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Home My WebLink About02-0922 BUILDING PERMITN2 0922 Va f~ ~UILDING ~5/~ ELECTRICAL CITY OF ZEPHYRHILLS (813) 788~6611 35' rfO PLUMBING Permit Pmpo"" Owno' ~ ~ ~-f. Job Address: ~ " rJ tI e . k5t- ..:+ <;" Water Conn: /-2S-(J~ . J, d ., (>"..g'O Sewer Conn 'I- '(J '350. IJ"O Water Meter: / tft) , QV 4 'IJ'(I~ ~ , . . l'7f'",o -ru I ffJ .. t91) :J-5~~ MECHANICAL Date Parcell.D. # Zoning: Energy Code: DescriDtion of Work M. ~ JJ . S~ I Radon Gas: FINAL NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Valuation or Contract Price City License Registration # State Certified License# 1../9' Pe'm;t Fee ~ Uignatu~ r~ S, - A Company Address Telephone# I3v1?~helI5 .~y BUILDING !1ce.. it if ~ (5 r/ 1/.-wh.eU5 -JI~7 .lJe -e ~ Ys ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. 'nsul. CL WL Tp. Serv. Rough In Meter Can Const. Pole Pool pre-M7 Final 2-7-0~ SLB Tub Set Water Sewer Final /0<-7-&1;2 ;e(~ Breakers Ducts Insl. Compressor Final /ol-7-0.;;L /((.'1' ;<Llf Driveway f/J :2 -7-08-- i--(;Ke II ~Iq /L{- 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. f.Q,S ' 1<ec. y;J REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Twenty Five and 001100 Dollars ($25.00) shall be made for each trip for each trade: The payment of inspection fees shall be made before any further permits will be issued to the person owning same. EJ -~ .; J CD ~ :! ~ ., q; ~ ~ CD ;:::. .\ q; ci a; r1 () :J a o if ia ~ 1i; :J <Xl W () Z ~ " E2 " W 0. 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U. o I- ::l :z: (f.l a: ~ w (f.l o w () ~ w (f.l z o z a: ::l I- a: ~ UJ (f.l o ~ ~ w (f.l z o z a: ~ w ~ ~ O~ a: ~ UJ ::i1 ::J is (f.l ~ UJ ~ >- ~~ ~ Z ::I u. >- 0 ts ~ ~'i i ~ 5 I- W :I ~ i ~ I- ~ in z (.) 0::1 0 Q. g ~ !a ~ 'ii: Q :I I I I I I I +lrt o ~ :1 - ~ en o o a: ~ w ::i1 g (f.l ~ a: ~ w ::; :.:: () w :z: () a: ~ w :I ~ w a: a: w 5 iD z w :.: is a: UJ a a: o , ~ -I I >- lD .r-i z 109! O~ w \ a a: o iDa a~ ~~ UJa. -'::; a.o ~() ()UJ :.::!;{ a:a ~o<l ~ -._"-"'-_._'~' '.- - --_.,--- ---- - -~-_.- I- ::J ~ as w ~ j ~ ! ~ I- I- % U. in z (.) >- 0 ~ 5 I!: 0 ts ~ ~ ~ ~ 5 ~--j I I I I I I o t ~ ~~ ~ c<) >- ala @~ Wa. it~ ~() ()UJ :.::!;{ ~~ o 0 a: ~ w ::i1 a US a: a: ~ w ::; :.:: a: () w ~ ~ >- lD Z UJ :.: is a: w a a: o ti ---.. r6 iD f {) ~ l I.' ffi \ /)ff o OWNBR'S NAME C-AI'V'-'J JOB SITE ADDRESS G.... r CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDi:R'Q DIIPARMH'!' 5335 8th STRBIIT ZIIPIITRIIILLS. I"I.- 33540 PhoneI813-780_0020 l"axI813-780-0021 _ DATil RBCIIJ:VJID ) - J. D - D :J-- PLANs llBVJ:BIf I'IIB Ii rJli I ~:',.J fYl. y- p f. z.~. 375.3? ~ PHon CONTACT LEGAL DESCRIPTION: LOT(S) f}vtl. . SUBDIVISION (,...'l~ H en r~ .. ~ PARCEL ID # BLOCK WORK PROPSBD: oNEW CONSTRUCTION oSIGN (OBTAIN FROM PROPERTY TAX NOTICE) o ADDITIC?N o MOVE o ALTERATION o REPAIR o INSTALL o DEMOLISH PROPOSED USE:OSGL FAMILY DWBLLING o COMMERCIAL OMULTI - FAMILY 0# OF UNITS D SWIMMING POOL B1roBILE HOME o OTHER o INDUSTRIAL D RESTAURANT & HEALTH DEPARTMENT APPROVAL DBSCRrPTrON OF WORS n JJ- 5d ~ BUILDING SIZE 't.. "P rycJ SQUARE FOOTAGE RESr'DENTIAL: COMMERCIAL: HEIGHT 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 REQUIRBD FOR ALL NEW CONSTRUCTION. PBRMITS. RBQUBSTBD o BUILDING o ELECTRICAL $ VALUATION OF TOTAL CONSTROCTION AMP SERVICE o FLORIDA POWER o W.R.E.C. o PLUMBING o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION DGAS o ROOFING o SPECIALTY o OTHBR TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLQOR ELEVATIONS IS PROJECT IN FLOOD ZONE ARBAD YES' 0 NO BUl:LDIIR IILIICTRJ:CJ:AN SIGNATURE i..A...J'~~ ***************************************************.*******....*** COMPANY STATE CBRT OR RBGIeT # CITY PROCBSSING #:. Y i SIQNATURE LJ~4~ COMPANY He- STATB CERT OR RBGIST # CITY PROCESSING # ~~ ***.*.*.********.*******************..****.*********************** PLUMBIIR SIGNATVRE LJ~~ COMPANY LJ....A'A/" /J? STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ******************.*********************************************** COMPANY ;Ir1 <:... ___ # ) STATB CERT OR REGIST # 'J:~~ crTY FROCBSSrNG I It 5' JlBCHAHICAL *************************~*************************************** OTSBR *******.