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HomeMy WebLinkAbout16-18015 CITY OF ZEPHYRHILLS 5335-8th Street (813)780-0020 �$��� , EL,ECTRICAl, PERMIT PERMIT INFORMATION LOCATION INFURMATION Perrt�it�;:'180'15 lssued: 1211912016 Address; 5739 & 5741 1 ST STREET ' Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL. Class of V11ork: ELECTRICAL MlSC Township: Range: Propos�d Use: NOT APPLICABL.E Lot(s): Biock: Section: Sq. Fee�: Est, Yalue: Book: Page: Cost: !� 1,800.00 To#al Fees: 45.00 Subdivision: TREE LANE VILLAGE Amoun �Paid: 45.00 Date Paid: 12/19/2016 Parcel Number; 10-26-21-0000-00100-0000 i CC}NTRACTOR INFQRMATtON 01NNER INFORMATIflN Name: , IM'S ELEGTRICAL SERVICES INC Name: TREE LANE LTD Addc: 18302 EASTWYGK DR Address: 10912 56TH ST N ���AMPA FL 33647 TEMPLE TERRACE FL 33617 Phone:�(813)810-4079 Lic: Phone: (813 361-9128 Wo k Desc: REPLACE POLE METER AND PANEL � APPLICATI4N FEES ELECTRICAL FEE 45.04 � � ' INSPECTI4NS REQUIRED RQUGH EUECTRIC CONSTRU,�TION POLE Pi2E-MET�F2 1'C/ FINAL � � �`� ' I � �� � ` I � ( REINS,�PECT°ION FEES:(c)With respect to Reinspection fees will comply with Flarida Statute 553.80 (2)(c)the loca!�overnment shail impose a fee af four times the arnounfi of the fee imposed far the initial inspectian or I 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 6�faund in the public records af this county, and there may 6e additionai permits required from other governmental � entities such as water management, state agencies or federal agencies. °Wa �ning to awner: Your failure to recard a notice of commencement may r�suEt in yaur paying twice for imprc�vements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Camp(�te Plans, Specifications and Fee Must Accompany App(ication. All work shall be pertormed in accordance with City Codes and Ordinances, � � i � I ,�1'"�—_l=�-�� � c� CONTRACTOR PER OFFI PERMIT EXPIRES IN 5 MONTHS WITHOUT APPRCJVED INSPECTIO � CALL FOR INSPECTTON - 8 HOUR NOTICE REQUIRED PRCITECT CARD FROM WEATHER i s��-a`aaooxo City of Zephyrhills Permit Application Fax s��-�so-ao2� @uilding Department � . ' Date Receive �`�,,, f G� 1 lr� �D _ �6 7� , � 1 r -!�� f� €.Phane'=Cont�ct for,�Perniittin .7 . � ° Owner'a Nam �f�-�- �V�.-<' V�.1( Owner Phane Number � e Owner's Addr ss r�:9��� N�6 '� S� /,`���e.. (K.�`,/- . Owner Ph'one:Number �� � Fee S(mpie T( eholden�:Name �� � � ' Owner Phane Number �� � � �� �-�, - Fee 3lmpte Til eholder Addresa _ .lfl8 ADUFtES, �� �J 1 S � LOT# C_w� sU�D}V�s�ori. f s"e-e G�'— ��cE�..lo� ' . � _ � � ' (OBYAINED FROM.PROPERTY,TAX NOTICE) WORK FROP Ed ��NEw CONSTR ADDlA1.+1' [� SIGN` 'Q Q �DEMOI:ISii . , .. �,.e, iNSTALL 8 �...REPAIR � PROPQSED: $E .,.. . - �J • SFR. ' [� GQMM . � �QTHER'_ . . TYPE tJF CO I 3'fRUGTiON •" Q� �'BLOCK r [� FRAhAE ..� 'STEEL 'Q DESCRIPTiOA!OF WORK,' � •. ���`� P`�t"�'� �e�C.:.. D�e �ov�e,� - _ ;. I . ,:. BUtIDfNG�S!i `�� ��$Q'�EOOTAGE,�: .HElGH�'��`� � - - QSUlI.RlNG $ . .,. � , � _ ..> ' , . , VAL.UATiOt+1'�OF'TO'i'AL-60NSTR1IG'CIOPt - ,. „ � „ � .. .. EL 'CTRICAL ' $ _Q�d..,�� � AMP.S�RVICE. ' � �:[� �PROGRESS ENERGY � W.R.E:C. Y [�PL�MBIN4� $ ' � ' � . I ���: t. . [�ME�HANICAL $ � ' VALUA710N OF,MECFIPIlVICALlNSTi?►LLATION: � . : .. �r; ..� ..i:i'� ::. :,�.j.7. ;. . . '. • �� C]�I [� , RQOFING ;:CI,�,:�_ SpEGIAI,T!;.� .. ..�THER�, .: . � - � FINiSHED fl� OR EI.EVATiC3NS ��� FI.00D�43NE ARFr4 QYQS. ,NO I , . .. . j;a �•� — , i;,�> ;it^ ^ . BUlLDER COMPANY''- _ .��:.�`•�.-`- . _ , - , StGNATURE REGISTERED- L Y/ N •'"`-�``�EEE CURREA=' ' Y�/'N � '� • 'k,14 -�c�5 . y:...i�` 1'�: � �t�rBSSI :: ;�: _ i., . cr�;.j � _ ��{C@t1S8.