HomeMy WebLinkAbout91-1961
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STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
PermitN~ 1961-5
Datefi-::> ..,q /
P7G
Job Address:
Legal Description:
Sub.Div.
Lot
Blk.
Zoning CI:
Description of Work
(4) ~'.p
.Jj.} .or. r'~ ~
~'
Energy Code Readout:
Complete Plans, Specifications and Fee Must Accompany Application
OCCUPATIONAL LICENSE # ~ 7~
.1J y~t:J _/
:~:~AT~. T~.
COMPANY__
ADDRESS
TELEPHONE #
Estimated Cost:
1:1/2, ~ ~ lJ
../
All work sha!! be perlormed in accordance
w;Ih the above and all Cily Codes
and Ordinances.
Tp.Se .
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
MEC~~L
I'
Ftr,
Pre SLB
lintel
FRM.
Insul.CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due 10 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 PERI'IIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
PHONE rgoo 6 d-f6 ~ 33218
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D, IF
WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install
_Sign/Temp, ~ign _rlove _Demolish
PROPOSED USE: _Single Family _M/F _# of lIni ts __1'1/H
_Commercial _Indust. _Swim. Pool Other
\
BUILDING SIZE: ~x~,
_Restaurant & Health Department Approval
4- \ Q.m ~
,
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 FORrIS.''''*
**COPY OF CONTRACT REQUIRED,
PERMITS REOUESTED
_BUILDING
$
\~,~.
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.
*****************************************~
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
Signature
ELECTRICIAN
Company
State Cert, or Regist. #
City License Registration #
********************************~*~~******
Signature
PLUMBER
Company
State Cert. or Regist. #
City License Registration g
************************~*****************
Signature
MECHANICAL
Signature
Company
State Cert. or Regist, #
City License Registration
:! - ;.<, '4
****************************************~*
Signature
Company
Stat~ Cert, or Regist, #
City License Registration
OTHER
I
~t€h1g
APPLICATION APPROVED BY ~~*,,*H***" PE",'leT e'FFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit may be subject to "deed restrictions" which may b~ ~ore restrictive than City
regulations. The undersigned assules responsibility for compliance with any applicable deed restrictions,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with
state and 10fal regulations. If the contractor is not licensed as required by law, both the O\lner and contractor ~ay be
cited for a ~isdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirements lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, IBI3}
7B8-6611,
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 (,wner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes yc,u to sign
as contractor that 5ay 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 Pr(,tection
Guide' prepared by the Florida Departient of Agriculture and Consumer Affairs. If the applicant is soeeone other than the
'owner', I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the
'owner' prior to cOI~enceffient.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all Mork will be done in co~pliance with all
applicable laws regulating construction, zoning, and land developDent.
Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no wor~ or
installation has comreenced priDr to issuance of a perlit 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 regulatiDns of other governmental agencies may aeel~ to the intended worl:, and that it is
my responsibility to identify what actic.ns I must t.ake to be in cC'ffipliance. Such agE?f1cies include bid", e i1(.l li,~ited tc.:
I Department of Environaental Reoulation - Cypress Bayheads, Wetland Areas and EnvirDnmentally Sensi tjj! L~nds,
Hater/Wastewater Treatment
. Southwest Florida Hater HanaQetllent District - Wells, Cypress Bayheads, Wetland Areas, Altering HatercDUfses
I Ar~y Corps of EnQineers - Seawalls, DDcks, Navigable Waterways
I Department of Health L Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~e~~. Septic Tanks
f US Environmental Protection AQency - Asbestos abatement
I also certify that, if fill material is to be used in Flc.c.d Zone "A" or "A,etc.', it is unders,tc,(,j tl."l a j. ainage plan
addressing a 'compensating volutie" will be subDitted which is prepared by a professional engineer reqi5t~r0j in the State of
Florida prior tD per~it issuance,
A permit issu~d shall be construed to be a license to proceed with the work and not as authority to ~ioj~te, cancel alter, or
set aside any provisions of the technical cc.des, nor shall issuance c.f a permit prevent the Building L1ff'.ci"1 frc,m thereafte!
requiring a correctiDn of errors in plans, construction, or violations of any code. Every permit issu~j ~ha]l becote invalid
unless the wc.rk authorized by such permit is cc.alllenced within six months of issuance, [,r if \'I(qf; autl.rOl j,ed hi' the permit is
suspended or abandoned for a period of six months after the time the work is commenced. One 90 day ~~IE~510" of ti~e, ~ay be
allowed for the permit with fee charge of $15,00. The extension shall be requested in \'Iriting to the Building Official. An
approved inspection must be logged during each six month periDd, or the project will be considered dbdi,doned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERfY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. BS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF CO ENCEMENT".
