HomeMy WebLinkAbout91-1930
STATE OF FLORIDA
City of Zephyrhills'
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PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
19306
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Type of Permit J.tJ. '_'.'
OUILD~ C~
Date
Property Owners Name:
Job Address:
~"-_..
#;{~~~, -
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Legal Description:
Sub.Div. /~- :;J(y - ;1/- O~~tJ .- ('.) cJe)cx:) ,- CO It)
Blk.
Zoning CI:
Description of Work
Energy Code Readout:
_1-$~2.4?
Complete Plans, Specifications and Fee Must Accompany Application
:~=~~E5;J~~
COMPANY
ADDRESS
TELEPHONE #
Estimated cos~
j)i:J
~. 179' - ~
,
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
AL LICENSE # -7 /~~u,,'-4J
Tp.Serv.
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
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
...
L
, .
APPLICANT
ADDRESS
PHONE
/RZ~3oYV'
OWNER
LEGAL DESCRIPTION: LOT(S)
BLOCK
,-
LOT SIZE~X ~ AREA SQ,FT.
SUBDIVISION ~ ~ ~~
O~ -- flOeOO - Q 0/0
~lteration ____Repair ____Install
JOB LOCATION
PARCEL I.D.4~
JL/- &-Co
,
CA.I
WORK PROPOSED:____New Construction ----Addition
_Sign/Temp.
_Sign _Move. _Demolish
o
PROPOSED USE: ____Single Family
---ll/F ____4~ 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.
PF.RMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
~ELECTRICAL
AMP Service
Florida.power Corp.
_W.R.E,C.
____MECHANICAL
_PLUMBIt{G
$
Valuation of Mechanical Installation
....
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block _Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************y]** ********
#....1 CONTRACTOR SECTION . t1J //1 4.-. 0{
~ T . Company H
State Cert. or Regist. #
City License Registration #
*******************************
a~
Company
State Cert, or Regist. #
City License Registration # ,0/
***************************************
Company
State Cert. or Regist, #
City License Registration # -
******************************************
PLUMBER
Signature
.
Company
State Cert, or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Company
State Cert, or Regist, #
City,.Li-e,nse Registration l~ -
**~'~** fr*"'J*~. * . **** ' ****'~****
~ ~_6J&L~ ~ PERMIT OFFICER.
-- ' :
OTHER
Signature
APPLICATION APPROVED BY
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS ,.
The undersigned understands that this perlit lay bl subject to "deed restrictions' whicfi lay be lore res~rietive ~an City
regulations. The undersigned aiSUte. r.aponsibili\y. for. cOlpliance with any applicable deed restrictions. . .
, . .... .~.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractor. to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor i. 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 Departlent, (813)
788-6611. '
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) 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 contract~r that lay be an indication that he is not pro~erly 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 Departlent of Agriculture and Consuler Affairs. If the applicant is soleone other than the
'owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
"owner" prior to cOllencelent.
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 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 Dr
installation has cOllenced prior to issuance of I perlit and that all work will be perfor.ed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt "'I e not lilited to:
I Departlent of Environ.ental Requlation - Cypress Bayheads, Wetl~nd Areas and Environlentally Sensitive lands,
Water/Wastewater Treatlent .
I Southwest Florida Water Hanaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways . .
I Depart.ent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatment. Septic Tanks
I US Environlental Protection Aqencv - Asbestos abatelBnt
I also certify that, if fill laterial is to be used in Flood Zone 'A' or 'A,etc.', it is understood tl.at a drainage plan
addressing a 'colpensating volule' will be sublitted which is prepared by a professional engineer registei~d in the State of
Florida prior to perlit issu~nce.
A per.it issued shall be construed to be a license to proceed with the work and not as authority to viol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issllvd shall beeole invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorl1ed by the per.it is
suspended or abandoned for a period of six lonths after the ti.e the work is cOlmenced. One 90 day e~t~nsioll of tile, .ay be
allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to th~ Building Official, An
approved inspection lust be logged during each six lonth period, or the project will be considered dballdoned.
