HomeMy WebLinkAbout99-8826
50.~
BU~ING ELECTRICAL PLU~NG
Property Owner: k~r e.o/ ~h.^ ke
Job Address: "'] ~ r I , f ~ c. (d y p ks Or.
Parcell.D. # DJ -) b - '21- t!)2'f 0 - OoootJ .' 01'70
Zoning: Energy Code: Radon Gas:
DescriPtion of Work ~'~c..tr:t ..f!o.r Shl.(.UerS
BUILDING PE,RMIT, 8826
CITY OF ZEPHYRHILLS Permit
(813) 788-6611 Date ~ I" I 'i 9
MECH~ICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
9.. IS: '1
DA
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
City License Registration #
State Certified License#
Jl~)
~:~;:::,:e?~ ~.
Company
Address
- Telephone# ~ 6<g-3 ? <;;-05 ()I..~3 ? ~
Valuation or rC EJIl
Contract Price 511 00 . '.
B ILDING
ELECTRICAL
ME
Driveway
Tp. Servo
Rough In
Meter Can
Con st. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($ 25.00) 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.
APPLICATION FOR PERKIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
JOB ADDRESS
;(7?r~f/./~
OWNER'S N
OWNER'S ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL I. D.' t') d.. - ;;;J.'?; - ;X I - () ~ V O-{) OO{5r) -{)/7fJ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition -ftlteration _Repair _Install
_Sign
----"ove
_Deaolish
PROPOSED USE: _Single Faaily
----"IF
_' of Units _M/H
_~ercial
_Indust.
_Swia. Pool _Other
Resta~anl/ & Health De~rtaent Approval
DESCRIPTION OF WORK: 1J(7p/l h /f;r 1;1 , '( b tZ1./1 P C7,AAO
d?lPF( ~
BUILDING SIZE:
x
Square Feet,
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.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
ZIRC
ELECTRICAL
$
PERMITS REOUESTED
s-r On t/ 0 Valuation of Total Construction
AMP Service
Florida Power Corp.
W.R.E.C.
---1IEGllANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF GOBSTRUCTION: _Block _Fraae _Steel
Other
FDlISBED FLOOR ELEVAnONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRACTOR SECTION
COMPANY
State Cert. or Regist. .
City License Registration .
~....................~........
COMPANY ~ ~ N7pll. _ 'Pf, It- Rn/!;! - f,{J Y
State Cert. or Regist.' "t:;:,.- A ~/? )V~~
City License Registration' a I ....-.:.i
..........................................
BUILDER
Signature
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
PLUMBER
Signature
COMPANY
State Cert. or Regist. t
City License Registration .
..........................................
MECHANICAL
Signature
COMPANY
State Cert. or Regist. f
City License Registration .
..........................................
OTR'RR
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A.... NOTICE OF DEED RESTRICTIONS
-lb. under.Igned understands th.t tbI. per.It .,y be .ubject tu 'd.ed restrIctIun.' shIeh say ba aur. restrIcti.. tboo City
regulations. rbe undersigned assUles responsibility for co.pliance witb any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe ..... loa blred · runtr.ctor ur runtr.ctur. tn und.rtele work. tb.y say be reguIred to be liceooed io accooIenca .ith
.t,t. and loc'l r.gul.ti.... If the contr.ctor i. not licen.ed as r"luired by las. bolb tbe ..... and conbolotor IOf be
cited lor · .Iad.....or .iol.tion und.r .t.t. I... If tb. ....r or Intended contractor are uncerlaio as to aIot liceosing
cogolr....t. say 'pply lor tb. int.nded NOrk. lb.y .r. edvI.ed to contect the City of Zephyrbill. BoIldIog Deporlaeot. (813)
788-6611.
Furtberaur.. if tbe ooner 10. bIred · CORtr.ctor or contr.ctor.. b. i. 'dvised to 10.. tbe ,,"tr.ctor(.) .Iga porlJ... of 1Io
'Cootractor Secti.... of thI. applIcation for aIIIeh tbay .m be res_Ibl.. If roo. as tbe Mer Riga .. the contractor.
roo .r. IndIcating th.t roo. r.lbor lion lbo contr.ctor. .r. respon'Ibl. for th. ..rl. If the contractor .lBIoa roo to Riga
as contractor tbat .ay be an indication that he is not properly licensed and is not entitled to peDlitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND U'l'ILI'rY CONNECTION FEES ,.<
D. CONSTRUC'l'ION LIEN Lnw (CHAPTER '113, FLORIDA STA'rUTES, AS AMENDED)
I certify lb.t I, ibe applIcant, b... been pro.Ided with. copy of 'YlorIda'. Con.truction Lien Lao _ 8Dae0a0er'. Protecti..
GuideN prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant i8 sOleone other than the
.....r.. I certify tbat I b... obt.ined · copy of tb. above described doc....t and proai.. 10 good f.Ith to deIl.er It to tbe
Nowner" prior to COalenCelent.
E. CONTRACTOR' S/OWNER' S AFFIDAVI'l'
I certify that all the infor.ation in tbis application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developlent.
