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Home My WebLink About91-1874 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY PermitN~ - 1874/1{ l:;if1?~ '!.e 17_,-0 BUILDI~';1~7~~~~;N:,- _ ~G-- ~ICAL A~ ~~ ~:~::~r~:~ers Name: ~~) ~ )::; tift!!. -~L, ~~ ~ ~ ':/ 0, Date / } ,- - 7' Lot d- ./- Blk. _..:> Legal Description: Sub.Div. ~::~nr~p~~no~:or~(, d~/ ,/j~ (/I<'4t~t ,~~# , ,// /'~ ~ }J '1- ~ &t- Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated cost:!f ~ I( 7..~ ~ __.~ .h ()D Fee:;r' ~'D' _. SIGNATURE "./") G..:/, r. COMPANY e e' ./ . ADDRESS TELEPHONE # ------:.... All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE # 71 11 / L... F ( BlJl mNG ING EL SLB Tub Set Water Sewer Final Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final ... 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 tcn ($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. c ," t ....' j""1'";"~,7' ~., ~'-:-::'''~' ~.,-" ,":f" ADDRESS ,1.I.L'Kinsey Central"'. ,\, Heat & Air-Conditioning 7722 Fort King Highway. P.O. Box 2209 Zephyrhills, Rorida 33539-2209 (813) 782-2300 -9'-1 -eR. ;)...Yl. DATE PROMISED APARTMENT CllY MAKE MODEL SERIAL NO. msTIMATE o CASH o CHARGE NATURE OF ~ SERVICE LV REQUEST QUAN, PART NO, DESCRIPTION PRICE AMOUNT I!~ SERVICE PERFORMED TOTAL MATERIAL TECHNICAL SERVICE T ME TAX DATE COMPLETED TOTAL CAS H ON COMPLETION -"" OF WORK -, 7~~! CUSTOMER'S SIGNATURE TECHNICIAN ,l J'" IJ --_... \ AP?LICATION FOR EERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT L -2' ~D iG' APPLlCANT ;<",';.) 5 '7 C.P-.v fr...J? ADDRESS /' 7 ,~A F)L .x;~ OWNER f< < V . .5 tAJ is /.,u JOB LOCATION t, lot; I 02. ~ S rf . 1J./~y/4/c PHONE LOT SIZE_____X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. # WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. _Sign _Move ____Demolish PROPOSED USE: _Single Family _M/F _~~ of Uni ts ._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.H **COPY OF CONTRACT REQUIRED. PF.RMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL ~ECHANICAL AMP Service Florida power Corp, _W.R.E.C. $ 2f11r ~ 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, j~- City License Registration # ****************************************** J3UILDER Si~'nature Company State Cert. or Regist. # City License Registration # ****************************************** F.T.FCTRICl AN Signature Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER QTHER Company J{: "A.j 5 ~' L:.JI-rV r! "': ~ State Cert, or Re st, 4~ /(11~OSi. ~~'R City License Registration # 71 ****************************************** Signature Signature Company State Cert. or Regist. j~- CityL;:icense Registration ~.~ .** PERMIT OFFICER. APPLtCATION APPROVED BY ~----",.,. .- CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS - The undersigned understands that this perait aay be subject to "deed restrictions" which lay be lore restr.ictive than City regulations. The undersigned assuaes responsibility'for co.pliance with any applicable deed restrictions. . , B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake work, they aay 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 may be cited for a lisdeaeanor 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, (8131 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 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 - HOleowner's Protection Guide" prepared by the Florida Departaent of Agriculture and Consuler Affairs. If the applicant is sOle6ne other than the "owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the "owner" prior to cOllencelent. 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 cOlpliance with all applicable laws regulating construction, zoning, and land develop.ent. Application is hereby lade to obtain a per.it 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 leet 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 govern.ental agencies lay apply'to the intended work, and that it is .y responsibility to identify what actions I lust take to be in coepliance. Such agencies include but ~l e not liaited to: . '\ ... . J. I Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive ldnds, Water/Wastewater Treataent * SouthNest Florida Water ManaQelent District - Wells; Cypress Bayheads, Wetland.Areas, Altering Watercourses I Aray Corps of EnQineers - Seawal~s, Docks, Navigable Waterways I Departaent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks t US Environaental Protection AQency - Asbestos abatement I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.', it is understood tt.3t a drainage plan addressing a 'colpensating volule" will be subaitted which is prepared by a professional engineer registEied in the State of Florida prior to perlit issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a per~it prevent the Building Official frol thereafter requiring a correction of errors in plans; construction, or violations of any code. Every permit issll~d ;hall becole invalid unless the work authorized by such peraitis cOllenced within six lonths of issuance, or if work authoflzed by the perlit is suspended or abandoned for a period of six aonths after the tiae the work is commenced. One 90 day e~ttnsioll of tile, lay be alloNed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection ~ust be logged during each six aonth period, or the project will be considered abdlldoned. 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~3:::J~~,"~( ____ SIGN"rURE___O&~ OWNER OR AGENT ~ ~~TR::TOR ( l}A if _L~i=-._-l ~lr--LlJ-~-L-__-__- __._______ DA TE ___.Q~j_:..__:L'1T_LJJJ_ ----- --------.-- ~~~~:V O~S A~~NT -.c1.k-~- J!~___ ~g~~~~C~~R:~ctJb--~i- ,---- MV COMMISSION EXPIREs-5~f___~"J_~~~___ MV COMMISSION EXPIRES_~~~J9_j-t~~---