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HomeMy WebLinkAbout16-17996 • ° CITY OF ZEPHYRHILLS 5335-8th Streefi (813)780-0020 '17996 EI.ECTRICAI. PERMIT RERMIT INFORMATION LOCATION INFORMATION Permit#':17996 Issued. 1211312016 Address: 5728 57.30 APO�LC} ST Permit Type: ELECTRICAL MISC ZEPHYRHIL,LS, FL. Ciass of Work: ELECTRICAL MISC Township: Range: Propos�d Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet�: Est. Value: Book: Page: Cost: � 1,800A0 Total Fees: 45.00 Subdivision: TREE LANE VILLAGE Amount Paid: 45.00 Date Paid: 12/13/2016 Parcel Number: 10-26-21-0000-00100-0000 Ci�NTRACTOR INFORMATION QWNEF�INFORMATI{3N Name: �11M'S ELECTRICAL SERVICES INC Name: TREE LANE LTD Addr: �8302 EASTWYGK DR Address: 10912 56TH ST TAMPA FL 33647 TEMPLE TERRACE FL 33617 Phone: (813)810-4079 Lic: Phone: Work Desc: REPLACE POLE I METER J PANEL BOX APPLIGATION FEES E�ECTR]CAC.FEE 45.00 INSPECTI4NS REQUIRED ROUGH ELECTRIC � CONSTRU�TION POLE PRE-MET R FINAL � . � � � 1� . ��. l� REINS ECTION FEES:(c)Wi#h respect to Reinspection fees will comply with Flarida Statute 553.80 (2)(c)the loca!�overnment shail impase a tee of four tienes fihe amoant af the fee impasecf far the initial inspection or first reinspection,whichever is greater,for each such subsequent reinspection. NQTIC�: In addition to the reguirements of this permit, fihere may be additional restrictions applicable to this property that rnay be faund in the pub(ic recards of this caunty, and there may 6e additianal permits required from other governmenta( entities such as water management, sfiate agencies or federal agencies. F "Wa�ning to owner: Your failare to record a notice af commencement may result in yaur paying twice for imprcpvements to your property. If you intend to abtain financing,consult with your lender or an attorney + before recvrding your notice of commencement." Complete Plans, Specifications and Fee Must Accompany Application. AII work shall be per�ormed in accordance with City Codes and Ordinances. �r CONTRACTOR PER OFFI PERMIT EXPIRES IN fi Mt)NTHS WITHOUT APPRt�VED INSPECTIO CALI. FOR INSPECTION - 8 HOUR NOTICE REQUIRED PRCI►TECT CARD FROM WEATHER 813-�8ao��o City of Zephyrhills Permit Application Fax 813-780-0021 ~ Bullding Depactment Date Recelve ,/:,�.-� ,�j .::.P}�one=Gontact:for,�Permtttfn : ��� � ��a - 7'`O7� ' ,. Owner's Namd Owner Phone Number Owner's Add ss � � ���' N �E' I� � � � � e�` � Owner Ph'one:Number•.��� � Fee 31mple Ti ieiio{der'�Name � �� � �, Owner Phane Nunnbar � � � � Fee Simpte TI eholdrar Addresa - JOB AtiDRES ���Z3 � '�� �lo S � 4 LOT# �_� SkIBDFVlStON �I"�e ��'t'��- ,� PARCEI.ID# � . , (OBYAINED F.ROM,PROPERTI!TAX NOTICE) WQRiC PROP .SED �;NEW CONSfR ApDlALT �� SIGN' 'Q � `Q �flEt1+lOi:ISH y _e, ,INSTALL , � REPAIR PROPOSED.. $� . • :Q $FR. � COMM' �. � � OTHER . TYPE OF CD STRUC'LiON�"�� :�'' �'•'BLOCK r [�� FRANIE � STEEL .Q . �,.. �. , DE3CRiPT10A!OF WORK I` '�� �•�.. ``�� ,/ �'1 e-� i �'�"`•`- � ' - . 3,. BUI�D{NG�Sl�E'' � ��8Q'FOO'i'AGE,�: HEIGFiT :�� QBU! RlNG �� VALUATIOtt!!OF�TO'1'Al COtySTitl'tG'CION ` _ � GTRIG�l. $ � � � � A{41P$FRV{CE ' �'Q '�PROGRESS ENEi2GY Q W:R:E.C. [�]PL MBING • " ' ' � , � � � ... . QME�HANICAL . . , , . �. . . , � � VALIJATION OPtIiAECHAIVlCAL INSTALLATlON. C]cA [� RooF�r�� .CI. ;� s�eci�,nc:.�_.�. orH�R�; .: � FItVISHED PL�OR ELEVATiQ1VS ��� FLOOD;�UNE AREA ` L:[�Y�S. .NO - t. . - '- ,.,.��.-, r�.._ .;�;,.;,.; 8���.QER +{`OMpANY', �. _ . :,�._:;... __i � - ,-' $1GNATUR£ REGISTERED Y/ N �=���F.EE cuR��='� � '' k�Y/N` � � . „�K: - �' :' ,.:.':�� ;:.'�;��� , �aar� �..,-�. _ - r .. -t.� ... ucense:�;1 '�_ , :� . - .. � , :...; ,: .. '``_` . . ..� � _ s�.., . ,� „ , ..:.'� '. � �.