HomeMy WebLinkAbout17-19103 CITY OF ZEPHYRHILLS
y :; 5335-8th Street
(813)780-0020 1��d�
ELECTRICAI. PERMIT
PERNdIT-INFORMATION " - -� LOCATION INFORMATION � � �
Permif#:19103 Issued: 12104I2017 Address: 38723 VUL.CAN C1R
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICElNEW Township: Range:
Proposed Use: NOT APPL(CABLE Lot(s): Btock: Section:
Sq. Feet: Est. Value: Book: Page:
Gost: 1,977.42 Total Fees: 45.00 Subdivision: V(LLAGE GROVE
Amount Paid: 45.00 Date Paid: 12/04/2017 Parcel Number: 02-26-21-001C-00000-0200
CC?NTRACTflR INFORMATION tJWNER INFQRNIATtON
Name: PATTIE ELEC. & REFRIGERATION Name: FREEZE SHERRI
Addr: 39111 PATTI RD Address: 40011 PRQUD MOCKINGBIRD RD
ZEPHYRHILLS, FL. 33540 ZEPHYRHILLS FL 33540-1512
Phone: (813)782-33'k 9 Lic: Phone:
Work Desc: REPLACE EXTERIOR ELECTRICAL SERV PANEL
APPLtCATION FEES
E�ECTRICAL FEE 45A0
.
INSPE t} IRED
ROUGH EL.ECTRIC �
CONSTRUCTION POLE
PRE-ME7ER �/
FINAL �
REINSPECTION FEES:(c)With respect ta Reinspection fees will comply with Florida �tatute 553.80 (2)(c)the
local governmenfi shall irnpase a fee af four times the amounfi of the fee impased for the initial inspectian or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit,there may be additional restricCions ap}alicabfe to this property that
may be found in the public records of this county, and there may be additionai permits required from other governmental
entities such as water management, sfiate agencies or federal agencies.
"Warning�o awner: Your failare ta recard a noti+ce af commencement may resuEt in your paying twice for
improvements to your property. If you intend to abtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application. All wark shall be performed in accordance with City
Cades and Qrdinances.
Gc����
CONTRACTOR PER OFFI
PERMIT EXPTRES IN fi MUNTHS 1NITH4UT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PRt)TECT CARD FROM WEATHER
� 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
Building Department '�
s ' � '
Date Received - :�: P.,hone•Contactfor°Permlttin
Owner's Name �� ��z�'i! LJ Owner Phone Number
Owner's Address � �� � (1� �D� � I� Owner Phone Number
Fee Slmple�Titleholder Name �^ Owrier Phone Number
� - ~ .
Fee Simple lTitleholder Address �
JOB ADDRESS �J� ( �J U �.'Cl. l� LOT# ��
I .
SUBDIVISION � PARCEL ID# d�����^ � "�l� ����� ���D�
� . (OBTAINED F OM.PROPERTY,TAX NOTICE)
WORK PROPOSED. fVEW CONSTR ADD/ALT Q SIGN`` Q- � Q DEMOLISH
f •;e. INSTALL � : REPAIR -
PROPOSED=USE Q SFR Q COMM Q -OTHER - ' •
TYPE OF CONSTRUCTION Q� BLOCK ' Q FRAME Q STEEC Q '
+ S
DESCRIPTIONOFWORK Q}C -eV� U� ��'Q� o�l- -2V'c'[C'e �'
I .
BUILDING SIZE � SQ FOOTAGE ,HEIGHT�
� � . ��: •
[�BUILDING $ VALUATION'OF-TOTAI:'CONSTRIJCTION s "
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QELECTRICAL $ " y AMP SERVICE Q PROGRESS ENERGY [� W.R.E:C.
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QPLUMBING $ - '
( ' ��
QMECHANICAL $ ' ' VALUATION OF,MECHANICAL INSTALLATION ��
QGAS Q ROOFING .Q SPECIAL7Y � � OTHER - �j� �" -
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FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES :NO ��
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BUILDER � COMPANY�' ' = �' �"
SIGNATURE REGISTERED Y/ N 'FEE cuR�� ' Y/N
Address Llcense# '
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ELECTRICIAN: -COANPANY �'
SIGNATURE � REGISTERED Y/ N FEE CURR ` ='Y/N
Address ' , � _ ,_ Llcense# G`-��0� �.