#'� '[ !• -_�. ...". , ' , . I � . . . ., , ,•, : �.. _ .'.: � _ r"..... ' :, .. .. . ; � ! ' �• �i`� . .Y:...,,5. .� �4� . ��Ecr��c < i:�� � ., :- �h; µ.�con��A++nrr � _ �~`�+°-�c�;c,�l ��;,.;=._:!�_ ..' SIGNATURE � '�` �REGISTERED � Y/ N FEE:CURRE�;� ' ;>Y/:N. ' . ` : ' �y oc;;,,�.. '�i�' .. �� . .: ' • ' ` '. ., . _ ``;�!.; ,; , ' i. r � � Address i l`r.� v� � :,1-`` s .. � .�:' : � :l.lcense;#�;_ .�::,.•,>,:13�c'.��",-�j'`�'C� �tµt'fFl.j.ief:�,! _ - PLUMBER '-� ' ,. , ... . , ' � ,G�MPANY . _r;, `.'''�� �� � . , . SlGNATtlRE''�` "� � � . - ,, �riE�iST�i�o , ,Y•./,;N,; ;_ -tlF��CURREns�< '1f-7N. < Addr�eas � N � ... . ., _;,-;, `�-0 �. - -. _, r . ,.,., , . . . ... , C .�C811S9�# r,t...:._r`P,r �- ' .. - . , . , '�>.: MECHANIC ., .,:<; ' � , .. ,. . .. ,,. � . . �;. ,�; � . � StGNATURE� ,:� ' .. ,.�. � .. . _ _ , C�MPANY. . - .: � ._;�.,�,..,, '' ftEGiSTERED Y;/.I�I' FEECURRE��= �Y./;N ,c•� ..}. � . . • . � -< Address. ._ .. . >,.�- .:J _,:ir", .. _ , - �� t « � � :1. ... , ,. - ' l�c�nse# . , 07HER �.,,�.( , .. -.� . _ _ , .,. .. � �•� _ ..;,, ,. .. :.:�, , , ,. , _ ,. '` ' � .COMP�1t+lY' _ ' r,-� . SlfiaN1R1'Uf2E� ._ #�" d;� :, ., x. - . '{�` Y�.. „u , - �REGt'STERED`` Y 1'IV;...'.: ;FE6'GURREt�• '. Y/N . �.;�, r•; ;�.,.-�= .. . ._.. � ... �:. � ._ ..: , ..:.:- . . _ ...... : :�':°�.., ' ����� ' e�y.f,•R :ef,'"`1��y. � dF`Wb�., . "'�}.. .. �t���� „ � � `�:3 . ' . 9�� " — 1�IC8ttS@#`�� RESlDEN71AL c; ,Altil"Ch�2 'P'!oflP 7 �. ._i . -,.. ...y. ,_::...�. � ft;�::rc�a...: � �x.�.._i;_; ,>,a... ,,;., :,,. . ..., a'�' , , . :( �Ip ;latis;;:(2�set"s��of8u�ldirig<P<,lan"s;('I)set=ofdEriergy;F'orii�s;�R=Q=W=#�eimlCfcir�riewi�nstrua�tbri, ' � ,;`�=Nllntmumt.#en;{;iA)wari5ingfd�ysaafterasybri�ittai'date,��eijulredon's{fe;'Gons#iucNon`Plans;`S'tdr`enwatei'Rla`'n's°wiSilt�Fence�iristelled, Senifary Faciiltles:r&c�1�;dumpster•;,Site=Work;Permit;for,subdiv(slons/lerge?p.noJect"ss�::,;.�';�;,:;�:.."< _, ` ^+ � - �OMMERClAL. Attech{3)`eomplete"set"s'of'Bultding Plans""pius a�t:ife""S'af�iky Page;�(1j set of�Energy Forms.R-0-1IV�Permitfar neW:cor►stnu�on.• � I Minimum ten{10}working days affer submittat date. Required onsite,Constructlan Pians,Stomrwater Plans w/Silt Fence instailed, Sanitary Facllitles&1 dumpster.Slte Work Permft for all new:proji�i.�t's':i411 commerGalre4aul[emen4s,must meet compllance`` ' - ._..�,. .�._ ,.�.,....._ -=SlGN P�RMlT Attacfi'(2)"seis afEngfneei:ed%P�laAs:,,:,=.r;:�.�F - .s.- T ,.�.-.,�,� , . , , - "'*PROPERTY SURVEY required far ett NEW construcdon.,,,. . � - D�r@Ct10»$: ' . :�',;;,.isE..,:� , ... � Fitl aut ap�ppp�ticatlon comptetety. . Owner�otractar slgn back.of applfcatlon,notarized Ef ovec OO�,a,Nottce.of Com�ertcement ia requlred (AtC upgrades aver 3T504) � , ,. :�„*b,t::.��'f," _ � - Agent(far�thevoontra,ctar)qr'Poviie�af'Attoriiey"(for the ovuner)wiauld be someone with notarized letter from owner authorizing same , K3VER�TNE_C UNTE�i�PERMETf,ING�. _,�:�-{Front of Apptica#iorr�Oniy}...___. , _-�� .. � ., . Reroofs if shtn i les Sewers . .Servlce Upgrades A!C Fences(Plat/Survey/Footage) ,_ - . .. f . ry�•{.;r�., Drlvewa -Na#over Gounter if an pubtla roadways.iieeds Rtil+V ' ' ��, . � ._.. r s ' �"-ir:z:.�a"•n:.Le�v N�'�tGE��F DEED.RESTttiCT10�1S:. The.unde_r:stgn�d;under�tandsr:th�>�thl�?.��rm�f;:�nay..l�e.sub�e.c#;to,��deed���estrl�#1o�►s.:...�.,�, which may;tie<more��restir�ctive�xth��t�Caunty�i�egri.lsitfons 'The un"d'ersl,�ned''assumes�`respnnsi�bittty�for.compliance�in►ith"any""`�"�`�`°h� appllcatife�deed=res#rlctlons. =��e�.