HomeMy WebLinkAbout17-18999 CITY OF ZEPHYRHILLS
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5335-8th Street f'
'S (813)780-0020 r'1'8999 '
ELECTRICAL PERMIT
" � PERMIT INFORIVIATION - LOCATION INFORMATION
Permit#:18999 Issued: 11/01/2017 Address: 38450 9TH AVE
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE REPLACEME T Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 30.00 Total Fees: 40.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 40.00 Date Paid: 11/01/2017 Parcel Number: 11-26-21-0010-10200-0010
CONTRACTOR INFORMATION OWNER INFORMATION
Name: HOMEOWNER Name: HINTZ, KEVIN & HINTZ ROBERT &DEN
Addr: Address: 207 BROOKVIEW AVE
OLEAN NY 14760-1244
Phone: Lic: Phone: 716-801-0215
Work Desc: REPAIR RISER TO BUILDING
APPLICATION F-ES
ELECTRICAL FEE 40.00
� , �
INSPE TIONS REQ I
ROUGH ELECTRIC
CONSTRUCTION POLE ,/
PRE-METER
FINAL �
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.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
I Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
I i/�(� .
CONTRACTOR PER OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF / / / / BUILDIN�
t�PHli'RHILLS DEPARTMENT
OF ADDITION OR CORRECTION
� • • - •
ADDRESS DATE PERMIT,f,
3 $ �Sa ��` /�Z-, � �
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the job
will be accepted.
I ��`f/l.P � �j0/Y/� /I94ST !rC i/SP�I �r' S'U�PO/� B� �/'�,
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It is unlawtul tor any Carpenter,Contractor,sui�der,or other persons,to AFTER CORRECTIONS AR MADE CALL
cover or cause to be covered,any part of the work with flooring,lath,earth 780-0020 FOR R -I ECTION
or other material,un61 the proper inspector has had ample time to approve
the installation.
OFFICE HOURS 7:30AM-4:30 PM MON.-FRI. INSPECTOR
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department . `
Date Received Phone�Contact�for�Permittin
Owner's Name � �i�'Y/t,5 � �,,��Owner Phone Number -- �—�Z
', OwnePs Address � y Owner Phone'Number .
i '
Fee Slmple;Titleholder Name • � � � Owner Phone Number
Fee Slmple�Titleholder Address
JOB ADDRESS � i" ,(I LOT# �
SUBDIVISION PARCEL ID� �
j , (OBTAINED F.ROM,PROPERT1f:TAX NOTICE) �
WORK PROPOSED . NEW CONSTR ADD/ALl' SIGN' Q � Q DEMOLISH
, �B: INSTALL B REPAIR �
PROPOSED�.USE Q SFR• Q 'COMM Q •OTHER � �
TYPE OF CON3TRUCTIOPI Q` •BLOCK " Q FRAME � [�]° :STEEL Q �
DESCRIPTION OF WORK r� Il7COt2�f'4 e�! J C � �/ �� � �,.�,,�J
i
BUILDINS'a SIZE �"SQ FOOTAGE�� HEI,GHT� .
Q B,UILDING S VALUATION�"OF TOTAL CONSTRUCTION e.
[�]E�LECTRICAL $ Q, AMP SERVICE Q PROGRESS ENERG W, E:C.
� . � , , • �
� .
QP�LUMBING � �$ '
,
i ' ' l
QMECHANICAL $ � VALUATION OF MECHANICAL INSTALWTION iU
i
QGAS Q ROOFING Q SPECIALTY Q OTHER � f� R� '
�Yl�
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. N ; � U
BUILDER COMPANY � ` �
SIGNATURE REGISTEREO Y/ fV FEE CURRE� Y/N
Address Llcense#' ' �
ELECTRICIAN :COMPANY -
SIGNATURE � � � REGISTERED N
; FEE CURRE�=' Y/N
Address �' . � _ . License# .
PLUMBER`: ; COMPANY -
SIGNATURE' � REGISTERED- Y./ N� � ., rt �FEE•CURREP " Y-/N . �
�
Address � , `- , License,,# " - .
- ' � ';F:, !.
AAECHANICAI: ' , COMPANY, ._ - ' ,.
SIGNATUP2E � � � ` � ' " "' REGISTERED Y,/_N FEE CURRE�. , X,/rN' ,
Address����-= ��. .. , . � -- � ` . _ � License#
OTHER � - � ' ':.COMPANY, �� ' - .
