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Home My WebLink About91-1926 STATE OF FLORIDA City of Zephyrhills BUILDING ELECTRICAL (~LUMRIN~ MECHANICAL permitN~ 1926f I'L- III 'C1 / Date , _ ,':/- _ ,~ <-~ ,v~hJ3. /i1~ '7 /j - 7' q I PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Type of Permit Property Owners Name: .~A~~ 6...) />>l. 8/ ' Job Address: ~:3.. ~/J);t ~ A: { /f.i J Legal Description: Sub.Div. J,..ot Blk. Energy Code Readout: ) Zoning CI: Description of Work ..J~_?I Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: Am / Fee: 0<tD All work shal! be performed in accordance with the above and all City Codes and Ordinances. COMPANY ADDRESS TELEPHONE # ------------ OCCUPATIONAL L1CENS~ ,U;)~h7~ PLUMBING ELE L ~-- SLB Tub Set Water Sewer Final Tp.Serv. Rough In Meter Can Canst. Pole Pool Pre-Meter Final Ftr. re SLB Lintel FRM. Insul.CL WL Breakers Ducts Ins!. 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 2h~1tlJ~ /#. tJ ~ ADDRESS /;23 '1 ~~~~/l.--~ ~ . ..2-~, FR. OWNER lV~ l/ " ~~ / ~ JOB LOCATION 1~37 r~~~. 7.-~fl LOT SIZE~X 1h AREA LEGAL DESCRIPTION: LOT(S) f'~L..()a?f'l~~VJ...--9 BLOCK SUBDIVISION tl/pA.CL PHONE ~~!'--1-fjo9 SQ. FT. Y JLtc4<- t;J:~ (J PARCEL I.D.4F 35"-25 -.;2.1_ t)o5o -- OCJC)oo~ CJ500 _. / /;2J116,,17or1 fl1f.7f.tz..,.J- ~M~ LI,v~5 WORK PROPOSED:____New Construction ~Addition ____Alteration ____Repair ____Install _Sign/Temp. PROPOSED USE: ~-.Single Family ____Sign _Move ____Demolish _M/F ____4F 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 FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. 'H **COPY OF CONTRACT REQUIRED, PERMITS REOUESTED _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, ****************************************** CONTRACTOR SECTION Company State Cert, or Regist. # City License Registration # ****************************************** BUILDER Signature SiQ:nature Company State Cert, or Regist. # City License Registration 4F ****************************************** ELECTRTCIAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist, # City License Registration # ****************************************** MECHANICAL Signature OTHER Signature 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 lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES . . If the owner has hired a contractor Dr contractors to undertake work, they lay 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 lay be cited for a lisdeleanor 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 Department, l8131 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 Departlent 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 cOllencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforiation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation 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 governmental agencies may apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in compliance. Such agencies include bllt ile not limited to: I Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive ldnds, Water/Wastewater Treatlent I Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health ~ Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treat;ent, Septic Tanks f US Environlental Protection AQency - Asbestos abate.ent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating volute" w.ill be submitted which is prepared by a professional engineer registered 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 vioj~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Officii] from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issu~d ;ball becole invalid unless the work authorized by such permit is cOllenced within six lonths of issuance, or if work auth~l lIed by the per.it is suspended or abandoned for a period of six lonths after the tile the work is cOlmenced. One 90 day e~tE~SJOIl of tile, may be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official, An approved inspection must be logged during each six lonth period, or the project will be considered abaildoned. 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 REC.~ING .YDUR NOTICE .OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED 0 RECORD AND P, "NOTICE OF COMMENCEMENT". SIGNATURE_~~~_~~ _ ~>>l : SIGNATURE______________________________ OWNER OR AGEN~~~ CONTRACTOR DATE_____~-=J-~~~~---------------------- ~~~~=YO~SA~~NT_~~~.-~~'C~..'.'~~~-~-;,~;~~_ MY COMMISSION EXP~~~~~~~~~~~-~-----~~- DATE NOTARY AS TO CONTRACTOR_____________________________ MY COMMISSION EXPIRES