HomeMy WebLinkAbout94-4536
CITY OF ZEPHYRHILLS
(813) 788-6611
97--.S~ ;l6.~ /;)O.~ '
Gj c-E[;~;~) CPLUMBIN~
Pmp'~v OW""U~:m::~
Job Address: 6..::i..-<-1 _______./L
Parcell.D. # 3-,,:} (p --d.-/ - O/..2A - 0 LJD c9 0 -.... 1/7 4-
BUILDING PERMIT
Permit N~
4536/J
/ fJ - / ;J.." -1~-
Date
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: ~ Energy Code: Radon Gas:
DescriptionofWork~ fI~/h. / ~
~:L/!J:1$;g
NO OCCUPANCY BEFORE C.O.- __IJ _:s'~.&~
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL J-fDIJ-
DATE
c.o.
DATE
Inspector
City License Registration #
State Certified License#
sv
P.,ml' F.~ f.:
Signature ~ ~J..i .-11
Company -
Address
Tel<<:Phone#lf/) J cf64 c:2.5e'3
Valuation or
Contract Price
9 0 /5-: OD
,
(g~~ IMk
BUILDING
M~~~
ELECTRICAL J,6-~
a~',p~
PLUMBING -.::SY:
MECHANICAL
SLB 12~l~-q~ t>LLi
Tub Set
Water
Sewer
Final
:~s~/5~
Lintel
FRM.
Insul. CL
WL
Driveway
~'~;tg-q'-t fXJQ
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
~1,5--'3~ ~
Breakers
Ducts Insl.
Compressor
Final
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
~
~PC ZEPH YILLS OPS [TR TE~:813-
. Florida
;. .: Power
~7 ...........
. ...
Nov 15'94 '10:36 No.OO? P.Ol
~ w
,
NME
ADDRESS
C'I"!Y
(J%l-SI J fJdaw
~ 227: -::m. (,I19'l t1Ybttr 1)1{ .
~#YV#aJ
.
~ POOL PROPOSED FOR CONSTRUcnON AT THE ABOVE ADDRESS DOES NOT
CONFLIcr \\lITH ANY UN'DERGROUND OR OVERHEAD F ACIUTIES OF FLORIDA
POWER CORPORA.TION, PROVIDED THAT THE POOL IS INSTALLED IN THE
LOCATION SHO\\IN ON mE AITACHED SITE PLA'I PROVIDED TO US BY THE POOL
CONlRACTOR.
mE PCXJL PROPOSED FOR CONSTRUCTION A TTHE ABOVEADDRES DOES CONFLlCf
V/ITH: OVERHEAD UNDERGROUND
FACIIlTIES OF FLORIDA POWER CORPORTATION.
.'
ARRANGa.1ENTS HAVE BEENM.ADE V/ITHUS FORRELOCA nON OF ruE F ACIllTIES
SO AS TO CLEAR THE POOL AREA SHOWN ON THE ATTACHED SITE PLAN.
;;;:!I;~ i();~jJ .
COST FOR RELOCATION OF E'LEClRIC FACIIlTlES WILL BE PAID BY:
OWNER
POOL CONl'RAC'I'OR
PRIOR TO RELOCATION OF FACIllTIES AND CONsmUCTION OF POOL
,
ZEPHYRHIUS OISTRJCT OFFlCE: ]sUI 5th.411'l. . Z'~i'lyrtrUfs, RotJd~ J3S~ . (.U] 7.2-U1,
A Florldtl P,gg,us CDmlHllfY
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OASISPOOLS
l~g~:.~1l1994 ....~
~~eiliJj~ ~ .. '" .,. ''''''l
t:4IMi J3t:iQNs:(@1 ~)lgg-191 V
HOME OWNER: MS. mcAlAW RESIDENCE WORK PHONE:(813)841-8448
CURRENT ADDRESS: 7231 LlTfLE ROAD, NPR, FL 34654
JOB ADDRESS: 6221 Sll..VER OAKS DRIVE,
LEGAL DESCRIPTION: IDT IT1-A Sll..VER OAKS
POWER COMPANY:
DIRECTIONS:
POOL SHAPE: ROMAN
WIDTH: 13 ·
LENGTH: 28' 48 DEPTHS:3 In' TO: S In'
TOTALAREA: 718 SQ.FT.