- :� ,;_ ,. .. . .. ,�.w . . ,. . ��.�cr�c�. ;�1,, ��:���.,,-S�'"� � � . �_ , .�J.�.;;::��..#�s._,_IEJ=�.��.:.,�n-_ �,,.:� .,.,. � i,_�OMPANY'` ��� = - . , SIGNATURE '� REGISTERED Y J N �EE�cu��: �:Y/.N�' ' � �' c! _� �'�, Address j g,� °o`�- .1� S ��' r ''�}� 't �r:�-'�t�C.�� 6 y;;7�. �<:.y�4a�- �lEcense=#=;r f��;:r���S�$` �'� `°,;�''__- P'LUMBER ' . . , .. . ,.GQ1Y9,R,�1tdY. _ _ ..�.f�:,> ;� > ;.,__,.. - , _m..,,,;. . . . , r. StGNATURE'� °� . ' . � ,. ,,- ,t . , .. ` `1tEGiS?.ERED .Y/,�.N:: :,: .FF�;CuttREn:� X�/N�. - � . �. ,- ..�.: ,, �.. _ . , . � .., ,, , _ _, , - , . Addreas . � � - ' :�tcerisev#�t;:..::..,.:•- � t,.,, ' _ ' - ` �. _- , •, ' ➢}, ::s MECM1�tt�➢!C � , ;,. ,. ' , , • , � � CQMPANY ` , , .� � :x:. �,. . .;3 „ , , - . - StGNATURE� -�': , ,. � . - . : _ ,- i3EGiS7EiiED Y/...N - .FE CUFtRE�:.. `Y. .. �: /�N,..: Addfes�.�".a.t '`� , �..- • .. �:: , . . ... , ,tic�tise#s_� . � � . � . . . , . , . . , , . � � � - � ' � OTHE[2 = ,:> ,. •. ._ • ' ..�_ -,�. ;i,.�. . ,,. ,_ � ,_ �,�. ` ` . .� ,coM�ia�+i�r _. ... .. SIGNA'TURE�: �.�' �:�� ;�: �� ,-� , . . _ .b �n,��,:;.< b:.... , . 'REGISTERED' "Y J�N:..,: ,F�E"Cii�n " Y%N ,: :.u, • „ .a ,.�. _ � - :. :: ,,< .,, ,. Addres� �:�,.�r::Y.R."... .,���:,�.. � . ..}. . - -� '.� • ' 'IJceiise#°:{":' . � � _. � . :r:l'n�.',p:, �:.:_•.... -.d�,� - ` � "_.-% ?/. , 'S'.. ..�..'t l.�:�n..,:.......- - -"4,i,_F:...;.' �.�*r;: „ RESlDEIdT!, �Att$ch,2)aP'l,ot;;Plans,.�(2)se�s:o€'Buitdin��.Plans;�('1�}set'of=Ensrgy��oFii�s;-F3=0=W=Pemiif fqrinevr ccinstructio�i, . ,-�.t;tl;,�Minijnum�t�ap�{10)�,w►ort4ingpdi�ys:after�sr�bmitfsl:dafe`;Requlred ons(f'e`;:^Gonefnicildn'Pians;�StomiwaterPlans-w/Silt Fence instelted, ' San(taryFa IIUes,&s�dum s,ter��8lte°Work;Permit,#or,su4di�iisions/large;projeccs�';=a�":i' " :�+'�x-.`,," - . , ' �T • -..._ . .. .., x..!�.. ,_,ti;,t E�, , R. __..a;.M:,.. �.� f I��h.'�".;' � '],�:' 3.+:i. .r..,.,. .., it...E'..�:'� � _ COMMERGi Attach(3)'eomptete'sets`of'Bu'i!ding'Plans pius a Ufe S'afefy Page;{j)sef of Energy Farms,R-4-VY PermSt for nsw constnuctEdn:� � • Minimum ten(10)wrorking days after subrnittai date. Required onsite,Constructian Plans,Stormwater Plans w/S�it Fence instalied, Sanifary Facllitlas&1 dumpster.Site Work Permik fur all new:pr+ojects:All commercia!repuirements_must meet campliance �° " � ' .�Si�aN PERiI�I Attacti{2)sefsof�ngir%ee�:eiisPlatis:,:,rN�,;,�:��_ :_v�:s.. :s+.�� . _ .� .. ; , , , "••PROPER't'Y SURVEY required fi}r aii NEW,construcdun.__ _ �.,: ;,;_;;. , � D1i�Ctlo»Sc .._r��r��,*�:< . _ - - F01 out appticadon comptetety. Owner 8�ontractar sign back of appltcatian,notadzed !f avar�500,,a Nottcs af Cammencerrceet 1�r,equlred. {A/C upgrade�ovet ST500) •- � �,-,�.�:�,�.,,.,:,;s,�,y, < Agent(fo the�contractqr)qr"Powier of'Attor"riey(for the oduner)�would be sameone with natarized letter from owner autharizing same OVER'FHE.0�UNTER�PERMtTT1NG-�-.-.�:-{Fmntof-AppltcaSozr-Oniy}._.,__ , , - .' Reroots if shtngles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) _ ! .._.._:....�_..,_ ,....,._ w..... �_ ._ ._, :.�.,. . ... .� ,�,�.,,.,„.,. �=•�f::r;. Drlvaw:` Not aver Goun#ar if on public roadways..needs ROW . � +. ,� � �- , 1 . I - ' . � ., h • " r NOTICE OF:DEED ItESTRICTIO�IS:. The und�csi ned;under�tands��,th�t;;thls� rmi�:•.� , �'�•`v`"�r" g_ _, ,p�_ rt�ay._b,e,subJect.to.;j,deed"�restrlctions?::�,.�„_.,,,._�..,, which may`.tie<more-'r.esttict(ve:t#ia�rCountji`�neg�:latfons. TMe>undei�slgned�`as`s�imes��r'esponsi�tiillly��fo"r`compllance:�!ith any`'`'""`�"�""`�' applicable deed=rest�lcttons. ,:z��,�;-�,;;c;:�r.-�,,;:..;=. `� � _ _ .. _ _,T _�;� r��_.:��t.