HomeMy WebLinkAbout91-1954
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
~: {TV
Type of Permit d..... {;J.. 0-0
CBG.LDIN-;;~ECTRI;:a P~
Property Owners ~me:.1L fr
Job Address: --5 P" c2 I bLt~
BUILDING DEPARTMENT
1-813-788-6611
Permit _
N~ 1954 (3
1/ '1"" 9/
Date / / . c:;:# /' - r _
ME~
Legal Description:
Sub.Div.
LO~ ~/b'/7-fr-Blk.
,
/3.
Zoning CI: / . )) 7f
Descriptio.(lofWork ~-Z..u ~~
_AA_?-~
/.M!.,--~,dLj
Q~/
Energy Code Readout:
Complete Plans. Specifications and Fee Must Accompany Application
Estimated Cost:
;7 .3 --o--z;
t)()
Fee:
;<-5--
,
SIGNATURE
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE # ~-
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
Reinspectlons: When extra inspection trips are necessary due to anyone of the following reasons. a charge of ten ($10.00)
dollars shall be made for each trip.
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(c) Repairs or corrections not made when inspection called for
(d) Work not ready for inspection when called.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
APPLICATION FOR PER1'lIT
CITY OF ZEPHYRHILLS
BUILDING DEPART!'1ENT
APPLICANT i/;N;i~f/l& h(~. . . . . ... .
ADDRESS ~q'5fl!;t/'fh':./J41. /~PIlONE ?r?-.?,q-3~$/
OWNER 11. :t2~-=--- -141- ~ p ;j. dfl /d~/r/ a ~I /C-
Jon LOCATION 5'~rZ/ &ACL-. t3~, LOT SIZE X
LECAL DESCRIPTION: LOT(S)1" I~,~ /.f B~~ SUBDIVISION
PARCEL LuOtl-I'1I? _ {/ t:1,r ~~vn:/~j"
. I .
AREA SQ. FT.
WORK PROPOSED:____New Construction _Addition ____Alteration ____Repair ~Install
_Sign/Temp.
..x..Sign
~/F
____~love
____Demolish
PROPOSED USE: ____Single Family
_t~ of Units
, .____M / H
,X..... Comme rc ial
_Indust.
_Swim, Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COM1'lERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORI-IS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~IS.**
**COPY OF CONTRACT REQUIRED.
EF.RMTTS REOUESTED
~BUILDING
$ 7s~C:>
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 SF.CTI~ . (1
. Company _ _~~_~.u.X
State Cert. or Regist. 0
City License Registration 0
********************************
SQ/'vJk--..JJ
:1f. ~ ('rb
Company
State Cert. or Regist, 0
City License Registration 0
***************************************
~~~0 --
Signature
Company
State Cert. or Regist. 0
City License Registration a
******************************************
PUTMRER
Signature
Company
State Cert. or Regist, 0
City License Registration 0
******************************************
MECHANICAL
OTHER
Signature
Company
State Cert. or Regist. 0
City License Registration 0
APPLICATION APPROVED BY
******************************************
)1d~h~ _VieAAM- ..
PERI-lIT OFFICER.
CONDITIONS. OF,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The.undersigned understands that this perlit lay be subject io "deed restrictions" which ~ay be Dore restrjctive than City
regulations. The undersigned assulles responsibilitf;forcollpliance with any applicable deed restrictions.
. ,
B. UNLICENSED CONtRACTORS AND CONTRACTOR RESPONSIBILITIES
If the own~r has hired a cDntractor .or contractors to undertake Hork, .they lay be required tD be licensed in accordance with
state and local regulations. . If the contractor is not licensed as required by law, both the o>>ner and contractor nay be
cited for a .isdemeanor violation under state laH. If the OHner or intended contractor are uncertain as to what licensing
require.ents lay apply for the intended Hork, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-bbll.
Furthermore, if the OHner has hired a contractor or contractors, he is advised to have the conlractor(s) sign portions of the
'Contractor Sections" of this application for which they Hill be responsible. If YDU, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the wory.. If lhe contractor wishes you to sign
as contractor that may be an indication that he is not properly licensed ~nd is not entitled to per~ilting 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 C(lnstruction lien law - Ho~eowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the ~rplicant is SOle~ne other than the
"oHner", I certify that 1 have [.btained a. copy of the above described de,cument and prclrr,i~e in g(,od fai th to del iver it to the
"owner" prior to cO.llence.ent.
;1.',:: "
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will be dDne in coapliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby made to obtain a per.it to'do work and install~tion as indicated. I certify that no work or
installation has COllmenced prior to issuance of a per.it and that all wory. will be perfor~ed to roeet standards of all laMS
regulating construction, City codes, zoning regulations, an~ 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 tel identify what actions I must take to be in cOlllpliance. Such agencies include but ~le 1\[ll liaited to:
...
I Deparhe~,t Df Envir~nllental ReQul;tion - Cypres5 Fayheads, Hetland Areas and EnvifClnITientally Sensi tj\ie L~nds,
Water/HasteMater Treatment
I Southwest Florida Hater ManaQement District - Hells; Cypress Bayheads, Hetland Areas, Altering ~aterc0urses
. ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways
. Departlent of Health L Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~en~. Septic Tanks
. US Environaental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flc.od Ze,ne "A" [.r "A,etc.', it is unders.tel(ld 11,,1 a drainage plan
addressing a 'compensating volule" will be sublitted which is prepared by a rrDfessiona\ engineer registered in the state of
Florida prior to permit issuance.
A perlit issued shall be construed to be a license to proceed with the wory. and not as authority to viol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Offi[i~J frol thereafter
requiring a cHrection e,f errors in plans; c[lnstructi[.n, c.r violations of any [clde. bery per~it iSSll,!J ::hall bHc'!e invalid
unless the wc.rk authelrized by such permit is celllllenced within six lIlonths of issuance, (Ir if \itld. autl.e" !,ed by the per.it is
suspended or abandoned feor a period e.f Sill lonths after the ti:lle the lllJry. is c(I~lmenced. One 90 day ('~l"i.sio\l of tile, may be
allowed for the per0it with fee charge of $15.00. The extension shall be requested in writing to th~ Building Official. An
approved inspecti,.n oust be logged during each six lIlonth period, c.r the prc.ject Iii II be cc,nsidNed db.;lldc.n..d.
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 $2,500 IN V UE
DO NOT NEED TO RE ORD AND POST A II NOT I CE OF COMMENCEt1EN r" .
SIGNATURE ----- -I ~~:~__________ SIGNATURE --~~
OWNER R AGENT NTRACTOR
DATE__.JJ&d.L::Zr-Lfi..2.L------------ DATE _/-L2:1J:-::.lL.----------------
NOTARY AS TO -/.../ ./ \,(l NOTARY AS TO.// ~I . '\ Y2._ .,JJ_
OWNER OR AGEN:r4~~~A-- /Ylf~i/:t!J._ CONTRACTO~~-1h.~/&:f-"L~--
MY COMMISSION EXPIRES NotaryPul:!lic.StateofFl;~d~_9t3 MY COMMISSION EXPIRE!JI.!!9r...L~li'<<-$!~t!.!ln'!!~!.='1
"Mj-cGfiljftllstlJrr1rpln!~ ' My (omnliGJion Expires Sept. 26, 1993
Bonded T....rv fro)' Fain. Insuronce lAc. Dond~d Thru Troy Fain. IMUrance Inc.
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