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Home My WebLink About91-1780 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit )I~ 1780vU Type of Permit ~ E~L GUMBI:~ M~~L Properly Owners Name: ~E?~~ Job Address: ~ b ~ :5 - / ~ ~ ' ../1-, Date 9 - /:J- -9 I Legal Description: Sub.Div. Lot Blk. Zoning CI: DescriPlionofWork_~b. 4?4'~-;;::" .Z '~-67~ 4~:t;::-~ Energy Code Readout: ~ /Z-Zt:..-4j Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: ~A Fee: ~./; ~/:" ./' All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE #~"o TELEPHONE # ~~~A~ SLB Tp.Serv. Tub Set Rough In Water Meter Can Sewer Const. Pole Final Pool Pre-Meter Final ME~NICAL ~ ~G ~ Ftr. Pre SLB Lintel FRM. Insul.CL WL 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 PERNIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT ~ - , APPLICANT f:~; /JfI'~~17t7A1 ADDRESS ~_~ _~_1<<.;t , ~ANe-' 2~I/S OWNER A,I'NtlYID PIII/;' P.s' I /6 $r 7-/kIIS PHONE ?fR''-9'b3t JOB LOCATION ~~ LOT SIZE_X AREA SQ.FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.# ~nstall WORK PROPOSED:_New Construction _Addition ____Alteration _Repair ____Sign/Temp. PROPOSED USE: ~Single Family ____Sign _Hove ____Demolish ____M/F _t~ of Uni ts , .____M I 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 FORHS. ** **COPY OF CONTRACT REQUIRED. ~F.RMITS REOUESTED ____BUILDING $ 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 SECTION Company State Cert. or Regist. # City License Registration U ****************************************** J3U1LDER Sillnature Company State Cert. or Regist. U City License Registration U ****************************************** ELECTRTCTAN Signature Company State Cert. or Regist. 6 City License Registration # ****************************************** PLllMRF.R Signature Company State Cert. or Regist. D City License Registration # ****************************************** MECHANICAL Signature Company 1S 0 &~/: 1'/ /' ~~,6f7i11?' , State Cert. or Regist. U City License Registration !~ .~t:> APPLICATION APPROVED BY jv.r;~"~;~:;::;:""'~"*+"****"*' 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 more rest~ictive than City regulations. The undersigned assules respDnsibilitf;for, co.pliance with. a)'lY app,1 icable Qeed rutrictions. "~. '.". B. UNLICENS~D' CONTRACTORS AND CONTRACTOR RESPONSIBILITIES , .. ,. '" . ' If the owner has hired a contractor 'or contractors to undertake HDrk, they lay be required to be licensed in accordance with state and local regulations. 1f the contractor is not 1 icensed as required by I aw, both the lIlIner'a'ml contractor I)aybe cited for a .isdeaeanor violation under state lall. If the ollner or intended contractor are uncertain as to what licensing requirelents lay apply fClr the intended lIork, they are advised to cc,ntact th'e t3ity{,f ZephyrhiHs Building pepartaent, (813) 788-6611. ' Furtherlore, if the ollner has hired a contractor Dr contractors, he is advised to have the contractor(s) sign portions of the 'Contractor "Sections' of this application for lIhich 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 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 - HOleowner's Protection Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOlec.ne other than the 'owner" , I certify that I have obtained a, copy of the above described dc,cuJlient and prorrlise in good faith to deliver it to the 'ollner' prior to cOllencelent. 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 coapliance with all applicable lalls regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to'do Kork and inslall~tion as indicated. I certify that no 1I0rk or installation has COllenced 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 govern~ental agencies ~ay apply'to the intended work, and that it is IY responsibility tc, identify what actions I lust take to be in cOlllpliance. Such agencies include bllt ~l e liC,l limited to: ... . Departle~t of Envir~nlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment . Southwest Florida Water ManaQelllent District - Hells; Cypress Bayheads, Wetland Areas, Altering Watercourses . ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Hastewater Treat~en~. Septic Tanks I US Environmental Protection AQenc~ - Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "Aft or 'A,etc.', it is understc1c.d 1I"t a drainage plan addressing a 'colpensating volullle' will be sublitted which is prepared by a professional engineer regist2ied in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a p~rmit prevent the Building Official frol thereafter requiring a correction of errors in plans; construction, or violations of any code. Every per~it iss\l~d ~hall becole invalid unless the work authorized by such perlit is cOlmenced lIithin six months of issuance, or if H01'k authDr Ized by the per.it is suspended or abandoned for a period of six lonths after the ti~e the wDrk is commenced. One 90 day e:te~sioll of tile, aay 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 inspection must be logged during each six month period, or the prDject will be considered ~bdlJdoned. 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 $~,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEM N' SIGNATURE~_Jif~~~ c OWNER OR AGENT V-v. DA TE_______~._~'t/L~gL-------------.------- ~~~~:yO~SA~~NT_~~~~~~~~-~- MY COMMISSION E:~ -~T~,",0"~,:~,",,~,r_:,',,..~,;!,~f,.I~,:,~"~,"','c,f,.IOF-R]~DA .' ' ..... ~, " DEC..~18~':::r~)4 ~,'~~l,::>.,,_l 'rt,.:\~; :J~ \<~:. :~':;\L 11~5'~ Ui\iU. DATE______~~---:1T~~~7j~---~~-------- NOTARY AS TO~ L"(;'''' " CONTRACTOR _____ ~:::.:'=!:::~il-~:!--d-d-- MY CO"MMISSION EXP S, ",:, "c'"c' <;'i'i'T''" rr: r:' ,-,,)"":!;, . '.. . , .'.. . .' . '.' ....'... , , , . ''- , ,r '. '_ ~'.. \, ~ ' . - - -:'::-. ~ '7' ,-. ~--;- ~.~. ~.- SJ.:~T;3: .~ ':'~: .:~ ~~ ------------ SIGNATURE I ~.:~:. 1.,;':'J ~