SIGNATURE '" � � - , � ` �
� REGISTERED - ' Y/ N:.. � FEE CURRE� Y/N
Address ,': � � . ' License# _ , .
RESIDENTIAL:�- _ Attach(2)�P_„Iot�P;lans;.:(2)sets:of�Bulldi'ng�'Plan's•'�(1)'set'of=Energy-FoiFn,s;'.R=O=WPerrriltfornewconstruction,, - ' �
• �..,J�.Minimum;ten,_(:1,0);working;dajis;after;submiEtal`date�::R'equir`eil onsite;,;ConstrucBon=Rlans;'Stortnwater'Plans w/SIItFence installed,
f Sanitary�FacllfUes:&,1:dumpste,r„SIte�Work:.P.ermitfor,subdiv_islonsAarge;pro]ects�_ _.,, ._,, • '� �' ° ' ` =
COMMERC!/4L Attach(3)�complete sets of Building Plans plus a Life Safety Page;`(1)set of Energy Forms.R-O-W Permit for new construcUon.
Minlmum ten(10)wo�lcing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Fadlides&1 dumpster.Site Work Permit for all new:projects:.All commercial requlrements.must meet compliance `
SIGN PERMIT Attacti(2)sets of Erigineer.edcPlans.; �;.--�.- � : .: � . �- - - '
"••PROPERTY SURVEY required for_all„NE,W,gonstrucUon.. .
Directlons: .,.... - ._ - � -
Fill out appiicaUon completely.
Owner&Contractor sign back of applicatlon,notarized
If�over 52500,a Notice of Commencement la requlred. (AIC upgrades over 57500) ,
" Agent(for tfie contractor)�or'Powe�of Attomey(for tFie owner)would be�someone with notarized letter from owner authorizing same
DVER THE•COUNTER.PERMITTING•-� -.- �(Front of-Application Only)�
Reraofs if shingles Sewers Service Upgrades A/C Fences(PlodSuroey/Footage)
Driveways-Not over Counter if an public roadways..needs ROW� '
�'
M�T10E OF DEED RESTItiCT101dS: The undersigned undergtands�:th�t-this,�pr�moif.may.be.sub)ect to"aaea"_resUlctions" .._ � '�
v�hich may be,more��r.est�ictive>th�n County-`�reg�latCons:�`The`undersign�d'assumes�responsibflity for'compilance wlth any � �
applicable deed restrictlons. � -
IAMLIGENSED CONTRl1CTORS �ND CON'Ptt�4CTOR RES�ON3I�ILITI�§: °If�the owner�has�fiired' a c�ntractor or
cont�actors to undertake work, they may:be;ce�quired;_to:be,licensed In.accordance.wtth state.and�local_regulatlons: If the� � �
contractor ts-not Itcensed a�s requlred�tiy law, b'oth the obrner and�contractor m�y be-cited for�a�rriisdemeanor violatlon
under state law. If the owner ar Intee�ded;contcaCtor are,uncertain as to w►hat Itcen�tng,;require�roenCs°enay��pply,�:�or'the •� • �
intended work, they are advised to contact fhe Pasco County�uilding:inspection.DIvi�Ior�-L•(censing�ectton at 727-847-
8009. Furthermore, If the owner fias hi�ed a contracfor or contractors. he is advised to have the contractor(s),,sign
portlons of the "contractor Block" of thls application_foc.vvhtch..they will::be.respo�sible. If:you�.as.the owner''sign�as the
contractor, 4hat tnay b� an Indication that he is not.properly Ilcensed"and�is not entitled to per�nftting privlleges In Pasco �
County. . ;� � . �
T�1M�PORTATION.IMPACT/UTILITIES�rM�AC'I�ANb I�E�0U1tCE FtECOV�RY�FEE3: The underslgned understands
that Transportation Impact F�es and.Reco.urse Recove.ry.Fees may.apply_t��the construction.of new,buildtngs,�change�of'� � ' '�
use in existing buildings,-or�expansi�nrof�existin,g.,•6uildings, as specifled.in Pasco County Ordinance number 89-07 and '
90-07, as amended.,�.The undersigned also3vrtd�rstands, 4har such fees„as�may__�e�..due;�.wlli be identi�ed at the"time-of--�
permitting. It is furtFier understood that Transpor�ation Impact Fees and°Resource.Recovery�Fees..must be pald prbr to