�.�.:.�� .,y;.,�f..;: ,r�.�. :�. `�' - .. . .. ._,__. �. ..,...M.�..... ..;� �r'�,_;�. � ��:���-� UNLtCENSED�`CONTRACTORS��AI�D CCMNTRACTOR�RESP�NSIBiCiT1�S: �=<if-�iie��owner�°�fias°'Fitred�"a`;cdr�fir�ctar or � contractors.#o undectake work�-they riiay�bo�requli?ed:to;�1���Ilcensed=lrt..accardance.with,state�.and�Iacal�:re ulaN.' .��� �°�Y".' ,•. . g�_.. �ins� -1f'}the��•��' GOAtF'£�C#Q[TS`ROt�IICBt}S@tf�88'�re'qt�ii�;'6y�liaiiiv� tiattt'=#he awner arid'cont�ictoT��may:�ties.clteil4:fo���imtsdeiriesnor vlolatton under state law. If the owner.ar intended;p,conha�tor;ar,e;�uncertain �s`to va+hat Itcenaing,;,reyulretnents;�mey�jeiipl�iti�for�'tiie��;�:�:�x-i7�°� ;�...��: intended�wortc, ttiey aTe;ativlsetl ta�contact�tl�ie�.Pasco:Cou�tty Buitdiitg:lnspecttcn�Dlvlslarta-1,.[censfng Sectlon at:727-847- � � .. __ .. _,w _, .. �._._.� ..__.,:n_. n 8008. Furtliermare, ff�#he oitiner`t�as�'fiir�i+ii�a�conlrecfor`or coMractots� he�ts advised to fiave�,tfie cant;acto�r(s)�sign..`,���,,r�,y portions of the:�"contrecta�.Biock'.of,,,this.tapplicetl�n�for.:whlch..,they,will:;be�r,e�ponslble.-.�,:if�you;�as.�#he yowne�c;si��gn as the� ' contractar;tF"tet�m�i be an Indicatiart Niat'Iie�is'not.properly iicensed antl°�ts"'~riot`en�tleiil to�reimilttli�g priitlieges in Pasco . ; �4,ti!:5?�°v Counly. . , 5,..:�_. .,., ., TRANSPQRTI�Tit1Ny1MP!I�CT/UT!!It'!ES}!�'It��C'fi���l�Nf?��tESOUItC�REGQVE[tYfEES:"The�unde�sl��ei�understands , thatTransportatlon Impact Fees and.Reco.urse.Recovery.Fees msy;�p}ily:�tc�ti�e;construction�of new..b.ulldtngs;.change��of�Ai�`�=```=i�"c'. �use in exisHng buiidings���or.�exparialbnr-of�ekisti��:'�buildings,as speclfled.in P�sco County Or'dtnance number 89-07 and ,f' 90-U7', as amended,;:,Th� underslgned also;i�ntlerstands; fFiaifi�sych tees;as�may�;�r.due�xw11F�6e.idetitified at the�tii�ie�of`��-��"�"��` permitting. It is fiu'rtiie�underetood thet Tre�isp�o�tatlon impacf'`Fees a`rtct`�f3esource�Recoireryz`�ees:,must be pald prlar to rece�ving�a"certEficate=of�occups�cy"�or fln�l-.power-�elease."�:1#�th�pro�ec#.;does.�riot 1nvolve:a;certi�cate of ot�upaticji�o���'-"•:.p,�.�ts:y ' final awer�release���ilie;fees�iir�r��t'tie atd. rlor#a; ecmft Issuarice. f�xtt�ermore;•ff:Pascc�,,Gounty"1Nater/Sewer.:�.lmpact �. . . p j P �tP' . P..._: :. ,,r,�;r> �..,... _ , . . ::..,.�..: . ... � fees are due,:they.>m.ust:be;pali�`'p�loc.�a..permtlhlss.uance°:In,accordanc.�wlthr�:appllcalile�Pasco�:Gounty:oiiltnaaces. - � �ONSTRUC''CION'�.IEN L,AVIt tCliapter 713� Ftor�da Statutes�aa am�and�dj: ifivalua�an af work ts$2,500.00$or.�mor�;,,M���i1 =°�_: certify that-I, #he�:applicant;:;have�been providetl�with� a=copy��:of;�the��"Florida-°Constructton:��Lien�.`Law Homeowne�'s ._.. . . P�otectlon Gulde" prepared by',=`tFie Fl��ds Departmecit"af Ag�taui#�re and Cansr�m�r;;kl�~alr`s. If the appllcant{s someone:-:;,..: �.:;--�} ather than the"owner", I certifj►,,-that:,l�:ti�ve,o�t�ineid"a=copy.of:#he:abQva:rlescritied:�locu�enttand;p�:ot�ise;:in;good�.falth,to , -�:S.> delhret IYto�.the:'o�rrier.'<':`prior�ta�:�c�tnnierii�rtterit:" s . ` .. � . . ,.. . � _ �ONTR/1CTOR'SlOWNER'S AFFIDAVIT: i.ce%tttjr;;tt��t�ati,;the�g{�mnattontl��thi�appiicatlon ts accurat�.and thatail�work � ,r., will'be done in compliance.wikh all.applicable�laws regulating constructlon� xoning and:�land�°developm�nt. Appli+catlan,is hereby made ta obtain:':a.petmlt:�;�to,:.do;w�f�k�,and�:tf;istall$tlon as icid{�eitt�.il:�=.