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Home My WebLink About91-1626 STATE OF FLORIDA City of Zephyrhills B 't> 20,0 /~~ ~ PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PL/ M~ Permit N~ 1626 G=- )- 8- q / Date Property Owners Name: Mi. h, ..To~ A ,"- Job Address: . 5' 5lJ ~ - 1> fl.... ~ '+,. Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of VVork '5Cr.i2..v'lCl~ \.Jr-G MOe Energy Code Readout: + 7-(0- '(I f;.,f Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: N/t-l OCCUPATIONAL LICENSE # Jo ZOO Fee: O. . C53 SIGNATU~~.... ffi . COMPANY ADDRESS TELEPHONE # All work shal! be performed in accordance with the above and all City Codes and Ordinances. Ftr. Pre SLB Lintel FRM. Insul.C VVL SLB Tub Set VVater Sewer Final Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of tulldf. MQ) dollars shall be made for each ... /r.i-d..e... (is: ffD) (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 OF ZEPHYRHILLS BUILDING DEPARTMENT ADDRESS \(\.~- ~" ~\0...C- '- ~ K ~ t..\ \...\ \- \ 2- ~ ~_ D JOB LOCATION ~........~- 0 :::,-- PHONE '),~ .1~0 '-I LlO APPLICANT OWNER "\'-r. "l,k.4. ~'Z.. A. r<.. .a f? r '--:-- 2)' I , LOT SIZE X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. tF WORK PROPOSED:____New Construction _Addition _Alteration ____Repair _Install ____Sign/Temp. _Sign _~love _Demolish PROPOSED USE: _Single Family _M/F _# of Units ._M/H _Commercial _Indust. _Swim. Pool Other _Restaurant & Health Department Approval BUILDING SIZE: x Square Fee t, Height RESIDENTIAL: COMl-IERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~lS. ** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING ~ELECTRICAL $ Valuation of Total Construction ~o U AMP Service ~ Florida Pmver Corp. _\-l.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLlJMBHtG GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration 4~ ****************************************** BUILDER Signature ELECTRICIAN ~. ~~~~,~\....~ Company 7-r \.\ \\....L,\ ~~c..'X _ ~ ~IQ..U\ c.2 ~ ~ ~~ State Cert. or Regist. il C)c.JO?-\Co&:- Si!!nature-..........~~ \-..-/L-) City License Registration il It\ fe* **** ******** ****** * *,~ ** ** ,~*,~ -;: ,': -;:,~,~ ,': -;: -;: -;: ,': PLUMBER Company State Cert. or Regist. 0 Signature City License Registration il **************~***+~********************** MECHANICAL Company State Cert. or Regist. 0 Signa ture . Ci ty License Regis tration ii ****************************************** OTHER Company State Cert. or Regist. # Signature City License Registration # APPLICATION APPROVED BY .PERl'lIT OFFICER. CONDIT.IONS OF PERMIT AFFIDAVIT A": NOT I CE: OF DE:E:D RESTR I CT IONS:. . The under5ign~d underst~nds that this per.it .ay be sublect to "deed restrictions' which may b~ ~or~ restrictive than City regulations. The undersigned assules responsiblli'~...f~.~ co.pliance with any applicabl~ deed restrictions, .:' ':.~" ',. '. . ~ B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ONner has hired a contractor or contractors to undertake Hor~, 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 OMner and contractor ~ay be cited for a misdemeanor violation under state laM. . If the OHner or intended contractor are uncertain as to what licensing r.g.I.....,. .., .,,1, f.. 'h. I.t..d.d ...k, th" ... ."I.,d ,. ".1." ,.. "" ,. z.,.,.hl'l. ,,,\"., ,.,..1..." "'31 7BB-bbll, Further.ore, if the owner has hired a contractor Dr contractors, he is advised to have the ce,ntractor!s) sign portions of the 'Contractor Sections' of this application for which they Hill be responsible. If you, as the owner sign as the contractor, ,.. ... I.dl"".g th.t "', ..Ih.r th.. tho ,..t,.,t.., ... ,..p...lbl. ... 