~
~~T6R~~-~D
DATE__i~~~~~_~_l_------------------
SIGNATURE~ftk.liiff;;-VIPEo-
DATE____!O'Z~~~~!------------------------
1.3''1 GNA TU
MY COMMISSION EXPIRE~_~~ QMed~~~~~Y
nwr.vulMII$sIoIl1!lp!r11-Jan:--m-1S9S
B-:.mdsd thru Maynm'd Dont!i~ A;ze:tc.Y
~~~~~~C~~R~~_~~~----
OoNA.J SV1(OU
COMMISSION EXPIRES__________________
NOTARY PUBLIC, STATE OF FLORIDA
My commission expires Jan. 28, 1995
Bonded thru Patterson - Becht Agency
NOT ARY AS", TO
OWNER OR AGENT ~__,~===---=-~---=====-----
APPLI(;ATlo(~ FCP, PERNIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
St. Andrews Construction Inc.
. TX 76016
ADDRESS 3825 Green Oaks Blvd. N., Suite #300-ArllngtonpHONE (817)457-9129
1.1G '2.CO $. A1JD~l,~~; SOl ~ ~
OWNER N . . f:12.0M-E:. L. ~O
. 4 -z.:i PHe~j.(II;t.~ I r-L .
JOB LOCATION 7'2 2 .C/ML (lO~O b313'41 ", LOT SIZE, tJlA: =-<- AREA SQ. FT. N/A
'2 ~fH'Y~JhL(,7 f{.,. .335.f1 5fe:flV,,-, ~?~OVJtJS"H(.' 4?~ ~lin-l ~ti(~ 21 EN71
. LEGAL DESCRIPTIOk: LOT (S) - BLOCK --- SUBDIVIS ION1eAGT &J 2 f. PHi {l. /111k ~
PLAf i?aott- 1.- PA&f,.::i!J 1911f}j..~ U-COflOS PWO LCJ. J' c.Oi-lJ'-l t ('{)~P/>.LJl( , ,-
PARCEL 1. D .IF 'P/HlrE'l \l f-" nf fOw~ VI,".W S~' ~&p, (f-,jfAZ- 1f- .~t? - 2.6 . 2i - 00,0'- () B800 OocO
WORK PROPOSED:_New Construction _Addition ~~Alteration _Repair _Install
_Sign/Temp. _Sign _rlove _Demolish
PROPOSED USE: ____Single Family _M/F ____# of Units __M/H
~Commercial _Indus t, _Swim. Pool Other
____Restaurant & Health Depart~ Approval
BUILDING SIZE: 1()\ x-.1.fLl, 4800 Square Feet, -f~1 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 FORrlS. H
**COPY OF CONTRACT REQUIRED.
'~UILDING
7ELECTRICAL
PERMITS REOUESTED
$ 79,299.00 Valuation of Total Construction
AMP Service Florida Power Corp.
_H.R.E.C.
N/AMECHANICAL
N/A PLUMBING
$
Valuation of Mechanical Installation
NjA GAS
N/A ROOFING
N/A
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
_Frame ____Steel
Finish Out
Other
FINISHED FLOOR ELEVATIONS: FT,
******************************************
CONTRACTOR SECTION
BUnDER st. Andrews coq: Inc. Company St. Andrews Construction Ino.
~ ~., State Cert. or Reglst.:' CB C053090
Signature -= ", City License Registration i!
,
******************************************
Signature
.--
,.
