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Home My WebLink About91-2006 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit Nt.: 200sE Type of Permit ~~ E~ PL~~____ ME~L Property Owners Name t::&,~ ili Job Address: Y<.f- cJ.-::L Date-.1'c;l -/7- 9/ Legal Description: Sub.Div. Lot Blk. Zoning CI: ~ Description of Work ~. / ~: - Energy Code Readout: ~ 1Z.-Llt1-'fJ Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: ....!:;~. c;-:u Fee: rJ ~. o-u SIGNATURE (~Rd'"Y7A~-", All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE #~ 9'3 COMPANY ADDRESS TELEPHONE # B ~~C_(;;f~-,h ~ C-/ BlJILDIN0 PLWvl~ ~, Ftr. SLB Pre SLB Tub Set Lintel Water FRM. Sewer Insul.CL Final WL ELE~L , " Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final M~ICAL '" 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 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 j) .i ( Co~_A-QA-<:...-+oe. <; ADDRESS S 7 0 8 ?:!..!::::- 5-1-... OWNER ~ "Lm_ (;rI~;~ JOB LOCATION 'f,f-;;.;).. -~ ~-0( 2-1.; 1I( PHONE ',0 07 Q/S''1 APPLICANT LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.iF ~/ ____Repair _Ins tall WORK PROPOSED:____New Construction ____Addition ____Alteration ____Sign/Temp. _Sign _Move _Demolish PROPOSED USE: ____Single Family _M/F ____iF of Uni ts ,_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 FORt'1S. H **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED V _BUILDING $ --S- Cr7J . cr0 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. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration 4F ****************************************** BUILDER Signature Signature Company State Cert. or Regist. 4F City License Registration 4F ****************************************** ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ********************~********************* MECHANICAL Signature Company State Cert. or Regist. # City License Registration 4F OTHER Signature APPLICATION APPROVED BY ~.;:::;:~..~:;:;::~..*.*.**.*...* A C () M /111 j ICCAL GtfEC K.. ,.:5 PERMIT OFFICER. KEG. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit lay be subject to "deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance 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 may apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (813) 788-6bI1. Furthermore, 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 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 document and promise in good faith to deliver it to the "owner" prior to cOlmencelent. 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 development. Application is hereby lade to obtain a permit to do work and installation as i~dicated. I certify that no work or installation has commenced 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 work, and that it is Iy responsibility to identify what actions I lust take to be in compliance. Such agencies include Iml ~iP. IiO~ liltited to: I Department of Environ.ental ReQulatic.n - Cypress Bayheads, Wetland Areas and Environmentally Sensi ti Vi? Lands, Water/Wastewater Treatlent I Southwest Florida Water ManaQelent District - Wells, Cypress Barheads, Wetland Areas, Altering Watercourses I Army Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Department of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~en~, Septic Tanks I US Environlental Protection AQency - Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.", it is understood th.t a drainage plan addressing a "compensating volume" will be sublitted which is prepared by a professional engineer feqistci~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 vioi3te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Uffici~] from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issu~d shall become invalid unless the work authorized by such perlit is comlenced within six aonths of issuance, or if work authDllzed by the perlit is suspended or abandoned for a period of six months after the tile the work is commenced. One 90 day e~tE~SIO" of tile, lay 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 must be logged during each six lonth period, or the project will be considered dbai~Dlied. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERrV. 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_~~-~------- CONTRACTOR DATE_____l~_tL1[~~L_________________ NOTARY AS TO. / tI/ ~' CONTRACTOR__~f;r~n:-Y~~~---- Notary PubUc, State of Florida MY COMMISSION EXPIRES~~:~~~~~~~~~~~A~~ SIGNATURE ---------------------------------- OWNER OR AGENT DATE --------------------------------------- NOTARY AS TO OWNER OR AGENT_____________________________ MY COMMISSION EXPIRES ---------------------- tJ \ . , I \ \ -J t \'3) ~ --- \ :~J ~. " ,j '. y Q