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Home My WebLink About91-2011 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Type of Permit . ..-d~ p~ ~NI~V Property Owners Name: ~~~......... ,)j~ ~ Job Address: ~V c2 t,... ~-..Y;;t -H: 201111 Date/:2. -.J (:J - <J' / Permit N u '. Legal Description: Sub.Div. Lot Blk. Zoning CI: Description of Work ~a J/<t-v- ~~ ~ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Fee: 0-{). 0-0 ~ SIGNA~~ ~~ COMPANY ADDRESS TELEPHONE # Estimated Cost: ~/ ~ (), crt) All work shal! be performed in accordance with the above and all City Codes and Ordinances, OCCUPATIONAL LICENSE #:2. -- BUILDING --- -------- Breakers Ducts Insl. Compressor Final Tp,Se .-_. Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Ftr. Pre SLB Lintel FRM. Insul.CL WL Driveway Reinspectlons: 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. y /. ~ I. ~ ?rY'-V7~1 . . . VJ..\.oJ .u.~~"~- _.~O-- Signature/\ 4A _ / ****~***************************~********* Signature Company State Cert. or Regist. n City License Registration n PTHER APPLICATION APPROVED BY ~~;;~~*~~:.~:;::.*~.**'*"'+..*" PERtlIT OFFICER. ~ r.'9~4~;)' I.t)' ir"~-~'ii~;--'-""""" .. ; ~,>" .~ _\~ :)tt~' 1 !I,';;' l .;:;:Wo ~', ~ 'Y '"'~:,.. )" '(IGn..t" . ,j l ' _M'_.._..'~'_ ~:~~: ~:~~,~_.~~~ d\,,., '. ~~,.. :.'~~ -.~.~~...,.,. .~ f":..(~" ., J ; j" ~" I \ ";;'1' ,V': atr"~,. ,"'. .'~""----,-:!."4"'-"""""""""'4~_,.~.;;;_.~._,......_.. ......-_..:....~~..J:.~~l____..A.-: ,_...."--. ., .~:"'':''-, -.. .., CONDITIONS~OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The ,undersigned understands that this perlit lay bl subject to "deed restricti~ns' which ~ay be D~re res~r,ictive ~han City regulations. The undersigned nsules responsibilitf:for,colpliance with any applicable deed restrictions. ',1.1'- " ' . ", I, B. UNLICENSED CONTRACTORS AND CONT~ACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake wor~, 'they.ay be required to be licensed in accordance with state and local regulations. lf the contractor is not licensed as required by law, both the ~wner and contractor ~ay be cited for a eisde.eanor violation under state laK.: If the owner ~r intended contractor are uncertain as to what licensing requirelents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 7BB-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 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 provi'ded Kith a copy of "Florida's Construction lien Law - HOleowner's Protection Guide" prepared by the FI~rida Departlent of Agriculture and Consumer Affairs. If the applicant is soeec.ne other than the "owner", I certify that I have c,btained a, copy of the above described dC'CUllent and prc,~,i5t> in ge,od fai th to del iver it to the 'owner' prior to cOllencelent. ; : \, -: _~.:~. I., \ ; .' 