HomeMy WebLinkAbout91-1731
STATE OF FLORIDA
City of Zephyrhills
Type of Permit
C~~~)
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Property owner~N_~me:J . 41 / '. //
Job Address: .....) c1-- /)/ - / ~) ..-/A
PASCO COUNTY
BUILDING DEPARTMENT
1-813- 788-6611
Permit N~
173115
Date ,,f/.:J.3 - 7'/
~
~
ME~AL
d,~ l~'
#
---- ,
Legal Description:
Sub.Div.
Zoning CI:
Description of Work~~~ -<. .~~,
Lot
Blk.
1..'
~~ /d}f~P
+ q_ll-lfl Au
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
t :-,-- crD
(/-Lj
- '--' ')
Fee: .;2 <) r {U
SIGNAT~?v-..
COMP~
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/
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
y/ {1 fl' ~Jl t~f /
ADDRESS
TELEPHONE #
OCCUPATIONAL LICENSE #
}J;,y (la<~
c' ~UILDING ~)
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
~~G
--'-
~LECTRICAL
TP.Se~
Rough In
Meter Can
Const. Pole
POOl
Pre-Meter
Final
M'EC.ttAN ICAL
~
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Ins I.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due 10 anyone of the following reasons, a charge of ~J )
dollars shall be made for each ".-;Tr.>l..-d e. ( /1.5'": ~ )
(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 PERl-lIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT ~~e5 :f. ~ 71 ~
ADDRESS __~ s;, 7:H __
-..70 hA) -r: t.J CLA-4 k'
JOB LOCATION S7/'I IO~ Sf.
LEGAL DESCRIPTION: LOT(S) 17 -- ~
PARCEL I.D.# //-;l- ~ - ;t I - oc) 10 - O~b6LJ -
PHONE
70 cf- s-c. 7 - 0303
.
OWNER
CT,(! ,
'.
LOT SIZE /;LO X 13.5 AREA
3t:. SUBDIVISION
SQ.FT.
BLOCK
170
_Sign/Temp.
____Addition _Alteration
____Sign Sc>f',c,";.. f ~
_Repair
_Install
WORK PROPOSED:_New Construction
_Hove
_Demolish
PROPOSED USE: ~Single Family
_M/F
_I~ of Uni ts
,__M/H
_Commercial
_Indust.
_Swim.. Poo 1
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 FORNS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$ ~-5l2?, &,.E
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block ____Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
BUILDER J /JlJfcS
Signa~
ET.ECTRTCT AN
/2
e.
~' CONTRACTOR SECIION
~ Ai Company /-lYE ~f.t..U'4~A.Iu..A/{
. State Cert. or Regist. #
~ City License Registration IF 7'
******************************************
Signature
Company
State Cert. or Regist. ff
City License Registration ff
******************************************
Company
State Cert. or Regist. #
City License Registration ff
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. l.!___
City License Registration ff .-
******************************************
MECHANICAl.
Signature
Company
State Cert. or Regist. ff
City License Registration ff
------""
OTHER
Signature
.. ..... '. ***************.*y*t:J**.**.*. *....*. .*..***;:-1'.-::-1:***-1:*****
APP1\If.'I~~:,1(1: -/,1", fi'-A11'~~~~ " .
. ..-..',(..110 t" ....,'
PERMIT OFFICER.
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..
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
-
The ,undersigned understands that this perlit lay be subject to "deed restricti~ns' which may be more restr.ictive than City
regulations. The undersigned assules responsibility;for, coapliance with any applicable deed restrictions.
, ,
E. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractorl to undertake work, they lay be required to be licensed in accordance with
stlte and local regulations. If the contractor il not licensed as required by laM, both the owner and contractor lay be
cited for a aisdeleanor violation under state law. If the ~wner or intended contractor are uncertain as to what licensing
requirelents aay apply f~r the intended work, they are advised to contact the City of Zephyrhills Building Departlent, !BI3)
7B8-6611.
