HomeMy WebLinkAbout91-2014
STATE OF FLORIDA
City of Zephyrhills
PASCO COUNTY
BUILDING DEPARTMENT
1-813-788-6611
Permit N~
2014,e
Type of Permit
B~~TRI-;:L"~P~ ME~
:::P:~:r~:~erSName:Y~bni~ ~~~rq~~)
Legal Description: Sub.Div, Lot Blk.
Date_l~ -c.?/-7/
Zoning CI: ~
Description of Work.. ~ "",:" J2. u - ~'rf6 0 .
Energy Code Readout:
~~2-
/,,1
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
~A-
Fee: dO ~ o-V ,
~ / .
SIGNATURE ,/~t..7-'
COMPANY
ADDRESS
TELEPHONE #
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances.
OCCUPATIONAL LICENSE # q
P
SLB
Tub Set
Water
Sewer
Final
c::--
BUILDING-----
Tp, e .
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
M~NICAL
~
Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
Breakers
Ducts Insl.
Compressor
Final
Driveway
Reinspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten (SIO.OO)
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.
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APPLICATION FOR PERMIT
CITY OF ZEPHYRlIILLS
BUILDING DEPM\nlENT
..
\npLICANT
PItONE,51-3 '-.232.. -- ,27(1
"
r)h'NER
LOT SIZE_X
AREA SQ. FT.
LSGAL DESCRIPTION: LOT(S)
BLOCK
SU13DIVISION
~',\RCEL LD.tl
_SiGn/Temp.
_Addition
~Sign
/~teration
_Repair
_Install
',,'ORK PROPOSED :____Ne\,) Cons truc t.ion
_~Iove
_Demolish
i'ROPOSED USE: ____Single Family
~mmcrciill
_H/F
_tl of Uni ts
.__H/H
_Indust.
_Swim. Pool
Other
_RCSU:l\n'~\n(: [, llc;llth Department Approval
EUILDING SIZE:
~\_,
Square Feet,
Height
RESIDENTIAL:
SOmlERCIAL :
ATTACH (2) PLOT PLANS [, (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) Sr::TS OF nUILDING PLANS & (1) SET ENERGY FORNS.*'"
**COPY OF CmHRACT REQUIRED.
ElillIT:L.REQUESTED
__BUILDING
L/fLECTRICAL
# "7 '
S ?/Jl./y //(l)
, / .
{C
o Valuation of Total Construction
MIP Service
v Florida Power Corp.
_W.R.E.C.
_MECHANICAL
s
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOfING
SPECIATuTY
TYPE OF CONSTRUCTION: _Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
**~**1ru**************~*~******************
Signature
~~~R SECTION
Company
State Cert. or Regist. ff
City License Registration U
~****************TI***************~******~*
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E1.ECTRICIAN la-a<..2 ~.Lcc/Z::<-~ CompilI1Y 1>['.( it..<:. c0-c-7~~
__ / State Cert. or Eegist. II
//l'7 (?i-:Yt City License Registration ;',!
f f .;I .f: 1.; * 01: +. ..'c *"* -!c* ** ** * * * '*"* -.or..... 1: -k-!r...'t **** '1't* '1':-!: 'I': o{: * *,':-;': ** *
n1JIT.DER
<v
//
Signature
signature
Company
State Cert. or Regist. ~
City License Registration II
*-!r*****************~**********************
PLUMBER
Signa ture
Company
State Cert. or Regist. 11
City License Registration 0
*********************~********************
i'lECHANICAL
'.
Signature
Company
State Cert. or Regist. 0
City License Registration lj
0THER
APPLICA nON APPROVED BY ::37;:;:;; ~~~' :;~:;: ~.~. w, *w**'..
PEIU-tIT OFFICER.
COt'-JDITIONS OF, PEnr1JT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
-
lhe ,undersigned understands that this permit may be subject to 'deed restrictions" which $ay be lore restrJetivI than City
regulations. The unders\~ned assumes responslblllty:for, co~pllance with any applicable deed restrictions,
",' . . ,
E. UN ICENSED CONTRACTORS AND CONTRACTOR RESPONS BILITIES
If the own~r has hired a contractor or contractors to undertake Hork, 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 ~ay be
cited for a lisdeneanor violation under state law.: If the owner Dr intended contractor are uncertain as to what licensing
require.ents lay apply for the intended Hork, they are advised to contact the City of Zephyrhills Building Depart.ent, (813)
7B8-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is} sign portions of the
'Contractor Sections' of this application for which they will be responsible. If you, as the owner sign IS 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 oay be an indication that he is not properly licensed and is not entitled to pertitting privileges in the
City of Zephyrhllls.
