HomeMy WebLinkAbout91-1611
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STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788.6611
Permit N~
1611h
Type of Permit
~
4 be 4
Property Owners Name: ~ ra.....n~
Job Address: /7 A.... 1:.) -- / d , ;z;( 4
Date---L2" -,.)-.5._- :? I
~
.~
M ECf::tA-NJ CA L
(j/ ~''<L. L
.~
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: d - d b - j;L: - 0 0 -;. i) <) 0 - ~ -.:; n -
DescriplionofWork ~Q i!!4->L-rit _ ~ - ~ '" A ~fj-9-
o (J c> c:;J.- /
Energy Code Readout:
(f 7-2.-,/1 /fJ.1jJ
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
4ft
OCCUPATIONAL LICENSE #
Fee: .:0 -" . crv ~
SIGNATURE.&v/~"l2#.
COMPANY 1);// PY'fty - -~ _ _
ADDRESS .3 DJ- C~Y'f51-/~ '1/ M-. J:H41>b Of I-y
TELEPHONE # '-).~ (-060 s-
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
~^~
I. BUILD1~; : -
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
<:::-
PL~
-.
EL~L
-----
M~AL
~.
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons. a charge Of-IIR (5:t O.QO)
dollars shall be made for each ~.I T' d. d e (/~__ OV)
(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.
APPLkCATkON FOR PERMkT
CITY OFZEPHYRHILLS
BUILDING DEPARTMENT
. APPLICANT .:J3 ; I / V t<. ~y
3':'- .... /'lIr .. ,t,,(.
ADDRESS 0 6 L ...AA V } 5>' 'f- / A- ...v'
,:;U~ J5,q~)L
JOB LOCATION I);;' 0 / ~');{ CJ-j-,.2, If' LOT SIZE
LEGAL DESCRIPTION' LOT (S) ~ BLOCK \"- SUBDIVISION 2 '" ~y ~ i I ~ &b'r- 'ft"n""j>A.v~
PARCEL I.D.~~ 01- a.b - ':J..{-'b'" ~I')6)O- 4-00- C>~";L}
,
Pd. 1).c.
Fl.
PHONE
"e!)2J-CJ66_') - :.
'.,' "
OWNER
x
AREA SQ. FT.
WORK PROPOSED:____New Construction '~ddition ~lteration _Repair ____Install
I:. ~ .'
____Sign/Temp. _Sign _Nove A-DemoliSh
PROPOSED USE: ____Single Family '.~M/F --'-~~ of Units __H/H
_Commercial ~Indust. _Swim. Pool Other
_Restaurant & Health Department Approval
.?O xei. '>;0 (0 r--
BUILDING SIZE: Square Feet, Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COM.l'1ERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.H
**COPY OF CONTRACT REQUIRED. '
,PBRMTTS REQtmSTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida power Corp.
H.R.B.C.
____MECHANICAL
$
Va~uation of Mechanical Installation
....
GAS
ROOFING
SPECIALTY
____PLUMBIN"G
TYPE OF CONSTRUCTION: ____Block ____Frame _Steel
_Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
~ONTRACTOR SECTION
Company
, State Cert. or Regist. n
City License Registration ~~
******************************************
nUTT.DER
Si!:'nature
Company
State Cert. or Regist. U
City License Registration 0
******************************************
ELECTRTCTAN
Signature
Company
State Cert. or.Regist. ~
City License Registration 0
*******************************~**********
p'LUMBF.R
Signature
Company
State Cert. or Regist. 0
.City License Registration 0
*************************K***************6
HECHAN1CAL
Company
State Cert. or Rcgist. 0_
City License Registration
If [))(:> '/ J.../'7 I / /17
"
1r
Signature
**********************************f*******
PERl-lIT OFFICER.
APPLICATION APPROVED BY.
"
CONDITIONS. OF PERMIT AFFIDAVIT
A.',' NOT 1 CE OF D~EO RESTR I CT IONS ;.. ,
The underslgn~d understinds that this perllt lay b~ subject t~ "d~ed restrlcti~ns' ~hich ~ay b~ ft~re res'rictive thin Ci.y
regulations. The undersigned a55Ules responslblll'~,fo~ co.pliance with any applicabl~ d~~d r~strlctions.
0:' ,:.\' ." ,I '.
E. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
; ,\, ~,:.,
If the ~Nntr has hired a c~ntractor or contractor. to undertake Hor~, they may b& r~quir~d t.~ be licensed in accordance with
.~ate and local r'gulati~ns. If the contractor II not licensed al required by law, both the ouner and contractor ftay be
cIted for a lisdeaeanor violation under state law.', If the ~wner ~r intended c~ntract~r are uncertain as to what licensing
requirelents lay apply f~r the intended work, they are advised to c~ntact tho City ~f Z~phyrhills ~uildin9 Departeent, [913)
7B9-6611. ......
