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Home My WebLink About91-1680 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 permitN~ 1680 B Date-L7-3 0'- 7' I Type of Permit /~~ '--- ~L~~~...I ELECTRICAt:- PLUM-B-WG.-_ M EeHAlliCA1.... Property Owners Name:' ::1AJ2I~t:J 1l1~~ .4/' Job Address: ~5.j 6 3 ~ - - ,5 -.;tf <~ {L"f!.. , Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work ('JJ''j'-;lA/)I - -IAJ 0 t /) :/A4t c: I ,n0~ Energy Code Readout: ~ ~"~3-W ~ Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: / cr- 6 7', 0--0 , All work shal! be performed in accordance with the above and a/l City Codes and Ordinances. OCCUPATIONAL LICENSE # 7;7 &<'0\ (;,;li. Fee: \)~.~ tr;>>-"'(!:, 4 . SIGNATURE '1~- t (:5rJ-,'Y ~ COMPANY ADDRESS TELEPHONE # ~/~J;; (jfiL~ "--'-"--"'--'" ----~ ( BlJILDING- --- PL~ - SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul.CL WL Driveway E~ Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final M~AL ------- --., Breakers Ducts Insl. Compressor Final Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of"tIHI (SI9MO) dollars shall be made for each..-..- TY'a. de (/.j-; tJD) (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. SIT E PLAN PERMIT # (RESIDENTIAL USE ONLY ) LEGAL DESCRIPTION: SEcn ON TOWNSHIP RANGE SUBDIVISION OR OTHER LOCATION DESCRIPTION: REAR FT. ) '--- ~~ . l- LL. c, '6 ~. L L ( '1 G-(:::)Q.O ........- L1.J Cl ...... Vi ,., -l . .-. I (J J ~ <:::. __--FRONT ( FT. ) ---_.~-._~ Show all existing and proposed structur~vi~g ~imensions and setbacks. Also, indicate any a~jacent bodies of water and roadwa~cr:ta~to the property. Indicate size of mobile homes such as: 12' x 60', 24' X 36'. ----- .::> EXAMPLES J~i .......^""''''........... "...."'...,....."... wnOT't:' unLIt:' CI:'TIID 'rnpnliul Page No. of Pages '~ '. .. ',;; <\TI<~TF '~"~ If"JI!!.qn~1I H..,f1C., "<..,;' 3.' ~ 'LFI t .,._\.", .,;.~. > 'd" '1 - . 37528 Hwy 54 West 7r (Ji_l\tQU!' '__C "'-1(':;::";-; :', 3~li; , 4- ,,'u ,'.' ('8'1L3:'7~'8:7jD.gt~;2. ~"-~ ..-,,1._.. ,-, -'; ~'~J-,(; ~~ ) <-- P~,,-, - -, (;<;,-, j - ; . '. i "'s ........., '-~ "-> \... '-., ,-'_J ~,t' ...,,,r:.1<"\ $(j1l!,~",~,.... . ('.---.. ,-{>' ~( .,-~ "'. ! ,~ "} . --"'''',j$' 4f.....fllH.." !.l' (: I I ~,' ,.' '..if ' ~{~., "" -," r'--,. "''-......i (1 '" '. -I; r:'~ JOB NAME STREET . -- :" ....-', \ -.'2........:.:.. .....J ~j":::; "-. CITY, STATE AND ZIP CODE /2.-==- +\. \ \..."-. ~ ARCHITECT <;~,. \- \...:.::,-~ . -=:... (' (r ~,6.~\ DATE OF PLANS JOB LOCATION JOB PHONE We hereby submit specifications and estimates for: \ \.~)~\-D\.-",- +-t,,~ <: ~.- ',... "" .,....... \ ' .~. ....:l"-l. ~ --.J ~J'" '- .~ .---, ,-.., oz d.. X::' ~~ ...------ .- r -'-'-~-", ---..., 1\--- L:J ,-","''-".J "-1, : , \ ~-).~....... t~~ , .' -,~.....~ ~,~--.:: ',:>C ,_ I ~~) ---y- ------- -'- ~...... _ ~__'- ----. - -=-nii-- - \ _ _bU- --- J \ C l-t."c,"- Or' "-.'--, I / ~'\ r~ - \\ ~.------'_. N..')f1 L-)'. 0~\~:>-""-'--'--'''~ ~ " --- .......,..---- ~) \C;?\<- \ \.)\ ..~ .:. )(1 . c:'~- ~ ~r \ -~'h":_::" ,'-:,,:,,,:,,';.'1>,_.;_ { (~J ~ q \ , ) '-..0 , -.- Dr 'rnpn.ar hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: dollars ($ ). Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifica- tions involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. ~ -~ -/ /L Authorized , ./ y________ / _~..c,e. . 