C. TRANSPORTAT LQ!~_I MPACT FEES AND tIT I L I TY CONNECT I ON FEES
D.
CONSTRUCTION LIEN LAW
<CHAPTER 713~ FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been prov(dcd with a copy of 'Florida's C~nstructlon Lien Law - HOleowner's Protection
Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is sOle6ne other than the
'owner", I certify that I have ~btaincd a c~py of the abOVe described docu~cnt and promise In good faith to deliver it to the
'owner" prior to cDI~cnce~cnt.
:'.:'::.', I'
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforffiati~n In this application is accurate and that all "ork will be done In cOlpliance with all
applicable laws regulating c~nstructlon, z~ning, and land dcvelopDent.
Application is hereby ~ade to obtain a permit to'do work and install~tlon as indicated. I certify that no work or
installation has co~"enced prior to issuance of a perllt and that all work will be performed to leet standards of all laws
regulating construction, City codes, zoning regulations, an~ land development regulations In the jurisdiction. I also
",lily Ih.1 I .nd.rst.,d th.t th, r'g."t".s ,I ,th,r g"".".i., "l,n,i,s n'Y .p~ly-I' th' ini,nd,d ,.rt, .nd Ih.1 il is
'Y r's~..si'ilily ,. ",.t"y .h,t .,t"'s I "5' t.., I. ., ,. ,..~Ii..". S.,h .g..,"s ",I.d, .., ., ..i li.i'" ,.,
~ '
I Deparhe~,t elf Envir;n~ental re~11ation - Cypress Bayheads, \l~tland Areas and EnvirC<M,entally Sensi \jve lands,
Water/WasteHater lreatment
I Se.uthwest Florida Water l',anaile~,ent District - Wells,' Cypress Bayheads, Hetland Areas, Altering Haterc!lurses
I ArlY Corps ~f Enqineers - SeaHa\ls, DDcks, Navigable WaterNays
. ~,."I"r,' ,I ".. I" t "'h,h" ".n" Smi ros. EO" ron.",.1 ""I \h U.it - 1\.11 5, ~",,,,i" T ".1..,\. S'p Ii, 10.15
I US Environ~ental Protection nqencl - Asbestos abatement
I also certify that, if fill material is to be used In Flbod Zone "A" or "R,etc.", it is understood that a drainage plan
.dd"ssi'g . '".p..s.l'.g ..10'" .\1' ., s.b"t',' ..,.. ,. ,r,p.." b, , pr.I,.s"..l ,.g"'" "gist..,d i. ,., S,.i' ,I
Florida prior to per~it i5~uance.
",r.ii iss.,d 5.,11 b. ...,t".. ,. b. , I"'." ,. p."'" ."h ,., "., .., ..t .. ..th..,l, t. ,i,l.t" ,..,,1 .It,r, ..
.,t .si" "Y ""'s,.,. .1 Ih. t",.\,.1 """ .., 5.,11 "5"'" ., . ".,,1 p',"" 'h, ,.,I.i.g O"i,i.l ".. ,.".."..
",.'ring . """ti... ,., .""os ,. pi,,,; ""'mil,,, ... "..I.Il"S " "y "d.. 'my .".11 155"" ,..'1 bm" i".ti.
..1m I" IOrl '" th..., ,,' by ""h ,,,,II '5 co","" ,it'" 5" ,,,ths ., 's,,"'co, " if ",' """... ,,' by I" .or. II is
"..on',' or ...""", I.... . .or',' ..1 s ,. ..nths '''or ", ti" th, ..rl is ",,"CO,. ,.,,, .., ,,1m 1." ,I ti", '" b.
.1I...d for i" pmit .ith lee ,h"" ,I '15.00. ]h, "tens'on ...11 b' ",...t,' \. "lIi.g " th, '.ildi.g Offi"'J. "
approved inspecti{,n rJust be Ic,~~ed d\1rin~ each si~ lIIonth perio~, (Ir the pr(,jed liill be nnsidered aboll,d(.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, CONSUL"r WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECOFD AND POST A "NOTICE OF COMMENCEMENT".
NOTARY AS TO
OWNER OR AGENT
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SIGNATURE_~~~~~~~3C-------------
?JNTRAgJ'OR
DATE L'.z_=_~?J-f' 1- - - - ---.-- -- - - - - -- - - ----
~g~~:~C~~R~~_~~-l~~~-
MY' CClMMISSION EXPIRES___6:-:-~3--=-Z::1-::
SIGNATURE__________________________________
mn'1[R OR AGENT
DATE
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MY COMMISSION EXPInES______________________
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