HomeMy WebLinkAbout91-1568
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N JO
!> 1568 I:)
Date f<~ -- 6.- 9/
Type of Permit
~ ELel.rAICAL -_ <i>wMIlL~~ MEC~
Property Owners N-"me: ~;) ~~~ ~ ~ p ~
Job Address: --S ? Cl_ - _ ~_ _ _
uk
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI:
Description of Work
J-- ~/ r/~iA
'l : -
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: c;2J &0. G""T'"V
Fee:
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #
COMPAN
ADDRE~
TELEPHOfifE #
~Y1(}/7
~.
./ BUILDING ~
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
G
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of 'In (Ii 18.68)
dollars shall be made for each ~./)" d... d.. e.. (J.5: O/J )
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(e) Repairs or corrections not made when inspection called for
fork not ready for inspection when called.
.lent of reinspection fees shall be made before any further permits will be issued to the person owning same.
Si~
MECHANI-
State Cert. or Regist. #
City License Registration #
******************************************
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it .ay be subject to "deed restrictions" which lay be .ore restrictive than City
regulations. The undersigned assu.es responsibility for co.pliance Nit~ any applic~ble deed .restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ONner has hired a contractor or contractors to undertake work, they .ay be required to be licensed ~naccordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor aay be
cited for a .isdeaeanor violation under state law, If the ONner or intended contractor aTe uncert.aiJ) il.S to what licensing
require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, !813l
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!sl sign portions of the
'Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that .ay 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 with a copy of 'Florida's Construction lien law - HOleowner's Protection
Guide' prepared by the Florida Departlent of Agriculture and Consu.er Affairs. If the applicant is sOleone other than the
'owner', I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the
.owner' prior to cOI.encelent,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation in this application is accurate and that all Nork Nill be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has co..enced prior to issuance of a per.it and that all work will be performed to leet standards of all laNS
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
8Y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not lilited to:
I Depart.~t of Envir~n.en~tl ReQulation - Cypress Bayheads, Wetland Areas and Environtentally Sensitive lands,
Water/Wastewater Treat.ent
I Southwest Florida Water ManaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health L Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental Protection AQency - Asbestos abate.ent
I also certify that, if fill .aterial is to be used in Flood Zone "A" Dr 'A,etc.., it is understood th~t a drainage plan
addressing a .colpensating volute' will be sublitted which is prepared by a professional engineer registei~d in the State of
Florida prior to per.it issuance.
A per.it issued shall be construed to be a license to proceed with the work and not as authority to viojate, cancel alter, or
set aside any provisions of the technical codes, nor shall .issuance of a pertit prevent the Building Official frot thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued 5hall becole invalid
unless the work authorized by such per.it is cO.lenced within six lonths of issuance, or if work authorIzed by the perlit is
suspended or abandoned for a period of six .onths after the ti.e the work is cOlmenced, One 90 day exteosioll of tile, lay be
allowed for the perlit with fee charge of $15,00; The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six .onth period, or the project will be considered aballdoned.
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. JOBS UNDER $2,500 IN VALUE
DO NOT NEE 0 R ND POST A "NOTICE OF COMMENCEMENT".
OWNER OR
DATE_____~_:_~~_~_l____________________
SIGNATURE
------------------------------
SIGNATURE
CONTRACTOR
DATE
-----------------------------------
NOTARY AS ,0 /....- .
OWNER OR AGENT_~4~bea~A~
Notary P Iic, State of Florida"
MY COMMISSION EXPIRES_~~~~~~~T~~~
OTARY AS TO
NTRACTOR_____________________________
MY COMMISSION EXPIRES
JOB LOCATION
'J) C~TY OF
~oBeRT N.
S32b
ZEPHYRH~LLS BUILD~NG DEPARTMENT
f'R4E
8~ St. Z~pl..yrh.I.'lls
{
OWNER
PARCEL I.D, #
SHOW ALL EX~ST~NG & PROPOSED STRUCTURES GIV~NG DIMENSIONS & SETBACKS.
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2~ STRGtT
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2) STREET
1. SETBACKS FOR R1, R2 ZONING
60'
10'
p E
R X
0 I
I 10 I P S 10'
0 T 1 0'
S I
E N
D G
20'
FRONT PROPERTY LINE
60'
10 ~,.,
. ,
C 'l7l-J-rac ().
~'Dc.EE.T ~
2. SETBACKS FOR R3 ZONING
60' -
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
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GIVE: M\-{ P&R.M\SSrON FOR. f<O'BERrT
N. PRL-{ E(l DS -FINANCiAL .s~ETC.\JIGGS/l~()
TO (<E-& (S T\::R M "-1 BU~ I ~ E S S; W IT14
1l-t-1; CiT\..f 0':: Z.SPHYfCHt l-L$. t ,ALSo
G-\"~ ML{ PERMISSION "'TO COMPLJETb
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Nary Public. State of FlorIda at l."trliff
M CommissIon Expires Oct. 11.. 1993.
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INVOICE
DATE
Paul Hetrick
1611 Marshall Drive · Plant City, Florida 33565
(813) 754-1764
\ DC... -
To: #'~:> t:.r-JANCiAL- 's-t='lVIIIOE$
53'2~ EHj1..)TI1 STft.EEr
2ePHYRHILLS
-78'g - 2_ {oc> 15'013 P rc L1 E
QUANTITY
DESCRIPTION
UNIT PRICE
AMOUNT
PAYMENT DUE UPON RECEIPT OF THIS BILL.
SUB1UTAL Z 000...
TAX :1 0 '.
TOTAL 41' ;;2. I (;lO .~ ~ 0