r�ceiving-a "certificate-of occupancy" or flnal•power:rele�se. :If�Ehe proj�ct..does�not involve a-certfficate of occupancy�or "-�
flnal power release; the-#ees mu�t be pald;pr:lor to_,permiQ issuanc�. Fu�tk�ermore;�if Pasco:;County'Wat�r/Sewer�:Impact - :_ �
fees are due,they�must.be=pald=prlorto..permit_�Issuance=ln accordance.viritfi�applicable l�asco�County ordinances. �
CONST'RUCTION LIEN"LAW"(Chepter 793, Florlda 3tatutea�a�s amended): If valuatlon of work is$2,500.00:or rr9ore, I ,
certify that I, the applicant,;-have.been provided �with a copy�of the. "Florida� Constructlon�_Llen:,Law—Horr�eowner's
Protection Guidep prepared by the Flo�ida D.epartmenf of Agric.ulture and Con�umerAffairs. If the applicant is someone ,
other than the"ouvner", I certify�-that;l,have,obtained-a copy.of.the�aboda.described�document�and:ptomise:in,good:faith�fo ,
deliver It to.the,°ownec".piior to�cornmencement:`` � " -
CONTF�lGTOR'S/OWNER'�AFFIDAVIT: I certify:ttiat,all.the.;inf.ormatlon:;l��thi�applicatlon is accurat��nd that all work
will'be done in compliance with ail.appiicable laws regtilating construction, zonin8 and:;land�development. Appiication is
hereby made to,obtain .a .pecmik to do_:wocic.,and installatlon �s indt��ted:-� I: certifjr that no work:or fnst�llatton fias
commenced prior to Issuance of'a perm(f and that�.all�work will be pertormed to meet standards of �II laws regulating�
construction, County and City codes, zoning regulatians, and land development regulations�in the Jurisdfction. I al'so
certify that I understand that the reg�alations of othec goveenment ag�ncies may�apply�to the_intended.work, and that it is
my responsibillt�to Ident(fy.what.acEions I must t�ke to be,in:.corrlpllancs..S.�ach agencles include but-are.not Iimited to: �
- Department of E�lvironmentai:Protection=Cypr�s�.'Bayhead�, !lVetland Areas and Environmentally Sensitide
Land�,W�terMlastew�ter Trea4ment.
- �outhwest Florlda 1Nater RAanagement .Distrtct-Wells, Cypress.��Bayhe�ds; Wetland Areas, Altering
Watercourses. �
- Army Corps of Engineers-Seav►ralls, Docks, Navigable Waterways.
- Department of Health'& ReY�abllitative�,Services/Envitonmen#�I H�alth Unit Weil.s, Wastewater�Treatment,
Septic Tanks: .
- US Environrv9ental Protectfon Agency-Asbestos abatement.
- Federal Av.lation:Authority-Runways. �
I understand that the_following.�estrictions apply to tFie use of flll:
- Use of fill Is not allowed in Flood:Zone"V"unless expressly permitted.
- If the fill material ts to be usetl:.in �Flood Zone tlA", it. is understood that a drainage plan addressing a
°compensating volume" will be submitted at time of permitting which is prepared by a profess(on�l eng(neer
Iicensed by�he State of Florida. -
- If the iill mat�rial�.is to be•used In Flood Zone "A" in�connection�with�a ��ermitted buildlhg using stem wall
� construct(on, I ce�tify that flll;wlll=b.e used only.to.fiil the area within the�stem�wail:
- If fl�ll materlal (s to be used in any area, I �certify tfiat .use of such�flll vvill not adversely affec4 adjacent
p�operties. If use of fiEl is found to adversely:�ffect adJaeent properties,.the owner may be cited for violating
the conditions of the building,permit is"sued^u�der the_�atEached permit application,�for.lots less than.one (1)
acre wh(ch are elevated�6y flll,a�englneered dr�inag�plan is requlred. .
