HomeMy WebLinkAbout91-1628
STATE OF FLORIDA
City of Zephyrhills
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Type of Permit
PASCO COUNTY
Permit N~
Legal Description:
Sub.Div. /IJ '-,:J(~-.2 / - / - I ~~
Lot
1628 ~
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~ILDINY
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CELECTRICAU
BUILDING DEPARTMENT
~ -813-788-6611 6J-
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C~ GCHAN~.'.--""'. '
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Property Owners Name:
Job Address:
Zoning CI:
Description of VVork
cSty
Estimated Cost:
.,$ 2. Dut)'
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Fee: rf 2$5' ~ I J / grr J/,j.
SIGNATURE/..~/ //j1.:JJ~J/
Complete Plans, Specifications and Fee Must Accompany Application
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
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COMPANY
ADDRESS
TELEPHONE #
Ftr. I
Pre SLB
Lintel
FRM.
Insul.CL
VVL
"-
ELECTRICAL# l).
U MECHANICA~
SLB
Tub Set
VVater
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Const. 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 tr f'" '^ "(')
dollars shall be made for each -=1 r;;t.cLe (/S: /J7))
(a) Wrong Address ~) /) /J ..' ) {J- / 7 _ ~71
(b) Condemned work resulting from faulty construction 4. .lA..v _
(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.
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NOTES:
1. BOUNVARV SURVEY ONLY.
Z. LEGAL DESCRIPTION FURNISHED BY CLIENT, (DEED)
3. BEARINGS BASED ON DEED DESCRIPTION.
4. THIS SURVEYOR IS NOT RESPONSIBLE FOR EASEMENTS,
RIGHT -OF -WAYS OR ENCUMBRANCES OF RECORD "OT SH()(~N
HEREON THAT HAVE NOT BEEN FURNISHED TO THIS OFF!CE
OR THAT HE HAS NO KNOWLEDGE THEREOF.
S. REVlSEV 6-Z1-!6
TRACT 127
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TRACT 128
* FOR lEGAl. DESCRIPTIOI! SEE
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CITY OF ZE~HYRHILLS
Building De~artment
OWNER E IT R L + 5' i13 \/ L. D /16L&2 y-
JOB LOCA;IO~ ~ -:r 7 C; ::z..;Z ,I {;, it U C( tv .
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LEGAL DESCRIPT.:;Vi \ S e'E? ErN! b l'f A ~.'
LOT 3 7 J,J-:t,
Show all existing and proposed structures giving dimensions and setbacks.
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Street Name 10th Street
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10th Street
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NoTICE
OF
RESOURCE RECOVERY ASSESSMENT FORM
PERMIT II , .. ,..' .' ,
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DATE , _..- ") - :
APPLICANT/OWNER
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COUNTY PARCEL II
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USE/CODE DESCRIPTION
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RESIDENTIAL
NON-RESIDENTIAL
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GROSS SQ. FT. (GSF)
Ii UNITS
RATE/ERU=$50.00 X 0.96*/YEAR OR $0.1315/DAY ERU ASSIGN IF
ASSESSMENT = (IF UNITS)X($0.1315)X(NO OF DAYS) ASSESSMENT=(GSF)X(ERU)X(0.1315)X(NO DAYS)
100
$
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TOTAL FEE
TOTAL FEE = $
PREPARED BY
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* DISCOUNTED FOR PREPAYMENT
-------------------------------------------------------------------------------------
The above assessment has been established pursuant to the Pasco County Ordinance
No. 89-07 and Resolution No. 89-197 as commended.
THE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE C/O. NO CERTIFICATE
OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE ASSESSMENT HAS BEEN PAID.
APPLICANT HEREBY ACKNOWLEDGES RECEIPT OF THI~~ THE REQUIREMENT OF ASSESSMENT
FEE PAYMENT PRIOR TO C/O OR FINp~ RELEASE. I1C"~IVItl
. 1'1 1M
DATE
~~,.,....
RECEIVED BY
---------------------------------------------------------------------------------------
FOR OFFICE USE ONLY
RECEIPT IF :
DATE
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JOB LOCATION
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APPLICATION FOR PERMIT
CITY OFZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
j)/fI(EIIt.
