HomeMy WebLinkAbout91-1776
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
1776--P
Type of Permit
~
ELE~
GUMBI~G"~
Date-2' - / / - '7/
MEC~CAL
Property Owners Name:" -i.~7i~~LA ,~Z c// J~1 .LJZ..LJ' {tV! -0A
Job Address: ~-- '7' (> ? - / / 7,{ --J1- '
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: ,
Description of Work.-~t....x->7 _,L/~v2 / _A../d;"e.e>~~'''-.i
~fl---ql
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
4/ /It
~ /
/
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #,J 9-1}~f.It1i (~il
Fee:
COMPANY
ADDRESS
TELEPHONE #
B't:tt-bo.lli G
/1 "
(~~\A./c;~/~
(' PLUM~
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
Driveway
~CAL
~
MEC'~L
"--
Tp.Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten ($10.00)
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 PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
First United Methodist Church Asst. Pastor Parsonage
ADDRESS
5409 11th Street
Zephvrhills
PHONEChurch office 782-5645
OWNER
First United Methodist Church
38635 5th Avenue
Zephyr hills
JOB LOCATION
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.~~
WORK PROPOSED:____New Construction ----Addition ----^lteration ____Repair ____Install
____sign/Temp.
____Sign
_Move
____Demolish
PROPOSED USE: ____Single Family
_M/F
_~F of Uni ts
_____M / H
____commercial
____Indust.
____Swim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t,
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.
PF:RMITS REQUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
____MECHANICAL
$
Valuation of Mechanical Installation
~PLUMBIN'G
.0#>
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration IF
******************************************
BUILDER
Sillnature
Company
State Cert. or Regist. #
City License Registration #
******************************************
ELECTRTCTAN
PLUMBER Bruce Carrigan Company Bruce Card g:an Pll1mh; ng
.,
/1- (: , .; k State Cert. or Regist. iF RF-001884?
Signat'(~~::-\/"Cf \, (;)J:J;;.-( <.: "Sf) City License Registration H .?Q
" ******************************* * *,', *;: ;:**1: *;:
Signature
Company
State Cert. or Regist. ~F
City License Registration lF .
******************************************
MECHANICAL
OTHER
Signature
Company
State Cert. or Regist. #
City License Registration #
APPLICATION APPROVED BY
******************************************
cyJ d~'<,~ x:J ,2a-<"~"
, ~
'\
PERMIT OFFICER.
,,'.-
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" which'may be lore res~rictive than City
regulations. The undersigned assules responsibili_y.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 eisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Further.ore, 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 lay be an indication that he is not properly licensed and is not entitled to permitting 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 - HOleowner's Protection
Suide" prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is SOlE one other than the
"owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the
"owner' prior to cotlence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will be done in compliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby aade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has cOI.enced prior to issuance of a perlit and that all work will be performed to meet standards of all laws
regulating construction, City codes, zoning regulations, and land development 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
IY responsibility to identify what actions I lust take to be in compliance. Such agencies include but. ~I e liCIt. Iilited to:
I Departeent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatment
I Southwest Florida Water ManaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I Army Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Departtent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatme~t, Septic Tanks
I US Environmental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Fle,od Ze,ne "A" or "A,etc.", it is underste.od th~t a drainage plan
addressing a 'colpensating volule" will be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to permit issuance.
A per.it issued shall be construed to be a license to proceed with the work and not as authority to viol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every permit issued 3hall becote invalid
unless the work authorized by such per.it is co..enced within six sonths of, issuance, or if work authoflzed by the pertit is
suspended or abandoned for a period of six tonths after the tile the work is commenced. One 90 day e~t.~nsioli of tile, may be
allowed for the per~it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
appTl1tEtl inspection must be le'ggeoduring i!dl.ii "ix i1lilU\11 ji~1 i.,u, l'i Ljl~ Plc.jl'd l'Ii;i ~t: CLiilsidored clUdllJUllt'J.
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".
SIGNATUREik'2~_{A1~!lN2&~" - ' {
CONTRACTOR 0 ~. -
DATE________~:j~:-~-J----------------
/'7k"~ 4 I
SIGNATURE_~Lf~~~_ ~___~_~~~~~~.
i,/ OWNEWbR AGENT /
DATE_______~~-~-~~~~-----------------
NOTARY AS TO '12..Ci:J. ' ~
OWNER OR AGENT___~.~~~~---~~~~------
MY COMMISSION EXP S '""',T.,...',,.,,>.,,:,"-,.,',,,','-,. :',',",",;",.,.c ,;., :C'. ('"."",.
-~-7ry'-.~~~~,-::777;--~--~~~...1"": :;,
NOTARY
CONTRAC
XFIRES
t!OrA':Y FuSLfC:-STATE-OrFLORIOKI-
MY C",:hiSSlUN EXPIRES: JAN. Z8. 199:i1oi
0<:-,'",1:..,:::0 'fHR.U NOTARY PUBl-IC UNDERWRITERSj1