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.W4
STATE OF FLORIDA
City of Zephyrhills
~ ~5 1;9-
,/Type'OlPermit
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
permitN~ 1965~
Date/:; -.:1- 5'> I
(~!.~
C' " 7 . r, / . ~ C 9-fJ.
::::;;r~:~erSName/:j~ ~~ ~ '-U/),n^"
Legal Description: S:.Di.. J.? A) ." ~-) Lot
../
,~D
~LEgIJ:!lCAL
P~qMBING
...~";
MEC~
Blk.
Zoning CI:
Description of Work
,-y/ ~ (/)~
Energy Code Readout:
I~ t2h~~'Z.
~3- ,-;.-
.5,)3 -9;,)
Rdtl~
Fee:f :;' ~
SIGNATURE ~ ~ ~
Complete Plans, Specifications and Fee Must Accompany Application
~::~fl::f
Estimated cost:-!" If
All work shal! be performed in accordance
with the above and all Cily Codes
and Ordinances,
OCCUPATIONAL LICENSE #
2~~~O~
Ftr, .TZr-~- tf ( t.;..t
Pre SLB t!;:;;;J
Lintel Iz~')~C](
FRM,
Insul.CL
WL
P~~
./
SLB
Tub Set
Water
Sewer
Final
Driveway
COMPANY
ADDRESS
TELEPHONE #
ME~'
Tp,Serv .
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
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 PER!'lIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER
General Home Develooment Corp.
817 U.S. 98" Bypass South. Dade' C;tv. FI 33575
Smith Cattle and Grove
PHONE 904-567-6581
APPLICANT
ADDRESS
JOB LOCATION Silver Oaks Golf & Country Club
LOT SIZE_X
AREA SQ.FT,
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION Brentwood, PB 26, Pages 86-89
PARCEL 1. D, ~~
WORK PROPOSED:~New Construction ____Addition ~Alteration ~Repair ~Install
~Sign/Temp.
____Sign
X Entrance Wall
_Hove
_Demolish
PROPOSED USE: ~Single Family
----YI I F
_~~ 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 FORMS,H
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOllilS. **
**COPY OF CONTRACT REQUIRED.
r>ERMIT~ REOUESTED
_BUILDING
$ 2,200.00
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 SECTION
nllTT,DER K~e in T ROber~~_ _ _ Company ~eopr.l HoD1f' Dpyplogmppt Corp
. State Cert. or Regist. il CGC005695
Signature ' -or " City License Registration il
******************************************
~
ELECTRICT AN Roberts H.
~i~nature ~ 1i
Martin. Jr. Company M ",r+: t'\
.J. State Cert. or Regist. II
~ ~ City License Registration
*******' *********************************
Signature
Company
State Cert. or Regist, 6
City License Registration #
******************************************
PLUMBER
Signature
Company
State Cert, or Regist, 1F
City License Registration #
******************************************
MECHANICAT.
Signature
Company
State Cert. or Regist. 0
City License Registration 0
,} ',.. '/.
*~~*** ~~~~~~***** PERMIT OFFICER.
OTHER
APPLICATION APPROVED BY
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
Th~,und~rsign~d und~rstands that this p~r.it may be subject to "deed restrictions" which may be more restr.ictive than City
regulations, The undersigned assules responsibilit)F;for;,colpliance with any applicable deed restrictions.
. ;/." . ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hir~d a contractor or contractor. to undertake work, they .ay be required to be licensed in accordance with
,tat. and local regulations, If the contractor 11 not licensed as required by law, both the owner and contractor lay be
cited for a .isdeleanor violation under state la"., If the owner or intended contractor are uncertain as to what licensing
requir~lents may 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 contractor!s) sign portions of the
"Contractor Sections" of this application for which they "ill 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 - HOleowner's Protection
Guide" prepared by the Florida Department of Agriculture and Consuler Affairs. If the applicant is sOle6ne other than the
"o"ner", I certify that I have obtained a, copy of the above described dCtculent and prc.mise in good fai th to deliver it to th~
"owner" prior to COllencelent,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work "ill be done in coapliance with all
applicable laws r~gulating construction, zoning, and land developDent, .
Application is hereby tade to obtain a permit to'do work and install~tion as indicated, I certify that no work or
installation has cOltenced prior to issuance of a permit and that all work "ill be performed to leet 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 ~gencies fiay apply'to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in compliance. Such agencies include bIll il e not li_ited to:
0#-
f Depart.e~t of Envir~ntental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive lands,
Water/Wastewater Treatment
f Southwest Florida Water ManaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health t Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~en~. Septic Tanks
f US Environlental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Hc.od Zone "A" or "A,etc,', it is understc.c,d tl,~t a drainage plan
addressing a 'colpensating volute" will be subtitted which is prepared by a professional engineer regist~red in the State of
Florida prior to permit 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 provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every permit isslled ;hall becole invalid
unless the work authorized by such permit is coalenced within six aonths of issuance, or if work authDrlzed by the perlit is
suspended or abandoned for a period of six tonths after the tiJe the work is commenced, One 90 day e:t~~sioll of tile, aay be
allowed for the perlit 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 lonth period, or the project will be considered dbdlJdoned,
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 NDT NEED TO RECORD AND POST A IINOTICE OF COMMENCEMENT".
,/ ~ '., ,/ \ Q
SIGNATURE~ii~~----- SIGNATURE~T~~-------
;~;=~:;;:i~=~:;i~:~~~~--------~;~
l~otarv Pub':r.. ~.'te " Florida" ;'~'?" , "'. ;(!~
MY COMMISSION EXPIRES__.:~~~~.:.::.:.__._:~g~~---- MY COMM EXPIRES,.~~:::':.:.:._..:_,,-~L