ADDRESS
PHONE
--7C;,/.
/ ~ 2-
,
~ / >0/
OWNER
'J- '2-.
LOT SIZE/1f x /'ifO AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
PARCEL I.D.it I~J - d&- d--/ - J
BLOCK
SUBDIVISION
D4et ~
r12AII~ fJMk~
lJ-t....:....3
WORK PROPOSED:~New Construction ____Addition ----Alteration
_Repair
_Install
____Sign/Temp.
PROPOSED USE: ~Sing1e Family
____Sign
_t-Iove
_Demolish
____M/F
_i~ of Units
__H/H
____Commercial
_Indust,
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE: 23 x~b , / 2- fl'?" Square Fee t, Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL : ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl'IS . *-1:
**COPY OF CONTRACT REQUIRED,
PERMITS REQUESTED
-LBUILDING
V ELECTRICAL
~MECHANICAL
~LUMBUfG
$ J:Jj if7/D .
~{J~
,. .~ I J - -f AMP
$
Valuation of Total Construction
Service
Florida Power Corp.
_W.R.E.C.
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
f!1/lLu IIt-;~ther
TYPE OF CONSTRUCTION: _Block _.Frame _Steel
FINISHED FLOOR ELEVATIONS: FT,
******************************************
BtJII.DER ~
Signature ~J #(t//~v?/
,
CQNTRACTQE SECIlr ~.~.. .,d' ~ d, .r> .....--.
Company ".h:? JO/l.J.n )A' J ~> -?~
State Cert. or -\.egist. if CBG '-40(>~S-
City License Registration if 3/ h
******************************************
Signature
Company Dflnd~en- F~fu~ -4!J. .~
State Cert. or Regis t. ii _~.3 Cell ~
City License Registration;1 .E"C-J;JoDoO<s
*i, ** **** i,* ************** ,,<** ** ,,< -/; ,,< 1: -I: 1: ',<',,< ,': 1: 1: i: ,': ;;J.O :s
#/nn"'~ ~/orl'l h/~Jt c
;-
h9'
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
ELECTRTCTAN
Sipnature L~ L fJJ~
.
PLUI1BER
Signature
~4 d~.'~
Company EXlpf.v7-'YL Ih'~ g~f;'kJn~ k
State Cert. or Regist. !,! <2/1- O~lX.S-..s-
. City License Registration iF 9 f/
I1ECHANICAL
*****~******~****~*****~~~****************
Company
State Cert. or Regist. 0
City License Registration ff
OTHER
Signature
******************************************
rnp"r-BI.?;j '.T.T f"\..}' I .h ~~. V. .E. D B.Y
, ..c'.., .~ .UtA()f """",1
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PERl'IIT OFFICER.
.'-., "--->""'~~'
tONDITIONSOF PERMIT AFFIDAVIT
~
~
A:. NOT I CE: OF DE:E:D RE:STR I CT IONS:. ,
The under5ign~d understands that this perlit lay be subject to .d~ed restrictie'ns' which ~ay b~ $Dre res~rictive than City
regulations, The und~rsigned a55Ules re5pons1bil1'Y.,f~.~ cotpliance with any applicable deed restrictions,
,. ,..\, '\, . ,
8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by IaN, bDth the OHner and contractDr nay be
cited for a tisdeaeanor violation under state law, , If the owner Dr intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills ~uilding Departeent, (813)
7811-6bll.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s} sign portions of the
'Contractor Sections' of this application for which they will be responsible. If you, as the ONner 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 provided Kith a copy of 'Florida's Construction Lien Law - Homeowner's Protection
Guide' prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is sOleone other than the
'oHner', I certify that I have ~btained a ropy of. the above described d~cumen\ and pro~i~e in good faith to deliver it to the
'owner' prior to cOimenrement,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the informati~n in this application is arrurate and that all Hork Hill be done in co~pliance with all
applirable laws regulating ronstruction, zonin9, and land development.