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 Kith all applicable laws regulating construction, zoning, and land development. Application is hereby lade to obtain a perlit to'dD work and install~tion as indicated. I certify that no work or installation has cOlmenced prior to issuance of a perlit and that all work will be performed to ~e~t standards of all laws regulating construction, City cod~s, zoning regulations, and land development regulations in the jurisdiction. I also ",'i'y "., 1 .,d"".,d ,h., ", ",.1.,;", ., .'h,' ,."".",.1 "",i" "Y .,ply ,. ;h' ;,I"d,d ,.,k, .,d 'h., ;, ;, .y ,osp"" i bi I it Y " ; don Ii' Y ,h.' "Ii on, I ",' hk, " b' i, mp Ii "',. S"" .""".. i ,," 0" b,,' '" ,,,' Ii. it,' ,,, . ".r I Departlent of Environmental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive lands, Water/Wastewater Treatment I Southwest Florida Hater. ManaQement District - Hells; Cypress Bayheads, Hetland ~reas, Altering Watercourses I ArlY Corps ,of EnQineHs - Seal1alls, Docks, Navigable Haterways . D,p,,"'" " H,.I'h , ",.bili,.'i" S",;"" E,vi""",.1 ".I'h U,i' - "",, ,."".", ",;1"", S'pli' ,.,k' I US EnvironDental ProtEction AQenct - Asbestos abatement I also certify that, if fill laterial is to be used in Hc.od Zc,ne "A" or "~,etC.", it is underst(,(.d lIdt a drainage plan .dd""i" . ','.p",.I;" ,,10'" ,ill b, ,ob.i",d ,hi,h i, p"p."d by . ",'"'i,,.1 ,.,i.", ",;".", " 'h' S,.I, " Florida prior to permit issuance. . p"';' i"o,d ,h.11 b, ,."I,o,d " b. . Ii,.". ,. p,.,..d ,i'h 'h. ,.,k ." .,1 ., '0,.,,;1, ,. ,;,1.'" ,.".1 .11", " set aside any provisions of the technical codes, nor shall issuance of a p~rmit pr~vent the Building Official frol thereafter ",oi d', . "",01' on " """ " P""; "",,,,tlon, " ,i,l. Ii... " "Y "". E"', p",it i "',,' ,l..l1 b"''' i '" Ii d unless the work\authorized by such permit is cOllenced within six months of issuance, or if \'Ie,rk aulhe" l,ed bi the per.it is ,"p,,',d ., .b."."d ,., . p"i.d " ,1. ..,'h, ."" Ih, ,i., ,., ",k i, "".",d. 0...' d., ,.l.";'" " ';", ..y b, allowed for the per~it l1ith fee charge of $15.00. The extension shall be requestt>d in writing to the Building Official. An approved inspectie.n i!lust be le.gged during each six month period, or the prc,j!:'cl \'Ii 11 be c(,nsidered ilb61Ide,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 OBTAI~ FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMM~CEMENTlI' SIGNATURE)!. f) ___~~7!C;;~------ SIGNATUR~_ ------- ~~-.fi!.----- ~WNER OR AGENT CON RACTOR DATE ____7J.~-:..-~-D.-.:J-.!.f:l.~'------,---~--- DATE :[)-Lc., 30 /99/ -----------------~---------------- ~~~~:Y B~S A~~NT __~--:t..---d~ MY COMMISSION EXPIRES______________________ NOTARY AS TO ;;;;f --d CONTRACTOR_~ ----:...