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__________________