DECK AREA: 368
PATIO AREA: 272
SPA AREA:
II PUMP: STA-RITE 1 UP
II FILTER: CARTRIDGE
II TlLE:AT-RF 60 (MAROON) 0
II COPING:DM-l00 (WHITE) 0
II POOL DECK: KOOL DECK 0
II PATIO FINISH: KOOL DECK
POOL DESCRIPTION
II POOLUGHT: 100 WAIT
o SWIM-OUT:
AUTOMATIC POOL CLEANER
II PARTIAL BELLY-BAND
H STEP INDICATORS
H STEPS
H HAND RAIL
H LADDER
BENCH SEAT:
THERAPY JETS:
01 SPA PACKAGE
HJ. N011~3S
(3'V:>S ON) $IxY HonOl:J
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Pools, Inc,
SWIMMING POOL CONTRACT
14703 U.S. 19
Hudson, Florida 34667
(813) 869-2583 · (904) 683-9019
FAX (813) 869-3322
Date: \, / \\ jq '-'I
I
OASIS POOLS, INC. (hereinafter referred to as .Contractorj, whose address is: 14703 U.S. 19, Hudson, Florida 34667, Phone (813)
869-2583 or (904) 683-9019.
Purchaser/Owner: (~mJ. j<J\. t't\ ~ .flr ~.DM e J (~~( a.. [0"",-) Y (} 9 (hereinafter referred to as .Purchaserj,
whose current address is: 7~3/ L ,.tI&... /!..04.'d ) /y.(J.;2., I::::C- Home Phone: ( 813) 78> 2.. - / 6/ r
Job Address 6 ~ I .s;tv(( 0 G'tks hr--I Ve_ ) Work Phone: ( ~ ( 3 ) 8'7/ ,- ~ '7 r K
Legal Description: kt \ \ '7- A ~i 11J~ C)alc-s
Power Company
Purchaser hereby contracts with Contractor for the installation described herein at the price and on the terms and conditions set forth on
this contract.
Total Amount of Contract (incl. all applicable taxes) .................................$
10% Cash Deposit upon signing this agreement......................................$
Balance to be paid as follows:
30% when steel and concrete shell is in place .........................................$
30% when rough deck is in place .............................................................$
30% (or balance) upon completion ...........................................................$
<i\O IS. hO
~)cnS'. 00
~.O(}S, 00
,
3, ooS", 60
POOL DESCRIPTION (+ or -Inches)
(j) r 1'/ /
Pool Shape----\1'-~~C"' ,Length 11- ~ '1. ,Width /3 ,Pool Depths
Total Area 7 f 8 ~ ,Pool Area SS"VJt ,Deck Area 36%...6', Pool Perimeter
POOL FEATURES
V1 Pump 5k:t t,,+e.. 1- 11 f> Y1 Main Drain, Skimmer and Retums
J.--t Filter ('"r ---1~r= ( ) Automatic Pool Cleaner
~ In-Lin Chlorinato ) k1' Overflow
[ ~ Tile [ ) Autofill
Vi Coping I/'] Vacuum Kit
.l"1 Decking .v-1 Test Kit
vr Patio Finish Vi" Start-Up Chemicals
vr Pool Light V1 Instruction Booklet
Vt Partial Belly-Band V1 Fibermesh
Vi' Step Indicators [./f' Permits
vf Steps
o Ladder
V1' Hand RaU
V1 Automatic Clock Timer
..v1 Deck-O-Drain
[ ) French Drain
( ) Therapy Jets
( ) Swim Out
[ ) Bench Seat
equipment Placement.lit Pre1a~ .
o.ck Elevation ~k,l., _ _ ~ I
[ ) Pre-grade [ ) Shuttle Dig .
Additional Work ~ n) \ ~tJ..:Je.ef .S-hA -0 V t /
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[ )
[ ]
[ )
[ )
SPA PACKAGE
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Ground Elevation
Construction Access
3)f~0 sX-
, Patio Area Z 7 ?H
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[ ) Pump Deck / ,J .1
])lctf\1(\.,.) :ann ((1((/(7: hh/~ y IJh-f(~
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UNLESS OTHERWISE SPECIFIED, BUYER IS RESPONSIBLE FOR SOD AND SPRINKLER REPAIRS.
