HomeMy WebLinkAbout91-1610
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813.788.6611
Permit N~
1610/,-1
Date
Type of Permit
B~ EL~ pl~G ~I~
Property Owners Name: ~~_~.,t7A1.." ?~,;J
Job Address: '-??- 3 Y b - /7_d aJ-€
,r - c
b ._~ -'7/
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: / / - _~ 6 - d-I ~., P / D
Description of work;rf/C (~-f./JLrJp7 La.~J-
Od...5C)U
o d--O /
Energy Code Readout:
~l'L
7-(0-1/ ~
,
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: I 'f7 b ,-;J. . CT{)
/
Fee: ~'~ ~'
K~
L;('S--' OV
SIGNATURE ~-,'------
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE # 9/ 1/C. &4,
BmLUI~
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C MECHANICAL' /
-----_/
Ftr.
Pre SLB
lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Canst. 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 t (II = ee)
dollars shall be made for each Mp../J"d.- cLe f-5""": OP )
(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.
FORT LAUDERDALE
-:lSOO S.W. 21st TERR. e. 103
FORT LAUDERDALE. Fl333t2
.. DADE: 821-8412 -
~QWARO: 791-5606
'.8OCA RATON: 3lI8.,.189
'''''''~West,'''' 'ISPNo. 49902
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WEST PALM BEACH
1387 N K1LUAN
;.pASCO
:;846.1212
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DEPOSIT .$ .lJ.Ci!ITn..s ~I( NATUrlE -<;
BALANCE DUE $..... CARD EXP. .. ~
'-J NO. DATE
LAKE PARK. FL 33403 FT. MYERS. FL
'PALMBCH.: 84&-1407 CHARl.OTTE:
. MARTlN: 283-8469 ..c' teE: 215-8720
lIT. WC'~4:8d.()2?~ . .~ :'_'). i 'c:;OL,U~: 69.7..,,1~ .
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1187.0395
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11
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
~".. ~
.. ...~. ~f
APPLICANT ~d.'
ADDRESS ,3 ~~ .... ii'~PHONE 7cfj ~o cfk,
/) ;rT 11} 8 E It) J-. fH_!'< A-I? D
983 yt, If re f\-LI
OWNER
LEGAL DESCRIPTION: LOT(S)
BLOCK
LOT SIZE X AREA SQ. FT.
SUBDIVISION . 'VJS
JOB LOCATION
PARCEL I. D. ~1 -, 1- l.b - 2{ _tH) I V -- 02 ~ 00 -" 20 \
WORK PROPOSED:____New Construction ----Addition ~lteration ~epair ____Install
_Sign/Temp.
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
~/F
_41 of Units
~/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.
PERMITS REOUESTED
_BUILDING
$ f'flt-L. ~
Valuation of Total Construction
, '
_ELECTRICAL
~ECHANICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
$
17"'{;;) : :!!-
Valuation of Mechanical Installation
____PLUMBING
~
.' ,
GAS '
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
~.~ CkcV1~~-' .:---t-. (tiv\~r~jcYL
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
Signature
SilZnature
Company
State Cert. or Regist. #
City License Registration #
******************************************
F.T.F.CTRTCTAN
Company
State Cert. or Regist. #
City License Registration ~1 _
******************************************
PLUMBF.R
Signature
MECHANICAL
fflcJ-I M 0 yfvr,..612
.
Signature
Company (1.1/(> c.. u KI rt? Q 1.. ..f' tJ
State Cert. or Regist. ~~ C I~C: 0 3../'1.f 'Jt
~/!'/ .&- City License Registration 41 ~\
******************************************
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 pertit .ay be subject to 'deed restrictions" which tay be tore res~rictive than City
regulations" T~I undersigned a~lu.el reIPonlibilitY,:for co.plilnce with any applIcable deed restrictions.
" '
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they tay be required to be licensed in accordance with
state Bnd local regulations. If the contractor is not licensed as required by law, both the owner and contractor .ay be
cited for a .isde.eanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing
require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, 18131
788-66l1. .
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) 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 Ire indicating that you, rather than the contractor, are responsible for the work. If the contractor Nishes you to sign
as contractor that .ay be an indication that he is not properly licensed and is not entitled to pertitting 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.eoNner's Protection
Guide' prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the
"oNner', I certify that I have obtained a copy of the above described docutent and pro.ise in good faith to deliver it to the
'oNner" prior to co..ence.ent.
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 co.pliance Nith all
applicable laws regulating construction, zoning, and land,develop.ent.
Application is hereby .ade to obtain a per.it to. do Nork and installation as indicated. I certify that no work or
installation has cot.enced prior to issuance of . per.it and that all Nork will be perfor.ed to .eet standards of all laNs
regulating construction, City codes, zoning regulations, and land developtent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies tay apply to the intended Nork, and that it is
.y responsibility to identify Nhatactions I .ust take to be in co.pliance. Such agencies include but iU e IIOt li.ited tot
I Departlent of EnvironlentSl ReQulation ~ Cypress Bayheads, Wetland Areas and Environ.entally Sensitive lands,
Water/WasteNater Treattent
f SouthNest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I Ar.y Corps of EnQineers - SeaNalls, Docks, Navigable Waterways
f Departlent of Health L Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
f US Environlental Protection AQency - Asbestos abatelent
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 "co.pensating volute" will be sub.itted which is prepared by a professional engineer registered in the state of
Florida prior to per.it issuance.
A perlit issued shall be construed to be a license to proceed Nith the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Official frot thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issu~d shall beco.e invalid
unless the Nork authorized by such perlit is co..enced Nithin six .onths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six .onths after the ti.e the work is cot.enced. One 90 day extension of tite, tay be
alloNed for the per.it Nith fee charge of $15.00. The extension shall be requested in Nriting to the Building Dfficial. An
approved inspection .ust be logged during each six tonth period, or the project will be considered abaudoned.
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".
SlGNATURE~~_~~____
DATE___~__af2___Lcz].L________
:~:y OR A:N ._ iJ ______m ~~*:~c*~~~_ ------~-----15------
. ,UC, State of Florida at large / ~ ~ ;.:
MY COMMISSIm -:":"~~~:~~ie~ ~ 1~~_ MY COMMISSION EXPIRES___f',L~_~.!~____
. -~-~ .
SIGNATURE_~~~~-~____-__--__-
CONTRACTOR
DATE__________~~~~-~L