I
Application is hereby .ade to obtain a per.it to do work and instailation as indicated. I certify that no work or
installation bas cOllenced prior to issuance of a per.it and that all work will be perfoIJed to leet standards of all lar8
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of otber govecn.ental agencies aay apply to the intended worl, and that it is
.y responsibility to identify wbat actions I .ust take to be in co.pliance. Such agencies include but are not li1ited to:
t Departlent of RnviroD8ental Regulation - Cypress Bayheads, Wetland Areas and RnviroD8entally Sensitive Lands,
Water/Wastewater Treablent
t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t Ar.y Corps of Engineers - Seawall's, Docks, Navigable Waterways
t De artlent of Health & Rehabilitative Services EnvirOD8ental Health Unit - Wells, Wastewater Treatlent, Septic 'anks
t US EnviroDlental Protection Agency - Asbestos abate.ent
I also certify that, if fIll .aterial is to be used in Flood Zone NAN or NA,etc.N, it is understood that a drainage plan
addressing a .co.pensating VolO8eN will be sub.itted which is prepared by a professional engineer registered iD the State of
Florida prior to per.it. issuance.
. A per.it issued shall be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical' codes, nor shall is~u~ce of a per.it prevent the Building Official frUl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Bvery petlit issued shall beCOll invalid
unless the work authorized by such per.it is cOllenced within six IOntbs of issuance, or if work authoriled by the petlit is
suspended or abandoned for a period of six IOnths after the tile the work is c_enced. One 90 day eltension of u.e, ., be
allowed for the perlit with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. In
approved inspection .ust be logged during each six IOntb period, or tbe project will be considered abandoned.
WARNIlfG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR PAYING l'IlICE FOR IHPROVIIIDrS fO YOUR
PROPERTY. IF "YOU Ilf1'END ro OBTAIN FIIfANCING, COltSULT WIra YOUR LENDER OR Alf ATrORln BEFORB RBCORDIItG YOUR lfO'l'ICE OF
ClIIIIIm...~~ ,:LlItl -=- IIICORD AJD rosr A · aIIIlIII ___
..d/ C~-
SI ArU. OR AGBltT
" I
STATE OF FLORIDA
COUlf1'Y OF
The foregOing instrument
before me this
was acknowledged
, 19_ by
STATK OF FLORIDA
COUlITY OF
The foregOing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
JQ. 40-00000-6)11 ()
MEN CEMENT
PARCEL 1.0. NUMBER
1111111111111111I111111111111111111111111111111111
99083955
Rcpt: 340011 Rec: 6.00
DS: 0.00 IT: 0.00
07/02/99 Dpty Clerk
JED PITT"AN, PASCO COUNTY CLERK
07/02/99 10:26a. 1 of 1
OR BK 4181 PG 1311
STATE OF FLORIDA
The UNDERSIGNED hereby gIves notice that Improvement will be made to certain real property
and In accordance with Chapter 713, FLORIDA STATUTES, the followlng Informallon Is provided
In this Nollee of Commencement.
LEGAL DESCRIPTION .
;:~~;~R~~:~~
OWNER INFORMATION
NAME Ii L f 1" .Q. d
INTEREST IN PROPERTY
') I
~D~~nK.e-
CJ U</VtO /l- -
AO~":S? ~ ~\~ ~' - F~- \L3Q~~tfJ ius, J)r " n:
A/f} ..
...
1// f)-
NAME & ADDRESS OF FEE SIMPLE TITLEHOLDER (if other th~owner)
GENER~L ..9ESC~IPnON OF IMPRO~~NT
:J/k:.~JI}II _~~/1 /11 ,dfi f/ J:lpn -S,
:'If!';-V''::"o;,,
"~ ~.
CONTRACTOR
BOND AMOUNTS
/1/11
/l/f)
fi/j}
ADDRESS
NAME & ADDRESS OF SURETY
10601 Oak Str. NE, St. Petersburg,FL.33716
NAME
Jerry Hicks, Prime Marketing Group/Qualifier
1//l-
v
LENDING ORGANIZATION
(Name and Address)
P . /
ersons WIthIn the State of Ronda, designated by owner upon who notices or other documents may be served as provided by SECTION 713.13 (1) (a) (7).
FLORIDA STATUTES.
Ii L tr~. J ~.e, ~~ \1\ \{..e
~DDRESS~? 3 \ I . t Lt C Q Lfi"J ius .j) r ; v<-. . ^ R (1 h ~ 1I -s f= I :33 5' 4 0
In addition to himself, oWner deslgnat.es of
N.AJ.-1E
(Name)
to receive a copy of Uenor's as provided In SECTION 713.13 (1) (b) FLORIDA STATUTES.
EXPIRATION DATE NOnCE OF COMMENCEMENT
(Address)
Signature of Owner Ott/rwi Jjc:i;-yy t~
Printed Name /7 L j- '-R 1-;- JJ 8 1-"- .JIlt/ I{ E
(One year from date of recording, unless specified)
STATE OF
Fc
CERTIRCATION - ~
l.:OUNTY OF I {( ') C c) ._
"1.A-~ .199~ by A(.(' fel (3-t:' j) rv kc
f
. as Idenlifi~lio>~~1!~mcf&= take an oath.
Commission Number Expira8 June 08. Ml'I
(Stamp)
The foregoing Instrument was acknowledged before me this ..;2 ~- day of
-".":-'Yknoon ":.~