HomeMy WebLinkAbout91-1695
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
Permit N'!
1695~
;~-Io -7 I
./
Type of Permit j).D
B~('E~~~~~I~
::::;;r~:~ers Name . ~~1::~!1ff~
BUILDING DEPARTMENT
1-813-788-6611 -"'"
~O
~_.. ,.,.'.,.",
M CHAN~?AL )
Date
~.
{It>..AT:-
Legal Description:
Sub.Div. IO'-.;1(p- ;J/- oloA- ~DDDG>'- DS;2!.'V
Complete Plans, Specifications and Fee Must Accompany Application
Of
Zoning CI:
Description of Work
,.-&)/.
I
Energy Code Readout: Jl )f!
Estimated Cost: ~ (-;:</ () J/ / . $-
- ~
Fee: ~~. ~ ? ~
SIGNATURE (:::'t-v c(llA ~/L-
COMPANY
ADDRESS
TELEPHONE #
All work shall be perfarmed in accordance
with the above and all City Codes
and Ordinances,
{!/f t!rJ 3 'j1S~-
OCCUPATIONAL LICENSE # ~ '3 ~~.
Tp.Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
lintel
FRM.
Insul.CL
WL
Breakers
Ducts Insl.
Compressor
Final
Driveway
Reinspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of teiii (119."99)
dollars shall be made for each 1I=ip./rd.-.JB. (/0-: d7J)
(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 wiIl be issued to the person owning same.
E: ..
,..; r:. " i....!.' ~
;'",_:1.., j !.. ..
'.". i'.'"!..
"'1' "
,:,1:..:....
....,'-....
.(>1\,.;,>..'
. ,
....
... 1\; ...' ;., L ..
~' .::
, ;'i
',I
: l'
H. :;1;. I
t .ii. {!! !::
.. ..ut
:..; i-..l L: ,...
j!"'
\:;1 1;..
i:: ;':i"
:<\::L..
I"'j:,'j::.
'::.!I<L iui ;. {..!!:"
i i..i",.... .-'
. , . (:,!<
.1 j ,...,
.A,J'-:!
. .. .! {.~.'
r"'} \.,1 ()
"
r::,
,..., i
" .i.
':.'
,. j:,
".J i;.: L', L: I"Oi h: i.'j L, 1)
L:, F' t..j ../ h~ H
~ ": ! .'\ !~"1 . :"' f'..J ..!
:'.'1 j:.
j:,:
!...,l <) i. . ,
..,!.,i
....t..,_:.I
;.': '."."'-
; ~;.,' I ,
t.\ :'.
!',:,
;"....1 1 ~ ,..". r-: i: -'
. ...,
j..' (:i \ '\..
I,': :::- ::. L<
...,
..
1... ~':>:
!.'l "
!:,11'
.of
.. !.)
::.!. 'j
\ l. ...,
(,.,(,.,'il';;" {.\1
, ."i"
L': 1.. : ! j ,: i<
.' i.J F: 1.'
i..'
~. !:: . .
H ./
! : i.:. 'i F:, -.. :..,; j..' \ \
'.,' i
l:::l:. ;.\i (:'!H
("1 I:,
1"\ t.~.l I.)
:(Ii..
i:: ...
;,...,'
"J ~
:\, .), ;, ~ (:',
1 ~".::-'l f-::
(.'j
: ....1..1:.. (':
.. i..'
~" ! \'-. ~
,u,L,
j"1;':
. !. -;.. , '! "'- ! l,\ ~.
':3 '
(.),.\
!.\ !\.'
,"
, I.:,
; I"
L: !.~J ;..:
Ul<
! ('..1'...: I
!.....~
,.. H 'y" hI \ .. .~'. ~. L
r : ,.... '.:'
,Ul. ;
!:.
..:(j..
L.j\..,
I.....] 1"";1
:.,.,1 I:,
.. !.> r> . 1::
1""" ..
,.:
C r-)
I iC .".
.'::-.,:,..,,,.1
:! j.:
U ......... j :\!!-:: !)F
i:.'i..
;.,,;.'.
I.:.~ !.J f ! L,.
:.'i.":.'.1
I:.:' \'. \ ..~ .1. j..'
... 1,.1 i.:,:
f.'"
1..
L. ('il"..Jj .! '.."
: .:~ t...: L.. ':.'
;'.1 () '::' i-.., i."
~', '. _.; ':'. ..
,- l
" I..;
i.J .: f ~
C'.\.
J.
::.;.
~....:
~-- H
!; I:
f':i .;.
i,'.l
1.: j
. ...l C
i.. ,... ,.
..:.: ~_:;.; ;. !:', I ~.,
I';,:
h~ !::: !. . C 'r !: . .'.
'..:\ :'i,-','
,t..;. :..;, ().
;
i,.
(' .;. ,.;.
i:
r.]
H "'. L.!
l',!.
. .-,.....,
c: ,:> 'j' I::
d:l.i ....
',H"
~. ..' f.."
