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Home My WebLink About91-1696 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N~ 1- "-- Date 1696 9/ Type of Permit ~UILOING ~~ }1/f Property Owners Name: !,/ cL Job Address: ..3;;)/ I / ,Y'" (; PL~ ......... MECt-i~ Legal Description: Lot Blk. Sub.Div, Zoning CI: / ,7 ':J;~,- (") / - c7 tJ cJ D - 0 Y .,/&1 L) Description of Work '~'J_<J...r _(~ c' .Le I<'~ ?>LLr (C;; /. ~ . {! ("; '::;J (~ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany A Estimated Cost: / ' /f';/ if' . , -, t, I Fee: oX ( / U 1.- . .---- SIGNATURE ,/;~'-;,/ / / L J'~ A. :1 v All work shal! be performed in accordance with the above and all City Codes and Ordinances, COMPANY OCCUPATIONAL LICENSE # ...!.. - Sf '~~:~cJ;>>~_. ADDRESS TELEPHONE # - /~-f1;- :' .-- ~.- - { ~ {~ 'h ;I- {/f:.<'/ ,( '~-...--.... .... ME~AL '-.,.,. ~- P~ ELECTRICAL Ftr. Pre SLB lintel FRM. Insul.CL WL 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 I_.r III: ~) dollars shall be made for each ...7ra.de. (/6-"t7l) ) (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 wilJ be issued to the person owning same. ------.--.-- -" APPLICATION FOR PERNIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER PHONE APPLICANT ADDRESS " ,57Y// f'~ UAA P LOT SIZE X AREA SQ.FT. LEGAL DESCRIPTION: LOT (S) ~- Gt - I BLOCt}IJ{) 0 SUBDIVISION 0 Y 7 ~ () - () () 0 0 PARCEL I.D.l~ I~ -;l.(L --2/ - ()Oi)() .- Of7atJ - 0000 ,- WORK PROPOSED:____New Construction ----Addition ----Alteration ~:air ____Install _Sign/Temp. _Sign _Hove _Demolish PROPOSED USE: ____Single Family _M/F _l~ of Uni ts ,._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 FORNS. ",.* **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED AMP Service Valuation of Total Construction ~lorida Power Corp. _W.R.E.C. _~:rLDING ~ELECTRICAL $ _MECHANICAL $ Valuation of Mechanical Installation .'" . _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION nlITT,DER Company State Cert. or Regist. # Signature City License Registration j~ ****************************************** F.I.F.CTRTCTAN~ a;t;~ company/l:t(;i[a2~. ---r State Cert. or Regist. j~ ~ ,,"nature /~ ~ City License Registration # .s>,t , * ***************** ********* ** **,,;, -;, -;,* *,' 'I, ** * " Signature Company State Cert. or Regist. # City License Registration j~ . ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHAN1CAl. OTHER Signature Company State Cert. or Regist. # City License Registration j~ APPLICATION APPROVED BY ****************************************** ,);1" ~ ~;] )<'i.J,~r PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . Th, und,rsign,d understands that this penH uy bl subject to "deed rl!litrlctie,ns' which Illay be 1I0re restr.ietive than City regulations. The undersigned alluteS responslbillty;for. cotpliance with any applicable deed restrictions. E. 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 ~ay be cited for a tisde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing require.ents tay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, !BI3) 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 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. Jf the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed- and is not entitled to perllitting 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 provi'ded with a copy of "Florida's Construction Lien Law - HOleowner's Protection Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOlec.ne other than the 'owner", I certify that I have obtained a, copy of the above described document and pro~ise in good faith to deliver it to the "owner" prior to co.mencelent. 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 coapliance with all applicable laws regulating construction, 20ning, and land developlent. '. Application is hereby lade to obtain a perlit to do wDrk and install~tion as indicated. I certify that no work or installation has coatenced prior to issuance of a perlit and that all work will be perfor~ed to Illeet standards of all laws regulating construction, City cod~s, 20ning regulati~ns, anrl land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies ~ay apply to the intended work, and that it is my responsibility tel identify what actions I must take to be in cOlilplianc~. Such agencies include bllt ~le nt,t lillited to: . ",.#' I Department of Environmental Requlation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Ldnds, Water/Wastewater Treatment * Southwest Florida Water Manaqement District - Wells; Cypress Bayheads, Wetland Areas, Altering HatercOUfses I Arty CClrps .of Enqineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - W~lls, Wastewater Tr~at~en~. Septic Tan~s I US Environmental Protection Aqency - Asbestos abatement I also certify that, if fill material is to be used in Fltood Ze,ne "A" or "A,etc.', it is understc,c,d tt..t a drainage plan addressing a 'colpensating volule" will be sublitted which is prepared by a professional engineer regist~ied in the state of Florida prior to perlit issuance. A perlit 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 p~rmit prevent the Building Official fro~ thereafter requiring a correction of errors in plans; construction, or violations of any code. Every percit issll~d :hall becoae invalid unless the wor~ authorized by such permit is commenced within six months of issuance, or if WDl'k authol lied by the perait is suspended or abandoned fDr a period of six lonths after the ii,e the work is co~menced. One 90 day e:tE~sioll of tile, say be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspectie,n !!lust be logged during each six tonth period, Dr the pre,ject will be C[,nsidered ilbtil,de,ned. 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_~o~------------- SIGNATURE_~~----- OATE_______<t:..:t...:fL--------------------- OATE__f-:&-~-~-------------------- NOTARY AS TO n /f IUA./ OWNER OR AGENT~~-~k-~~-----~- MY COMMISSION EXPIRES___€_=_;[~~~~----- ~~~~~~C~~R~~~~~--~~---- .. -- MY COMMISSION EXPIRES___~_~~_~~~----