� ,�r-y UNLICENSED��CONTRACTORS�:ANb CON�RACTOR�RESPON31B1LiT1E$: ��=1f=tlie��owner� has�hiced"a`�c�r�Nactor or ,, __: . ,,. . . contractors.to undertake work,�they;may;be,�requi�ed�:to.;ti��Ilcensed=lrt;accordanceRwith;state�,and;Iocal�;tegulallo�s:z�r�lf�th'e}=•��`�- -�'=�! .....,,k . , ., _:,.,: fi:.�,.:,:-..<..� _.�.� �._ ; .. . _, .. contractor«t§�not`�Ilcens�ed=a���re'qulred,tiy law, tiotlt''th"e'owner-and'=contractor�mey��be�cited�fo�r�a�}mi�demeanor violation under state taw. if the owner or interidedT:contraator;ere,;;unc�rtaln.aa�to�.wFiat Itcenaing.requireRnents�may:�eppij�r�ffirrthe`,Tr�k�>;.�"� f., ti:r�a. intended"work, tH"e"y ar"e advl§ed'to�contact`_tF�e"��Pasco`County Building Inspection_Dh►lsior%Licensfng SecBon et.727-847- ._,.. k _.__ ,..���.,. .. 8009. Furtfiermo�e;1f�the�oviirier�has�nrrea a �ori��to��o��o�t��ro�s. he is advised to have�.the contractor(s)�;signrf,_ _,, .-�- .x s_.�._ .,��... portions�of the�°conttactor-Block'.of:this.;epplicatlan�for whlch..they_willA�b.e�resp.onslble.�r lf,you,,as�.rythe oviin'e��'sign"`as�the'"��`' y'�'� contractor;'tFiat�may be an indtcailon that'fie'-1s"not:prope�ly`Ilcensed an��'is�`not enfltlea b permitting pri�tileges in Pasco . County. r ' ����'' � z.�.�,.:.ft::;.;��h:� TRAN�PORTATION�IMPACT/UTIL{TIES�IMPAC`�ANb FtE�0U1tCE RECOVERY�FEES:��The undersigned'uiiderstands � thatTransportation Impact Fe�s:and.Reco.urse Recovery_Fees may;appiy4ta�t�e�construction;of.new bulidtngs��change"of���'��`���'�`� use in exisHng buiidings,�or�_expan��e�r:of�ekie�i�,g��bulldings� as specifled.In P�sco Cvunty Ordtnance number 89-07 �nd. 90-07, as amende,d.;.�;he undei�signed also:understands, thet�such fees�aas�majr:b�•=due;;�wlll,be.idenfffied at theKtli�ie�of��' ����'��fi` ,.; _ . <� _;,� ,.�. ,... permitt(ng. It is turthe�unde�sfood that Tre�isp�ortation Impact�Fees artct��Resource.?Recovsryi�Fees�,muat be paid prlor to receiving�a'cerEfflcate�::of�occupe�cy"-,or;flnal�.power-,release;�:lf�the.proJect:�doess.no�involve�a•�certfftcafe of oc:cupaney<o�-�-�.�':=,;°���� flnal power.-release;�the`:fees-�niu�.t�ti�e paid�pclor to,permit Issuance. Ft�tther�rnore;:If::Pascv3�Countq��WaterlSewer�:lmpact �•�;��R�r� h.e�.,. � �. ..,. fees are due;_.they�must:be,pal�__p�lor_#o;,perrnit'-lssyance,�n.accordanceiivitti�::applloabte�Pasco�:Gounty�cnilnances. • CONSTttUCT10N'LIEN��LAY�I(Cliaptar 715� FlorXda$tatut�s�as amended): If valuaHon of work Is�2,500.00d.o,r more;Al°���, �:i°:• certify tFiat�-.I� the :appllcant;:-have;.been. provlded°=w1th-a�-cvpy°�.of-ther:"FIo�Ida-��on�ti�uctlon�=Llen-:Law—Homeowne�'s Protectton Guide" prepared by;�"tFie'�Florlda Depertmenkof Agrlcultnre and Consum�r;Rffalr`s. If the appllcant ts.someone���.. -_.:•���� otherthanthe'oum��", Icertf�►,�.th�at.!I�.have:o�t�itned�'a��copy;of:#he�3abova�descrlbed:docii�ent�and;ptorxil��:tn,good��.falt.h�to .._. -. f, deliver I to: ,, ;�,,, �. .. _ :: . .... . . .. .... , . �,.:.....: . . _ _.. t .tFie.�.owner."piio��to�`commericement: „ �ONTRACTOR'�/OVYNER'S AFFIDAVIT: I.cectKy�:tt.i�tall��thg,lnf�rmatlorr�l��thls appllcatlon Is accurate.�nd that all wark ,�.,, w(II'be done in compllance.with all.appltcable laws regul�ting constructlon, zoning antl��land�:developm�nt. Appllcatlon.Is � hereby made�to obtaln�a.pecmtt,;:ta�.dor.woflc�,,and�;lhstallatlon as Indl�ated�����1� ce�tffy that no work�°or Ins�llation fias'� � comm�nced prlo� to Issuance of�.a permit'"and that':all work wlll be perfo�med�to meet:standaTds�of<:all laws �egulating- constructlon, County and City codes� zoning regulatlans� and land development regulatlons�ln ifie Jurlsdtctlon:�'�I`��al'so� certify th�t I u�derstand that the regulatlons of ather�government a8encles may�apply;;to.the:,lntended work, and that it Is . my responslblltty to Identliy•what.acdons I.must=take:to.be;ln;oompllar�ce::j{S,uch:.agencles°Include=but=a�e.not Ilmfted to: - , . - Depafinent of E�hvlronmentaf iRrotection=Gyp'ress:`BeyFiead�, V�letl'and Areas and Envlronmentally Sensltive _ Lands�W�tedWastewater Treatment. _... _ �� � � - Southwest Florida Water Managemerit�--:'��Istrlct-lNells;`�'=Cyptess:y�Bey�ead��;;`Wetland� Areas� Altering Watercour�es. ;>.