Authorized NOTE: This contract may b8-.
Signature'-- withdrawn by us if not accepte91vilhin
UYER AGREES TO ADDITIONAL TERMS ON THE REVERSE SID~,OF THIS P)>'NTRACT.
/lCC PTANCE OF CONTRACT: The - prices, spec:lficaIions, L-.-~
warranty provisions, and conditions are satisfactory and are ,J
hereby accepted, You are authorized to do the work as specified. 7
Payment wiD be mode os outlined above. " this Contre<t Is placed Purchaser/Owl} n - &, -'---,-
in the hands of an attorney for collection, we agree to pay all costs --
of collection, Including reasonable attorney's fees and costs.
Date of Acceptance:.
Purchaser/Owner
days.
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POOL ENCLOSURE AFFIDAVIT
It is understood and agreed that the OWNER will comply with the following regulations
concerning pool enclosure:
1. That immediately upon completion of pool construction, the OWNER shall:
a. Construct around the pool a four (4) foot high fence with self-
closing, self-latching gates with no openings large enough to admit
a four (4) inch sphere;
b. Construct Ii screen enclosure around the pool which is p~rmil(:ted by
the Pasco County Central Permitting Division; or
c. In the case of a portable above-ground spo, provide an impenetrable
spa- cover securely fastened over the structure when not in use.
2. That one of the enclosures described above will be compl.,'..~d prior to final
inspection of the pool.
], That the OWNER will require his/her pool contractor and screen enclosure
contractor (if applicable) to call for IJ final inspection immediately fol-
lowing the structure's completion.
4,
If the following conditions are found on the property,
presumptive evidence that the OWNER is in violation of
Standard Swimming Pool Code and Section 530.4-D of the
Development Regulations:
it shall comprise
Section 315 of the
Pasco County Land
a. More than seven (7) days have passed since all work was completed on
the pool structure, except for a final inspection, and:
(1) A fence or pool enclosure as described above is not in
place; or
(2) Work to build a fence or pool enclosure as described above
has not commenced and is proceeding in good faith; or
,
b. The pool is being used for swimming or bathing purposes without a
fence or screen enclosure as described above.
5. That a violation of Section 315 of the Standard S~imming Pool Code or Sec-
tion 530.4-0 of the Pasco County Land Development Regulations shall result
in the issuance of a "Notice of Violation" to the O\</NER by the Pasco County
Building Official and may result in a fine not to exceed $500.00 for each
day the violation exists.
6. I f the signature of the OWNER 'S AGEI'IT appears be low, the AGEI'IT promises in
good faith to make the OWNER aware of the above-described requirements and
penalties before commencing construction.
?oO 1 : c e
SWORN AND SUBSCRIBED BEFORE HE TIiIS
ILf ~ , DAY OF ~v:
@"-Ktu;t;-y ~
NOTARY BLIC ~
;!- """~""" IIAIllI2A""'" J. C.'MENI
" ':$'l'..~ mIV1WVU;1 ru
~1{.:" ':~ MVCOMMfSSIONICC342115
~; EXPIRES: JIIluIUy 13. 1981
" . IlandId 1IIu NolIry PublIc lhIIlMIItra
19f'/ ~
~""NE.B ORYGE;h-CS.~S;G. NATURE
tJlIefi. /e:cr H<;;'CI-e4.-
PLEASE TYPE OR PRINT NAME ABOVE
///0 D#!1 td M
-';t€41 A:/'ltJuJl7 ~
NJ r~
7/92
II -;l 9-. 7' 7'
/: ~~?/f
APFI.lGATION FOR PKllKIT
(:IU 0... ZRFHYlUllLLB
BUILDlNG DRPARTKRNT
OWND · 5 NAHRW,l}d ~ mer .J.kQj{S % /J?S. ?'S(" II (~
LJ I71L f?odd JJ . P. R ~ 3t/f...-.J -I
JOR ADJ)R8SS~ (; t1().. I S; I Ve If!. O~
I.RGAL DBSClUl"TlOR: LOT(S) 11'7 11 BLO<'''R,OOOOOSUBDIVl9IOH
~-U~ ~,- ~ 1~ -.((bXX)J 11jk
PHONE
7lH -FL/-/-8WY
OWRER' S AJ)I)USS_~ 7d< a I
010l. IJ .
