HomeMy WebLinkAbout91-1804
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
1804 J-)
Date~- rJ-};-- 9 I
Type of Permit
~E~ ~O ME~HA)JiCAL
Property Owners Name: 1, &:11' t<L;tL ~-/L
Job Address: 3' H-o.J. - {{, &t,r2
Legal Description:
Sub.Div.
Zoning CI: ~
Description of Work A~
~J-7
Energy Code Readout:
Lot
Blk.
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
,A//A
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances,
OCCUPATIONAL LICENSE # 51' 1!Ia~1 U,
~
c!~I~~
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
Driveway
C1~d-:;r7J:,~)5.&'h
Fee: d. 6
SIGNATURE
COMPANY
ADDRESS
TELEPHONE #
E~L
~
ME~ICAL
~
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 PERtlIT
CITY OF ZEPIIYRlIILLS
BUILDING DEPARTMENT
eAt ~ ..
PH~:~ 7't~,,-g/3
rHu.((H
"
APPLICANT
51 i 0tWJ4j) (l-fRiAJ;-c
ADDRESS ,3 ?5.~ ()2. /;' '';-( AUP'
/3 T- ~,s~f';J CatNoL,(
JOB LOCATION -::? (sf, Cj.() (Z, rJ./-t A-VG-
OWNER
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D .l~
WORK PROPOSED:____New Construction ____Addition --Alteration _Repair ____Ins tall
____Sign/Temp. ____Sign _Nove ____Demolish
PROPOSED USE: ____Single Family _M/F _l~ of Units ' .____M I H
____Commercial _Indust. ____Swim. , Pool Other
____Restaurant & Health Department Approval
BUILDING SIZE:
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS, **
**COPY OF CONTRACT REQUIRED.
x
Square Feet,
Height
pERM1TS REOUESTED
____BUILDING
$
valuation of Total Construction
_ELECTRICAL
AMP Service
Florida power Corp.
_W.R.E.C.
____MECHANICAL
XPLUMBING
$
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block _Frame
____Steel
Iyq,s/I ~ l~ho/t
W/+/-I tua et. Heatef-
FINISHED FLOOR ELEVATIONS: FT.
******************************************
~ONTRACTOR SECTION
Company
State Cert. or Regist. #
Ci ty License Regis tra t ion j~
******************************************
nmLDER
Signature
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
ET.ECTR1C1AN
Company
State Cert. or Regist. 0 ~
City License Registration
******************************************
Signature
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHAN1CAL
Signature
APPLICATION APPROVED BY ~;;:~...~~:::;;:;*...~*'*.***.*..** PERMIT OFFICER.
Company
State Cert. or Regist. U
City License Registration #
pTHER
w'
CONDITIONS, OF FERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The,underslgntd understands that this perlit lay be subject to "deed restrictions" which ~ay be lor' restr.ictive than City
regulatlDns. The undersigned a5SUles responsibility;for",colpliance with any applicable deed restrictions.
8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake Hork, they lay be r~quired 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 ~ay be
cited for a .isdeleanor violation under state lall. If the owner or intended contractor are uncertain as to IIhat licensing
requirelents lay apply for the intended llork, they are advised to contact the City of Zephyrhills Building Depart.ent, (BI3)
7BB-6611.
Furtherlore, if the OHner has hired a contractor Dr contractors, he is advised to have the contractor!s) sign portions of the
.Contractor Sections. of this application for llhich they llill 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 aay 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 llith a copy of .Florida's Construction Lien Law - Ho.eowner's Protection
Guide. prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
.owner., I certify that I have obtained a, copy of the above described document and promis~ in good faith to deliver it to the
.oHner. 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 compliance lIith all
applicable laws regulating construction, zoning, and land developllnt. '
Application is hereby lade to obtain a perlit to'do Mort and install~tion 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 ~eet 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 governmental agencies fiay apply'to the intended work, and that it is
.y responsibility to identify what actions I lust take to be in compliance. Such agencies include bill ale nol liaited to:
....
I also certify that, if fill laterial is to be used in Flc,od Ze,ne .1\" or "A,etc.', il is underste,[,d th~t a drainage plan
addressing a "colpensating volute. will be sublitted which is prepared by a professional engineer reuist~ied in the State of
Florida prior to permit issuance.
A pertit issued shall be construed to be a license to proceed with the work and not as authority to viol3te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every per~it issued ~hall becole invalid
unless the work authorized by such perlit is COlmenced llithin six months of issuance, or if wOl'k authol lIed by the per.it is
susp~nded or abandoned for a period of six lonths after the ti,e the work is commenced. One 90 day e=tensioll of tile, lay be
allowed for the permit lIith fee charge of $15.00. The extension shall be requested in writing tD the Building Official. An
approved inspection aust be logged during each six lonth period, ~r the project Hill be considered ~b~IJdDned.
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_~~--- SIGNATURE~
OWNER OR AGEjT CO ~RAC
DATE______________9!fAJi/-<J.Lu--------
NOTARY AS TO 'A ~. '
OWNER OR AG __~_ 14(~~~----
/
XPIRES___~~t~:~~_______
MY COMMISSI
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EXP I RES __~.::(~~7!~___
MY COMM