEES
ELECTRICAL FEE 40.00
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I ECT , NS REQUIRED
ROUGH ELECTRIC
CONSTRUCTION POLE �
PRE-METER �
FINAL �
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REINS�ECTION FEES:(c)With respect to Reinspectio ees 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: 'i 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
�I before recording your notice of commencement."
Complet i Plans, Specifications and Fee Must Accompany Application. All work shall be pertormed in accordance with City
Codes and Ordinances.
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iC NTRACTOR PER OFFI
, PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
II CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
i PROTECT CARD FROM WEATHER
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 �
' • Building Department
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Date Recelved
Phone Contact for Permitting � —
Owner's Name ,, \�V� Q� F— Owner Phone Number C"� C.�
Owner's Addlress � ���� �S� Owner Phone Number ��� � p� 1 \ \.
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Fee Simple Tptleholder Name Owner Phone Number
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Fee Simple Tltleholder Address .
JOB ADDRE I S � C9�-� �S LOT# I O
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SUBDIVISION PARCEL ID# ,
(OBTAINED FROM PROPERTY TAX NOTICE) ,
WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN Q � Q DEMOLISH ,
e INSTALL e REPAIR
PROPOSED UISE Q SFR Q COMM � OTHER '
TYPE'OF CO ISTRUCTION Q BLOCK - Q FRAME � STEEL Q
DESCRIPTION OF WORK G vC-C ,C % � � v�
BUILDING SIZE SQ FOOTAGE� HEIGHT
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0 BUILDING $ VALUATION OF TOTAL CONSTRUCTION �
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I/ XIELECTRICAL $ . �`pp AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. 'I
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QPLUMBING $ �
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QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � 1!�/ / y
� 1 �, ��
QGAS Q ROOFING Q SPECIALTY 0 OTHER �(,f ,
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ��
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BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N �
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Address � �License#
ELECTRICIAN ; COMPANY � � lA S��. / � t
SIGNATURE REGISTERED Y N FEE CURRE� Y/N
, Address , o� S . � Cicense# � ��� � I�
i lPLUMBER COMPANY
SIGNATURE REGISTERED Y-/ N FEE CURRE� Y/N i
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� Address - License#'• ' '
MECHANICAL , _ , COMPANY -
SIGNATURE' REGISTERED r.E Y/ N FEE CURRE� Y/N '
Add�ess ' , _ L•icense#�
-OTHER� '"' COMPANY '
SIGNAT.UREr. ,.. - REGISTERED Y/ N . FEE CURRE�' Y,/N
Addcess- • � � � ' License#
RESIDENTIAL -,� Attach.(2)iPlot'Plans;(2)�setsof�Building�Plans'(1)set of�Energy Fo,rms;R;0-W.Permit,for new construction,
� , , � Minimum:ten�(10)working,d"ays after°subrriittal date. Requireii onsite;Construction Plans,_Stormwater.Plans w/Silt Fence installed,
' Sanita,ry�Facilities.&_1�.dumpste[;Site Work Permitforsubd'ivisions/large projects. , _
COMMERCIAL � Attach-�(2)'corriplete sets of BuilBing Plans�plus a Life Safety Page;(1)set of Energy Forms.R-O-W Perrtiit for new construction.
> � --- -- ' Minimum ten(_10)-working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
' Sanitary Facilities&1 dumpster.Site Work Permit fo��all new projects.All commercial requirements must meet compliance '
' �SIGN PERMIT 'I Attach`(2)sets ofEngineered Plans. ',
""*PROPERTY SURVEY requi[ed for.all.NEW.consWction.
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�Directions: � � .. �
FiII ouYapplication completely.
. Owner&Contiactor sign.back of application,notarized
• If over$2500,�a Notice of Commencement is required. (AIC upgrades over$7500) ' �
" Agent(for`4h'e�contractor)orPower of Attomey(for�the owner)would be someone with notarized letter from owner authorizing same �;
.OVER THE COUNTER PERMITTING (copy of contract required) ,
Reroofs if shingles �, Sewers Service Upgrades A/C Fences(PIot/Survey/Footage) - 'i
Driveways-Not over Counter if on public roadways..needs ROW I,
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N{3TiCE OF DEED RESTRICTiONS: The undersigned understands that this permit may be subject to"deed"restrictions° _
which may be moce restrictive.than County cegulations: �7he•�undersigned assumes-'r`•esponsibility:foc compliance with any �`
applicable deed restrictions. ._ . .. ��� ,:� - ` -
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSiBiLiTiES:- tf fhe�awner-has� hired-�a-_contractor or
contractors�to undertake work, they may be required to be licensed in accordance with state and Iocal regulations: If the��-
contractor-is not licensed as rEqui�ed�by law, both the awner and contractor--rr�iay�-be cited-for a ti�i'sdemeanor violation
under state law. If the owner or intended co�tractor are uncertain as to what licensing requireri�ents.rinay::appiy for-the: �'
intended work, they are advised to contact the Pasco County Building Inspectian Division=Licensing Sectian at 727-847-
8009. Furthermore, if #he owner has hired`a cont"ractor or contractors, he is advised to 'have the contractor.(s) sign __., .
portions af the "contractor Block" of this application for which they wil! be responsible, .!f yau, as�the-owner sign as ttie
contractor, that.may be an indication that he�is not properly licensed and is riot ent#tied�to permitting�privileges in Pasco :
Gaunty.
