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Home My WebLink About91-2004 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 ~L~ p~ MEC~ Properly Owners ~ame: ~~ Job Address: <.S '6 :L 5~- ~ Permit :N~ 200~ Date I~ -/7-7>/ Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of wor;- )('.(! A-t.~ ~ IZ-z.o...91 Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: e2 '/70, , en) Fee: 2 CJ SIGNATURE COMPANY ADDRESS TELEPHONE # .~ All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE #..!>- f:!!:;/~~ ,~ILDIN~ PL~ Ftr. SLB Pre SLB Tub Set Lintel VVater FRM. Sewer Insul.CL Final WL ---- ~AL ~ ~NICAL ~ Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Filnal Driveway Reinspections: 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. JOB LOCATION APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BU LDING DEPARTMENT APPLICANT r ADDRESS PHONE OWNER LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.~F WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ____Single Family _M/F ____iF of Units _____M / 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.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ,\,* **COPY OF CONTRACT REQUIRED. _BUILDING $ ~ C(?o PERMITS REOUESTED 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. Signature Company State Cert. or Regist. # City License Registration ******************************* Signature Company State Cert. or Regist. iF City License Registration # ****************************************** ELECTRICIAN Company State Cert. or Regist. 4F City License Registration iF ****************************************** PLUMBER Signature Company State Cert. or Regist. iF City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration 4F _ OTHER Signature ... C;:~**********:*lt************************ /'{ (}Au' .A 1 :z:j... q/L~..... r- '---1tt~ ~ ~ ~ PERMIT OFFICER. APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions" which may be more restrictive than City regulations. The undersigned assules responsibility for cOI~liance 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 lay 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 Building Department, (813) 788-6611. 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 may 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 - HOleowner's Protection Guide" prepared by the Florida DepartMent 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 doculent and promise in good faith to deliver it to the "owner" prior to cOlmence.ent. 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 regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a perlit and that all work will 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 agencies 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 bllt ~\e not li~ited to: * Depart.ent of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment . Southwest Florida Water HanaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Depart.ent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatment. Septic Tanks * US Environ.ental 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 tbat a drainage plan addressing a "colpensating volume" will be sublitted which is prepared by a professional engineer feqistfi~d in the State of Florida prior to permit issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to vioi~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Offici~l from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issu~d ;hall becole invalid unless the work authorized by such perlit is cOlmenced within six months of issuance, or if wOlk authorIzed by the perlit is suspended or abandoned for a period of six lonths after the tile the work is commenced. One 90 day e~ttDSIOll of time, may be allowed for the permit with fee charge of itS.QO. The extension shall be requested in writing to the Building Official. An appro'red inspectic,n must be lc.gged during each six month peri[,d, or the prceject will be c[,nsidf?Ted dbtiildoned. NOTARY AS TO CONTRACTOR MY COMMISSION EXPIRES-l101'1\'R"'1'U8l1e~1'm-er-Fl-{)IHOA MY COMMISSION EXPIRE~W.LP!JauG-~A-lE-9F-Ff:{)RlDA MY COMMISSION EXP. OCT, 15.1994 MY COMMISSION EXP. OCT.15.1994 BONDED THRU GENERAl INS. UNO. BONDED THRU GENERAl INS. UNO. Please Send Remittance to: A. ilnrtlttt IUtnfittg (Of Clttntra13J;lnri~a. Int. c/o Richard Bartlett 38408 3rd. Ave. ZEPHYRHILLS, FLORIDA 33541 One Of The Largest, Oldest, Most Dependable Roofing Companies in Central Florida Specializing in Mobile Home Uniroyal White Rubber Roofs RESIDENTIAL * COMMERCIAL * MOBILE HOME LICENSED-INSURED & BONDED * MEMBER OF CHAMBER OF COMMERCE * OFFICE PHONE (813) 782-5585 Lic.# RC 0031769 Serving Zephyrhills, Dade City, Ridge Manor, Quail Hollow. Land 0' Lakes, and Surrounding Areas We have reroofed over 6000 Homes and Mobile Homes in the last 17 years. .}:-1 /rl , I i ,,/ '- Oat. /, _ //_-] IOJ '. ,," I. !! i' / 1/ / Nam. Addr... Phon. I II AMOUNT ,"'--. /~"'\ t..__: / ~.lf' ./ I,., I 'i " ,,/ t lA- THANK YOU ' " if Your Business is Appreciated ! J Payment upon completion unless previous arrangement made. Warranties pertain to original owner All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance, Our workers are fully covered by Workmen's Compensation Insurance, ----