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HomeMy WebLinkAbout91-1910 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813- 788-6611 Permit N~ 1910 6 / / -0-- 9 / / Type of Permit c!~G~ EL~ ~ M~L propertYOwners~am_e: JJ!ti.. ~~ Job Address: -~ =';>3 :i ~1~ ~_ Date Legal Description: Sub.Div. Lot Blk. ZoningCI: // -2 -d.-/ - ~L ~~o O. b6~D Description of Wor~ _ ~'/) I!<? A? ' ~ _ .€-k~. : ~ ..d..Jj rJfc,k $~ ~ Energy Code Readout: '//- / ~ --9/ Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: / 7 cPZ'" tf() / OCCUPATIONAL LICENSE # /;7 Fee: . ;)!,-: ~ /.;l.s'j;J.l1 SIGNATUR4 __~ COMPANY ADDRESS TELEPHONE # All work shal! be performed in accordance with the above and all City Codes and Ordinances, PL SLB Tub Set Water Sewer Final Et.: r. Pre SLB Lintel FRM. Insul.CL WL 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 ten ($10.00) dollars shall be made for each trip. (a) Wrong Address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when inspection called for (d) Work not ready for inspection when called. The payment of reinspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PER!'IIT CITY OF ZEPIIYRHILLS BUILDING DEPARTHENT , " APPLICANT :$'\...). ~ ~cS'\lf-:.... ADDRESS '~~ OWNER ~I-S -:2-- <t'') S"\ ~ I;:Ll-\ crt- Q- ~ \ ~LLb'::J 5"?:> ""5"'L. ...j.,'" 5-f' . ""2\..\ \ \... "-'~ ~S'-~ PHONE (~\ -3. \ I~<{<" -1 ~lj<B " JOB LOCATION \~~ '""'S\ LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. ~t WORK PROPOSED:~New Construction ~Addition _Alteration ____Hepair ____Install ____Sign/Temp. _Sign ____Hove ____Demolish PROPOSED USE: ____Single Family ~M/F _~t of Units ,._H/H _Commercial _Indust. _Swim. Pool Other _Restaurant & Health Department Approval ,) BUILDING SIZE: \ ~ X l S , Square Fee t, 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 FORHS.*"-" **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED VBUILDING $~7HJ,dU 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. ****************************************** CONTRACTOR SECTION Company ~~ ~~ ~L,u""",", State Cert. or Rcgist. lj ,Q. C City License Registration;; " ****************************************** ELECTRTCTAN Company State Cert. or Regist, n City License Registration ;; ****************************************** Si<:>nature Company State Cert. or Regist. 0 City License Registration 0 ****************************************** PLUMBER Signature Company State Cert. or Regist. 0 City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. ff City License Registration ;F OTHF.R Signature APPLICATION APPROVED BY ~::~*~*:~:~~.*.**~*.********'*' PER1'llT OFFICER. CONDITIONS;O~cPERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Th. ,,'m"'" ,,'m'oo" \h.. \h" ,m" .., h. ..hi'" i, ",,' ". .",\i,'" ,hi ,h to' h' "" '" ,,', \I" \hoo tll, regulations. the undersigned aS5Ulles responsib~1\,t'f.for;,colp1\ance with any appl icable deed restrictions. " ".,,' " ' ' . B. " UN ICENSED CONTRACTORS AND ONTRACTOR RESPONSIBILITIES II 'h. ,..., h.. h"" . 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CONSTRUCTION LIEN LAW (CHAPTER 713~ FLORIDA STATUTES, AS AMENDED) I ,.,'if, 'h.' I, 'h. .p,I".." h." b... ""i,., ."h . "" .1 'Fl.",.,. C""e.,'i.. Li,. L.' - H......,,', ".,.",.. S,,,.' ,,,,u.' b, \h. Floc \d. D.,u'.'" ,I A,rl""'" oo' C....'" "h'''' If \h. 'OP Ii ,.., ,. "..,,, .\h" th.. th. ,,,,,,', I ",\if, \h., I h>VI .bh'''' ., "~BY .nh. .bm "",ib., 'oc,m' ..' ,mi" ,. goo' h"h " d.Ii." " ,. \h. 'owner' prior to cOI~ence~ent. : ','~ .:~':.. ". 1 ; :' E. CONTRACTOR'S/OWNER'S AFFIDAVIT I ,.,"f, ,h., .'1 'h. ,.1.""'" ,. 