HomeMy WebLinkAbout04-2826
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CITY OF ZEPHYRHILLS
5335-th street
(813) 780-0020
ELECTRICAL PERMIT
2826
Permit Number: 2826
Permit Type: ELECTRICAL MISC
Class of Work: ELECTRICAL MISC
Proposed Use: NOT APPLICABLE
Contractor: ATA ELEC. CO.
Square Feet:
I Est. Value:
Improv. Cost:
L Date Issued: 3/15/2004
Total Fees: 44.00
Amount Paid: 44.00
Date Paid: 3/15/2004
Work Desc: POWER SUPPLY FOR CATV
Address: 5436 TANGERINE DR
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
RICKY WILKINSON
5436 TANGERINE DR
ZEPHYRHILLS, FL. 33542
R~.LN::HJ~C l'.LUN r'~~::;:
following reasons,
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
The payment of inspection fees shall be made before any further permits will be issued to
the person owning same
-nwarn1ng----eooWiler :--YOur-U1l ure~-t:o -recoraanoC1ceoY--commencemen1:InayreS\lIt:-rn 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...
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be
performed in accordance with City Codes and Ordinances.
Phone:
ROUGH ELECTRIC
FINAL
,--1__,_____,_._
~
PERMIT OFF I
INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
~ BY: A"A EcECTR!C;
~
7:;'7 939 4296;
APR-23-04 1 :01PM;
PAGE 1 Ii
ATA ELECTRIC COMPANY, INC.
,
Residential:'" Co.ftmercial ... Industrial
licensed &:ln8ur~ #ER 0013164
4510 Mile Stretdi Dr., Holiday, Fl 34690
PHONE (727) 938--7224 FAX (727) 939-4286
;
April 22" 2004
City of 2ephYthills
5335- Th :Stre~t
Zephyrhills, FL
To Whom It May Concern:
I, Tony Kalliv~ousis, authorize Harry Schmit to Cancel permit numbers 2826 on
illY khatf. If You have any questions please feel free to contact me.
~
:~.
To . Ilivro~sis, President
ATA ELECTRIC COMPANY
Signed and sealed before me this :t~
nay of ~: I
, 200 f../ .
NOtary Public ;
u.
Pz3
~
My assignment expires:
VMIUIa 8IICMCIS
MY CONMl8sIt14.. DO 1.f9j51
l EXPIRES: Aupt ZI, 2006
IlonaI'lIIluNOlllJ'PIM;~
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8n St, Zephyrhills, FL 33542
813-780-0020 FAX:813-780-0021
DATE RECEIVED
] j:J /tJ'-/
, .
PHONE CONTACT FOR PERMITTING
OWNER'S NAME
,0 C tll
I
S-tf3h
lA11Ki'h '<)on /snqhfj,OI{ s--e
7bn ref") J1 'e.. /)2.
PHONE
At.,q
7,J7 - 9) ~- 7d,A l/
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) .1 BLOCK
PARCEL ID # JJ.-~b- .)/- 6040-00'/00 - 00)0
'I
SUBDIVISION
(ORTAIN FROM PROPERTY TAX NOTICE\
WORK PROPSED: [JNEW CONSTRUCTION
[J SIGN
PROPOSED USE: [JSGL FAMILY DWELLING
[J COMMERCIAL
[J ADDITION
[J MOVE
[JALTERATION
[J DEMOLISH
[J REPAIR
nv{NSTALL
OMULT I - FAMILY
[J INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
[J OTHER
DESCRIPTION OF WORK
o RESTAURANT & HEALTH DEPARTMENT APPROVAL
CATV
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
[J BUILDING
o ELECTRICAL
$
VALUATION OF TOTAL CONSTRUCTION
(00
AMP SERVICE
29 FLORIDA POWER
o W.R.E.C.
o PLUMBING
[J MECHANICAL
$
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 AREAO YES 0 NO
cp~g!l'OR;$ECTI()N
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
'LECTRICIAN~ J .
SIGNATURE f!l1cJcY . JL~Jl
Ati4 ~ lee/ric
STATE CERT OR REGIST # ?;).Ci -3
I he.
COMPANY
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
MECHANICAL
******************************************************************
COMPANY
SIGNATURE
STATE CERT OR REGIST #
*****************************************************************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign po~tions 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 fora
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".
