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HomeMy WebLinkAbout91-1620 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit :N~ 1620 E - "'l II Date /- 0' - Type of Permit ~~ Q./)' / Property ownerS..."Name: (;Y.4~ (~"-1-1./1- Job Address: ~\ 9d-.Y7 <3 A4 ()~ PL~ MECH~L Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of vvorkfl () A~ Energy Code Readout: ~t:' Complete Plans, Specifications and Fee Must Accompany Application Fee: ;;Lo -- u>-J) SIGNATURE tt 1 d C COMPANY ADDRESS TELEPHONE # G~n- J- Estimated Cost: '-.6 ---{) 7J. tJ{) All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE # ~ 0UILDIN~ Ftr. Pre SLB Lintel FRM. Insul.CL VVL PL~ SLB Tub Set VVater Sewer Final ELECT~ M~ 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 NR (t 19.00) dollars shall be made for each .../Y'd.-de. (/6';tJ!J) (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 OFZEPHYRHILLS BUILDING DEPARTMENT OWNER fi51 ~ COO1-Je'-j 3m !tift Zej"i\1rh',lls . Sf\~f- f\-~ t\~\)C S~<<\E- , ?ftj4 7 F( PHONE .9 'J / - / /5'/ APPLICANT ADDRESS LOT SIZE_X AREA SQ. FT. Jon LOCATION LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D .IF WORK PROPOSED:____New Construction ____Addition ____Alteration ~epair ____Install _Sign/Temp. ____Sign _l':iove _Demolish PROPOSED USE: _Single Family ____M/F _IF of Units ._H/ll. _Commercial ____Indust. _Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: x Square Fee t, Height RESIDENTIAL: COWtERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.'~* **COPY OF CONTRACT REQUIRED, ~ERMTTS REQUESTED ~UILDING o( $ SM--" Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. .... GAS Valuation of Mechanical Installation V ROOFING SPECIALTY _MECHANICAL $ _PLlJMBIN'G TYPE OF CONSTRUCTION: _Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT, ****************************************** Signature ~ONTRACTOR SECTION Company State Cert. or Regist. 0 City License Registration ~fr ****************************************** nUll.DER Si!!nature Company State Cert, or Regist. 0 City License Registration 0 ****************************************** ELECTRTCIAN Signature Company State Cert. or Regist. 0 City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. 0 City License Registration 0 ****************************************** MECHANICAl. Signature Company State Cert. or Regist. 0 City License Registration 0 OTHER APPLICATION APPROVED BY ~~*~******************~~***~~~~A~~~~AA~~~A ~" . .~,. ............................... eM. Ala >t! d /I 4A_) , PERtlIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A,': NOT I CE OF DEED RESTR I CT IONS:. . The undersign~d understands that this perlit lay bl subject to "deed restrictions' which ~ay b~ more restrictive than City regulations, The und~tsigned ISSUles responsibili~y.for compliance with any applicable deed reslriclion~. . "', 8, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake wDr~, they may b& required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the OHner and contractor nay be cited for a .isdeleanor violation under state lall.. If the [,wner c,r intended cCl.ntracte,r are uncertain as to whal licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departeent, (813) 788-6611. Furthermore, if the ollner has hired a contractor or contractors, he is advised to have the contractorts) sign portions of the "Contractor Sections' of this application for IIhich they lIil1 be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to 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 provid~d .ith a copy of 'Florida's Construction Lien Law - Homeowner's Protection Guide' prepared by the Florida Depart~ent of Agriculture and Consumer Affairs. If the applicant is sOleone other than the 'owner', I certify that I hav~ obtained a copy of.the abov~ described document and proffiise in good faith to d~liver 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 work will be don~ in co~pliance with all applicable laws r~gulating construction, zoning, and land d~velopment. Application is hereby aade to obtain a perait to do 1I0rk and installation as indicated. I certify that no work or installation has co&~enced prior to issuance of a p~rlit and that all work will be performed to roeet standards of all laws regulating construction, City codes, zoning regulations, and land dev~lopment regulations in the jurisdiction. I also c~rtify that I understand that th~ r~gulations of oth~r governmental agencies may apply to the intended work, and that it is my responsibility to identify what actions I lust take to be in compliance. Such agencies include bllt i\1e n,,1 li'lited to: I Departlent of Envi,onm~ntal ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensi live Lands, Hater/Wastewater Treatment I Southwest Florida Water ManaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering HatercDUfses I Army CorDs of Enoineers - Seawalls, Docks, Navigable Waterways I Depart.ent of Health L Rehabilitative Services, Environmental Health Unit - W~lls, WasteHater Treat~En:. Septic Tanks I US Environ~ental Protection AQency - Asbestos abatement I also c~rtify that, if fill lIat!?rial is to be used in Fle.od Ze,ne "A" or '!\,etc,', it is underste,od tll~t a drainage plan addressing a 'co.pensating volullle" will be sub.itted which is prepared by a professional engineer registired in the State of Florida prior to permit issuftnce, A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every per~it issued ~hall becole invalid unless the work authorized by such p~rmit is cOlllmenced within six 1Il0nths of issuance, or if HOI.k authoflzed by the perlit is suspended or abandoned for a period of six tonths after the time th~ uork is commenced. One 90 day ~=te~5joll of tiae, ~ay be allowed for the per~it with fee charge of $15,00, The extension shall be requ~sted in uriting to the Building Official. An approved inspectic,n /:lust be Ic,ggedduring ~ach six Mnth period, c.r the project I;i 11 be c(,nsider",j dbaiidc,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__~w&lR-~---~----- DATE_________~~_~~_1L____________________ SIGNATURE ------------------------------ CONTRACTOR DATE ----------------------------------- NOTARY AS TO O~NER OR AGENT _~~~1:i~2 MY COMMISSION EXPIRES'T 01"'1"------------- NOTARY PUBLIC, STA F LV'''''''' MY COMMISSION EXPIRES: NOV. 16. 1992. BONDEO THRU NdTARV PUBLIC UNDERWRITERS.iI NOTARY AS TO CONTRACTOR_____________________________ MY COMMISSION EXPIRES__________________