�°I� certify #hat na work=�or instafitatton �Fias- � . camme�ced p�lor b issu�nce of`a permit"and that�:all work will be pe�formed�to meet�standards-of�all I�ws regula�ing� consMsctfan, Gounty and Gity codes, zoning regnlatlans� and tand developmertt cegt`sta�ons�'tn tfiie J,i�rlsdlcfion.t��'t�al'sb- - aerGfy that 1 uader�tand that the regulatfons of other'gouernment agencies may�apply::#a:.the..lntended.work, and that It ts - my responstbll(ty#o(dentlty�what.actlons l,muat:teke,:to be.fl��comp��nce T�Su�h;agen,clesilnclude�but=ate.nat limited to:: - � - depai�tment of Efiviranmentat�Protectiori=Gypress':�syhead�� WeH'and Areas;and Envtronmentatly Sensitive Lands�WateNWastewater Tnalment. - �� � - Sout��uvest Ftar�da Wa#er Managemenk::.:t�fs#r1c#.-Wells;�'Gyptes.s.�Bay#�eai��; �VYef#ar�d� Arees� Atter�ng , Watercaurses. � ':I .;:,.;,,,�:�.; : ..,, , _ - Army Corps oE Englneers�Seaw�alls;Docks,(Vavlgatile Waternays. � , - - Depar#ment..of.,Heaith,�,B,:Re�iaGllitativ�;.Se,niices/Ernr.it+onmen#al�F�ealth-Untt_Wetts;�V1Eastewater�TreatmeM; ' Septic T`anks:.. -�.} . .- �� ..... ` . .. - - U5 Envlronmental Protectlan Agency-Asbes#os abateme.nt. � . Federal AvleUonrAuthority;eRunways:� � • 1 understand.that:the.foltowirig�restrtctlons appty fa ttie use o#flll: ' - �Use of`flli ls not atlowed In�Ftood=Zone"V"unless expressly permitted. , - If the�•fll! mateital�-ls�4o'�b.e �use�;!i►..Flood�2one. aA", tt is understood that`a drainage plan addresstng a , "compe�sating vatame*;will be s�bmitted a##ime o#�permitting w�ilch is prepared by a professtanai engineer:. . Iicensetl by��he:�tat�of:fiotida: �.. - - _ _., .� - If th� #Itl:�.meterlat-ts�`to:bat used in Ftood �one 'A" in�connectian�vdrlth:a��ermltted bnildlr�g ersing stem wall.. ., ' constnuctton, I certify:that:flll:i�rall:b.e.used only.to;fill#h�are.a�within�the�stem�watl: � � , - � !t fll! mateilaf..ls to tie used-In ariy area; 1 �asnity that:use af•.such f!!1 wlll.not adversely atfeat adjacent . ., propetties. if.use:-of flti.is.fonnd#o.-advers�Fy:,�ffec#adja+�erat�prctperties,.the awner may be citad for vl�ating. � the condwons�of,:the bulldimg;perrriit�is�sued�u�der tlie:fa'ttached�ecmit_applicatlonR-for:lots�.less�:ttian:one (1� acre w�iicti"e�e elevated��tiy flll,��t engineer-ed dralnage ptan is requlred. • . �� . If I am the AQENTr wOR TM��O'YVNER;,I�prorrtlse.ln;good.faith ta Inform��the awner.of��the permitting condRlons setforth in thls affidavtt`pr3or Ea'�commencing constructlon. �i utiilerstarid that�a�s�parate`permlt may be required for etectrRcai�.wark, -. . k.�,.�,..� � ptumbing,;sigros� weits�,:poots,�alr�:.conditioning,.g���::or.o#heT instell�ti`ons nat��pec�fcally included-in.fhe�application. �A . � � permit Issued�hall be coitsitrued to"b'e a�license'to��pr'oceed with°ttiewViiork and�;not-as:authoNty::to:viblate;.-c+�ncel� alter� or , set aslde ai�y�provlsidns of�the:t'e+'chi�Ecal.cades;;nor.shalt Issu�nce�of a.permlt.pr.event ttre Bulldirig Ct#ftdalfrom theceaffer '' requlring a car�ectian af-errors In�.plans;:cons#ructlon.or.violations of-any�codes:�-�v►ery�`p'ermlt��issi�ed�stialf tiecome��invalld uniess the work autharized_by such permlt:�s-commenEed•withln sf�c„months of�permit I�suance. ar!f work ae�thorized by ' ' #he petmit is.suspended:or;ebaradoned�for:a;perlodr�of;six:�8)�manfFis�..aftet�the�tlnae the�wotkds commenced.. An eactensian i may be requested� In.writlrig,,:.ir`om tfie;Building,Offlclal�for a perlod�.nnt.to-exceed'=ninei�r�(90)'��ays a�id�wlll"demvnshate �ust�iable.c�use for:�the e�ension: tf v�►ork ce�ses:for nlne#y.{90}�oa�s.+act�tive:day��..#he�job�ls constdered aba�di�ned. - IAtARNlNG Tt? OWNER: YOU�_�AlI.R+tRE:TtI,:l�EdCQEtQ.