HomeMy WebLinkAbout91-1642
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STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Type 0
BUILDIN~ ~L
~
Permit N~
1642fi
Date ,,/ _. / J -7/
M~CAL
Property Owners Name: 7z/d~ J/:J ~../1__
Job Address: .3 f 7/ 7 7~L~ C~ ~ .
Legal Description:
Sub,Div.
Zoning CI: c:2 - d-~ -- eJ-/ - (ZJ - [/ - d ~ -=?
Deser; plion of Work .fl A..<' -1H' "" l'=-<c]
Energy Code Readout:
Lot
Blk.
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
rrcr-o ~ c/D
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #/;
)11~
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..------ BUILDING ~.
~--~
Ftr. - .
Pre SLB .
Lintel
FRM.
Insul.CL
WL
Fee; ;;LO -
COMPANY
ADDRESS
TELEPHONE #
~G
------
SLB
Tub Set
Water
Sewer
Final
Driveway
~CTRICAL
Tp,serv.~
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
~ANICAL
~,
Breakers
Ducts Insl.
Compressor
Final
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge ot:.t___ (119.80)
dollars shall be made for each-k;i;p-.Tra de (/<5-:- &?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.
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APPLICATION FOR PERMIT
CITY OFZEPHYRHILLS
BUILDING DEPARTMENT
OWNER
APPLICANT
ADDRESS
PHONE 7Jz ~S-~'Z-}
Jon LOCATION
LOT SIZE_X
AREA SQ. FT. (P O(), "
LEGAL DESCRIPTION: LOT(S)
PARCEL 1. D. f~ 2~.:2h - .5</
BLOCK
SUBDIVISION
/iI - CJ - .,2.7
WORK PROPOSED:____New Construction "_Addition -^lteration _,Repair _Install
_Sign/Temp. _Sign _.t-love _Demolish
PROPOSED USE: _Single Family _M/F _f~ of Units ._H/II
_Commercial --...:......Indust. _Swim. Pool Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t, ~() 0
Height
RESIDENTIAL:
Cm-frtERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~IS. ,~*
**COPY OF CONTRACT REQUIRED. '
_BUILDING
$ ~.f' $: cTVJ
.PERMTTS REQtillSTED
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_\-l.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLlJNButG
GAS
ROOFING
SPECIA1.TY
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. ~
City License Rer,is tra Uon I~ /1
******************************************
ELECTRICIAN
Company
State Cert. or Rer,ist. 0
City License Registration 0
******************************************
SitTnature
Company
State Cert. or Regist. I!
City License Registration #
******************************************
PUTMRER
Signature
Company
State Cert. or Regist. 0
City License Registration ti
tiE-CHANICAL
Sign<tture.
******************~***********************
Company
State Cert. or'Regist, 0
City License Registration r
.Q.TJiER
SignatuI'e
APPLICATION APPROVED BY.
*o/t* * * * * ****** *******... J.* J, * J, J. J. J. ,'. J, ,'. ,t. ,C ,'. ,', ,'. J. J, ,',
"d-~."'(j XI a;,<'--J.--' ,.. -:.. ,..... -...
PERmT OFFICER.
~ONDITIONS, OF PERMIT AFFIDAVIT
A.': NOT I CE OF DEED Re:STR I CT IONS ;', , ,
Thl und.rsiQned understinds that thll plr.it ..y bl sub'lct to "deed restricti~ns' which ~ay be a~re restrictive than City
regulations. The undersigned ISSUles responslbill\Y for cOlpllance with any applicable rleed restrictlon~.
. '-' -:" f:.\"~.' ~ .,~.
\ ,~~..\
E. UNLICENSED CONTRACTORS AND' tONTRACTOR RESPONSIBILITIES
If the OKner has hired a contractor or contractors tD undertake work, they may bi required to be licensed In accordance with
I\lh and local r!QulaHons. 11 thl contra~tor 11 not liclnSl!d II re.lluired by Jaw, bc.th the OHner and contradeor ~ay be
cited for a lisdeaeanor violation under stlte laK.', If the owner or intended contractor are uncertain as to what licensing
requiresents lay apply for the intended work, they are advised lo contact the City of Zephyrhllls 8ulldlng Oepartaent, (B13l
7 BIl-b 6 I I. ',"
Furthlrlore, if the owner has hired a contractor, or contractors, he is advised to have the contractorlsl sign portions of the
'Contractor Sections' of this application for which they will bl responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the Kork. If the contractor wishes you to sign
a5 contractor that lay be an indication that he is not properly licensed and Is not entitled te, per<ting 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 LaK - Hooeowner's Protection
Guide" prepared by the Fl~rida Departaent of Agriculture and Consumer Affairs. If the applicant Is SOBEe,ne other than the
.0Kner", 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
'OKner' prior to cOilencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all worr. will be done In co~pliance Kith all
applicable laws regulating construction, zoning, and land developaent.