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SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
acknowledged
, 2~
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
, 20_
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Owho has produced
(type
and whoO did 0 did not
of identification)
take an oath.
o who has produced
(type of identification)
and who Odid 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
,'vI~)lIO:, .,"
P'"ASCO-COUNTY DEVELOPMENT REVIEW
V'/eST PASCO GOVT. CENTER S-230
7530 LITTLE ROAD
NEW PORT RICHEY, FL 34654
(727) 847-8142
(352) 521-5144
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" RIGHT-Of-WAY USE PERMITI
PA~CO CQUNTY
- USE PERMIT -
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"Sunahlne-One all"
(800) 432-4770
- 48 hours prior to excavation -
GENERAL INSTRUCTIONS
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, No constructlon, under ground or above ground, bf any lacilHy, shall be accomplished on any Counly Rights 01 Way without written appro~al'from
the County. Any applicatIon for approval of construction operatIons on any County owned Rights of Way shall furnish a detailed drawing showing the
complete scope of the proposed work in quadruplicate to the County for review and approval prior to the commencement of any work. A copy of this
permit mu.t,'be kept readily evat/abte at the "te 0' the work at aU time..).
Sec. No T .. R County Road ".j'.,",; ,.'..:",..",.1/..., Date /0. .3/, (>3 .
Permit For : .;.,< ,/J/:Nt't:l/I/i./V/- I
LOCATION (Legal Description)
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(Project Name)
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for the construction and maintenance of
Permission is hereby granted to
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(Descripti()n of Work)
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subject to the following conditions:
1. The construction and maintenance of such utility shall not interfere with the property and rights of a prior occupant.
2. All work shall be done in keeping with the standards of Pasco County and at the satisfaction 01 Pasco County, who will be notified at least
one day prior to commencement of construction.
3. All materials and equipment shall be subject to inspection by Pasco County.
';,'~. During conatruction all safety regulations of the Florida Department 01 Transportation shall be observed; and Pasco County shall be relieved
of aU responsibility from damage of any nature arising from this permit. Subject to the same terms and conditions, the permit holder may take such
safety measures, Including placing and display of caution signs, as it may deem necessary in conduct of construction and maintenance work hereunder,
5. AUprivate and all Pasco County property shall be restored to its original condition as lar as practical, in the opinion of Pasco County.
6. All underground crossing installations shall be laid at such depth as may be specified by Pasco County, unless otherwise authorized. Installa-
tlQn of ulWtI.. under County I'CMIda .hell be by IKklng and borlflil only_
7. The sketch (four copies) covering the details of this installation shall be made a part of their permit. This permit is granted with the understanding
that the awllcant hilS notified all other ulllity users In the area covered by the permit and takes full respolll!iiblllty for any damage incurred by prior
Installations as a result of his operations. He also takes full responsibility lor notifying any and all utility or underground users of his proposed operations
in order that they may saleguard their interests. .
8. II is e!lpressly stipulated that this permit Is a license for permissive use only and that the placing of facilities upon public prClpertypursuant
to this permit shall nol operate to create or to vest any property right in said holder. '
9. Whenever Pasco County decides to further exploit the County Rights of Way, any or all 01 said poles, wires, pipes, cables or other facilities
and a~purtenances authorized hereunder, shall be immediately removed Irom said Rights of Way, or reset or relocated thereon as required by Pasco
Count~ at the expen.. of the holder of this permit.
10. The holder shall save and keep Pasco County harmless from any and all damages, claims, or injuries that may occur by reason of the construc-
lion, maintenance and operation of said facility. '
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11, The hotder shall com~te the requeated work Wlthi@"3Oi60/90l1BC.Ldavs.br this permit shall become null and void. In Ihe event the work're-
quested ia not completed upon the expiration date of this per;nit~hall have the right to complete such work and to charge the holder
01 the permit for all costa incurred In completing said work,
" 12, )rhe permittee shall post a cash or surety performance guarant.. with the County Clerk. Based on a cost estimate prepared by the permiltee's
\, lJnglneer and apptOllWd by the County, The amount of the guarantee is to be an amount aqual to 125% of the cost to conatruct the permitted improvel1l8Ots.
)rithe event a aurety bond II poated, the said surety bond shall be made payable to Pasco County and shall obligate the surety ,to hold the County
('harm"" In the event the holder of this permit should fail to meet any of its obligations, hereun. der. The bond shall also indemnify P88CO County for
aU court coata and reasonable attorneys fees in the event legal action is required to collect or said bond.
