HomeMy WebLinkAbout91-1564
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
1564 ~()
Date I" - ./..f - 9 I
PL~
MEC~
Properly Owners Name: ----Ja ~ ~~)
Job Address: 55~ ~_ _ ~
Legal Description: Sub.Div.IJ~ 20-1/- OOl" -Obioc - 0 I ~ Lot
Blk.
Zoning CI:
Description of Work
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Energy Code Readout:
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Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
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Fee: -iJ~O ~.
SIGNATURE v-7:l~ (jl ~
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE # J ~tJ 4- ~If/
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
i
MEC~ICAL
/
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of L [II L~)
dollars shall be made for each vip. /-r-a.de. (/06: t)D)
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(c) Repairs or corrections not made when inspection called for
(d) Work not ready for inspection when called.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
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OWNER \:5D f2LLG1V &rJH:81l\
JOB LOCATION &"'5"'?7 C/lJ-t- ilL ilL).
LEGAL DESCRIPTION/SUB DIV.
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BLK.
LOT
Show all existing and propos~d structures "giving dimensions & setbacks.
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1015 sf
slret{
':ron
10 rf, st~
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38545 Palm Grove Drive
Zephyrhills, Florida 33540
ACE
ALUMINUM
Job No.
Phone: (813) 782-2818
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SOLDTO ~D 'Pu-"EN ft1t?J.ltt Ii fr\
ADDRESS _~S-:? 7 c.1Ji-l- /lLV./J. 7-Jl/~,-:-s r/tf
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SHIP TO
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PHONE 7 ,,~- 1~ "h
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PERMIT
PRICE
TAX
TOTAL PRICE
I DEPOSIT
, BALANCE C.O.D.
/
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
fJ~E llt-uM I
ADDRESS :? cf..5VS' PIlt-/11 r;.b)tJ~ v. Z-II/t-t:f' h /9
OWNER .:r 0 lZ-l-ktS rV FJ4-~ {\.J H"~fY1
JOB LOCATION:( ~J 7 ClJtL 1ftt/f). 2 -III LL.{' rill. LOT SIZE
APPLICANT
PHONE
7c?rS2-d6/6
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCR
SUBDIVISION
PARCEL I.D.4F
WORK PROPOSED:_New Construction ~ddition _Alteration _Repair _Install
_Sign/Temp.
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
_M/F
_if of Units
__M/H
_Commercial
_Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
AI>DII\J17
BUILDING SIZE: II' X I~' , rtv/Y ~#I--t-.( Square Feet,U,.vL)elt $A7..rf: R~
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ,~*
**COPY OF CONTRACT REQUIRED.
V' BUILDING
~ELECTRICAL
I
9SOV
PERMITS REOUESTED
Valuation of Total Construction
AMP Service
Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of MechaniGal Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
SECTION
Company RUE /!LI./ 1"'7,
S ta te Cert. or Regis t. if C/l. CD J'/6 tPO
City License Registration iF /107
.
********;;;;'*****************************
- Company M~,(7b,J ~ I t~ 71,- e
State Cert. 'or Regist. iF
City License Registration iF
******************************************
PLUMBER
Company
State Cert. or Regist. iF
City License Registration iF
******************************************
Signature
MECHANICAL
Company
State Cert. or Regist. iF
City License Registration iF
******************************************
Signature
OTHER
Company
State Cert. or Regist. if
City License Registration if
Signature
APPLICATION APPROVED
~~,*******************************
BY ".'1~
tY ..
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait aay be subject to "deed restrictions" which lay be aore restrictive than City
regulations. The undersigned assules responsibility for coapliance with any applicable deed, restrictions.
B. UNL I CEN.SED CONTRACTORS AND CONTF'ACTOR RESPONS I BI LIT I ES
If the owner has hired a contractor or contractors to undert.he work, th~y;.ay'~e r~g~irep to be lic~nsed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the o~np.r and contractor aay be
cited for a lisdeleanor violation under state law. If the OWller or intended contractRr are uncertain as to what licensing
requireaents lay apply for the intended work, they are advis~d to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtheraore, if the owner has hired a contractor or contractrrs, he is advised to have the contractor(s) sign portions of the
'Contractor Sections' of this application for which they wilj be responsible. If you,'as the ollner sign ilS the contractor,
you are indicating thilt you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills,
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided lIith a copy of 'Florida's Construction lien law - HOleowner's Protection
Guide' prepared by the Florida Departlent of Agriculture anei Consuler Affairs'.' Lf-the applicant is sOleone other than the
'owner', I certify tbat I .have obtil'ined a copy of the above described-dctE11aent alld -pro.ise in good faith to deliver it to the
'owner' prior to cOlmencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby lade to obtain a pertit to do work and installation as indicated, I certify that no 1I0rk or
installation has comaenced prior to issuance of a perlit and that all 1I0rk will be performed to leet standards of all laws
regulating construction, City codes, zoning regulations, anll land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govl!rnlental agencies liay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in compliance. Such agencies include but ill P. 1I0t li.ited to:
. Departtent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
Water/Wastewater Treatlent
. Southwest Florida Water ManaQelent District - Wells, Cypr~ss Bayheads, Wetland Areas, Altering Watercourses
. ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
. Departlent of Health ~ Rehabilitative Services, Environler1al Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
. US Environ.ental Protection AQency - Asbestos abatelent
I also certify that, if fill laterial is tQ be used in Floon Zone "A" or "A,etc,., it is understood thilt a drainage plan
addressing a 'colpensating volute' will be sublitted which is prepared by a professittnal 'engineer registered in the State of
Florida prior to perlit issuance.
A per.it issued shall be construed to be a license to proceed with the IIttrk and not as authority to violate, cancel alter, or
set aside, any provisions of the technical codes, nor shall issuance Df a permit prevept the. Building Official from thereafter
requiring a rorrection of errors in plans, construction, [Ir violations of any code. Every petmit 'isslIpd ~hall becclle invalid
unless the Nttrk authorized by such permit is cOI.enced within six months of issuance~ or if work authorIzed by the permit is
suspended or abandoned for a period of six lonths after the tile the work is commenced. One' 90 day e~tEnsioii of tile, lay be
allowed for the permit lIith fee charge of $15.00. The extel,sion shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six tonth peliod, or the project will be considered abaBdoned.
WARNING TO OWNER: YOUR FAILURE TO ~ECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN yOUR PAYING TWICE FOR IMP~QVEMENTS TO YOUR PROPERTY. IF YOII
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECO DING YOUR ~IC OF COMMENCEMENT. JOBS UND 500
DO NOT NEE ECO D D R ST A "NOTICE OF COMMEN ".
SIGNAT ~-o AGENT ~~---- SIGNATU ~NTRACTOR-----------
__Gc~~ _L1~~----- __________.,_ DATE_~~__~t_L'_fj1~-_------------
NOTARY AS TO NOTA~~~~ A ~ A C~./ .I ~ ~ _ ./
OWNER OR AGEN ~ _ i_ _ _~~~~~ CONTRACTO~~;I\~~
p f'Of:da .~i~-'.~0 f.J Lar~la. I 11~ ~.h
MY COMMISSION EXPIRES_~~~~~~;2~~j~~~0~~~ MY COMMISSION EXPIRES___~~~~2~-----
DATE