----~-~- , "' -----y- MY COMMISSION EXPIRES__________________ ornc:IaI seal "" L'" Notary PullIc, StIlI afFlarlda My ccmm.llqIIfII 0llL I.'. comm. No. CC1" ~ --.:>>...-..0 . . _'1""_--- ........-...<<-. -... , ...... 'rupuaul Page No. of P.ages of'O~'!I'P!',("o ""t""(',~, fl"~ ADDI ." NC":"~ ,~ . 'ti:: '.. '. .... ;..Jt""'~'":J'vi:!i II .. Ib-li!'",i .....v, 3399 South Highway 301 DAD:: CITY. FLORiDA 33525 (904) 567-6224 INC. PROPOSAL SUBMJTTEO TO PHONE r-7N? / /'; ...........- STRE JOB NAME ---I '/ , J .-..-.. j, .' . ?~,:~>t:.r JOB LOCATION CITY, ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estiJTIates for: / // ~'r // .... /d:/, / 1-:,-: /t/4/7'--.--' ..<a1-/t-LJ~~ .~~5t-'i~fi}~ ..r.-y' '. / ' '?~ / ' /./ //,1 () ')'/\ V / c) v .Ii !/I,--LI c'~? ;..1/ , Y I c-, /1'1 r..- ~"'1 r. Ii./' .) ,:< I, v I,. , /; - ;1 l 7- ~rtA- 7~~ ., /- ') ~ ~ '.]i.."".!:!.; . .,' "'::../ -.- .- I .' (I /1jA I'.! /r -,#. /.'/ / A/~/ t/l/ ./ i . /) )~ // 1/___ ,/(1. " // >>d. . , / // I :.-/' / /-;2/'10 I 0- /....--'6/ / (.l c) / LI r) q:.O / I 1\.1 i J </'11 .-11 I' ..-. ~/7 , o rY y , '-) j /- t I~-'- H __ PI- I ( :, (.( '1 .' , I L/ / ...I 4 /'1 -_./ ... C' ~ ;, 1 ' I ," ,..~ ,.,~ -," f/ .z:1 '. J. _".; ~~'-"'A...'1o .., mr JropO.!ir hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: Payment to be made as follows: dollars ($ ). ,/ All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifica. tions inVOlving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. 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. , / // Authorized;' ----f/~ S+gnat~-;--:::/-" , ./" // Note: thiS p(:pp. sal may be withdrawn by us if not accepted within days, Atttplautt nf Jrnpnsul- The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above, Signature Date of Acceptance: Signatur: PROOUClI18-3 INEB5/~lnc, Groton. Mass. 01471. ToOrcler PHONE TOLL FRE{1i-800-225-6380 APPL'ICAT'ION FOR PERI-lIT CITY OF ZEPIITRHILLS BUILDING DEPARTHENT APPLICANTa~~ ~ ~~ '7J!~. ADDRESS l/' - - ~ ,- Jf:2.. : , ,,; ,\,.' ',_;J,;z. PHONE OWNER ~~ ~ ~ JOB LOCATION r- 20 / --~.-' "J...z- ~ sIzf 7r?.:z. -<?~ ~Ci , " x AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL Ln.il ~!.. · ~/~1>-~ ,~ WORK PROPOSED:____New construction~ Addition ____Alteration ____Repair ---- nstall _Sign/Temp. _Sign ____Hove ____Demolish PROPOSED USE: ~Single Family _M/F ____iF of Llni ts ,._H/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 FORl'lS.** **COPY OF CONTRACT REQUIRED. ~ERMTTS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL V- MECHANICAL AMP Service' Florida Power Corp. _"".R.E.C. $ 2/~!J1 Db 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 0 *************************** BUILDER Signature Signature Company -eA' ~ State Cert. or egist. 