HomeMy WebLinkAbout91-1687
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STATE OF FLORIDA
City of Zephyrhills ~
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
PermitN'~
168713
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it
Date
BUILDING
TRICAL
PL~
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Property Owners Na~e: ':7j '~__ II & ~
Job Address: 1/.P / 7 - ~ ' I
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI:
Description of WOrknQ
/)~~:
, I
....
, ~-- 1/
.f::{, ~ "2,0' ct 1--,0-
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
OCCUPATIONAL LICENSE # Y::; -- k ~1J U-
~~~~
....-~_.-- ----
~ B~~~~~_; ~)
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
Fee: r.J .5~'. c:J-i) ;
SIG NATURE 7? 'vig~h:;1f"~-
COMPANY v
ADDRESS
TELEPHONE #
Estimated Cost: ~ 6 c:ro; rT7)
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
-~
ELE~L
~,
M~ICAL
~
"-
PL~
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of k.. {118.eO)
dollars shall be made for each.. T rd. de.. V~-; crv )
(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~\ ~C'~(JJYJ(' C~....~~iN'--
~_ i.1t~ q~- ~d.t(2~ ;:f/~ONE lqvti)
OWNER ~O..sA.. C() \ \0.('\ ,
JOB LOCATION h\.R l<1 q~ St.
ADDRESS
8~a
LJJJ I ~ gSg'D
2J.l.
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D. ~~
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____Sign/Temp.
____Sign
_Move
____Demolish
PROPOSED USE: ____Single Family
--.--M / F
____# 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
~UILDING
$ /b c;rv. u~
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
____PLUMBING
GAS
Valuation of Mechanical Installation
~ROOFING SPECIALTY
____Frame ____Steel Other
____MECHANICAL $
.#- .
TYPE OF CONSTRUCTION:
____Block
FINISHED FLOOR ELEVATIONS: FT.
Signature
******************************************
CONTRACTO& SRCTTQN~~ ()~ l.
Company (' ~ c.'f-1iJv"...
State Cert. or Regis . #
City License Registration jfr. -$12...
******************************************
r
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
ELECTRICTAN
Company
State Cert. or Regist. #
City License Registration H
******************************************
PLlIMBER
Signature
Company
State Cert. or Regist. jfr___
City License Registration 4fr -
******************************************
MECHANICAL
Signature _
Company .
State Cert. or Regist. #_~
City License Registration #
OTHER
Signature
******************************************
PERMIT OFFICER.
APPLICATION APPROVED BY
--~
lJlll41
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The undersigned understands that this pertit lay be subject to "deed restrictions. which lay be lore restr.ictive than City
regulations. The undersigned assules responsibilitY for cOlpliance lIith any applicable deed restrictions.
. ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ollner has hired a contractor or contractors to undertake work, 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 OMner and contractor lay be
cited for a lisdeleanor violation under state law, If the ollner or intended contractor are uncertain as to Mhat licensing
requirelents 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 or contractors, he is advised to have the contractor!s) sign portions of the
'Contractor Sections' of this application for Mhich 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 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)
I certify that I, the applicant, have been provided with a copy of "Florida's Const~uction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departtent of Agriculture and Consuler Affairs. If the applicant is sOle(,ne other than the
.owner", I certify that I have obtained a copy of the above described docutent and promise in good faith to deliver it to the
"owner" prior to cOllencelent.
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 cOlpliance with all
applicable laMS regulating construction, zoning, and land develop.ent.
Application is hereby lade to obtain a pertit to do work and install~tion as indicated. I certify that no work or
installation has COI.enced prior to issuance of a pertit and that all work Mill be performed to leet standards of all lalls
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies lay apply'to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in co.pliance. Such agencies include bIll ile not liaited to:
....
I also certify that, if fill laterial is to be used in Flood Zone "A. or .A,etc.', it is understood that a drainage plan
addressing a .colpensating volute" will be subtitted which is prepared by a professional engineer re9ist~icd in the State of
Florida prior to per.it issuance.
A pertit 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 pr~vent the Building Official frol thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every permit issllud ;hall becole invalid
unless the work authorized hy such per.it is coa.enced within six .onths of issuance, or if Hork authol ILed by the perlit is
suspended or ahandoned for a period of six tonths after the tiJe the work is commenced. One 90 day e~t.€nSiOIi of tile, lay be
allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust he logged during each six tonth period, or the project will be considered dbalidoned.
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 L DER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF \.OMMENCEMENT. UND R $2,500 IN VALUE
DO NOT NEED TO RECORD AND POS A "NOTICE OF COM E
SIGNATURE___~~~---------------
O~NER OR AGENT
DATE_._!1.L-LfJ.-------------------.-------
,
~ '
NOTARY AS TO '
OWNER OR AGE ,'.f:t&Lf{t;k~AJL~i-~-
MY COMMISSION PIRES______________________
SIGNATURE__
-------.-----.-----
NOTARY PUBLIC. STATE OF 'FLORID~.
NY COMMISSION EXPIRES: MAY 17,1992..
.OHDED THRU NOTARY PUBLIC UNDERWRITER",
DATE_~~_~~-_-----------------------
~ .1
NOTARY AS 0 3
CONTRACTO _ _ _L__e..f.LitcI':IJ/'Jl.-ik-'i.~
, l/
MY COMMISSI~ EXPIRAES~ -
NOTl in' ru.>Oc.-sTATE'"t)Frco1<<Ji'jr.
MY COMMISSION EXPIRES: MAY 17.1992.
130N-DE'D THRU NOTARY PUSL.IC UNDERWRITER..