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Home My WebLink About91-1591 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Type of Permit 8IJ1lnlNC) E~ PlU~ ~ANI~ propertYOWnerSNa~e: Q-.~. /3~-/~ Job Address: d <?- 3~- Y c--25( a ~ Legal Description: Sub.Div. Lot Zoning CI: / / -;).6 ~ d-/ -- 00/0 - / ~~ 00 --. 0 ~.<,s. Description of Work Jj(e. ~ J- 1/ C _ ./ -<'..A1.; / Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: / '7~-~ , Fee: 00 All work shal! be performed in accordance with the above and all City Codes and Ordinances. SIGNATURE ) COMPANY /'/ ADORESS OCCUPATIONAL LICENSE #7/ A/c ~J;, TELEPHONE # Permit N~ 1591/1 Date (,; - /;>;- - 9/ Blk. ~~- ( /~S~() F EL~AL Tp.Serv. ~ Rough In Meter Can Const. Pole Pool Pre-Meter Final ~MBING SLB ~-~ Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul.CL WL Driveway Breakers Ducts Ins!. Compressor Final Relnspect/ons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of _ (118.66) dollars shall be made for each.,"7 r a... de.. (/..f:. -; tTD ) (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. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER ;(;~,.~, c~.J2;/~ If/C { I' ~ ....-z!!iJ ~;<;z. I-;r ; ~ }-.if '3 J ~ ~ ======. tf PHONE J (.L IV JL E j.ad! $.0.P 7 t3~7-1&~ F3 APPLICANT ADDRESS JOB LOCATION '3235 S--o c{-- 4<.0/ >- II ;ZG. ,;?I &010 LEGAL DESCRIPTION: LOT(S) BLOCK LOT SIZE_____X AREA SQ. FT. /350D O~/5 SUBDIVISION PARCEL I.D.4F WORK PROPOSED:____New Construction ~ddition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move _Demolish PROPOSED USE: ____Single Family _M/F ____~F of Units __M/H ____commercial _Indust. ____Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, 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. pF.RMITS REOUF.STED _BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service /q?O_CfO . Florida Power Corp. _____W.R.E.C. / ..LMECHANICAL $ Valuation of Mechanical Installation _PLUMBIN"G GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame ____Steel _Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR 0ECTION Company State Cert. or Regist. # City License Registration # ****************************************** nmLDER Sil?:nature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRTCTAN Signature Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company Il..&;;'<r, rp_,,L~ ~ ~ -!pc State Ccrt. or Re ist. ~i f?. N OO<>tbd~f? City License Registration # 71 ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration # OTHER ****************************************** APPLICATION APPROVED BY /'/ lL"~~-C'~ . ->&--eA~ PERNIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions" whicfi may be lore restrictive than City regulations. The undersigned assules responsibility for coapliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they eay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor ~ay be cited for a aisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-bb11. Furtherlore, if the owner has hired a contractor or contractors, he is advised tQ have the contractor Is) sign portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the ~wner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes y~u to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to permitting 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 C~nstruction Lien Law - HOleowner's Protection Guide" prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is s~leone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to cOlmenceeent. A, 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 c~lpliance with all applicable laws regulating construction, zoning, and land development. Application is hereby aade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a perlit and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may 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 bill ale not li.ited to: I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treat.ent I Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wflls, Wastewater Treatment. Septic Tanks I US Environtental Protection AQency - Asbestos abate.ent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volume" will be subtitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issu,ance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to viol~te, cancel alter, Dr set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frot thereafter requiring a correction of errors in plans, construction, Dr violati~ns of any code. Every permit issued ;hall bec~le invalid unless the work authorized by such perlit is coaeenced within six months of issuance, Dr if work authorIzed by the perlit is suspended or abandoned for a period of six lonths after the tile the work is commenced. One 90 day e~t€nsioli of tile, may be allowed for the permit 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 month period, or the project will be considered ~balidoned. 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 NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE --- C6N~~~----~- SIGNATURE___~_~________ DATE________~~:~:;_::sr;::::------------- NOTARY AS TO j(') P r ...J-I OWNER OR AGENT__~_~~_~_~__ DATE___ NOTARY AS T~ ~ CONTRACTOR__~~~~~~ ~L)_ ~' Notary Publi MY COMMISSION EXPI ES_~J&mm~_ MY CD-MM I 58 ION EXP I RES ~. Mohrry 'ublit, Sf!l'eoUforlJcr -MVl:rn~rf.1?;'Gii!~:if"fi""M&ai"TT," TV 9 5 Bon"o"'-:.1 Thru T(;)/ Fain. 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