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HomeMy WebLinkAbout91-1679 1tJ_.....___...l Page No. of Pages STATE OF FLORIDA City of Zephyrhills Type of Permit /' PO PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 ()O I)/_~ 1ft '. ~- ~CHAN~AY) PermitN"~ 1679;1? Date 7-.:2 7- C; / JJJH:OTN-G ",,...,,-- -""- ~ 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. po 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 _ ",****J.J.**J_** ******.........*J. * * .'. .',', J, J...... .'.......... J..' J. J... J. .... . _. .~.... ,.. ........ ~~ ... ... 71 11 .. .... .. .. .. .. .. .. n .. .. .. .. OTHER Signature IF APPLICATION APPROVED BY PERNIT OFFICER. \'" r--~ 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 ? -/~-// ----------------------------------- ~~~~~~C~;R~~_~~--~~---- MY COMMISSION EXPIRES___~~_~~~~~--