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Home My WebLink About01-0332 BUILDING PERMITN~ 0332- CITY OF ZEPHYRHILLS (813) 788~6611 Permit ., YO.oJ- BUILDING ~ t;, ~ ELECTRICAL Date ~/2Z/o, 35, ~ PLUMBING Water Meter: ......:'1. 17).~ I~O.~' 2 s, ilE MECHANICAL Sewer Conn Property Owner: 6 rA ,. J Uu ,. ; 'Z (J '" Job Address: j 7 5" ') s- tJe cA. 1<0,,", Avf . Parcell.D. # J"I-1ll..7\- 00.0.01800.1"12,0 Water Conn: T,I.F.'s: Zoning: Energy ~pde: Description of Work }t1 1)10: Ie 1-'0"", (I St!.. lAf rl~L p: . t -,5-:'0 / /b,~()Ftnv a? lYIeL~,(IIe:. NO OCCUPANCY BEFORE C.O. Radon Gas: Valuation or Contract Price Permit Fee 377 t-A FINAL Complete Plans. Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinanees. Inspector City License Registration # State Certified License# Signature Company Address Telephone# 7lS''''' -7 'is' '-7 f~c.c.~ f;eA J BUILDING '-18 A~ Ef.,{. ;~"",r~.C~(cI A<.~ ee~:~ ' MECHANICAL 'i)" ELECTRICAL PLUMBING Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Serv. 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 Twenty Five 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. CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DBPARTMENT 5335 8th STRBBT ZBPHYRHILLS, PL 33540 Phone:813-780-0020 Pax:813-780-0021 DATB RBCBIVED PLANS REVIEW PBB OWNER'S NAME tr^~ \ /I (j)'r.,/.......... ".J PHONE CONTACT JOB SITE ADDRESS Lr. T 1'1"2- LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # WORK PROPSED: DNEW CONSTRUCTION (OBTAIN FROM PROPERTY TAX NOTICE) o ADDITION o ALTERATION o REPAIR o INSTALL DSIGN o MOVE o DEMOLISH PROPOSED USE: DSGL FAMILY DWELLING o MULTI - FAMILY 0# OF UNITS [j MOBILE HOME o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o 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 o BUILDING $ VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C. o PLUMBING o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES o NO BUILDBR SIGNATURE \.l) ~p:;,>~ COMPANY g~ STATE CERT OR R GIST # CITY PROCESSING # '-('is" ****************************************************************** BLBCTRICIAN SIGNATURE ~.L1 q~ COMPANY ,14 c...-C.- STATE CERT OR REGIST # CITY PROCESSING # **************************************************~~************** SIGNATURE c~~7!b COMPANY STATE CERT OR REGIST # CITY PROCESSING # ~ ~ EJ PLUMBBR MECHANICAL ****************************************************************** SIGNATURE W~~? COMPANY /1-~.. oC..-- STATE CERT OR REGIST # CITY PROCESSING # ,/ (5/ ***************************************************************** OTHBR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE 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 penmitting 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 penmit 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 penmit 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 penmit prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every penmit issued shall become invalid unless the work authorized by such permit is commenced within six months of issuance, or if work authorized by the penmit 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) [1ho is personally known to me, or (name of person acknowledged) Dwho is personally known to me, or of identification) take an oath. Dwho has produced (type of identification) and who Ddid DUd not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped ,/ {:? / )8' ,/ 3) 7" 't /Ylel)! 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'j (' ~ )., ; l!) i' ;:';. l'-'; II 'I':' hi ;d',I!" it ':.1;'\ .J !- I /1 t";1 ! I',) . ~ ,1 . ." - "''''''',' ..". , ",' "'\".~' -.' c:.~., I '. .,.. ;.~ ''- 'r: ,~ " . ... .. PASCO CQUNTY, FLORIDA Permit Nu, ()!~ 2 ! I L:f"'-\ II Date Permitted _ " , ,; .:. . v Builder Name/Owner Name @1,.!.tJ, .0' " ~ I I I ('t County Parcel No. 7: '-.~ . t;,... \ C U '\,' ,>?: v'.; - /"';? .:' Address/Location ~,~~ '"/ ~~ ~~, 'J: . t. \..< , j_ 1 \.,. l~. ." Subd. (", ( ti 1:.... (., i'. Classificationffype of Use r' ;" I. t \ How Determined TRANSPORTATION IMPACT FEE CALCULATION EXEMPT 0 &(,-I.(-{)J , f Why? Rate $ Zone No. Sq. FtlUnit Prepared By ",~ ,/ / Impact Fee Amount $ CheckedBy / " The above impact fee has beeIl.established pursuant to the Pasco County Transportation Impact Ordinance as adopted by the Board of Pasco County ~Commissioners. This amount is payable PRIOR to the issuance of a Certificate of Occupancy or r utilization of the pepnltted structure. f RESOURCE,RtCOYERY ASSESSMENT EXEMPT 0 RESIDENTIAL NONRESIDENTIAL No. Units Gross Sq. Ft. (GSF) Ratc ERL: 5200/Year or $0.142/Day ERU ASSIgn No, A~~C~~flll'nl - (No Units) x ($0,142) \ i No. Day~) As~es~ment - (GSF) x (ERU) x (0142) x (No. Days) 100 TOTAL FEE $ . i TOTAL FEE $ NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED UNTIL THE AMOUNTS LISTED HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTI~G OFFICE OF PASCO COUNTY. Acknowiedgement below does not imply acceptance of concurrence. but simply rCCl?lpt 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, ,'1.. f ? DATE DATE BY BY ~T-- -'f White Applicant Canary Trans/Finance Canary RR/Finance Pink Office Green Bldg/lnsp feecalce PC93113094/D