HomeMy WebLinkAbout91-1679
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STATE OF FLORIDA
City of Zephyrhills
Type of Permit
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PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611 ()O
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PermitN"~ 1679;1?
Date 7-.:2 7- C; /
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Property Owners Name:
Job Address:
/f;:-;~~jJl S2(r~
Legal Description:
Sub.DiVjl- db-r:2/- DO//)- JOftJ~t- (J ./~D
Blk.
Zoning CI:
Description of Work
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated cos?1 ~ 7~' ~
;
OCCUPATIONAL LICENSE # 5" 6- /J /(7
Fee:-f-Z;;;it ~
SIGNATURE ," '11/,.
COMPANY
ADDRESS
TELEPHONE #
All work sha!! be performed in accordance
with the above and all City Codes
and Ordinances.
PLUMBIN.G.~~'
~
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
BUlL
F t r.------
Pre SLB
Lintel
FRM.
Insul.CL
WL
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 rUIO)
dollars shall be made for each Nip; T rd.-de (<s: &TD )
(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
APPLICANT ~U)50 IJ \<E.rlrlE..-\-\1..
ADDRESS S-S' ~~ ll~ S-teee.:f
OWNER t4'Ci1"aPSoIJ, t<e.t'\.t'\6H\ M..
"V\A
PHONE l~l z,fn1
JOB LOCATION~~~
LEGAL DESCRIPTION: LOT(S)
A-t'- "3t3~ LOT SIZE_X
13 I ,4 BLOCK lc4- SUBDIVISION
AREA SQ. FT.
_Sign/Temp.
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
_M/F
_4~ of Units
._M/H
_Commercial
_Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS. **
**COPY OF CONTRACT REQUIRED,
PERMITS REQUESTED
AMP Service
Valuation of Total Construction
~ Florida Power Corp.
_W.R.E.C.
_BUILDING
~ELECTRICAL
...LMECHANICAL
$
$ 4443,11
Valuation of Mechanical Installation
_PLUMBIN"G
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
~Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
BUILDER Company
State Cert. or Regist. #
Signature City License Registration 4:
:::::::::~~~*.*********~~~~;:~~~~~~~
******************************************
Company
State Cert. or Regist. n
City License Registration # _
******************************************
PLUMBER
Signature
MECHANICAl Company ~v+~t ~ <
~ State Cert. or Regist. II
Signature City License Registration iF _
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.... . _. .~.... ,.. ........ ~~ ... ... 71 11 .. .... .. .. .. .. .. .. n .. .. .. ..
OTHER
Signature
IF
APPLICATION APPROVED BY
PERNIT OFFICER.
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictic'ns" which' may be more restrictive than City
regulations. The undersigned assules 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 work, they m~1~b~ requiredtobe licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor ~ay be
cited for a lisdeaeanor 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 Departeent, (B13l
7BB-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractorts) sign portions of the
'Contractor Sections' of this application for which they will be responsible. lf 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 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 Construction Lien Law - HOleowner's Protection
Guide' prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is SOIEone other than the
'owner', I certify that I have obtained a copy of the above described document and prc,mise in good faith to deliver it to 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 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 indicat~d. I c~rtify that no work or
installation has comm~nc~d prior to issuance of a perait and that all work will be p~rformed to meet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in th~ jurisdiction. 1 also
certify that 1 understand that the regulations of other governmental agencies ffiay apply to the intended work, and that it is
/lY responsibility to identify what actictns I lust take to be in cc.mpliance. Such agencies include bill ~i e m,t lillited to:
I Department of Envi,on~ental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatm~nt
I Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I Army CorDs of EnQineers - Seawalls, Docks, Mavigable Waterways
I Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - W~lls, Wast~wat~r Treat~ent. Septic Tanks
I US Environaental Protection AQency - Asbestos abatement
I also certify that, if fillaaterial is to be used in Flc.od Zone "Aft or "A,dc.', it is understc,c,d t!.ilt a drainage plan
addressing a 'colpensating volule" will be submitted which is prepared by a professional engineer regist~rr.d in the State of
Florida prior to permit issu,ance.
A perlit 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, or violations of any code. Every permit issued shall becole invalid
unless the work authorized by such permit is cOI~enced within six months of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the time the wort is commenced. One 90'day e~tE~5iD" 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 month period, or the project Mill be consid~red abaiidoned.
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".
SIGNATUREA!~hiJ~~44~-_----
OWNER.OR"';A~tNT
DATE________~~~~~~~------------------
NOTARY AS TO n /J I ~./.AJ~
OWNER OR AGENT_~~~-----
MY COMMISSION EXPIRES___~_=_~_J.!~==------
DATE
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MY COMMISSION EXPIRES___~~_~~~~~--