Appliration is hereby made to obtain a ,erait to do Mork and installation as indirated. I certify that no Hork or
installation has co&~enced prior tD issuance Df a perlit and that all work Hi]l be performed to roeet standards of all laws
regulating (C,nstrudion, City (C.des, z~ning regulations, and land devele.prnent, requlatie.ns in the jurisdictie.n. ] also
certify that I understand that the regulations of other g~vernmental agenries may apply to the intended Hork, and that it is
ay responsibility to identify Khat artions I llIusttake to be in romplianre. Such agencies include bill ~le not ]i.1i\ed to:
I Department of Envi~onmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensj\iv~ Lands,
~ater/Wastellater Treatment
I S~uthwest Florida Water ManaQement District - Hells, Cypress Dayheads, Het]and ~reas, A]tering Watercourses
t Army CorDs of Enoineers - SeawallS, Dorks, Navigable Waterways
I Depart_ent ~f Health L Rehabilitative Servires, Environmental Health Unit ~ W~lls: Wastewater Treat~En~. Septic Tanks
t US Envir~noental Protecti~n AQenry - Asbestos abatement
I also certify that, if fill aaterial is to be used in Fle.od Zc.ne "A" or '~,etc.', it is underste.e,d t,,~t a drainage plan
addressing a 'co.pensating volume" lIill be subtitted which is prepared by a professional engineer reqist~ied in the State of
Florida prior to permit issu,ance.
A perlit issued shall be construed to be a lirense to proceed with the Hork and not as authority to yi~l~te, cancel alter, or
set aside any provisions of the terhniral codes, nor shall issuance of a permit prevent the Building Official fre,~ thereafter
requiring a correction of errors in plans, c~nstructi~n, Dr violations of any code. Every permit iSSlled ;hall becole invalid
unless the work auth~rized by such permit is COlmenced lIithin six months of issuance, Dr if lIo1.k author lied by the per.it is
suspended or abande.ned fe.r a perie.d of six tonths after the time the \lork is COJ!lmenced. One 9(; day ;:d.:"sioll e,f tile, Ilay be
allowed for the per~it ~ith fee rharge of $15,00, The extension shall be requested in Hritinq to the Building Official. An
approved inspertie,n I!lust be le.ggedduring earh six Illonth period, c.r the pre.jed Hill be [(,nsidered dbaiide,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".
i SIGNATuRE_d!d----12-~- SIGNATURE~~~#d4!!'.--
OWNER OR AGENT CONTRACTOR
:::::~-~~r--4.l11L~--;--;;---I-;
OWNER OR AGE ~:~~~
MY COMMISSION ~XPIRES____~~~~~~~~~~
5 ...... iiMPE
--~~---
My Comm. Exp. ~pr. 17. 1994
APPLICATION POR PERMIT
CITY OFZEPHYru~ILLS
BUILDING DEPARTMENT
APPLICANT
J c0~~~
ADDRESS
PHONE
OWNER
JOB LOCATION
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
PARCEL I.D,t~
BLOCK
SUBDIVISION
WORK PROPOSED:_New Construction~ddition _Alteration _Repair _Install
_Sign/Temp,
_Sign
__t-love
_Demolish
PROPOSED USE: _Single Family
~M/F
_t~ of Units
._1'1/ II
_Commercial
~Indust,
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
CQt-I}!ERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SIn ENERGY fORt-1S.'~*
**COPY OF CONTRACT REQUIRED,
PERMITS REQUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
H.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBIN'G
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT,
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. 0
City License Rcg"istratinn i~
******************************************
BUILDER
Signature
ELECTRTCTAN
Company
State Cert. or it
City License R gistration 0
":::::::/I~ ;":'70:; /Z~ b /:V e-
State Cert. or .Reg1.s t. ,.. A
City License Registration it &::- i
******************************************
Company
State Cert. or Regist. 0
,City License Registration 0
******************************************
Signature
Company
State Cert. or Regist. #
City License Registration 0
OTHER
Signature
******************************************
APPLICATION APPROVED BY.
PERNIT OFFICER.
.......
CONDITIONS OF PERMIT AFFIDAVIT
A.': NOTICE OF DEED RESTRICTIONS ;:, , .
The undersign~d understinds that this perlit lay be sublect to 'd~ed restricti~ns' ~hich ~ay b~ m~r~ restrictiv~ than City
regulations, The undersigned aSIUles responllblll~~,f~~ co.pllance with any applicabl~ rl~ed restrictlon~.
