HomeMy WebLinkAbout91-1671
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
PermitN~ 1671 ~
Date 7-dS -9/
E~l PLU~ ME~l
Property Owners Name: ~~ ~_~
Job Address: 3f5t3 / 7 ~ r:M-.
Legal Description: Sub.Div. Lot
Blk,
Zoning CI:
Description of Work
J.t/- 2- h .~j- CJ/6t> -/)))1)2) , t/S"/O
~"/71L~ -~~~/kt~
Estimated Cost:
II '} 04 lJ" 0 0
cS~
Fee: <15S;d~
SIGNATUFUJ ~ ~ ----'
v ..-
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances,
COMPANY
ADDRESS
TELEPHONE #
~fia~/fYl/
OCCUPATIONAL LICENSE # /pd
F .
Pre SLB
Lintel
FRM.
Insul.CL
WL
MECH NICAL
SLB
Tub Set
Water
Sewer
Final
Tp,Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
~iVeWay ~
/{a ~~A~ fcomL 7-lf-'i1 ~
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of &11 (lie (0)
dollars shall be made for each~.lrd--.1 e. (i~-. O"V)
(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.
38545 Palm Grove Drive
Zephyrhills. Florida 33540
ACE,
ALUMINUM
Job No.
Phone: (813) 782-2616
('\
SOLO TO Jj,VL D t: c 'is [10 (:) I L-n: j.lo~ IS S H ~~) (fI/1fi: Q".f) /lJ /J1JTft:s- J
ADDRESS k>~ ""'~~.I-~AlL)~ . J
SHIP TO wfl t( /AJ. '/(f) W w" 0/ .. '2 - /; ) J.,L.-S rJ IJ.
DATE 1- .:2:2- 9/
PHONE
,/I.x p)( I J s: /lPO'- /J){ /.1 S bR.VE/tJ R/Jo /VI r;)-
(\, 6X~Xh SvtU:cAJ ~/H" /C:<x'/f ~#:.R/o~
(',
The undersigned agrees to pay
INSTALLERS IN FULL ON COMPLETION
PERMIT
PRICE
TAX
Tor AL PRICE
DEPOSIT
~~ ~CE C.OO.
OtJ
$tit' :
Rep.
'''''',-
APPLXCATION FOR PERMIT
CITY OPZEPHYRHILLS
BUILDING DEPARTMENT
;leE l1'-tlM'
ADDRESS -.f~ys- r/}LJ'YJG-,Q{)J~. 'lJtR,
J!AMLtJ /'It)HrcS'',';:
, "" 2-)l/1..":S' ,
Jon LOCATION,.(t?7 ~ JRIf/7 J.. Ed,tf/iJlj:};~'''f)(C.. 10;9, LOT SIZEs:? x ~O AREA SQ, FT, /.?'6
LEGAL DESCRIPTION: LOT(S) /1/, BLOCK db SUBDIVISION
/4-,~1r ~ "
PARCEL 1. D. {f~ -~/c,c - ,.ItJ{)t1tJ - #S'I'C?
.",.--- " , " '
WORK PROPOSED:____New Construction \~Addition ----Alteration _Repair ____Install
'f; ~ J'~~ ,~,t , '
APPLICANT
: ;1" ,\:"., " ,
PHONE
1~-J ~ d..b / ~
,
OWNER
'-1;
.,(
L'I
____Sign/Temp.
_Sign
__~Iove
____Demolish
PROPOSED USE: ____Single Family
';~M/F
____i~ of Uni ts
._N/II
____Commercial
.' ~Indlts t.
_Swim, Pool
Other
____Restaurant & Health Department Approval
BUILDING ~IZE:
x
\
Sq\'are Fce t,
Height
RESIDENTIAL:
CO~frIERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOIUtS. **
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY rORHS,**
**COPY OF CONTRACT REQUIRED.
,PERMITS REQUESTED
~ BUILDING
$
'if) ~tJ.Otl
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_H.R,E,C,
____MECHANICAL
$
Va~uation of Mechanical Installation
____PLut-m ufG
....
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
Signature
******************************************
~~~. CONTRACTOR SECTION /7 /7/ d/}1,
~ ~ Company /;;~ t'L~:..:.<.-
, ... State. Cert. or Regist. U C;eC() dVb?~
-- -- - ___ - - City License Rer.istration I! /t..O
******************************************
BlJIT,DF.R
ELECTRTCTAN
Company
State Cert. or Regist, 0
City License Registration D
******************************************
Sif'Qature
Company
State Cert. or Regist. lj
City License Registration U
******************************************
PLlJMRF.R
Signature
Company
State Cert. or Regist, 0
,City License Registration #
******************************************
MECHANICAL
Signature
Company
State Cert. or"Regist, 0
City License Registration 0
OTHER
Signature
APPLICATION APPROVED BY,
~*... * ~***** ** ***.LJ.*J.**J.J.J....J.J..r.~.',...J.J.J,.',
,.. ~ ^ 1'1. ...... 1. .. 1. .. .. .. ., .. .. .. .. ..