T12ANSPaRTAT10N IMPACTIUTILiTtES IMPACT AND RESOURCE RECOVERY FEES:The undersigned understands �
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction af new buildings, change>of ��
use in existing buildings, ar expansion of existing buildings, as specified in Fasca County Ordinance number 89-07 and
90-Q7, as amended. The undersigned also understands, that such fees, as may be.due, will 6e identified at�=the�time ofi
permitting. it is further understoad that Transportation impact Fees and Resaurce� Recovery Fees must be paid priar to �
receiving a "certificate of occupancy" o�final pawer release. If the.project does not involve a certificate of occuparzcy<oc ,
final pawer release, the fees must be paid prior to permit issuance. Furthermare, if Pasco Caunty Water/Sewer,-tmpact� � �
fees are due, they must be paid prior ta permit issuance in accardance with appiicable Pasco Caunty ardinances. V
CONSTRUCTiON LIEN LAW(Chap#er 793, Florida Statutes, as amended): If valuation of work is$2,5QO.Q,O,_or more,-I ._
certify that (, the applicant, have been provided with a copy. of the °Florida Construction l.ien Law=Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the appiicant is someone
ather than the"awner", # certify that I have obtained a capy af the above described dacument�and promise in,good faith,to .
deliver it ta#he`°owner"prior to cammencement.
CONTRACTOR'S/OWNER'3 AFFIDAVlT: ! certify tha#aA the information in this applicatian is accurate and thaE at!work
wiN be dQne in compliance w�th a!I applicable laws regulating construction, zoning and land,development. Application is
hereby made to obtain a permit to do work and installation as indicated. 1 certify that no work or instal(afion has
commenced priar to issuarice of a permit and that all work will be performed to meet standards of all laws regulating ,
construction, County and City codes, aoning regulations, and land development regulations in the jurisdictian. ! alsa
certify that ! understand that the regulatians of other gavernment agencies may apply to the intended work, and #hat it is �
my responsibility to identify what actions f must take to be in campliance. Such agenaies include bu#are not limited to: , •
- Department of Environmenfa( Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WaterlWastewater Treatment.
- Southwest Florida Water Management District Wells, Cypress Bayheads, Wetland Areas, Aitering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative ServiceslEnviranmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks. '
- US Environmentat Pratection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
1 understand that the following restrictions apply to the use of fill:
- Use of fill is not allawed in Flaod Zone"V" unless expressly permitted.
- If the fill material is ta be used in Fiaod Zone "A", it is understaod that a drainage plan addressing a
"campensating volume" will be submitted at time of permitting which is prepared by a professianal engineer �
licensed by the State of Florida.
- If the fi!! material is to be used in Flood Zane "A" in connection with a permitted building using stem wall
construction, I certify thaf fill will be used only#a fill the area within the stem wali.
- (f fill material is to _be used in any area, I certify that use af such fill will nat adversely affec# adjacent
properties. !f use af fi!! is found to adversely affect adjacen# properties, the owner may be cited for vialating
the condi#ions of the building permit issued under the attached permit application, for iots less than one (1)
acre whioh are elevated by fifl, an engineered drainage pian is required. ,
If I am the AGENT FOR THE OWNER, 1 promise in good faith to inform the owner of the perrnitting conditions set for#h in
this affidavit prior to commencing constructlon. I understand that a separate permit may be required far electrical work, •
plumbing, signs, wells, poals, air canditioning, gas, or�other ins#allations not specifically included in the application. A
permit issued shall be construed to be a license ta praceed with fhe work and not as authority to violate, cancel, alter, or
set aside any provisions af the fechnical codes, nor shall issuance of a permi#prevent the Building O�cia}from thereafte�
requiring a correction of errors in plans, construction or violations af any codes. Every permit issued shali become invatid
unless the work authorized by such permit is cammenced within six months af permit issuance, or ifi wark authorized by
#he permit is suspended or abandaned for a periad-_of six(6}monfhs after the time the work is commenced. An eactension
may be requested, in writing, from the Buildirig Official fior a period not to exceed•ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
WARNING TO OWNER: YOUR FAfLURE TO RECQRD A NaTICE OE Cf3MMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR iMPROVEMENTS TO YOUR PRQPERTY.:IF YOU INTEND"�TO OBTAIN FINANGING;CONSULT
WITH Y(JUR CENDER OR AN ATTORNEY BEFORE RECORDlNG YC1UR�NOTICE OF GOMMENCEMENT.
- --F�OFtIDIi`JU4't"NT-(r:5:-1i7=0sj ---�-_.T_ _ __ .�__-----—�- - --
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OWNER OR AGENT GONTRACTOR . ��-i� ,��-!�-��� �,_^
Subscribed and swom to or affirmed befare me this Subscribed aod swom to or affirm d befare m 's
bY � ) by,�' �..Ul G 2.L..t' `���,._{ r 1r
Who is/are personally known to me or haslhave produced " Who islare personally knQwn to me ar has have produced
as ldentiflcatian. as ldentificaUon.
Notary Public � Notary Public
Commission No. Gommission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed ar stamped �