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Home My WebLink About91-1727 STATE OF FLORIDA City of ZephyrhiIIs PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN~ 1727 E ,~-d-/- ?/ TDe:5) ~ILDIN ) . Date ELE~, PLU~ M~AL Property Owners Name: _ ~~ ~J1-.<1 Job Address: 37c;t y '-/ - hY'.L ~ Legal Description: Sub.Div. Lot Blk. Zoning CI: DescriPtionofWork~.e ~ L ~/ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Fee: 3 0 - SIGNATURE COMPANY ADDRESS TELEPHONE # Estimated Cost: ;2. J-7 !) . 0-0 ./ All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE #..b-/;;fr""(fu"t.. ~d,~+ ' ".......' . a-UILDINi .. ~~ Ftr. SLB Pre SLB Tub Set Lintel VVater FRM. Sewer Insul.CL Final WL E~ICAL ------- ME~NICAL """ Tp.Serv. Rough In Meter Can Canst. 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 IT II It) dollars shall be made for each". /rd.. de. (/-s- dZJ) (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. OWNER PHONE APPLICANT ADDRESS 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. ____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 ____BUILDING 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. I,~ :L ;t 0 PF.RMITS REOUESTED RESIDENTIAL: COMMERCIAL : Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLUMBIN'G .. GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ******************************* CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** Signature s Sie:nature Company State Cert. or Regist. # City License Registration # ****************************************** F.LECTRTCTAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration # OTHER Signature APPLICATION APPROVED BY ****************************************** ':1f dAV'A 1 0' #/l.<I0 , \I PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this per.it lay be subject to .deed restrictions. which lay be lore restrictive than City regulations. The undersigned ISIUles responsibility for tOlpliante 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 .ay be cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (813) 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is} 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 per.itting 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 Departlent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the "owner., I certify that I have obtained a copy of the above described docu.ent and prolise in good faith to deliver it to the "owner" prior to co.mence.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 laws regulating construction, zoning, and land develop.ent. Application is hereby .ade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a perlit and that all work will be performed to .eet 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 govern.ental agencies lay apply to the intended work, and that it is 'Y responsibility te. identify what actions I .ust take to be in co.pliance. Such agencies include bllt ~l e Iiot li.ited to: * Depart.ent of Envitonlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treat.ent * Southwest Florida Water ManaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways * Depart.ent of Health & Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treat.ent. Septic Tanks I US Environ.ental Protection AQency - Asbestos abate.ent I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood th3t a drainage plan addressing a "co.pensating volu.e" will be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A permit 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 issll~d ~hall becole invalid unless the work authorized by such per.it is co..enced within six tonths of issuance, or if work authollzed by the perlit is suspended or abandoned for a period of six .onths after the tile the work is commenced. One 90 day e~ttnSiOIi 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 lust be logged during each six tonth period, or the project will be considered dbaiidoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FDR 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 T- REeD AND 8--T A "NuT leE UF COf")MENCEMENT" /' ( / SIGNATURE_~ SIGNATURE DATE _~L_~~J_____________ DATE_~ ------~J-e-S?j--------- NOTARY AS T _ ( .....-t-,_ NOTARY AS T . OWNER OR AGENT_____ ~ B~qR19ID9ASCONTRACTOR---- ___~~. ~. F-2~Oi~J " . Jan. 28, ''IV'" .. res Jan. 0, My commiSSion eXPIres A eney ...'N\.JL. commiSSion ex pi ht Agency MY COMMISSION EXPIRES~~~_~~~~~~~~o~~~~~~_! MY COMMISSION EXPIR~~~~l~~!~~~~~_~~~~_ c''1.,,- i :;-it;:':<.':'+:~:\:':";" tr\t<' Please Send Remittance to: A. ihu1lttt iRnnfittg OOf Q!entral 3Jf1nriila. Int. c/o Richard Bartlett 38408 3rd. Ave. ZEPHYRHILLS, FLORIDA 33541 One Of The Largest, Oldest, Most Dependable Roofing Companies in Central Florida Specializing in Mobile Home Uniroyal White Rubber Roofs RESIDENTIAL * COMMERCIAL * MOBILE HOME LICENSED-INSURED & BONDED * MEMBER OF CHAMBER OF COMMERCE * OFFICE PHONE (813) 782-5585 Serving Zephyrhills, Dade City, Ridge Manor, Quail Hollow, Land 0' Lakes, and Surround~ng Area.~ ! ' i ,- ..., / I -'. I . "./ -' i ).-- .I / 'j' .f ,,/ .'~; ji / _/ _ ' / / ! Date Name / / ! I ; .r . } ! , if /",(':'~/\A/l ..' I ,. r I . . i ,J:'}', //,- j,., " . ~). t'l-,'l' ,/ -- "_ ,,1/ -"~'" , Phone '~/l I /. ,-/ f:>{ 'p, '7" ,/ "'<::/ " ."-[/1//' " ,..'" .I I I " ., / /~/~ ~. i~ . /.1'/ /, I it ,(J '. ..( j ..., , ,/ /' -,'.4'''''( ,/ Address t.- . r ,I". ( . ,'.'. .' ,f ;;1: 1 J. /1 / L,:'-1..i~/ 'f" --' - ___ .... DESCRIPTION AMOUNT .. ~~i(..i j " I- ~ I a.7 .I / ;Ie' ! ,:t,C[.j' ,I (: .// I ,/ j" :....._._\...."'" ,I /' ,..' .'/1.(/ , I.>- .../ ,.; / 1 "'.rf. lilt.f' , ; / ,>( /J,'// . .",' t/' f..." i -,../ ! .. , " .,' 1/ I J /J , "':., "'l-~l:---./" / t':, A //..., f .,- ;/\ .' / '~ fl.:i1,./:- 1.'" {f,-- THANK YOU / Your Business is Appreciated.J Payment upon completion unless previous arrangement made. Warranties pertain to original owner All agreements contingent upon strikes, accidents or delays beyond our control. CN;ner to carry fire, tornado and other necessary insurance, Our workers are fully covered by Workmen's Compensation Insurance. ( 'f ,4 ~taf ."/1' " ,. I' Y