~ian
-1tOve
-.J>etIOl ish
PROPOSIID Wlh ~ing1e F&ally
----1'11 F
_' of Unit.
i ~ ,./1'11<-
entfV I
_Other pe(r(
~I
scrt{/1 i;ne)oSur<2-WJlJJ
----1t/8
~~('ct.l _lndu8t. ~ V"Swia. Pool
--1le8buu:ant &, Bulth Dflpartaf'!~t Approvl.ll ~d)
DESmuPTlOI OP WORk! f1J91t>/J./Id ,SuJIMIhI.vJ poaL-~ 4
\ ; I,,,
BUILDING SUI, .-1.2 x_~ '1. SqUAlr:e Feet. Be1pt
us IDBIIT1AL!
COKI1D.OIAL ;
ATTACH (2) PLOT PLANS & (2) S8TS OF BUILDlMG PLANS & (1) SIT ENEROY FORHS.
ATrAaJ (3) SBTS OF BUILDING PLANS" (1) SRT RNERGY FORMS.
PROPERTY 8U1tVIT Rl<<lUllUID FOR ALL NEW CONSTRUCTION.
P.qaITS UOUISTU
____BUlLD1J1G
$.~tOIS,60
Va.lut1on ot Totel Con8tru~tion
~1...BC11llCAL
__...JtRCRUlCAL
NIP Sf!rvlee
.Florida Powl9r Corp.
_w.R.e.c.
*
Valuation of "@chenie.l Installation
_YUllBIIG
GAS
ROOFiNG
SPBClALTY
Gd(\\\e..
Oth~r
nrlJ OF OOWSD.UCTIONI ---"lock
_Ftaa@ _St@f!l
FUlSBP nooa BLBVATIONS'
n.
IS PROJECT IN FLOOD ZONR AlBA, _
YES NO
..........................................
IQJ ItP~
.GON'l1L\laQJl SEL". pH
.AMY S I~ /lo
State Oert. Qr leaiat. .
City License Real.t~.tloD .
..........................................
. ~
COKPANY'~ /JLl- bin? t1(f:i-riC
:~ ."to c..t. or ....10.. .
.~ -- City License ReahtraUOD ,
..........................................
IW'QI COttPANY~t04~ ~o,~~c.
~ s.... Con. or ..,I.t.' ('if'!o~ ~ril9
Slanotut@ ~-- City Licens@ Re.iBtration . _..1 '-I
~.................*......t............. '
:lIT
-
~lCAL COHPANY~,
State CerL. or Real.t. f
Stgo.etuct! __ City Lic.osf! lteat9tratloo .
..........................................
amBll COMlANr
S~te O4lct. or Re8ht. .
Slgnatur@ r ,~ City Lteeose Ileahtration .
.It.......................................
APPI.ICATION APP1l0VlW BY PBRKlT OFPIOO.
I III' I 1 CO; . ':::! .1f I 11= 1.'\ : 0':, I D :
T F:L Ilfl:
1:IlJO'3 P02
CONDITIONS OF PERMIT AYFIDAVIT
1\. NOTICE 0.. DEBD RESTRICTIONS
The unO.rtlllll84 \me.rnanc1l ~t thb Penlt 131 be iubject: to 'deed [sltrlctl0l181 wblc.h 118' be lOre rutrlcthe tbln City
regulation.. Ybe onderl1gDeG a8eu.eJ relponttbllity for co.pllanc@ 11th lRJ appllClble Ilea r..ttletIODl.
