HomeMy WebLinkAbout91-1955
STATE OF FLORIDA
City of Zephyrhills
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Type of Permit
~.
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PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit )J~
1955 E
Property Owners Name:
Job Address: --.5 ~-~.;L./
Date_if ~ c2 7 -7/
PLUMsm&--- M Ed1~mc'~b_<
Lot~/6 /7- / V Blk. / ~
Legal Description:
Sub.Div.
Zoning CI:
Descriptio!! of Work '7/?' ~_
. '<~'<1~~ (; ~,L(
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Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
g--~~
Or)
Fee:
OCCUPATIONAL LICENSE #Sg-S
SIGNATURE .<
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
p.
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 (SIO.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 PEmlIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTl'1ENT
~~?-/
APPLICANT aA( e: tg'~5'~-;;/. ...
ADDREssj<---::;riA., ~e/~(/!J L/CJ7. ~E 0~~~;:IY~.35t~
OWNER /l t:?H/l~ - /)1'5A jYJf/J ~4//-'7 //:/I/L
JOn LOCATION ~ >? 2--/ ~ A/I t5 bLJ ~
LEGAL DESCRIPTION: LOT(S)~// (1 Iff BLOCK 1;:--- SUBDIVISION
----" " .
C/1Z/1/~ /e?~~~' Z-o/ j~{-"~
LOT SIZE_X
AREA SQ. FT.
PARCEL 1. D .l~
WORK PROPOSED:____New Construction _Addition _Alteration ____Repair ____Install
____Sign/Temp. _Sign _~love ____Demolish
PROPOSED USE: __Single Family _M/F _i~ of Units , .____M I 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 FORl'lS.**
A TT ACH (3) SETS OF BUILDING PLANS & (1) SET EN ERGY FORl'lS. **
**COPY OF CONTRACT REQUIRED.
~F.RMTTS REOUESTED
~BUILDING
$
(ft/~
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_h'.R.E.C.
____MECHANICAL
$
Valuation of Mechanical Installation
--
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame ~Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
*********~********************************
signature
SF.CTION
Compaf'Y
State Cert. or Regist. #
City License RegL~trat.i.on II ~1?'":.-<--
* ** * * * * ****** * -I< * * * * i,.., ..,* ..,*.., ie ie i, ,', .:, ,', i, i, ,', i, ,', * J \
d/ . c.~ .
Company L.L-r-rJz~/.A 7t2.~/\-.e
f~"1 ~ ;~~~\:~~~~eO~e~~~~~~~i~O " 4"M " ·
**** ~ *********************************
Signature
Company
State Cert. or Regist. a
City License Registration fl
******************************************
PUJMBF.R
Signature
Company
State Cert. or Regist. 0
City License Registration t
******************************************
MF.CHAN1CAl.
Signature
Company
State Cert. or Regist, 0
City License Registration 1
OTHER
APPLICATION APPROVED BY
~* * * *********; * **** * * * * * ** i, 1,.., ,',..,1, ,', i, ,', ,', ,', * ie *
/1 A1. 1\___ 8 _ -{J. t?A Al...,,;J .'
PER~lIT OFFICER.
CONDITIONS. OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
-
The.undersigned understands that this permit ~ay be subject to "deed restricti~ns' which ~ay be oore restr.ictive than City
regulations. The undersigned assumes responsibiIit(;for coapliance with any applicable deed restrictions.
..' '
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor .or contractors to undertake work, .they lay be required to be licensed in accordance with
state and local regulati~ns. If the contractor is not licensed as required by law, b~th the ~\tner and contractor ~ay be
cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
require.ents may apply for the intended \tork, they are advised to contact the City of Zcphyrhills 8uilding Depart.ent, (813)
7BB-bbll.
Furthermore, if the owner 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 will be responsible. If you, as the owner sign as the c~ntractor,
you are indicating that you, rather than the contractor, are resp~nsibIe for the \t~rk. If the c~ntract~r wishes y~u to sign
as contractor that may be an indication that he is not properly licensed and is not entitled to per~itting 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 - Ho~eowner's Protection
Guide" prepared by the FI~rida Department of Agriculture and Consumer Affairs. If the applicant is s~~eDne other than the
"owner", I certify that I have obtained a. copy of the above described document and proffiise in good faith to deliver it to the
"owner" prior to COlmencement.
~ 1 '. .:.' "
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all Mork Mill be done in co~pliance with all
applicable laws regulating construction, zoning, and land developaent.
Application is hereby made to obtain a permit to' do work and installction as indicated. I certify that no work or
installation has commenced prior to issuance Df a permit and that all work will be performed to roect standards of all laMS
regulating construction, City codes, zoning regulations, anc land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other governmental agencies ~ay apply'to the intended Mork, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include bid ~\e ne,l lil!ited to:
...
I Departme~t of Envir~nmental ReQul~tjon - Cypress Bayheads, H~tland ~reas and Environmentally Sensi tive lands,
Water/Wastewater Treatment
\ Southwest Florida Water ManaQement District - Wells; Cypress Bayheads, Hetland Areas, Altering Hatercourses
I Are, Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways
I Department of Health ~ Rehabilitative Services, Environffiental Health Unit - Hells, Hastewater Treat~en~. Septic Tanks
I US Environcental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flr,od Zr.ne "A" c.r "A,etc.', it is underste,e,d \I"l a drainage plan
addressing a 'compensating volume" will be sub.itted which is prepared by a professional engineer regist~,ed in the State of
Florida prior tn perlit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any pr~visiDns of the technical codes, nor shall issuance of a permit prevent the Building Ufficial fro~ thereafter
requiring a [(.rrection (.f errors in plans; c(,nsiructic,n, (.r violations of any c(,de. Every per~it issll~d :toall bec(,~e invalid
unless the w(.rk authc.ri2ed by such permit is cr'JlIllenced within six 1lI0nths of issllance, c,r if Hc,d; alllhe.. ],ed bi the perlit is
suspended or abandoned for a period of six months after the ti)e the Mork is co~menced. One 90 day e:tE~5ioll of tile, llIay be
allowed for the per~it with fee charge of $15.00. The extension shall be requested in Hriting to the 8uilding Official. An
approved inspedir.n i!lust be logged during each six Ilonth period, r.r the prc.ject liill be ce,nsidered dbdl.dc.ned.
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 RECORD AND POST A "NOTICE OF COMMENCEMENT".
~c
SIGNATURE ~-
- --- CONTRAcTOR
:::::~-~~~~-~~------;---~ n
CONTRACTOR~~In..~~
.. Notary Public, State of Florida
MY COMMISSION EXPIRES 3
My~ummmmm~~~~pr.2~;qq
SIGNATURE
OWN OR AGENT
DATE____/;2~--L2'2..L.----.--,-------
~~~~:y O~S A~~'II~~U.~)4~~
Notary i'tib~~" SIGie Gf florida
MY COMMISSION EXPIRE~5~~~~~!~~!L~~~~~J!!~
Bonded Thru Troy Fain. !n5Urgnce Inc.
---------------------
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Bonded rhru Troy fain Itr,\.!!:".nr' 'M
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COVER ENGINEER!NG, INC.
2011 AIRPORT ROAD
) LAKELAND, FLA. 33811/
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2011 AIRPORT ROAD
) LAKELANw:D, FLA. 33811
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