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Home My WebLink About91-1875 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit X~ 1875B Date /0 .~ ;;g- ... r / T~~4 ~ -a&nRI~AL ~ ME~L Property Owners Name: ~{'._{ ~I 1~ M Job Address: ~/ tJ 0-- / 7 R ~ Legal Description: Sub.Div. Lot Blk. Zoning CI: Descrlplion of wor:/I(" ~ /",;~1-'1'/ ~ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application OCCUPATIONAL LICENSE #~ fl7~ if Z /tf' f , 1'1 A' <( A /~ ~.....c.- . B~ILDlI'IG-" '0 PL~________ Ftr. SLB - Pre SLB Tub Set Lintel VVater FRM. Sewer Insul.CL Final WL Fee: .:s C! " ~ SIGNATURE~'~ \.1Mv1ujtvrtJ COMPANY ADDRESS TELEPHONE # Estimated Cost: c2/ trzJ ~ o-V / All work shal! be performed in accordance with the above and all City Codes and Ordinances. ELECJ.BICAL ~ ME~ICAL ~ Tp.Serv. Rough In Meter Can Const. 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 tcn ($10.00) dollars shall be made for each trip. (a) Wrong Address (b) Condemned work resulting from faulty construction (e) 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 PEIDlIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT ADDRESS - DCWtct WtJ1sJ~ {pIDD l~ SfYeeJ PHONE~ ~ --'1Q 2- (pLf.g4 APPLICANT OWNER II ~. JOB LOCATION II LOT SIZE x AREA SQ. FT. N/4 , LEGAL DESCRIPTION: LOT(S) ()2~2t.J; - 2/-018D - 00000 BLOCK SUBDIVISION o .5 'f-O PARCEL I,D.i~ WORK PROPOSED:____New Construction _Addition ____Alteration ____Repair ~nstall ____sign/Temp. _Sign 1?e-~o . _Hove ____Demolish PROPOSED USE: _Single Family ~/F _i~ 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,** **COPY OF CONTRACT REQUIRED. pRRMITS RROUESTED _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. ~UT),DF.R ~ ~ONTR~~~~~n~F.CTT01}}UVlI..e/ ~ ~ohY<q ~\ V State Cert. or Regist, iF ~ 'V . Signatur~-<ilO.IJ1 -/' City License Registration iF ..sf? . ****************************************** ****************************************** Signature Company State Cert. or Regist. # City License Registration # ****************************************** f.T.ECTRTCTAN Signature Company State Cert. or Regist. 0 City License Registration # ****************************************** PLUMBER Signature Company State Gert. or Regist. 0 City License Registration 0 ****************************************** MECHANICAL Signature Company State Cert. or Regist. 0 City License Registration # OTHRR AFPLICA~.Q~jAfPROVED BY c,t.. ~ ~, PERMIT OFFICER. ~ . ~~ . "..." .,j.............. __, ""oIh~"'~'" ~~.iH\.'" ,.~;,,~ ;. -':a~~ 'Ii' CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The .undersigned undlntands that this penU uy 01 lubJect to "deed restridit.ns" which lIay be 1I0re restr.ictive than City rel.luhtionl. The undersigned anullu re5ponsibllit'/~'for;co.pHance lIith any applicable deed restriction,. . !,,' ' , '. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ollner has hired a contractor~r contractors to undertake 1I0rk, .they .ay be required to be licensed in accordance with state and local regulations. If the contractor il not licensed as required by law, both the owner and contractor lay be cited for a sisde.eanor violation under state lall. If the OKner or intended contractor are uncertain as to what licensing requiresents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (813) 7B8-66l1. Further.ore, if the OKner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the 'Contractor Sections' of this application for which they Kill 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 Kishes 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 Const~uction Lien LaK - HOleowner's Protection Guide' prepared by the Florida Departsent of Agriculture and Consuler Affairs. If the applicant is SOler.ne other than the 'oKner', I certify that I have obtained a. copy of.the above described document and promise in good faith to deliver it to the 'ollner' prior to co..encelent. ;,..:" E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work Kill be done in cOlpliance Kith all applicable laKs regulating construction, zoning, and land developeent. . Application is hereby lade to obtain a perlit to' do "ork and install~tion as indicated. I certify that no work or installation has co.menced prior to issuance of a perlit and that all work will be performed to meet