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Home My WebLink About91-1765 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1.813.788.6611 Permit N~ 1765 J::-~ 9" -?'/ Date (~, - / Type of Permit ---=---- ~~ B~~ (=--ELE~~!:-, / PltIM-fmLG_ ME~L L ~dy . Property Owners Name: /~, A'\/'I --<.'" .~. ,:- 1<65 f~ (.. -1_(?/h.. -?~- '(1 ,;-j 'a Job Address: _~ J- ,<..:) -" ~'4~? . ,~ Legal Description: Sub.Div. Lot Blk. 00/ () - /-.Sc1 0 C' --. 0/0 D ---CA_'Y',,2 :;/,><~/l~ -=V _ l) c' ~ /)~ -)!;-~ n..:L 7/ >' - j/ L Zoning CI: J / '- ,::) b . d / - Description of Wor~ ~/1 /i-r'~..s<. Complete Plans, Specifications and Fee Must Accompany Application ~( II/J!> Energy Code Readout: Estimated Cost: /~//1 All work shal! be performed in atcordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE # hI &:~t tTJ~ ') /' /"'j7 ., Fee: ,--,L L" LJ ,-" SIGNATURE Q^" --^"A':. COMPANY ADDRESS TELEPHONE # .~ - Ftr. Pre SLB Lintel FRM. Insul.CL WL __ '- ~j ,'i'vA~lc /) ~.'.'/- ~LECTRI~ -~--" Rough In Meter Can Canst. Pole Pool Pre-Meter Final ME~ICAL "'- -~G SLB Tub Set Water Sewer Final ----troTLUING Breakers Ducts Insl. Compressor Final Driveway ~I e following reasons, a charge of ten ($ 10.00) 5etw~ Relnspectlons: When extra inspection trips are necessary due to anyone 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-PERNIT CITY OF ZEPIIYRllILLS BUILDING DEPARTHENT , " OWNER oS U /If S ;-; / Ai c= ' C:;=AL..70 j2 LI ~BS2 q 5TH ~lf"'V~NV€- If 6 ;<./!2- I pc) H v' 0 ~ A I /f./ 6/\/ JOB LOCATION '3 B S'2 q /,uc-. APPLICANT PHONE ?B8r 98'3/ ADDRESS ~, s- 7/-1 LEGAL DESCRIPTION: LOT(S~ _ I/)- II BLOCK/ -~?SUBDIVISION PARCEL I.D.~~ jl - ?-6 - 2/ - 0010, - / 5200 ~ 0 (00 AV6 . LOT SIZE x AREA SQ. FT. WORK PROPOSED:____New Construction ~Addition ____Alteration ____Repair ____Install ____Sign/Temp. _Sign ____Hove ____Demolish ____Commercial _Indust, ____Swim., Pool ..____l'I!H IlpL~lI'acl+, Other Revwt~lo v'\ PROPOSED USE: ____Single Family ~M/F ____~~ of 'Units ____Restaurant & Health Department Approval BUILDING SIZE: RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR1-1S.** **COPY OF CONTRACT REQUIRED. x Square Feet, Height Ef,RMTTS REOUESTED _ELECTRICAL $ 300 valuation of Total Construction ____BUILDING AMP Service' K Florida power Corp. _H.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block '-:"-Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ~ONTRACTOR 0ECTION ml1LDER Company State Cert. or Regist. 0 Signature City License Registration U ***********.****************************** EJ,EOTRT 01 A~ D.e vWl i 'J-rr;z. n~1 Company D~", "d '-;:z. VI o..Je-(, ;Z; //Ie U" ~ - State Cert. or Re[Yist. ii c)c9t9--rJ?l?~ Sirmatnre ~P/\o<~' City License Re[0:stration ii (, ry ,************************************** ****************************************** Signature Company State Cert. or Regist. n City License Registration U ****************************************** PLUMBER Signature Company State Cert. or Regist. a City License Registration 0 ****************************************** MECHAN1CAl, Signature Company State Cert. or Regist, U City License Registration 0 pTHER APPLICATION APPROVED BY ~..*.******~*.*..**.***.***********.'** .' a " <'~1Yd) /'v-) . PERNlT OFFICER. COND I T IONS, OF',.. P&:RM I T AF'F' I DAV I T A. NOTICE OF' DEED RESTRICTIONS The ,undersigned understands that this perlit lay bl subject to "deed restrictions' which ~ay be ~ore reltr,jetive than City regulations. The undersigned USUle! respons\bilitf;for.,colpliance with any appl icable deed restrictions. , ;41' ~ " . . E. 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 ftay be cited for a .isdeaeanor violation under state law.; .If the owner or intended contractor are uncertain as to what licensing require.ents lay apply for the intended Hork, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Furthermore, 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 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 be an indication that he is not properly licensed ~nd is not entitled to per~Ittlng 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 - HOleowneros Protection Guide" prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is SOlec.ne other than the "owner", I certify that I have (obtained a, co'py of the above described dc,culllent and prc,rr,ise in gc,od faith to deliver it to the 'owner' prior to co.menceDent. "' ~ '..