HomeMy WebLinkAbout91-1849
STATE OF FLORIDA
City of Zephyrhills
,] 7",~ ()
Type of Permit
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
184913
Date / 0 -/5~- 7j
BUILDING
ELE~
PL~
ME~L
Property Owners Name: O~~o_d~ -a--<' "- "h A.l:>_ 4<- ~"- ,
Job Address: 36-~__~
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI: / ) - ::Lb
Description of Work / 9 Y /1
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Energy Code Readout:
SIGNATURE
COMPANY
ADDRESS
TELEPHONE #
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
lintel
FRM.
Insul.CL
WL
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.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
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CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
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APPLICATION FOR PEm1IT
CITY OF ZEPHYRHILLS
BUILDING DEPARTt-tENT
APPLICANT
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ADDRESS
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PHONE
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OWNER
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JOB LOCATION '] '( '1 '") (,.' .~a p,,, -< LOT SIZE_X
LEGAL DESCRIPTION: LOT(S) (,~:') / '1 .5. BLOCK /;"'- SUBDIVISION
PARCEL I. D. ~F /-,+ 1:;:2 _.. P ":< ,I f? 4~ . ~-;-i'
AREA SQ. FT. l?,..,
WORK PROPOSED:~New Construction ____Addition
\,
...-:::.-Alteration
_Repair
I '
~Instal1
_Sign/Temp.
_Sign
_Hove
_Demolish
PROPOSED USE: ____Single Family
...:..-M/F
_iF of Units
,._M/H
_commercial
_Indust.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE: I!
X :' ,;;'~,p ,
Square Fee t,
Height
RESIDENTIAL:
COM1'1ERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR1'1S.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl-IS. **
**COPY OF CONTRACT REQUIRED.
~RMITS REOUESTED
~BUILDING
_ELECTRICAL
$
l ~.'"
, .
Valuation of Total Construction
AMP Service
Florida power Corp.
_H.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
.-
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION:
____Block
____Frame
____Steel
AI .
I ;f h' " /', j /C'
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
~ONTRACTOR 0ECTTON
Company
State Cert. or Rcgist. 0
City License Registration 0
*****************************************~
illllLDER
Signature
Sio-nature
Company
State Cert. or Regist. n
City License ReGistration 0
******************************************
f,1.F:CTRTCTAN
Signature
Company
State Cert. or Regist. ~
City License Registration 0
******************************************
PUlMRER
Signature
Company
State Cert. or Regist. a
City License Registration 0
******************************************
I1ECHANTCAT.
Signature
Company
State Cert. or Regist. 0
City License Registration 0
OTHER
APPLICATION APPROVED
~**********g********************~;*~****
BY .Lfd.,"'I'"';j _..Ij pA fll,j . .,' --- P "RHIT OFFICER,
.;~~
CONDITIONS OF,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The,und~rslgned understands that this perlit lay be subject to 'deed restrictions' which may be ~ore restr,ictive than City
regulations. The undersigned assules responslbilitf:for, compliance with any applicable de~d restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the own~r 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 ouner and contractor ~ay be
cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (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 Hhich 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 Hishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to permitting 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 - Ho~eowner's Protection
Guide' prepared by the Florida Depart_ent of Agriculture and Consumer Affairs. If the applicant is sOleCne other than the
'owner", I certify that I have obtained ~ copy of the above described document and promise in good faith to deliver it to the
'owner' prior to cOlmencement.
;1"".:
I. '".
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work Hill be done in co~pliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby made to obtain a permit to'do work and install~tion as indicated. I certify that no work or
installation has commenced prior to issuance of a perlit and that all work Hill be perfor~ed 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 governmental agencies ~ay apply'te, the intended work, and that it is
.y responsibility tel identify what actions I must take to be in compliance. Such agencies include bill ~l e n(,t li~ited to:
...
I Deparhe~Jt elf Envir~nllenial ReQul~tion - Cypress Bayheads, Hetland Areas and Environmentally Sensi tj\ie Ldnds,
Hater/Wastewater Treatment
. Southwest Florida Hater ManaQelent District - Wells; Cypress Bayheads, Hetland Areas, Altering HatercDurses
f Arty Corps ~f EnQineers - Seawalls, DDcks, Navigable Waterways
f D~partlent of Health L R~habilitative Services, Environ~ental Health Unit - W~lls, Wastewater Treat~en:, Septic Tanks
f US Environaental Protection AQency - Asbestos abatement
also c~rtify that, if fill material is to be used in Helod Ze,ne 'A' (lr 'A,dc,', it is underste,(,d tl.31 d drainage plan
addressing a 'colpensating volume' will be sub.itted which is prepared by a professional enqin~cr icqist~rcd in the State of
Florida prior to permit issuance.
A perlit issued shall be construed to be a license to proceed with the work dnd not as authority to yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance Df a permit prevent the Building Official fro~ thereafter
requiring a ce,rrection elf errors in plans; constructi(,n, e,r violations of any ce,de, [very per~it issued :haJI becl.le invalid
unless the we,rk authe,ri1ed by such permit is celuenced within six 1lI0nths e,f issuance, (,r if l"iCoJ f; dulI,(" ],ed by the perlit is
suspended Dr abandoned for a period of six lonths after the ti~e the Hork is commenced. One 90 ddt c:tensioll of ti&e, aay be
allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the 8uilding Official. An
approved inspectie,n !!lust be logged during each six month period, or the project liill be cc,nsiderr:d dDol,de,ned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT I N YOUR PAY I NG TW I CE FOR I MPROVEMENTS TO YOUf~ PROPERTY. I F YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al-TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
I ,
SIGNATURE__(~~_~_~=_~~--------
Grace M. Fer;u~PWNER OR AGENT
DATE ___cv.U__L~__~_~l_____-------,-------
~~~~~YO~SA~~N~~~_(;__~_~_~_
13cmita. G. Jones
MY COMMISSION EXPIRES',''"
--- ~ ..ulillClo "lltiti-oTflorid"--
!!I--....... ~I'M Feb. 28, 1994
--..--~~
SIGNATURE
------------------------------
CONTRACTOR
DATE
-----------------------------------
NOTARY AS TO
CONTRACTOR_____________________________
MY COMMISSION EXPIRES
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