HomeMy WebLinkAbout20-22461 CITY OF ZEPHYRHILLS
5335-8th Street 22461
(813)780-0020
ELECTRICAL PERMIT
QATI A -N
PERIVIMINFORMATION 0 OWANPO WATION MP,
Permit#:22461 Issued: 2/10/2020 Address: 6135 9TH ST
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE REPLACEMENT Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 1,600-00 Total Fees: 50.00 Subdivision: TYSON
Amount Paid: 50-00 Date Paid: 2/10/2020 Parcel Number: 02-26-21-016-000-2000-10
'I NE 'R��CONTTRACTOR'l N FORMATION .;'_',_0WNERI .0 , MATION-
Name: HOMEOWNER Name: HALL, DANNY& JOAN
Addr: Address: 2119 STOUT RD
WELLSVILLE, NY. 14895
Phone: Lic: Phone: (813)779-2773
Work Desc: REPLACE MAIN ELECTRICAL PANEL BOX
-APPLICATION.FEES"
ELECTRICAL FEE 50.00
INSPECTIONSREQUIREW
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 property. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
CONTRACTOR PERNMOFFFII
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIOr
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780=0020 City of:Zephyrhilis Permit Application . Fax-813-780.002'
Bulldtng Department'
'ghl Phone. ,ontact fbr Permittin .;
-Owner's.Name.'
G OWn®r Plioni`Number". .�'
' rt +;Owner's;Add[eFs OiNnerPlrone Number
G2 3 3SV Owtiar:Phonm'Nuirti®t'
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LOT
"SUBDIVISION, EL
-:s(OB?AINED0OM.PI3GPERTIK,7AXIJOTIC�)irv�`
1NOHK,PROP,OSED_:�.. '. :'NE'W:COATR'�'' 'y
ADi)/ALT _:' :SfGN"
s,r . e.: ';DEMOLISH'
INSTAL
ell
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PROPOSEDrUSE;.r -SFR:._ G.OMM '"' =OTHEF;
TYP.E'OF..CONST
RUCTION'' "BLOCK Ft2AME-7$4'
f, \-iDESCRIpT10N-0F..WORK. ra, e /9�IG//I 'ellv G'
gyp.
:SQ-FOOTAGE
BUILDING.SI2E `HEILaHT;;;.
I _
VALUAT.ION,OE�TOTAL:;CONST.RUCTION.'
ELECTRICAL. $. .AWSERVICE DUKE;ENERGY'';
=PLUMBING. - .. $'" ... ;
QMECHANICAL $, VALUATION'OF.MECHANICALt.INSTALLAT�ON..
• •'ice:.f' _-i"..:'j , ' -.. ..
=GAS Q ROOFING.r`[ ;; ;„SPECIALTY.. ., OTHER{
,FINISHED FLOOR;ELEVATIONS' :. ,' .r' LOOI)iZONE AREA:.`" '-DYES NO .
,.: .,..
14+
BUILDER COMPANY:'
SIGNATURE ROGIs EDr _•.,...,..., :;
r'Y/.N;S :FEE;CURREt�: ;<<:Y%N r
'-
Andress „. -
. `�.. .Ucense;;#;
ELECTRI,CIAN'. ,.COMP.,ANY-:.
J\. SIGNATURE �� 'REGISTE_. ;:FEE'C
v `RED Y'%N:: ;Y,/'.N'.r,r•s'.
Address.:. xr:F
tlrknse#_
'PLUMBER' . . COMF►ANY_`"::
'SIGNATURE F :;
RE'GIS�t3REb " Y%='M.` .Tf,EE,CURREk::"S.
'Address: Liieehse.a `ai•
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MECHANICAL `.., .. COMPANY 'F
SIGNATURE''. ri ,. ft. r`
-
. .. .. ..; ,:•'...>.,� EGISTERED�::. '>=Y�L�:�N�y:' FEE_GURREK ,r.;. ,
Address,.: .:
',:.Cleans
OTHER'.. COMPANY;
SIGNATURE` k"
REGISTERED Y,&N;;;' N':',:'
— .
