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Home My WebLink About91-1657 STATE OF FLORIDA City of Zephyrhills Date 1657 ;6 '7/'7-7/ PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Type of Permit (frulJ~~~ ELE~AL P LUjA'8TffG-- PermitN~ -----.. MECHANICAL Property Owners Name: Job Address: ,&;~ ,';;!f1Y~r Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work (L" ,~~~~~,r~dp~~ il ~~ Energy Code Readout: ~ Complete Plans, Speclflcallons and Fee Musl Accompany Appllcal;on ~ >P -f") , -- Estimated Cost: :J (9- () All work shal! be performed in accordance with the above and all City Codes and Ordinances. ~1/ 7" If;, OCCUPATIONAL LICENSE # ,; ~ ( 17 ~~ ~~t? (~< ,., ".. ~\"'-' . &~,~o.IN~ ~~G . SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. ~~/1>~f Insul.CL WL ~~J.J Driveway 7-'2~$"f( ~ Fee.f ,0:< l) ~W-. SIGN~TURE ~P,*,""1' COMPANY ADDRESS TELEPHONE # !' /' ~~ , E L E C:!].1.CAt:. . ----- Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final ME~AL .- Breakers Ducts Insl. Compressor Final Reinspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of1lr:n ,J.JJ..QO) dollars shall be made for each tzip.:7Y--C1-de (/J-: 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 OFZEPHYRHILLS BUILDING DEPARTMENT APPLICANT~;; ?'t(/~p( ADDRESS.7ft. . r4 g/ C OWNER Mr/;' ::!.~J S- JOB LOCATION r"f-7. <,1" iffr: . . 7 ?C>~ LEGAL DESCRIPTION: LOT(S) -?i!// PHONE ~/i/ ('/11 aJ;);. 8/~T' SIZE_X AREA SQ. FT. BLOCK SUBDIVISION PARCEL 1. D. 4~ WORK PROPOSED:____New Construction ____Addition ~Alteration ____Repair ____Install _Sign/Temp. _Sign ____~fove ____Demolish _commercial _Indust. .2.-4~ of Units .____~l/H _Swim. Pool O/~ r.> Other A 1. ~#~t/c- )i~A--t. C~ff cIoC',f'.f pprova #c - ~~k~ /VirL - %~at . Square Fa:t,' He~ght PROPOSED USE: _Single Family _M/F _Restaurant & Health Department BUILDING SIZE: X RESIDENTIAL: COMl'tERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS.H **COPY OF CONTRACT REQUIRED, f-BUILDING _ELECTRICAL JlERMITS REQUESTED ~~~ Valuation of Total Construction $ AMP Service Florida POh'cr Corp. _H.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLlJMBIN'G GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** &- . & '/ / ~ONTRACTOR SECTION nUl1.DER __,lfN / b./f.A Company r~ ~ /' #-/.4 State Cert. or Regist, il Signature / /t:"'~h~ City License ReGistration <Z/ ' . 1e ** *** * 1e * * * ** ***** * * ** 1e ,', 1e 1,,~ 1e1e ,'e -I, ,', -I: ,': ,': ,': -I: 1: ,': ,', ,': * (11(lC{~1 '1// i.' Yl? Sirmature Company State Cert. or Regist. 0 City License Registration 1 ****************************************** E1.ECTR1C1AN Signature Company State Cert. or Regist. a City License Registration # ****************************************** Pl.UMBER Signature Company State Cert. or Regist. 0 City License Registration 0 *************************************~**~* MECHANICAl. Signature Company State Cert. or Regist. 0 City License Registration 0 .oTHER APPLICATION APPROVED BY / ...... ....4(.*..._*-...~* **~1:::-* * * * * * * *... J. * J, * J. J. J. J. .'. J_ J. J. _c .'. .'. J_ J. J. ,'- .... .... ~1. ~ " ," . ... '],; 1'. 1. ,~ .... .. h .. .. .. .. .. ., .. .. .. r C-.JJ" . . ,-". ~ PERl-lIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A.', NOTICE OF DEED RESTRICTIONS:. . The undersigned understands that this per.it lay be subject to "deed restrictions' ~hich ~ay be ~ore res~rictive than City regulations. The undersigned assumes responsibili~y..for compliance with any applicable deed restrictions. . ".,', ".,', B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake wor~, 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 OHner and contractor ~ay be cited for a .isdeaeanor violation under state law, . If the owner or intended contractor are uncertain as to what licensing require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills ~uilding Departeent, (813) 7811-6611. Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor Is) 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 ~ork. 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 2ephyrhills. 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 - Hoeeowner's Protection Guide' prepared by the Florida Department 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 docuffienl and promise in good faith to deliver it tD the 'owner' prior to cOimencement. E. CONTRACToR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work Mill be done in co~pliance with all applicable laws regulating construction, zoning, and land development. Application is hereby aade to obtain a permit to do work and installation as indicated. I certify that no wor~ or installation has co&tenced prior to issuance of a perait and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning 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 "or~, and that it is ay responsibility to identify what actions I /Dust ta~e to be in compliance. Such agencies include bllt .le Iir.lli'lited to: I Department of Envi,on~ental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive L~nds, Hater/Wastewater Treataent I Southwest Florida Water ManaQeaent District - Hells, Cypress Bayheads, Hetland Areas, Altering Watercourses I Army CorDs of Enoineers - Seawalls, Docks, Navigable Waterways I Departaent of Health L Rehabilitative Services, Environmental Health Unit - W~lls, Wastewater Treat~en~. Septic Tanks I US Environaental Protection Anency - Asbestos abatement I also certify that, if fill lIaterial is to be used in Fle'od Zone "A" or "A,dc.", it is understc,c,d tl..t a drainage plan addressing a 'cD.pensating volume" will be sublitted which is prepared by a professional engineer regist~jed in the State of Florida prior to perllit iss~ance. A perait 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 frol thereafter requiring a correction of errors in plans, construction, Dr violations of any code. Every permit issued ;hall beCDle invalid unless the work authorized by such permit is commenced within six months of issuance, Of if Hork authorIzed by the perlit is suspended or abandDned for a period of six lonths after the time the work is commenced. One 90 day e=te~5iDII Df tile, aay be allowed for the permit with fee charge of $15.00, The extension shall be requested in writing to the Building Official. An approved inspectie,n r..ust be le.ggedduring each six month period, Cor the prc.j\!ct Iii] I be cc,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 $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE~c~~---- . CONTRACTOR SIGNATURE_~::i.~/--- -~----- OWNER OR A~ NOTARY AS TO ~i1" '-k' /, /~ , OWNER OR AGENT_~~_~_~~~~~~~~;f- / MY COMMISSION EXP I~~"" c.-"~ ... "";':'-i:J.O"m.\- r:1~/ l:i-;t~j;}7;:T~~~:.,:,i~'7:;S: Nov~ 27;~ 1994:- '.!lONDED nuw NOTARY HJllLlC llNJ)r;l~WlUTEU. DATE____;Z~~=:_~~-------------- NOTARY AS TO 0 ''-1 ~ CONTRACTOR____~_T--_------ Notary PubliC MY COMMISSION EXPIRES Slaleof Florida It Large hly-Conmns$lOlT Expires1Ict21.1!l9t -- DATE___~::!~~Jf_-_______-_____-__-_-__