HomeMy WebLinkAbout91-1730
STATE OF FLORIDA
City of Zephyrhills
,\ype Of. P ermil ;J o. ~~
B~G ~ICAL_.)
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
1730#
p~
,;) 5---' (7"0
~
Date ,f ~ ;;L:?- 7 I
Property owners. Name: (X<<:":"J2;, /7.
Job Address: h,) / 7' /.1,--:cc/ +rl. L-< ; ~ '
, /,1" :// ;;/
Legal Description: Sub.Div. L.. '- d.:~./ L c k_~.
Zoning CI: I;) - d {~ - ;L/ ~ .5- - C
? /
Description of Work):/' /.r: , :. 1/ ('__
Lot
Blk,
Energy Code Readout:
I
2- b-0 I
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost: ~ c2. u-u . G ~
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #.f..Y ,~'<T (;;j;,
COMPANY
ADDRESS
TELEPHONE #
DING
~'..- tj/ c-
7y
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
dollars shall be made for each _. /"Y'd- de
(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.
Relnspect/ons: When extra inspection trips are necessary due to anyone of the fOllowing reasons, a charge of .1 J 1 19)
( /6:0-0 )
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER
Ch 17 f' f~ C; ,C; ~ t!J A. e;,
b d. J if S f}-y /> ~ 0 I)"c-;> _ S 9'-~
53 ft.-. IY) t.E. /
(!J 11-1<" 5 , dE
PHONE .
APPLICANT
ADDRESS
'.
JOB LOCATION
~ A r-y") ~
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D. #
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign/Temp. _Sign _Nove _Demolish
PROPOSED USE: ____Single Family _H/F _i~ of Uni ts . ._M / H
_Commercial _Indust. _Swim. Pool Other
_Restaurant & Health Departmert 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 REQUESTED
_BUILDING $
_ELECTRICAL J(tJ AMP Service
I -
_MECHANICAL $
. 0#-
_PLUMBING GAS
Valuation of Total Construction
~orida Power Corp.
_W.R.E.C.
Valuation of Mechanical Installation
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
____Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
BUILDER Company
State Cert. or Regist. #
Signature City License Registration il
******************************************
::::::.::AGf~~*~\:jm:;h~~~;;;.~ "
PLUMBER Company
State Cert. or Regist. 0
Signature City License Registration H
******************************************
l;; !~('~
~J1'
Signature
Company ifJ'1J1e.3 h,u,I'/;,J,
. ,
.z... State Cert. or Regist. il
, /,.6'-< ___ City License Registration
~ ******************************************
611.. .JL 1JG J.: IV c
(" ilJCCyJ"t Y&>
il /:
MECHANICAT.
OTHER
Signature
Company
State Cert. or Regist. H
City License Registration #
******************************************
PERMIT OFFICER.
APPLICATION APPROVED BY
~____v..______---'-~. -
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
lh.u,d.,.i".d u,d.,.I,nd. Ih.' Ihi. ,.,.il "y b. sobl.,1 " "d.,d ,..I,i,II".' .hl,h "y b. .". ".',l,'i'. 'h., Ci'y
regulations. the undersigned a55Ules responsibllltf;for. co.pllant! with any applicable deed restrictions.
d' . ,
E. UNLICENSED CONTRACTORS AND CON:RACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undert.ake "ork, they aay be required to be licensed in accordance with
stlte and local regulations. 1f the contractor is not 1icen!?d as required by 1a", both the owner and contractor lay be
cited for a .isdeleanor violation under state law. If the owner ~t intended contractor are uncertain as to "hat licensing
,.,ui""'" "y ."Iy f., 'h. inl.nd.d ."t, Ih.y ". ,d,i..d " ",',,' ,h. Ci'y ,f Z.phy,hill. 'ulldin, D.,."..", IBI"
7813-6611.
Fu,'h.""', if 'h. ,.,., h., hi,.d , e"I"el,' " e,,',.el,'" h. i. ,d,i..d " h.'. 'h. "",.",,1., .i" ",'i,,' ,f ,h.
