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Home My WebLink About91-1763 STATE OF FLORIDA City of Zephyrhills Type of Permit J-8 ; 61) BU~GCTRIC;V Property Owners Name~d Job Address: ~ Y Y 7 PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 .3 0 . d'i:) PL~ ~ECHANIC~ PermitN'~ 1763 9-7'-7/ /1 Date ~~ / /..ZK -4'-. Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work # c ~;~T Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application 7/ .. Estimated Cost: 4 J....s7:> . c:T'D Fee: All work shal! be performed in accordance with the above and all City Codes and Ordinances, OCCUPATIONAL LICENSE # TELEPHONE # Ftr. Pre SLB Lintel FRM. Insul.CL WL SLB Tub Set Water Sewer Final Tp. erv, Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final Driveway Relnspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten (SIO.OO) 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. - r 1 APPLICATION F6~ PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT JOB LOCATION ;('N~;>/C~Ir~ '} :; .~ ,;2.. F", ~lVy R/ c- j~ C/,o~i/)V //'-<s";" APPLICANT ADDRESS PHONE "7 g .;< - .,<..3 CJ-CJ OWNER S't 'f 7 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 _Move ____Demolish PROPOSED USE: ____Single Family ~/F _~~ of Uni ts .____M/ 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 FORMS.** **COPY OF CONTRACT REQUIRED. PERMTTS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service ;< '3 s-z> _ en) 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 Company State Cert. or Regist. # City License Registration # ****************************************** BtJ1LDER Signature Company r:',e 5 T (d ~-; #jf s~ate ?ert. or R~gist. . ~{ E~S f'E; '7 Clty Llcense Reglstratlon # ,~*************************** Signature Company State Cert. or Regist. # City License Registration # ****************************************** Company to,. ':t; C~i-. ~~~/C State Cert. or Re st. ~fr /(AjJ.. e<it:J/(') . Ci ty License Regis tration lfr ? / ****************************************** PLUMBER Signature Signature Company State Cert. or Regist. # City License Registration # APPLICATION APPROVED BY ~**********~************************ A 4 . - . t2 A ...........:J' PERMIT OFFICER. .. .~'-..., ~ ~--~~ .-.. ,_"L-' 'i '. ~ '*'~~ U ~",,--.._. ----'Milt III CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS lhe undersigned understands that this perlit lay be subject to "deed restrictions. which lay be lore restr,ictive than City regulations. The undersigned assules responsibility.'for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake Kork, they lay be required to be licensed in accordance Kith state and local regulations. If the contractor is not licehsed as required by law, both, the owner and contractor lay be cited for a lisde.eanor violation under state laK. If the owner or intended contractor are uncertain as to what licensing requirelents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (BI3) 7BB-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorts) sign portions of the .Contractor Sections. of this application for Khich they Kill 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 aay 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 certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien LaK - HOleoKner's Protection Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the "owner" prior to cOllencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this applica~ion is accurate and that all work Kill be done in coapliance Kith all applicable laKs regulating construction, zoning, and land developlent. Application is hereby tade 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 Kill be performed to meet standards of all laKs 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 IY responsibility tCI identify what actions I lust take to be in COlpliance. Such agencies include bill ~ie not liaited to: 0'" I also certify that, if filllaterial is to be used in Hc,od Zc,ne "A" or "A,etc.', it is understc.od that a drainage plan addressing a "coapensating volule" will be sublitted which is prepared by a professional engineer feqist~ied in the State of Florida prior to permit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to yiol~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a per~it pr~vent the Building Offici.l fro. thereafter requiring a correction of errors in plans, construction, Dr violations of any cod~. Every perGit issued ~hall becote invalid unless the work authori2ed by such perait is coa.enced within six aonths of issuance, Dr if work authol Ized by the pertit is suspended or abandoned for a period of six lonths after the tile the work is co~menced. One 90 day e~tensioB of tile, aay be allowed for the permit with fee charge of ~15.00. lhe extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six lonth period, or the project will be considered dbd\ldoned. 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 $2,500 IN VALUE DO NOT TO RE RD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE SIGNATURE " --------------------------- -~--- OWNER OR AGENT ONTRACTOR ~~~~~y o~s A~~NT ~;_ A... !/ ~g~~:;~~~R~~--- - A -- -~ MY COl'lMlSSlG~J EXPIRE ".'B .... ~ ... _ ______ MV COMMISS1UN' E IR~ Nl P fil:":..a...w..~.--"'-' '..L.- . TlItIIlIq' "flit!! of1'lorida' ;:" , u Iii' u ,..,''''0'0 ",-nun....- ~ixp. Mar. 11, 1995 .. My,...Comm. Exp. M.r. U, l~~g ,...,.-...... I' ....., c " ~,. :;.:'r~'l2'~.' .,....~. .....'..~."..~.'...'" ......"".. .~... .Illw!i~"'~.".~f$...,~',..",~,.l;.i.F';.,)lI','~~.~i3.' ~.. . '. '..'.;'j(i;';~~ c~~;~~i":,:'" .~~ ....c<.1 Heat & Air-Conditioning ~1 7722 Fort King Highway. P.O. Box 2209 Zephyrhills, Florida 33539-2209 (813) 782-2300 f CITY MAKE MODEL SERIAl NO, NATURE OF r-I\. SERVICE L..V REQUEST QUAN, PART NO. DESCRIPTION l.... r r' f. l f [ t f [" I' f r f, t,' I r SERVICE PERFORMED / / _ ,;< b _..< 1_ 0 0/0 - I? ? u .,. () 0 I DATE COMPlffiD 7~~1 CASH ::~:LETlON-+ TECHNICIAN CUSTOMER'S SIGNATURE IV - APARTMENT . ~TIMATE o CASH o CHARGE PRICE AMOUNT I TOTAL MATERIAl TECHNICAL SERVICE TIME TAX TOTAL