HomeMy WebLinkAbout02-1413
BUILDING PERMIT
Permit N!
CITY OF ZEPHYRHILLS
(813) 780-0020
1413
Date
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v o. (J'O
BUILDING
i.lo'~
ELECTRICAL
Vo ' tfJ<)
PLUMBING
35',0
MECHANICAL
Energy Code: Radon Gas:
K.W 5~-"f
Property Owner:
Job Address:
Parcell.D. ,
Zoning:
DescriDtion of Work
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
;-; -' #2-
~ 7 DATE 1 _
r- f .- Ov
NO OCCUPANCY BEFORE C.O.
DATE
Inspector
Permit Fee
~----
. nature~
Company
Address
Telephone#
l~~-
Valuation or
Contract Price
City license Registration #
State Certified license#
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.
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final .-----,l? t-~
9-/? -c'Z..
SLB
Tub Set
Water
Sewer ~
Final c/ ~ /7-07 ~(~
/d"D
,Pttfffo
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final /"1-17-02
Ftr.
Pre SLB
lintel
FRM.
Insul. CL
WL
//50
Driveway
(f '1'-/~~02. (fidq~1J7~
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. 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.
I(~s. ~. ~
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
I OWNER'S l1AME
CITY OF ZEP!iYRHII.lIJ8 PERMIT APPLICA'rION
BUILI>IN(~ DEPAR'l'MlllN'r 5335 8th 8TRlllE'r ZBPHYRHILLS, FIJ 33940
Phon61813-780-0020 FaxI813-780-0021
DATB RBCBIVIID _~.;2,;2- t2:Z __.
JilI,ANS RBVIBW "B.
C-I'L;o-......J
PHONE! CONTACT
JOB SI'I'E ADDRESS _?<./ I 'l- 'i
PARCEL to #
LEGAL DESCRIPTION, LOT(S)
BLOCK
CN<."........J 1+01"1:::'"
SUBDIVISION
(OBTAIN (I'ROM PROPERTY TAX NOTICE)
WORK PROP8ED I 0 NEW CONS'I'RUCTION
D ADDITION
llAUfERATION
[] REPAIR
IJ INS1'AIJI,
DSIGN
rJ DEMOLI SH
[J MOVE
PROPOSED USE I OSGIJ FAMILY DWELLING
DMlJLTI - F'AMtLY
0# OF UNI'I'S
EtM6BILE HOME
o OTHER
o COMMERCIAl,
o SWIMMING POOl,
o lNDUSTRIAI,
o RESTAURANT & HEALTH DEPAR'I'MEN'1' APPROVAl,
/hi( Sd~
BUILDING SIZE
DESCRIPTION OF WORK
RESIDENTIAIJ I
COMr-1ERCIAIJ I
D BlJII.I)UIG
[J HlIJEC'l'RICAL
[] PI,UMBHW
0 MmCHANICAL
[] (JAS
o ROOF lNG
SQUARE FOOTAGE
HEIGHT
A'l'TACH (2) PLOT PLANS & (2) SE'fS OF BUUJDING PLANS & (1.) SET ENERGY FORMS.
ATTACH (3) SETS OF Bun,DING PLANS & (1.) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR AL,I, NEW CONSTRUCTION.
PERMITS REQUESTED
$
VAl.tJATION OF TO'1'Al, c!cmS'I'RUCTION
AMP SERVICE
o W.R.E,C,
o FI,ORIDA POWER
$
VAI,UATION OF MECHANCIAIJ IH8TAIII,~TION
[1 SPECIAUrv
[J OTHER
'l'YPBl OF CONB'l'RUCTION I L1 BLOCK
o FRAME
o STEEI~
o OTHER
FlNI811ED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YBlS CJ NO
BUILDBR COMPANY ~-
~~1f} STA'I'EJ CEJRT OR REGIST # ___________.
8lGNA'fURE w~~ CITY PROCBl88IN(~ ~
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IILJllCTRIUIAN
SlGNA'l'IJRE U-1'~!J~~.-
PLUMBER
SIGNATURE
MECHANICAL
SIGNATURE
OTHER
COMPANY ,.,c.. '"'-
STATE CER'I' OR REGIS'!' #
CITY PROCESSING #
******************************************************************
Lf~
COfvIPANY- ... __
STATE e'ERT OR REG 1ST #
CI1ty PROCESSING #
0-J' ~-ey;K2 -
******************************************************************
COMPANY n~ "-./
.
