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Home My WebLink About91-1606 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N~ 16068 Type of Permit ~ 'Et:EOTRI"AL ~ M~IlA'~l~L Properly Owners N_ame: __ ~4 :J~ <:4 Job Address: --5~. -...S.s ~ ~_~~ Date ~~ -;2)1- 7/ Legal Description: Sub.Div. Lot Blk. Zoning CI: Descrlp';onofwo'kfl"" j\~ ~ leJ-3C) -t91 Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: 9?tJ~ 0-0 Fee: ~A~ All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE # COMPANY ADDRESS TELEPHONE # /~ C BUILD~~ Ftr. Pre SLB Lintel FRM. Insul.CL WL ~AL Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final ME~AL Breakers Ducts Insl. Compressor Final Driveway Relnspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of. 1111.89) dollars shall be made for each ....'/rci.d..e. (i.!:>:OlJ) (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 APPLICANT ;j('/tj 1<117 /7tfr ADDRESS .5:), -r- ,-;;; r-~. S- ~'. PHONE 7.>(:' OWNER 2?~,tnp~ c,i-~~~J ~~' Jon LOCA nON -_ - - ," ~ t __ _ r . . LOi: SIZE $' Q x <'I 'IC ,\REA LEGAL DESCRIPTION: BLOCKl~~~~SUBDIVISION Lj~' 1.3 SQ. FT. PARCEL 1. D. ~~ ,?-VOObGC) WORK PROPOSED:____New Construction ____Addition ~lteration ~Repair ____Install ____sign/Temp. _Sign _~love ____Demolish PROPOSED USE: ____Single Family *commercial ____M/F _# of Units __1'1/H ____Indust. _Swim. Pool Other ____Restaurant & Health Department Approval 7.~. I,X 3(.~S- . / BUILDING SIZE: \ (p. 11 X 'i ? tA.. ~ ~. 0 t Square Fee t, Height RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl'lS.** **COPY OF CONTRACT REQUIRED. :PERMITS REOUESTED ____BUILDING $ ?'lo.u-o Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _H.R.E.C. _PLlJMBIN"G GAS Valuation of Mechanical Installation .1( ROOFING SPECIALTY _MECHANICAL $ TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration t~ ****************************************** BUILDER Signature ELECTRTC1AN Company State Cert. or Regist. # City License Registration 0 ****************************************** Si!!nature Company State Cert. or Regist. 0 City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. 0 .Cit~' License Registration 4~ ****************************************** MECHANICAL Signature OTHER Company State Ce,t. or Regist. 0 City License Registrati6n # . Signature APPLICATION APPROVED BY ****************************************** _ -n '" ~~ ~ P!u>)...- PERl'lIT OFFICER. CONDIT.IONS OF PERMIT AFFIDAVIT A:: NOT J CE: OF' DEED RESTR I CT IONS:. . The undersign~d understands that this perlit lay be subject to "de~d restrictir,ns" which ~ay b~ m~re res~rictive than City regulations. The undersigned assumes re5ponsibili~y.fo~ 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 b& required 1.0 be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor nay be cited for a lisdemeanor violation under state law. . If the owner or intended contract~r are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills 8uilding Departeent, (813) 788-6611. Furtherlore, if the OHner has hired a contractor or contractors, he is advised to have the c~ntract~r(s) sign porti~ns of the "Contractor Sections" of this application for which they Hill be responsible. If y~u, as the ~wner sign as the contractor, you are indicating that you, rather than the contractor, are resp~nsible for the work. If the ce,ntractor wishes y~u to sign as c~ntractor that lay be an indication that he is not pr~perly 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 STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Ho~eowner's Protection Guide" prepared by the Florida Departlent of Agriculture aod Consumer Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of " the above described docurne~\ and ~roffii5e in good faith to deliver it to the "owner" prior to COlmencement. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all Nork Mill be done in co~pliance with all applicable laws regulating construction, zoning, and land development. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installati~n has c~&!enced prior to issuance of a perlit and that all Nor\: will be perf~rmed to meet standards ~f all liWS regulating construction, City codes, zoning regulations, and land development regulations in the jurisdicti~n. I also certify that 1 understand that the regulations of other governmental agenci~s may apply to the intended ~ork, and that it is ay responsibility to identify what actions laust take to be in cc,mpliance. Such agencies include bllt ~le nc,t litlited to: I Department of Environmental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive Lanas, Water/Wastewater Treatment I Southwest Florida Hater ManaQe~ent District - Wells, Cypress Bayheads, Hetland ~reas, Altering Haterc~urses I Ar~y Coros of Enoineers - Seawalls, Docks, Navigable Waterways I Departlent of Health L Rehabilitative Services. Environffiental Health Unit - W~IIs, Wastewater Treat~en:. Septic Tanks I US Environcental Protection ~Qency - Asbestos abatement I also certify that, if fill material is to be used in FIMd Zc,ne .~. or .~,etc.", it is understr,(,d tt.~t a drainage plan addressing a 'colpensating volu~e" will be sublitted which is prepared by a professional engineer reqistaied in the State of Florida prior to permit iss~ance. A per~it issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, ~r set aside any provisi~ns of the technical codes, nor shall issuance of a p~rmit prevent the Building Official fro~ thereafter requiring a correction Df errors in plans, construction, or violations of any code. Every permit issu~d shall bec~.e invalid unless the work authorized by such permit is com~enced within six months of issuance, or if Mork author lied by the perlit is suspended or abandoned ftor a peric,d of six lonths after the time the Ilork is CO!!lffienced. One 9(; day c.~t,,;,;:i(lll e,f tile, say be allowed for the per~it with fee charge of $15.00. The extension shall be request~d in writing to the Building Official. An approved inspectie,n l!Iust be lc.ggedduring each six Mnth period, c,r the project liill be ct'nsidered abailde,ned. 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_-:'-.ctz;;~. ...~.. '7 OW1R OR.. GENT DATE____~--_~~-~---~--~~---------- NOTARY AS TO \.-_ ~ ~'\ ~ ~TARY AS TO\ r-~-'~ '\'\~ ~. ~ OWNER OR AGENT~~_ ~_~~j~~~J-~~~ CONTRACTOR__~~_ ._~~~~~-~~~~~~( NorA~' STATE OF FLORID A.- . ~ NOfARY PIC, STATE OF FLORIDA'.nn.,~ MY COMMISSION EX.I"III":;&",,,ON EXPORES, APRILS, "93.. M COMmSSION ~ON EX"RES, APROL 5. '99.C Elo,,,OliL:l TI'mO"'Flt71'iRrI'tlllCT/:"0Ntl"ERWRTTER..-- · IE H HG'f".......-f'i:t't1...t(MtN~.............lTE1<S- SIGNATURE DATE_____~-~-~-~~-~~-----------