'h. ...k. \. 'h. ,..'r."" ...h.. ,.. ,. "g. as contractor that aay be an indication that he is not properly licensed and is not entitled to ?er~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 ,..,11, 'h., I, tho .ppl"..I, h." b... p..,ld,d .I'h . ,.p, ,. 'FI,.ld.'. "..,.."... L'" L.. - H..,...,.'. p..,.,I'.. Guide" prepared by the Florida Departsent of Agriculture and Consumer Affairs. If the applicant is SO~Eone other than the ....,.., I ""," th.t I h'" .b'.I.,d . ,.p, .f Ih, .b'" d.".,b.d d.'...., .,d p""" i. g..d f,"h I. d,\"" " ,. ,.. "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 wort will be done 1n co~pliance with all applicable laws regulating construction, zoning, and land development, Application is hereby aade to obtain a ~erlit to do Mork and installation as indicated. I certify that no work or installation has co&!enc~d prior to issuance of a perlit and that all wor!: Hill be performed to roeet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. 1 also ""," Ih.t 1 ..,...,..d Ih.1 'h' ,."I.tl.., .f ,Ih,. g.,......,.l .g..,'" ,., .~p\, ,. ,.. .",.d., "", ." 'h., ., .. ., ",p,,'ibil ii, t. ",,' ii, .h., "Ii,", I ",t to" ,. b. i. ",pli .".. S"h .,.""" i" \.d. b", ". ,." \ i .i1,d '" I Department of Environ~ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensi\iv~ L3naS, Water/WasteMater Treatment I Southwest Florida Hater ManaQelent District - Wells, Cypress Bayheads, Hetland Areas, Altering Hatercourses I Army CorDs of EnQineers - SeaHalls, Docks, Navigable Waterways I Depart.ent of Health L Rehabilitative Services, EnvirDn~ental Health Unit - W(lls, Wastewater. Treal~en~, Septic Tanks I US Environoental Protection AQenci - Asbestos abatement I also certify that, if fillllaterial is to be used in FIMd Zone "A' or 'A,etc.', it is understc,c,d th,t a drainage plan addressing a 'co.pensating volule" will be sublitted which is prepared by a professional engineer reqist~ied in the State of Florida prior to perlit iss~ance. A p,..I' I".,d ...11 b. ",,'r..d " b, . 11".., t. p..",d .ilh 'h. ...k "d ..1 .. ..,...i', " "'\"', ,..,.1 .1"., ,. set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter .".1.1., . "..,,".. ,. ,..". ,. pl"', ,...I..,ti.., " ,i.\.,I... ,. .., "d.. ".., "..., .,.".. ,h.ll b.,.., ",,\'d unless the work authorized by such permit is commenced within six months of issuance, or if work aulhofl]ed by the perlit is ...p..,., o. ....d..., f,. . p..I,d .. .1, .,.th. .f'.' tho 'i., ". .or' ., ,.....,.d. 0.. 9' d., "1..,1,,, ,I ,..., .., b. allowed for the per~it with fee charge of $15,00, The extension shall be requested in Hriting to the Building Official. An approved inspec\ie,n /!lust be lc.ggedduring each six Mnth period, CoT the prc,jl:d \iill be [(,nsidered dl)diidoned. 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 EEFDRE RECDRDING YDUR NDTICE DF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGN~~-- . CONTRAC~- __,/ \,;-:Z ~ SIGNATURE_~~~ ~ -- -----~----- OWNER OR AGEN DATE___:t~_~~_:1j----------------------- ::~::::::::::T:~~~~0~~~~ .-~~~~--~~T,f~~fS~~~IT~ DATE___:I:=:-~~--~~---------------- NOTARY AS TO ~~ . "M ' CONTRACTO~___ '-<!..~:'~-;:'.7F-cf!.- ~ ."''1 [l'i.:"}C ST~.TF./OF fLOn,)!\ MY COMMISSION EX,:: \,~,?2:i.wLLii'_,)'i~':-:';;4~2'!.- B()\\J;;;; 'In'd CS',;:":;".:. 1:';". \j,IL'.