~
PER~IIT OFFICER,
, '
CONDITIONS: OF PERMIT AFFIDAVIT
A.': NOT I CE OF DEED RESTR I CT IONS j'. , .'
lh. und.rlivnod underltinds that thi. p.rlit lay bl lubJ.c\ \0 "diad rlstrlctl~ns' .,hich may b~ .~r~ restrictive than City
regulations. Thl undersigned assules relponlibili\~.fo~ cDlpliante Hlth any applicable need restrictlon~.
. . '1 ..' .:. .:.'... ~ "'\" . " . .
t,...; .
B. UNL ICENSED CONTRACTORS AN~,"doNTRACTOR RESPONS I B I LIT I ES
If the owner has hired a c~ntractor Dr contractorl tD undertaka work, they may be required 10 be licensed in accordance with
stat, and local regulations. 11 the contra~tor is not licensud al required by law, b~th the ouner and c~ntractor ftay be
cited for a lisde.eanor violation under state laM.', If the OHner or intended contractor are uncrrtain as to what licensing
req~irelents lay apply,for the intended Hork, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611. "",
FurthllTun, if the owner hn hired I contrachr,.Dr contractors, ha is advised to have the cc,ntractorls) sign porti~ns of the
'Contractor Sections' of this application for which they Hili ba responsible. ,If you, as the ~Hner sign as the contractor,
you are indicating that you, rather than the ~ontractor. are responsible for the Hork. If the c~ntractor Nishes you to sign
as contractor that lay be an indication that he Is not properly licensed and is not entitled to perlitting 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 provlded with a copy of "Florida's Construction Lien Law - HOle~wner's Protection
Guide' prepared by the Fiorlda Departlent of Agriculture and Consuler Affairs. If the applicant is soeeone other than the
'owner', I certify that I have obtained a copy of'the above described document and pro~i~l! in good failh to deliver it to the
'owner' prior to COI!enCelent.
, ~". . .
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
1 certify that all the inforlation in this application is accurate and that all Hork Hill be donI! in co~pliance with all
applicable laws regulating construction. zoning'. and land developDent.
I . ~,"",
Application is hereby lade to obtain a perlit' t~'do work and installation as indicated, I certify that no work or
installation has co..enced prior to Issuance of a perlit and that all Hork Hill be perfor~rd to ~eet standards ~f all laws
regulating construction, City codes, zoning regulations. and land development regulations in the jurisdiction. 1 also
certify that 1 understand that the regulations of other ~~vernaental agencies ~ay apply to the intended work, and that it is
.y responsibility to identify Hhat actions llust'hke to be in compliance. Such agr:rldes include bllt ~lC Ii(,t li'lited to:
I Depart.ent of Envi~onmental RCQulation - Cypress Bayheads. Hetland ~reas and Eflviron~enta\\y Srnsiliv~ l~nd5,
Hater/Wastewater Treat.ent
I Southwest Florida Ilater ManaQelent District - "ells, Cypress Dayheads, Hetland Areas, ~llerinq Haterc~~rsl!s
I ArlY Cc,rDs of EnQineers - Seawalls. DClcks. Navigable lIaterHays
I Departlent of Health L Rehabilitative Services. Environmental Health Unit - H~I\s, HastEHater Treat~€n~. Septic Tanks
t US Envir~n~ental Protection ~Qency - ~sbestDs abatement.
I also certify that, if fill uterial i's t'orb~used in Flc.od Zone "fI" or '(\,etc,', it is undHste,c,d 1I,~t is drainage plan
addressing a 'colpensating volule" will be sublitted which is prepared by a pr~fcssi~nal engincer rcgisl~rcd in the State of
Florida prior to permit iss~ance.
A periit issued shall be construed to be a license to proceed Hith the work and not as aulhority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a per~it prcvent the Building Officiisl fro~ thereafter
requiring a correction c,f errc.rs in plans, constructic.n, or violations of any ((.dr:, [\'try per~it iSSIIl!\l :t.all bece,.e invalid
unless the work authorized by such permit is couenced within six lonths of iSSllance, c.r if IIc,rk aulhc,rlZed by the pertit is
suspcnded or abandDned for a period of six lonths after the time the Hor~ is co~men[cd, One 90 day ~~li~5ioll of tile, lay be
allOHe~ for the per~it with fee charge of $15.QO. The extension shall be reqllesled in uriling to the Building Official. An
approved inspectic.n ",ust be Ic,gged 'during each six Mnth period, c,r the prc.ject Iii II be c[o[lsidcred ..b.lidc'i1~d,
. """'\
WARNING TO OWNER: YOUR FAICURE 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__n~-::-f:t~---- SIGNATURE ____g~L-------
~~~~ER OR AGENT CONTRACTOR
DATE_______~~~~~_qj----------------------
DATE 7 - ..23- 0/
__________________lL_______________
NOTARY AS TO -1/ 7' / Il_ J' .
OWNER OR AGENT __~j~L:i1t-~----
_~' Notary~lic. State At Large, FlOrida,
MY COMMISSION EXPIRES__~~~~A~6~W95
NOTARY AS TO
CONTRACTOI1____~.j~--7!x~
MY CO~lm SS I ON EXP I RES Notary Public, State At Large, Floi
_ -M)'-Gerflf'ft1SSlOf1np1re'S 1\l1nl 2. 1
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