HomeMy WebLinkAbout00-9547
BUILDING PERMIT
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BUILDING
)s
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 788-6611
'!(
PLUMBING
Permit
09547
/:;1/6100
,
Date
2~
MECHANICAL
Sewer Conn 12 (~
Water Conn: 3So
Water Meter: Ii 0
T_LF.'s: 1'-160
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P<aperty Own.. (, ror d ~J,r ; ~
Job Address: 31 b ,__ k", _, 5" ~
Parcell.D. #)'.r ]s -~ 21- 00 l()- o.2~ ov-
o3l{O.
Zoning: Energy Code:
Description of Work /l1. M. 5 0 ,~ ~ up
~. 6--tl1-0t() ~~3.~Jn~
,L#Jt4 #
NO OCCUPANCY BEFORE C.O.
Radon Gas:
FINAL
DATE
o
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
City License Registration #
State Certified License#
Inspector
Permit Fee "577 f, ....!2.
Signature W <...y--tJ~
Company
Address
Telephone# "7 }J~' -715'-'/
Valuation or
Contract Price
154* {.e I'
BUILDING [ii
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b(t(
ELECTRICAL
(i7
f5 CA. ~ 4e.r {; (! (r1
PLUMBING 'I S
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MECHANICAL
<fS"
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
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.
b.
C.
d.
e.
f.
g.
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
~ ).}e i1;>.1~f.
{4::. ; cI
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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PASCO COUNTYlt FLORIDA
Date Permitted
s ,{ 7
/ I . I
(::;. It'l {)()
Permit Nu_
Builder NamelOwner Name
17 I I ,', { (, lei
) t( ..f +1...,,, . ..~ , .
County Parcel No. 1" \.(.. ) (,
Address/Location .:, '7 t I 4'
') I
..J.
()o! C.
0) ~ (;0
C \l/o
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ClassificationfType of Use
l..",I.') Itv('
U""1' (.l
Subd. G f (-. C/ 1+" ,
Of'
'~ t;:
.. . i
r.1,_)hl 'P
How Determined
TRANSPORTATION IMPACT FEE CALCULATION
EXEMPT 0
Why?
Rate $
Zone No.
Sq. Ft/Unit
Impact Fee Amount ..$
Prepared By
C~esWfJf
,...,-~
---
The above.imp"~ct fee has been established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the
Boarci.,o{Pasco County Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or
."
utili'zation of the permitted structure.
RESOURCE RECOVERY ASSESSMENT
EXEMPT 0
RESIDENTIAL
NONRESIDENTIAL
No. Units
I
Gross Sq. Ft. (GSF)
Rate ERl'
5200/Yeaf
Of SO_I..t2/Dav
ERU ASSign No.
Asse~~fllent- (No. Units) x ($OI..t21
x (No_ Day~)
Assessment -
(GSF) x (ERU) x (01421 x (No_ Days)
100
TOTAL FEE $
i ;
-"
TOTAL FEE $
NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED l'NTIL THE AMOUNTS LISTED
HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY.
AcknOWledgement below docs not imply acceptance of concurrence. hut SImply fecelpt of a copy of this form. placing
the huildIng permit owner on notice of this assessment and the conditions of payment for same
Date
Received By
-~-~- ------- -----------------------------------------------------------------------------
OFFICE L'SE ONLY
TRANSPORTATION REC. NO_
RESOURCE RECOVERY REC. NO_
.I .. ! I
DATE
DATE
i ... ~ j
BY
'--_ BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
\ Pink
Office
Green
Bldg/lnsp
feecalce
PC93113094/D
APPLICATION FOR PEMfiT
CITY OF ZEPRYRRILLS
BUILDING DEPARTMENT
DATE RECEIVED
PLANS REVIEW FEE
OWNER'S NAME &f?a,4"vJ H CJ/'Lrz c',}'
JOB ADDRESS L-,u r ?f'i
LEGAL DESCRIPTION: LOT(S)
PHONE
BLOCK
SUBDIVISION
PARCEL ID #
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: [JNEW CONSTRUCTION
[J ADDITION
[JALTERATION
[J REPAIR
[J INSTALL
[J SIGN
[J MOVE
[J DEMOLISH
PROPOSED USE: [JSGL FAMILY DWELLING
[J COMMERCIAL
[JMULTI-FAMILY
[J INDUSTRIAL
[J# OF UNITS
o SWIMMING POOL
~BILE HOME
[J OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
DESCRIPTION OF WORK
BUILDING SIZE
SQUARE FOOTAGE
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.
