HomeMy WebLinkAbout91-1631
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N!
1631S
Type of Permit
.C9 ELE~ PLlJ1IIBI"G MECH~
propertyOwnerSNa~e: }!"A~jJ JI1-7;~ ,21,"cj"'AWA~
Job Address: Jr.f 0 /-..J ,LfYLrL~ ~L
Sub.Div. 7,)#-~.nA I)j~ f Lot -.5'-0
Zoning CI: /'1- .;). (;, .- Ol /)
Descri~yon o. f Work ~ j I~ / X rF ~
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Date ;7 - / 0 - 7' /
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Legal Description:
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Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Applicatio
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OCCUPATIONAL LICENSE #/bO 'v. J... TELEPHONE #
Estimated Cost:
;7 7~ /:" t'J{;!
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
c
o~ ~7 0 ~ h';lAA'---1A /YY\ ,
BUILDING
Ftr. -l--!t- &t I b:J..
Pre SLB -to ~'i' '0 Pv1
Lintel
FRM.
Insul.CL
VVL
_/
~
----------..., ,
ELE:C~
----...
ME~AL
~
SLB
Tub Set
VVater
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
DriM'ay7-!iJ I f;(, ~.
,,~ S -., I u.P
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of aM {JI(M)())
dollars shall be made for each t.8p. / r d- de (/6: CTD )
(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 OFZEPHYillIILLS
BUILDING DEPARTMENT
APPLICANT Ift:.E /9}.. Lf fYl .
ADDRESS 3g~~5 p/JUVJ (;.Rj)i/6 PIl. 2-JJILL(' ,filJ. PHONE '7 J>d-:Jb/(,
OWNER J! Att..f)L./J j?1/)Ar~ S-
f . '
JOB LOCATIONLDT":Q, ..?KIJ/? VdAJDJ}JS 1.../1,'2 -H)J.L~ HJt.LOT SIZE s:r' X !p' I\REA SQ. FT /OO~
LEGAL DESCRIPTION, LOT(S)'SO -f!I;:. BLOCK :;'C SUBDIVISION ~ (,/7 ,,>-o.-</lf_J
PARCEL I. D. t~ 1/ /)0- /JtJ~tJO- tf).5Pc:> / Y - 02 6 - d / -
WORK PROPOSED: v/ New Construction '____Addition ----Alteration ____Repair ____Install
____sign/Temp.
____Sign
_Hove
____Demolish
PROPOSED USE: ____Single Family
_M/F
_t~ of Uni ts
_____H/ll
____Commercial
~Indust,
_Swim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ATTACll (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COl-fr1ERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~IS. ,~-!:
**COPY OF CONTRACT REQUIRED,
V<UILDING
~F.RM1TS REOUESTED
$ 77:Jb. tJO
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
H.R.E.C.
____MECHANICAL
$
Valuation of Mechanical Installation
____PLmm ntG
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT,
******************************************
Signature
f(fJ Y tJl)JVJ j5";..S ~ONTR~~~~~n~r>>21~L#PJ.
/J J-I) t! State Cert. or Eegist. if
~{j?----/ City License Ecr.istrat~on
******************************************
C I? CO ..?~b ~t)
i'~ /6.0
,
IHJ1LDER
Si!!n::\ture
Company
State Cert. or Eer.ist. a
City Liccnse Registration 0
******************************************
ET .F.CTR1 C1 AN
Signature
Company
State Cert. or Rcgist. 0
City License Registration 0
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. a
City License Registration 0
**********+*****************************~*
HECHAN1CAL
Signature
Company
State Cert. or Eegist. 0
City License Registration ~~
OTHER
*~~*******************~*****~~*~*~~~~~~~~~
A P P [,I GA TI 0 N A PPROVED By:if a-~d 111 R~" ,'^ .. ... ................... P ER>1I T 0 FFl GER ,
tONDITIONS. OF PERMIT AFFIDAVIT
A.': NOTICE OF DEED RESTRICTIONS ;.. '.
The underslgn~d understinds that this plrllt I.Y bl sub',ct t~ 'dead restrlctiDns' which. ~ay b~ JDre restrictive than City
regulations. The undersigned assulas responsibll1\~ for cOlpliance with any applicable deed restriction~,
, ..:. I :.\' ~.. ~ "~. .