B. UNLl~.SJUl_~RACTORS AND CONTRACT,Q!LMSPONSIIULITIES
If tbI\ (M)er bee bind 8 oontr8ctor or conttllcton to undertake !IOrl, tbey ..y be rlqulclC1 to be HeeQed In accordance with
state an4 loed regullltiOOl. 11 the contractor lR not Hcen.ell 81 requir.~ bJ 11., both the OIIIW' 1184 contractor Ill' be
clte4 lor a .iedlllllllOOr violation llI1der Btat.e lilll. If tb. owner or Intended contrll:tor are \lDctrtaln u to tibet UCM8inv
r~ir_otll 113' IIpply (or the lote1lded lfOr~, they lUll IldviBeo h couteet: the City of IBpbyrbUlI Bulldll19 Deparblent, (813)
70A-~611.
FurtberlOre. If the owner ha. hir.d II contractor nr contract>>rB, he In ad~llIP.d to ha'. tbt cootractor(a) 91qo portlone of th~
"Contractor 9~ttmJ" of thb applicaUon for wbleb tbey .ill ~ rnpontlbl.. If you, iI8 the ovner '190 atl tb8 tontrllctor,
you 8re indiCAting thAt JOU. r.tbRf th8n the contr8ctor, are responsible foc tbe work. If th, contr.ctor wlahe. Jou to li~
ae coot18clor tbat la, b@ an iudlCltlon that hp. II not properly lic9n1.a end 19 nnt IDtltled to parllttlng prlYlleg.. In the
city or '~bJrbll1',
c _T~.~POR1-'~T~.9!L):~r!\,c;r___FBES AND UTILln cOmn~<;T;1:.Qlf.J.EEG
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STA'l'UTJS, AS AMENDKD)
I C,(t{~tbAt I, the eppllcant, blv~ been prowldea .ttb a coPY of 'Florioa'R cOOItructlon Lien Law - ~B(l. ProtectIon
Guld@" prepued bythll Florid, Depart..nt of Agriculture Mil COQBlJIII!r Affaiu. If the eppllcant i. IQIlIGOt\e other than th(l
"owner', J Clrtlrr that I ~v8 obt,lntO 8 copy of the &boy! described docu~nt and pr~II' In good f31th to dell'er It to the
"owner' prior to COII@nc~nt.
E. CONTRACTOR'S OWNER'S AFFIDAVIT
I certify t all the Inforlltlon in thl8 application is accurate Bnd thnt all fOrk will be ~on8 in COIPliaoct wJth all
8ppllrnbJ~ 1..- regul.tlng conIlructlon, .onino, an~ land d9f.lopl9Dt.
~pplication 18 ~r.8bJ lade to obtaIn a ~rllt to do work an4 installation a8 Indicat~. 1 certify that DO work or
inBtallatlon ~ ~ce6 prior to loou,nce of a ptrlit and that all work wIll be perforttd to ...t 8tandardJ of all lawe
r~gul~tlng con.tructloo, City coOeA, loning [!gUlationR, and land duyolopeent rogulatlonA in the jurltdlctlon. I allo
c~rttfy that I un41l.tanD tbat ~ rRgulatlon. or otbor gOJetDItDtal IV8ncl8B II' apply to the Intt04e4 work, aod that it IB
-v reBponIlblllty to 14entlty what actionA I .ust takl to be in co.pllannR. Such agonelo. Inelu4a but art not Illlttd tOI
. Depar:~t.j)t1ndI.QQI9Ilt~lJ'-9Jl.1~!!!J.!I - (yprllAR Boyhe8dl, Votlanc1 Are81 anl'l llRJitorwentAlly Rendthe ~i).00A,
Vllter {VaRtevitter Trellt"l9nt
t ~utbvelt Florid' Water Hanagll8Dt Dlat(lct . lell., Cypr881 Bayb.~dl, Vetl8nd ftreaRr Alterlnv Watercour891
. ~ Co~ of ~1DIIr. ~ 8",,11'1 DoCke, "8vlgable Watettlay.
t ~t.leDt Of trrB~UU'~~!tlenlC88, IDvixWIeJ1tlll Beeltb \h!U . W,UI, Vattft1fllhr TrMtIeIlt, 61ptlc tiUlh
t us Indrcaentll prot!JHr' IVIfICI ~ A8btato9 abatgent
( iito certify that, If IItlrlal Is to be used 1n flood lone MAM or 'A,ltC.', It I, unaer.tood that l draInage plin
a~rel,l"9 a -COIP8fta,ting voluae' .ill be RI~ltt@d which Ip prop,red by a professional '~gln.et tegletor8d In the Stale or
FJort~3 prior to perllt iIIUane@. .
