HomeMy WebLinkAbout96-5526
Date I-I/' -90
.3.5.-.. d7J ;ld. tID
CBUILDING ~ 0ECTRICAL' =.> QLUMBIN~ ~ECHANIC9 Sewer Conn '7 CJ7J. o-v
Water Conn: t1-Lr7J - c.n
PwpertyOwn." ~ :!!.5~ Wate<Met.". /&'.5-' dV
Job Address: 3_ _ ~ ---~'Z? T.I.F.'s: 9,/;J~crD
Parcell.D. # 1'/-r9b--d.-l- 016 f) ~ (9000 0- -o0d-"O
Zoning: JJ1. E91r9>>Co~: I ~ ~ _ ~Gas:
Description of Work _~ ~ ~-,-
BUILDING PERMIT'.
CITY OF ZEPHYRHILLS Permit JT!
(813) 788-6611
-;~. 552613
'Yo. ()[)
..3.S-: 07J
FINAL .;J.. \ V ~l"
DATE
C.O. .;J..-
DATE
All work shall be performed in accordance with City Codes and Ordinances. <"-::>'L
-J/?~ -S..dfr 02 -:J...j - 91:, g';1 --l:.d.- ,+1'1 17 ~ Inspector ~()..D
Perm;' Fee ~
Signature ~ .' r
Company
Address
Telephone#
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
Valuation or
Contract Price
~/ /t-
City License Registration #
State Certified License#
/6~-V
BUILDING
~J6S1
ELECTRICAL
~~/,6S7J
JJ~/6 y;r-
.~~ J!Jd~
IT .
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final z- (Z -~ ~ 8d,...
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can / - /6-7 b
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
M-~ l"'~~ ~~ wlLbf
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: Lf //' Cb /
~)J -7f ~'1 ~ /-;/6 r-'O
a. Wrong Address A/~ ~
b. Condemned work resulting from faulty construction. IJ :;2 -/) J - 7' -'-
C. Repairs or corrections not made when inspection called. /CK
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.
APPLICAnON FOR PERMIT
CITY OF ZEPBYRBILLS
BUILDING DEPARTMENT
. .
[Xp/'1I- rr'C;p
OWNER'S RAKE ~~/C/+ t!A/~RNZ PHONE
OWNER'S ADDRESS 38'0/9 it'9w~rV1.r- Loop
3 IS' cJ /9 I a rv/l/V~ /-ocJ~
LEGAL DESCRIPTION: LOT(S) c3 ~ BI.OClL--SUBDIVISION tJ,/-f)/w~Jj k.J1/v"1
.
PARCEL I.D.' /tj- g;(P~..:lI- 8/00 -00000 '- 638'6 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED: . ~ Construction -Jddition --Jlteration --.Jlepair _Install
JOB ADDRESS
_Sign
---1Iove
->>eaolish
PROPOSED USE: _Single Faaily
---.JI/F _' of Units t-!iii'
_ec:-ercial
_Indust. _Swia. Pool _Other
DESCRIPTION OF WORK: 7...?? 0 C" L e fO;r7;7 e
.
BUILDING SIZE:q/Y- X y;'~ Square Feet. /a
---.Jtestaurant & Health Departaent Approval
<)7 c/
I'
Height
(~~ t?,ULicr
;;rfk-,-
RESIDENTIAL: ATl'ACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORHS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
_BUILDING
$ ~jmc) ~
/ s: 0 MIP Service
$ 9c'o aC-
,A/(J GAS
,
PERMITS REOUESTED
Valuation of Total Construction
_ELECTRICAL
Florida Power Corp.
W.R.E.C.
--1IEClWlICAL
Valuation of lIecbanical Installation
---....PLUMBING
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FIllISHED FLOOR ELEVAnONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
K
NO
YES
******************************************
Signature
COIlTllAC'JOR ~E~lIII f
COIIPABY 'CJJ~~;V 7/706~Le ~~g
State Cert. or Regist. ,
City License Registration , / U? .5 ()
******************************************
COMPANY 7?;?~~ $~
State Cert. or Regist. ; f /20~-Sd? cY- S.
City License Registration' /b..5../
******************************************
COIIPANY G~/)t'..u/,)V P/t.1&LC' ~~
State Cert. or Regist. # /
City License Registration' / b~
******************************************
Birr' .DER
F.T.RCTRICIAN
SianJlture
PLDllBER
Signature
CotIPANY ~&~ A.J:k ~~ST
~ State Cert. or Regist.' C/7GO~a/
..... City License Registration * /6
***********************************
OTRRR COIIPANY
State Cert. or Regist. #
Signature City License Registration ,
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'l'he undersigned understands that this peralt laY be subject to -deed restrictions- whieb laY be lOre restrictive than City
regulations. !be undersigned assUJes responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, 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 ower and contractor MY be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
reguireJents laY apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813)
, 788-6611.