:Acld►es
..License
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RE i EN S D Tti4 ' A 1 Parts 2 §ets"of' IPdi ;p1r5s' ,1; et`ofErie(.), (.): u. n .l �(-.) ns•:RC)=p�lll a >for.newcoristuctioa,
'p n'fo '.1„i�ieF' �+'� 'a f v.31115 ..a.�. ..iw-Lys• :•:1.. ,�:':t:L' {•Y.? �'?( ^:w• ,-.,.`._.+'-
xM)t thwh. ' t0 5i ;6it �cia s.eftsr{sttbmi i;�ate:�t:R utred:ons teK' r''' :r
nstriictfon P-Ians;S>tormdateFl?faft w/.$IIt FAnce fnsta
SanitarycFacilfUes 8�rdgmpster�Sifs:Wtitic;Permit-ftir.'s Whii'sibn3Anpgs projects
COMMERCIAL Attach,(2pcomplete;sets'of,Bu;Iding-PlansplUs.';a;afe S,efety PagB;('1)'set`of Energy.•Fo'rms.;R-O=W Permit:for,new:cdJostructiow:
Mtnimum'ten(1;l);;workin da after"""`1iillttal?' aie ;.q ' ?e84onsite;-Consfrictton t? torinwateY Pl' ¢ % i;
�.., �; ^...,_,9,."�. ,,.,;xs.!!.ar .•:� : s; )as5<S an .waEltFenCe. stalled:
, .
Sanitary'FaCtlltres:&:1:,dtirrfpst raSit`e'llA Pi fffora1l'newpro)ects:,Alt commerdal:requtrenient§riiu t`'meet-como lance
SIGN PERMIT'' Attach(2)sets:of;Engtneen3d;Plans
"'`PROPER•T,YcNEY requtreb for air NE W.cofistnictton.
roLa.r, r
Directions:
.Fill.out application completely.
Ownb'r&Conti t:tor'§ign bacKofeppllcation,notarized.
If over$2500;a:Notfce of Corn nsnrrhent.is required. (AIC upgrades.over$7500)
Agent•(forthe%contractot)or:-Power;ofAttomey,,,(for the'oWner)avouid tie'someone'with notattied•letter from:owner.•authOriiingaame;
OVER:T,"E.COUNTER PERMITTING;;' (co rgi of contrast required) ., t: ...
Reroofs if sliingles Sewers Service;Upgrades';A%C:"" ':Fences(PIoUSurvey/Footage)
Driveways-Not over Counter-if on:pubtic roadways..needs'ROW _ =
NOTICE OF DEED RESTRICTIONS: The urfdbt'signed.understands that this permit-may be subject to"deed"restrictions"
which-may-.be.more:r.estrictive�than,Countiy,reguiations. The undersigned;,assumes=responsibiilvfor°compliance with,;any
applicable deed restrictions: •
UNLICEN:SED:CBNTR�ICTORSdANDCGINTRA' - .
.. ' ' CTOR<RES'wtlititSlBiLltil=5: "if�her o�lirtie "has Hired'a`coMactor or
contractors to undertake work;,..they,M.?t ibe=required,to be licensed in 9—rdance with;sta�ewand.localr regu{atlons:-1f the
..... ._.
-,contractor is.not licen�se'd.as required by law, both the-owner and contraotor triay be cited'"for a misitlemeanor violation
under state law. If the owner.:,or,,lntende'd:;contractor are uncertain•as;to what:licensing_re uire,merits:maylapplV�46Pthe
:intended work;wthey- Irwadvised to contact the Pasco County,Buildiitgvirtsp'ectiort'D!vrt!6 icensing Section at-727-847-
8009. Furthermore,, if the owner•:�has�hiredk.a,.contractor or,contractors,;he'.is adtrised.,.to: have the contractor(s) sign
portiows.of,the�°contra'ctor Block"..of.this,applicatidn:fdr.which.they,.Wili;.Oe,r._esponsibie.....If you, as the owner sign as the
contractor, that may be an*lndicationthat-he is not-properly licensed--and Is not entitled.-to-permitting privileges in Pasco
County,;.:
"TRANSPORTATION IMPACTIUTILITIES IMPACT.AND:RESOURCE RECOVERY'FEES: The undersigned,undeGstands
that Transportation,,Impact:Fees�and,Recouese.Recovery.:Fees-may=opply�to the,�constr*uction��of-crew buildings,-change of
-use int-existing dildirigs,"'or"expansian':ofeiiis#ing buildings, as specifidd-16 Pasco'Courty Ordinance-number 8"7 and
90-07,, as.amended---The..undersigned._also ur dersta6ds;'#haCisUbh fees,_,as-may:�b'edtre;�wiltzbe:identified of
permitting. It is fu'r`thbri-uhde stood tl a T asitportation.Impact.Fees-and Resource Recovery Fees must be-paid,prior to
receiving*u"cettificate::.gf.occupancy`a or flriat powor.ralease:K;°If the project•dbesFr ot�invoi.,ve4a certificafe of�o"cdupa'ncy or
final:power release, the fees must be paid prior to,permit issualnte. -furthermore if PaseoiCounty Water/Sewer impact
'feesare,,,due the.y must�tie:pald#pr'forito permijt,issuance;in accordanc6,,,vW h appticat le-Pa(ko'.County ordinances
=.CtDNSTRUCTIi3N irfEN'CA1N(Citiat�ter j't ,f#arlla4Statut�ea;;;asEamended).:�lf�rait ,��an'af inrorkis$2;50440<or:.more, !