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 y~u, as the ~wner sign as the c~ntraclor,
you are indicating that you, rather than the contractor, are resp~nsible for the wor~. If the contractor wishes you to sign
as contractor that lay be an indicati~n that he is not properly licensed' and is not entitled t~ 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 - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sDleCone other than the
"owner", I certify that I have ~btained a copy of the above described d~cu.ent and promise in good faith lo deliver it to the
"owner" prior to cOllencelenl.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all Mor~ will be done in coapliance with all
applicable laws regulating construction, zoning, and land developeent. .
Application is hereby lade to obtain a pertit to do work and install~tion as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perf~rmed t~ meet standards of all laws
regulating construction, City codes, zoning regulations, anrl land development regulations in the jurisdicti~n. I also
certify that 1 understand that the regulations of other governmental agencies ~ay apply' to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt ile not li.ited to:
'"
I Depart.e~t of Envir~nmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatlent
I Southwest Florida Water'ManaQelent District - Wells; Cypress Bayheads, Wetland Areas, AI~ering Watercourses
f Arty Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways
f Depart.ent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treat~ent. Sep~ic Tanks
f US EnvironAental Pr~tection AQenct - Asbestos abatement
1 also certify that, if fill aaterial is to be used in Flood Zone "A" or 'A,etc.', it is underst(l~d ~hit a drainage plan
addressing a 'coapensating volule" will be sublitted which is prepared by a professional engineer reqisl~ied in lhe Sta~e of
Florida prior ~o permit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority t~ viol~~e, cancel aller, or
set aside any provisi~ns of the technical codes, nor shall issuance of a p~rmit prevent the Building Official frol thereafter
requiring a correclion ~f errors in plans; construction, or violations of any code. Every permit iSS\led =hall bec~.e invalid
unless the Mork authorized by such permit is cOllenced within six lonlhs ~f issuance, or if wOlk aulh~1 lzed by the pertit is
suspended or abandoned f~r a period ~f six aonths after the tiJe the Hor~ is co~menced. One 90 day e:tE~siDll Df tile, lay be
allowed for the per~it with fee charge of $15.00. The extension shall be requested in Hri~ing l~ the Building Official. An
approved inspecti~n must be l~gged during each six lonth period, ~r the project will be considered obdlJdoned.
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".
SI\3NA1U~E,____Q_ k--z!:!~---- SIGNA~U - ~j2_ 1!U------
. ~ OWNER OR AGENT CONTRAC~~
p" cJ q /J
DA TE _~_____~ __:a/.--:-i'.J-----------.------- DATE - -- ------ a-::-Q -1-::_:1--- ---- -- .----
. /7 M~. NOTARY AS To,(I" f I\
____;.;,~~;;5~O;~i.~~NT~ACTOR-p~;~
MY COMMISSI EXPIRE9t\y COMMISSION EXPIRES ,..u. '0.'''' ., COMMISSlON~~~ DPlItIS APIllI!, 1m
IONDi"on.iU'lGlNft1l0nm-poPlA"";.' ~.tiiiU-AlIlRf'INOrAiy MOURA.
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.......LDCtiTED....
AT
MARTIN RESOURSES INC.
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H '/E AL.Ul'i I NUN
PO BC)), 456
D(iDE CITY 1 FI_
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All material to be as specified. All work to be completed in a workman like
manner according tC) standard pYactice~. Any deviation or alteration from above;
specifications involving extra costs will be executed only upon written orders:
and will become an extra charge over and above the estimate. All agreements
<~ ()f"'"i t 'l ,--, 9 er-i t t.tp ()n ~5 t.( i k €:~S;., ae c i d t~rn t "::;j, 7 ,:,'(' del ay's b ey'clf') ci ()!_t y (~ Cln t.( ()], It 01,,1,.1('1 e'f t CI
c.aY'Yv fir8y t(){'fladc' and l:l.they r1ecessary if15Ut'ance. OLtY wCir~::ers are fully c!~ver:
eel by [,.10'( knifE':'''''' ~". C:c::ompens..::\t 1. ()n I I-,sur anc e.
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ACCEPTANCE OF PROPOSAL-
The above prices, specifications and conditions are satisfactory and aye!
hereby accepted. Payment will be made as outlined above.
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