Application is hereby aade to obtain a per~it' t~'do Mork and installation as indicated. I certify that no work or
installation has co&!enced prior to issuance of a perlit and that all Kork will be perfor~ed to meet standards of all laws
regulating [(,nstrudie,n, City [(Ides, zoning regulations, and land develc.pment. regulatie,ns in the jurisdictie,n. 1 also
[,rtily th.t I "d,r,'.nd lh.l lh, "g,I.11D" D~ ,Ih', gov,r"",.I .g",i" "j .,ply ,. 'h' i.I'.", "rk, "d 'h., it i'
'y mpon,ibiI i 'y 10 id,,1i ly ,h.t "lion' I ,,,n.ke ID b, i, ",p Ii m' , Soch .go<,' i" i r.d ,d, b,,' '" ",' Ii. i ,,' ,,,
I Departs!!nt of Envir'onlilental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally 5ensitiv~ Ldnds,
Water/Wastewater Treatment
I Southwest Florida ~Iater ManaQelent District - Wells, Cypress Bayheads, Hetland Arcas, Altering Haterc~urses
I Aray CorDs of EnQineers - Seawalls, DOCKS, Navigable Haterways
I Depart.ent of Health L Rehabilitative Services. Environmental Health Unit - W~lls, Wastewater Trl!at~en~. Septic Tanks
I US Environoental Protection AQencl - Asbestos abatement,
I also certify that, if fill lIaterial is to'be used in Flood Zone "A" or 'I\,elc.', it is underste,e,d tl.~t a drainage plan
addressing a "coapensating volule" "ill be subtitted which is prepared by a professional en~ineer rl!qlst~ied In the State of
Florida prior to permit issu.ance.
A p,r,it !""d ,0.'1 b, 'D""'" t. b' . Ii"", ID p'D["d ,ith th' "r' .,d ,., ., .,".ri'y ,. ,i.I.", ,.",1 .It,r, .r
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official froA thereafter
",,'ri'g . ,.rr"li.. ,I .r,.r' I. pl"', ,...1"""0, .. vi".ti". or ,'y ,.d., .,.ry p".il i....' ...11 b.,.., i.,.lid
unless the work auth~rized by such permit is commenced within six months of issuance, or if work aulhorli~d by the peralt Is
,",p"d.d or .b"d."d lor . pori.d .1 .j, ".th. .Ilor th, ti.. th, "or' I. ,,,,,,,,d, Or.." d.y ",..,.j.., .r Ii.., "y b.
alloKed for the per~it with fee charge of ~15.00. The extension shall be requested in writing to the Building Official. An
apprtlved inspectie.n l!Iust be le'gged'during each six Mnth period, c,r the prc,ject Iii II be c['nsidered iiboliGe,r.ed.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUH PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
8EFORE RECORDING YOUR NOTICE OF COMMENCEMENT. J08~UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOT I CE OF COMM&:1\lCEMENT". ,...---7
/,,/ / :/:~:/-/..-
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SIGNATUR~~-~-~~~~----~-------------
, >r-ErnnR~\CTOR
.;
I
DATE _____L-Z~L?:--~-r.{-------- --'- -----
SIGNATURE
----------------------------------
OWNER OR AGENT
DATE
---------------------------------------
NOTARY AS TO /;; / A.---;r-, ' P.
CONTRACTOR_~-()J"!J:zu~:::'I-A~!i'-
MY COMt-l I SS I ON NDXP/fmfIi18L1C, STATE OF FLORIDA
. My commissrcjirexpire~Jmr.~~;-~-
eonded thru Patterson. Becht Agen,cy
NOTARY AS TO
OWNER OR AGENT_____________________________
MY COMMISSION EXPIRES______________________