�A��.Q��1GE�>QFwCQMMEMCEME�#T>N�AY�RESU�T IN��Y�UR � PAYIN6 TWI,CE:FQR��IMPROVEMEN;��•.T�t�Y�O.UR�:PRCC��'ER�TY:>�tE�-Y0U;1�1'�EWCI��TG:rY�BTA�N"F1NiA►�IEiN.C�;._C�N�ULT� - WIT - - [1 �O::EiI�- TT8 6�'. 4, - — k� ;g � ;_ _ ,> . , ' - . h't.flR10A.lURA'��{FsS::11Z:Q3�: ,. . . . . �>. . .-.. � . .... _ -, _.. . ,.., >:�:.,_ ,, _ _ ,.. OWNER QR Af�EN7 . CONTEtACTOR �_•)i�� �-----'`� 8ubsafbed arn!swom ta(�a�irmed)befor�me fhis Sub�cxlbed'and'swom��{ot'aflJnnedpt��tote rtta°tti1S . by . _,�by.... `_� ,�,..^ fi'C,s�.1�..ci�t � , 1Mlo Islare persanaliy kr�owm to,me.or:heafhave,produced Who.ie/are:p.ersonelly.knowmlo�:me;or#leailhhave:prodiiced- • es 1d"eii��a8pn. es tdentNicatton. . Nobary Pubilc . � Notary Pubtic COtTi1nlSSI4ii NO': Coinnt�Isabn�No, Name of Notaty typed�Prtnied or stamped Neme oi Notary iyped.Printed or stamped , � � . s�s-�saoozo City of Zephyrhills Permit Applica#ion Fax 813-780.0021 ~ Bullding Depariment i ' ' pate Receive , J,� — � �'—.� G -( , �n _ ��-�- Phone�Gantact'for:yFerrntttfn Owner's Nam� �����e '`J���°'� Owner Phane Number " � ' r Owner's Addr ss ��'q12 N�6 � �� T' ��'��-- ' Owrner Ph'ane Number•.•� Fee Simple Til iefioider:Name �� � ,� Own�r Phone Number �� � � � .s ` � I - - . Fee 3lmple'I`il eholder.,Addre�a ' � sas�wor�Es; ��T .� � S�' S �^ LOT# �� SUBDIYiS10N r�� ��""� F!J4RCEi..lD# � � - • �' � , , , (OBTAINED FROM.PROPER'TY,TAX NOTICE) WORKPROP' SED , .x-NEW�C0145TR . ADD/A�T �� SIGIU' `Q � ` Q DEMQ1:l3H ,, �IWSTALL. � .. REPi4iR PROPOSED?.�S� . � :C] SFR [,� 'COMM ' , � �Q7HER' TYPE OF CO I STRUCYiON �� Q" �r BLOCIC '' [� FRAME ' [,� STEEL 'Q I � �"'� $ • _ DESCRIPTION OF WORK' -� ` . � , . I � ��: � . ..,��._� Bt!lLDING St E=`���� �'SC!FQQTA�E HE1GFlT i . . � � f e..-. .�. .. .- .,_ QSUti DlNG � �_.—����. _� VAI.UAT10[V�.fO�:TOTAL-CONS'FFtUGT10iU . - [� GTR{CAl �$ @����, AMP SERVECE. � Q' "�PROGRE$S ENEFtGY � W:R:E.C. , •1.�....� , . � QPL�MBING� $ � . � ' � r .;��� � �, � � QME Hi4NICAL $ Vi4LUATIONOt';[it1ECHAFIICAL-!lVS7'ALWl'IC1N. �,� ... , , . . „ . . . , . , . � I �< -. . � [� , ROOFING ;[�; • SPECIAI.TY:::�;...;OTHER�; � . FtPi1SNED FL�• OR Et�EVATtl3NS ��� FLOOD ZONE ARE�4 [�YES. _.NO i • ... �. �' � � „ �" •..1:�'�.i�i... .F': : '-. � . _ ,,� _ ...�-.i �tti.et -i�:.i BUILDER CflMPANY, _ .,___�. � � , _, - SIGAIA't'tIRE REGi3TERED ` Y/ N ' °�"'FEE CURREA" ° Y'/N" : ' ' I =.,. _. .r�;, .��' ',`. ..s;�::':<^ c:���: '.'` ,. , . :� Addre�si . ,•. + . - „ . ,�Llceiise�#` `>�'_�_,�4 ': , ��:.: . . . . .-:� • :r,' ELECTttIC _ � y� �� '��----, ... .� :1`'�G..ONIPANY�., ��j,r.;?,!S��fi;,���c�Lw' „'-S'�"`!-^=� , - , SlGNATURE. � . ; ; �: _ . , � t�REGISTERED Y/ N FEE:cuRREh�-' ' Y/:N�' ;< .�� � �o..��wr�,..�,�:= , _ . :.�£:� _ . , _ . .. . _;K:.��-� } : :. : .. � � � 1 ABdressl' �$ �� . 'i;r:,,�.:LE,cense;#..�, . �'..�, a��.�� PLUMBER �� . .. .. ... : �z:. =.r, ,.:;.:.: . , � . . - , .! . . . ,GOiI�.P..Al�lY .;:.-�Y... ,�. ..;..: . :,_, .; . SlGNATURE'' � � . .. - - ;'`=REGIS.TERED ,_Y_/,.N:.a -�,F�-cur;tREn:�� Y.�/N, - - - - �, . -. , . ,, a, .. Address I � ; .. _; , . � -�. . , "�~R,: �^ . ��-'r _ . . , . . ,. � - - .. .. . , . . ;.�tcen§e# ��. . ,za.x_. MECN�►tdICAl�:` ,,, . . /►� ���y . .; . -,t -�; . . , . V���M[. .-� ::;. c, f StGNATURE�� - :' .. " ` � _ . y ; ' ' ' ' " + REGI§TEftED . Y/.N FEE CuttREn.. Y/�N'. ry � - . . ... . :,. , Addrea�;� w. �'F �- . ,,f. ., .,:.-� . .. � _ , , . , ,_ , . „_ ` ;(,��.,� . � � �tcense# � _ . , . ,. ..., .- _ , _ . ... . ., _ �.,�..: ., , OTliER - ..,. ... , , ,. •�,: _ ( ,;n:,�., . . . r- , - , :.