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HomeMy WebLinkAbout91-1705 STATE OF FLORIDA City of Zephyrhills B~HtCr PASCO COUNTY Permit:N'~ 1705::1) BUILDING DEPARTMENT ,- r ~~13-788-6611 Date ~..- ?? ~ 9/ ~~I~ M~ ;-dLP<~;~j~7~ Property Owners Name: ~~ j ~ 0;;:4/116-1-./ Job Address: ._; e. s ' . Legal Description: Sub.Div, Lot Blk. Type of Permit E~' Zoning CI: Description of Work (y~,-~-:; 1~ "-,>J~tI~.;J ';W~ ../ Energy Code Readout: ) I 41t,~ Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: vii Fee: (f t- ADDRESS OCCUPATIONAL LICENSE t1,(~-ui, . TfLEPHONE II ~{,/ 't<,<<<ft L-, "?t<9.Jk?%, j/ AO/-jj! C~-~-~.~~) , ~E~L SLB Tp.Serv, Tub Set Rough In Water Meter Can Sewer Const. Pole Final Pool Pre-Meter Final All work shal! be performed in accordance with the above and all City Codes and Ordinances, ~ ../ Ftr. Pre SLB Lintel FRM. Insul.CL WL M~AL ,,~ Breakers Ducts Insl. Compressor Final Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons. a charge of l~.. iSI8.80) dollars shall be made for each~. /r,*- de (/~'"": tJ7) ) (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. ~ C~TY OF ZEPHYRH~LLS BU~LD~NG DEPARTMENT OWNER (ZP~ '-~~A~~ JOB LOCATION ~ - 6 3 t, ~ A;I, PA.RCEL I.D. # SHOW ALL EX~ST~NG & PROPOSED STRUCTURES G~V~NG D~HENSIONS & SETBA.CKS. p-Q / ~ --- cf7) A j-?( ~r~ ~ [] j--/~~J ~ -.:;:;,-.,.... '- UTILITY BUILDINGS MUST SHOW SIZE & FOUNDATION INFOR- MATION. FRONT PROPERTY LINE (NOTE EXAMPLES 1 & 2) STREET 1. SETBACKS FOR Rl, R2 ZONING 60' 2. SETBACKS FOR R3 ZONING 60' 10' P E~ R X 0 I \ 10' P S 10' 0 T S I E N D G 20' 1 0' 10' 10' EXISTING 10' PROPOSED 20'SGL FAH 30'DUPLEX 1 O' FRONT PROPERTY LINE FRONT PROPERTY LINE APPLICATION FOR PERl"lIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT () V I LA ADDRESS ....!?-fo:J "- OWNER 0 V I L A f'. L ESP 'Cf( A A/ c r ' c y Ire E S S Sf , /. L6.5' f/t=-R A IV C E PHONE 7ff;Z <7..j-(}" DL JOB LOCATION S{, J '" c y ~tfc:;5 r ST LOT SIZE x AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. ~~ WORK PROPOSED:_New Construction _Addition _Alteration ____Repair ____Install _Sign/Temp, PROPOSED USE: ~. Single Family _Sign _Hove ____Demolish _Commercial _Indust. _Swim.. poo 1 ,._M/H ~t.-~:' Other f/ _M/F _t~ of Uni ts _Restaurant & Health Department Approval BUILDING SIZE: x Square Fee t , 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 FOIlilS. H **COPY OF CONTRACT REQUIRED. pERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida power Corp. _W.R.E.C. _MECHANICAL LL:..PLUMBING $ Valuation of Mechanical Installation GAS ROOFING SPECIALTY .#- . TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature ~ONTRACTOR SECTION Company State Cert, or Regist. iF_ City License Registration if ****************************************** BPTLDER Signature Company State Cert. or Regist. iF City License Registration if ****************************************** f,T.Er:TRTCT AN Signature Company State Cert. or Regist. 11 City License Registration ji ;?j -S & y ******************************* Signature Company State Cert. or Regist. if Cicy License Registration ~ ****************************************** Company State Cert. or Regist. if City ~cense Registration !~ OTHER () Y L LA ^ ( Z I'" E A. A ,v c F Signature d..:d ~4,;;wr/~ *~'it:r-~* ~:. APPLICATION APPROVED BY {"f /" PERMIT OFFICER. '. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . The ,undersigned understands that this perlit lay be subject to "deed restrictions" which may be more restr.ictive than City regulations. The undersigned assules responsibillty":for, co_pliance with any applicable deed restrictions, '. . , B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owntr 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 .isdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended Hork, 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 contractorts) sign portions of the 'Contractor Sections' of this application for which they Hill be responsible. If you, as the OHner 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 Const\uction Lien Law - HOleowner's Protection Guide' prepared by the Florida Depart_ent of Agriculture and Consuler Affairs. If the applicant is sOleone other 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 cOIDenceDent. 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 compliance 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 per_it and that all work Hill be performed to leet 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 governlental agencies ~ay apply'to the intended worK, and that it is IY responsibility to identify what actions I lust taKe to be in compliance. Such agencies include but ~l e m.t liaited to: ... I Departle~t of Envir~nmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment f Southwest Florida Water ManaQeDent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses I Arty Corps Gf EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treat~ent. Septic TanKS I US Environaental Protection AQency - Asbestos abatement I also certify that, if filllaterial is to be used in Flood Zone 'A" or "A,etc.", it is underste.od th,t a drainage plan addressing a "colpensating volute' will be sublitted which is prepared by a professional engineer regist~(ed in the State of Florida prior to permit issuance. A pertit issued shall be construed to be a license to proceed with the HorK and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Offici~l frol thereafter requiring a correction of errors in plans; construction, or violations of any code. Every permit issll~d ;hall becote invalid unless the work authorized by such permit is cOIDenced within six months of issuance, or if H01'k authDI lied by the pertit is suspended or abandoned for a period of six lonths after the tiJe the work is commenced. One 90 day e:tE~siD" 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 ~ust be logged during each six Donth period, or the project will be considered dbdlldoned. 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_____________~~~-- OWNER OR A~NT DATE !1u fl.t, S:t ~ Lee; / ,. -- _:1-:) }tL_______j-_ ..LA------~-.- ---- NOTARY AS TO l '~I - ) // OW\\IER OR AGENTva~' - -1;2iLr-tlLf!f" ~J,. ..'. -,'.,.. ','.:''.'-, ",;t :tlqo-,.iJa MY COMMISSION EXPI~ff~~;~~,',;;~;J7~~9~-- .. t,;;.,,:':?G ''-il;.:; Tp/ fain, ..ll):>ur(,.1nc.~ 10<;.. ..~ SIGNATURE______________________________ CONTRACTOR DATE ----------------------------------- NOTARY AS TO CONTRACTOR_____________________________ " MY COMMISSION EXPIRES ------------------