The URL can be used to link to this page

Home My WebLink About91-1718 ST ATE OF FLORI DA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN~ - 1718/- 0- Date~ .. -j b 9/ Type of Permit ~~ ~~~ PLOM8!.N..G ME~tCAL , /"7, Property Owners Name: ]/,"-f"/t~y\, ::::> c' '--/ C; 9 ;-- 1/ Job Address: ,--> ,,,r ~ I .....) 7 ~:h :lx1 j::.' / ~ Jt/ f" .. 4 ) , '" fi-/lR _ ~-;~/L' A~d4 11 k~ Legal Description: Sub.Div. Lot Blk. Zoning CI: )'2 '" /7. -, ' " !Zl7 DeSC:ij'lion of Work '7:/"": ! in? d~'7:- ~'l .c'-""." ~.K ~,; A; . f ~I ~.A.V. > <dtz.t// ~~ zP/L'-<L- /L~/. . .. ; if ~ Estimated Cost: ~/// _ / 4- / 1~ 2Jo .Pi Fee ~~~~9 SIGNATURF _ )<. ~ r' " "'.. COMPANY ,_./ ; r? /~f17" Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application All work shal! be performed in accordance with the above and all City Codes and Ordinances. ADDRESS TELEPHONE # OCCUPATIONAL LICENSE # /!>~/ ",~dlt~ /!4~j' ../ _.~ ( ELECTRICAL' '------ Tp.Serv. ._,-, Rough In Meter Can Canst. Pole Pool Pre-Meter Final BUILDING PL~ ........ ME~CAL " SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul.CL WL Breakers Ducts Insl. Compressor Final Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of I I ) dollars shall be made for each.. T y d. d e (/6: tTD ) (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. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT !); CJ ~ / S; /-t h ADDRESS j fst 99 ' ss/ E PHONt fl. i' ') ;7.5:2" V f'C)? OWNER (/~-LG': S,Z:,i:,6 JOB LOCATI~. .. 1',,".A,.f ()~1 JIJz'We LOT SIZE_X. AREA SQ.FT. /J LEGAL DESCRIPTION: LOT(S) (J 6> ,{ 0 BLOCK{)(mn SUBDIVISION,? "'/' hr~ ;/,Y, ~/~"7 (;0. \, PARCEL 1. D. ~~ 0;;< ~ ,;) <:,.. -.;;2 I -- 60/ r:.;) ~ CJ C:- a 00 - 00 / d V / WORK PROPOSED:____New Construction ----Addition ____Alteration ____Repair ____Install ____sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ____Single Family ~ercial _M/F ____~~ of Uni ts _M/H ____Indust. ____Swim. Pool Other ____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 FORMS.~'* **COPY OF CONTRACT REQUIRED. pERMITS REOUESTED Valuation ~otal Construction Service ~Florida Power Corp. _W.R.E.C. Valuation of Mechanical Installation ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. n City License Registration # ****************************************** ~lJ1T.DER Company State Cert. or Regist. # City License Registration # ************************************** /~~' Signature Company State Cert. or Regist. # City License Registration # ****************************************** PUTMRER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration # OTHER ****************************************** PERMIT OFFICER. APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions' whicn lay be .ore res~rictive 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 may 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Further.ore, 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. If the contractor wishes you to sign as contractor that .ay 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 Construction Lien Law - Ho.eowner's Protection Guide' prepared by the Florida Departaent of Agriculture and Consumer 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 co.aencement. 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 installation as indicated. I certify that no work or installation has cO'lenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlllpliance. Such agencies include but ~le liCIt liltited to: . Department of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive lands, Water/Wastewater Treatment . Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses . Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways . Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Tr~atment, Septic Tanks . US Environlental Protection AQency - Asbestos abate.ent I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volule" will be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to per.it iss~ance. 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 permit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issu~d "hall becole invalid unless the work authorized by such per.it is co..enced within six months of issuance, or if Hork authorIzed by the per.it is suspended or abandoned for a period of six lonths after the time the work is commenced. One 90 day e~tEnsioll of tile, lay be allowed for the per~it 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 lonth 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A II NOT I CE OF $ENCEMENT II . SIGNATuR~jll~__1J__k~__ SIGNATURE__ _ ~ OWNER OR AGENT CONTRACT DATE__2.f_~_~~~_~~_____________________ NOTARY AS TO L/f!.. (/~I/// ,/ OWNER OR AGENTI/t{f~/ C(-, , ~----- " ;. J:;' Notary P Ii . MY C[)M.'I~r'ION" ~-"PI S~' II..,.. . State of FlOrida , r.~;;) t;..... -e. .~ "~J1llD.. fx/.l-ArIal:.-Y.m~-- DATE___2l~~-~~~~----------1- ------ NOTARY AS TO~~~ -4 I~ / CONTRACTOR /. / /-r. . '-. --- - " 'N' Public S e- Fion a-' ~ ' o,sry , 17. 1995' : MY COMMISS:ON EXP] .J!!!5".~~~'::~_~____~.