.;. 1;0\ ." '.. . " . ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
; ,q....
If the o~ner has hired a contractor or contractorl to undertake work, they may be r~quired \.0 be licensed in accordance with
st.te .nd local regulations, If the contrlctor 11 not llcensod IS requlr~d by law, b~th the o~ncr and contractor nay be
cited for a .isdellanor violation under state laM,', If the owner or intended contractor are uncertain as to what licensing
require.ents aay apply for the intended work, they are advised to contact the City of Zephyrhills ~uilding Departeent, (813)
7BI3-66 1 I. ',','
Furtherlore, If the owner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the
'Contractor Sections' of this application for which they will be responsible. If y~u, as the owner sign as the contr.ctor,
you are indicating that you, rather than the contractor, are responsible for the H~rk. If \.he contractor wishes Y~u to sign
as contractor that lay be an indication that he 15 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)
t certify that I, the applicant, have been provided .wlth a copy of "Florida's Construction Lien Law - Hooeowner's Protection
Guide" prepared by the Fl~rida Departlent of Agriculture and Consuler Affairs. If the arplicant is somec,ne other than the
"owner., I certify that I have obtained a copy of'the above described docuro~nt and pr~6i~e in good faith t~ deliver it t~ the
"owner' prior to cOI~enCeftent,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all Mork l1ill be done in co~pliance \lith all
applicable laws regulating construction, zoning, and land developDent,
Application is hereby lade to obtain a ~er.it to'do Mork and installation as indicated. I certify that no work or
installation has co&~enced prior to Issuance of a per.it and that all work Hill be perf~r~ed to ~eet standards of all laws
regulating ce,nstructic,n, City ce.des, zoning regulations, and land development. requlatie,ns in the jurisdictie,n. I also
certify that I understand that the regulations of other governmental agencies may apply \.0 the intended \lork, and that it is
IY responsibility to identify I1hat actions 1 must'take to be in cc.mpliance. Such aqencies include bllt ~le Iit,t li~ited to:
I Department of Envitonmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive ldilds,
Water/Wastewater Treatment
I Southwest Florida Ilater ManaQement District - Wells, Cypress Dayheads, Hetland Areas, Altering Hatercourses
I ArDY Coros of Enoineers - Seal1alls, Docks, Navigable Waterways
I Departaent of Health L Rehabilitative Services. Environ~ental Health Unit - W~lls, Waste"ater Treat~!n~. Septic Tanks
f US Environ~ental Protection nnency - Asbestos abatement.
I also certify that, if fill material is to'be used in Fle,od Ze,ne "A" or 'n,etc.', it is understc,(,d t,,~t a drainage plan
addressing a 'coapensating volume' Hill be sublitted I1hich is prepared by a rrDfessional engineer reqist~rDd in the State of
Florida prior to permit i5s~ance.
A per~it issued shall be construed to be a license to proceed with the Hork" and not as authority to yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the 9uildinq Official fro~ thereafter
requiring a correction e,f errcors in plans, ce.nstructie,n, e,r violations e,f any c(,de. Every per~it isslll!d ohall bece'lf invalid
unless the work authorized by such permit is co.~enced Hithin six months of issuanCE, or if lIDrk authofJied by the perait is
suspended or abande,ned fe,r a periCtd of six tonths after the time the \fork is c('Menced. One 9(. day l'~t~;,:;i('1I e,r tile, lay be
allowed for the permit Hith fee charge of $15,00, The extension shall be requested in IIriting to the Building Official. An
apprCtved inspectie,n tlust be le,gged .during each six Ilonth period, clr the pre,jed lIill be ct,nsidered db,;iideonfd.
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".
SIGNATUIlE
-----------------------------
cmHRAC TOR
SIGNATURE
- --- - - - -------- --....------'" --.._&_--. ".- ...-
OWNER OR AGENT
DATE___________________________________
DATE
---------------------------------------
MY COMMISSION EXPIRES______________________
NOTARY AS TO
CONTRACTOIl_____________________________
MY C6MMISSION EXPIRES
------------------
NOTARY AS TO
OWNER OR AGENT_____________________________
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