~ pf!rln lDRUM 8MB be conJtrued to b@ II liteM! to procp.ed lllth lbll work tlOd not 88 autborlty to ,lolatll, canool alter, or
8et SRlde Inr provl.lon. or the technical cod~n, nor 8hnll In,uBDce or 3 per.,t pCQy@nt tb& Bull~lD9 Officill f[Ol tb't9lftlt
requiring I corr,ctJon ot errore In plane, con.lruction, or viol~tlone of any code. SV.fJ pttllt IIBUed shall becoII 1>>.8116
unJp-RI the work .uthorlltd by Ruch per.lt i8 c~nced llltbln ,I. IOntbt of i8.u8nc~, or If work lutborlaod by tb8 "tltt 18
IJU'p".nd~ or lIbamld for 8 perii'd of sh JO.lltM aHer tbo tlM the work 18 ~Dced. Ooe 90 aay utlMlon of t1Je, IIY be
3Jlow@d for t.lt~ Pfnlt vltJI fll clI8f9' of U5.00. !bl! ule.n9lon ,ball 00 tequt8tOO in "dUny to the 8uUdlno Offlelal. An
3WrovP/1 11l8~cUOll I\Ilt tit 1099~ ~uriOi BlICh sh IOnlb period, or tb, ptoj.ct IfUI be ooDJIl4ere4 abanOOntd.
"ftR'H~G TO lNDJI~ TOOl rAlLU1l1 TO RlCORO A "OTICE OF C{JIKnCllMm IOIY RE9ULT IN YOOR PUIKG !VICl fOR IMPRC.YnJtDT8 TO YOOR
PllQrltm. 11 TOO JJlIID TO OB'fIIJI ,rWCll((l, COIISUL! WitH YOOR LPUB OR All AnORm BIFORI RICOIUlING YOOR MOT1Cl OF
r1JDWltWJn'. J0B6 ""DIR t2,500 1M VALUI 00 Il(1f IIlID TO ~KCOIID lND p09f A "MOUCll Of WVlDCIKQJ'.
~""Rf-,th>~
STATll 0' Fl.OJlIOA /)
crom OF t"a..J..1!.A.')
Tbe foregoing in,trUllent MiiJ-lic7~ledged
bdoro mp thh t!.tfI. 21--, 19 . by
- ~ r.'iit Hfa.h.sck- -
who 19 persona knOMn to ~a or who hoa
produced
89 i~entif1~lion aDd who dI~/did not
take "" !!h~; 1/J..t.d; ~
TIilVDa'.tUreJ~~L . i. ~ . .
,~"__ ()J ... 41
(N~.eTyped, Printed or Bt~ped)
lillTI\8Y PUB~IC
IITAJIi OF Ft.otlIDA /J __
('1MIJY or ~
111.. (of9901iiij ~p-atruWtm'8CkilOlfludged
hAfore Jn~ tbi~' c.::lq r 19.!1f:- by
.b.;li~ellfe.~..-or who-h..
pro(lut:'~6
a8 idAI.lU7.IoaHon and who did/J.Ta"nor--
tek~ -
~:~gn:_::m~-' .1 J'~l~'
(",.e ,Typed, Printed o~.,~.~~..peO)
1fO!M!_,!UD~~c>> ~. "~'f'~ ';:~:~i'~=1&
- . ; ; El<P1~: Jt\t'tUllf'/. '3,111II
, Ilandti\ n:~,: Noll', ?l,;1Il1l \iIldIlWIIIII
--- ......
,oIJ....'!J....r.o.. MARGARET J. CRlMENI
~QJ:r ,~ MY COMM~SSION' CC 342115
<..~ "i EXPIAES. Janumy 18. i.