PLUMBER ' -COMP.ANY � �
SIGNATURE • ' , ,REGIS7ERED. > Y/,�N ;FEE CURRE� , Y�/N �- '
i , , �
Address ' .� � ' .LI'oenseJ#� � _ � " -
MECHANICAL' ' COMPANY - � °
SIGNATURE ` �' ` REGIS7ERED., .Y/.N. , �,FEE+CURRE�: � Y-/�N �
. ,_ r . ,
Addre�` • . . : _ . _ � ` . , � �, , , � i License# _
OTHER � - ' _ � � '�COMPANY `" , - ` ' .
SIGNATURE ,. � `" � " " - � ` � `RE�Is7E�o Y/ Ns.: ' �E CURi�n Y/N
Address , _ . . � � _� Llcense# . ' ,-� .
RESIDENTIAL_�:�.. :Attach'(2),Plo.t-P,lans;;(2)sets..of�Builiiing�Plan"s;�(1)sefof'Energy>Forrns;�R�O=VV�Perirlitfor.newconstruction,.. �
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•- � �*:Minimum;tenr(1�,U)+,�working,d'ays=after,„submlEfal'date::.Requlred onsife,�.Constivodon:Plans;'Stortnwater`Pians w"'/SIIYFence installed,
� ���' Sanitery FaciltUes;&,,1�dumpster�Site-Work;Permitfor:sutidiVisions/iarge�projeofs... ;.�-- ' ' • '�
�...
COMMERCIAL Attach(3j�cbmplete sets of 8uildirig Plans plus a'Ufe�$afety Page;(1)set of Energy Forms.R-O-W Permtt for new constructlon.
Minimum ten(10)working days�after submittal date. Required onsite,ConsUuction Plans,Stortnwater Plans w/Silt Fence fnstalled,
Sanitary Facilitles&1 dumpster.Site Work Permit for ali new!projects:All commerdal requirements must meet campllance -
SIGN PERMIT Attach"(2)`sets ofEnginee[edcPlans:;.,� ;^-' , � � ,
"•'PROPERTY SURVEY reguired for al,l NEW construcdon..
Directlons: . . - � '
Ffll out applicatlon completely.
Owner 8 Contractor sign back of appl(catlon,notarized
If over 52500,a Notice of Commencement is requlred. (AIC upgrades over ST500) ,
;,..,�,;,,.r
" Agent(for the i�ntractor)or Power of Attomey�(for tFie owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITrING --, (FronEof-Application Only)- � � '
Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage)
Drivewaya-Not over�Coynter.if on;�public'roadwaqs..need's ROW
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NQ77CE OF DEED REST,RICTIONS: The uqderslgt�ed;,unde�tands°;th�t,#hi�.�p�rmlt:mayr.be sub�ect to;"deed";r�s#rlctloiis".�_.. �.,._,._:..
which majr:be�more`:restt:ictive-th���Cau�ty�regr�laf(ons.'�'The undersigned assumes�resprinsibility=for'complianc�'witii��any " � ' " `
appllcable.deed-resMctlons. • . _ . . .. ' _:�%
UNLICENSED�CGNTRACTORS AND CQN�RJ�ICTOR R@S@ONS181CtTtES: �ff-the owner�has�fiiced`fa`c:ontractor or
cont�actors to undertake work, they mey:be�re�qu;ir�,ed_�to.=b�;llcensed In:accordance.with state.and�local.regulattons,: �if�the�� y °��
contractor ts not 1lcensetl�es=requlred`tiy lavtir, tioth the avmer ari��eonUactoT�may be°clted�for��a�mis�emeanor v1olation
under state law. If the owner or Intended„�ao,ntraCtor,-;are.,ru�certaln as to what Ilcensing.requireRnents-;m�y�appiy�dfor--�the' �� °�- �
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intended�v�iork,they are`advtsed to caiiitact tl�ie,Pasco County,Building'.Insp�ictton.Divislon--L•fcensing Secttan et 727-847-
8v09. Furthermore, tf the owner'iias tiired�a con�ecto�'or�corifractors, he is ailvtsed to have #he cantractar(s), sign, ,
portlons of the "contcactac_Blockp of_thls�application_for:which.#hey.wUl,be;,cesp.onslble.- if:.you;.as-.#he own'e��sign`�a§`�the� � � '' �
contractar; that-�ay be an Iridicatlon�#hat`Fie�ts iia#properly Ilcensed aiitl`�Is'�iot`eti#itleif to�permltting priiiiileges In Pasca
County. , ;�:r� , _. , ._
TRANSPORTATION�IMPAGTtUTILI't'IES�=1NlRAGT ANb°RE$QUaCE RECOVERY�FEE�: The undersigned�unders#ands
thatTransportation impact Fees and.Reco.ucse Recovery:Fees mey�tappiy:ta�tfie:constru�fton s►f.new.buiidings�_.cfiange°-of`�� "���- ��'
use in existing bulitlings;�or._expansian�of��exl's'"ti�ig:•buildings� as speclfled.In Pascv County Or'dinance number 89-07 and..
