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Home My WebLink About91-1971 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N~ 1971$ /'2-5-9/ , (iO" ~;;.--' "' Date sr-='~\,;AL --' J?l"t1II1J8 Be 11m-h. ::::::r~:~ersNa'?~1 ;:%5i~;i1?0/~~p; &fl?' Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work ~. ~n, / ? I ~ ~I c>ler ~~ t1~ ~ ~ Complete Plans. Specificalions and Fee Must Accompany Appllcation (1.:' (~:)ft \ ~ ' eo P" Estimated Cost: 1 ~(17. Fee: 2.0 r _ . All work shal! be performed in accordance SIGNATURE?/. Irj\T~" ~ ~ with the above and all Cily Codes and Ordinances. COMPANY Energy Code Readout: r <<"""'<L.... ... ADDRESS TELEPHONE # OCCUPATIONAL LICENSE # c0u:Jt1e ( BUILDING PIII~1~' -.--- ~ !i"( I1UcAL - ~~~~.~JleA'L' Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Ftr, Pre SLB Lintel FRM, Insul.CL WL 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 resutting 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT ~~~~- 1, HI ~~~ OWNER 4- '7 ,S"'f .3ot-v\~ v0 ~ ~ /1-' r'r~/~/ .ti:jr;(r -" L"J U t ~L"1 t, n-- ~ F.to , 1> ~ ~!:! PHONE ADDRESS JOB LOCATION ..,s.c:;, UA e.- LEGAL DESCRIPTION: LOT(S) LOT SIZE x AREA SQ,FT, BLOCK SUBDIVISION PARCEL 1. D, ~~ WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____sign/Temp, ____Sign ____Move ____Demolish ____Commercial ____Indust, ____4~ of Units _____M/H _Swim. Pool ~lhk r~ Other PROPOSED USE: ____Single Family _M/F _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,** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Set'vice 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 Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER ~(-1P (- Signature SiQnature Company State Cert, or Regist, # City License Registration # ****************************************** ELECTRICIAN Company State Cert, or Regist. # City License Registration # ****************************************** PLlJMRER Signature Company State Cert, or Regist, # City License Registration iF ****************************************** MECHANICAL Signature Company State Cert, or Regist. # City License Registration # OTHER Signature ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands ~nat this perait aay be subject to "deed restrictions. which lay be lore restrictive than City regulations, The undersigned assules responsibility for coapliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake work, theyaay 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 lay be cited for a aisdeaeanor 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 Building Department, 1813l 788-6611. Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractorlsl 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 perlitting 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 Departlent of, Agriculture and Consuaer Affairs, If the applicant is sOleone other than the .owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the "owner" prior to cot.enceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in cotpliance with all applicable laws regulating construction, zoning, and land developaent. Application is hereby aade to obtain a pertit to do work and installation as indicated. I certify that no work Dr installation has cOllenced prior to issuance of a perait and that all work will be performed to teet 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 work, and that it is IY responsibility tel identify what actions I aust take to be in cOllpliance. Such agencies include bill ~i e Bot limited to: f Departaent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive lands, Water/Wastewater Treataent f Southwest Florida Water KanaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Arty Corps of EnQineer~ - Seawalls, Docks, Navigable Waterways f Departaent of Health ~ Rehabilitative Services. Environaental Health Unit - Wells, Wastewater Treatment. Septic Tanks f US Environaental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" Dr "A,etc,., it is understood th~l a drainage plan addressing a "coapensating volute" will be sublitted which is prepared by a professional engineer registeied in the State of Florida prior to perait issuance, A pertit issued shall be construed to be a license to proceed with the work and not as authority to vioj~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a p~r.it prevent the Building Officidl from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued ~haJl becote invalid unless the work authorized by such pertit is co.tenced within six months of issuance, or if wor~ authctI l1ed by the pertit is suspended Dr abandoned for a period of six aonths after the tiae the wor~ is coamenced, One 90 day e~t~~sioll of tile, aay be allowed for the permit with fee charge of $15,00, The extension shall be requested in writing to the Building Official, An approved insp2ction must be logged during each six tonth period, or the project will be considered aballdoned. 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 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,e_-=l"..~~~ (OWNER t3RAGENT SIGNATURE______________________________ CONTRACTOR DATE /<~- 5- 9 ( ---~--------------------------------- DATE___________________________________ NOTARY AS TO /~~ OWNER OR AGEN~~ _ MY COMMISSION EXPIRE~IhELE~~L~~~L~DL~~~4 My com:1~isc.i;) s 1 ~);. Bonded thru ?.::tt2rsor,.. U,'G',' Agc'ncy NOTARY AS TO CONTRACTOR_____________________________ MY COMMISSION EXPIRES