HomeMy WebLinkAbout91-1894
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813.788-6611
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Property Owners N:me~ AVy::z; <l~
Job Address: ..5? /~ ~ _~__'---
Legal Description: SUb.DiV.%p' ~~ 0 7dt&4.l? Lot
(.- (j
Zoning CI:
Description of work.::!:::!:.f'f7_ ~;7 ""~~~
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Energy Code Readout:
PermitN~
1894 B
Date ./ /J -d/ ~ 9'/
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Blk.
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Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
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All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE # 7 ()
PLU
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
Driveway
Fee: 3 0 . UU
SIGN-ATURE R~ f!~
.
COMPANY
ADDRESS
TELEPHONE #
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
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 PERNIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT Y'\,ose I \ 0... !)f/ ~ pS-Z'j
ADDRESS 513 1 q b ((")G\d vV)OO{~ )T(~Q
OWNER ~f).5.~ \ I G\. Ve-rv/ r se->j.
JOB LOCATION S~ 1 g D ('"'0 n.JrY)C)ore
~ VI'\ lOt i~ '
n/2. PHoN~-=--:l <s C) - Co 0') :\
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.~~
WORK PROPOSED:____New Construction ____Addition ~lteration ____Repair ____Install
____Sign/Temp.
__Sign
_Hove
____Demolish
PROPOSED USE: ~Single Family
~/F
____~~ of lIni ts
,.jCM/H
____Commercial
____Indust.
____Swim.. Poo 1
Other
____Restaurant & Health Department Approval
BUILDING SIZE: 3-xd<j ,
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.
~BUILDING
PERMITS REOUESTED
.~ ~5o . 0 0 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.
******************************************
Signature
CONTRACTOR SECT~N ,
. Company _ C+l 0 n A l Ur'YJ; n V r<)
State Cert. or Regist. #
City License Registration j~ '1 C)
******************************************
mJILDER
Signature
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
f,LECTRTCTAN
Signature
Company
State Cert. or Regist. #
City License Registration 0
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAT.
OTHER
Signature
Company
State Cert. or Regist. 0
City License Registration #
APPLICATION APPROVED BY
.~::::.~~~..*~*******'*****
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The .undersigned understands that this pertit lay be subject to "deed restrictions' which may be more restr.ictive than City
regulations. The undersigned assumes responsibility~for, co.pliance with any applicable deed restrictions.
, .
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or 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 ftay be
cited for a tisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended Hork, they are advised to contact the City of Zephyrhills Building Depart.ent, (BI3)
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) sign portions of the
'Contractor Sections' of this application for which they Hill 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 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 Departtent of Agriculture and Consu.er Affairs. If the applicant is sOler.ne other than the
'oHner", 1 certify that I have obtained a copy of the above described doculent and pro~ise in good faith to deliver it to the
'owner" prior to cOllencement.
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 coapliance with all
applicable laws regulating construction, zoning, and land develop.ent.
Application is hereby aade to obtain a perait to. do work and install~tion as indicated. I certify that no work or
installation has cottenced prior to issuance of a perlit and that all work Hill be performed to ~eet standards of all laws
regulating construction, City cod~s, zoning regulati~ns, and land d~velopment r~gulations in the jurisdiction. 1 also
certify that I understand that the regulations of other governmental agencies ~ay apply'to the intended work, and that it is
ay responsibility to identify what actions I lust take to be in complianc~. Such agencies include bllt ~Ie not liBited to:
....
I Departle~t of Envir~ntental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Ldnds,
Water/Wastewater Treatment
I Southwest Florida Water ManaQement District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
I Arty Ce,rps ,of EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health ~ Rehabilitative Services, Environ~ental Health Unit - Wells, Wastewater Treat~en~, Septic Tanks
I US Environmental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flbod Zone "A" or "A,etc.', it is understood tlla! a drainage plan
addressing a 'compensating volute" will be sublitted which is prepared by a professional engineer fegist~ied in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit 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 permit is co.aenced within six months of issuance, or if wOl.k authOI lzed by the perlit is
suspended Dr abandoned for a period of six lonths after the ti2e the work is commenced. One 90 day e~\~~sioll of tile, aay be
allowed for the permit with fee charge of ~15.00. The extension shall be request~d in writing to the Building Official. An
approved inspectie.n !!lust be logged during each six month period, e,r the pre.jed wi 11 be cH,sidered tlbdlide.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".