"'I. ,,~ JIllnded 11Hu NoIIIy NIIIc lbtItVlIlIIII
. Dade City: (904) 521-4206
410 E. Meridan Ave., Rm 234, Dade City
. New Port Richey: (813) 847-8126
7432 Little Road, New Port Richey
· Land O'Lakes: (813) 929-1266
4111 Land O'Lakes Blvd. (US 41), Land O'Lakes
CENTRAL PERMlmNG OFFICES:
THIS APPLICATION MUST BE TYPED OR PRINTED IN INK
8 . OWNER'S NAME: CUi'I\~\o.(l\fI\~- (-(olhes
~ JOB LOCATION: 6zz.\ Silver Oa.Jc.s
II: PARCEL 101: S ~ T Z b R.!::L SUse'Z,4 BU< oa:x>~
~ OWNER'S PRESENT ADDRESS: 7.;l.31 '-ftr~ P.Oq~
~
o
LOT
. FEE SIMPLE TITLEHOLDER'S NAME (II olher than owner):
address (II applicable):
. BONDING COMPANY:
~ ADDRESS: CITY STATE ZIP
0
9 . ARCHITECT/ENGINEER:
m
II: ADDRESS: CITY STATE ZIP
w
j: . MORTGAGE LENDE
0
ADDRESS: CITY STATE ZIP
CITY
STATE
ZIP
. DESCRIPTION OF WORK:
LIVING AREA:
# BEDROOMS
~
8
..J
m
~ . IF MOBILE HOME OR RV: MAKE
~
a.
~
o
Ul
w
c
SIZE
. WORK CODE: _ PLANS ON FILE?
MODEL NAME:
If,() (S.b()
o NO 0 YES
VALUATION: $
.~(".
". PHONE#(~/3 )K'(p9 -c45B :.
~ CITY PASCO ~ ~MPUTER IOII~TATE /J?()O~~~................... ... ................ .......
~ . ELECTRICAL CONTRACT.OR: '- - L/<1e- Ekcfr~ g~ ..Eu:bTRI~~~..
~ ~~DN:;:m9F27~. CITY 6pr/YIb MiIONE;T~TE ,Jj, ZIP - ~ 0 IOFEei$t>
8 ~~~:RL~o~ (if apPlicableA..,...~ ~c_ SA:~ CO COMPUTER lOll: Iof!;: O^ ./ :;::;:;;;.;/...:r::::;..:...::..)i..;:;...::;).:::::;::.::.i....;
. MECHANICAL CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE L1C # (if applicable):
o NEW 0 ALTERATION VALUATION: $
PHONE # (
CITY STATE
PASCO CO COMPUTER ION:
(Required)
ZIP
. PLUMBING CONTRACTO
SIGNATURE:
ADO
STATE L1C # (if applicable):
# FIXTURES:
j)~k
<J.-yl G I
- SEPTIC PER #:
. OTHER CONTRACTOR:
SIGNATURE:
ADDRESS:
STATE L1C # (If applicable):
TYPE CONTRACTOR:
PHONE # ( )
CllY STATE ZIP
PASCO CO COMPUTER lOll:
VALUATION: $
JOBS UNDER $2,500 IN VALUE DO NOT NEED TO
RECORD AND POST A "NOTICE OF COMMENCEMENT"
. " ." NOTICE"...
BOTH THE OWNER AND CONTRACTOR OF RECORD (Ueense Holder) MUST READ AND
(permit form 10/91) SIGN THE REVERSE SIDE OF THIS APPLICATION
EDITIONS OF THIS FORM RELEASED BEFORE 1/91 ARE OBSOLETE AND WILL NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF
PC93043032
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEFD RESTRICTIONS
The undersigned understand that this permit may be subject to "deed restrictions" which may be more restrictive than County regulations. The
undersigned assumes r86ponslbiUty for compliance with any applicable deed restrictions.
B. tJNUCENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
II the owner haS hired a contractor or contr8flO"s to undertake work, they may be required to be licensed In accordance with state and local regula-
tionS. II the contractor Is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. II
the owner or intended contractor are uncertain as to what licensing requirements may apply lor the Intended work, they ate advised to contact the
Pasco County Building Division. Uoensing Section at (813) 847-8009.
