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Home My WebLink About91-1786 STATE OF FLORIDA City of Zephyrhills Date 1786'P 9-/6 -7/ PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Type of Permit BUILDING EL~AL CPLUMBIN0 ME~AL ~:::::r~:~ers:~;~r~A1~ -z1~ Legal Description: Sub.Div. Zoning CI: Description ofWork4~rP/I Permit N~ Lot Blk. k~ - ~~~ Energy Code Readout: * .,1 ;'l-::;j? Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: r~/;4 All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE # Fee: ;) 0.. Gr-z} SIGNATURE~~- O,~ COMPANY ADDRESS TELEPHONE # '~I~JG- ~ PLUM-BING~ SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul.CL WL Driveway ELE~L "'" ME~AL ......... Tp.Serv. Rough In Meter Can Canst. 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 <S1O.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. ADDRESS APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT C~ ~r1 e sma 00( y S-l1 "-/0 I c; LA- 5T PHONE erl'v'(t'T Q' 'irJ- - 7 'if Yy APPLICANT OWNER '. JOB LOCATION .5PM e u5 Afjove LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. ~~ ~' ____Repair ____Install WORK PROPOSED:____New Construction ____Addition ____Alteration ____Sign/Temp. ____Sign _Hove ____Demolish PROPOSED USE: ____Single Family ____M/F ____t~ 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 FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ____MECHANICAL ~LUMBING $ Valuation of Mechanical Installation .'" . 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 # ****************************************** BUILDER Signature Company State Cert. or Regist. # City License Registration # ****************************************** f,LECTRTCIAN . PLUMBER x Company State Cert. or Regist. # City License Registration # ****************************************** Signature Company State Cert. or Regist. tF City License Registration a ****************************************** MECHANICAl. Signature OTHER Rtf!:fU old ~'~1 Signature ~va. ~-<'.ro-c& - ~ Company State Cert. or Regist. 0 City License Registration # APPLICATION APPROVED BY *)V7*********~~************************ _ . /7 A1 ~ g /} -dl/\ -:r- . PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. .NOT. I CE OF' DEED RESTR I CT IONS - The,undersigned understands that this perlit lay be subject to "deed restrictions" which may be more restr,ictive than City regulations. The undersigned assules responsibility:~for;,co.pliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor ~r 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 ftay be cited for a lisdeleanor 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. Furtherlore, 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 Const~uction Lien Law - HOleowner's Protection Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOle{.ne other than the 'owner', I certify that 1 have {obtained a copy of the above described document and pr(Irrlise in good faith to deliver it to the "owner' prior to cO.lencelent. ., 'j '. .: ~ '. 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 development. Application is hereby lade to obtain a perlit to'do wDrk and install~tion as indicated. I certify that no work or installation has cOltenced 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 govern~ental agencies ~ay apply'to the intended "Cork, and that it is IY responsibility to identify "hat actions I lust take to be in compliance. Such agencies include bllt ~l eliCIt lil!ited to: . ".#' I Depart.ent of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment I Southwest Florida Water ManaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps -of Enqineers - Seawalls, Docks, Navigable Waterways I Depart.ent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~en~. Septic Tanks I US Environ!!ental Protection AQencI - Asbestos abatement I also certify that, if filllaterial is to be used in Hood ZClne "A" or "A,etc.', it is understc.(.d 11.01 a drainage plan addressing a 'colpensating volute" will be sublitted which is prepared by a professional engineer re~ist~ied in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the "ork and not as authority to viol~te, cancel alter, Dr 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 isslIed ;hall becole invalid unless the work authorized by such permit is cOMmenced within six months of issuance, or if wOl'k author lIed by the perlit is suspended or abandoned for a period of six lonths after the tiJe the work is co~menced. One 90 day e~tr~sioll of tile, lay be allowed for the permit "ith 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 lonth period, or the project will be considered dbo\.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". SIGNATURE_d~~--Q.:._~ EOIHRt'!\[TelFr'" cn-u~ DATE____~~~~,--~{~-~1-1t----------- NOTARY AS TO ,~ to CONT~ACTOR___~.L'~~~-~~--- MY COMM I S5 I O~dj~ \ijJ~6c....~.!l!t~..9.!.f!911.Q~~!.b~]! 'MY C6mmission Expires Dec. 14, 1991 80nded thru p-'gent's Notary Brokerag& SIGNATURE ---------------------------------- OWNER OR AGENT DATE ------------------------------~_._------ NOTARY AS TO OWNER OR AGENT ----------------------------- MY COMMISSION EXPIRES ----------------------