(\1 . of) ~.. .
SIGNATUR~_~~ - : ----
OWNER OR AGENT
DATE __(Pdji--T--.J._f.~f~_------,-------
k
NOTARY AS TO. .
OWNER OR AGENT / .
--- M~t."i~---"-
MY COMMISSION EXPI~ornmi55ion bllires Apirl2, 1992
~iid.<l1hriilro7 rarn :"lM'UI"dl!'" IIWO - - - --
SIGNATUREfJ~J;LfL~-----
CONTRACTOR
DATE____~~~--~!-7-~~~-~--------
~~~~~~C~~R~~--~--~~-----
" thtcrV rc!:!k, Stut.. !It n3rittt.
MY COMMISSION ~~Q~~~~!~~~Y2kL~J!!~t---
!londed Thru Troy fo;"' Inlurur".ln..
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PHONE 783-1344
516E FT. KING RD.
ZEPHYRHILLS, FLORIDA 34248
ACTION ALUMINUM
JOB NO.
SOLD TO
DATE
ADDRESS
PHONE
SHIP TO
.#.
J . PANS _ FT. LONG PATIO CABANA ROOF CEILING GUTTER
PANS_ FT. LONG CARPORT ROOF CEILING GUTTER
PANS _ FT LONG OVERHANG CEILING GUTTER
"T" BARS CARPORT PATIO ROOF ---
',. ,
FT. AWNING RAIL (STD. OR GUTTER TYPE) , -
FLASH FRONT
GABLE AND BEAM WORK ON FLUSH FRONT .
FT. GUTTER ON SIDE OF COACH
2 X 2 FASCIA BACKUP BAR
X _X __SCREEN ENCLOSURE (DOORS INCLUDE CLOSER, THRESHOLD Be KEY LOCK)
SPLASH PLATE BUGSHI ELD SCREEN X__ MESH
CANTED WALL __ DOOR(S) BELL GRI LL(S)
X_UTILITY RooM_ WINDOW --_SHELVES (TO RooFBeSTD)
X _X -- CABANA WALLS (2" EXTRUDED OR 3" WOOD WITH TRAILER SKIN
INTERIOR PANELING_ OUTLETS OUTSIDE LIGHT BELL
AWNING WINDOWS SINGLE HUNG WINDOWS . DOOR(S)
PANEL TRAILER WALL -_BUILD 4TH WALL CUT ARCHWA Y
X__ RAISED WOOD FLOOR (2X6JOIST.PLYWooD FLOOR. METAL FLASHING
LIN. FT. (ALUMINUM OR BLOCK) FILL FROM GROUND TO FLOOR
HEAT DUCTS OR ELECTRIC BASEBOARD HEATERS
RAISE ROOF ABOVE TRAILER
X _INSULATED CEILING (SPECIFY)
WINDOW AWNINGS: SIZES
HURRICANE TIE DOWN ANCHORS
LINEAL FT. SKIRT BLOCKING -----COL.oR
LINEAL FT. PLANTER (;OL.OR
SET STEPS (_ TREADS) (-TREADS)
X_ PLATFORM FOR STEPS
X_ UTILITY SLAB / A.C. SLAB
X_ PATIO SLAB
X_ DRIVEWAY (WITH / WITHOUT FLAIRS)
X_ SIDEWALK
X_ RAISED SLAB (SPLITS - REGULAR BLOCK
~
PERMIT
PRICE.
TAX
TOTAL PRICE
DEPOSIT
BALANCE C.O.D.
The undersigned agrees to pay
INSTALLERS IN FULL ON COMPLETION
REP.
ACTION ALUMINUM
CUSTOMER SIGNATURE
"