�., .�:� ' �; :.:. ;s � � , , . . - Army Corps of Eng(neers�:Seawalls;�Docks, Navlgatile Waterways. - - Deparl.ment,..of,,Healthx:;B:,,Ret�abllltatlV,e,,,Se.r;vlceslEnvitanmental�.Mealth��U�it-Wel[s;-�Wastewater=�Treatment, � Septic Tank�s :� ._ _ . �� . - _. � '-� - - US Environmental Protec�on Agency-Asbestos�b�tement. � Fede�I Avlatton.Autho,r;Ity;Runwaysiy� " ' I understand 1hat�the..follovving.�restcictlons apply fo the use of flll:� - Use of flll Is not allowed In iFloodrZone"V"unless expressly permltted. - If the-:flll�nieterlal=ls���to�b.e us���ln :flood�2one. "A", It Is understood th'af-a dralnage plan addregstng a "compe�sating volume" w111 be submltted at#lme ofspermltting wfilch ts prepared by a professional eng(neer� � Ilcensed.by,tiae;�tate'of?Floflda: � � � - �� �� - - If th� fllh�materlal�.ta�to:be,used In Flood Zone�'A" In+conneotton•virlth�a�permltted building�using stem wall„ _. � constcuction,.I ce�tfy�;th,at�;fill:w111.b:e:�used only to fll�the area�wlthln�the�s#em�wall: • e - If flll mate�laf�ls�to tie used-in any .area; I �c��tlty.that .us� of;such flll wlll.not adversely affect ad)acent . propertles.. .If.use:of f111 ls-founc#_to.advers�Ey:.�ifect a�JaEent��prc�pertles,.the owner may be clted for vl�l�ting, ,- the cond�lons��of��the„bulldlcig�:perrrilt Issued��under tlie'atta,ched,_�ermlt��pplicatlon;rfor.:lots��.le"ss�#han:one (1) acre whlch are�eleveted'by flll;��t.englneered dralnage plan Is�equlred. • . •� If I am the AGENT FOR TNE�.OWNER;.I:promise.':In_good;.f.alth to InformrtF�e�owner of the petmltting condftions set forth In thts affidavit prlor to commeracing constructlon. �I unit�rs�iid thet aiseparate�permlt may be requlred for electrlcal work, .- .»x.. � .�„�...,;.-�_ � plumbing,,.slgns� wells,.poolsr.alr.condltloning;=:gas�:or.other Install�tlbn� not�specpfic�lly Included-tn.the applicatlon. .A . - permlt Issued 5hall be conshued to'�be`a'llcense`�to�praceed wlth�tFie.;viio�k and:not-as:�authoNtyrto_vlolate;�cancel,�alter, or set aslde any'provlslons of the:technlc�l..codes;;nor shall fssu�nce�of a.permtt.prevent the Bulldtrig Of�lclal from thereaftec � , ., .,:.;s.. . . requlrin.g a coRectlon af;er.ro.rs_in=�plans;:con'structlon..or_vlolatlons of�any�codes:� �very�p�erti�lt��lss'ueii'§FialF•tieaome-invalld unless the �nrork autho�lzed.by such permlt:�Is.commenEed�wlthln,-s:f�c�months of�permit Issuance� or If work authoNzed by the pemntt Is suspended•o[•:eba�doned�:for:a-perlod�of:;six:f8)�mon�s��aRe�the tltne�the�wo�"k�ls commenaed.. An extenslon . . . . .: .. __. .. .... may be requested� In.wrltln`g;;,from-tFie:Bulldtng,Offlctal�for a perlod..not.taexceed'=nlnety�(90)�=days a�d•-wlll�`demonshate Justlfiable'cause tor.�the extenstor�: If work ceas.es:for nlnety.(90)cons.ecutive�days...th�)ob�ls consldered aba�doned. �. _ �. . _. :- , ., . . . ., . . .._. _ !M�llt�llNf�-TO-OIRlN�R:Y�IR;FAIlLlRE:Tta.,:R���t�Tt.c�=E�.�TIGE�:OF�C,SaHMEN��lE1�'T�:MAYt:RESULT-iN YOtJOt— �_—_ -- . _ _ ,.. PAYING TWICE;FOR.IMPROr/,EMEN,�'S�,T�;��(,OUEt�>:P�RE�7Y:�:��I�-:YO.Ua1�TEKID:�T�`��OB7"AIN�FINif�pElN.f�;'CONSULT WITH YOUR L6NDER OR AI�i�7TORNEI�$EFaR�RE�OR�INC�'�1TEU1�`�T10E�dF�'��IIAItlIENC��;``" � � FLORIDA JURA'f�(F.S::t17:03)..., - . ._,. . � _ ,-;. -.. ,,;: ..,,�<. . , , , .. : : ..,..: -,;..,.;, •- ,:..., ..,.,,. ,.,. ._. .,:.. .. OWNER OR AOENT .. Ji^' •��—. • . � CdNTRACTOR_� � -----�� - Subscrlbed and ewom to(o�afflrtnedj before me thls Su e b and'awom�to�aflfrm��b0tote me'fFilb� by / :.by.... :�C� : K-��-�� r� � -� I Wtio Islare personally knovm to.me.or:haalhave,produced , Who.l. a ;p.etsonal Jmoutm�.ta;me;,or.