- _, _�-. . , , , ,GQMPANY' - , StCaNATURE._ . .,�. ,�x:. •.� �<.n �,� . � •f ¢a._ ...�. , _ � t REGISTEREU Y/ N:..,: ;FEE�CUi2REA�� Y/N +'lN{��$$�. .�� Prn.��.¢„f. '4;.e�y ��'�a�.:.ir_ . . i{M ... ., .-_-'•.,� .3- .� :.c:.�: M1 . .� _ .�.. ` :r,^;: :.;�...�. .....� ��t�ti$9�`� RESIDENTlA�.; _�:i4ttaicti.{2)'Frllo Plaif :2 , � ' - - '�-,�,;^" .� `",,s:;�p,.;., . , >-`r ,s� � ., ,,._ ,: .: - � , _ .F :� s;;( j sets=of.=Bu�ltllrig�'Plan's;�('!)set'of=Energy�Forii�s,=R'0=t+1t�PeriniEfor new co"'nstruc�ton,r �!�.,��.;;.:tVltnlmumt�en-�{t1Aa�wott�ing;de�ys aitarusybinititai:date:.:�Requlred oristfe;:�Gonstiu�c�tlon:Plans;�Sfomiwater�?lan`'s wl Sitt fence installed, � = - �`Sanita'�'Facllldes�&;�1 dum ste,r•;Site°Work Perm t;far,sutidiy(slons/le�� "t ` � � ` • rY .. �� , P , r,� .� .. ,. ►'8e:pro]egts;p.:;=�;,:�: . :� ::••:�.` �: : ,. ;J. COMlWEltC! Attach 3'�i�om'Iste se'ts°of'Buiidln`"Plans`"��lus a�Cffe Safei"""Pa'e;��1 set of Ene Forms.R-O-Wf Pemttt far navi%consttuc#ton.• ' ( )r..;� p . 9 P 1Y 9 '{ j r£�Y ' Minimurn ten(90}woricing days after submlttat date. Required onsite,ConstrucNan Pians,Stortnwater Pians w/Silt Fence instailed, Sanifery Facllitles&1 dumpster.Stte Work Permik far all new�projects'r:All commercial re,pulram�nts_must meet campliance • ' - _ 5lGN PERM! AttaCh"(2}"sets of�Eit i'neePedat?(a�S:,� _.s�:� ., ,�:� -��<�,� _ . .. ,' � . s�..__ a , "*"PROPERTY SUFtVEY requ�i red fqr ali NEW corlstrucHian.--. -- - " _ �„ L?IraCtlQttB: I .._���rN,�:;y;:;.':_ , �� .. . Flil out a� ticatlon completety. Owner 8� ntractor sign back.of appltcatlon,aotarixed If over � D,a Nottc�of.Camrrte»cernent la r�qalred. {AtC upgr�des over ST500} , .. � tr:�,.-���,;�,�';,,. Agent(fo flie contractor)o"r'Power"6f Attor"riey(for the owner)would be sameone wtth�note�ized letter from owner autharizing same OVER TFiE C�UN7'ER:.P.:ERMtFfiNGri., _,.-,..(Front�of-Appllrstion:Only} _..___ , . ... .,E Reroofs if shin$les Sewers Servlce Upgrades A/C Fences(PIaUSurvey/Footage) _. _.__ � __ ..._ ..... _, a._ ._ - - - _ - ,-,�: ' Dtivewaps-Not over Counter if an publio roadwiaps::needs ROW' � � ' . , .Y , _ � i r•�::4at?E2;:a:y. NOTICE OF DEED.RESTRqCYlO�i�:. The under�igned;under�tandst,th�t�ihls>p, rmif:�may;;be.subJect:to"deed.�restr�ctioiis°:,.����. � , ,�. �... , .,, ;�. � ���::•.r., �..,��... which may:tie'=more'�'r.e�stHctive�ttiel�`County�%��ilatfons':�`�The und':erslgne.d��assumes��responsitilittjr-for compllance with�any"� �Y ' ,._,. applicable'deed=re"strictions. ,:.t,,:.��,:;;:;-, �t:� ,�. "' � ., ,... .___..�.__ �; 3+c::,':3�` M•"'.`{-; . .�: ................. .._ . _ ,.: _. ._. ,_.. ....,.....a.. _., ,; I�NLiCENSED�rtCONTRACTORS aND .CONTRs4CTOR�RESPON�IBI�ITIE�$:���If=�Iiem�owner�has�htred�awcdr�ti�lctor or - contractors.to unde�take work, they may�beir�qulre:d�_to:,�be�llcensed:l accordance. g_ �_ '?� ���-=° rt; with�stateµ.and.�local;re utaHo s� .If=the�•�<':�RA.� s �.:, , ,..r�,.,..�:.��r,. ._�._., :, �,... . .r..._,.;�.,,�..,.,. contracto� 1s-•not�itcens�ed��as-�cequired:;tiy lauv,��:ti�otlr=the�'owner and�contractor-�mey�'tie���citecl':for��`�riii�demeanor violation under state law. If the owner.or intended,�=conha.�tor;er,'e.�;uncertaln as to what Itcensing.cequirementsA�may:�epplyt��fbr•``tfie����=r�- -=;�^ ,;.�, ..,_.. _ . ._,. .o..t � t}t M. _p.u....._..yr•..,r,. '...-».�-�.'�✓.:v intended"veioiic, tney a�e�aavigea to'�contact:tiie.Pasco.County Bullding=lnspeetion�Dh►lston-Licensing Section at.72T-847- .. .. ... ..... w. �-.�i-...�..:-.i.�. .^a-�-- .�-.:r_.r '...n ... �;:�.