0 , City License Re,istration 4F 'Jff ****************************************** ELECTRTCTAN PLUMBER Company State Cert. or Regist. 0 Signature City License Registration 4! , ***********~********,****~'*~**; -:dddd'**~'.&f"~-:' . M' .i . . MECHANICA~ ," Company '~ ~t ' .. Signa turex.J:'4 .J? flM1~ J, . ~~~~\~~~~~e o~e~iS ~;~ ~ i~n i~ i r " . **~************************************ OTHER Company State Cert. or Regist. 0 City License Registration 1 Signature APPLICATION APPROVED BY ~Z:*********~************************* G1411- - J.AA'\~, ' PERt-lIT OFFICER. ':~' '."' ....' .,... .-.. .,..""'"....----... : ,tIn'''!' iIII:\) c.:'.'!m'j--'''' ; ,~" '~ .!.. . JC(~' 1~.i,' l '~:j~=;~~~m f'': l '":~~'!y J"~" ~ :. - f -..........;.---.,..,..- "'''--';- .......,..,........,..,.6\......... .......... ", .~'-,._.,."_ ',..~~.'._.'. I (~' \. J:~ .'" ~...~-..MIII.....""'-.;~4 -Ut"~t, .' , .......-...._~..,"" .:;~t: CONDITIONS;OF,PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . Th..,.."I".d .,d."I.,., Ih.1 'hi' ,.,.1' .., b. ,.b\'" I, 'd,.d ,.",\.1'",' ,hl,h ..y b, "" ,.",1"'" 'h" C"y ",.hU"" Th. "dm I,,,. ",.m ,""'''''! ;I\".~"" .", ""CO ,I th "y ." II cob!, ,,,' ",'d. "",. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If Ih. ."., h.' hi'.' . .""..1., ., ,.",..,." ,. .nd"I." ",I. 'Ih.y..y b' ",."" ,. b' I'.'n'" In ...,,'.n" ,"h ,1.\. .,d 1.,.1 ,.,.I.I\.n.. If 'h. ,.n""'" I, n.l 11,.",d .. ,.,.\"d by I.,. b,'h Ih' ..", ." ..n""'" "y b. ,I,.d f., . .i......n.' ,1.\.I'.n .,d., .1.1. I..., If Ih' ."" " Inl.,d,d .",...1., ." ".,,'.'n .. ,. ,h.1 11",.1', ,."i,..,nl. "y .,,1y f.' 'h, \nl,nd.d "". Ih., .,. .d,i..' ,. ""..1 \h, C,\y ,f ",hy,hlll. ,.'Id", D".,\.,,'. ""I 788-6611. ' , ' F.,lh.,..,.. if 'h. ."" h., h\"d . ,.",..1" ., ,.,1,..1"'. h, I, .d,I,,' .. h." 'h' .,..,.""", 'I,. ,.,'1." ,f 'h, 'C.,.,..l., $,.'i..,' .f 'hi' ."li..li.. f.' .hl,h lh" .111 b, ""."Ibl,. If "'. ., 'h' "'" ,i" ., 'h, ,""""', ,.. ." I,di,.'i', \h.1 "'. ,.Ih" Ih.n lh, ,..1,.'1". ." "",.,ibl' f,' Ih, .,,1. If ih, ",1'.,\" ."h" ". " ,i,. ., ,..1,.,1., 'h.1 .., h, .. i,di,.II,. \h.1 h, i, .,1 "",'1, II""" ..d I, .,\ "li\l,d I, ",.'lli., "i,'I'", i, \h. City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713? FLORIDA STATUTES, AS AMENDED) I ",Iif, Ih.\ I, \h, ."li,..I, h." b'" ".,id.d .ilh . ,." ,f 'FI"id.', C.."",\I'. II" I" - ",.,.,.,,', P"I.,'i" ..Id.' "".". b, Ih' FI"i" D.,.,I..., ,f A"I,.II." ..d C,.,.." Aff.I". If 'h, ."1".,, " ".",. .'h" .h., .h. ,...,,', I ",'if, \h.1 1 h." ,b,.i.,d . "" .f lh, .b.v, d""ib,d d"."" .nd ,.",., " ,." f.l.h " .,11'" I' " 'h' 'owner" prior to cOI~encement. ~ \. ':~.~~. I" \ : :' E. CONTRACTOR'S/OWNER'S AFFIDAVIT I ",lif, Ih.