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Home My WebLink About91-1855 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN~ - /' 1855 t Date /0 ~ /0 - 9/ . Type of Permit BUILDING ~CTR~ PLUMBING MECHANICAL , j- -;J-. ]/h' +- ~,1 ~J Property Owners Name: J/A.A!~ / /IA A<.If r.D Job Address: S / I ;}. - ~ T./ -/...!I, Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work ffiA,.J 4.//'lA.J-f.-e 1 "'fP~'A~k/~ Energy Code Readout: ~....Ii'.-~ Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: _A:/A Fee ~~ ~ SIG~ATURE ~ COMPANY ADDRESS TELEPHONE # All work shall be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE # )/7 PL SLB Tub Set Water Sewer Final ELECTRICAL <==- BUILDING. Ftr. Pre SLB Lintel FRM. Insul.CL WL Breakers Ducts Insl. Compressor Final Rough In Meter Can Canst. Pole Pool Pre-Meter 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. The payment of reinspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PEru-nT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT "J \ ,\ 0- ~\:>+S, ADDRESS .5'~1 ?- ~~. ~~~ PHONE 7?{'J-~ I ~ 3 OWNER o \~ ~nx- ~ l \ , ~ JOB LOCATION .~f ()... (~-d. ~+. LOT SIZE X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION WORK PROPOSED:____New Construction ____Addition ~lteration PARCEL 1. D. ~~ ____Repair ____Install ____Sign/Temp. ____Sign _Hove ____Demolish PROPOSED USE: ____Single Family ~mmercial ____M/F ____~~ of Uni ts .____M I H _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 FORNS. ** **COpy OF CONTRACT REQUIRED. J'F,RMTTS REOUESTED ____ELECTRICAL AMP Service Valuation of Total Construction ~Florida power Corp. _W.R.E.C. ____BUILDING ____MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY 0'" . TYPE OF CONSTRUCTION: ____Block _Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ~ONTRACTOR 0ECTION nUTT,DER Company State Cert. or Ftegist. ~ Signature City License Registration U :1::::::a ..**......*******:::::::***~2.~ ;0 _ Jv."d() ~a . ~~~~\~~:~~:~e~~~~~~;i~n ,~ //7' ***~************************************* ****************************************** ~ Signature Company State Cert. or Regist. ~ City License Registration U ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration 0 ****************************************** MECHANICA1, Signature Company State Cert. or Regist. # City License Registration 0 OTHER APPLICATION APPROVED BY ****************************************** 7t t&~~ ;;; ./I-~ . PERMIT 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 m~re restr.ictive than City regulations. The undersigned assules responsibility;for co.pliance with any applicable deed restrictions. . , B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a c~ntractor or contractors to undertake work, they lay be required t~ be licensed in acc~rdance with state and local regulations, If the contractor is not licensed as required by law, both the owner and c~ntractor ftay be cited for a lisdeaeanor violation under state law, If the owner or intended contractor are uncertain as to what licensing requirelents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (B131 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised t~ have the contractor(sl 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 wor~. 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 perlitting 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 sOle{.ne other than the 'owner', I certify that I have obtained a. copy of the above described document and promise in g~od faith to deliver it to the 'owner' prior to cOlaencement, 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 of a perlit and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land devel~pment regulations in the jurisdiction. 1 also certify that I understand that the regulations of other governlental agencies ~ay apply. to the intended wor~, and that it is IY responsibility tel identify what actions I lust ta~e to be in compliance. Such agencies include bill ~le Ii(,t liaited to: 0#- J Deparhe~,t e,f Envir~nllental ReQulation - Cypress Bayheads, lietland I\reas and Environmentally Sensitive lands, Water/Wastewater Treatment I Southwest Florida Water ManaQeaent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treat~en~, Septic Tan~s f US Environaental Protection AQency - Asbestos abatement I also certify that, if fill laterial is to be used in FlC,od Zone "A" or "A,etc.', it is underst(,(.d tli~t a drainage plan addressing a 'c~lpensating volule' "ill be sublitted which is prepared by a professional engin~er regist21ed in the state of Florida prior to permit issuance, A perlit issued shall be construed to be a license to proceed with the wor~ and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit pr~vent the Building Official frOM thereafter requiring a cc.rrection e,f errors in plans; ce,nstructie,n, e,r violations of any ce,d~. Every pNlIli t iSSlled "hall ben'le invalid unless the work authorized by such perlit is cOllenced within six months of issuance, or if 1l01.~ aulhol lied by the perlit is suspended or abandoned for a period of six lonths after the ti>>e the wor~ is co~menced. One 90 day e:le~5iol\ of tile, lay be allowed for the permit with fee charge of $15.00, The extension shall be requested in wriling to the Building Official. An approved inspectie,n must be le,gged during each six lIlonth period, e,r the prc,ject Iii II be ctonsidered dbcillde,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 COMMENCEMENT". SIGNATURE~_~:i_~~~ ~--- ~ONTRACTOR ~. DATE____~~_~~~~-i~---------------- SI GNA TURE_.l~L,1.,..._1::d1~~~- OWNER OR AGENT _~_l6_--r-l~SL.\------,------- NOTARY AS TO . ~ ~ OWNER OR AGENT__~~~~-~---------- - -- MY COMMISSION EXPIREs~otary Public. State of FlorIda 1ltI 'C(lll1llTISSnnrf:xplfes- falr.:i,5-... -i~- ~g~~=~c~~&\}.~,~~~b_- MY COMM I 55 I ON EX P I ~~ary Public, state of F10rrdcJ M~CiiffiffilsSToii 'EXpires 1an~25:- 1992