HomeMy WebLinkAbout91-1665
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
.~y~it
/.c~~)
c_~
E~AL
PL~'
PermitN~ 16658
Date 7- ~2. -9/
M~Al-
Blk.
Zoning CI:
Description of Work
Energy Code Readout: A:Z
Complete Plans, Specifications and Fee Must Accompany Application
Estimated co;f11.221 ~
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #
/~D
,
!:l~'
Ftr. I"Z3"~1 ~;ll
Pre SLB
Lintel
FRM,
Insul.CL
WL
~tJ~
SLB
Tub Set
Water
Sewer
Final
-6=>
Fee 56. E1 ft:=tt.
SIG~A TUREY a.-vn J
.
COMPANY
ADDRESS
TELEPHONE #
-FI rr.Tr.llgA~
MECHU"C'AL-
Tp.Serv.
Rough In
Meter Can
Const. Pole
POOl
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
Drive~ .c-:. I ~
~' :) 51.-/J1H'} f(lVi+l3 "7- VI '1
Relnspectlons: Wh n extra inspectIon trips are necessary due to anyone of the follOWing reasons, a charge of' _ (I. D.IC)
dollars shall be made for each ~/rd.. de. (/S:.OV 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 shalI be made before any further permits wilI be issued to the person owning same,
APPLICATION FOR PERMIT
CITY OFZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT IIc~. IlL 11M.
ADDRESS JR"Stfr PI}J.r1 @tJi/,t!L)2. Z-IJI/...L.S HIl. PHONE 7J2'-~6/1-
". '
OWNER II 1IWL-.IJ fYl6A~~ .,' , .
Jon LOCATI~~ 1 .storr I.IIIAllltVl>/UfJ. /AlflYUlA~~ W/II!,or :t~OT SIZE r/' X /~/) I AREA SQ. FT. 8 ?~
. '
LEGAL DESCRIPTION: LOT (S) 11 BLOCK 2t:. SUBDIVISION :2/
PARCEL 1. D. ~~ 1J/6tJ -tJPllat)~ ZJt17P
WORK PROPOSED:~ew Co~st~uction
'_Addition
-^lteration
_Repair
_Install
_Sign/Temp.
_Sign
_~Iove
_Demolish
PROPOSED USE: _Single Family
--=-M/F
_~~ of Uni ts
__HI II
_Commercial
.~Indust.
_Swim, Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Peet,
Height
RESIDENTIAL:
COl11'tERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY POR~IS.'~*
**COPY OF CONTRACT REQUIRED.
./ BUILDING
PERMITS REQUESTED
7:1 ~ ) ,DO ' Valuation of Total Construction
$
_ELECTRICAL
AMP Service
Florida Power Corp.
H,R,E.C,
_MECHANICAL
$
Valuation of Mechanical Installation
_PL'U1'mHtG GAS
ROOFING
~Frame _Steel
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
flL.fA fYI, Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
;!.IJY fl/J/f/IEI- ('
tl~ L-:-
,
CONTRACTOR SECTION /1/ ,J
Company !?1~~./7~/~.
State Cert, or Hegis t, i! C.~C6 ~?1/6tf'O
City License Registration i,~ /bt!J
******************************************
nUTLDER
Si!:'nature
Company
State Cert. or Regist, 0
City License Registration U
******************************************
El.ECTRTCTAN
Company
State Cert. or Regist. ~
City License Registration 0
******************************************
PLUMBER
Signature
.
Company
State Cert, or Regist. Ii
.City License Registration !}
******************************************
MECHANICAl.
Signature
Company
State Cert. or"Regist, 0
City License Registration 0
OTHER
Signature
APPLICATION APPROVED BY
PERHIT OFFICER.
bONDITIONS, OF PERMIT AFFIDAVIT
A": NOTICE OF DEED RESTRICTIONS:, "
Th, undersigned undtr.tinds that this plrllt lay bl lub~.ct to "dtod restrlctieons' which ~ay b~ 5~re res rictive than City
regulations. Tht undersigned assules responsibility for cOlpllance with any applicable need restriction
" .'.., ',~:' .::,"~.. ;,':, , :, ' .