'h'. ."I".'i.. ,. .".,.,. ..d 'h.' .'1 .." .'11 b. d... ,. ,..,'i..,. ."h .11 applicable laws regulating construction, zoning, and land development. A"II,.li.. i. h.,.b, ..d. ,. ,b,.i. . ,er.il "'d' .." ..d i..,.II,li.. .s i.'i"ted. I ,.,'ify ,h., ., ..,k ., i..,.ll.'i,. h.' "....,., "i., ,. ,..,..,. .1 . ,.,." ..d 'h.. .11 .", .il' h. ,.,f.,..d ,. ..., .I..,.,d. .f .11 I... ,.,.1."., """""'" C", "d'S, ,..,., ,.,.1.",.., .., I..' d.,.I.p...' ""I.'i.., ,. th, i"i,d"t'... I .1.. ,.,"f, 'h.' I ,..".,.., th.' 'h. ,."I.'I..s .f .lh., ,.,.,....,.1 .,..'1., "I .,,1, ,. ,h. i.".d,d "", ... 'h.' " 's ., ",p'" ib llll, " ".. \i f, .h., "Ii ". I ". \ ",. ,. h. ,. ,,,,Ii ant,. S"' h',,,,, i" i." ,d. ,,, I '" ,,". Ii. ited ,,, #" . J. . I ~e.""'" ,I E.,i"..e.,.1 R."l.\I.. - c"r.ss B.yh..ds, w.ll.nd ~re.s ,n' E.'i,.n".,.111 s..,i!i" L,"s, Water/Wastewater 1reataent I Southwest Florida Water'ManaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Hatercourses I Army CClrps ,of EnQineers - Seawalls, Docks, Navigable Waterllays . ~'c,,'..nt ,f H,."h , ,.h.bill'.",. S.,,',.. E.""..e.,.1 H..I'h ".i' - "I\s, H."...I" """,,\, 5."" T.." I US Environaental Protection AQencl - Asbestos abatement I .1" ",Ii f, \h.t, 11 Ii II ..,..,., Is \. b. lS.d I. Hoo' '''' '~. " 'A,.l'.', it is ",..s",.d \I,,' · d"i ..,. P \I. .'d,...,., . ',..p"""" ,.1...' .,11 b. ..h.",., .hi,h i. p,.p.,.d b, . p,.!.,'i...1 ..,i.'" ",i",,'d i. Ih. s,.,. .f Florida prior to permit issuance. ~ ,.,.1' ,..,.d .h.11 b. ,...",., ,. h. . 1".'" ,. ".,... .,'h 'h. .'" ,.d ..1 .. ..'h.,i', " 'i.I,", ,..,., .1'." ., ,., ..'d. .., p"""'" .f 'h. ,.,h.".1 """ .., .h.11 ,.....,. .f . p".i' p,...., Ih. ',il'i., Offiri.\ f,'" 'h.,..f'" ,.,.i,'., . ,.".,ti'. .1 .".,. i. ,I...; """"'\'" ., ",I,ti.., ,f "v ,.d.. ""1 p.,.i' i""" ,h,t1 b"'" i.,.'i' ..1..' 'h. .." .,'h.,i..d b, ..,h ,.,." \. ,.....,ed .,thi. sl. .,.'h. ,f i.,o"'" ., if ..r' ,.1'00 ,..d by 'h. p.,.i' ,. ,",p..'" " .bu,d..., I" . p..i.d .1 .il ...lh. .1\.. \h. Ii.. 'h. .oc, i. "",,""c 0.. 9t, d'j "I","'" .f "", '" b' .I"..d f., Ih. ,.,.it .,'~I.. ,h.r,' .f 115.00. Th. ..,...1.. sh,ll h. ,.."",.d ,. .,ili., ,. 'h, ,.i1di., Offi".I. A. 'PP"'" ,osp" \l" ". t b. I.".d d,"" ",h .\. ...th ,,,' ,d, " \h. p" i.d ,,\I b, '''' "" ,d ,b,,,doo,d. WARNING TO OWNER. YOUR FAILURE TO RECORD A NOTTCE OF COMMENCEMENT MAY RESULT TN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDTNG YOUR NOTICE OF COMMENCEMENT. J08S UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". ", ,_..,..,.~.~. ~...~~.-".~..,~.^..". -~- ~ ... 5IGNATU~ -- AGENT------------- DATE_____~\5\-:S.L--------- ~~~~:YO~5A~~NT---~~~~---~---- MY COMMISSION EXPIRES________~----~oft---- NotafY 'Pub\ic ~SCO . 3 \q95 M~ Commiss\on bp\ttS Ma~ \. DATE NOTARY AS TO CONTRACTOR__ MY COMMISSION EXPIRES ~~~~~i\r---- NotafY Plio"" ~v '" . M~ Commission Expitts May \3. \995 ,-,~---- " -----~.....f_,............_ ____."_.___.__.____.. ,.,_ '_................_-.....___ ')I. ~~ ~ \J . '0 " . . -- --- -- ----------. I- , r~~ ~~~ VI ~~~ IO~~ \'> ~ \ ~ ~~ Q " ~~ ~~ ~ ~~ ~: - - ~\. ~ ~~ ~ ,,~ Cl\l ~,~ " ~\t 'tl'- ~ ~~ ~~~ .' 'S \,)"\)1 ~~ ~~ \) ~ (' ~i \) ~ . ~ j.:.. \I ~~ ,~ ~ '- c{) '''-t I I I I I I , I ~-- - - ~---_._.-. - ___0 \ " , - -~.+---_.._~ _. -----. "..+, ..' -~ ~ ~ , '- '" '" '" '''\ ,~ ~ 'V u ~ . e " i ~ ~ ~t: ~... ~~~ gl ~ \J " ... V\ " \ ~ ~ %%) ~ S IT E PLA'N PERMIT # (RESIDENTIAL USE ONLY LEGAL DESCRIPTION: SECTION TOWNSHIP RANGE SUBDIVISION OR OTHER LOCATION DESCRIPTION: ~) L:;3?'~ K- 19 s?r REAR ( FT. ) ID 1~5\~l.,-- ~ c.. "-.6... ,""\ "-I)- f,'" ,~ r...."\ ,; ,,) -..... . I- I.J... \5 r;:XI S\)r~ f.-t GYY\E. <.n ...... o fT1 -..... -'"\S- ........ I.LJ t 0 ...... ." V) --l . 3-:J FRONT ( FT. ) Show all existing and proposed structures giving dimensions and setbacks. Also, indicate any a~jacent bodies of water and roadways adjacent to the property. Indicate size of mobile homes such as: 121 x 601, 241 X 361. EXAMPLES