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 COMMENC ,ENT".
SIGNATURE_~~ _ _ SIGNATURE -------~
OWNER OR AGENT CONTRACTOR
DATE~~_~~l-l-~~-----------------
~~~:VO:SA~~NT_~--~-~~--^-
MY COMMISSION EXPIim~;"'(r":' -r.: ~T'C: C. rL:;;;.,il.
. SC,t;. "'~T~:.~~r!:"~~~~7~~1:-F75 ---
~-,~J jJ
DATE_____~~~~ ::~~-----------
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.. OTARY PUBLIC, STATE OF FLORIDA.-
MY COMMISSlmCf!!lO~mWBEXPIRES:APRIL 12.>. Ul.JlL...
BONDED THRU Nol'jtItYl'Cm.TcuNciERWRiTER~ -
NOTARY AS TO '
CONTRACTOR
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S!'17. ?~\.)if
OU?..5rJENTW... ",JSE ONLY)
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~11 drawings shall be dravn to scale for all parcels or lots five acres or less.
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Si-lOW /\J..:.... EX:STING A.~D P.QOPOSE.') S7R''':C';.1.TRES GIVING DIMENSIONS AND SETBACx.s. ALSO, INDICATE
A..\"! BODIES OF WATE-1:\. Iu'V.D ROADWAYS (INCLUDI~G NAM.BS) ADJACENT TO THE PROPERTY. INDICATE
'DiE SIZE, YEAR. fu'r) NAME OF MOBILE; SUCH AS 12' x 60'. 1981. FLEETWOOD.
HC'.,JSE: CONSTRUCTION
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27 -<Z.y~ ~e.,^
No
Date
/~-;;/-9/
Sheet No.
Proposal Submitted To:
'N:;~~~'--'--'lV~ - ~ h ii-;r;y -------------"-,
Street 4/ '7 ~ I ~ 6t /~ _ ,
i.::ity J
State r 4- /
,,~hO~__~~ 8'6" - 9 .~.S- / __
Work To Be Performed At:
r::,et- ~ 7 ::<; ~~ /"0' c f' .
l~~:e of Plans State
Architect A{ a.....:
(We hereby p~-;;;~se t;-fu;;:~hthe materials and perform th--;!abor necessary for the completion of
/7/-;2b-,~ / ();(~() - OOO~O-OO/t?
/;'1 /X/~,.~. IC~/~;J~~_
7- 37 ^ SO j ~M~5;0~ 6(//~r~--:7
/ - .3 '/ k P 0 r/ <.:::. ~ ~.tJ /S' /-e,qr~p c,~ 0 Y,
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All material is guaranteed to be as specified, and the above work Ji;"~med in accorda~ ~ll ~ drawings and
specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
. ,f}/ "" . 9 C7(!:J) - /? 'I .-, ~Ollar~($3/~m)
with payments to be made as",follows: / ~ ;/ ~ 1:Scr-.l:~",.._:> /;Q() .
(7), ~~ Ck'U 7"55"7 /lu/~
J ;/6 /7d7C
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Respectfully submitted ~~~/ 4/~ _
?/ ----
~~ /
/ ~ttA-~t7#
10
1.:5 r? 7'f-, a..~,
Any alteration or deviation from above specifications involving 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 our control. Owner to carry
fire, tornado and Jther necessary insurance upon above work. Work-
men's Compensat'on and Public liability Insurance on above work to be
taken out by
Per
Note- This proposal may be withdrawn by us if not accepted
within days.
"'\
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted~ You are authorized to do the,JlOrk as specified.
Payment will be made as outlined above. ~ ..
. .ij;0~......h~//~r C-
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Date Signature l_.
L___
fClPS.FORM 3850
DUf"L1CA TI!!
.ITHO IN USA
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