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Home My WebLink About91-1668 STATE OF FLORIDA City of Zephyrhills ~' PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN~ 166s.B Date 7-;;'3-(? J ~~2!?ermlt ....,..."....., '" ~ ~'- ME9:!At..I/CAL Property Owners Name: ~11L _~ - Job Address: ~ _ _ ~ ._.~. ELEG=fRICAL Legal Description: Sub.Div, Lot Blk, ZoningCI: ~ Description of Work _ _ --- _ -. ~ ~7('. . ~ GJ/(l~ Energy Code Readout: All work shal! be performed in accordance with the above and all City Codes and Ordinances, Complete Plans, Specifications and Fee Must Accompany Application "?{.- I If P ~ Q-c Fee: ~.- SIGNATURE v-' "r;:Ch -L~ COMPANY }~~~. ( , .. .-~ Estimated Cost: ~ ,/.~ () , ~ OCCUPATIONAL LICENSE . .><:- ,/---'~ / ~ (()~n1"1 BUILDING ADDRESS TELEPHONE # PLUMBIN.G .,..." sa::-........... Tub Set Water Sewer Final ELECraJCAL ----- - Tp,Serv. Rough In Meter Can Const. Pole POOl Pre-Meter Final M ECH A N 1.9.AL-, ~ Ftr, Pre SLB lintel FRM. Insul.CL WL Breakers Ducts Insl. Compressor Final Driveway Reinspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of t...... (51 O,li)(,)) dollars shall be made for each ~Tr~d e (/.5;..07)) (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. r APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT ADDRESS - APPLICANT ~ 'e ~ a F c.-( .3 egG" 3 3 OWNER If; Gh a. y-d ;-/ tL (/(} e C c JOB LOCATION :3 '5(6- 33 8"'f~. 4~c::. ..~~~~ PHONE '7 g;;; - 1.;2 ~ r ~ ///;:1, h .'JL. a Hu 00 .-1__ ~ [,. y , I' I' LOT SIZE~X IJ-O AREA SQ,FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION ~:;.,~_.,.._~~. (i''''PA~CEL I.D.lF~"'i "I-.J:.~- :Sj- 00/ o-/~ d~l!J -CJ /l.j- ,./ WORK PROPOSED:~New Constru~tion _Addition _Alteration _Repair _Install _Sign/Temp, _Sign _t-love _Demolish PROPOSED USE: _Single Family _M/F -~~ of Units ._M/H _Commercial _Indust. _Swim, Pool Other _Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR}lS.** **COPY OF CONTRACT REQUIRED. PRRMITS REQUESTED [) e ~BUILDING $ ) :JL9 Q.:E ( Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp, _W.R,E,C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBUfG GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block ~Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SRCTION Company State Cert. or Regist, # City License Registration # ****************************************** BUILDER Signature ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Si!!nature Company State Cert. or Regist, # City License Registration # ****************************************** PLtJMRER Signature Company State Cert, or Regist. # City License Registration # ********************************~********* MECHANICAL Signature OTHER Signature IF APPLICATION APPROVED BY PER1'IIT OFFICER, II CONDITIONS OF PERMIT AFFIDAVIT A; NOTICE OF DEED RESTRICTIONS. The undersigned understands that this perlit lay be subject to "deed restrictions' which' ~ay be I~re res~rictive than City regulations. The undersigned assules responsibility,for co.pliance with any applicable deed re~trictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake wor~, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor ftay be cited for a .isdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (B131 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised,to have the contractorlsl sign portions ~f 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 wor~. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled tc, 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 CClnstruction Lien Law - HOleowner's Protection Guide' prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is sO.rone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the 'owner' prior to cOlmencement. E. CONTRACTOR'S/OWNER'S AFFIDAVIT 'I certify that all the information in this application is accurate and that all work will be done in co&pliance with all applicable laws regulating construction, zoning, and land development. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has com~enced prior to issuance of a permit and that all wor~ 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 work, and that it is IIY responsibility to identify what acticlns I must ta~e to be in compliance. Such agencies include bllt ~j e nc,t liilited to: I Depart.ent of Environmental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatlent I Southwest Florida Water ManaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways t Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - W~lls, Wastewater Treat~ent. Septic Tanks t US Environ~ental Protection AQency - Asbestos abatement I also certify that, if fill laterial is to be used in Flc10d Zone "A" or "A,etc.', it is understc1c.d th~t a drainage plan addressing a "colpensating volu~e" will be sub.itted which is prepared by a professional engineer regist~red in the state of Florida prior to permit issuance. A periit issued shall be construed to be a license to proceed with the wor~ and not as authority to viol3te, 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, or violations of any code. Every permit issued =hall becole invalid unless the work authorized by such permit is coamenced within six months of issuance, or if work authorIzed by the perlit is suspended or abandoned for a period of six lonths after the tile the Hor~ is commenced. One 90 day e:le~5ioll of tile, may be allowed for the per~it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspectic1n must be lc,ggedduring each six Mnth period, or the proj!?ct Ilill be considered ilbalidoned. 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". SIGNA TURE.:.:~_jjfdJ- ti'J1J____ " OWNER OR AG~T /rv-- _~~--J~-~J-------------- DATE___________________________________ _~- -L-I---~ ~~lDA~g~~~~C~~R~~--------------------------- NOTA&.t~!~ My commission expires Jan, 28, 1995 ~' MY COMMISSION EXPIRES~~ili~e~~n~~~~i~BencYMY COMMISSION EXPIRES__________________ SIGNATURE______________________________ CONTRACTOR DATE ~ ~ fl C.," ... ;.......... . I: , c/ () . ,< /1' ',./ I \ '~ r I Ii I , , li.,_. ~_ , . , I iiJ I: l !. t~ -<> ).". r' I t. ,1;0 .~ ...., ~y U/ ()_ ( / I '(JeIf .....,--. r H 1 1, I r I ., ' _.._-------~-! \, .........~) ...~. " .~<: ..) J::><'. 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