90-07, as amended...,�;he undetsigned also,.understands, #hat:�such fees;�as,�nay;be�>.due;,.will.�be identiliad at the�time�of��` �°� '
permikting. It Is fur'thier unders'tood that Traasp�ortatlon ImpacC�Fees and;R'esource:Recodery��Fees,.must be pald prlor to
rece�ving-a»cerf€�cate,of accupancy°;or�#�naE��power�elease: :l��the.proJ�ct.:does;tto�Irntolve:a>ce�t�ti�te of occupancy.or�==.;��,� `:
final power_retease;�,tF:�e�:t'ees�mu�t:�tie"pald7p�tor ta�permft Issuance. F��thermore;�If:PascoM1_County"INater/$ewet�:lmpact . -
fees are due,.they;must,be<{�ald:prlor.�o,permiE_Isst�ance=ln.,accardance wttfi:��rppllcatilePasco'�Gounty�ordlnances. •
CONSTRIfCi'!ON'1:lEN"I.AitV{CFiapter 713�Flartda Statutes,as amendedj: ifivaluallon of work is$2,5q0.00,:ar more, { � :=af._
certify that I, �he .appllcant,-have:been .provlded:•w(th-a--copy of�#he"Florida��4onstivctton� Llen :Law--Homeowner's
Protectios� Gufde" prepared by tt�e"Flo�da Depe�men#�of Agrlcut#�re and Consumer;kffat�. (f the appltcant Is �omeone� . .
ather than the"owner", I certlfjr.that I„h�ve.o�itaine'�tl�a�`eopy.of:the�above.-.rles.crltied.�locument�and.ptomise�ln,good'falthto ,
deli�er It to:the:`owrie�"'prior=to�siomriiericemerit:�'� .., . . .. _. ,. ;., . . .
CONTRACTOR'Stt'�WNER'8 A�FIDAVIT: I.ceitifyr;ttiat-all�the�lraformation:ln'�thi� appllcatlon is accurate and that all wark
will'be done in compliance with all app8cable�laws regulating constructlon� zoning and�land-devetopment. Appltcatlor� Is
hereby made to obtatn .a permit��to,,..do-wor�:.7and`tnstalla#ion as Indl�afed:�:.;1. certify that no worit ror Instaltation fias
commenced p�lo� to Issuance af'a�permtt and that`.all work wIU be pertormed�ta meet�.standards of all laws regulating�
aonshuctlan, Gounty and Ctty cades, zontng regtalatians, and land devetopment cegt,ita�ans�tn the ju�isdlc#ion.= i at'so
certify that I u�derstand that the regulatlons of other govemment agencles may�apply�to#he lntended work, a�d that it is
my responslbility to Identlfy•what.actlona!must-take:to be<In:.corrlpllance:_S,uch.agenales Include but�are.not limiked to.
- Depattment of Errvironmental�Protectian=Cy�iTe§s.'B$yt�ead�, 1NeNand Areas and Erntronmentaliy Sensitive
I.ands,WaterlWastewater Treatment. °
- Southwest Fbrtda Wa#er Management: .C�lstrlct Wells� Cypress.b�Bay_heads; Wetland' Areas� Altering,
Watercaurses. ' �
- Army Corps of EnglneersSeawalls�Docks,Navlgable Waketways.
- Department af_,Hea{th.� .Ret�ab�litafive>:Setvlces/Environmen#al>>Flealtb�Unit-Weti.s; Wastewater�Treafinent„
Septic Tanks::rv. . ' ' � - : .
- US Envt�onmentai Protsc�ton Agency Asbestas$b�temen#..
