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Home My WebLink About91-1750 STATE OF FLORIDA City of Zephyrhills 00 TYPl!? ~ermit G~:~~ ~o 1,P." ----~-~. PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N~ 175013 Date-.ir- '-I -'1/ PLU~ MECH~L Property Owners Name: ~ Job Address: .:5.&31 ro/t:X:o nl S'A)~l1l- IZft.. 5+ Legal Description: Sub.Div. Lot e2.. Blk. ~ ZoningCI: d-~ Description of Work . ~O II (AJ~~ J- ~~ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application ,/}JI,v/>vv>~ 5et-vle.'- U~SI-. ~ . ~ .. , t;o 0 E~ Estimated Cosi: 0 ~ 1'1 Fee:'~ Ci. ~ ~ C All work shal! be performed in accordance SIGNATURE.{ _ _ ) _ I -u_ _/7 with the above and all City Codes and Ordinances. COMPANY ADDRESS TELEPHONE # OCCUPATIONAL LICENSE # BUILDING 6 C~)J tS-J!... OCt W- ELECTRICAL L Ftr. Pre SLB Linte! FRM. Insul.CL WL Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Driveway !X.tvtc (, -!J7.. ~ II> -i:; -1 , Relnspectlons: When extra inspection trips are necessary due to anyone 0 he following reasons, a charge of ten ($ IO'()()) dollars shall be made for each trip. (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 PEru-lIT CITY OF ZEPIIYRHILLS BUILDING DEPARTHENT PHONE -t J't. o/'ZCJ 9 ~ . '. ~ JOB LOCATION aft) ~ LOT SIZEZ~ X /5Y AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) - BLOCK 6 SUBDIVISION PARCEL 1. D. tt WORK PROPOSED:____New construction ~ddition ----Alteration ____Repair ____Install _Sign/Temp. _Sign _Hove _Demolish PROPOSED USE: ~Single Family ~M/F _tt of Units ,._H/H _commercial _Indust. _Swim. Pool Other _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.~d' **COPY OF CONTRACT REQUIRED. Ef~MITS REOUESTED _BUILDING $ Valuation of Total construction _ELECTRICAL AHP Service Florida power Corp. _H.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUM.BING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. 17 ( };ONTRACTOR ~ECTION. BJII),UF.R I~-I--]) S-uJ -'1/&. Company ~ \> ~ I. State Cert. 01' Regis t. !I Signature ~~ ~ ~. L ...I.~ .(p City License Regi~U-<ltinn ;/ ********* *************<{,*<{,*<{,*** ,'r;: {, ,', .:, ;:" .:, ;,,',.~ b t.. (2..~ j) ****************************************** Company State Cert. or Regist. n City License Registration a *********************************;'******** Signature Company State Cert. or Regist. !~ City License Registration n ****************************************** , ~UJMRF.R Signature Company State Cert. or Regist. 0 City License Registratior, 11 *************************~**************** t1ECHANICA1. Signature APPLICATION APPROVED BY -(~-~;Z~~-~~*******.****. PEmlIT OFFICER, Company State Cert. or Regist. # City License Registration # OTHER CONDITIONS: O~ P~~MIT A~~ID^VrT A. NOTICE OF DEED RESTRICTIONS The ,undersigned understands that this perlit lay be sub3ect to "deed restrictions" which ~ay b~ ~ore restrictive than City regulations. The undersigned aSSUIe5 re5ponslbi1itr~.~or;.'.collpliance with any applicabl~ d~~d restrictions. B. '. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSI8ILITI~S 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 reqtiired by law, both the o"n~r 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 2ephyrhills ~uilding Departaent, (813) 788-6611. Furthermore, 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 may 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 - Homeowner's Protection Guide' prepared by the Florida Depart.ent of Agriculture and ConSUDer Affairs. If the applicant is sote6ne other than the "owner', I certify that I have obtained l c~py of the above described document and promise in good fajth to deliver it to the .owner' prior to cOI!ence!ent. :l.':(.".\:: E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will b~ don~ in coapliance with all applicable laws regulating construction, zoning, and land developD~nt. Application is hereby Jade to obtain a permit to'do Mork and installction as indicated. I certify that no work or installation has co.menced prior to issuance of a perlit and that all work will be performed to ~eet standards of all laMS regulating construction, City codes, zDning regulatiDns, anrl land development 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 to identify what actions I lIIust take to be in compliance. Such agencies include bill ::>1 eliCIt lillited to: . J_~ I Departlent of Environmental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensi live Lands, Hater/Hastewater Treatment I Southwest Florida Hater ManaQeJent District - Hells; Cypress Bayheads, Hetland Areas, Altering Halercourses I ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways I Departtent of Health L Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~en:, Septic Tanks I US Environaental Protection AQency - Asbestos abatement I also certify that, if filllaterial is to be used in Flc,od Zcone "A" or "I\,elc,', it is understclcld tllat a drainage plan addressing a 'colpensating volume" will be sub.itted which is prepared by a professional engineer regist2ied in the State of Florida prior to permit issuance. A perlit issued shall be construed to be a license to prDceed with the wClrk an'd 'nt,tas aulheority lCI vie,hte, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fro~ thereafter requiring a CC'Trr:ction c.f errors in plans; constructicon, or violations of any cc.de. Every per~it isslJed :hall benlle invalid unless the work authc.ri2ed by such penit is ccouenced within six months c,f isslJance,"c.r if IlClrk .BlIt\'cII);:ed by the perlit is suspended or abandoned for a period of six tonths after the tiJe the Hork is cpmmenced. One 90 day e:IE~5ioll of tile, aay be al1c,wed for the perlllit with fee charge of $15.00. The extensic,n shall be requ~sied in liriling ie. the Building Official. An approved inspectic,n l!iust be lc,gged during each six 1I0nth period, or the project wi] I be cc.nsidered ilbcil,doiled. 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". SIGNATURE~_~_____-___~_ ~WNER?AGENT ::::~~~~~~1'-__ ------~-----..~--~--- OWNER OR AG _ ~_~-~~~~----- Jerr Connell ' IRES ' NOTARY PuBLiC~siATioFFiORiDA.------ MY COMMISSION EXPIRES: June 30, 1995. BONDED THaU NOTARY PUBLIC UNDERWRITERS- SIGNATURE ------------------------------ CONTRACTOR DATE ----------------------------------- NOTARY AS TO CONTRACTOR_____________________________ " MY COMMISSION EXPIRES ------------------