HomeMy WebLinkAbout91-1685
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
16853
Type of Permit
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Property OwnersName: L5'J" '/ ~, /}' :)<
Job Address: 6 L./ / / '2 ~ '--{/~'"
,/ iii
Legal Description: Sub.Div.
Date "7 - J / - ::; /
E~,_
P~
MEC'HA.N1CAL
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Lot
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Zoning CI: ,-:;Z..... oJ- ',- 0'- - (1 0 (, - v u (./ .L !2.
Description of Work. ~.rU' pl/t-? ~~'>---7'Y""L-
Energy Code Readout:
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Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
..? t C) 6 ~ GJ-[]
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OCCUPATIONAL LICENSE #
Fee ,5'-5: C7) i~
SIGNATU~4~~. · ~
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
n~ CV1 v'/1 (" vl e ,~/ tJ ;)0 /~~ !
~~~~,
Ftr._.- !?r ~~ SLB
Pre SLB Tub Set
Lintel Water
FRM. Sewer
Insul.CL Final
WL
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Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
ME~AL
~,
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of t [I - 00)
dollars shall be made for each ....".. /Y' 4 d. e. (J 6: dlJ )
(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.
CITY OF ZEPHYRH~LLS BUILD~NG DEPARTMENT
OWNER -H G-~J~ rt'<, Co/JI'-.l/rO BrlRr_4\?A ~Of\l\i(_lfL)
JOB LOCATION {eYII U)ODU(ZU FI:: CS+
PARCEL I. D, # t1t}.. f) (f' - ;). /- (1)0 ((Jt"J - (j ri~()O - n 1~ 0
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
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! RECEIPT FOR AD'VA.LOREM;:iTAXE'S"AND NON-AD VALOREM ASSESSMENT~
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PARCEL 02-26-21-0060-00eOO-Olf
ASSESSO VAL
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57469 ZEPHtR;;;:P'dU<'-iPB 3 PG10 LOTS 18
25000 l~Hirj;.Ji~~v~CATED<BV Bee
32469 (FULL'DESCRIPTION QNTAX ROLL)
MLCD 30;
C~KLIN HERBERT W &:SARBARA E
6411 WOODRUFF ST
I EPHYRH ILLS F L33540-6336
.PAI D*
01/31/91152119
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APPLICATION FOR PERMIT
CITY OF ZEPHYRH~LLS
BUILDING DEPARTMENT
APPLICANT
ADDRESS In l/ / / tAl Of) f) r2 u pi:::. st.
OWNER H E-r< e) !? R+ ct- '-~e M ~ 10 I? 1+ CnttJ tJ... L '/IV
JOn LOCATION (J~II (JDDI:> ~u FF S-L
PHONE .1fJ -lpLf~~
LOT SIZE~X /3() I AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S) log) \qJ;).,() BLOCK C SUBDIVISION
PARCEL I.D.i~ ()c2-J0-.:;p-(")(){on_Vof'.-(')O-OI$?D
WORK PROPOSED:____New Construction \~Addition ____Alteration
_Repair
_Install
____Sign/Temp.
_Sign
~love
_Demolish
PROPOSED USE: _Single Family
_M/F
_i~ of Uni ts
,_l'l/H
____Commercial
~Indust,
_Swim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t,
Height
RESIDENTIAL:
COM1'lERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORt-IS. ,~*
**COPY OF CONTRACT REQUIRED.
PERMITS REQUESTED
LBUILDING
$
1000.00
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBIN'G
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame ____Steel
4 i- Ll i()'\ .
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. 0
City License Registration #
******************************************
BUILDER
Signature
ET.ECTRICTAN
Company
State Cert. or Regist. #
City License Registration 0
******************************************
Si!!nature
Company
State Cert. or Regist. #
City License Registration fl
******************************************
PLUMBER
Signature
Company
State Cert. or Regist, #
.City License Registration }~
*************************************~**~*
~lECHAN1 CA T.
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
**********************************f*******
APPLICATION APPROVED BY
PERtIIT OFFICER.
, ,
CONDITIONS OF PERMIT AFFIDAVIT
A.~ NOTICE OF DEED RESTRICTIONS:. ,
The under5ign~d understands that this perlit lay be subject to "deed restrictions' ~hich' may be lore re5~rictive than City
regulations. The undersigned usuaes responsibili~:r,f~~. cOlpliance with any applicable- deed restrictions.
. . .
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be re-quired t.o be licensed in accordance with
shte and local regulations. If the contractor is not licensed as required by law, be,th the oltner and contracte,r nay be
cited for a .isdeaeanor 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, lSl31
7SS-bbll.
Furtheraore, 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. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for t~e 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 te, per&itting privilegc-s 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 C(,nstruction Lien Law - Homeowner's Protection
Guide' prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is SOIEone oth~r than the
"owner', I certify that I have obtained a copy of the above described document and promiSE in good faith to deliver it to the
'owner' prior to cOI~encement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all w~r~ Hill be d~ne in c(,~pliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby aade to obtain a perait to 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 work will be performed t~ ro~et standards of all laws
regulating construction, City codes, zoning r~gulations, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other governmental agencies may apply t~ the Intended work, and that it is
/lY responsibility to identify Hhat actions I must take to be in c(,mpliance. Such agencies include bllt ~l e liOt li'lit~d to:
I Depart.ent of Envi,on~ental ReQulation - Cypress Bayheads, Wetland Areas and Envir~nmentally Sensitive Lands,
Water/Wastewater Treatment
I S~uthwest Florida ~ater ManaQelent District - Wells, Cypress Bayheads, Hetland Areas, Altering Watercourses
I ArlY CorDS of Enoineers - Seawalls, Docks, Navigable Waterways
I Depart.ent of Health L Rehabilitative Services. Environmental Health Unit '" W~lls, Wastewater Treat~En~, Septic Tanks
I US Environ~ental Protection AQency - Asbestos abatement
I also certify that, if fillllaterial is to be used in Fle,od Ze,ne "A' Of 'I\,etc,', it is underst(<(,d th,l a drainage plan
addressing a 'colpensating volume" will be sub.itted which is prepared by a professional engineer reyisl~ied in th~ State of
Florida prior to permit issu,ance.
A per.it issued shall be construed to be a license to proceed with the work and n~t as authority t~ yio]~te, canc~l alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fr~1 th~reafter
requiring a correction ~f err~rs in plans, construction, Of violations of any code. Every permit issu~d shall bec~le invalid
unless the work authorized by such permit is coalenced within six months of issuance, or if uork auth~rJzed by the perlit is
suspended or abandoned for a peri~d of six .onths after the time ,the Mork is commenced. One 90 day e=tE~5joll ~f tile, aay be
allowed for the per~it with fee charge of $15.00. The extension 5h~11 be requested in writing t~ the Building Official. An
approved i nsped i (,n r..us t be 1 c,ggedduri ng each six JIlonth peri od, (of the pro jed Ii ill be ((,ns i dered ilbaiid(.r,ed.
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".
SIGNATURE_k6~-[_.fj~k----
OWNER OR AGENT
SIGNATU~E
------------------------------
CONTRACTOR
DATE______]_~~Q:_il_______________________
DATE
-----------------------------------
NOTARY AS TO J? l. j
OWNER OR AGENT --rr--.C"Ii2fJ--------------
MY COMMISSION EXPIRES___~~~'.!!~~~. ~!.a!:..~f-FI~lda
My Commission txpires July 23. 1991
NOTARY AS TO
CONTRACTOn_____________________________
MY COMMISSION EXPIRES__________________