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PERMIT NUMBER"`=.<`
5335 Eighth Street
Zephyrhills, FL 33542 BGC-000074-2020
Phone: (813)780-0020
Fax: (813)780-0021 Issue Date: 05/14/2020
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Permit Type: Building General (Commercial)
Property Number Street Address
12 26 21 002A 00500 0040 5525 23Rd Street
Owner Information Permit Information- Contractor Information
Name: Permit Type:Building General(Commercial) Contractor: DUKE ENERGY
Class of Work:Right of Way Temporary Use
Address: Building Valuation:$0.00
Electrical Valuation:
Phone: Mechanical Valuation:
Plumbing Valuation:
Total Valuation:$0.00
Total Fees:
Amount Paid: V
Date Paid:
Project Description
MIS SEE DESCRIPTION WO 35715711
Application Fees
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 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 permit 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 add fee Must Accompany Application.All work shall be performed in
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
WO':35715711
Right of Way Use Permit
CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT
RIGHT-OF-WAY USE PERMIT
DATE: PERMIT#
No construction under ground or above,ground of any facility shall be accomplished on any
City Rights of Way without written approval from the City Building Department. Any application
for approval of construction operations on any City owned Rights of Way shall furnish a detailed
drawing showing the complete scope of the proposed work in triplicate to the office of the
Building Official for approval prior to the commencement of any work. A copy of this permit is to
be kept readily available at the site of the work at all times.
PARCEL I.D. # 12-26-21-26-002A-00500-0040 -CITY Zephyrhills-
ROAD— 5525 23rd Street. Zephyrholls. FL, 33542
DATE 4[6/2020
LOCATION (Legal Description) :
SUB OF S112 OF NW1/4&SW114 OF NE1/4AKA M YINGLING PB 2 PG 16 NORTH 1/2 OF EAST 94.00 FT OF TRACT 5 LESS SOUTH 11.00 FT THEREOF OR 4875 PG 618
Permission is hereby granted
to Laurie Jackson Duke Energy of
4427 Pet Lane ste 101, Lutz, FL, 33559
for the construction and maintenance of: Replace pole due to decayed top
subject to the following conditions:
1. The construction and maintenance of such utility shall not interfere with the property
and rights of a prior occupant.
2.All work shall be done in keeping with the standards of the City Streets Department
and under the supervision of the City Building Official, who will be notified at
least one day prior to commencement of construction.
3. All materials and equipment shall bes: ubject to inspection by the City Building Official.
4. During construction all safety regulations of the Department of Transportation shall be
observed and the City shall be relieved of all responsibility from damage of any
nature arising from this permit. Subject10 the same terms and conditions,
the permit holder may take such safety measures, including placing and display of
caution signs, as it may deem necessary in conduct of construction and
maintenance work hereunder. It is the responsibility of the
Per 4 ittee to ????
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5. All private and all City properly shall be restored to its original condition as far as
practical in the opinion of the City Building Official.
6. All underground crossing installations shall be laid at such depth as may be specified
by the City Building Official. 1
7. The sketch covering the details of this installation shall be made a part of this permit.
This permit is granted with the understanding that the applicant has notified all
other utility users in the area covered by the permit and takes full
responsibility for any damage incurred by prior installations as a result of his operations
in order that they may safe guard their interests.
8. It is expressly stipulated that this permit is a license for permissive use only and that
the placing of facilities upon public property pursuant to this permit shall not
operate to create or to vest any property right in said holder.
9.Whenever the City decides to further exploit the City Rights of Way, any or all said
poles,wires, pipes, cables, or other facilities and appurtenances authorized
hereunder, shall be immediately removed from said Rights of Way,
or reset or relocated thereon as required by the City Building Official at
the expense of the holder of this permit.
10. The holder shall save and keep the;City harmless from any and all damages, claims,
or injuries that may occur by reason of the construction, maintenance, and
operation of said facility.
11. The holder shall complete the requ elsted work within days or this permit
shall become null and void. In the event the work requested is not completed
upon the expiration date of this permit, the City shall have the right to
complete such work and to charge the,holder of the permit for all costs incurred in
completing said work.
12. The holder shall post a cash or surety bond with the City Manager in the sum
of$_dollars to guarantee performance of the obligations herein,
and to guarantee maintenance of the right-of-way described herein for a
period of one(1) year following completion of the requested installation. In the event a
surety bond is posted, the surety bond shall be made payable to the
City and shall obligate the surety to hold the City harmless in
the event the holder of this permit should fall to meet any of
its obligations hereunder. The bond shall also
indemnify the City for all court costs
and reasonable attorneys fees in the event legal
action is required to collect on said bond.
SUBMITTED BY:
(Permittee) Lauie Jackson Duke Energy
Signature &Title
Address 4427 Pet Lane ste 101 , Lutz, FL, 33559
APPROVED BY:
CITY OF ZEPHYRHILLS
Building Official
Date:
Utilities Supervisor Se.& 4771-AW60 g,"AA4,ok
Date:—
Public Works
Date:
City Manager
Date:
USP: RECLOSER 6631431 Safety Reminders I Adverse Conditions PI:28.238110,-82.167650
CAUTION: iw
SAFETYRI'St CHAINLINK FENCE NEAR PI
JOINT USE PEDESTAL NEAR Pt
REMEMBER:Work zone area conditions may have changed for this jobs Everyone Is responsible for verifying the above safety Information Is correct prior to any work being performed each day.
ANY, POL17,45711-35-5
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POL OB3114-35-5 MISSIONARY CHURCH Work Order Number. 35715711
Cwtomedconfact
F5521] Cantodpho_ 6521 23RD ST
Job We Address
CRY ZEPHYRHILLS
county PASCO
POLE-B 1215 5 88-414 State,ZIP FL.
33542
DesIg-, ALBERTO CRUZ
SCOPE OF WORK: IIOIVF-442703-3 -6 Ve$1qw Phono 321-316-41146
REPLACE POLE DUE TO DECAYED TOP POLE-44 6.4-30-6
Ca11 M C851
PROJECT LEAD:ALBERTO CRUZ �Mvorup 12,47f7.2 W
PHONE:321-3164846 EXT.1115 P.,,QPqjd Y__N1_
EMAEL:ALBERTO.CRUZ@DUKE-ENERGY.COM 6TH AVE Peem Typeft.
k — P1 EAST PrmQTWnNo.2
PI CONSTRUCTION NOTES: P..M To w.3
-P1 IS ACCESSIBLE BY TRUCK FROM 5521 23RD ST FL w A LL Pemgt`r,�4
LOCATE P1 IN NORTH-EAST C/O PROPERTY
-DISTANCE FROM EOP TO P1 IS APPROX 25 FT SN 7 3 10 10 &DUKE Shoot
.LIGHT TRAFFIC AREA,MOT IS REQUIREDVENERGY. smde.160,
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