"Contractor Sections" of this application for which they "ill be responsible. If you, as the owner sign as the contractor,
y'u .,. i,die.'i', Ih., y'u, ,.,h., Ih,n Ih. e"I"e'", ". ,.."n.ibl. f" Ih. ."t. If 'h. ",',',',' ,i.h.. y" I' .1"
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 e.,'lfy ,.., I, Ih' ",Ii"", h.,. h..n ",'i~.d .ilh . ,,-, ,f "FI'rid.'. ",.'",11" li.' l.. - ".....n.". P,.I.,li"
',Id'" ,,,,,,,d by Ih. F1.dd. D.,acl..n' .f A,den"'" .., _c.S" ", "'". If""" ",,,' I. "",""thH thon th.
",.,.,", I ,.,Iify 'h., 1 h... .hl.I,.d . e"y .f 'h. .b," d.."ib,d d.,u..n' o,d "..i.. i, ,.,d f.i,h ,. "Ii", I' I.' 'h.
'owner' prior to cOllencelent.
.'; ..
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I e.,lify 'b.1 .11 Ih. inf"..'i,n in Ihl. ."Iie.'i,n I. .eeu,'" .nd 'h.1 .11 .,rl .ill b. d.,. i, ,..pll.". ,ilh .11
applicable 1a"s regulating construction, zoning, and land development.
Application is hereby .ade to obtain a pertit to' do work and installction as indicated. I certify that no work or
installation has cOllenced prior to issuance of a pertit and that all work will be performed to meet standards of all laws
,.g,I.lin, "n.l,u,'i.n, 'i'y e,d'., .,ning ,.gul.ti,n" .n' .on< d,..l.p..n' ",ul.'i,,' i' Ih, iu,i.di,'i'.. I .1.,
m'ify th.1 I ",,,,I ond !h. I 'i,. "gu 11 lion' of ,lhH gDlOm..to 1 .goud os "y 'p, I Y . I' 'h. i. 'H,d.d ."' I, IUd th.1 i' i 5
~ ,..p,..ibili'y I. i,.nlify .h., .e'i,n, I ~,I ,.t. " h, in e,.,li..", S.,O .,..,i,. i"lud, b., N' .., li.i'.d ,,'
.....
I also certify that, if fill aateria1 is to be used in Hood Zone "A" or "AIde.", it is understc1c,d that a drainage plan
.dd,...ing . '"."n..'in, ..lu.." .ill b. ,ub.I'I.d .hi,h i. ""."d by . "",..i.n.1 ",i.'" ",i,.",d in 'h. s,." ,f
Florida prior to permit issuance.
A p.,.i' i.,u.d .h.ll h, ,.n."u,' '0 h. . lie..,. I' ",e..d ,ilh ,b. ."t ,nd "I .. .u,o.,ity ,. .i.I,'" ,.ne,l ,I,.r, .r
set aside any provisions of the technical codes, nor shall issuanl2 of a permit prevent the Building Official frol thereafter
""i,in, . ,.,r.el;,n ,f .,r.r. in pl.n.; e,n,',ue'i.n, ., ,;.I.,'.n5 ,f "y ,.d.. ",'y ,.,.;, i..'" ,0.11 b.,... i".lid
unl..' 'h. ."t .ulh.'i..d by .ueh ,H.il i. ,,~.ne.d .i'hin .i. ..n'h' .f i..""'. ., if ..,t ,,"w ".d by ,h. ",.i' i'
...,..d,d " .b.,d.... f.' . p.,i.d .f .i. ...Ih. ,"H Ih. 1\.' lh. ..,t i. ,....."d. 0"" d., ,..,..i.. ,f 'i", "y b.
allowed for the permit with fee charge of ~lS.OO. The extensaDO sl.all be requested in Hriting to thp Building Official. An
approved inspection must be logged during each six tonth period, or the project Hill be considered dbd\.o(lfied.
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 OBTAI~ 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 P ST A "NOTICE OF COMMENCEMENT".
SIGNATURE-~-A~ENT / SIGNATURE_~---
(J'J n V
DATE________~-~37-j-fjCL---------
NOTARY AS TO L-If : UnJ. ,; "'--/
CONT~ACTOR--..;./k.;r.-rc-----
MY COMMISSION EXP~~~~~~~~~----
My Commission Expires July 15, 1993
Bonded l'hnJ Troy Fain. In1uronce Inc.
DATE_______________________________________
NOTARY AS TO ,AI . ~~
OWNER OR AGENT~~~-~ ---~~-.----
MY COMMISSION EXPIRES Notary .1IUi~,St!lf.ofFlcrida
-My-{-vmmisstarrtrptM1l"1/y"TI;" TftJ
Bonded Thru Troy fain. Insurao<;. Inc:.