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Home My WebLink About91-1963 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 PermitN'~ 1963 n1 Date 1'/ -:z- - 7./ Type of Permit BUILDING Property Owners Name: Job Address: ~2- tf"7 Legal Description: Sub,Div. Lot Blk. Zoning CI: Description of Work ~I ct~~ OJf { 2~ Energy Code Readout: b ql wf/vV Complete Plans, Specifications and Fee Must Accompany Application !:YJI' ~ ----- c ..B:l . '1.lc1NG Fee: f.b-~ ~<' SIGNATURES~'.// =. COMPANY _ _ ADDRESS TELEPHONE # tt!s Estimated Cost: /?".J:O~. All work shal! be performed in accordance with Ihe above and all Cily Codes and Ordinances. OCCUPATIONAL LICENSE # /__<7" ~~G Ftr, Pre SLB Lintel FRM. Insul.CL WL SLB Tub Set Water Sewer Final Tp,Serv. Rough In Meter Can Canst. 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 ($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 inspeclion 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 OWNER ~'1V5-{ ; Ca~i~ ? 7' ? c7~ /7 ~,-vO Ii I) ~ Or .( Fr f"L ( . PHONE ? 8,<- ~.?&-o APPLICANT ADDRESS JOB LOCATION ,~~ Y 7 5 "6'5r/" LOT SIZE_X AREA SQ,FT, LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D, ~,~ WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp, ____Sign _Hove ____Demolish PROPOSED USE: ____Single Family _M/F ____# of Units ,_H/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 FOR..'1S. ** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORt-IS, 1", **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction $ AHP Service /17S-:~ Florida Power Corp. _h',R,E.C. ____ELECTRICAL ____HECHANICAL Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame __Steel Other FINISHED FLOOR ELEVATIONS: FT, ****************************************** CONTRACTOR SECTION BUILDER Company State Cert, or Regist. # Signature City License Registration if :::::~. (~t;"'''''''''::::::-;;::~';*(?~'~''{frJ' . - . . " ' S~ate ?ert. or R:gis t, . l.frleOo i I 5 1'1 ______ _ Cl.ty Ll.cense Regl.stratl.on iF /SC{ ****************************************** Company State Cert, or Regist, # City License Registration # ****************************************** PLUMBER Signature Signature Company f0 /I, < ~ v C "- ~....~ State Cert, or Re1fist. ;, I? ~?OSb'b8' City License Registration 'F ? / '-. Company State Cert, or Regist. # ____ City License Registration # *::,~ "'IlW>"f<>...f~. I ,;'. #-4'!-p-<---' ". '/ PERHIT OFFICER. Signature APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands }~at this pertit lay be subject to "deed restrictions" which may b~ more restrictive than City regulations, The undersigned assutes responsibility for co.pliance 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 regulations. If the contractor is not licensed as required by law, both the owner and contractor ~ay be cited for a misdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requiretents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (SI3) 7aB-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 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 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 - Homeowner'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 document and promise in good faith to deliver it to the ~ "owner" prior to co.mencetent. 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 compliance with all applicable laws regulatinq construction, zoning, and land develop.ent, Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a permit 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 regulations of other governlental agencies lay apply to the intended wor!:, and that it is /lY responsibility to identify what actions I lust take to be in ct1llpliance. Such agencies include bill ~Ie iiCll liilited to: * Deparhent of Environ.ental ReQuliition - Cypress Bayheads, Wetland Areas and Envirc.nmentally Sensi tjie Ldnds, Water/Wastewater Treat.ent * Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Aitering Watercourses * ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways * Departient of Health t Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~ent. Septic Tanks * US Environlental Protection AQency - Asbestos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood thit a drainage plan addressing a "colpensating volUMe" will be submitted which is prepared by a professional engineer registEred in the State of Florida prior to periit issuance. A perMit issued shall be construed to be a license to proceed with the work and not as authority to yioj~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Ufficio} froll thereafter requiring a correction of errors in plans, construction, or violations of any code, Every permit issuud ;hall becoie invalid unless the work authorized by such penit is c[llllenced within six lIlonths of issuance, (Ir if \'Iwk authfll lzed by the perlit is suspended or abandoned for a period of six lonths after the time the work is commenced, One 90 day e~t~nsJolI 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 lust be logged during each six month period, or the project will be considered dbd\~oned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERfV. 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 COMMENCEMENT". DATE ____:~_LL-------=- NTRACTOR SIGNATURE~~_~___________ OWNER OR AGENT DATE__~~==_~_=_~_L?~_____-_______-_____ NOTARY AS TO V1/ r/ -/ / OWNER OR AGENT_);t:::::a~:.L~~ ~- ~-"'--- Notary PUDlII. ale 0 r10fl1l8 My Comm. ,Mar, 17. 199!j. MY COMMISSION EXPIR __~_~_________________ SIGNATURE _::L.~-:.~-~--=-t:t----- NOTARY AS T~~ ~ CONTRACTOR_/.../{...a:z~_:...~- -- , , ta Pu i MV COMMISSION EX RES~_~~ff~ ~ ..,~' ,." -' ~,'''''r'''iP.1"'!l<f' .', . _ \". ;,,-,>~ r'o . ;~'!:*:.~"""j~'1.~:~-:~'I;,:.;"l'e' .':" '~'.~i"~ ::~; ~-~'~.Jlt\"~':"'-~'-~_~-Oi.~;'~~ ;t~ '-' . . ';" KftlSe}i Central"" Heat & Air-Conditioning , 7722 Fort King Highway · P,O. Box 2209 Zephyrhills, Aorlda 33539-2209 (813) 782-2300 ., \ ..fti NAME APARTMENT DAn: OF ORDER DAn: PROMISED AllORESS CllY .. MAKE MODEL SERIAL NO. ~MATE [J CASH [J CHARGE NATURE OF r.I'\. SERVICE LV REQUEST QUAN. PART NO. OESCRIPTION PRICE AMOUNT SERVICE PERFORMEO TOTAL MATERIAL n:CHNICAI. SERVICE TIME TAX r l L CASH ~~:~~LETlON~ DAn:COMPLrnD TOTAL 7~~! TECHNICIAN CUSTOMER'S SIGNATURE - ._-~--,.-.--""" ._~.. -~------ ~,