/Z.kd-IIZ..;~ Sell-V/"c.. "'(, J~~any
State Cert. or Regist, :! EC 600<' 8-:?3
- City License Registration #
****************************************~*
ELFCTRTCTAN M-OU,NO
PLt'MBER
N/A
Company
State Cert. or Regist. ~
City License Registration
*****************************************~
Signature
MECHANICAL
N/A
Company
State Cert. or Regist. r
City License Registration 1
Signature
******************************************
OTHER
;VIA
Company
State Cert. or Regist. #
City License Registration
Signature
APPLICATION APPROVED BY
*~~~~~~***A******~A***~~*~~~~~~~~~~~~~~~~~
'~~~_ ~~;.. OHHH W 0
PERmT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it may be subject to "deed restrictions" which ~ay be ~ore restrictive than City
regulations, The undersigned assuaes responsibility for compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
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 ~ay be
cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
require.ents iay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (813)
788-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portic,ns 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. TRANSPORTAT I ON IMP..B~_T FE_ES__.Br~'.ld__l)T lL I TY C.QN.NECT I ON 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 Florida Department of Agriculture and Consumer Affairs, If the ~pplicant is so~eone other than the
'owner', I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the
'owner' prior to COimencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will be done in co&pliance with all
applicable laws regulating construction, zoning, and land development,
Application is hereby made to obtain a permit to do Mork and installation as indicated. I certify that nD wC'ik Oi
installation has com~enced prior to issuance of a perait and that all work will be perfDrmed tu meet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulatiuns in the jurisdiction. 1 also
certify that I understand that the regulations of other governmental agenciES may apply to the intended Mork, and that it is
ItY responsibility to identify what actions I lIlust take to be in cClmpliance, Such agEncies include bill ~,r. 1I[,t limited to:
* Department of Environmental Reoulation - Cypress Bayheads, Hetland Areas and EnvirDnmentally Sensi Ill! L~nds,
Hater/Wastewater \rea~ffient
* SouthMest Florida Hater Manaoe_ent District - Wells, Cypress Bayheads, Hetland Areas, Altering WatercDurses
I ArDY CorDS of EnQineers - Seawalls, Docks, Navigable Waterways
I Department of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Waste~atei Trp.at~e~~. Septic Tanks
I US Environmental Prutection AQeney - Asbestos abatement
I also certify that, if fill material is to be used in FIc.od Zc.ne "A" Dr "A,etc.', it is underdc,c,d li,~t. "d!ainage plan
addressing a 'coltpensating volume" will be submitted which is prepared by a prufessional Engineer ie4isl~.i'd in the State of
Florida prior to permit issuance,
A perlllit issu~d shall be construed to be a license to proceed with the work and nut as authority tu ,ioj~te, cancel alter, Dr
set aside any provisi(.ns of the technical c(.des, nor shall issuance [.f a permit prevent the Building lJff:.ci,,] flc,m thereafter
requiring a torr~ction of errors in plans, construction, or violations of any code. Every permit issu~d ~hall beeole invalid
unless the wc.rk authclrized by such perlliit is cc,mlllenced within six ff!H,ths of issuance, ur if \'ICl1 h al1thrq j,i?d h)' the permit is
suspended Dr aband(,ned f c,r a per i [10 (If six lonths after the t i /lie the 110rk is e uK,li\enC ed . One 9G,d ay L'~ Il',,~ 10" 0 f time, may be
allowed for the permit with fee charge of $15,00. The extension shall be reqUEsted in \'Iiiting tD thr Building Official. An
appro"ved inspectic,n must be logged during Each six mc,nth peric,o, [Ir the pr(lji:ct Iii 1 1 be (['!isidered db6i,dc'ned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERfY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENnER OR AN A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE_ f!tf1:.t' SIGNAT~_-:;.k~J - -------
~~ WNER CONTRACTOR Bill Costin
-::Jb _ ~ I
DATE __lL-:J.3..:~il__--------------------- ---
DATE
-----------------------------------
11 November 1991
~~~~:Y O~S A~~NT _~Q~~
MY COMMISSION EXPIRES_~_~-~~~~---
MY COMMISS
!I>...\.,\~V'~'!,,'-
~G'A""'~
~:;..' .\:~
:;'~'. "~E
;;:;i'ori\.~~:1
It'n"."\:
DONNA D. ADAMS
MY COMI~IS510N EXPIRES
May 8. 1995
DONDED TIiRU ALAN INSURANCE AGENCY
k....""..,~~>~-~
..,.',;y.p;..,. mVi '_'':~'''''''v "
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'j;;;>" ~ '~S"'; NOT',r)v P' ""l'~ ~
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