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Home My WebLink About92-2018 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 cJ..S: tr[) Type of Permit BUILDING PL~ Property Owners Name:t ....1'4 Job Address: \..~ ? - Legal Description: Sub.Div. Zoning CI: II -~ -:.::; Description of Work r : o 0/ ~ - r~g Permit Nt.:' 201813 Date..1' - .l -- 9/ ME~AL Lot Blk. O/3'oo-tt~/o ~ ..d~A ~..vz /vr~ \ \ /H j13 Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: / tn:nJ - em / All work shal! be performed in accordance with the above and all City Codes and Ordinances. OCCUPATIONAL LICENSE /I Fee: :ti(/j rat I SIGN"TUR .. . . __." tltl _j COMPANY ADDRESS TELEPHONE /I C;:I~ Ftr. Pre SLB Lintel FRM. Insul.CL WL ~BING ------- > SLB Tub Set Water Sewer Final Driveway E~L ~ ~NICAL ~ Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final Reinspections: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten <$10.(0) 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 APPLICANT K e II V 'J ;vJ ,I} LA 12 (r: Y ADDRESS 5 ~ 31 ~TtI 3/ zzttIYl..H-I/L5 3.35''/GPHONE OWNER KE/I'! T A/tUt!-KcY . , JOB LOCATION $'6 -3 ( gTIf <1/ 2~fHYIII'/I!oT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK- SUBDIVISION PARCEL I.D.# Ji-l(o.-21 OD{O - 0/300- otic) WORK PROPOSED:____New Construction ____Addition ~teration ____Repair ____Install ____Sign/Temp. _Sign _Move ____Demolish PROPOSED USE: ____Single Family _M/F ____4~ of Units _____M/ H _Commercial _Indust. ____Swim. Pool Other _Restaurant & Health Department Approval 11/ '1. J-I BUILDING SIZE: 7 / X~O .3 ~ I {'D Square Fee t, 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 CONTR~CT REQUIRED. ~UILDING PERMITS REOUESTED $ /j CJ?rlJ ~ cr'D Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.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 # *********************~******************** BUILDER Signature ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Si2nature Company State Cert. or Regist. # City License Registration # ******************~*********************** PLUMBER Signature Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL OTHER ~ Company State Cert. or Regist. # City License Registration # Signature APPLICATION APPROVED BY ~********~************************** ~ O/l~ PERMIT OFFICER. .... CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands ~hat this per.it .ay be subject to "deed restrictions" which may be more 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 or contractors to undertake work, they .ay 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 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 Zephyrhills Building Department, (813l 788-6611. 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 lay 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 - Homeowner's Protection Guide" prepared by the Florida Depart.ent of, Agriculture and Consumer 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 cO.lencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land develop.ent. Application is hereby ,ade to obtain a pertit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit 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 may apply to the intended work, and that it is 'Y responsibility to identify what actions I lust take to be in compliance. Such agencies include bllt ~il? iiO~ liitited to: I Deparhent of Environ.ental ReQuhtion - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Ldnd.., Water/Wastewater Treatlent t Southwest Florida Water HanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Depart.ent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~ent. Septic Tanks I US Environ.ental Protection AQency - Asbe~tos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" Dr "A,etc.', it is understood that a d,ainage plan addressing a "colpensating volule" will be sublitted which is prepared by a professional engineer reqist2iud in the State of Florida prior to per.it issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to yioj~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Ufficial from thereafter requiring a correction of errors in plans, construction, Dr violations of any code. EvelY permit issu~d ~hall become invalid unless the work authorized by such penit is cneenced within six months of issuance, [II if work auth{lllZed by the perMit is suspended or abandoned for a period of six lonths after the time the work is commenced. One 90 day e~tf~~IOII 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 approved inspection lust be logged during each six month period, Dr the project will be considered ~ba~~oned. 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 TD OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A1TORNEY BEFORE RECORDING YOUR NOTICE OF CDMMENCEMENT. J08S UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND PO if A "NOTICE OF COMMENCEMENT". 4 SIGNATURE_~~'_~~ ~J- ______ SIGNATURE__~~ ~~- --- ----- ~~R\JR AGENT ~~ACTOR DATE___j:~~Jf~_--_-___-__-__-_-------_-_- DATE____l~~~5[~______________________ MY COMMISSION EXPIRES_~~_______________ NOTARY AS TO /,~f I .LJJ~ OWNER OR AGENT __~~-~~~~~=~:::-.- MY COMMISSION EXPIRES____~~~~~~~~!~~~_ NOTARY AS TO LI - f /7 CONTRACTOR~~__~~_ , .- - - - - ----------.....--, 5(,' 'I" I J I I I J , I , , , I , J \ , \ \ 1 '--- -- fRlJ ff):5lJJ ~ ,('t'l ~ I f~.';ftC Y (€'NCC -_.....--~~ E}l.~ -r,;)t, (.~ J'1' :5" J), I e'l ~ ) ~ J()~ 7' ,/1 J:/~'tJ <. - n. 15 -r,.} (. t ~/ fioh Pt'c>pw-""'i (.....INK. . ff..~ fo.s e 10 /3/)' L D foRctl t (,' ~ ft. 1/) Ii L Y (E,.) C. C J"O E 1<- l~ -r,iJ I: {)&J ~ 11/1)6 ' i