HomeMy WebLinkAbout91-1853
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
PermitN~
1853E
Type of Permit
~GECTRIC~ ~_ ME~
Property Owners Name 11.~z!tJit:z
Job Address: d~ 7c2-0 __~_ _ _
Sub.Div. Ydt1Jl ~~
ZoningCI: d-- J-b - d-/ - I J) - 0 - /
Description of Work fJ Ar_tu-:- - -;t: ~~,~)-YL(? M" ~.7 ...c~
Date / () -~/6 --51' I
Legal Description:
Lot
Blk.
Energy Code Readout:
~/'-lJ-f'j
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
.~A
Fee:
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE #
SIGNATURE
COMPANY
ADDRESS
TELEPHONE #
'Ke /7cf7-8
-~
7?c: J~Y?
-~BING
..............,
SLB
Tub Set
Water
Sewer
Final
\. 7:Jf'k cJi~~
ceLECTRICAS'
Tp.Serv.
Rough In IO-/~'" (
Meter Can
Const. Pole
Pool
Pre-Meter
Final
~{J I .I ~J-9/'-1
M~NICAL
~
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
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.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT ~~ ~eYJV;e~
ADDRESS 3>1 V {,II~ ( ~ C(~de
PHONE
OWNER
L)~ ( ( ~c. ~
I
LEGAL DESCRIPTION: LOT(S)
~u~
LOT SIZE_____~ AREA SQ. FT.
JOB LOCATION
BLOCK
SUBDIVISION
PARCEL I.D.~F
:2 - :26 - dLl_ /,0 - 0
/
WORK PROPOSED:____New Construction ____Addition ----Alteration ____Repair ____Install
____Sign/Temp.
_Sign
____Move
____Demolish
PROPOSED USE: ____Single Family
____M/F
_# of Units
__M/H
____Commercial
____Indust.
____Swim. Pool
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 FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
----~
____ELECTRICAL
AMP Service
Valuation of Total Construction
~da Power Corp.
_____W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBIN'G
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. IF
City License Registration #
******************************************
BUILDER
Signature
Company
State Cert. or Regist. #
City License Registration #
***************************
l~
Company
State Cert. or Regist. #
City License Registration #
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
S~gnature
Company
State Cert. or Regist. iF
City License Registration #
OTHER
Signature
APPLICATION APPROVED BY
~**********~*************************
tt'1'\...CAJ oA -lhAJ-- "
PERMIT OFFICER.
A;-'~~
- -""'~"
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Th~ undersign~d und~rstands that this p~rlit lay be subject to "deed restrictions" which' ~ay be lore res~rictive than City
regulations. The undersigned aSSUle5 responsibili'y for co~pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the own~r has hired a contractor Dr contractors to und~rtake work, th~y lay be required to b~ lic~nsed 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 .isdeleanor 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, (813)
788-6611. '
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 Consuler Affairs. If the applicant is SOleone other than the
"owner", I certify that I have obtained a copy of the above described docuient and promise in good faith to deliver it to the
"owner" prior to cO'lenceaent.
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 cospliance with all
applicable laws regulating construction, zoning, and land develop.ent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has co..enced prior to issuance of a perlit and that all work will be performed to meet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the'J~risdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is
IY responsibility to idenHfy what actions I must take to be in compliance. Such agencies include bllt ~le not liilited to:
I Depart.lnt of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treat.ent
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Army Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - W~lls, Wastewater Treatment. Septic Tanks
I US Environ.ental Protection AQency - Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.', it is understood that a drainage plan
addressing a "co.pensating volule" will be sublitted which is prepared by a professional engineer reqistered 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 viol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building ~fficial frol thereafter
requiring a correction of errors in plans, constructie.n, or violations of ~ny code. Every perllit isslwd ;hall becole invalid
unless the work autho.rized by such penit is cOlllenced within six lIonths of issuance, (lr i.f work autholl Led by the perlli t is
suspended or aband(.ned for a period of six lonths after the ti/le the 1I0rk is cOllJllenced. One 90 '<lay c.~tHi5io\l of tile, lay 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 inspection must be logged during each six month period, or the project will be considered aballdoned.
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 COMMENCEMEN. OBS UNDER $2,500 I
DO NOT NEED TO RECORD AND POST A "NOTICE 0 COMM NCEMENT"
SIGNATURE_~~~ ~~~~;~-------
OWNER OR AstNlt~
DATE__~>L_:_~s{_::_~~--------~-----
NOTARY AS TO ~ J2
OWNER OR AGENT _ _ _ ~~
Notary Public. Sta Florida
MY COMMISSI0NEXPIRES___~~~~~~~~-~~-~~~~~-
SIGNATURE
DATE__~_<2_:_~~-~-~~-----
NOTARY AS T~ ~
CONTRACTOR_~~J~~~~ .
~ ' &~
MY COMMISSION EX RE~_~