***************.***.....****.***..**..*****.*********.**. COMPANY STATE CERT OR REGIST # CITY PROCESSING # l( r SIGNATURB A. NUTICE 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 RES~ONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with st~te 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, 813-188-6611. 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 contraptor that may be an indication that he is not properly licensed and is not entitleq to permitting privileges in the City of Zephyrhills. C. TRANS~ORTATION IM~ACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION LIEN LAW (CHA~TER 113, 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. J 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 code~, zoning regulations, and land development regulations in the jurisdiction. I also certify that 'I understand that the regulations of other governmental agenciea may apply to the intended work, and that it ia 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, Cypxess 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 ~rotection Agency-Asbestos abatement I also certify that, if till material is to be used in Flood Zone ~A" or "A,etc.", it is understood that a drainage plan addressing a ~compensatingvolume" 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 Offic!al from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall become invalid unless the work a~thorlzed by such penmit 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 OJ!' COMMENCi:MENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD.AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR acknowledged , 1!L- STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this -----Pay of by STATE 01' FLORIDA COUNTY OF The foregoing instrument was Before me this _ day of by acknowledged , 19 (name of person ackno~iedged) 'Dwho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or of identification) take an oath. o who has produced (type of identification) and who Od1d [)Ud not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped I , /00 /00 , ;' ~I" ~ if~ ~ 't ~ .~ ~ ~ ;' ~ if),) :tJ" S '-\ ('";fR f'()Je r C\.: -.., ~ '< - - - \::J f\J '- ~ ~ '" , , ~ ';0 g(lO ~ ~ k ~ O~((/6tvAY 'J ~ '-.J ~/ (.Ie .. ~ I . ~O ;:: .,j v~Oij.::l Hd<:1 ;<:1 5661-17<:-[ k ~o >1 , 020 , 20 ,; It;S h"~ ,,' 1-- 1'1' , /J.5" $Ift;d S~ft&G A./ /( Of? M , a ~ / to. I< 11106 I t.5 ~l41e j~' '''7 '~'''.._",_.'>> PASCO COUNTY, FLORIDA Permit Nu, ~, ",>4... Date Permitted /: ~.. ~ "'"'" ,,''''' ~ ~ Builder Name/Owner Name i k.. ,.jj""~'" r. ...... I ,'i.....,j County Parcel No. < ..: 7 ,.~::-..I,~ /.. t 1,""- ~; ,])" .f \-- ~, ," i{'" J~7 '.' u ---.'- i ;";f ~,...-" .." 1- f.-.!; ..,",11,' ~ -~ ...... ) ,;;. j ,;' " Subd. '" . ~ . ; ,~, ~." " ":'-':1- -., , : \...""- Address/Location .... CI assificationffype of Use ,'I II" t} " II t ~f,.;'; ~'_ How Determined ,," TRANSPORTATION IMPACT FEE CALCULATION ,-' EXEMPT 0 Why? Rate $ Zone No. " Sq. FtlUnit Prepared By Impact Fee Amount $ Checked By The above impact fee has been 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 utilization of the permitted structure. RESOURCE RECOVERY ASSESSMENT EXEMPT 0 RESIDENTIAL " NONRESIDENTIAL No. Units I Gross Sq. Ft. (GSF) RatL' ER l:" 52, OOIY ear or SO. 1 42/Day ERU ASSIgn No. A~~L'~~TllL'nt- ()\;o Units) x ($0,142) \ (No, Day~) As~essment - (GSF)_x (ERU) x <0,142) x (No. Days) 100 TOT AL FEE $ TOTAL FEE $ NO CERTIFICATE OF OCCUPANCY OR FINAL POWER RELEASE WILL BE ISSUED lTNTIL THE AMOUNTS LISTED HA VE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY. Acknowiedgement 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 payment for same. Date Received By ----- ---------------------------------------------------------------------------- ------------------------- - - - - ------------ ------------------------ OFFICE L'SE ONL Y TRANSPORTATION REC. NO. RESOURCE RECOVERY REC. NO. DATE DATE BY BY White Applicant Canary Trans/Finance Canary RR/Flnance Pink Oltice Green Bldg/lnsp oqd-'J- feecal:ce 'C93113094/D