; ('...Ij:
_f.W~!:!.t;I!;lU!!d~m!oH""",.ftm_-.-' r .~..d_llfIII
-,.';'il' ....:....-;.,.... ..., ~";'hli~.n;:~"".;"'~"" ,...~ :...;;.--...- "",,,-_.'"
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
m';~;ER
---&.-- .
i
iI,
r
" (. J' ,,?i E ~ V . '
\: i ~l~ i tj-!-~
ADDRESS
~}T
2-h{f~
PHONE
'1 ?f)-, -.5]};- C;
~.
;:..,....L
A-l?PUCANT
<<:.
~.;
.Jell LOCATIon'.~
LOT SIZE_X
AREA SQ. FT.
lSGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
P:\RCEL I. D. 11
WJRK PP.OPOSED: _New Construction _Addition .-!:-Alteration _Repair t'- Install
.. ,"~
'~~ Go '2.. I
c /();q
c C' () c:> c.
D S'-,L c.J
_Sign/Temp.
_Sign
_Move
_Demolish
rROPOSED USE: _Single Family
_M/F
_4~ of Uni ts
" ~M/H
_Commercial
_Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
CO~I}lERCIAL :
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.
pF.RMTTS REOUESTED
"
~ELECTRICAL
_~~_J1ECHA'~I CAL
valuation of Total Construction
/ 'ci ~-'V' o./c
~~AMP Service ~' Florida Power Corp.
. .'#<J
_BLJILD~~NG
_W.R.E.C.
$ ,:)[)/..; /. Oi)
Valuation of Mechanical Installation
_PLL'MBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
S igna tur'~
~ONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
IlJlILDER
"
,~)I
fi' I
~r / ./
F;U:CT"RICIAN' J.:.-/-<',//
'y
Company Ii c: f2 f( (? +J- /~ e-./' ff~o;~ J <uc .
State Cert. or Reg1st. 41 /F~J()()[)..'lDrJ?!
City License Registration 4F l..j~'7
******************************************
"0~
/i;~. 2 <><J
~i[matur~
Si~r,nature
ME r;I IANI :;aI. ,,' _ , Company rJ (' '" ;7 p+ J, , ",d" /- {"l7 /<0 ~ :J~',
(' --V _ k-' State Cert. or Regist. j; (21c..o:'J97SS
s;gnature...~;~AV /_ ~ J d'A/fY City License Registration j; In'~
******* *********************************
Company
State Cert. or Regist. 41
City License Registration 4F
******************************************
.r.L1ll1B.ER..
Signature
D!HER
;~
PERHIT OFFICER.
APPLICATION APPROVED BY
'!l~"'~
'"
J~_
1],1..~ j -<!.IIlilIf~"'" __1
~I
-~;~
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The undersigned understands that this perlit lay be subject to "deed restrictions" which &ay b~ more restr.ictive than City
regulations. The undersigned assules responsibility for 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 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 owner and contractor lay be
cited for a lisdeaeanor violation under state la~. If th~ owner or intended contractor are uncertain as to what licensing
requiresents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, 1813l
788-6611.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised t~ have the contractorlsl 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 cun'fdLtor, are res~onsible 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 FE~S AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided Kith a copy of .Florida's Construction Lien Law - HOleoMner's Protection
Guide. prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOle6ne 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 cOllencement.
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 cOlpliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby lade to obtain a perlit to do work and install~tion as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be performed to meet standards of all laMS
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies fiay apply"to the intended work, and that it is
IY responsibility tel identify what actions I lust take to be in (l'lIpliance. Such agencies include but ~le not lilited to:
....
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.., it is understood tho! a drainage plan
addressing a .colpensating volule" will be sub.itted which is prepared by a professional engineer regist2i~d in the State of
Florida prior to pertit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall i~s~ance of a per~it pr~vent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or ~lolations of any cod~. Every permit issued ihall beco.e invalid
unless the work authorized by such pertit is cOllenced withip ~ix months of issuance, or if work authoflzed by the perlit is
suspended or abandoned for a period of six lonths after the tlJe the work is commenced. One 90 day e~t~nsioli of tile, lay be
allowed for the perlit 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 tonth period, or the project will be considered dbdildoned.
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".
SIGNATU.a_<~&~-
" CONTRACT tI
DATE____~Lj.i. rL._ .__________________
l "C .
S IGNATURE-bB%~~~~GEN;:-------------
DATE____~L122.I,__~____________._______
fl":
NOTARY AS TO ) .' ~
OWNER OR AGENT __!fl'(Lr(~~/ #.--
rvJ'ii61iC.-state of Aorida .......,
My ( '.
MY COMMISSION EXPIRES__~~n!x~!~~~~~~
1"7oy -rain - JmurancllI Inc.,
NOTARY AS TO.. .~ fj .-~'
::N:~:::::~::~~:~~;~~~::.'
11MIl'!Uh5f,-hpifes1Iii1e"'S;' 1:919'\
Bondltd Thru Trvy Fain' ImiJraocllI Inc:.