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Home My WebLink About91-1969 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY permitN~ 1969 m Date I~ -1/- C// --- Type of Permit <":L D ~~t ~ Property Owners Name: 0~~~ $r/j7,~)~ Job Address: _2. __ - I if - .$ , BUILDING DEPARTMENT 1-813-788-6611 ..- 30",., G -~ tv!.ECHAN~ Legal Description: Sub.Div. Lot Blk. AIr!- / (!~-1?~l>7 -<- ~;~ Zoning CI: Description of Work / (J~A 1-1-8...9"2-- Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application i::- :2 // C! " Estimated Cost: _.3' / U Fee: SU"~ SIGNATUR~- ,r.1r-y,/YL0 /1 {7 v' COMPANY /(i~f) All work shall be performed in accordance with the above and all City Codes and Ordinances, ~<J ADDRESS TELEPHONE # OCCUPATIONAL LICENSE # (~~11;~~ Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final ~;~c/~~ ( "'~ EC~~~':,) PL.YM-BtN<3 6 Tub Set Water Sewer Final B U 1J,.DH'tG'...- .,- Ftr, Pre SLB Lintel FRM. Insul.CL WL Breakers Ducts Insl. Compressor Final Driveway Relnspectlons: When extra inspection trips are necessary due 10 anyone of the following reasons, a charge of ten (SlO,OC)) 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. f"'i '-,;:~:?~"~-.~~r!\IW~J~~~"' " ':-'*'-;':~'(WJ~_~~1.{;k~::.fi~:'~',{.:-: " ,." ~ ~~,~;~,~' > CONTRACT ,ZEPHYRAlRE P.Q, Box 1243 . Zephyrhills, FL33539"'r; !.iS~.',',,' . '~",;" ",. ~:\,}~'I'i f'~~~(:' /'^ ;~i.c # ~B05084 , , Contract S Itted To: r' A"# Phone (office) (813) 788-6284 Date ' ' f-/.F- PO Job Name Job location ). Induding Tax, APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER 5c2~g J}e ..-? /l/ lJeAN Rob,JL/'1~IJ ,/Ze/I/Y.L 7'/ . /? ~T 7-/~/~ R 33SL/o ffi>-6/ /' L -4.R ZJ /'7 77/ ~ 7 7-. ~~ t. ~~~ APPLICANT PHONE 7?tf. -tf, 2 R7'" ADDRESS JOB LOCATION .:;-;?.38 LOT SIZE_X AREA SQ.FT, LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D, t~ ____Sign/Temp, ____Sign ~ ';:y,,;cp.;(/C'.v7 ----Alteration ~Repair ____Install Cl!4M&e t.?tfvr- ____Demolish WORK PROPOSED:____New Construction ____Addition PROPOSED USE: ____Single Family _M/F _t~ of Units _____I'I/H ____commercial _Indust, _Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** COMl'1ERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl-IS.H: **COPY OF CONTRACT REQUIRED. x Square Feet, Height l'ERM1TS REOUESTED ____BUILDING X-ELECTRICAL -A-MECHANICAL $ valuation of Total Construction AMP Service Florida power Corp. _H.R,E,C, $ &2890 OJ! Valuation of Mechanical Installation _PLUtIBIN'G GAS ROOFING SPECI,\LTY TYPE OF CONSTRUCTION: ____Block _Frame _Steel _Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature ~ONTRACTOR SECTION Company State Cert. or Regist. # City License Rcg"istration 4~ ****************************************** BUIT.DER :1:~~ Company "l.-\\,"'-<; E:u:~", <:;;"1\.U. : .. - State Cert. or Regis t. Ii Il cc ~l' IS' '~ e - ' . ...............~~;~;;~~~~~:.~~~;~;~~;;~~ " ,<> Signature Company State Cert, or Regist. Q City License Registration 0 ****************************************** J:UTMRER tlF.\:Il~NJ CAT. ft -"'..<1:>'/ ,4", e . Company ;;Te /#'// ~-" e : __~~ State Cert. or Regist. 11_ .e'4-pL>,W?L~ Signature -':::., ' /'- - .v. City License Registration !i Jr. - - - 7"** *~.~. * ***...* * **...... ...*~. * * "'l"~' J, ,'. .'. J, ....c...... J, ,C J, J. '" ,', ".. ."." ... n.... "".. n 11 l' .. ,. .. .. " .. .. .. " .. .. .. .. .' ' = Signature Company State Cert. or Regist. ii__ City Lic:~nse Regis tration ii Q1lJ.ER- PERl-lIT OFFICER. APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A.': NOT I CE OF' DEED RESTR I CT IONS:. . The undersign~d understands that this perlit lay be subject to "de~d restricti~ns' which' may b~ &~r~ restrictive than City regulations. The undersigned assumes responsiblli~y for compliance with any applicable deed restriction~, . \ .' ,'. .. . ,~ B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake wor~, they may be required to be licensed in accordance with state and local regulations. If the contractor is not Ilcen5~d as required by law, both th~ o>>n~r and contract~r nay be cited for a lisdeleanor violation under state law, If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills ~uilding Departeent, (8131 788-6611. Furtherlore, If the OWner has hired a contractor or contractors, he is advised to have the contractor!sl 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 c~ntractor wishes y~u to sign as contrachr that aay be an indi'cation that he is not properly licensed and is not entitled to pmr.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 ConstructiDn Lien Law - Ho~eowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is SOIEc'ne 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 "~wner" pri~r to cOlmencement, E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inf~rmation in this application is accurate and that all work Hill be done in co~pliance with all applicable laws regulating construction, zoning, and land development. Application is hereby .ade t~ ~btain a perait to do work and installation as indicated. I certify that no work ~r installation has com!enced prior to issuance of a perlit and that all work Hill be perf~rmed to meet standards of all laws regulating cc.nstructic.n, City ([,des, zc.ning regulations, and land development, regulatie,ns in the jurisdictie.n. I also certify that I understand that the regulations of other governmental agencies may apply to the intended Hork, and that it is flY responsibility to identify what actions I lDusttah to be in compliance, Such agencies include bllt ~le liCIt Ij'lited to: I Department ~f Envi(onmental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensi tive L~nds, Water/Wastewater Treatment I Southwest Florida Hater HanaQelent District - Hells, Cypress Bayheads, Hetland Areas, Altering WatercDurses I ArDY CorDs of EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health L Rehabilitative Services, Environmental Health Unit - Neils, Wastewater Treal~en~. Septic Tanks I US Environoental Protection AQency - Asbestos abatement I also certify that, if fill laterial is to be used in Flc,od Zc,ne "A" or "A,etc.', 'i t is underste,e,d th,t a drainage plan addressing a 'c~lpensating volume" will be sub.itted which is prepared by a professional engineer regisl~iod in the State of Florida prior to permit iss~ance, A perlit issued shall be construed to be a license to proceed with the work 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 Official fr~~ thereafter requiring a correction c,f ernrs in plans, constructie,n, or violations of any cc.de, Every permi t isslled "ha] I becc'le in'!al id unless the work authori2ed by such permit is cO/lmenced within six months of issuance, or if work authorIzed by the perlit is suspended or abandoned for a period of six lonths after the time the work is commenced. One 90 day e:te~5iDII of tile, aay be allowed for the permit with fee charge of ~15.00. The extension shall be requested in writing to the Building Officjal. An approved inspedic.n /:lust be le,ggedduring each six month period, Cor the proj!!ct lii]1 be ce,r,sider!;d dboiide,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 VALUE ~O ~IOT NEED, T~ RECORD AND POST ~ "NOTICE OF CoMME~~C~/)/. / ./ SIGN'~TUREj)g~ 0.~lGNATURE__( ~_-Z;--:/~L_- , OWNER OR ~~. - -~~ONTRACTci~~--- (. DATE _ _ _ _ __ _ _ _ .12.:-_2:... ~ v- _ _ --.. _ - -- - - - - --- 'J NOTARY AS TO k ~ L% ' ./:" /) CONTRACTOn _iLlkriL.'"L- Jg:L~~k~ - ---- Notary Public MY COMMISSION EXPIRES . Stale.ofFlori~aall.arge -,-.lAlo'llllll65lO!t &lIIresilec;2O;199I- DATE __ ..____ ___________!<?~~91__------------ NOTARY AS TO T fi'~f),ijJ' /)1' OWNER OR AGEN _~~-----~----------- Nolary Public MY COMMISSION EXPIRES SlaleolFloridaatLargt -~~m~~ntXpmi~c.zr~----