~ ,~.:~_. ~. I ; .' E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all th~ information in this application is accurat~ and that all work will be done in coaplianc~ with all applicable laws regulating construction, zoning, and land development. Application is hereby lade to obtain a per.it to'do work and install~tion as indicated. I c~rtify that no work or installation has COlmenced prior to issuance of a perlit and that all work will be performed to ~eet standards of all laMS regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governlllental agencies "ay apply tc, the intended work, and that it is .y responsibility tc. identify Hhat actions I lIlust take to be in compliance. Such agencies include bill ill e not liJ!ited to: ... I Departle~t of Envir~nmental ReQulation - Cypr~ss Bayheads, Wetland Areas and Environmentally Sensitive Ldnds, Water/Wastewater lreatlllen~ . Southwest Florida Wat~r ManaQelent District - Wells; Cypress Bayheads, Wetland ~reas, Altering HatercoursEs I ArlY Corps ~f EnQin~Ers - Seawalls, Docks, Navigable Waterways I Departlent of Health L Rehabilitative Servic~s. Environmental H~alth Unit - Uclls, Hastewater Treat~en~. Septic Tanks I US Environaental Protection AQency - Asb~stos abat~ment I also c~rtify that, if fill laterial is to be used in Fltood Zcone "A" or "A,etc.', it is undHstc,c,d t1"t a drainage plan addressing a 'coMpensating volule' will be sublitted which is prepared by a professional engineer regist~ied in the State of Florida prior to permit issuance. A p~rlit issued shall be constru~d to be a license to proceed with the work and not as authority to violjte, cancel alter, or set aside any provisions of the t~chnical codes, nor shall issuance of a permit prevent the Building Official froD thereafter requiring a corredion clf errors in plans; constructicon, or violations of any cc,de. Every perillit isslled "hall becc'le invalid unless the lIork authcorized by such permit is COllllenced within six months clf issuance, CoT if Hc,rk allthc'l lzed by the perlit is suspended or abandoned for a period of six lonths after the ti,e the work is commenced. One 90 day e~t~osioll of tile, lIIay be allowed for the per~it with fee charge of $15,00. The extension shall be requested in writing to the Building Official. An approved inspedic,n l!Iust be lc,gged during each six Mnth period, (Ir the prc,j\:ct ljlll be C(,nsidered iibdl,dc,ned. 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 C0I1MENCEMENT". SIGNATURE__!!'~~~;::~~---~---------- SIGNATURE~l-~---- OWNER OR AGENT CONTRAC~~~ DATE --------------------------------.------- 09. ~6 - 9/ DATE 09. 06. ~ t::j" / ----------------------------------- 'li!Y. tit'- .; NOTARY AS TO (\ ,", ^ ~ .' " ....nw~...ER OR AGENT _~~-- ---- - ~ RYP ... . . ' **.~o'l.~ vsv;.. NGTj'~V Pi'r" T" '~IDr\ __.. M~. ~'~~~,7:T;~"~':'-:~::~~ ;.,>~:.l-~~..~, ':;(~u.<:r\~ : M~l1MISSION EXPIRES I.{ C..'.,..,/lJ....>.".... ".'...... r.,.'.'...,~,',.:.Y10 . * -~~~~~~-~~-,-~--U~ :- b}'" uiJl';....{.;.U S,,l'\J 1..:.-._.,_,_1">.\1... ll'.,,). ~'..J. '... ~~Wt-"cil :- \ ~\7.~.!,~' : **- U):q '.,i,V};"; ,.-'~r..it **:E: OF f'...O~~*-" 1".... \tL~,>6 *~,~ NOTARY AS TCh f'.A ~ CONTRACTOR_~-~J--- ~C__ '\ ' NOTP,RY PU[UC Tl\Tt: olloRIDA MY r.;;:__rt5SION EXPIRm C(j'::>lIc;S,::~!j'E._6ul.2.:L1Y95 ,/'~o 'S(,;;." B017.-'EITl7mrITi.:,:Ei;t;L IHS. UNO. * " * * * * " * " .. ... : \ ..~~ ;....: *<:'S ~::;,';,i~:>C< 1JCFFICTA[ t~JfA~Y '~~ALII (2:,:,'EES .:-;~F" YC~:;',1l; r,~Y C~"",:. EXP. ':/2'9';95 "OFFICIAL t:ClTfJ.RY SEP.L" Cf-"mI S <:",- YO: .".- MY COH:i Txp, 4i2~;/9~