FurtherJOre, 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 whieb 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 MY be an indication that he is not properly licensed and is not entitled to peraltting 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 -Plorida's Construction Lien Law - lIcIIeoImer's Protection
Guide- prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOIeOJle other than the
"owner", I certify that I bave obtained a copy of the above described dOCUJent and prOlise in good faith to deliver it to the
uowner" prior to COIIIeIlCl!lH!llt.
E. CONTRACTOR' S/OWER' S AFFIDAVIT
I certify that all the inforJation in this application is accurate and that all work will be done in COIIpliance with all
applicable laws regulating construction, loning, and land developamt.
Application is hereby Jade to obtain a perJit to do work and installation as indicated. I certify that no work or
installation has COIIIeIlced prior to issuance of a perlit and that all work will be perf OIled to Jeet standards of all laws
regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. Ialso
certify that I understand that the regulations of other goverDJental agencies laY apply to the intended work, and that it is
If responsibility to identify what actions I lust take to be in COIpliance. Sueb agencies include but are not liJited to:
t DepartJent of EnvirOllleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDJelltally Sensitive Lands,
Water jIIastewater TreatJent
t Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t A[If Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health & Rehabilitative Services, BnviIODl8Jltal Health Unit - Wells, Wastewater TreatJent, Septic'l'anb
t US Envil'Ollll!lltal Protection Agency - Asbestos abateJent
I also certify that, if fill Jaterial is to be used in Flood ZOne "A- or "A,etc.", it is understood that a drainage plan
addressing a uCOJpenSating vol.- will be subJitted whieb is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance.
A perJit issued shall be construed to be a license to proceed with the work and not as autbority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOlthereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery pemit issued shall bec;oIe invillid
unless the work autboriled by sueb petlit is co.enced within six JOntbs of issuance, or if work authoriled by the petlit is
suspended or abandoned for a period of six JOntbs after the tHe the work is coaenced. One 90 day extension of tille, MY be
allowed for the perlit with fee charge of $15.00. 'l'be extension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb six IODth period, or the project will be considered abandoned.
IWUlIlfG TO 0IUfER: YOUR FAILURE TO RECORD A NotICE OP allllBlCEIIBI'I' lilY RESUL'I' IN YOUR PAYING fIIICE FOR DIPROVBIIBI!S TO YOUR
PROPERtY. IF YOU IJI'I'BID TO OBtAIN PIJlAMCING, COISUL'I' WI'I'H YOUR LlllDBR OJ II AnoRDY BEFORE RECORDIIG YOUR DICE OP
altHElfCEMEN'l'. JOBS UKDER $2,500 IN VALUE 00 Not MEED '1'0 RECORD lID POS'I' A "NotiCE OF aJIHEXCEIIEIII".
SIGJIA'fURI: OIIHER OR AGENT
SIGJIA'fURI: comIAC'I'OB
SUTE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
STAR OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_ by
wbo is personally known to me or wbo bas
produced
as identification and who did/did not
take an oath.
wbo is personally known to me or who has
produced
as identification and who didldid not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
LOT PLAN
MUST SHOW SIZE OF LO"T, SIZE OF HOME, SETBACKS OF HOME FROM LOT
LINES, PLACEMENT OF WELL, SEPTIC, POWER POLE, AIR, DRIVEWAY.
WELL & SEPTIC MUST BE 75 FEET APART.
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PASCO COUNTY, FLORIDA
Permit No.
Date Permitted
Builder Name/Owner Name
County Parcel No.
,,'
,~
t
Subd.
Location
Classification/Type of Use
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT D
Rate $
Zone No.
Sq. Ft./Unit
Prepared By
Impact Fee Amount $
The above impact fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted
by the Board of County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy
or authority to utilize the permitted structure.
RESOURCE RECOVERY ASSESSMENT
EXEMPT D
RESIDENTIAL
NONRESIDENTIAL
No. Units
Gross Sq. Ft. (GSF)
Rate/ERU - >>n;1V.,. 52.00/Year
or ~,~,,~r $O.142/>>ay
Assessment - (No. Units) x ~"" (0.142)
x (No. Days)
ERU Assign No.
Assessment - (0.142)
(GSF) x (ERU) X ~~ x (No. Days)
100
TOTAL FEE $
TOTAL FEE $
The above assessment has been established pursuant to the Pasco County Ordinance No. 89-07 and Resolution No. 89-197,
as commended.
THE ASSESSMENT WILL BE CALCULATED AT THE TIME OF ISSUANCE OF THE CERTIFICATE OF
OCCUPANCY.
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY,
Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing
the building permit owner on notice of this assessment and the conditions of payroent for same.
, ,~'T..
Date
(
I
Received By
---------------------------------------------------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
TRANSPORTATION REC. NO.
/ J ' "fi ,
RESOURCE RECOVERY REC. NQ;,"': J I /{) , ,""
---"
DATE
....-\.
DATE ,::;.)
"Y, ,
BY
BY
,....1
/1
fi
"
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldgllnsp
feecal:ce
PC93113094/A