Federal Avlat�on�Authorlty»�Runways:- . � �
f understand that the..foAow�ng;restr!'ctlons apply'to tFie use of fllt:
- Use af fill is not ailowed in;Flood Zope"V"uniess expressly permitted. �
- If the� flll materfal-Is'�to�"be used:��In:-�Flood-Zone. "A", (t�Is understood that a dralnage plan addresstng a�
"compensating votume"wili be subm[tted at time of�permEtttng wl�Ich is prepared by a professionai engineer;
Ilcensed by`the State of:Flotlda. � ., �
- If th� �ill matertal`ts to-:be:used In Ftood Zone 'A" In4 cann�ion�w1th�a��ecmt#ted bultdlrtg using stem wa1i,
' aonstruction, i ce�tity that.flll:viiail:bs�used only.to.fill#he area wlthln the�stem�wall: �
- If flll materla!�Is to be used In anjr area, 1 �ceKlfy tfiat .use of such AI! wlll not adversely afFect ad�acent;
propertles. ff use of fill is.found.to advetsely,�ffect adja�ent�properties�.the owner may be cifed for vioi'ating�
the condl#lons_of the b�llding':permlt Is'sued�under the�att�cfied.,pecmlt eppltcatlon�:for:lots-.less than:one (1)l
�cre whlch aie eleva#ecl�by tIE1,a�t en�trteered dralnage pian ts requlred. . .. �
If I am the.AQENT.FOR THE OYVNER, I;promise In good fatth to Inform the awner of•the permlt#1ng condftlans set forth In;
this affidavlt'prlar to commer�cing consh�uctlan. I understand tha#a�separate pertnit may be requtted for electrRcal work,�
piumbing,:signs, wetls,.,poots;, alr canditioning,.gas� or ott�er`. in�tatl�tions nat�spea�iaalty inctuded�in.the application. .Aj
permit Issued shall be construed to'be'a�Itcense�to�proceed wlth the:wark anr!•not�as:authoNty b vlolate;.cancel� alter, arf
set aslde eny�provtsions of the.#eahnlcal c�dei�;�nar shatl issuance°of a.permlt.pcevent the Bultdlrig Of�ctal from thereafter;
requlring a correctian af errors In:plans,;constivctlan orvlolatlons of�any codes. Every��p�etmlt Issued sfiall beaoma invalid{
unless the wo�k auEhorized.by suah permlt:�ls.commensed�wlthln stx_months of�permlt lssuance, or IF watk aathorized by; �
the penrtit is suspended ar:abac�doned:•for-a:period:af six:f8}�montiis,-.after,the tlrne the�wotk��s cammenced.. An extenslon i
may be requested,,ln writing;:from_tlie"�iullding,Officlal for a perlod-not.to.exeeed�ninety�(90)"days and will demonstrate'
justt#fable cause for:#he extension: If work ceas+�s..for nlne#y{90}cons.ecutive:day.s,_the�ob�is cansidered abaadoned. • {
WARHING TO QWNER: YOUR.FAIL.tJRE.Tit1,.R�E.C.ORD,A,.[��TtGE:IaF;•CQMM�MGEME�T�:Nl�i4YsRESU1:T IN-YQUR i - `
PAYiNG i'WICE:FOR iMPROVEMENTS�TOhYOUR��PROPER�TY.�41F°.YO.U�1�1"FErVD�'Ta=��lBTAIN>FIPFAI�EtNG;'C.ONSUL7' I
wir u o� o: n� � o N� o. �����oR� G:� ou � �
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OWNER 4R AGENT COM'RAC70 � �
8ubscxibed and awam to�or af�mted)before me lhts Stibstxib snj!'swnm'fia o fftntted)�befot+e me'#tit�- r I
by a'by J� • ;
Who Islare personally kne+nm to.me or haslhave prpduced . o.ls/are p.ersonally own.to me•or haslhave-�ir+aduced • � �. !
as IdenBftca�on, ' ��� ��iden8�ca#lon. _
Nniery pubflc _ �\ 0 9-lU��f�=X- `
�,�'���f� f�����.'' NotaryPubllc
CammissRon No:� Commisstan.No;�� �(��J}�-f�'.� ;
1��� �
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Name of Notary typed,prfnted or stamped Neme cf Natary typed,printed ar stam .+.r.�
_ •��a�:ym� DEBRA ELAINE RUFFELt
� ='��' 'k',;;Commission#GG 045343
..xy :,,�,�,�:Fxpires November T,2Q20
1;kodF;;`�'� Bortded Thru Troy F�in Ins�rance 8U0-38ST019
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