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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