#iaalhev,e:produced- • � es ld`enUflcatlpn.' �— �./ entlftcaUon. Idotary Publlc _ � Notary Publlc Commisalon No:S Commiselon•No. ��T (�1�5 �JL��J � i��h�'�,� ��G�n�e Rv�ill.. Name ot Nolary typed,printed or atamped Name ot Motery qrped,printed or atamped 893-I ea�ozo City of Zephyrhills Permit Application Fax 813-780-002� . Bullding Department Date Recelv�d 1 �— l�= 1., ,° ,,�j („� 8�� _ _ � � / , .�• � : ' Phone�Contact:foe�Permlttin - • Own�r's Nam ��"�' G� �'S Owner Phone Number � ' Owner's Addr�ss ��� �� � SG � � L 1 ��efr�- ' Owner Ph'one;Number ' Fee Simple TltleholderWame •� � � � Owner Phone Number �� ;�s. Fee Simple T�tleholder„Address , JOB ADDFtESS ��� � ��1 � ��n S� LOT# � SUBDIVISIO �re'e ,�'� ' PARCEL..ID# � - � � . , (OBTAINED F.R,ONI PROPERTY,TAX NOYICE) WORK PROP SED . NEW�CONSTR' . ADD/ALT CJ ' SIGN' ''Q• � ' Q �DEMOLISH ,. �.e,, w^INSTALL � -.;. REPAIR PROPOSED:. $� . • :Q� SFR. [� COMM : Q •OTHER � TYPE OF CO STRUCTION"� Q� 'r`'BLOCK �'' Q FRAME � .Q 'STEEL 'Q . - • �:,,_ �. , DESCRIPTIO OF WORK' • � �'� �"� �l'e / �tQ� o�'v'e�/" . ::• . . - BUILDIWG�SI E` f � � . ' ,`S4�FOOTAGE{�: , , .HEI,GHT�.�.. . ' �- - QBUI DING S ; VALUATIONaOF`TOTAL GONSTRUCI'ION^L - L CTRICAL' $ .q p � AMP SERVICE. - 'Q '�PROGRESS ENERGY Q W.R.E.C. 1 QPL MBING � '$ - - � _ � I ,� . . , . QAAE Hi4NICAL , $ ' , � VALUATION OF;tiAECHAFII.CAL INSTALLATION. , ,. . - . , _ . :,•r , .. � QGA [� ROOFING• ,O: :,, S,P,EGIALIY,,;O;,..;.OTMER-;;; , . FINISHED FL OR ELEVATIONS FLOOD ZONE ARF�4 ,QY�S. rN0 � ..., .::. . . .� :� ��,:� ..�: �"- � _ ` � - ,t .�� -:�._ ._�„ �:,.. 5<i� _ - BUILDER COMPANY" ; .`;�;:,`- v � , � - SIGNATURE REGISTERED Y/ N • ��'���F.EE CCJRitEA�� "�'Y%`N" '' �� " . ..+,tJr {'txF� r.:.i+ "f;�� _ . _ , _.. Addres F,; ;x; �- � .�„- f� w +License;#'' `°�' = ; _.. , �.�.',,, ,�. �+� � :�r . . .,'..`. r"..f:.:,� - ' ::` :; ";�� _. ., . ���;:�,�S��'1����ti�.:a :S��--�,r� ,���, �, ELEC41tIC�� ��,;,_»"_` `_ -: �aCOMPAPIY'-:: . xa., �::,:,,,-sr.z,�:,: ::r.• �>. '- ' - - , ; . ;. SIGNATURE � �REGISTERED Y/ N FEE:GURRE�y'< ��;"��Y/N- -° � -� I' � .. L. ' . , . ., : .r ,.;;, " �i. � � 0 6 � .:L.'s'." r r` �ddress � �302 .E°31.�j/�12 �s- f �p-����L33 y� ;�;.=r.,:.:License�:#:T`L�:�3..�-��_� /.. PLUMBER ` - ., . '. - .COIIAPANY • .:z�:.,�'^ �.t ,:,,_. :,- .=: <;. . . ..,_ . :, SIGNATURE; • �,:, � _. � . REGIS.TERED YJ,,N_a :,;.,.FEE;Cu��:., - Y�/.N,_�: , ` ,_ ... � .,- . .. . . T . - .. Address . ' ., " ,License�#.r � - � :. 4 . .. - , • _. . .. . • .._� MECFIANIC .t . =: -� . . � . " a COWIPANY ... , . �-. . . , �,:;.:;,�;�:w�.,� 4j �' « _,. SIGNATURE: , -��'�. -,. .. . ,. , . , . „ ,;.. ,:= - REGI$TERED Y/.,N ,FEE CURREI�::, �Y IrN- ,r —��," . . - . . . ,.. , , � , Addres' .._ �'u - �..... .� : . .. , - � _ . ,. -_ :k:� , , , � . , :_ ... _ticense#t ; _.,_... , .� _,.� ; . .. . , _ <.. _,.,. , , .. � , - f:,.._ ° . _ . _ � OTHEIt r7�_ .. .. -, � , , . � .���, -�.�fCO�I,PANY _ ' � - - - ..r: r.,.�� �>-.-:._ SIGNATURE� _r. � �a', _ "` , - �'': , � _ . �¢ :REGI§TERED . — , Y/ N:..,: ��e'Cu��:"~. �Y`/N . ,, �; ,, � �,. . _ . . ,_ , ;s.t; >� �.;��< -a� ;..� :,<i -.. ._.. . . . . .., _ ._ _,:� c .', • ".' � , , � -_ . i�ddre - ,�,,..s�.,._ _ =;s�„-t" -r;'' ... .. ' iise#� Lice _,. � -,,�.y..�,i-s ^i� :��: 'b-th,-4: ,-F. s- �'�,,�:'.:v^'.a '✓.,i. �:-r� '�`.;-"::: ,�, ec� �' `' _ -- -- - �- , =-� �"2 .