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Home My WebLink About91-1785 STATE OF FLORIDA City of Zephyrhills AI uO Type oJermIL-J'lO' BUI~ING @CtRIC~ PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit X~ 1785 f- Date 9-lb -q ) PLUM~ ME~AL Property Owners Name: l.eh);.q Job Address: 56 '3 () ,I q II-- L~ 7J f-, Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work /42,,, ~ ,,~~ 11P~ ,r~~ ~ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application J' fill Estimated Cost: Fee: 2.o,~ SIGNATUR ~~ _ COMPANY All work shal! be performed in accordance with the above and all City Codes and Ordinances. Ii) ADDRESS TELEPHONE # OCCUPATIONAL LICENSE # SLB Tub Set Water Sewer Final lYe % E ECTRICAL Ftr. Pre SLB Lintel FRM. Insul.C W ! Tp.Serv. Rough In , Meter Can tj-f(,-4 ( t>;;..t Canst. Pole Pool Pre-Meter Final AL Breaker Ducts I sl. ComR essor Fin Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten <SIO.OO) 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 PEIDlIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT ~ _ GoD ~ of' ~ t E'L "t:\ 0 ADDRESS 3~ a \ \ Q,\ A W~C-\ _.:..... OWNER lJ\N'V r'~..)o\- L~v.J'" S JOB LOCATION $' L. '30 - \ q 'ti ~" PHONE "'2 s:-i -- ~'513 '. LOT SIZE X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. ~~ WORK PROPOSED:____New Construction ____Addition ____Alteration ~Repair ____Install ____Sign/Temp. ____Sign _Hove ____Demolish PROPOSED USE: ____Single Family ~/F ____~~ of Uni ts . .____M / H ____Commercial ____Indust. ____Swim.. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, Height RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FO~lS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction -LELECTRICAL \ al') 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 CONTRACTOR SECTION Company State Cert. or Regist. ff City License Registration ff ****************************************** BUILDER :T::~'~'~B Company 7-I;:-\'L\S I::<:~q, ';;€l!-'ll<'€ State Cert. or Regist. Ii aDO ?.-lG:.R- :e - - _. ~ . ... .. 2~.~~~~.~~;:~:~.~:;.~:;;~;~~~ jj I" Signature Company State Cert. or Regist. ff City License Registration I~ ****************************************** PLUMBER Signature Company State Cert. or Regist. ff City License Registration ff ****************************************** MECHANICAL OTHER Signature Company State Cert. or Regist. ff City License Registration ff APPLICATION APPROVED BY "L1:r~~*~~***"*" PERMIT OFFICER, CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS - Th~.und~rsign~d und~rstands that this pertit tay be subject to .d~ed r~strictions" which may be mor~ restr.ictive than City' regulations. The undersigned aS5Ules respon5ibility~for cotpliance with any applicable d~ed restrictions. 8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If th~ owner has hired a contractor .or contractors to undertake work, th~y tay be required to be licensed in accordance with state and local regulations. If th~ contractor is not licens~d as required by law, both the owner and contractor ~ay be cited for a tisdet~anor violation under state law. If the owner or 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) 7BB-bbI1. 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 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 Departtent of Agriculture and Consuler Affairs. If the applicant is soae6ne 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 cOllencelent. :i.,:' \ ,. 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 laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a pertit to'do work and installction as indicated. I certify that no work or installation has cotlenced prior to issuance of a pertit and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulatiGns, 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 tY responsibility te, identify what a~tions I lust take to be in c[)lIlplian~l!. Such agencies include bul ~le Belt lilllited to: . J I Department of Environmental Renulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive lands, Water/Wastewater Treatment I Southwest Florida Water Mananelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses I Arty Corps ~f EnQineers - Seawalls, Do~ks, Navigable Waterways I Depart.ent of Health ~ Rehabilitative Services, Environmental Health Unit - Wl!lls, Wastewater Treat~e~~. Septic Tanks I US Environaental Protection Anenct - Asbestos abatement I also certify that, if fill aaterial is to be used in Flbod Zone "A" or "A,etc.., it is understood tl.it a drainage plan addressing a .colpensating volule" Hill be subtitted which is prepared by a professional engineer regist~ied in the state of Florida prior to perlit 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 perlllit prevent the Building Official frol thereafter requiring a correction of errors in plans; construction, or violations of any code. Every permit issu~d shall becole invalid unless the work authorized by such permit is COllmenced within six months of issuance, or if work authDilzed by the pertit is suspended or abandoned for a period of six lonths after the ti3e the work is commenced. One 90 day e~ttDSiOIl of tile, lay 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 aust be logged during each six month period, or the project will be considered dbal,doned. 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". SlGNATURE.lltJ9--..fJJ~ OWNER OR AGENT SIGNATUR~~ _' CONTRACTO DATE . 0- \ .......\- C\. \ .. _____~-------__-___k-------~-.------- DATE aa - \ '-l - <1. I -----~------------~------------- NOTARY AS TO L..j) ../}') . OWNER OR AGENT~~~~~~~-~-----~--- MY COMMISSION EX~_____~________________ W\TC\R.Y P\IBLIC STjl,TE OF FLORIDA r>J<~~.r(':)'_;~lI",~ f~-\\:'. CE.e. "i8) 1994- bDi,:'-JLD "idF.U GC;;:;':~~HL Ii-lS." U~'.IO. NOTARY AS TO ~~ . J \ JJi. CONTR AC T OR _ _ _ _ ::-::.. ::..'=..-.:l!:..-l::::-r f.6........2 4- - - -- MY COMMISSION E IRESJWIfu~_~~~ff~ ... ~6:;[:J;.' 'i .!::0(',~..~s';f~3~~;0J;;~~