standards of all laws regulating construction, City cod~s, zoning regulati~ns, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governGental ~gencies ~ay apply. to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlllpliance. Such agencies include bllt ~Je not lilited to: . ",."'" I Depart.ent of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment I Southwest Florida Water' ManaQe.ent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses I Ar.y Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways I Departsent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Ilastewater Treat~en~. Septic Tanks I US Environaental Protection AQency - Asbestos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.', it is understood th~t a drainage plan addressing a 'colpensating volul~' will be sublitted which is prepared by a professional engineer fegist~ied 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 violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Offici.l frol thereafter requiring a correction of errors in plans; construction, or violations of any code. Ev~ry permit iss\l~d :hall becole invalid unless the work authorized by such permit is cOllllenced within six months of issuance, or if work authDrlzed by the perlit is suspended or abandoned for a period of six lonths after the tiJe the work is cDmm~nced. One 90 day e~tf~sioll of tile, lay be alloKed for the permit with fee charge of $15.00. The extension shall be requested in ~riting to the Building Official. An approved inspectic.n l!Iust be lc.gged during each six Mnth period, or the project will be c[.nsidered dbdlldoned. 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 00 NOT N/jECORO ANO POST A "NOTICE OF COMMENCEMENT",' SIGNATURE~ . _ SIGNATUR~~'===--- OWNER OR AGENT CONTRACTO ::::~~_::_~-:(Ljf-~L~~------,----~-~--) ::::~~-::-~:!~}~-.~~~--,----------- OWNER OR AGE~~~~~J~~~~-~ CONT~ACTOR__~~~_~~~~~~ MY COMMISSION EXPIREs_____~-;;~~'ICOMMISSION EXPIRES PROPOSAL Proposal No, ,. ~ l\.S -;- ~- ;:) ,,- r-'''' <'" ~ ~J " I'":; 7 4 'l i r ~",~--.. .~ .. Sheet No, r"'-"--.--- l.; ... ~ . ~ ,..~ Date -_._-. jU{J8 j_(:_~ 19~:1 Proposal Submitted To Work To Be Performed At Name rC,~v;'l t....{ :,.:~) ~-~.:l' Street _ [I { J) '-,' !' f' (',1' (.p.... i City___~____ State Telephone Number F' .~....TL'_f,4';.~.c Street f~ 1 (,)f) t 7 t 0, .:~ j'" r(:.~:.t" City . (":'hti'li j 1r, Date of Plans , (\-,~;._(, Architect State We hereby propose to furnish the materials and perform the labor necessary for the completion of :.' f ~3h,f.~(?t ~ tear'"..crf a.ndh}~~~J ~W'a'y cC c",~~i~jt>i:'::!;r S1:12.191 (.;;::- .s r_:~aci W(j{)~_I ! ~=pl,3c:e::~ ~:-<:. ~_ .~'(/81: Iik~~~;t~.Ll :.0 ~ ~.'->'. :~i:-;\'i r r,' It., .:. "H~t' L l:L.-~;t:,,:\}lat.il~)J} Ot XlE:vit. ~~{ ,~ .ll;,rr(tx:~l I:~::!.r:;ldt;ed at. rc:(~ti.l,t Inst<ill 2 :GF.~;~ .l.~'~a~j }-::'G'"'Jt..s tLlt"{Jllg1: a_:r~1),n<j p\~:;.r:irnt~?,r Irlsi:c\11 Ih:'.} 2C ./L' .~S J. _~ ')C ~)er 1. i.nf':;.~Ll ft. ,t\)(;_:: '.' I~4,:mtl,l r.~:"\ri 1.. =) i3,"~ '.._i"";';' 'lf~dr"'"'(,:fl fl(~L ;~';i.:~'C.;\ ;::;~r\d r:~}.:l.a'~~ j-~i~"li 1_}~)(.J,~'~~1,LSS S} stf~~E~ \,; ,T tL ufI,-e {;:)at ()X~('j ;.. 1.LdL ,:~..,,).::.i. ()t .1" v ~~ C (\)i~-~ t. t~' V.: fl! h..1.,t . , .,. 2iJl..l..~~ .r 21r;i:;~;i <~.:j :~, t.._~; tJ.'.i(;: ., .......'- ; \J~..! . , :':Jlt>C:.. 'l-lr' i~:''1; (.: i (:'>cU:" ~;a(,(a.llty" ,/'~., ~ l ;:;.at-v"I. L,~~:::; ar.':'; t.:f'I"Y~jr ft,,;[";'" All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of .i\'i-t ';~;;'h,jU~(;;.rlG CkH':: dl;n(1.i.~€,:j .~~(:.~_~ ,')(, ~h,,; q,'" " '~" [)ollars ($ ~.;! f J'): ;_..!\~, ). with payments to be made as follows: r...,:(Jhr~ t ~3 r: J ':,J.n. Any alteration or deviation from above specifications involving Respectfully submitted extra costs, will be executed only upon written orders, and . ,....~ will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond PerPrcr~..r~:-i:t/..,)t:,~.:;t PCOr; fl'. lnc. our control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's Compensation and Note - This proposal may be withdrawn Public liability Insurance on above work to be taken out by . ':'1(<> t "~d. '. ,,< by us if not accepted within q, days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date Signature TOPS FORM NO. 3750 LITHO IN U.S.A.