�ot�.Plans'�2:sefs=_ofBuiltlin =:Plans��1 sebof=Ene ;Fortns;R�OiW�Pemiltfor''oew�con§tructio�i,_ " " .. .RESIDER!'TIA�'��:.�, Altach;(_);P_._.. „( ) 9 �( ) r9Y,.� ,j - :�. ;�,,.,, - �;�:���Minimum�,ten_,(;I,O)�wo,rl�ing,d�ys�:aRer�sabmiEtal':date�>-,:R.equlredon'site;'Consfiuctlon`'Plans;�StomnwaterPlan$�w1SiltFence�nstslled,� _.. � t�:, �:� `SanitaryFeciltyes,&�1�,�dumpster,-�Sita�'Worlc�Pertnft;for;sutidivi'sions/IargeFproJ'ects;�wv�,;.;;��` ---_ • _. ,�'_-a,t, , 4�s,,..;=^..-,.,�.„,f. .,, . �„ ..... , ; -�:::;�� COWIAAfERCI Attach(3)LLeomple4e"sets'of'Builtlfng Plans'plus a Gfe Safety Page;(1)set of E'nergy Forms.R O 1N Permit for neai;construction.• -< • Minimum ten(10)working days after submittal date. Requlred onsite,Construcdon Plans,Stormwater Plans w/Siit Fence installed, , Sanitary Facilitles&1 dumpster.Site Work Pertnit ior all neuiraprojl�ets:"All commercial.requi�ments_must meet campliance ``, .-SIGN PERMl1 Attach"(2)sets of`Eng,i'neeredsPlans:,,�z.��_:`'~ _ _�- ..... - .. '' - ' "••PROPERTY SURVEY requirec�;(or.all,_NEW constcuction._.-.- -, -. � . ,.,.,.;,w _ " . ' Direc,tion�: . .ds;,,,J,,-;;�., . �.� _ _, . -,- _ .. . � Ftll aut a plfcadon campletely. Ow+ner 8 Contractor sign back of applfcaUon,�otarized {f�over� 500,.a Notta;e of Commencement is requlred. (AIC up�r�de�over$7500) •-_ ,. .,-.�.�p;�x,;;,;e r�zE� '• Agent(f r the'contr�ctqr)Gr'Povir`e`r of'Attortiey(for the owner)�would be someone with notarized letter from owner authorizing same DVER�THE:G�OUNTERa.PERMITTIWG��--•�-�••(Front�of-Application•Only)----� ' "��� ��� � Reroofs if sht gles Sewers Service Upgredes A/C Fences(PlodSurvey/Footage) . _ _ wtv'.�y',:i:`�::�:;F j:' �-v.ti,Y»'F!•a� f*f.,3 ' "�..�...-.....�. �..�... . ;+�_ . .� _ ,- �,� f� _�" �. .� �. .. _"` .u. , _.r, ,.i .r Drlvew ya-Not over Counter if on public roaduvay�::_i,%eed�+R4�W��:� �'::�� ' � F 1i'. � � „ ,i�e:c)�n i'r`Y.2t:�i?}^f+�:�' �}1. . � � ��. •`14eji::S��Ji�il..1��'...1� Y•���`'` ? ., �. . -' ilU•... . ,�'L"'.'tTif!:dR�i �.:"� r _ , ,.�.. ..--n__n, -�s. ....•.na_..,a=s-,....x... _,.�1 _ ' . ._ , i . ' • ' ' � i' ,• ' �r _ "_t _ � . . ........ ...ak'"„�.i:�.k'{.S(t�.."�i�.: NATICE O�Dl�ED-RESTRICTiONS:.�The:u�,de�signe�{unders�tands�;#h�#�thlg.;•��armlt�may;b,e,,subJe.ct�to;:"deed";�res.trfctians�,...�„.-.,,,s.y_� -„.: .s. «'s� > .i . . • �i t� D ac d�3�.z� n ar f,r.:a.: ;.a�a..�3.. which may�6ie=more�r�sti�ctNe`t#�sl��Co�in'tj►'r�g�fat�ons��`'The:un'ders�i,�ne.c��assumes�:respon��bfliiy��fax"compNance with>any'" appllGable<.d±aed�testtlCttons. -:':r�;:..;;.:�:.::y;.p �. ' - -. _ .r..�:�. _ �._f.� . ... , ,.., p�r '',-:��.•', �. � r,. :';'t — _ d'.n ;�fw,'^i IUAILlCEMSE���GOWTIti4C'�"+DRS�_A�1� CQN�'RRiO►GT'1?R�R��F��NSlBlC:ITI�S:�-.lf=�ie-"owner has��hi�tl`���:cc�rt�r`siator or contraictors to undertake�work,the ._nriayab��a�qut'etl:=�to;;�e�llc�ns�d�lft:.aicco,rdance.with:state,�.and:•local�re ul�tio s�=yif�the«:�-..��"�'"' <<�!_ - ,�..����z.�w...-�.-�t.;.�..,.;�..�=w_-;�: ..>,:x.,�i-- 9�.._, �- contractor=l`s' natY�ilcens�ed�a�°=re'qulred`6y�'law�%tiofh-'the owner and=°condractorX�may�be��citeid��fcir���rit§deirtieanor violatlon under state f�vd. iF the owner.or intet:idedt>>cb;i�±�torFrare�:uncertaln �s�to:wii�t itcensing.require�ne»ts";may=apptyt��ft`irnthe�e��sy��� ��'� �•! �--.. �;:..�.. e r ..,�, . . ...,�,.., e�_.�._..� x..Y,. iniended i+vork�ttiey�re=advlseii to"ca�ry#�ict'�#t�e;�asca;CountyBuitding�tnspecttonTMd�vtalon--�:ic�nsing Sectian at:727-847- 80S?9. Fucthermore; It'the own `..,..._. __,. : ...�_.. .�.�:..w_.�, ... _..., .,,., .._.� � , ...�.<�:.��:.... � __. r{r)�,�.� ,_<�s:.*�;....x . .` • er'ha's"`tilre+d�a cciriVactor,or contractors. he ts advlsed ta have:the cor�tr,acto.s :slgn.. �.