�....... ._.+.�_ �. ��::" �:.v . .. 8009. Furthermore, If the owner'has�'tiired e c6�ntFacto�'o�contractors� he l� advised to have�the con:,tractor(s),rsitgn:�5�:fl;,w,i=s portions of.th.e."contractor.,Block".of.;thie.:.eppllcatiQnTforawhich.they.wil�,_b.e.r.esponslbie..�,If:your_els=lhe oviine�"sign es�tlie� contractor,'thet�rnay�be an indlcatlon�that�'fie�=ls noY'.properly licensed�and'is"`not enBHed`to permitting ptiuileges in Pasco County. ' � _. .._ .. ' ..., . _..,.._ ._........w �.�`4:�:�t.� ,.;�::��, TRANSPORTATION�IMPACT/UTILITIES�IMp�4C`��ANb�RESO�RCE RECOVERY-fEES:'The undersigned understands that Transportation Impact Feas�and.Recourse.Recove.ry_.Fees m'ay�;apply�td t�te Yconstructlon;of new,bulidtngs,;tchange��of-�=�� =���`,��' use in exieNng buiidings,�or��expar�sibi�:of ek�ali�i�`�buildings; as speciiled.(n Paeco County Ordinance number 89-07 and; 90-07, as amende,d;t:;,,�he undersigned also;,urtderstands; th�t�such fees;;as�may�:�b•zdue;.�wlll�be tdentff(ed at the�=tiiPie`of��� •_-=��'`�' perrt�itting. It Is fu`rthe��nd�refood that Tre�sportatton Impacf�Fees and'��Resoui�ce_;Recodsryz�Fees:,must be pald prior to receivtng��a "certiflcate�,.of�occupency",orfinal�power.release:: :If�the.project:;does�:not tnvolve,a�csrtfficate of occupancy�o��{'4,`��:3�4�' flnal povirer-release;�>:ine:fees mri�k��tie paid:pc1�r to�permR issuance. Ft��.kthermore�,if:Pascu�;County`Waterl3ewer1:lmpact-- •�.:5�w�� fees are due�_.they must:be�pald:p�lor.,to,perrinit�lssyence�in.accordance with:_appllcabfe:Pasco',Gounty�'ordinances. • CONSTIaUCTiON'LIEN�LAIN�(Chapter 713� FIorJ'da Statute:�as amend�d): Ifi valuallon of work is 52�500.00�or�more;,:1�•�.�: •=�:�� certify tHat .I, 4he-�applicant,:-have:.be.ea provided��wtth-�a�=copy��.of_=ther�":Flo�ida-Constivc.tion:-`Llen-.:Law—tiomeowner's Protection Guide" prepared by'tFie Florida Departme�t;.of Agriculture and Consqmsr,;Affairs. If the appltcant is.someone:�.;..;-�,:��-,:� other than the`ow�er" I cert �.th�at l...have:o tainedya��co .oi..the�ab ve::de � �� � �!! ... � . .� b PY:_ .a _ scrlfbe�d;�locu�ent;and ptoi�ls�`iri;gooda.faith��to . :t= rs de8ver It to.'.tlie:�'owner���p%io��to�comEiiencement:'. .,. ' ' l � '.,: � " � . .= " . - . _ 60NTRACTOR'S/OWNER'S AFFIDAVIT: I.cer.t(ty;��:th�t.all:��th�;Inf�rmatlon:J��tF�l�appllcatlon ts accurat�.and that all work wlll'be done in compllance.wfth all.appltc�ble lauus regulating construc8on� zoning and:�land`developm�nt. Appllcatlon,is hereby made to�obtaln::a.pecmit:�Co,:,do��w�rk�,and;.tnstallatlon as indl�efed:��.°I, certffjr lhat no work��or Installatton has� cammenced prto� b Issuance of:a perriilf'"and that�:all work wlll be pe�Formed�to meet�-standardsrof all laws reguladng- constructlon, County and City codes� zoning regulatlans, and land developr�ent r.egulatlons�in tFie :Jurtsdlcttort:��`�'�P�-al'so: certlfy that I understand that the regulatlons of othergovernment agencles may�apply,to:the.:lntended.work, and that it is ' my responslbllity to Identf�y�wh�t.ac8ons I,must�teke.to,be,I��oornpllar�ce;;�S.uch.agencles�lnclude bufa�e:not Ilmlted.to:.� -� • �s.<� , �.,:..,,,� � ��. ,.:.,.�,,, - Department of E�1vlronmentaG�Protectton=Gypress`BeyFiead�; WeHand Areas and Envlronmentally Sensltive Lands�WaterlWastewater Treatment. _.� ,. - � " - Southvvest Florlda Water Management>"'��Isfrict-Wells;"'�Cypl�ess•'�Beyheads; Wetland� Areas� Altering W8t9�'OUfS6$. .-t ...:i. .s.� ;.:1,'as;'�' ,, _�itr: � ' • ,,'g•: ^ , - Army Corps of Englneers�;Seawalls;�.Docks, Navlgatile Waterways. - � � - Department::of;Health4!