The URL can be used to link to this page

Home My WebLink About91-1764 ST A TE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788.6611 Permit N~ 1764/3 9-9-9/ ~ / BUI~~NG <' ~ l...__-----~/- Date P~ ME~AL Property Owners Name: Job Address: ~5-d _S"; /71/ t /j f ' /9 ,1 'ft! / / ./1/.L J /f ~ ~7' ,J:;I, Legal Description: Sub.Div. Lot Blk. Zoning CI: --I) Description of Work Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application ~ C)t Q /) rr--f' Estimated Cost: / / L, , C L' Fee: ?() ~/ ~ - (, " /' _,_-~~A-,n . All work shal! be performed in accordance with the above and all City Codes and Ordinances, OCCUPATIONAL LICENSE "",~E~"J t"i. SIGNATURE COMPANY ADDRESS TELEPHONE # Ftr. Pre SLB Lintel FRM. Insul.CL WL ------ ICAL PL SLB Tub Set Water Sewer Final ING Tp.Serv. 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 shaH be made before any further permits will be issued to the person owning same. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT ~ ~/( ~ ::::SS :; j;:/d? PHONE JOB LOCATION LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.~F WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____~F of Units _____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. ~G PERMITS REOUESTED Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. -.-MECHANICAL $ Valuation of Mechanical Installation ____PLUMBIN"G GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ******************************** Z-S-L- S- ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Signature Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist.-# City License Registration # OTHER Signature APPLICATION APPROVED BY ,***!s * * *,* * ******71<*** ** ******* * * * * **** * * * * '--7/7, ')(7/~" "r- / ( 7 /.1 L-e/i' j / k/L.(;~, / .. \j PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be tore res~rictive 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 work, they lay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be cited for a lisdeaeanor violation under state law, If the owner or intended contractor are uncertain as to what licensing requireaents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, 1813l 788-6611. Furthertore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) 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 lay bean 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 Law - Hoaeowner's Protection Guide" prepared by the Florida Departaent of Agriculture and Consuaer Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docuaent and promise in good faith to deliver it to the "owner" prior to cO'lencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that no work or installation has cOltenced prior to issuance of a perlit and that all work will be performed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is ay responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but ale not liaited to: I Departaent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive lands, Water/Wastewater Treataent I Southwest Florida Water ManaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departaent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatment, Septic Tanks I US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volute" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to vioiate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issu~d shall becoae invalid unless the work authorized by such perlit is CO'lenced within six lonths of issuance, or if work authol lIed by the perlit is suspended or abandoned for a period of six lonths after the tile the work is co..enced. One 90 day e~tEnsioli of tile, lay be allowed for the perlit with fee charge of $15,00. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six lonth period, or the project will be considered abaudoned. RESULT INTEND BEFORE DO NOT SIGNATURE . NOTARY AS T E..OL.f~.9RIDiCONTRACTOR _ .' '. J n 28 1995 My commiSSion eXPires a. , MY COMM I SS I ON EXP I RES _~Q.n.fl~c!.!.h.!~!~~~.:~n_.!:.:~~~genc~y COMM I SS I ON "~,~\y" ',~."""." ~ '''''''''''_''.:["''1",:,.. ; . ',: ., ~ '....'~' " ';'l' '-, \l- ~ ': ; I . Please Send Remittance to: ~. IInrthtt 1Rnnfing OOf <!trntrn13JUnriba. Inc. c/o Richard Bartlett 38408 3rd. Ave. / ZEPHYRHILLS, FLORIDA 33541 ([) ~ UM :;.one Of The Largest, Oldest, Most Dependable U Roofing Companies in Central Florida ---- Speclaltzmg m Mobile Home Umroyal White Rubber Roofs RESIDENTIAL * COMMERCIAL * MOBILE HOME LICENSED-INSURED & BONDED '* MEMBER OF CHAMBER OF COMMERCE '* OFFICE PHONE (813) 782-5585 Serving Zephyrhllls, Dade City, Ridge Manor, Quail Hollow, LandO' Lakes, and Surrounding Areas ~ c;~vJtte;v C1NM/ ~ ~l~ ii /.. /~ (>, /1 /!'~) I. l(j (j {) -r / III /CIUL'LDate / j / / / /' "1' t. ~",l ! ,/I! CL I) II '/ (~ , Vl, \..,tl--r I Name Phone ,/ ! ..~. ~"-, -~:-<~~.~. / /~ It ~ , , I I' I 1 IL....~:,L Li.,,- '1:'" 11...-; (*) i (- -'. A / ,. :', 7' I ~/: '-"-,~"-'I / ' ~" / O./L/JGC .I Addre.. )'- ~' ! ) / -...,,;, ; / \ '\ .' _:i___,/"i.,.A..{: J'i DESCRIPTION /' 1. C> _L_ (/(.: I ,( .L/UL/Lz" AMOUNT _/ ~VA/i1 ,/~-- I " ) ,. ,,~ ,{ ff1, j, , ,', j' /V'" / ./ \ , , I /IU cv 22-0 if THANK YOU , LO' F Your Business is Appreciat ._< Payment upon completion unless previous arrange ent ma Warranties pertain to original owner All agreements connngent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance, Our workers are fully covered by Workmen's Compensation Insurance, ----