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Home My WebLink About91-1689 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 // ~o Type of Permit (ffi~~~ ELECTBJGAL ----,...> PL~ Date 1689$ 9-,5"" -CJ/ . PermitN~ ~c-" '--'~ . 711 ~ cJ..-tAa7fO ~D/,~ /D~ r~ " .. Property Owners Name: Job Address: Legal Description: Sub.Div. Zoning CJ: Description of Work Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Estimated Cost: ~ .~ r:2 71J ~ All work shal! be performed in accordance with the above and all City Codes and Ordinances. Ftr. ---', Pre SLB Lintel FRM. Insul.CL WL Driveway Lot Blk. pp':tion 71.1' / ::~T;;5 W~Ctjwli- COMPANY ADDRESS TELEPHONE # ELECTRICAL MEC Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final Relnspectlons: When extra inspection trips are necessary due 10 anyone of the following reasons, a charge of t~1 (t I 0 00) dollars shall be made for each "./ra- k ()o-' cro) (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. i~i6 ~li~ r;~]. f11',',i:: I I" )j;~ fit ~;] ~~ ;q ''t. ! ~~.'J. .--.- -11:,~ '1.'-0, )f;:"~ I'l NtJ J:t ~'f Nam~l )1 f ~j.i~' '1"" Addie s ft~' ~'<'" ;..~:.::~ l~/ Ph 0 ht _ "~r/~:t:~'-/tIVL-( 1 ttl . '/0' 1 j :,',,1, ',;",,~, "; I,',','y</ ," ) 1(11 /,.';, ," '~ i;".,l' / /) 2' 01 / Date;rI / / j', ' , 1) ~~~r c;fi'ahd haul away old roofing (clean U#dail>,~. . ,,:1 l!isla!! new iI,l 1,.',:1: ! (,1 !H ': ! _ ~~iu~ral ~LUl;'ilta. ~1Uo ~ 1, ,i '~l~: '. ! i~artlett JAve,) LqRIDA 33541 r- FF~CE ,::;;; t-ll 0 i'J f= , Q .a ii . ~ -'t,\ '-- If"""""\' 702 r.;t::; I\v.,-,; Q-~..""", L .J ,.,) 'Amount -~, ~ i _) felt paper ,~7'i , , //-1- ')"'\ j' ' -.........' "-..-J. -..I........ # t ' U I.; .i ,../' 4) 5) ~ ) 6) 7) 8) I I '. ;H'fr!!i ' '/ ,.'."'.,"',.'~'." ,-"-" t 1,:i'.A. ,/ /, (' ,\_,,';'~. --~,-' / THANK YiDU ,", ';"'1')\' ,(, , . ., . . ' ''1 ' , !~)" i, i . Your B,!smess IS Apqreclate(i':.,H)i! .'. . j Payment upon comp/9tlon unless prevlousarra, gemJAt made. v Warranties pertain to origif"lalown r :;f'1\,1 :. . wenn stJikE"5. c),;ciccrt'> or G.:I~"~ beyond oUt ~ntriil~ QVimer to carry fire. tornado .. 'L.'-_~-: Y:l,'2r,~-fr~-"":~<1fJmP'}D:i!J19Jl)Dl~;~E?nce. ~~_ 1 i~~ , , ! I I I I I I ; . I L~/;-;f/" ' I 7" ,; ,'--, , T ,O~I,--/-.:.? ." /' ~'. ',J 'l.......... 1 ./ f" -- ./ V' 9) 10) JOB LOCATION APPLICATION FOR PERMIT CITY OF ZgPHYRHILLS BUILD DEPARTMENT APPLICANT ADDRESS s-- OWNER 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. H **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. Signature CONTRACTOR Company State Cert. or Regist. # City License Registration # ****************************************** '- Signature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRICTAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Signature Company State Cert. or Regist. # City License Registration # OTHER *************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to "deed restrictions" which' .ay be .ore restrjctive than City regulations. The undersigned assu.es responsibility f~r cOlplia~ce with any applicable. deed restrittions. B. UNLICENSED CONTRACTORS AND CO[qTRACTOR RESPONSIBILITIES . If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed 4n accordance with state and local regulations. If the contractor is not licensed as required by iaw, both the owner"and contractor lay be cited for a tisdeleanor violation under state law. If the owner or intended contr~ctor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact th~ tity of Zephyrhill~ Building Departlent, 1813} 788-6611. Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractorls} 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 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 perlitting 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 Departtent of Agriculture and Consu.er Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the "owner" prior to co..ence.ent. 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 lalls regulating construction, zoning, and land develop.ent. Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has co.tenced prior to issuance of a per.it and that all work will be performed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent 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 but aie not li.ited to: . Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive lands, Water/Wastewater Treat.ent . Southwest Florida Water KanaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses . Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways . Departlent of Health t Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks . US Environlental Protection AQency - Asbestos abate.ent I al'5o ce{'tify'that, i.f fiJI.aterial is to be u'sed in Flood Zone "A" or "A,etc..,.it is understood that il drainage plan addres,simj a .colpensating volute. will be sub.Hted which is prepared by a proftssional engineer registered in the State of Florida prior to per.it issuance. A per.it 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 per.it prevent the Building Official frot thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit iSSlli!d shall becole invalid unless the work authorized by such perlit is co..enced within six .onths of issuance, or if work authoflzed by the per.it is suspended or abandoned for a period of six aonths after the tile the work is coamenced; One 90 day e~tensiOll of tile, lay be allowed for the permit lIith fee rharge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six .onth period, or the project will be considered abaiidoned. MAY RESULT INTEND BEFORE DO NOT SIGNATURE SIGNATURE DATE <::f-- .5 -- rJ / -------------~~----------------------- DATE ____s:X.:_0-.._________________ ________ NOTARY AS TO,' 2. ~ -/-~ CONTRACTOR_~LJl!J:;ik-~?fYl<4 MY COMMISSION EXpl~~;~~~~-~~T+~----~ NOTARY AS TO /2 ~ ' -~~ OWNER OR AGENT~~&!.-:::'~:; ~~ ~OTARY PUBLIC, STATE F ~LC;( )'. MY COMMISSION EXPIRE~~...).>i.oi~...L:...~-1~)5 Bonded thru Patterson - bcchtAg"ncy