B. UNLICENSED CONTRACTORS ANO'~ONTRACTOR RESPONSIBILITIES
If the,owner has hired a contractor or contractors to undertako wor~, they may be required t~ be licensed in accordance with
statt and local regulations. If the contra~tor is not licensed as re,quired by law, be.th the Ollner and contractc.r nay b,
cited for a .isdeaeanH violation under state law.,. If the,c.wncrc.r .\nl'l!ndl!d contr,actc.r are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City 'of Zephyrhills Building Departlent, (913)
7BIH611. ',',
Furtherlore, if the owner has hired a contractor or contractors, he is advised t~ have Ihe contraclorls) sign porti~ns of Ihe
'Contractor Sections' of this application for which they will be responsible. If y~u, as the owner sign as the c~ntractor,
you are indicating that you, rather than the contractor, are responsible for t~c wor~. If the ceontractor wishes y~u to sign
as contractor that lay be an indication that he is not properly licensed and is not enlitled 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 prllvided 'with'a copy of "Flc,rida's Cc,nstruction Lien Law - HC.leowner's Prc,tection
Guide' prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is so.e~ne Dther than the
'oHner', I certify that I have obtained a copy of "the above described docu~ent and pro~i~e in good faith to deliver it to Ihe
'owner" prior to COI~encement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work Mill be done in co~pliance Hith all
applicable laws regulating construction, zoning, and land development.
. ",,;
Application is hereby lade to obtain a ~er~it' t~'do work and 'installation as indicated, I certify that no work or
installation has cOI!enced prior to issuance of a perlit and that all work will br. perfor~ed to ~eet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations o~ other governmental agencies ~ay apply to the intended work, and that it is
.y responsibility to identify t1hat actions IlDust'ta~e to be in compliance. Such agencies include bnt ~Ie Be.l li.tiled to:
I Department of Environ~ental ReQulation -Cypress Bayheads, Wetland ~reas and Environmentally Sensitive L3nds,
Water/Wastetlater Treatment
I Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland ~reas, Altering Watercourses
I Army CorDS of Enqineers - Seawalls, Docks, Navigable Waterways
I Depart.ent of Health L Rehabilitative Services. Environmental Health Unit - W~1Is, Was\eHater Tr~at~!n~. Septic Tanks
I US Environoental Protection AQencl - Asbestos abatement,
I als~ certify that, if fill material is to'be used in Flood Zone .~' or "n,etc,', it is understood tl'3t a drainage plan
addressing a 'colpensating volume" ~ill be sublitted which is prepared by a professional engineer reqist~i~d in the State of
Florida prior to permit issu,ance.
A perDit issued shall be construed to be a license to proceed with the wor~ and nol as authority to vioJ~te, cancel alter, Dr
set aside any provisions of the technical codes, nor shall issuance of a p~rmit prevent the ~uildin9 Officidl frDft lhereafter
requiring a correction of errors in plans, construction, or violations of any code, Every per~il issued shall beCOle invalid
unless the work authorized by such permit is CDlftenced within six months of issuance, or if uOl'k aulhorlied by the perlit is
suspended Dr abandoned fc.r a peric,d tlf six lonths after the time the Ilork is cO!.lmenced, Or,e 90 day e;:\ti,sioll c.r tile, say be
allowed for the per~it with fee charge of $15.00. The extension shall be requested in Iliiting to Ihe Building Official. An
approved inspedic.n !:lust be lc.gged 'during each six month period, cor the prc.jecl \'Ji 11 be ((.nsidered dboiidc'i,ed,
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".
__:IiL:/~~~;:-Lt--- SIGNATunE___g~L-----
OWNER OR AGENT CONTRACTOR .
DATE______~_L~~---------------------- DATE______~~~~~-----------------
~~~~~Y D~S A~~N~tMIh-':K.~- ~g~~~~c~~n~':J(?~
MY COMMISSION EXPIRES___-L~~f2~=-~~--- MY COMMISSION EXPIRES__~~~-~~~-?-~
C.1_Ty' OF Z~P~RHIL.LS ~_UILD~N~_ DE~ARTMEN~
OWNER -!)ARDL~ (YlDITT~S; ,
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38545 Palm Grove Drive
Zephyrhills, Florida 33540
ACE
, ALUMINUM
Job No,
Phone: (813) 782-2616
,/-'\
SOLD TO C4lt--.C }(,r..'1"> (VI,! N ~ I'lL~S ~;1I12 OI-D ,ft1f)/tr~-f)
ADDRESS L() r 7 \. 7J>~~ L~J1/RtV[)A-~-;O'
SHIPTO yJftiV/r-~fJ WIn) I }H ,PI}f( :z~PJ+rlUflLL::!'" ~//9.
DATE 7-/7-9/
PHONE 7~3 - /'0 ~7
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PERMIT
PRICE
TAX
The undersigned agrees to pay TOTAL PRICE
INSTAllERS IN FUll ON COMPLETION DEPOSIT
~ ..j? BAlANCE C.O.D.
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