\ .11 Ih' i,f"..li,. i, lhi' .,p\i,.II,. i, .".,.1. ..d Ih.1 ,II ",k ,ill b' d'" " ".,li.." .'Ih .11 applicable laws regulating construction, zoning, and land development. A"li,.li'. i, h."b, ..d, I' ,bl.i. . ",.il I~' d' ..,t ..d i.,I.ll,\i,. "i,d".I.d. I ",I'fj Ih.1 .' ",I .r i",.\I.li.. h., "..,."d "i,' I' i,""" .f . ,.,.il .., Ih,l .Jl .", ,ill b, ",r.",. I' ."t ,..,..,d' ,f .11 I." "g.I.I'.g ,..",.,1;". CII, "d". ".i., ,'gul.l;"', ,.d I... d",I".,,1 "g.I.."" i' 'h. j",,'i,I',.. I .1,. ",Iif, Ih.\ 1 .,d",I.,d 'h.1 Ih, ",ul.1i'" ,f ,Ih.' g.",..,.I.l .".,i" ,.j .p,ly " th' "',,d,d "", .,. Ih.' ,I is ., m,m \bit it, I' id.. Ii f, .h. I "Ii 'IS I ",I la', I. b, i. m, \I '"co. 5.. h .g""'" "el ,', b,,' '" ..., II. it,d ,,, ... . D".,\.,~l ,f E,v,,;..,.I.1 R",\.li.. - e,p,;" B.,h..." "'II'.. A"" "d Env",.."I.!ly s""tj" 1"d5, Hat~r/Ha5tewater Treatment f Southwest Florida Hater'ManaQe!ent District - Wells; Cypress Bayheads, Wetland Areas, Altering Hatercourses I ArlY Corps ~f Enqineers - Seawalls, Docks, Navigabl~ ~aterways . D, .,1.,,1 ,f ""Ith h R,h.bilil.li,' $",i," E,v;"..,.I.1 ",.llh O,il - ",11'. ",t".t,. 1".1.,,\. S,,'" T.'" I US EnvironBental Protection Aqenc~ - Asbestos abatement I .Iso ",I ify th.l. if f\ 11 ..1,d.1 i' to b' ."d i. m,d "~no 'A' " 'R,'I'.'. It i' "dm I"d II", · d'" .." ,I '" .dd""i., . ',..".,."" "I..,' ,ill b' ,.b.ill" .hi,h i' ".",'d b, . ,.,r"s;".1 '""0'" "glsl."d " Ih, 5'." .f Florida prior to permit issuance. A ",.il ;".,. ,h.ll b, ,.nsl,.,d I, b' . Ii"." I' """d .ilh Ih' ..,t "d ",. ., ..'h"'" t, ",I,t,. ,.",1 .11". " "t .,id, ." ""i"'" of Ih, t"h.i,.l """ ." ,h.l1 i,""" ,f , ",.1' """. 'h, ','Id", orr",.' r,'" 'h",.I'" .."i,I" . "",,11" ,f ",m ,. ,I,",; co"l," Ii" , " v',I,Ii." 01 "y ",d,. E,oc, '''' It ,,,",' ,h.ll b"'" ',YO \I d "I", th, '" ,. ,,,Ih,d zo' b, ,",h pm it " "....cod .ith i, ,i. ".th' ,f '''"'"''. " If .co' l '" 1I, '" · "d b, th, '''' it i, """d,d " ....d."d f" . "",. ,f ,i. ...Ih, .fl,' Ih' I'.' Ih' ",' """,."d. D., " do, ..",.,," ,f 'i.', .., b' .Il",d f', 'h' ,.,.il ,ilh f,' ,h.", ,I 115.0D. Th' ,.I",i.. ,h.ll b, "q",',d ,. ,."", " 'h. "il"', Dfr',I.I. A' .".."d i ",,, l\" '"' t b, l,gg,d d.d', ",h ,i. mlh "d.d. "' Ih' pc<' j ,ct ,111 .. ""Id .co' ,b .","'". 0 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 NOT NEED T~ RECORD AND POST A "NOTICE OF COMM~CEMENT'" SIGNATUR~ f) ___~:-7LW~------ SIGNATURf/L ------- ~.1!-./!!----- ~WiNER OR AGENT CON RACTOR DATE ____ Ci1.d:&____~-l!...:J_J.l.J:.~------,---:..--- DATE J).L-C, 3D J 9 q / -----------------~---------------- ~~~~~y o~S A~~NT Jk>_?-_;{"-_d~ MY COMMISSION EXPIRES______________________ NOTARY AS TO ;;i! -..d CONTRACTOR_~ ----:...----~-~- , " -----y- MY COMMISSION EXPIRES__________________ orIIdlll SeI1l AII'f L'" NOtary PuIIIIC, 81* arFllltda My comm..... Oct." 1. eomm.No.~ ~ ~....... . _l'l1lO---- ......-....... -.... , ........'