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Home My WebLink About91-1779 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit }lf~ 1779/3 Type of Permit ~, ~ME~L :::P:::r~:~e:/;6 !t?~ Date 9- /J. -9/ . Legal Description: Sub,Div, Lot Blk. Zoning CI: Descripllon of Work"?~ ~ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: flS7J. Of::) OCCUPATIONAL LICENSE # Fee' ;LtJ ~ 0-0 SIG~AruR~.L.4--vft1 M-AU J COMPANY ADDRESS TELEPHONE # All work shal! be performed in accordance with the above and all City Codes and Ordinances. i?~ / -__~UI~ Pre SlB Lintel FRM. Insul.CL WL ~ SLB ~ Tub Set Water Sewer Final ~CAL ~ M~NICAl "'\ Tp,Serv. Rough In Meter Can Canst. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final Driveway 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 J,fl(1,~ rr> ~ A1 fO.AJ' 5 S ADDRESS \1'/ '{ f? & rc;:. ..{n /.-'/1,4// p' b<' ,# OWNER "/..VO,),re S 'A/'~~ c '" JOB LOCATION v/ , \/"/ AA -p PHONE ,?~>J- 003.3 " LOT SIZE x AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) PARCEL I. D . ~~ Y.... BLOCK SUBDIVISION ~epair ____Ins tall WORK PROPOSED:____New Construction ____Addition ____Alteration ____Sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ~Single Family ~/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 FORtIS. ** **COPY OF CONTRACT REQUIRED. ~F.RMTTS REOtJESTED t//BUILDING $ ~ 0(; . crD Valuation of Total Construction ____ELECTRICAL AMP Service 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. ****************************************** Signature ~ONTRACTOR SF.CTION Company State Cert. or Regist. ~ City License Registration ~ ****************************************** J3U1LDER Sil:mature Company State Cert. or Regist. # City License Registration D ****************************************** f,T.ECTRTCT AN Signature Company State Cert. or Regist. ~ City License Registration # ****************************************** PLUMBF.R Signature Company State Cert. or Regist. if City License Registration # ****************************************** MECHANICAL PTHER ~~~ I' to (' At c.:' /0 C <; Signature Company State Cert. or Regist. ~ City License Registration # ****************************************** PERMIT OFFICER. APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . The ,undersigned understands that this perlit lay be subject to "deed restrictions" which may be more restr,ictive than City regulations. The undersigned assules responslblllti::for,.colpliance with any applicable deed restrictions. , , 8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor 'Dr 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 tisde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents tay 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 Dr 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 worr.. If the contractor wishes you to sign as contractor that may be an indication that he is not properly licensed and is not entitled to per&itting 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 Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOle6ne 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 cOlmencelent. ", .,." 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 conpliance with all applicable laws regulating construction, zoning, and land development. Application is hereby aade to obtain a pertit to'do Mork and install~tion as indacated. I certify that no work or installation has cOlmenced prior to issuance of a pertit and that all work will be performed to ~eet standards of all laws regulating construction, City codes, zoning regulations, anrl land development regulations in th~ jurisdiction. I also certify that I understand that th~ regulations of other govern~ental agencies ~ay apply' to th~ intended work, and that it is IY responsibility to identify what actions I lust take to be in cOAlplianc!!. Such agencies include bllt ~l e mlt li~ited to: . "..; I Department of Environmental 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 ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services, Environmental Health Unit - W!!lls, Ilastewater Treat~err~. Septic Tanks I US Environaental Prot~ction AQency - Asbestos abatement I also certify that, if fill aatl?rial is to be used in Flt,od ZClne "A" or 'A,etc:.', it is understcl(ld t1,~t a drainage plan addressing a .colpensating volume" will be sub.itted which is prepared by a professional engineer regist2ied 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 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 corr~ction of errors in plans; construction, or violations of any code. Every permit isslIed :haJI becole invalid unless the work authori2~d by such permit is cOlmenced within six lonths of issuance, Dr if wOl'k authDIJ~ed by th~ p~rlit is suspend~d Dr abandoned for a p~riod of six lonths after the ti,e the \lork is commenc~d. One 90 day e~\t~sioll of tile, aay be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection eust be logged during each six month period, or the project will be considered dba\Jdoned. 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". SIGNATURE~~~~~------ OWNER OR AGENT SIGNATURE~~/~~~" CONTRACTOR DA TE_2.:-,c2_::~L___--------------,------- NOTARY AS TO _~, OWNER OR AGEtfbj~ MY COMMISSION EXPIRES "~'-{~.?7T~:."IT~~~"S~7?:::\~~D~-- d . "_l:i-'i-~ Li"-.;\~.J; 1">4.V J. &..7y 199..1 ~":,,,~:~~~a~;-:~~ 'l';UfAin pU;JLIC UNDER,WRITERS,} DATE________~~/~:-~~-------------- NOTARY AS TO / _/ /' CONTRACTOR_~~_-~ " MY COMMISSION EXPIRES ---~-------------- "..i-:Y PU~H..~C. STATE OF FLO?\JD!\. ,.., "0,,ih',"'::;;U;-.< EXP:r;t:S: NOV. 27. 199%. t;,....j~'-.Jc:8 THI:;:U r~o-rARY PUBLIC UNDERWRITERS.)