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Home My WebLink About91-1826 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN~ 1826 Date-LO -2 r-c,> ( jijJtJ B J. Hj - .,.(1 e ~ I M,{,AL ~IIA'~I(JAL Type of Permit Job Address: Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work /-:-rl'rtf:'1 Energy Code Readout: ~It. \0.. l~~l Go\- Complete Plans, Specification~ and Fee Must Accompany Application Estimated Cost: 1!' Fee: ~ All work shal! be performe in accordance with the above and all City Codes and Ordinances. COMPANY ADDRESS TELEPHONE # OCCUPATIONAL LICENSE # ~O ~rGv~f4/ PLUMBING SLB Tub Set Water Sewer Final ~Gl""'I(;AL MJ:r.~4""ICAl ~ Tp.Serv. Rough In Meter Can Canst. Pole POOl Pre-Meter 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 (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. Thc paymcnt of reinspection fecs shall bc made bcfore any further permits wiII be issued to thc person owning same. APPLICATION FOR PERI-lIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT /1; 3: /rJ+ ADDRESS ~?:>/O ?hl/nc"c' C~I1/t;r OWNER 7lkD C:;rArt;; nqe124/ ~AAK, ~ /1'1"(7.</7/011/ / '24//$ 335'0// PHONE ~I' 3 - ?yr- 9'S--3~ '. JOB LOCATION 65"/5/J/ &14.//I3/f/rJ Z-AlJ//c, LOT SIZE x AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. t~ WORK PROPOSED:____New Construction ____Addition ----Alteration ____Repair ~nstall ____Sign/Temp. ____Sign _Hove ____Demolish PROPOSED USE: ~Single Family ____M/F _t~ of Units .._M/H _Commercial ____Indust. ____Swim.. Poo 1 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 FORI-IS. H **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING $ 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. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration n ****************************************** nUILDER Si!;mature Company State Cert. or Regist. n City License Registration n ****************************************** ELECTR1C1AN Signature ..-:-' . Company I-;:;v;;"u:i 11"1"/111I11011/ State Cert. or Regist. 4ft City License Registration 1F ~6Q ****************************************** Signature Company . State Cert. or Regist. 1ft City License Registration # ****************************************** MECHANICAl, Signature Company State Cert. or Regist. ff City License Registration # OTHER ****************************************** PERMIT OFFICER. APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . The undersigned understands that this perlit lay be subject to "deed restrictions" which may be more restr.ictive than City regulations. The undersigned asSUII!S respon5ibili\,/~for:.colpliance with any applicable deed restr,ictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or 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 lay be cited for a aisdeleanor 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, (813) 788-6611. 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 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 Departlent of Agriculture and Consumer Affairs. If the applicant is sOle{.ne other than the "owner", I certify that I have obtained a c~py of the above described document and promise in good faith to deliver it to the "owner" prior to com~ence.ent. 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 developaent. Application is hereby lade to obtain a perlit to. do lIork and installntion as indicated. I certify that no 1I0rk or installation has cOI.enced prior to issuance of a perlit and that all work will be performed to meet standards of all lalls regulating construction, City codes, zoning regulati~ns, and land development regulations in the jurisdiction. I als~ certify that I understand that the regulations of other governmental agencies ~ay apply. to the intended work, and that it is IY responsibility t(. identify what actions I lust take to be in compliance. Such agencies include bill ~i e Iwl lil'lited to: . ,- I Department of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensi live Lands, Water/Wastewater Treatment I Southwest Florida Water ManaQe~ent District - Wells; Cypress Bayheads, Wetland Areas, Altering Hatercvurses I ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services, Envir~nmental Health Unit - Wells, \lastewater Treat~err~. Septic Tanks I US Environmental Protection AQenct - Asbestos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,elc.', it is understood tho! d drainage plan addressing a 'compensating volume" will be sublitted which is prepared by a professional engineer rcgisl2rcd in the State of Florida prior to permit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to yiol~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance ~f a permit prevent the Building Offici~l frolll thereafter requiring a correction of errors in plans; construction, or violati~ns of any code. Every per~it issu~d ~hall beeole invalid unless the work authorized by such permit is comaenced within six lonths of issuance, or if Ho,.k authol lied by the perlit is suspended or abandoned for a peri~d Df six lonths after the tiJe the work is co~meneed. Dne 90 day c:IE~5io'i ~f tile, lay be allowed f~r the permit with fee charge of $15.00. The extension shall be requested in Hriling to the Building Official. An approved inspedic,n llIust be logged during each six lonth peri~d, (Ir the project Iii II be cr,nsidered dbcil,de.ned. 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 COMMENCEM ~1/~ OWNER OR AGENT SIGNATURE DATE____~L2~_~---------------- ~g~~~~c~~R~~-~L2/-~.,f~~ - '~.,l,":_~,.~ ' DATE ___Lt2-=.l-::2L---------------.------- ~~~~~yO~SA~~NT~1JL~.-~~~f ~\ '; r"" '. ' MY COMMISSION EXPIRESJ.L....:.i'.l:l-"-D:_.;...l--_...:.._~-:..:_- R.ri~ir:"~' ;'~,. ~'" ,\i.,Y;.; . MY COMMISSION EXPIRt5 .,,;.,. . ..:,:::(irt:::r" - ~'~.~ -:-:---; -,~ - - -- - ---