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Home My WebLink About91-1622 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N~ 1622.E Type of Permit B~ ~CT~I~) Date~7 - 3- / / PL~ MEC~AL Property Owners Name: 21C-<..A-____ct/L/{f-+/ i2../\- 0:.- ;;:2. Sa:: / b, ZX (h~ Job Address: Legal Description: Sub.Div. Lot Blk. 70- (~/.;;LO Zoning CI: J ~ - d- (, - = Description of VVork ~.A .A/'-t: - - - ;;;~ :i~9~6 Energy Code Readout: 7-S-~d ~~ Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: ~~A Fee: d 0 - U() SIGNATUR":';;"#.If ~//741 COMPANY ADDRESS TELEPHONE # All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE #/ ,73 Md' ~_ P~ ..............., SLB Tub Set VVater Sewer Final ~~~~r ELECTRICAL .' Tp.Serv. Rough In Meter Can Canst. Pole Pool Pre-Meter Final M EC ttA.ttlCA L ~. ~~ Ftr. Pre SLB Lintel FRM. Insul.CL VVL Breakers Ducts Insl. Compressor Final Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge oft.... ~!J18.8tJ) dollars shall be made for each~./Y'..il-de. (/,:;-;c7lJ) (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. r APPLICATION FOR PERMIT CITY OFZEPHYRHILLS BUILDING DEPARTMENT OWNER 7n/J. 7) fJ-rVJer VeerV' 6- ;;l. 3 ~ /b. r)... ~ , /n1. UfitVder ueery- JOB LOCATION 0-;;' 3 fl / t" [J:..- J-r. PHONE APPLICANT ADDRESS LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. ~~ J J - d- I., " ;;2 j - 00/ 0 -' ) 7 q 0 0 - '7 () - OJ~o WORK PROPOSED:____New Construction ____Addition ----Alteration ____Repair ____Install ____Sign/Temp. _Sign _l'love ____Demolish PROPOSED USE: _Single Family ____M/F ____~~ of Uni ts .____1'1/ II _Commercial ____Indust. ____Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: x Square Fee t, Height RESIDENTIAL: COl'fr1ERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl'lS. ,~* **COPY OF CONTRACT REQUIRED, PERMITS REQUESTED ____BUILDING Valuation of Total Construction L-- ELECTRICAL AMP Service ~ Florida PO\,er Corp. _H.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLlH-lBHfG GAS ROOFING SPECIA1.TY TYPE OF CONSTRUCTION: _Block _Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. 0 City License Registration ~t ****************************************** BUILDER Signature /) ~/" c.1 r > ~ .~~' ET.ECTRTCT AN t" ~/.:247~ ~:/.?../'...r p~ Company ~1i ;;~ y;J~~/ --Jl/ State Cert. or Reist. iF E.R,. DO 11039 Si!!nature /./?..-7. ~ /,_ ~~ City License Registration il -P:- /? ~ .,~. *f,* :k, * f,* * ****** ******* ,~* * * *,~ *,~ 1:" -!:,~"" 1: 1: 1:" Company State Cert. or Regist. ~! City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. 0 City License Registration # ****************************************~* I'1ECHANTCAL Signature Company State Cert. or Regist. 0 City License Registration 0 OTHER Signature APPLICATION APPROVED BY **~*************************************** '// d4U',{~ .x-'o/ --<'_^ ~ , PERI-lIT OFFICER. CONDIT.IONS OF PERMIT AFFIDAVIT A": NOTICE OF DEED RESTRICTIONS:. . The undersignvd understands that this perlit lay bl subject to "deed restricti[,ns" which. may b~ 5or~ res~rictive than City regulations, The undvrsigned assumes responsibill~r.fo~ compliance with any applicable deed restrictions. ." . .\ '" .'\, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake work, they may b& required to be licensed in accordance with stlh and local regulations. If the contractor is not licensvd as requirtld by law, b[,th the oltner and contract[,r nay be cited for a aisdeaeanor violation under state law, . If the owntlr or intended contractor are uncertain as to what licensing requireaeots aay apply for the intended Hork, they are advised to contact the City of Zephyrhills Building Departeent, (B13l 711B-bbll. Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractortsl 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 are indicating that you, rather than the contractor, are responsible for the worr.. If the contractor wishes you to sign as contractor that aay 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 with a copy of 'Florida's Construction Lien Law - Ho~eowner's Protection Guide' prepared by the Florida Departaent of Agriculture and Consumer Affairs. If the applicant is soeEone other than the .owner', I certify that I have obtained a copy of. the above described document and pro~i~e in good faith to deliver it to the 'owner" prior to cOI~encement, E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in co~pliance with all applicable laws regulating construction, zoning, and land develop~ent. Application is hereby aade to obtain a pertit tD do work and installation as indicated. I certify that no wor~ or installation has commenced prior to issuance of a perlit and that all wor\: will br. performed to meet standards of all laws regulating construction, City codes, 20ning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may apply to the intended wor!:, and that it is my responsibility to identify what actions I lust take to be in cc,mpliance. Such agencies include bill ,,1 e m,t li~ited to: I Department of Envi~onmental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive Lands, Hater/Wastewater Treatment . Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Hatercourses I Ar~y Coros of EnQineers - Seawalls, Docks, Navigable Waterways . Departlent of Health L Rehabilitative Services. Environmental Health Unit - W~lls, Waste"ater TrEal~en~. Septic Tan!:s I US Envifonoental Protection AQenct - Asbestos abatement I also certify that, if fillllaterial is to be used in Flc.od Zc.ne "A" Of "A,etc.', it is underste,c,d t1"t a drainage plan addressing a .colpensating volule. will be sublitted which is prepared by a professic,nal engineer rEgist~jed in the State of Florida prior to permit issu.ance, A perlit issued shall be construed to be a license to proceed with the Hork 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 c,f ern<fS in plans, cc'nstructic,n, or violatic,ns c,f any cc,de. Every pefilli t issued :hall bece,.e in"al id unless the Hork authorized by such permit is coamenced within six months of issuance, or if \lor\: authofliEd by the perlit is suspended or abandoned for a period of six lonths after the time the Horr. is co~menced. One 90 day 0:IE~5ioll of tia~, aay be allowed for the per~it with fee charge of $15,00. The extension shall be requested in "riting to thQ Building Official. An approved i nsped i [,n r..us t be I eoggedduri ng each si x Mnth peri od, c,r the pre' jed Ii ill be ((,ns i dereo dbalidc'f,ed. 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". SI GNATUREl::Jfj.~~:! d./f!.. d~iaJr~_ ~~tt(JR ~""'''''-~.Y_ DATE___~_;?-_:_~~----------------- ~~~~~YO~SA~~NT~~~~~~~~~~~~C~~R~~---_----------------------- MY COMMISSION EXPIRES__~~;?~~Z:~L__--- MY COMMISSION EXPIRES__________________ SIGNATURE ------------------------------ CONTRACTOR DATE___________________________________