HomeMy WebLinkAbout91-1678
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
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Property Owners Name: ,LI/fJ-/J*!.
Job Address: S <:P '-.5-.3 ..:l..
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Legal Description:
Sub.Div.
Lot
Zoning CI:
Description of Work ~'" ~)~
PermitN~
167SJ3
Date 7-~ '7 - 51,/
Blk.
~1~
O-t- (6rY
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
7'y~. trv
Fee:
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
SIGNATURE
COMPANY
ADDRESS
TELEPHONE #
OCCU~ATlONAL LICENSE: ;~y
~~~~~~;~o ? b.
( UILDING j PLl:JMSJ.t!G
'-- ." ~
Ftr. SLB
Pre SLB Tub Set
Lintel Water
FRM. Sewer
Insul.CL Final
WL
ELE~L
~
"'-"
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
a c;-
M~ICAL
"'-
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of k-II (J I ~)
dollars shall be made for each __ /Y" a... de (/6'; t'1J)
(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 OF ZEPHYRHILLS
~_ BUILDING DEPARTMENT
APPLlCANTK,^( ~c'~p~
ADDRESS f) ., z., Sc> -lhv ~ ~
OWNER Dq, JLd ~JQ. (
JOB LOCATION 38-:)37_ Z "",~-e
~ (o:JC ~PHONE5(C, I
( ,
Bs-80
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.ff
WORK PROPOSED:____New Construction _Addition _Alteration ____Repair _Install
_Sign/Temp.
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
~/F
_ff 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 FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installa.tion
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTIONS C'" #is ~
Company r"'J .~t"" > &> ~
State Cert. or Re~. II_~OQ . 7 7~~
City License Registration i~ <.J 2-
******************************************
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
ELECTRICIAN
Company
State Cert. or Regist. ff
City License Registration # .
******************************************
PLUMBER
Signature
MECHANICAL Company
State Cert. or Regist. ff
Signature City License Registration iF
******************************************
OTHER Company
State Cert. or Regist. #
Signature City License Registration #
APPLICATION APPROVED BY PERMIT OFFICER.
"
....
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
Th~ und~rsigned understands that this perlit lay be subj~ct to "deed restrictions. which lay be lore restr.ictive than City
regulations. The undersigned assules responsibility"foT cOlpliance Nith any applicabl~ d~ed r~strictions.
. ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ONner has hir~d a contractor or contractors to undertake "ork, they lay 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 lay be
cited for a lisdeleanor violation under state law. If the OMner or intended contractor ar~ unc~rtain as to what licensing
requir~lents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor!s) 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 work, 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 permitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713~ FLORIDA STATUTES, AS AMENDED)
1 certify that 1, the applicant, have been provided with a copy of 'Florida's Const~uction Lien La" - HOleowner's Protection
Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOle6ne other than the
"o"ner', 1 certify that I have obtained a copy of the above described doculent and prom1se in good faith to deliver it to the
'oNner" prior to cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
1 certify that all the inforlation in this application is accurate and that all work will be done in compliance with all
applicable laws regulating construction, zoning, and land developDent.
Application is hereby lade to obtain a perlit to do work and install~tion as indicated. I certify that no work or
installation has CO.lenced prior to issuance of a perlit and that all work will be performed to meet standards of all laMS
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other governlental agencies lay apply' to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt ~le not lilited to:
....
1 also certify that, if fill laterial is to be used in Flood Zone "A" Dr "A,etc.', it is understood that a drainage plan
addressing a 'colpensating volUle' will be sublitted which is prepared by a professional engineer registEied in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, Dr
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 per~it issued ;hall becole invalid
unless the work authorized by such perlit is cOI.enced within six months of issuance, or if work authorIzed by the perlit is
suspended Dr abandoned for a period of six lonths after the tiJe the work is co~menced. One 90 day e~ten5ioll of tile, lay 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 inspection must be logged during each six lonth period, or the project will be considered dbdlldoned.
DATE____
ENCEMENT MAY
RTY. IF YOU
ATTORNEY
$2,500 IN VALUE
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO Y
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LE
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
:~G:A::R~:0TD REC~; A~TICS:G::Tu::M
t31~ GENT
NOTARY AS TO , l/ _. ~~
OWNER OR AGENT ~~~~-
MY COMMISSION EXPIRES l;~ . ,.:, :J. p
h~?2~77-~~~-----~~~;~-
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.-0,.d7.. -.,LLf-ny,/?-----/l/J
'1IltZL~hU-etl;k.
MY COMMISSION EXPIRES . ,.,..~
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