HomeMy WebLinkAbout02-1682
BUILDING PERMIT
Permit N~
~o ,tyO
BUilDING
~O.~..(,l
ELECTRICAL
CITY OF ZEPHYRHILLS
(813) 780-0020
fo ' (YO .5..5-' ~
PLUMBING MECHANICAL
1682
Date
((-27-0-:<
Energy Code:
k. \i. 5..d-
Radon Gas:
Sewer Conn ~:J 75' ~
Wate, Conn: fSo.. (!'.k>
Water Meter: /8-0' ()--O
PtJ. cO<J
. _ (.Ftr tf-O
~,1 -' ,yto
Yj . C~I1. - /75 .<
Property Owner:
Job Address:
Parcell.D, II
Zoning:
DescriPtion of Work
~r
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
A')..
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
~~ o~,.-o
Permit Fee 0
...( Signature 0J ~ .
Company
Address
X'Telephone# f7;J" S~3'"'
Valuation or
Contract Price'
City license Registration # Lf S-
State Certified license#
rg vtrerl::/./ld s
J1CsL ;tf
,
7101f -e-y Ft f. /1"1 C;
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PLUMBING
/1 CA7- I?
.
BUilDING
ELECTRICAL
MECHANICAL
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
pre-M~
Final t '2 .Lj - tJ 2.
SlB
Tub Set
Water
Sewer /'
Final t., / /2 -1 -t) l
Breakers
Ducts Insl.
Compressor
Final 1,,/ /.2 -9 ~ d.2..
Driveway
f?
1;1 r-f ~ t} ~ Jj: 'It; V/L0'a#
ff
REINSPECTlON 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.
140.~
o
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same,
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CO;\;Y-):~'j'IONS 0::' P~~pJ.If~:;.r~.1 AF~1TDA\r5.1~~
A, NOTICE OF bEED RESTRICTIONS
'I'lle unde"t:signed undet:stands that tills penrd,t: :nay be subject ;:0 "deed restrictions" H1d,ch
may be lilore restrictive than City r'=9ulations, The 1111~:!1=rs:L9ned assumes respoflsibJ.U,ty for
compliance Hith any applicable deE!d L,:!strict.iotls.
B, UNLICENSED CON'l'RACTORS AND CONTRACTOR RESPONEIIBILIT'IES
I f the owner has hired a contractor 0 L con,tractOL:, to undertake work, they may be r:equired
to be licensed in accordance with state and local regulations. If the contractor is not
l.icensed as requl.red by law, both the owner and contractor lIlay be cited for a misdemeanor
violation under state law. If the mmer or intended contl:actor are uncertain as to what
licens\.ng l:equlrements may apply for the intended work, they are advised to contact the
C.ity of Zephyrhills Bullding 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 whicll they
~dll be responsible. If you, as the OHner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work. If the contractor wishes
you to slgn as contractor that may be an indication that he is not properly licensed and is
not enti,tled to permitting privileges in the City of Zephyrhills.
C. 'I'RANSPOR'I'AlrION IMPAC'I' FEES AND UTILI'rY CONNECTION FEES
D. CONS'rRUC'I'UION I,IEN LAW (CHAP'rER 713, FLORIDA STAIl'UTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
Ii en IjaH - Homeowner's Protection Guide" prepared by the Florida Departmellt of Agriculture
alld Consumer Affairs. It the applicant is someone other that the "owner", I cerity that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to cOlTunencement.
E. CON'l'RAC'I'OR' S/OWNER' S AFFIDAVIT
I certify t;hat all the information in this application is accurate and that all work H1Ll
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 illdicated. I
certi fy 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 Hhat actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulatlon-Cypress Bayheads, Wetland Areas and Envlronmentally Sens~tive
Lands, Water/Wastewater 'l'reatment
* Southwest I.i'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waten.Jays
*Department of Health & Rehabilitative Services, Environmental Health Unit-We1.ls,
Wastewater Treatment, Septic Tanks
*U.S, Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used ill Flood Zone "A" or "A, etc.", it .is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared ~y a professional englneer registered in the State of Florida prior to permit
issuance.
A permit issued sllall 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 tecllnical codes,
nor.llall issuance of a pennit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall beoome invalid unless the work authorized by such permit is conunenced within
six months of issuance, or if work authorized by the perm1t is suspended or abandoned for a
period of six months after the t1me the work is commenced. One 90 day extension of time
may be all,oHed for the permit with fee charge of $15.00. The extension shall be requested
in writJng to the Building Official. An approved inspection must be logged during each six
mOllth period, or the project will be considered abandoned.
WARNING TO OWN!!',R: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESULT IN YOUR
PAYING 'l'WICE F'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND '1'0 OBTAIN FINANCING, CONSUL'r
WITH YOUR LF:NDER OR AN A'r'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,TOBS UNDER
$2,500 IN VALUE: DO 1'1011' NEED 11'0 RECORD AND POST A "NOTICE OF COMMENCEMEN'r".
------'------'-----r--
SIGNA'l'lJRE: OWNER OR AGEN'!,
SIGNATURE: CON'l'RACTOR
S'I'ATE OF FLORIDA
COUN'l'Y OF -----,
The fotegoing instrument was acknowledged
Before me this __ day of , 19_
by______
(name of person acknowledged)
Dwho is personally known to me, or
STATE OF FLORIDA
COUNTY OF ' ,-
The foregoing instrument Has acknowledged
Before me this ,_.-Slay of-------, 19 ~
by '--'--
(name of person acknoHledged)
C1110 is personally known to me, or
L1 who has produced
{type
and who[1 did Ddid not
D who has produced______,__________
(ty~e of identification)
and who Ddid DUd not take an oath
of identification)
take an oath.
Signature of person taking acknoHledgement
Signature of person taking acknowledgment
Name typed, prJnted or stamped
Name typed, printed or stamped
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PASCO COUNTY, FLORIDA
Builder Name/Owner Name J3 (\ -a: \"f:1~ I d )lllI-g
County Parcel No. :3 4 . J 5'., ;) I~ (J ell o"() ;).l{(l{l- J f';So
Permit No. -1 tJ7' ~ ')-..
Date Permitted / l~). 7 . ('fA
Control #
Address/Location , ') '7 S' 3 .:;' J 11 '1. . to
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ClassificationlType of Use lIlt, I} I / {'-'
"'" Cl
/.-1", e
() ,
SubDiv: l':')fYI H II f,~~ ~ () V\."S'
f..I (\ fH~,
TRANSPORTATION IMPACT FEE
Rate:
Sq Ft Unit:
Exempt 0 Yes 1ZI No How Determined
Impact Fee Amount $ ~ 48{> Zone No. T AZ:
SCHOOL IMPACT FEE A
Account (056) Single-Family Detached House Amount $ 1/ 1-1,
(057) Mobile Home
(058) Other Residential
.J)23) Collection Fee
Exempt ~ Yes 0 No How Determined
PARKS AND RECREATION FEE
Land Account Land Credit
Land Total
Recreation Account
Recreation Credit Recreation Total
Zone
TOTAL AMOUNT $
Exempt 0 Yes 0 No
How Determined
LIBRARY FEE
Land Account
Land Credit
Land Total
Facility Account
Facility Credit
Facility Total
Exempt 0 Yes 0 No
How Determined
Total Amount
RESOURCE FEE
TOTAL AMOUNT
ERU
~-.~ '. ("--")
Prepared B~ . ~ /.-<:../\..) 'h
Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement 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
RECEIPT NO.
RECEIVED BY
DATE
BY
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