HomeMy WebLinkAbout91-1742
STATE OF FLORIDA
City of Zephyrhills
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PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit M~
1742$
9-:[3 -9/
,
Type of Permit
,." .' -' ,..".._-.........
/"/.".BUILDING)
,--.~_..-,,,,,,---
Date
~CAL
P~NG
~~'
Job Address:
Property Owners Name: (.J. ).//il/D~ aL/~
5&30 -~ /~ L1t ~-t-.
Sub.Div'//_~Io'_~/_ OO/iJ- !o?t]Jo- O/.:2.D
Legal Description:
Blk.
Zoning CI:
Description of Work
Energy Code Readout:
?'tf
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
~ (JOt)' ~
t/c)
Fee:'7! ,20' ~ fl!d;.
SIGNATURE--4~7t:-- a~ --'
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #
~.
/
./
COMPANY
ADDRESS
TELEPHONE #
G;C) 4HJ -l/;
BUILDING
PLYM-rrfN G
~
Tub Set
Water
Sewer
Final
~AL
---
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
ME~AL
-~
Ftr.
Pre SLB
Linte!
FRM.
Insul.CL
WL
Breakers
Ducts Ins!.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of )
dollars shall be made for each....Tr-&.- d -e. r / 0-: 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 PElU'1'IT
CITY OF ZEPIIYRHILLS
BUILDING DEPARn1ENT
APPLICANT Lv / /// A/f
ADDRESS ~?..5 0 / ~
OWNER JA7/Z
JOB LOCATION J A '7/..::'
tt//t//I1'
/I .."
Z/.'sT :A*//5
/::/ JJrYOPIIoNE :;7%;,1- sS79
/
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
PARCEL I.D.~~ / / = ~~. ~ c:< /
BLOCK
SUBDIVISION
WORK PROPOSED:~New Construction ____Addition ____Alteration ____Repair ____Install
00/0 -/0700 - 6/~?O
_Sign/Temp.
____Sign
____~love
_Demolish
____Commercial
____Indust.
_Swim.. Pool
,._l'l/H
Sc/? ///~~/Y' / .N60ther
o Ihli' /? /,<70/
PROPOSED USE: ~Single Family
~M/F
_~t of Uni ts
_Restaurant & Health Department 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 FORl'lS.**
**COpy OF CONTRACT REQUIRED.
PERMITS REOUESTED
..LBUILDING
$ /000 . 00
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.
******************************************
~-
CONTRACTOR SECTION~ t
. Company /;I? cJ ~/.>i'< T _
/
State Cert. or Regist. 0
City License Registration n
******************************************
c> I.,A..-r/V./::/f
nUTLDER
Signature ,~
Signature
Company
State Cert. or Regist. n
City License Registration a
******************************************
f,T.ECTRTCTAN
Signature
Company
State Cert. or Regist. a
City License Registration it
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
MECHANICAL
OTHER
Signature
,.-.-
,/
*
Company
State Cert. or Regist. 0
City License Registration n
.7 /J
**** . .'J, ":i:i':'*~~'~'
PERl-lIT OFFICER.
APPLICATION APPROVED BY
, ..~.
..",..'
,'I'"
CONDITI0NS~O~,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The,undersigned understands that this perlit lay be subject to "deed restrictions' which ~ay be oor!! restr,ictive than City
regulations. The undersigned nsules responsibilH{;for;colpliance with any appl icable deed restrictions.
",fl" . .
,
B . UNL I CENSED CONTRACTORS AND CONTRACTOR RESPOt\lS I B I LIT I ES
If the owner has hired a contractor or contractors to undertake work, 'they lay be required to be licensed in accordance with
state Ind local regulations. If the contractor is not licensed as required by law, both the OHner and contractor ~ay be
cited for a lisde.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 Departlent, (813)
788-6611. ' . C,"
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sl 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 Mork. Jf the contractor wishes you to sign
as contractor that lay be an indication that he is not properly licensed ~nd 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 - Hoeeowneros Protection
Guide' prepared by the Florida Departlent of Agriculture and ConsUier Affairs. If the applicant is soee6ne other than the
"owner", I certify that I have obtained ~ c~py of the above described document and promise in good f~ith to deliver it to th~
'owner" prior to co.~ence~ent. I
~ '. . :~.~ 7.. :. I ; :
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inf~rmation in this applicati~n is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby made to obtain a perait to'do work and install~tion as indicated. J certify that nu work or
installation has COlmenc~d prior to issuance of a perlit and that all work will be performed to ~eet standards of all laws
regulating construction, City codes, zoning regulati~ns, and land devel~pment regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies ~ay apply to the intended work, and that it is
IY responsibility tc. identify what actions I lust take to be in compliance. Suet, agC:f1cies include bill ~l e IlC,t lillited t~:
...
I Departle~t of Envir~nmental ReQulation - Cypress Bayheads, ~etland Areas and Environmentally Sensi live L3ndsr
Water/Wastewater Treatment
I Southwest Florida Water'ManaQement District - Wells; Cypress Bayheads, Wetland Areas, Altering Hatercourses
I Arty Corps ~f EnQineers - Seawalls, Ducks, Navigable Waterways
I Depart.ent uf Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Tre.t~en~. Septic Tanks
I US Environaental Pr~tection AQenct - Asbestos abatement
I also certify that, if fill aatl?rial is t~ be used in Flc.od Zcone "A" or 'A,etc.', it is understo(,d t1li\t a drainage plan
addressing a 'colpensating volume" Mill be sublitted which is prepared by a professional enginc:er feqist~,ed in the State of
Florida prior tD permit issuance.
A permit issued shall be cDnstrued to be a license to proceed with the Mork and not as authority to viol~te, cancel alter, or
set aside any pfCovisi(,ns of the technical cc.des, nDr shall issuance of a permit prc:vent the Building Officii,} frc'~ thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every per~it iSSlled ~hall becole invalid
unless the work authCoTized by such penH is cLol1illlenced lIit.hiI', six I\\onths (.f issuanc!:, (,r if we,d; au\h('II.;;d hi the perlit is
suspended Dr abandoned for a period of six lonths after the ti)e the work is commenced. One 90 day e:\E~5ioll of tiae, lay be
allowed for the per~it with fee charge of $15.00. The extension shall be requested in wriling \0 the Building Official. An
approved inspecti(,n !:lust he lc.gged during each six month period, c,r the projl!c\ liill be c('Tlsidered abol,dc.nrd.
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 POST A II NOT I CE OF COMMENCEf'1ENT".
SIGNATUR~~~------ SIGNATURE_____-------------------------
OWNER OR AGENT CONTRACTOR
DATE__~-_-~-)---I1.!t-L------.---~---
~~~~:YO~SA~~NT--~~~~--~-
MY COMMISSION EXPIRESHOTARY PUIIlIC STATE ~ flORIDA
.~~~~e~t~~~~~
BONDED THRU GENElW. IllS. UMO.
DATE
-----------------------------------
NOTARY AS TO
CONTRACTOR_____________________________
MY COMMISSION EXPIRES
"
------------------
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