~. ,'d.l
B. UNLICENSED CONTRACTORS A~D.~ONTRACTbR RESPONSIBILITIES
If the OHnlr has hired a c~ntractor or contractors to undertake work, they may b& required tD be licensed in accordance with
s!ate and loc~1 regulatlCl~s. !f thl contra~tor 11 not llcens~d IS rl!,quired by law, bDth the blfne~ and cClntractc.r lIay be
clte~ for a mlsde.ean~r VIolatIon under state law,', If the ownl!r or intended contractor ar~ upcertain.as to what licensing
requIrements lay apply for the intended work,they are a~vised lo contact the City of Z~phyrhills Building Depart.ent, (813)
7BB-bbll, ',',"
Furthllrlon, If the owner has hired a contractor" or contractors; .hl1 is adv'i$ed tohav'e '~he ce,ntractor(s) sign portions Clf the
'Contractor Sections' of this application for which thl!Y will be rl!sponslble. If ye,u,' a"s the e,wner sign as the contractor
you are indicating that you, rather than the contractor, are responsible for t~c wDrk. If the cDntractor wishes you to si;n
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 with a copy of "Florida's Construction Lien Law - Homeowner's Protection
Guide" prepared by the FI~rida Depart.ent of Agriculture and Consumer Affairs. If the applicant is S08EOne other than the
"owner", I certify that I have obtained a copy of "the above described document and proli5e in qood faith to deliver it to the
"owner" prior to cOI~encement,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor~ation in this application is accurate and that all Mork Mill be done in co~pliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby lade to obtain a ~erli~ to'do work and installation as indicated. I certify that no work or
installation has CO&Renced prior to issuance of a perlit and that all wDrk Hill b~ performed to roeet standards of all laws
regulating cc.nstrudie.n, City cc.des, zoning re"gulations, and land development regulatie,ns in the jurisdidie.n. I also
certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is
ay responsibility te. identify IIhat actions llllust"take to be in cOlllpliance,"Such agencies include bill ~le liC.t li'lited to:
I Deparllent of EnviT'oMental ReQulation - Cypress Bayheads, Hetland Areas and EnviroMentally Sensitive Lands,
Water/Wastellater Treatment
. Southwest Florida \Iater ManaQelent District - Wells, Cypress Dayheads, Hetland Areas, Altering Hatercourses
I Army Coros of EnQineers - Seawalls, Docks, Navigable Haterways
. Department of Health L Rehabilitative Services. Environmental Health Unit - Wflls, Wastewater Treat~en~. Septic Tanks
I US Environoental Protection AQency - Asbestos abatement.
I"also certify tha.t, if fill uterialis to'be used in Fle.od Ze,ne "A' or 'A,dc.', it is underste,e.d tl.~t a drainage plan
addressing a 'compensating volu.e" will be sub.itted Hhich is prepared by a professional engineer registered in the State of
Florida prior to perlllit iss~ance,
A perlit 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 froft thereafter
requiring a correction e.f erTCtrs in plans, cons\ructic,n, or violations e.f any ce,de. EYery per~i t issued :;hall becc..e inval id
unless the work authorized by such permit is cOllllenced within six months of issuance, or if 1I0rk auth~rl!ed by the perait is
suspended or abande.ned fe,r a peri[.d of six tonths after the tillll! thl! 1I0rk is ce'Menced. One 9(; day ;:~t"j,si(\1I e.f till, Jay be
all~lIed for the per~it Hith fee charge of ~15,OO, The extension shall be requested in IIriting to the Building Official. An
approved inspection ~ust be logged "during each si~ mDnth periDd, or the project lIill be considered ~baljdoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUI~ PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
. SIGNATURE__ ft~_ff-$~-'~----- SIGNATU{1E___~b---------
~ OWNER OR AGENT CONTRACTOR
~ [ a
DATE__s=l~---;t--~--~~_?~--------~------
~~~~~YO~SA~~N~~
MY COMMISSION
DATE___~_~_~~___st7-_LJ-r~L-__~--- --
~~~~~~C~~R~==-~__--~-----------
EX P I RES ______________..,'I'r.:~..r:-"-~
- Nl'tllry Public, State 01 nOrlu'
My Commission Expires April 11. 1m
Bonded lhJlI !',0Y filin: '[J$!,l(.~ IAsiI .................
MY
C6MMISSION EXPIRES_________ --------
_ ........ Notary Public, State oi AoriCl. '
My Commission Expires April 21. 1992
"'nded lh~ll TroY fa;n' ini.r.nCl Inc..
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38545 Palm Grove Drive
Zephyrhills. Florida 33540
ACE
ALUMINUM
Job No.
Phone: (813) 782-2616
SOLD TO
ADDRESS
SHIP TO
DATE
PHONE
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PERMIT
PRICE
TAX
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The undersigned agrees to TOTAL PRICE ' ..,'(
pay
INSTALLERS IN FULL ON COMPLETION DEPOSIT
BALANCE C.O.D.
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CIT'i Of ZEPH);'HHILLS BUILDING DEPARTI(iENT
OWNER .Jjf\~o~ (Y\DATf~
JOB LOCATION LO'/~O Jf(/)J3 L€'{)A!/)/I1S.)..j).. t-VIJYtJJl}/li) t1/I/lI/)r'"
LEGAL DESCRIPTION/SUB DIV. BLK.
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Show all existing and propos~d structures 'giving dimensions & setbacks.
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