certify #hat;=1:=tt3e ;appi�cant;::have. ..l eem4pravlded-,wrth,-a:,copy',of�fife,t'larlda,67on.,tfi�ctlon-lien Law -Homeowner's
-Protection Guide" prepared by the-Florlda<:D.epartment of Agriculture'and:Consumer Affairs.,:If-theA pplisant is:sorrt ocre
-•other•-than=the"owner"Jtertify-tltiat",i:F a Va rnenf and-,promise'in good faith to
deliver it to the"owner:prior tol comm;enc�e ront.
to r am
CONTRACTOR'$1Q1AIN R; .FIYA: iT:,; 1 certify:thateil;tie� . fgra#i~on�,jn,.his,�.a Iloatiart:,is;a+curate;.and::that ali:;work
virilt`Ee done in compliance with atl'app able Taws regitlatmg construction;zoning arfd lsirid�develapment:; 1ppllcat1on is
hereby made to obtain a permit to d'ot;iu ick i id 4tstallati''WWr ik&ated. t certify-that no work or-installation has
commenced,prior to Issuance of a-permit trid-that all work wilt-be-performed-.to_moerf standards of all laws_regulating
construction;'4 my andrC'tt cotlas' zobing;�regulations, anif kind development regt',lations in theajurisdi'ction:-� I also
certify that i understand that the:regulations of other,government.agenciesx,may applyco-,the,lntended work, and!that.it is
my responsibility.to identify what actions:I:mu6t:take to.be�ln compliance. Such agenciesinclude but are=notnlimlted-to:
Department of Environmental Protection-Cypress Bayheads, Wetiand.Areasnand Environmentally Sensitive
Lands,•WaterMasteti+,.,*%e,ilf
Southwest Florida Water 'Management District-Wells, Cypress,, Bayheads, °Wetland Areasy -Altering
Watercourses.
Army Corps,of Engineers-S.g "."lis;:Docks,4Navigabte Waterways,-
- Department of�Health: 4jf#a i'ai ilitativek:Servlces.115hvironmerital Heaitf Unifi:Welis;tWastewatet.� reatment,
Septic Tanks
- US:'Environmental,=Prot-tictttxwCgency;'Aabestos>abaternent;",
-FederAFAriatfoh-Kdtii'octfy-Ftu--"waj*."
{understand-that_t el, Ct on pp o.:,the use of fill:
Use?ofllris.nots'iiouveli`!ri'° laod Mine"V"unless expressly permitfed _
if"the""'"fill. maferiat:is.,to•.be used in 'Flood Zone ph", it-is taiaderstoad -that a drainage .plan addres_sing a
"compensating;voitti ije' +I I;;p_e�sutirrlitted'at{time ofspermitt rlg,wh Oh,,.isr.prvep r;gd byNa°;professional°engineer
licensed'by tfie State of i=lartda.
1f.the.fill,:r atertal cis:t+ be used in�Flood.Zgrier°A"hin-connection with a permitted building-us1ng`st0M;,vaI!.
construction, l;certifytl'iat fil{, la&UAed only tQ 81('the a irr;•tbeastem,:wali:: ..:....__
If..fill material is to be..-used,in .any area, I certify that use.of-such.fill will not adversely affectadjacent
ryprvper#ies:.--'If,Use, ill is found_.to..ad.versely-af oedt�adjacer,lt�piopertt�es tiwiowtaer�, y-:be cited far vrolating
the conditions of the building.permit issued•.undeF;the--attached permit-application,for lots-less than one;.(!)..
acre:which are.elevated4"ll an engineecect:drainage plan Is required.