�.,,i;� portions.of the.�"cor►tcactor.,�lock':.o.f,::tk�Is.:app�Ilcallon2for�.whlch:,th�y-w1!l�.al�ea�;esponsibte:-:«.If:�you;ras::#he oviin�r�si(gn'`�as`tlie ` �ontractor,that�rnajr�be an lridicatlon'tfiat'fi��=1s`�nof".�roperly"Ilcensed"and"Is n"ot'einNNed£to�perniitting'�p�iitlleges In Pasco . . ' �a°.>.�':�;:�`-�„``:�'���:� Ct9U111�1. ' , TR�NSP:ARTATIQN;IMPJ�CTitl�Il:ETiES�lMp1�G`��AA1�R���U�tCE RECOVERY'�EES:�'The`uritli�signe�understands that Transpartatlon lmpact Fees:and.Reccurs�.Recov�.ry.���.maYkaPPfy�to>tf�e:,constnuc.,#lon:of.new buftdln�a�change'3of�p;;`':;`�:`r`°`'� _ :�..: ._. .... ....��;.,..:,.e...._...��-:..:..:.��. ..._....:w4..,.,�.. -. use 1n.exisNng buildings}:or=:expar,isi6n=of��5ils'tf��'�buil�tngs; as speclfied.In P�scc� Count�Qrydlnanc�number 89-U7 and. 90-07, as amende.d.,;=Th� unde�tgned also;.uiiiderstandsy tfiait�suc�hh fees;�a���maj�r.��=:due;z�ve�ilk�be ader�tffied at the�atii�e"�of=����=��=�"`' � ....�,. permitting. It Is furtlieir unde�stood that Tra�gp'ortatlon impacf�Feas an'd`��Reaource,;Rec4iiui�ry�Fees:,must be paid prlor to . ��- a �•� ���.<>>�-� g ^ ;�of oc�cripa�cy"_or��finai�power;�le�se:`-":if�the.projaet..d,oes�oio��tnvotve`:aF:certiflceEe of occupancy�o��°=h receivin •� certiflcate ' , ..: . . ,..r.. n�a� �.o�►e�r����e,=.t�e>�s �u�t�be� �ta;Pt�+�r fo permit issui�nce. Ft��tk►et�nare;-if:.Pasc�,,:Counfy Vliater/5ewer�lmpact� =-�;��w a°� -..,." ;., . > fees are dye;,they:mustrbe�;pald;p�lor<�o,.permlt'�isst�aiyce�ln,a�c.coc�ance wit�i.�ppllcebt�<Pasco�:Gaunty+.�c�linanr�es. - CON.�TRUCTlONI�ClEN"GAYV tC'.lii�i'�pt��T13�"FIiN�tls'3t��t�t�s�as amsnd�d}: !f valua�on of work is�2�50Q.OQ�or=more.��1�` !� .-;��1.: ceMify tliat�l; the:;�pplicant,:fieve:�beera. pr=ovldetl°�with-,a�'coPY°;:of_�t�ier�"Flo�ida-�'Cans#ti�8on::Llen�:.la►w—Homeownec's Protection Guide" prepared by�#he"FIo�1da DeparEment�of Agric,ulture and Consrimsc;�:kf�air�. If the �ppUcant Is.someone;;,::;�r_,_.,,:� ather#han th�'owner", I certKy�-#h�t tfi�ve:o�ta,inetl�'aycopy;of:the�ab.Qve:�des,cNbed il�:u�eritband;p.r.o�ilse;�lri;goodk:falth�.to . .. •.,�� deliv�r iE ta=.the:�"�ei�"prtor�#o�`coin�iii�naameiit:;.,� . ; ' , ., - ' =� ` � . , � .. . , - �ONT�I+�TQR'S1t?WNER'�A��lDAVlT: I.c�rtfEjr;;tlai�at:all�_th��lr�fonnatirin:��rtfiii�app!lcat�on i�sccur�#�$nd that all woric F Yw„ will'be done in c�mpUance wfth all.appltcable laws reguleting aonstruatlo�n, zoning at�a�lan��devetopin�nt. Appficatlan,is_ hereby made=.ta,.obtatn�:�.pemnit;�,to:�.,do�wo�.�,and',;:Ihistallation as ind[�efetl:�-���l� cert�j'r that no work"ar In�ta4latlan hea"� - commenced p�iar to issuance of a p�imit�and that#all work wlll be performed�ta meet-=standardsidf a11 laws �egula�ing� _ co�structi��►, Caunty and City cades� zaning.regula#ians� and iand devetapment �igulatlons�In�tFie�jurlsdtcttons�='I��al'so.� - aerttfy tha#1 unde�stand that the r��ilatlans of athet�gavernment agenates m�y�apply.:�to�.the:zitttended.work,.and that it is my rssponsibtlt#y t�lder�#Ify�what.scttons I;,mctsttske:;tcr.be.=[��c�r�tplla�ce:�,S.uch�agec►eleszinciude�but=are.not iimited�#o:-�. -. : - Dep�itment of E�vironmentai�'Pirotectian=4jrptess:'�yhead�;'1'IVe�and �reas.and Envtronmentaily Sensitive ; Landsf Water/Wast�wa#er Treatmen#. , ; ',--.. ` " ... . � - Southwest Florida Wate� Manageriment`'•:I�IstMct-VUells;'''Cyp►�ess{'�Bey_Mead�;;�Wetland� Areas. Altertn� Wafercourses. ,,�,, , ,. .•�j ,�.:;,.;�,',::�° :� �,- : , - � - , . _ - Army Corps of EngfnearsiSeawaitls�'.Docks,Navigatile We#erways. � = - Dep�r�ment,,of;Healthg:���,,Ret�ab!litatives.�Servlces%Env�ronmental�-#�eatth�UnFt-W�1�s;:-VlFastewater��Treafinent; - Sep#tc.Tan�s:.