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Home My WebLink About91-1805 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN'~ 180SP ~~ Property Owners Nam, e:t~ . + -Jii ~L A~ Job Address: ,] Lf..5' ~ / Type of Permit BDn.OIl'4G E~ Legal Description: Sub.Div. Date (~ - cJs ''- 9; ME~L Lot Blk. Zoning CI: Description of Work 'Ji.~-7 ,;t; A/L<f--' Z<;,~ ~ ~ Energy Code Readout: (ffrnpUh Id ~3o-41 Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: ~// ;4- t> / All work shal! be performed in accordance with the above and all City Codes and Ordinances, OCCUPATIONAL LICENSE 113:]---- 'I-!t~ ;;~ ( ~'t ~~t SLB Tub Set Water Sewer Final ~ - Ftr. Pre SLB Lintel FRM. Insul.CL WL Driveway Fee: .;L6. ~ SIGNATURE ~ ~L:J,l3aj/1 COMPANY ADDRESS TELEPHONE # ELE~ -------- MECH~L ~ " 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 PEru-lIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT ADDRESS TJ;..,e-L ~ C-J.aaJI. 'q , II /3 8" E) Y 0 ~f.. e L L,/c\ fJA-R L[(~ PHONE 7~2-Oh,~1 APPLICANT OWNER SA;/I/lL JOB LOCATION (~~ SLfo il< E/c/S LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D .l~ WORK PROPOSED:____New Construction ____Addition ----Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Hove ____Demolish ____Commercial ____Indust. ____Swim. Pool , .____1'1/ H Sf~/f1f, LSf!: Other ~~ 1'5 7l2:M PROPOSED USE: ____Single Family ____M/F ____l~ of llni ts ____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 FORNS."'* **COPY OF CONTRACT REQUIRED. ~ERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service Florida power Corp. _W.R.E.C. _MECHANICAL .A-PLUMBING $ Valuation of Mechanical Installation GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature ~ONTRACTOR ~ECTION Company State Cert. or Regist. Q City License Registration a ****************************************** j3UILDER Signature , Company CeLl (( (5 (SA-If f< Po' ~ %~ ' It) f-, tk ' ~ 51 rfnb State Cert. or Regist.!I IZ~-- :D't. ' --- . ,,(/2.. ' . City License Registration j~ ,C;"7 .. -- C" .......................................... Company State Cert. or Regist. a City License Registration 6 ****************************************** f,LECTRTCIAN Shmature PLUMBER Signature Company State Cert. or Regist. a City License Registration j~ ****************************************** MECHANICAl. Signature Company State Cert. or Regist. a City License Registration a QTHER APPLICATION APPROVED BY ***********~*************************** )14 ~A~ , -- PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . The undersigned understands that this perait lay be subject to .deed restrictions" IIhich ~ay be more restr,ictive than City regulations. The undersigned assUllles responsibilitf:'forcolpliance lIith any applicable deed restrictions. , , 8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they aay be required to be licensed in accordance lIith state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor ~ay be cited for a .isdeaeanor violation under state lall. 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, (BI3) 7BB-66 II. 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 llhich they Hill 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 Zephyrhl1ls. 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 - HOleollner's Protection Guide. prepared by the Florida Depart.ent of Agriculture and ConSUDer Affairs. If the applicant is sOleone other than the .0Hner., 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 COllenceDent. . ..... 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 cOlpliance with all applicable laws regulating construction, zoning, and land developDent. Application is hereby lade to obtain a per.it to'do work and install~tion as indicated. I certify that no work or installation has COIll.enced prior to issuance of a per.it 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 ~ay apply'to the intended work, and that it is .y responsibility tel identify llhat actions I lust take to be in compliance. Such agencies include but ~l e nr,t lillited to: ... I Departle~t of Envir~n.ental ReQulation - Cypress Bayheads, Wetland ~reas and Environmentally Sensitive Lands, Water/Wastellater Treat.ent f Southwest Florida Water ManaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps af EnQineers - Seawalls, Docks, Navigable Waterways I Departaent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treat~ent. Septic Tanks I US Environ.ental Protection AQency - Asbestos abatement I also certify that, if filllaterial is to be used in FlCoDd Zc,ne "A" c,r "A,etc.', it is understc,c,d tl.,t a drainage plan addressing a .colpensating volule. will be sub.itted which is prepared by a professional engineer reqist2ied in the State of Florida prior to per.it 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 permit prevent the Building Offici.l fro~ thereafter requiring a correction of errors in plans; construction, or violations of any code. Every permit issll~d :hall beco.e invalid unless the work authorized by such permit is commenced within six months of issuance, or if wOl'k autl.DI Ized by the per.it is suspended or abandoned for a period of six lonths after the ti3e the HDrk is co~menced, One 90 day e:tE~5ioll of tile, lay be alloHed for the permit 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 lonth period, or the project will be considered ab6l1doned. 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". CONTRAC R DATE________~-~~-------------- ~g~~~~c~~ =~_ ________~-~-- ~&i, SIGNATURE_~~~--------- OWNER OR AGENT DATE ______________~p-d-J!.------,------- ~~~~~yO~SA~~NT~-~~~--- / ' MY COMMISSIO~ ,EXPIR~S____~~~~j(_~----- SIGNATURE .. EXPIRES___~f~~~s::--- MY COMMI