If!am the:/kGEi'+tT fOR-TFIt OVt i ii6im16e.in,good faith ta.inform tTie owner of th`a.perrnitting conditions set forth in
this affidavit.prior to commencjng;construction. I understand.that a separate permit:maybe required for electrical work,
plumbing;..signs,:.weils;�,pools -air•conditloning,�.gas,;or other lnstallatlons n it specificaily.ancluded in the Fapptttration. A
permit.issued be.,construed to be a.license to_proceed;{withthe work.and not-as author! to•violate,cancel;>_=alteror,:.-
set aside any' rovisions-of ttae#ecttnlcal p desr.nor shalt:_issuance of•a permit°prevent the-Bu.1,din _cial fiom thereafter=
M.g _K_. .�.a
requiring:a.correctiori;of=errors-•in plans,.construction or vlolations-40f any-codes .Every.pern it.-issued=shall°'become•invalid
unless-the,work:authorized.bysuch,;permit is commenced.within-six;months..of-permit.1ssuanc.e,,,or...if..w-ork:authori�ddlby
the-permit°is:suspended'or-abandon'6d*-fdr-a�period of..six(6)months after the time`the:V+iork is commenced:'�Arrextenslon
may be.requested,_in:writing,jrom-•the:Building:Official*forr,a°period not to-exceed ninety(90)days and will'dernonsti'M6"
-i N: -
justifiablercause.:for',.,e'extension:v1tWoIrk-.ceas.+esfor•ninety(go)-consecutive:days,:the.job�!s<considered.abandona;.
WARN NG2:TO,QWN.ER: YOU.Ri, LURE TO':RECORD�A-<NOTICE-,OF µCO,MMENCEMENT MAY;RESULT-'IN;�YQUR
PAYlNG�TUVlCE PO`R;IMPROVE �Y4,URaPit3PEIt'ff:IF'Y"t>iu; NYND?i'O+D7`AiNIIAICiNC:Ct�i $I�LT Y.
1AlITH YOUR,LENDER�OIi�fAWA_TTdRNt=YSB>rFOi Est I:CO diNO YC3UI2:.Nt�l i.Cl OI~.00tUIME[�CI MENT.
- - LORiI AMURAF'(f+S 9`t7: .....- —
OWN.ER=.OR'AGENfi '
Subsciibedand;sworirto'i( '{ riri :} dfore+ 'e`=ftil Subscdbi dd and• worn�t ' ii ild)` 'e e�'
to-w. .t>y : _ ,L.� i U-2� ._
w is/�(e personaii'y�Known to a or has/hafie duced who Istare a on My, n m o rrie'oi1Waslri4VdVnidur "
+.rtlre�vers 4 r�7e-. as Identification. C i'Ce ��- :as identifibation
QNotary Public ;•Notary:Pjdblicp-
"' ' Jq .comma n No
Com sto G!SlELlY
Coininission#GG 276457"
r' E OGES•
Name of N SA ' ce8aa3asaots Mame,ofztVota.. .eFAAnAAAMI;F.F4P peel
�tri6 11tl?i"G 276457 _..
4=Expires December i2,2022
BwMTta Troy Fainln&ur C886045d019.
A
.
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
have read and fully understand and
agree to the provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile, that he or she
actually occupies, or will occupy by said domicile, and same is not for
rent, lease or sale. That he or she shall comply with the following conditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
4. That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
S. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
6. That prior to final inspection any additional fees, including reinspection
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 owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourself. You may build 0�;improve a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $75,000.
The building or residence must be for your own use or occupancy. It may not
be built or substantially improved for sale or lease. if you sell or lease a
building you have built or substantially improved yourself within I year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or .lease, which is a violation of this
exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your building. It is your responsibility to
make *sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means 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, ordinances, building
codes, and zoning rMlations I Z111-2/
OWNER'S SIGNATUREDATE d .
ADDRESS 1�_ Llz9)1-h
PHONE
WITNESS PERMIT #