Furthennore, If the owner has hired a contractor or contractors, he Is advised to have the contractor(s) sign portions 01 the "Contractor Block" 01 this
application lor which they will be responsible. II you, as the owner sign as the contractor, you ate Indicating that you, rather than the contractor, ate
responsible lor the work. II the contractor wishes you to sign as contractor, that may be an Indication that he Is not properly licensed and Is not entitled
to pennining privileges In Pasco County. .
C. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVE'RV FEES
The undersigned understand that Transportation Impact Fees and Resource Recovery Fees may apply to the construction of new buildings, change of
use In existing buildings, or expansion of existing buildings, as specilied In Pasco County Ordinance numbers 89'()7 and (lO.()4, as amended. The
undersigned also understand that such f886 as may be due will be identified at the time 01 permitting. It Is further understood that Transportation Impact
Fees and Resource Recovery Fees m:Jst be paid prior to rec:eivltlg a "certificate of occupancy" or final power release. lithe project does not Involve a
cer1ifica18 of ocx:upancy or final power release, the fees must be paid prior to pennlt Issuance.
Furthermore, If Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit Issuance, In accordance with applicable Pasco
County Ordinances.
D. CONSTRUCTION LIEN LAW (Chap18r 713, Florida Statutes, as amended)
If valuation of work is $2500.00 or more, I certify that I, the applicant, have been provided with a copy of "Florida Construction Lien Law - Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone 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 commencement.
E. CONTRACTOR'SIOWNER'S AFFADA VIT
I certify that all the inlormation in this application is accurate and that all work will be done in compliance with all applicable laws regulating construc-
lion, zoning, and land development.
Application is hereby made to obtain a permit to do work and Installation as indicated. I certify that no work or Installation has commended prior to
issuance of a permit and that aU work will be performed to meet standards of all laws regulating construction, County codes, zoning regulations, and
land development regulations In the jurisdiction. I also certify that I understand that the regulations 01 other government agencies may apply to the
in18nded work, and that It Is my responsibility to idenlify what actions I must take to be In compliance. Such agencies Include but ate not Umlted to:
o Deoartment of Environmental Reaulalion - Cypress Bayheads, Weiland Areas and Environmentally Sensitive Lands, WateriWastewater Treatment
o ~olJlhwest Florida Water Manaoement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
o Armv Corns 01 E'noineers . Seawalls, Docks, Navigable Waterways
o Deoartment ot Health & Rehabilitative Services Environmental Health Unit - Wells, Wastewa18r Treatment, Seplic Tanks
o US Environmental Protecti01 Aoencv - Asbestos abatement
I understand that the following restrictions apply to the use of fill:
o Use of fill is not allowed in Flood Zone "V" unless expressly pennitted.
o If fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of
permitting which is prepared by a professional engineer licensed by the Stete of Florida.
o If fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only
to fill the area within the stem wall.
o If fill material is to be used in ~ area I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect
adjacent properties, the owner may be cited for violating the conditions of the building pennit issued under the attached pennit application.
If I am the AGENT FOR THE OWNER, I promise in good faith to infonn the owner of the pennitting conditions set forth in this affidavit prior to commencing
construction.
I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not
specifically included in the application.
A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any pl'ovlsion of
the 18chnical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors In plans, construction, or
violations of any code. Every permit issued shall become Invalid unless the work authorized by such permit is commenced within six months of permit
issuance, or jf work authorized by the pennitls suspended or abandoned for a period of six months after the time the work Is commenced. One or
more extensions ot time, for periods not to exceed 90 days each, may be allowed for the permit The extension shall be requested In writing to the
Building Official. An approved inspection must be logged during each six-month period, or the project will be considered abandoned.
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 ATIORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
SIGNATURE ~ ~~ SI~NATURE ~ ~~
_____~wNe;O;;:GENT,&,e.e11fr~ ~RACTOR M#Y jJ~~e/.Jw
DATE /~AYr'/ DATE lIj/yfY
MY COMMISSION
EXPIRES
NOTARY AS TO
CONTRACTOR
GARET J. CRlMENI
MY COMMISSION' CC 842115
EXPIAES: JIInuI/y 18, 18118
NOTARY AS TO
OWNER OR AGENT
Y COMMISSION
XPIRES
WITS ~
Kl1iJl.ffl 10 AJu r/t'l'i