�:� _ _. � _ - .. .. � - _ _. - US Environmental Prot�ctian Agency-Asbestos�bateme.n�._ F`ederaFA�Istip�::Autho:rlty=,RumNays;•.. ` • � !undet�fand.that�#he�fattow�ng;restrictions appiy fo#i�e ttse af flil: - �Use offli!ls�nat a!lowed 1n_;FloadtZone"V"uniess expres�ly permitted. - !f the�-�11= m�te�lal=;ts�ta�`'tie us�:`!n_:Ftood Zo�e. "A", 1t is und�rstood that a drain�ge plan addressing a "compe�sating valume"v+illl.be st�timltted at Ume of�p.ermifting whiah ts prepared by a professlona! englneer �` �� ' Acensetl'.by�the��tateof'Fiotida: ;.� � � ����� -�� ' - - If th�,fl11�mater�aY;i�'#o�b�e:.used tn Fio�d Zone "A" in�connectibn�with�a���ermitted bullding us(ng stem waU_ :. constcuctton,:.l.certiiy�:t�i.at�:flii:�i�ll.ti:e��ssed�niy.#a fiill the a�re,a�within#he��tem�waii: � - !€ fl11 matei�ta!�Is°to be us+�-!n.ai�y aree; I.cettify that .use. af:such titl w1t1.not adversety.afFect adjacent ' propertles,...lf.,use:�of fi!!Is�found_to��dv,er�ely;,�ffeat adja�n#�;prc�pertlest.the a�nrner may be c�ted for u#oC�ting. " -. , ._.,_t,. : the condl#i`ons�#of.:the building�;permit is�aueid-�ut�der tNe:`��GI1BtI,,_.�l8!"4'lllt�B��IICa�IOR�°for�lots.les�-:tt��n:.one {1) acre wlilcti""a�e elevated°by,fll,l;���r engineered draln�g�plan Is required. If[am#he AGENT�OR;TM�OVYN�R;,i;,pronilse.in:good,:fat#fi to irtfort��•ttie�awner of��the permltting ciandltlans set forth In this a(fidavit prlor fo�iniine�ac€ng constcuct(oii. 1 uiiderster#d'#het a separete�permit may 6e required for electricat:work� .. _ plumbing, stgns� wells�.,pools;,alr.cond�ltioning;�:gas,�:;or.o..,tt�es In�tall��l�nns no! �pec�fcoai[y in�tuded�tn.the applicatio». .A permR Issued�hall be constnued to''�e�;a'license�to��pr�ce�d wlth'ttie:wo�k ancl�:not-as:e�uthoHty-to:vlol�te;�'ca�icc�l, ai#er� ar set aside any`provlslons of tiie:t�chntc�l.cadeis;;nor shall i�suance�af a.permtt.pr.even#the Bulidirig Officla!from ther.eafter requfring a correction-c�f;errors:lrn�p�ans;�constivction..or..iriolatlons of any cod��:���very��p�ermit=°iss`ued'stiap�•tiecomer��invalid uniess ihe wctrk aiithan�ed.by such perm!#�#s.cotatmenced�w�thin,�t�c,m.or.�ths of•permit issuance� or if wark authorized by ths pemti#Is�suaper�ded�or:ebar�doned�for�;pertod;�o€<�lx:�)�m�ntiis,:sfter the-#im�the�wa�lc��s cammenced.. An entension may be requested* in,writin�g,�f�om tl�e�°�ullding,t3fflolel for a perlod��nat-io�exc�etl'=nit�et3r�{90)�=day� e�id-�vltf�demonstrate justNlable'cause for.�the exE�ns(on� li wack ceases.for nineqr�(90)cons.ecutiue:day.�...th�job�Is considered aba�doned. � . . . . � , . . . _ . . _. ., . ._. �_ , �a�#3d��tt�� Td-taM1N��d:- 1�A�d��:��l��8t�,�T�.,..13����t�l:a�.�:�'Ct�:����.im�E�I�t�1+�E�fE�T�tN�aV�1RF�QD�:T�1M�-��DP�--� _._ _,�. PAYtNt3�TIRYICE;;�OR=111,I�P�tO�tEMEN�'l�,.T:O XIQ�!!�Pl��?ERTY.�:1�-:Yt?.Ua1t+��D?TQ"�'i�J�KIN�=FiMil�i�tF:tN.f.�;�ONSUE.7 VNIT A !� �� �,, " - . , . Fl.OR1DA JURA'��(F:S;:1.97:03).... ., . . ,. ._,. ,.;:.. ...:� :. . .,: .:_;��.. . �. � . ... :.. . ... .. . . . .. . ������� , OWN�R OR AGENT.� �. • COPJi'RAGTOR � 3ubsaibed and ewom M(or�fllrmed)before m¢thia Sub c,r b d end'�m to(ar atflrmedpb�fat�,me`Itii�� bY ' L��bY_.. �li�'i ��.Q.�.Q:fih-�-., ' IMio Isfare personally knovm to.,me.oc:heslhave,Produced -Wholsfare rtelly�Cnoym; ���n�e.;or.#aeltia�e+���rodut�d. . y ' " �e Id`en8flcatlon.' i4/'" L � ,��`ie as Identl�caUon. Natary Publta . ��l''�'..- ���C.Q.� .! �1... �� Natary PubRc CommissMn No:` Comn�Iseton No. t.a_� �lG�a.l.��. hr� a..c��e �� I tVam�af Notary iyped,Prtnted or�tamped Riame of N ry,, ,,p r `,; . ,�;.:".�, E UFFE�l. �. . � i,. :�:Commission#GG 0453 t3 Ei � .;";���,:;�icpires M1lovember 7,?020 ' ' ''a°F��`r''� BWIdedThNFiGyF81tt3�PattC0860�3&r?�Si� �i „�,�.• , e. - . ,� � 1 Y•