If i am tha AfaERlT�OR TIiE O1MNEit, I,�promise In good fatth to l�form the owner of-the permitting condlt(ons set forth in
this a�d�vi4�prior to commer�cing construction: I understand th�t a�separate petmlt may be requtred for elecMcal work,
plumbing, signs, wells,.pools;, air condttioning, .gas, or.other- Instali�tlons nol�spec�fically included�in.the application. .A
permit issued shall be construed to be�a'license�to��proceed vulth tFie wo�k�nd not as�authoNty to.viol�te;'cancel, atteP, or
set aside any provi§lons of the teohnical codes;�nor shall issuance•of a.perrrolt.prevent the Bulldirig Official from thereafter
requirin.g a correction af errors in:plans, constructEon or violatlons of any codes. Every�permit Issued shall become invalid
unless th� work author(zed by such permit:�ls-cotnmenced•within sCx.mocAths of permit Issuance. or if vvork authorized tiy
the permit is suspended or:abandoned-for a period.of six E�6)months..aft�r the:time the�work is commenced. An extension
may be requested, In vv�iting,-from tfie.Building,Official for a p�riod.not to exceed�'ninety�(90)=days and-will demonstrate
justffiable cause for.�the ext�nsivn: If work cease�:for ninety.(90)cons.ecuQfve day.s�..the job�is.cons(dered aba�doned. {
W/ARNIId� TO OINNER: YOUR.FAILURE�TO,R�EC.OltD A;P�OTIGE�:OF�COMMENCEMEMT-.MAY°ItE�ULT IN YOUR
PAYIfdG TWI.CE.FOR;INI,�OVEMEId.TS�TO.,YOI�f��P�tOP@R'Clf;r��llF�.YO.UiINTEhID�T�'�O�TIIIN�FIRFAI��ING;'CONSULT
�lYY�YOIJR i:EP➢�eF�OR��l°:a�`i'C�PP��',��FO�.'��9��0l3�9l�S�'1P9l����'1`I���`t�]F`��IMMENI�E'NIEPIT'_' .
FLORIDA JUFdAT(F.S:117.03) _ � � ' -
OIIYNER OR AOENT CONYRAGTOR ' �
Subscribed and swom ta(or atflrmed)betore me thls Subscribed and'swom-to(of afflrmedpbefore me ftil�
by ..by.-_. -
Who Islare personally knovm to.me or has/have produced VUho.ls/are p.ersonallyknou�m•to me•or haslhave•produced •
� es Identlflcetlon, as IdenBftcaUon.
Rlotary Public Notary Public
Commisslon No: Commission No.
Mame ot Notary typed,printed or stamped tdame of Nolery typed,printed or atamped
� � DISCLOSUR� STAT�MENT FOR OWN�R
CITY OF ZEPHYRHILLS BIIILDING D$PARTMENT
/ .
2, f,il/�1� � I�C,J�� have read and fully uaderstand and
� agree to the provisioas of this iastrument.
The undersigaed states and affirms that he or she is desirous of constructiag,
reaovating, addiag to or reroofiag his or her own domicile, that he or she
actually occupies, or will occupy by �aid domicile, aad same is not for
rent, lease or sale. That he or she shall comply with the followiag coaditions:
1. That the owner aad he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisioas of the City of Zephyrhills
ordiaances and codes pertinent to the buildiag.
3. That in the eveat various phases of constructioa are subcontracted, he will
� engage oaly properly liceased subcontractors and will personally supervise
such work.
4. That ia the eveat the Buildiag Iaspector shall require correctioas to be made,
the owaer will assume full respoasibility to iasure they are made, aad upon
completioa will call for a reiaspection before proceediag with the buildiag.
5. That the owner shall assume full responsibility for the constructioa aad will
aot expect supervision of his work from the City of Zephyrhills Buildiag
Department.
6. That prior to fiaal inspectioa any additional fees, includiag reiaspectioa
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owaer shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires constructioa to be doae by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owaer of your property, to act as your owa contractor with certain
restrictions even though you do aot have a licease. You must provide direct
oasite supervisioa of the constructioa yourself. You may build or improve a
oae-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial buildiag, provided your costs do aot exceed $75,000.
The buildiag or resideace must be for your owa use or occupancy. It may aot
be built or substantially improved for sale or lease. If you sell or lease a
buildiag you have built or substaatially improved yourself within 1 year after '
the construction is complete, the law will presume that you built or
substaatially improved if for sale or lease, which is a violatioa of this
exemptioa. You may aot hire an unliceased persoa to act as your coatractor or
to supervise people working on your building. It is your responsibility to
make sure that people employed by you have liceases required by state law and
, by county or municipal licensing ordinances. You may not delegate the
i respoasibility for supervisiag work to a liceased coatractor who is aot
liceased to perform the work being doae. Any persoa workiag on your buildiag
who is aot liceased must work vader your direct supervision and must be
employed by you, which meaas that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your construction must comply with all applicable laws, ordigances, building
codes, and zoning regula oas.
OWNER'S SIGN�tATURE ' �2 DATE ,
ADD S `t �
HONE �9/ Q i' J_
�T[�'—W-T—�� -
WITNESS PERMIT # /
1. � ���� �{J � /c/✓���Id� � /' " � , ��-���r "� Y / 7"�lpG
w.c��� � I