&;.:ReYiabllltattrr,e;>pSeni,.IceslEnvitonmental�.MeaItH=UnttWelts;:�VlFastewatert�Tre�hnent; � Septic TariKs:T.: _..�„ . ° . . . '- , �- _ " - US Environmental ProtecNon Agency-Asbestos abatement: . Federal�Avlat(on,�Authorlty-Runways:N '� I understand.that:the:folloaiing:��estrtctions apply"fo the use of flll:• - �Use of�fill Is no#�Ilowed IniFtood�Zone"V"unless�xpressly permltted. - If the�-flll�mete�lal='�Is �to-b`e used;"In::Flood Zone. "A"� tt Is understood that��a dreinage plan addressing a "compensating valume"uir111,be submltted at#ime of.permitting whlch Is prepared by a professtona) engineef� - � Ilcensed by'the•:�tate of�Floi�da: � �.. � � �-� -�- � . - If th� flll •materlal�ts to:be�,used (n Flood Zone 'A" in�connec�lqn�wlth�a��ermitted bullding using stem wall_ ., ' construction,,.l.certiy;that fill:�rJll.b'e>used only.to.flll the.area�wlthln�the�stem�walB: � - If flll mate�lal�Is-�to be used�ln.any .area; I �cenlfy-that .use. of,,such flll wlll not adversely affect ad)acent . „ ' propertles.. If..use�of flll�.ls�found:to adversely:.�ftect adJacent�;;propertfes�.the owner may be'clted for vlolating the'cond�lons-�,of�the.,tiullding�pernitt-fssued�<u�der tliefi'at�acfied„�ecmlt�appl(catlon��for:lots��.le"ss�than:`one (1) acre w1ilcFi are ele`vated�by.,flll;_��r.englneered dralnag�plan Is requtred. • . �� I If I am the AGENT FOR�TM�OWNER',:I�promise.ln.:good,falth to tnfortra���tFie owner of the p�miltting condltlons set forth In ' thts affidavtt�prlor to commerioing constructlon. I understa�nd thekt��a�separate permlt may be requlred for elecMcaf:work, .. plumbing,,-signs� wells,.,pools;.alr condltloning;�.g�a;�or.otMe� Install��fiins nok spec�lcally Included�in.the�applicallon. .A - permft Issued�hall be constcued to be�a`Ilcense"to�pr�oceed wlth tFie.wo�k aniJ��not-as.•authoNty,to:ulolate;�caricel, alter� or , set aslde any�provlslons of the:technlcal..aodes;�nor shall Issuance�of a.permlt.prevent the Bulldlrig Oiildal from thereafter requlrin.g a correcUon�af_eRors_In�,plans;.-conslractlon..oc_vlolatlons of-any�codes:�-.�very-p�ermlt��lssued slialf become�lnvalld unless the work autho�lzed.by auch permlt:�ts-commenEed•wlthln;sttc.months of�permlt Issuance� or if work authorized by the pemnit ts suspended�or.abandonedLfor-.a;perlodro�;six E8)�monti�s:eRer the tln�e the�wor�k�ls commenced. An extension may be requested�.ln.writtng;from.the�Bullding,bfflcfel for a perlod.�not-to.exceetl'�nlnety=(90)�days-a�d-wlll"demonstrate justlfiable`cause for.�the exfenslon If work ceas.es.for nlnety•(90)cons.ecutive:day.s,..the job�ls consldered aba�doned. WARNING TO OWNER: YO:UR;.FAIUIRE;:TC1.,.R�ECORQ;A�NO�'IGE:OF:�COMMEM�EMER�T�:NtAY4�RESULT IN��YOUR � PAYING TWiCE;;FOR.�IMPROVEMEN;����TtJ:YOUR�>:PRO�EitTY:;�I�-YO.UaIN��EWD�TOr�OB�'IRIN�FINi�1��1NG�;.`GON�ULT-- - ,�. _ _ . . _ : . Vif1YH iPOUR L6�t�E1�:OR-AN�A�TORNEY$EFaRL�itE�OR�IN6:�1rOUt�N�'TiC�'d �COi � . MC�EA��_"" . F�' FLORIDAJURA'��(F:S:�:1A7:03):, � .. . , � ".Y ,,..., . . ,. . .<. _ , , . , . .. , .. .,.. , _ . - OWNER OR AOENT . �- . _ .- . CONTRAGTOR �� ��� � Subscrlbed and swom to(or aflirtned)before me thla Subscribed and'auwm�to(ot atflrmedTbefot�e me�@ilb• by ,.by...,�►,,..� K�o:t� ct�� 1M10 Isfare persorrely knovm lo.me.or•haslhave,produced , Who:le/are:_p.ersonallyknown.to:m.e._oc.flaalh�v,e:prodin:ed• • '� ' '�e Id'enBflcatlpn. � ' • as Identlflcaflon. Notary Publlc . Notary Publlc � Commisslon No: Commisslon No. Name ot Notery typed,printed ar atemped Name oE Notery typed,printed or stamped