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Home My WebLink About91-2016 STATE OF FLORIDA City of Zephyrhills Type of Permit 2<::5 . o-D ~LE;'RI~ PASCO COUNTY BUILDING DEPARTMENT 1-813- 788.6611 JO~cri) ~UMBI~ Permit N\' 20169 Date----LB.~~/-? / ME~ ::~:::r~:~er;;;~~ ~~J5"K~ Legal Description: Sub.Div. Lot Blk. Zoning CI: ~ftvo~52~~~~ o~ ~ f,'-' A -<!.-~ .-: ~ - /0.- Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application OCCUPATIONAL LICENSE Ii ~7 Fee: ~~ ~ SlGNA,URE '~O- ---0 COMPANY ADDRESS TELEPHONE # Estimated Cost: ~ ~ --5 ~ . cr-o All work shal! be performed in accordance with the above and all City Codes and Ordinances. ING SLB Tub Set Water 1-"- '1 'Z- Sewer Final p. ." Rough In /-' ~crL Meter Can Const. Pole Pool Pre-Meter Final ME~ICAL ~ Ftr. Pre SLB Lintel FRM. Insul.CL WL Breakers Ducts Insl. Compressor Final Driveway Reinspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of tcn ($10.00) dollars shall bc 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 APPLICANT 5'~ f);' 0/ f:' r. ,-1:" ~ t}~ ~ ? 'il V (I/o( G AI ~ J .. OWNER 'fh=A/ II" " JOB LOC~TION I Ih ~ /).. A + U LEGAL DESCRIPTION: LOT(S) PHONE ADDRESS LOT SIZE_X AREA SQ.FT. BLOCK SUBDIVISION PARCEL 1. D. 4F WORK PROPOSED:____New Construction ~tion ----Alteration ____Repair _Install ____Sign/Temp. _Sign ____Move _Demolish PROPOSED USE: ____Single Family _M/F ____4F of Uni ts __M/H ____Commercial _Indust. ____Swim. Pool Other BUILDING SIZE: ____Restaurant & Health Department Approval ) S .R 1I. ~ "t:.s Square Feet, x 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 30 AMP Service Valuation of Total Construction ~da Power Corp. _W.R.E.C. _BUILDING ~RICAL $ ~ECHANICAL ~NG $ Valuation of Mechanical Installation 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 ELECTRT CI AN CCif If J~ ~d" _ E.-I € & . Company ct ..r1~ State Cert. or Regist. 4F Signature ~... L ___ - .../ City License Registration IF ****., **************************1,***** 1,** * PLUMBER r..PI ij rJ"Rd 19.A.1 E-/E t!.--~ Company t1~ f\ ~ State Cert. or Regist. iF Signature L -~ .... - . -z.../ J..... J City License Registration 4F *** ************************************* ...38'" a? Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. iF City License Registration 4F OTHER Signature APPLICATION APPROVED BY l ," : <dJ~~..~~I.c), P01;) f f 'to .. . '.' . '. , ************~************************** 7( AAUfa O/}~ :~' : PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands ~~at this per.it lay be subject to "deed restrictions" which may be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. " - B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake work, they may be required to be licensed in acc,of~ance 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 misdeleanor 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 ZephyrhillslBuilding Department, (813) 788-6611. 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 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 docuient and phomise in good faith to deliver it to the "owner" prior to cOlmencement. 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 made to obtain a permit to do work and installation as indicated. I certify that no work or installation has cOlmenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, City codes, 10ning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies may apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in ct.mpliance. Such agencies include bill ~il? lwt lillited to: I Department of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive ldnds, Water/Wastewater Treatment I Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Department of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatment. 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 tbat a dlainage plan addressing a "compensating voluie" will be submitted which is prepared by a professional engineer reqistciud 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 vioiate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Offieid] from thereafter requiring a correction c,f errors in plans, constructic.n, or violations of any cone. EveT'f pt>rllllt iS91tl!d' ;hall bece,le invalid unless the work authorized by such permit is commenced within six months of issuance, or ,if wOlk authol lzed by the per.it is suspended or abandoned for a period of six lonths after the tile the work i~ commenced. One 90 day 'e;tenSI~lI of tile, may be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An J approved inspection lust be logged during each six month period, or the,project will be con~idered dbdlldoned. 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 A1TO~NEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE SIGNATURE , 7' --.----- CONTRACTOR L; DATE_~c?A~~f(_-___---------------, /J ~~~=~~~_d~/ MY COMMISSION .-r1RGlW State d Florida My Comm. Exp. Sept 12. 1993 ---------------------------------- OWNER OR AGENT DATE --------------------------------------- NOTARY AS TO OWNER OR AGENT ----------------------------- MY COMMISSION EXPIRES______________________