Furthermore, If the owner has hired a contractor Dr contractors, he is advised to hav~ the c~ntractor(s) sign porti~ns of the
"Contractor Sections" of this application for which thoy will be resp~nslble. If y~u, as the ~Hn~r sign as the contractor,
y~u are indicating that you, rather than the contractor, are resp~nslble for tho H~r~. If t.he c~ntractor wishes y~u to sign
as c~ntractor that aay be an indication that he is not properly licensed and is not entitl~d t~ p~r&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 cedify that I, the applicant, have been provided with a cop.y of "FI~rida's CClnstruction Lien Law - Hc,aeowner's Prcdection
Guide" prepared by the Florida Depart.ent 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 d~cument and pr~mi~e in g~od faith to deliver it to the
"owner" prior to cOI~ence~ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
1 certify that all the information in this application is accurate and that all MDrk "ill be done in cD~pliance with all
applicable laws regulating construction, zoning, and land develop~ent.
Application is hereby lade to obtain a penit to do llork and installatit.n as indicated. I certify that nc. "'clr~ or
installati~n has c~&~enced prior to issuance of a perlit and that all w~rk will be perf~rmed t~ roeet standards of all l~."s
regulating cClnstrudicln, City cc.des, zoning re.gulations, and land devele,pment regulatic.ns in the jurisdicticln. I also
certify that I understand that the regulations of other governmental agencies ~ay apply to the intended Hork, and that it is
flY responsibility to identify what actions I lDust.take to be in ccllllpliance. Such agencies include bllt ~le Ii,.l li,lited to:
I Deparhent of Envir'oneent"al ReQulation - Cypress Bayheads, Hetland Areas and Envirc,nmentally Sensi live L~ifds,
Water/Wastewater Treatment
I Southwest Florida ~Iater ManaQellent District - Wells, Cypress Bayheads, Hetland Areas, Altering Hatercocrses
I Army CorDs of Enoineers - Seallalls, Docks, Havigable Waterways
I Departlent ~f H~alth L Rehabilitative Services. Environ~ental Health Unit - W~lls, Wastewater Treat~!n~. Septic Tanks
I US Environ~ental Protection Aqency - Asbestos abatement
I also cedify that, if fill material is to'be used in Flood ZClne "fl" or "A,etc,', it is understc,c,d 1I,~t a drainage plan
addressing a 'colpensating volume" will be sub.itted which is prepared by a professional ~ngine~r regisleied in the State of
Florida prior to permit iss~ance.
A permit issued shall be construed to be a license to proceed with the work and not as authDrity to vio]~te, cancel alter, ~r
set aside any provisi~ns of the technical codes, nor shall issuance of a permit prev~nt the Building Official froft thereafter
requiring a correction c,f ernrs in plans, construdicln, ~r violations ~f any cClue. Every p~rllit issued .hall becc.1t innlid
unless the work authorized by such permit is commenced llithin six months of issuance, or if lIol.k authofJzed by the perlit is
suspended or abandonod f~r a period of six lonths after the tillle tho "or~ is co~menced. One 90 day e=te~5ioll of tile, say be
all~wed for the per~it with fee charge of $15.00. The extension shall be requ~sted in wriling to the Building Official, An
approved inspectic.n /!lust be IClggedduring each six 1II0nth period, Cor the prc,j~ct ui 11 be cc.r,siGNed dt>aiiGclrlfd.
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".
o/YIGNATUR~;::~~~i:~~JQ'!~----- SIGNATURE~-
DATE_____~~_~_~~~~lJ----------------------
/ ;;: <- 0.":/
DATE____~2.~:.:__~~_:_.2.__________________
NOTARY AS TO 1/ . / .. --tv' _ . (/ NOTARY AS TO )i. /:/ L-J..I}})/ /;: l)
OWNER OR AGENT Ai!~{:!:0:;..___jel!~~----~ CONTRACTOR_4':l(~!_~~t-g:-- _:f! .f_::'_--
NOTARY PUBud. STATE OF FLORIDA.. .
MY COM,.... ISSION EXPIREdllYCOMMlSSIONEXPIRES: MAYZ5, 199!. MY COM~lISSUlN r:''iPTRFS
;., . ~1;l&g.:r~uall-IWItUc..WlnIE&l.WlUrER.J I't()1'ARY-PUBl.lc;SnrrE"OF~[6'RiDA:.---'----
MY COMMISSION EXPIRES; MAY 25 1993
BONDED THRU NOTARY PUSLIC UNOER';RI'J'ER;.
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