HomeMy WebLinkAbout91-1820
.
STATE OF FLORIDA
City of Zephyrhills
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PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
1820 13
rJ () ,TO
ELECTRI<:~
Date /0 - I - 9' /
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MEC~_
Property Owners Name~"~? #-'yf
Job Address: '- S ::2 - _
Legal Description:
Sub.Div.
Lot
Blk.
Zoning Ci: if. - iJ 6 - ()./ - -;. 0/ 0 ~ -e.2 () ~ 7's ()
Description of Work )0 " X/I'.-/~ ~ ~..A....1~
~~
,
PAi~-R
Energy Code Readout:
1,,.-'11 "f
/1;' V
Fee: 70. n -!;tJ~~
SIGNATU~' C~. ()
COMPANY
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
t 7 tf~ . 0-0
/
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
ADDRESS
TELEPHONE #
OCCUPATIONAL LICENSE #3/.s-
~I~~
Ftr. 10.7-1/ fiJ
Pre SLB
Lintel
FRM. IP",l,J __"i
Insul.CL
WLJ p "],3-q I
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ELECT~iCAL -- 7..3
Tp.Serv.
Rough In I P -' ~J - "" I
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
MEC~L
,
~NG
-
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten ($10.00)
dollars shall be made for each trip.
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(c) Repairs or corrections not made when inspection called for
(d) Work not ready for inspection when called.
Thc paymcnt of reinspection fccs shall bc madc bcforc any further permits will be issued to the person owning samc.
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U\WRENCE E. BENNE. 11
CIVIL ENGiNEER 8. DEVELOPMENT CONSLUANT
P.O. Ro( 4368 Soul" Doy!Ol"\o, rl. ~121-436B
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DATE OF PLANS
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We hereby submit specifications and estimates for:
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11 Dr Jrupl1.l3r hereby to furnish material and labor - complete In accordan..ce. N:th above ~peclflcatlons, for t:18 sum of: 11
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I~yment :O-,5e m~;f,~~~~.IOWS: /~ c"A">'/rlVO,' kAJ ,5lf(Y :t-~~ <7 do~af~ ($ b ( ,j '~ ,--)
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!I~l matenat IS guaranteed to be as specified All wori< to be completed In a NorkrTI:i.lllke _.... / ..,-' /' I
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I extra charge o~er and above the e5t:mate. Ail agreements contIngent upon strikes. aCCidents !
.I~ or delays beyond our controL Owner to Ca:-ry fire, tornado and other necessary Insurance. r'~ote: This proposal r."lay be Ii
, Our workers are fully covered by Vlork,nen's CompensatIOn Insurance. {I"hdrawn by,", If 'Ol d ~f'pted {,It,lIn days I
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II to do the work as specified. Payment will be made as outlined above. )
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APPLICATION FOR PERI-lIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
ADDRESS
/~/lo/
5'":2. '/ ~
9iAb~,,1
1/ .$f
-<'t;nJ. J~~' /I~
/
J:3 ,11/
PHONE
APPLICANT
OWNER
'.
JOB LOCATION
LOT SIZE ~O X /3-rJ AREA SQ.FT. 9tJOO.
LEGAL DESCRIPTION: LOT(S)
PARCEL l.D.# //"2t- 2/-0010 ,./X'/OD--
WORK PROPOSED: ~ew Construction ____Addition
BLOCK
SUBDIVISION
005"0
-^lteration
____Repair
_Install
_Sign/Temp.
PROPOSED USE: ~ingle Family
____Sign
_Nove
_Demolish
~/F
_t~ of lTni ts
,._M/H
_Commercial
____Indust.
_Swim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE: /1 X /1
/J--/
Square Feet,
7
I
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 FORMS.**
**COPY OF CONTRACT REQUIRED.
~BUILDING
PERMITS REOUESTED
6' 7lt':z.~ 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.
******************************************
BUILDER
Signature ~~.
",
CONTRACTOR SE~ ~ .
Company , c;) __< - -<'0I./""'- ;
{' / U f2, State Cert. or Regist. iF ..,.
~/Jt.. . City License Registration ir .~/S-
*******~*********************************
ET.F:CTRTCTAN Company ~*~ E~./'~';'-->
~ ~ State Certo 0 egist. II
Signatur~.(?: K ~/ City License Registration iF ~/ ?~
~ *************************************
Signature
Company
State Cert. or Regist. ~
City License Registration n
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. n
City License Registration #
******************************************
MECHANICAL
OTHER
Signature
Company
State Cert. or Regist. n
City License Registration il
APPLICATION APPROVED BY
~*********~*************************
aha .2.A4.......'I- .
PERl-lIT 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 ~ore restr.ictive than City
regulations. The undersigned assutes responsibllit(;for compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a c~ntract~r or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor il not licensed as required by law, both the owner and contractor lay be
cited for a lisdeleanor 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, (BI3)
7BB-bbll.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorts) sign portions of the
'Contractor Sections. of this application for which they will be responsible. If you, as the owner sign as the contract~r,
you are indicating that you, rather than the contractor, are responsible for the wor~. If the contractor wishes you to sign
as c~ntractor 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 Departlent of Agriculture and Consumer Affairs. If the applicant is sOlec.ne other than the
.owner., I certify that I have obtained l c~py of the above described document and proffiise in good faith to deliver it to the
.owner. prior to cOlmencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all wor~ will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby lade to obtain a perlit to do work and install~tion as indicated. I certify that no work or
installation has cOllenced prior to issuance Df a perlit and that all work will be performed to meet standards of all laMS
regulating construction, City cod~s, zoning regulations, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other governmental agencies ~ay apply. to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in compliance. Such agencies include bllt ~l e Ii(,t limited to:
#'
I Departle~t of Envir~nlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water. ManaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
I Any C[lrpS .of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Ilastewater Treat~en~. Septic Tanks
I US Environ.ental Protection AQency - Asbestos abatement
I also certify that, if fill lat~rial is to be used in Fl~od Zone "A" or "A,etc.', it is understood tll~t a drainage plan
addressing a 'colpensating volule" will be sublitted which is prepared by a professional engineer regist~ied in the State of
Florida prior to perlit issuanc~.
A perlit 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 Official frolll thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every per~it iSSlIed ~hall becole invalid
unless the work authorized by such permit is COlmenced within six months of issuance, Dr if H01.k authol lzed by the perlit is
suspended or abandoned for a period of six lonths after the tiJe the wDrk is cD~menced. One 90 day e:tE~5ioll 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 inspectie,n i!lust be l(,gged during each six month period, or the prc.jed will be c[,nsidered ilb';IJde1ned.
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".
SlGNATUR~.L-~ ~_~__ SlGNATU~~.~~ ClL
OWNER OR GEN ~."- ; CONTRACTOR ~~.
OATE.1.:..lf!--':..tL------------------.- OATE___t-:;!.~-::..(l!..---.----.--.-.-
NOTARY AS TO 1) .-\. ~ _ NOTARY AS TO 3 .-."- 7 v' fi I. -
OWNER OR AGENT~ . CONTRACTOR.~-1}~-~~
My Commission Expires . 1(), 1'9'93" Notary Public, State of Fltrid,. .
MY COMMISSION EXPIRES_____~~l~J~~~~~~~~L~~ MY COMMISSION EXPIR~LNwWu~~JkL~1993
~ded JI>LlI w>y Fain: Insuranca In..