STATE CBlRT OR RBl(HBT #
0C;r dJ~ CI'I'Y PROCBl8SING #
*****************************************************************
COMPANY
STATE CERT OR REGIST #
CITY PROCESSING #
SIGNATURE
*****************************************************************
CONDI'.','IONS O~ PERMIT AFFIDAVI'r
A. NO'rICE Oil' DlllmD RES'1'RIC::'l'IONS
'l'b.e undersigned understands that tinill pE:rmic may be subject to "deed restrictions" whioh
may be more restrictive than C1ty t'eUlllations. 'l'he undersigned assumes responsibility far
compliance \lith any appli.cable deed [Elstl.ic.~it)nB.
B. UNLICENSED CON'l'RACTORS AND CONTRAC'l'OF. RJ!lSI?ONSIBILI'l'IES
If the o~mer has hired a contractor or cont.-:act.ors to undertake work, they may be required
I to be licensed in acoordance w1th stolte and local regulations. If the contractor 1s not
licensed as required by law, both thE! OWlIer and contractor may be cited for a misdemeanor
violation under state law. If the o\'1I1er or intended contractor are uncertain as to what
liceusing requirements may apply for the intended Hor.k, they are advised to contact the
CHy of Zephyrhills Bu1ld1ng Departme,nt, 013-786-6611.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
Gontractor(s) sign portions of the "Contraotor Sections" of this application for wh10h they
will be responsible. If YOll, as the owner signs as the contractor, you are indicating that
you, rather than the contraotor, are responsible for the work. If the oontractor wishes
~'Oll to sign as contractor that may be an indication that he is not properly licensed and is
Hot entitled to permitting privileges in the City of Zephyrhills.
C. 'l'RJ\NSI?OR'l'A'I'ION IMPAC'l' FEES AND U'l'UITY CONNEC'l'ION FEES
D. CONB'l'RUC'l'UION MEN LAW (CHAE"l'ER '713, FLORIDA S'l'ATUTES, AS AMENDEm)
] cert! fy that I, the applicant, have been provicted Hith a copy of "Elorida's Construction
1i~n Law -- Homeowner' IS Protection Guide" prepared by the li'lorida Department of Agricul tllre
and Consllmer Affairs. If the applicant is someone other that the "owner", I cedfy that I
have obtained a copy of the above described ~ocument and promise in good faitll to deliver
it to the "owner" prior to commencement.
E. CON'l'RAC'l'OR' S/OWNER' S AFFIDAVI'1'
I certify that all the information 1n this application is accurate and that all Hark will
be done in compliance with all applioable laws regulating construction, zoning, and land
development.
Applioation is Ilereby made to obtain a permit to do work and installation as j,ndioated. I
certJfy that no work or installation has commenced pripr to iSliuanae of a permit and that
all work Hill be performed to meet standards of all laws regulating oonstruotion, City
codes, zoning regulations, and lalld 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 r~sponeibility 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 Seneitlve
Lands, Water/Wastewal:er 'Preatment
*Bouthwest H'loricta Water Management District-Wella, Cyp.reaa Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-SeaHalls, Docks, Navigable Waterways
*Uepartment of Health & Rehabilitative Services, EnVironmental Health Unit-Wells,
Wal'ltewater 'l'reatment, Septio 'l'anks
*u.S. Environmental Proteotion Agency-Asbestos abatement
]: also certify that, if fill material is to be used in Il'laad Zone "A" or "A, etc. f1, it is
understood that a drainage plan addressing a "compensating volume" will be submttted Vlhich
is prepared IlY a professional engineer reg.ietered in the state of Florida prior to permit
issllance.
A permit issued shall be construed to be a license to proceed with the work i!md not as
autllority to violate, cancel, alter, or set aside any provisions of the technical codee,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
doueation of errors in plaua, construotioJl, or violations of any oode. Every permit
luued shall beoome invalid unleu the work authorized by suoh permit is aonullenced wHldn
liiH month. 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 conunenced. One 90 day eHtension of thlle
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Offioial. An approved inspection must be logged during eacll six
month period, or the projeot will be considered abandoned.