7 Signature r-: Note: This proposal may be 7~ withdrawn by us if not accepted within. days. Signature Atttptuutt of 'ropollul- The above prices. specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance: PRODUCT 118-3 (N'6EiSlelnc.. Grolon.:ass. 0147iJo Order PHONE TOLL FREE 1+800-225-6380 L "j . " APPLICATION FOR PERMIT CITY OFZEPHYRHILLS BUILDING DEPARTMENT Jon LOCATION ~~ ~~~. ~ =t:7~~~ -sv ~ . .'. ~}....p\.~(\, ~~~\&4.~ ~ S4 M~Oh~ ,C\~. LOT' SIZE~X PHONE 1.~"Lr- 0<O4:~ APPLICANT ADDRESS OWNER AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) PARCEL 1. D, t~ WORK PROPOSED~New Construction ,____Addition ----Alteration ____Repair ____Install BLOCK SUBDIVISION ____Sign/Temp. ____sign _Hove ____Demolish PROPOSED USE: ____Single Family , ____M/F ____t~ of Units _____1-1/11 ____Commercial ~Indust. ____Swim.. Pool Other ____Restaurant & Health Department Approval BUILDING ~IZE: x Square Feet, Height RESIDENTIAL: COHl'tERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl-IS. ,~* **COPY OF CONTRACT REQUIRED. ,~RMTTS REOUESTED ____BUILDING ~--. -~ Valuation of Total Constl'uction _ELECTRICAL AMP Service Florida Power Corp. _H.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation _PLUMBIN'G GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT, ****************************************** ~ONTRACTOR ~ECTI0N Company cz:;~ ~~ ~ \..)V'- State Cert. or Rcgist. !F__ ~~~~~ ~ City License Registration ~' .-U . ****************************************** ET.F.CTRTCT AN Company State Cert. or Regist. 0 City License Registration 0 ****************************************** ::;i!mature Signature Company State Cert. or Regist. Q City License Registration ~ ****************************************** PUlMRER Signature Company State Cert. or Regist. 0 City License Registration 0 ********************~~~k********~********* MECHANTCAL Signature Company State Cert. or"Regist. U_ City License Registration 0 PTHER APPLICATION APPROVED BY. .........~:::.*~;V_..:d'*"".!'*"*..*" PERl'llT OFFICER. , . i:..;"-,'; >, tONDITIONS, OF PERMIT AFFIDAVIT A.': NOTICe: OF DEED RESTRICTIONS ;', , , The undersignvd understSnds that this per.lt lay be subject to "dved restr1cti~ns' whicK may b~ lore restrictive than City regulations. The undersigned nsulI!s rl!sponslblllt~",f~,~ cOllpllanc!! lIith any applicable d~~d res\ric\ion~. ~:. ,:.\ ,'. '.. . t- " '."~ . ( B. UNLICENSED CONTRACTORS AND' tONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertakc 1I0rk, they ~ay b~ required 10 be licensed in accordance with state and local regulations, If the contra~tor is not licensed as re,quired by law, be,\h the ollner and contracteor nay be cited for a .isdel!!anor violation under state lall,'. If the ollncr or intcnded contractor are uncertain as to what licensing requirelents lay apply for the intended work, thl!Y are advised to contact the City of Zephyrhills Building Departaent, (813) 788-6611. ',', Further.ore, if the ollner has hired a contractor. Dr contractors, hI! is advised to have the contractor!s) sign portions of the 'Contractor Sections' of this application for IIhleh they lIill 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 aay 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 cedify that I, the applicant, havl! b!!en pro'vldedlllth a cop'y of "Fle,rida's Ce.nstruction Lien lall - He'lleollner's Prc.teclion Guide' prepared by the Florida Department of Agriculture and ConSUI!!r Affairs. If the applicant is SOlE one other than the 'owner", I certify that I have ~btain!!d a copy of.the above d!!scribed document and proDi5e in gDod f~ith 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 Mill be done in c~ftpliance lIith all applicable lalls regulating construction, z~ning~ and land dl!velopaent. ~ -', ; Application is hereby made t~ obtain a pertit t'o'do 1I0rk andinstallatie.n as indicaied. I certify that no lle,rk or installation has co&!!!nced prior to issuance of a perlit and that all work will be perfor~ed to ~eet standards of all laws regulating ce.nstructie.n, City ce.dl!s, zoning re'gulations, and land develr,pment regulatie,ns in the jurisdictieln. I also certify that 1 understand that the regulations of other gov!!rnaental agencies ~ay apply tD th!! intended w~rk, and that it is .y responsibility to id!!ntify IIhat actions I lUSt' take to bl! in cCompliance. Such agencies include loII1 ~l!! liC.t li.lited to: I Departlent of EnvirCon~enial ReQulation - Cypress Bayheads, Hetland Areas and EnvirDnmentally Sensi tive l~nds, Water/Wastewater Treatlll!!nt I SCoUthllEst Florida Hatl!r ManaQelent District - Hells, Cypress Dayheads, Hetland Areas, Altering Watercourses I Army C~ros of EnQineers - Seallalls, Docks, Mavigable Haterways I Departlent Cof Health L Rehabilitativl! Services. Environmental Health Unit - H~lls, Wastewater Treat~en:, Septic Tanks I US EnvirCon~ental Protect iCon AQency - Asbestos abatem!!nt I I also certify that, if fill lIaterial is to'be used in Flood Ze,ne "A" or "A,etc.', it is underste,e.d t;.~t a drainage plan addressing a "colpensating volule" will be subtitted which is prepared by a professie,nal enqineer reqisl~iod in the State of Florida prior to perlllit iss~anc!!. A perlit issul!d shall be constru!!d to be a license to proce!!d with the work and nol as authority to yiDl~te, cancel alter, or set aside any provisions of th!! technical codes, nor shall issuance of a pcrmil prevenl the Building Official fro~ thereafter requiring a correction e.f errc.rs in plans, constructlc,n, or violations e.f any (e,de. EYery per~it iSSlled :hall bece,ae invalid unless lhe Nork auth~ri2!!d by such perllit is commenced within six months pf issuance, or if Hork authorIzed by the perlit is suspended or abandoned fpr a pl!ripd of six .onths aftl!r the time thl! H~rk is (o~men(ed, One 90 day ~:li~5ioll of tile, aay be allolled for the per~it with fee charge of $15.00. The ext!!nsion shall be requested in "riting lo the Building Official. An approved inspection ~ust be Ipgged 'during each six m~nth p!!riCod, ~r the project Hill be cDnsidered ~balidonfd. WARNING TO OWNER: YOUR FAI(URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUI~ 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 RE POST A "NOT I CE OF COMMENCEMENT ".' ---------------- ~nRAcTOR DATE_C_________~~f!-------------- NOTARY AS TO ~ It: ~ CONTRAC TOR _._-~-A.-tt,. ___ __l~.L-- ---- ~IY Celi'lm SS I ON EXP rPf6tlJy-PuWie-PIIeo-fo.-R.--- My Commission Elpirn May 13. 1995 WNER OR AGENT DATE______________~~~(---------------- ~~~~:yo~SA~~NT__!~~~0c~~~~------- MY COMMISSION EXPIREN~~1iiOlArft----- My Commission Etpircs May 13: I,'"