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Home My WebLink About91-1925 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit )l~ 192515 Date_/ / - /3--7/ ~~~~ ) ( BU~LDIN~.AL[CTRI~ ~ M~ Property Owners Name: 1M"-6.111i:z< Job Address: 3g--.7d_ 7/_U~--~ -~ . Legal Description: Sub.Div. Lot Blk. ZoningCI: ;;2 - tb.. (}.I- / = - 0 -/0 '/ , Description of Work j) ~ ~ ,"'nt.;j - - .L ~ ~j'" bHt 1&{, ;62 A. T<:, ~3 d-,I), Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Fee: BS C'.T2J -r-~: crv~ SIGNA TURE..::B, M".J.~ ,l, Ji.AJ~ ' COMPANY rmr ADDRESS TELEPHONE # Estimated Cost: i~ hn'. (1i) All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE # ;/';Y1e,~ - ~UILDING~ Ftr. Pre SLB Lintel FRM. Insul.CL WL ELE~AL ~-- ~ANICAL ~ ~G ~ Tp.Serv. Rough In Meter Can Canst. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT -~~ 1. ~I:O {~<X 70i-o Vol (q:, /rcle- PHONE 78,;) -P9oo ADDRESS OWNER 54 rI', P C1 $ ubou.'.e.. JOB LOCATION--f!..dd re ~<; a-ho l/ ~ LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.lF ;:J- a{~ - eJ-1.-ID- () - /0 y WORK PROPOSED:~New Construction _Addition _Alteration _Repair _Install _Sign/Temp. _Sign _Move _Demolish PROPOSED USE: _Single Family _M/F _IF of Units __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 FOR~S.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED -.2LBUILDING $ c::?J 600.00 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 State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature ELECTRTCTAN Company State Cert, or Regist. # City License Registration # ****************************************** Signature PLUMBER Company State Cert. or Regist. # City License Registration # ****************************************** Signature MECHANICAL Company State Cert, or Regist. # City License Registration # ****************************************** Signature OTHER Signature'~.J.. j'~';'l *'" ********** Company State Cert. or Regist. # City License Registration # APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perMit aay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned aSSUMes responsibility for cOMpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILfrlES If the owner has hired a contractor or contractors to undertake work, they May 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 .isdeMeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireMents May apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (B13) 7BB-6bl1. Furthermore, if the owner 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 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 May 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 - HOMeowner's Protection Guide" prepared by the Florida DepartMent of Agriculture and ConSUMer Affairs. If the applicant is sOleone 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 cOllenceMent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perMit to do work and installation as indicated. I certify that no work or installation has coaMenced prior to issuance of a perMit and that all work will be performed to meet 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 governmental agencies lay apply to the intended work, and that it is ItY responsibility tel identify llhat actions I Itust take to be in compliance. Such agencies include bllt ~iP. liCIt liillited to: I Deparhent of Environ.ental ReQuIation - Cypress Bayheads, Wetland Areas and Environfllentally Sensible L:Hids, Water/Wastellater Treatlent I Southwest Florida Water ManaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I Artv Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departaent of Health ~ Rehabilitative Services. EnvironMental Health Unit - Wells, Wastewater Treatment, Septic Tanks I US EnvironMental Protection AQency - Asbestos abateMent I also certify that, if fill Material is to be used in Flood Zone "A" or "II,etc.", it is understood tb~t a drainage plan addressing a .coMpensating volUMe. will be subMitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. II perMit issued shall be construed to be a license to proceed with the work and not as authority to vioiate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Offici~l frot thereafter requiring a correction of errors in plans, construction, or violations of any code, Every per.it issued ;hall becole invaJid unless the work authorized by such perlit is coltlenced within six months of issuance, or if wOl.k autbol lzed by the per.it is suspended or abandoned for a period of six Months after the tile the work is cOMmenced. One 90 day e~tt~SJOII of tile, may be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Buildinq Official, IIn approved inspection aust be logged durinq each six tonth period, or the project will be considered dbdildoned. 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~~_~~----- OWNER OR ?TUJ---- DATE-------jJ~.~;~Efvvoo~---:.------------;I NOTARY AS TO &/~ OWNER OR AGEN~a :J:!lj}LlC. STATE OF FLORIO.\.. MY COMlVnsSioN~xP11tJrS:lan7Z5';"m5:'----- BONDED TIlRU NOTARY PUBLIC UNDERWRITERS. MY COMMISSION EXPIRES______________________ SIGNATURE ------------------------------ CONTRACTOR DATE ----------------------------------- NOTARY AS TO CONTRACTOR ----------------------------- MY COMMISSION EXPIRES ------------------