WARNING '1'0 OWNERI YOUR FAII.tJRE TO RECORD A NO'l'ICE OF COMMENCEMEN'l' MAY RESUJ.'l' IN YOUR
PAYING 'I'WICE B'OR IMPROVEMEN'l'S TO YOUR PROPER'l'Y. IF YOU IN'l'END 'I'D DB'I'AIN FINANCING, CONSUL'l'
WITH YOUR I,ENDER OR AN A'I"l'ORNEY BEB'ORE RECORDING YOUR NonCE OF COMMENCEMEN'I'. ,JOBS UNnER
$2,500 IN VAI,UE DO NO'I' NEED '1'0 RECORD AND POB'l' A "NO'l'ICE OF COMMENCEMEN'I'".
SIGNATURE I OWNER OR AGENT
SIGNATURE I CONTRACTOR
-_._-----~...-----
S'PA'I'E OF H'I,ORIDA
COUN'I'Y OF
'l'he foregoing instrument was
aefore llIe this _____ day of__
by
acknowledged
, 1~_
BTA'l'E OF FLORIDA
COUN'I'Y OF
The foregoing instrument was
Before me this _J.iay of
by
acknowledged
, 19~
(name of person ackno~-Iledged)
IJ Hho is personally known to me, or
D~lo has produced
(type
and who!] did Ddid not
of identification)
take an oath.
(name of person acknowledged)
Qho is personally known to me, or
o who has produced
(type of identifioation)
and who Ddid DUd not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment I
Name typed, print.;d ~-;tamp~~----
Name typed, printed or stan~ed
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C\::J,ng(4L. PE'.PJ!IJ.TTTnU
PASCO COUNT~~ FLORIDA
pAGE \\ 1. 1_1\
1 ~:3b\.l\:'. OFF 1 CE \\ n
r..:FCFI.PT HUI-l\HI'-;:. \\ O()~:iO()O~:i5
OFF".IX;E.;; DADE C;lTY
'f.1!:-:,'H.:.:: \.)'7!'~""
l".:I.JNTF,,-,\Cl'OR "\\ 009H64
NAME \: BUTTE\~P :.~':\...\)
!~J)DR:: '5"76150 L.OREN?'\ AV
C/ST:: GRAND \..KW;:ll.ONS D..\1.U._S
C\-IE.C\::'. " 1727
FOR::
~:,OL ID \).IA~3TE.
crn,.rn;:ACTOR:: 009864
TOT?'\\...
COMPNY ACCOUNT
B4S0 ._ -'::~6-'::;()OO ....
AMOUN'l ::
CE.NTEJ;:
16MSO
A"'OUNT DESCHIPnON/PE,,"'T DATA
16MSO ****** SOLID WASTE FEE
DF~/CF:
60
AeeNT
114
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,;..
RC.C:F.I'JED BY ......Q...~a.......................................
....................................... .....................
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PASCO COUNTY, FLORIDA
Permit No.
":11 ~.)
Date Permitted _
~f'
"'~"", ,{'<
,
~...
~-~I""~
Builder Name/Owner Name
,
. .
~."
/; i-i
County Parcel No.
,t c'
,""'J. .
~'J :~
,[; (j J,';;"
.~ '
to-i' ,',"!"
.,
~
Subd. .
Address/Location
h1
ClassificationfType of Use
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
Gross Sq. Ft. (GSF)
Rate ERU - 54.00Near
or $0. 148/Day
ERU Assign No.
Assessment - (No. Units) x ($0.148)
x (No. Days)
TOT AL FEE $
Assessment -
(GSF) x (ERU) x (0.148) x (No. Days)
100 '
TOTAL FEE $
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.
Acknowiedgement below does not imply acceptance of concurrence, but simply receipt 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 USE ONLY
TRANSPORT A TION REC. NO.
RESOURCE RECOVERY REC. NO.
DATE
DATE
, '
BY
_BY
White
Applicant
Canary
Trans/Finance
Canary
RR/Finance
Pink
Office
Green
Bldg/lnsp
feecal:ce
PC93113094/E