HomeMy WebLinkAbout91-1601
ST ATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
PermitN~
1601 !J
BUILDING DEPARTMENT
0:7 S.O 1-813-788-6611
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Type of Permit . . C/ L/
~Ig) ~ ~.' MECHANICAL
Property Owners ~ame: ~~./ ~L ~ ti;-:1ft-S2.7~.h/l ;;10 "'~
Job Address: ~ .3 c,L -/ ~ /? 2:;{ ~
Legal Description: Sub.Div. Lot Blk.
Date
(; .- rJ/ - '1 /
Zoning CI: ;1/ ~ 1!i!:l' / / ' 0 0 /. 0 - / '7 'I - ~ 0 '
Description of Work VZ A 6< L" ,z,A-, </ /I 'J" <' < :-
E/7.D
C+ 7-12--1 I ~
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
/ () J cr-co. o-r:J
Fee:
1~3 7
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OCCUPATIONAL LICENSE # 77 &JJ (.~.
SIGNATURE
COMPANY
ADDRESS
TELEPHONE #
"""-
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
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~~ BUI~I~ 0UMBIN:-: . ~ECTRICA~J" ME~I~
Ftr. SLB""77';--.I Tp.Serv. ~ 7:? L
Pre SLB Tub Se\ -2-'11 ~ Rough In~ -'} -1/ ~ Breakers
Lintel Water Meter Can Oucts Insl.
FRM.V'1'-l-11 ~ Sewer Const. Pole Compressor
Insul.CL . Final Pool Final
WL Pre-Meter
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons. a charge of l_~ el. 0 00)
dollars shall be made for each ~:-rr..:).de. 'l6:- 0lJ)
(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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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
5b-l-S~o
OWNER ~ \l-
JOB LOCATION 53'2..-L(8~ S
, 1 BLOC~SUBDIVISION
'2\-'Ll:,-\\ -OOl.D
WORK PROPOSED:____New Construction
AREA SQ. FT.
~I 'D. ~Y
_ \ -"1 Y - DC - 0 I ., , 0
----Addition ~teration ~Repair ____Install
LEGAL DESCRIPTION: LOT(S)
PARCEL 1. D. ~F
_Sign/Temp.
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
_M/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 FORtIS. **
**COPY OF CONTRACT REQUIRED.
pERMITS REQUESTED
~BUILDING
. rID
$ fa ~ 00 D /"
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_H.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBH1G
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTT~ ' .. - ')
Company ?\V~,1.. CC:;~ ~\ fAJc....\l ~
State Cert. or Regist. #
City License Registration ~
******************************************
Company S're ( \.'0- \;\ ~ \ '(J {1 +... s. p v
State Cert. or Regist. IF ()-:J':,~7'f
City License Registration il ,)
**********************************
Signature
Company
State Cert. or Regist. ii ft t=' ~ LIt ~ ~.3'
'# City License Registration il If ~ ~
******************************************
Signature
Company
State Cert. or Regist. #
City License Registration ~
********************************~*********
MECHANICAL
Signature
Company
State Cert. or Regist. 0
City License Registration #
OTHER
******************************************
PERNIT OFFICER.
';J",N)J;'L,l~A;ION APPROVED BY
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_"~ ,,:Of:',... ',..',J 'iI~.. r l.~S
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it lay be subject to "deed restricti~ns" which ~ay be lore restrictive than City
regulations. The undersigned assules responsibilitJ.for compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with
state and local regulations. If the contractor is not licen$ed as required by law, b~th the ollner and contractor ~ay be
cited for a .isdeleanor 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 nepartlent, (813)
788-6611.
Furtherlore, if the owner has hired a r~ntractor or contractors, he is advised to have t~e c~ntractor(s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If y~u, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the wor~. If the ce,ntractor wishes y~u to sign
as contract~r that lay be an indication that he is not properly licensed and is not entitled te, per~itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTESJ 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 Consumer Affairs. If the applicant is SDleDne 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 cOlmencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information 1n this application is accurate and that all \lor~ will be done in co~pliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and. installation as indicated. ] certify that no work Dr
installati~n has comlenced prior to issuance of a perlit and that all w~rk will be performed to ~eet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that] understand that the regulations of other governmental agencies may apply to the intended work, and that it is
.y responsibility to identify what actions I lust take to be in compliance. Such agl<ncies include bllt ~ie not lii1ited to:
I Department of Environmental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive L~nd5,
Water/Wastewater Treatment
. Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Hetland Areas, Altering Watercourses
. ArDY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
. Departlent of Health ~ Rehabilitative Services, Environffiental Health Unit - Hells, WasteHater Treat~ent, Septic Tanks
I US Environmental Protection AQency - Asbestos abatement
1 also certify that, if fil1l1aterial is to be used in FICtOd Zc,ne "A" or "A,etc.',.it is underste,e,d tll~t a drainage plan
addressing a 'colpensating volume" Hill be sublitted which is prepared by a professie,nal engineer fegist~(ed in the State of
Florida prior to permit issu~nce.
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 fro. thereafter
requiring a correction of errors in plans, construction, or violatiDns of any code. Every permit issued ;hall bec~.e invalid
unless the work authorized by such per.it is co.~enced within six months of issuance, or if Hork authorlzed by the perlit is
suspended or abandoned for a period of six lonths after the time the lIork is commenced. One 90 day e:te~5jDII of tile, aay be
allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspecti~n oust be logged .during each six month period, or the project lIill be considered ibal~oned.
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. J BS U R $2J500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF CO M NET".
".
SIGNATURE_~~_~~~~lt~~~-------------- SI
",Ji ~. OW R QR AG~T - '.11
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DATE______4_:~~:~j_______________________ DATE______~~~~~~__________________
NOTARY AS TO fl 0 LJ /J/J
OWNER OR AGE~~--L)~--~-
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MY COMMISSION EXPIRES_~~~~~~~~l~--
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MY COMMISSION EXPIRES~~~.J~