PERMITS REQUESTED
[J BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
[J ELECTRICAL
[J PLUMBING
[J MECHANICAL
AMP SERVICE
o FLORIDA POWER
[J W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
[J GAS
o ROOFING
[J SPECIALTY
[J OTHER
TYPE OF CONSTRUCTION: [J BLOCK
[J FRAME
[J STEEL
[J OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREA[J YES
[J NO
SIGNATURE l.U~ P.-A~;(;;:J
COMPANY 8~. /J.r, N S'
STATE CERT OR REGIST #
CITY PROCESSING #
BUILDER
******************************************************************
SIGNATURE
w U-;r---t1~
COMPANY Jf c.. -<-
STATE CERT OR REGIST #
CITY PROCESSING #
ELECTRICIAN
SIGNATURE
******************************************************************
COMPANY I:J~
STATE CERT OR REGIST #
CITY PROCESSING #
PLUMBER
c---
w~LJ~
MECHANICAL
******************************************************************
. COMPANY /'9C ~
SIGNATURE
tJur- LJ~
STATE CERT OR REGIST #
CITY PROCESSING #
*****************************************************************
OTHER
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDITIONS OF PERMIT AFFIDAVIT
A.. NqTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to ~deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may 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 may be cited for a misdemeanor
violation under state law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of Zephyrhills Building Department, 813-788-6611.
Furthermore, 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 which they
will be responsible. If you, as the owner signs 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. CONSTRUCTUION 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 Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the ~owner", I cerify 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'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
development.
Application is hereby made to obtain a permit to do work and installation as indicated. I
certify that no work or installation has commenced prior to issuance of a permit 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 governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone ~A" or ~A,etc.", it is
understood that a drainage plan addressing a ~compensating volume" will be submitted which
is prepared by a professional engineer registered 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 violate, cancel, alter, or set aside any provisions of the technical 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 issuance, or if work authorized by the permit is suspended or abandoned for a
period of six months after the time the work is commenced. One 90 day extension of time
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 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____ day of
by
acknowledged
19
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
of identification)
take an oath.
o who has produced
(type of identification)
and who Ddid Diid not take an oath
o who has produced
(type
and whoD did 0 did not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-710-8008 FAX 813-710-7910
EJ
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CITY OF ZEPHYRHILLS cJ () :3 t; 7 r;
ZEPHYRHllLS, FLORIDA
WATER ACCT. NO. J /1/ IOh'
DATE f!) II b Il ~
~~~~~ if k,wf ~lJ
MAILING 5- (17 ~ ( I (5/I/()
bNrl,: /(S/ FL 3~5'11
SERVICE ADDRESS 3 7b I ~ k",J: s Av~.
SHUT OFF SERVICE 0 LuJ. 1 Y ~TER
o SEWER
TURN ON SERVICE &'
INSTAll METER ~
READ METER 0
CHECK METER 0
OTHER 0
3/ y 'f kr "J . /Vte.Jv
WORK COMPlETED BY
& DATE COMPLETED
o GARBAGE
~ITY
o OUT CITY
_ No. OF UNITS
- DEPOSIT AMOUNT
- AMOUNT lAST Bill
_ DATE
- MISC. CHARGE
ORDER TAKEN BY
10 (;~I ()O
ORDER GIVEN BY
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