1 13. The permittee shall post a cash or surety maintenance guarantee with the County Clerk based on a cost estimate prepared by the permittee's
I engineer and approved by the County. The amoung of the guarantee is to be an amount aquatto 15% of thec;o&l to construct the pennltted improvemenls,
\In the event a surety bond is posted it. s hall.meet all the criteria stated in N. o. 1~ above. .I _ J '. I," J, ,_' '1.2 /., ',. ,;
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\ 14. SPECIAL CONDITIONS ':', .~~ v' . J' I.,) , r':' (. J- .J>(r'://..J./;I'''''~''l . .r .'-,1'" i.,,# , '''' '..'. , '. .(
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APPROVED B':.!)...,) q Li~ 4' ,t.._ t '
Utilities Serv~~~' ,()~ r'"' I t~ I J r
Traffic Reviej). j;~:J..I j I I"
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SUBMITIED BY K I " ol _tJL'-_.,
Signature
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Print Name and Title
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" Public Works:
Guarantee Estimate Review: ,
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Development Review Approved: [! tiJ'
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Fee $
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BRIGHT HOUSE NETWORKS
GENERAL RIGHT OF WAY PERMIT
EXHIBIT" A "
Bright house Networks daily activities that do not require a specific right of way utilization permit
when working within the boundaries of Pasco County right of way
New Customer Service
1. Installation of service drops from serving location.
2. Installation of new aerial distribution cable from existing poles.
3. Installation of a second aerial distribution cable from existing poles.
4. Extension of existing aerial distribution cable from existing poles.
5. Installation of anew buried distribution cable that does not cross or begin in the pavcernent.
6. Extension of an existing buried distribution cable that does not cross or begin in the pavement.
7. Installation of two way foW' inch conduit system that does not cross or begin in the pavement.
8. Extension of a two way fOW" inch conduit systam that does not cross or begin in the pavement.
9. fu!lfSlllletion of a new pole line.
10. Extension of ~ pole .line providing it does not encroach into an Wlderground utility area.
11. Adding of new equiptment to existing cable.
12. Pulling in new underground feeder cables in an existing pennitted manhole and conduit system,
13. Digging of a splice hole to splice a new cable or changing equiptment.
14. Digging of a splice hole for cable acceptance testing for quality.
15. Digging of a splice hole to change the size of a cable leg for new service.
Maintenance of EJistin" CATV Facilities
1. Replacement of existing service drops.
2. Replacemcntl repair of an existing aerial cable providing other aerial utility service still exist.
3, Replacement of existing poles providing other aerial utility service still exist
4. Replacemcntl repair of existing equiptment.
5, ReplacementJ repair of an existing underground feeder cable in an existing permitted manhole
and conduit s}1Item.
6. Pumping water out of a manhole to maintain undergroWld cables in conduit system.
7. Digging of splice holes to locate and repair damaged cables.
8. Digging of a splice hole to change the size of the cable,
9. Diging of a splice hole to add a side leg off feeder cable,
10. Diaging of Ii hole to repair broken cooduits.
11. Diging of a splice hole for cable acceptance testing for quality,
12. Diging of a splice hole to repair damaged cable.
13. Digging of a hole to verify the location of buried facilities.
14. Removal of facilities no longer needed for 8eIYice.
15. Tree trimming to clear acri,aI facilities.
16. Adjust aerial facilities to accommodate other users of pole line Wld/ or to Ineet National Electri
Safety Code.
BRIGHT HOUSE NETWORKS
GENERAL RIGHT OF WAY PERMIT
EXlDBIT .. B ..
A GENERAL RIGH OF WAY PERMIT (GRP) - is given for certain routine repetitive work not requiring
a specific permit defined on Exhibit" A " that is 5 feet or greater from back of curb (BOC) or edge of
pavement (EP).
No roadway will be open cut or directional drilled with this permit.
Upon completion of work the Pasco COWlty Inspector shall be notified for a final inspection of the
project.
Best Management PractiCes (BMP) will be obseIVed at all times.
Noti1Y SW1Bhinc State One Call of Florida at 1-800-432-4770 not less than 48 hoUls or more than
5 days prior to construction,and all other requirements of Florida Stabite 556 will be observed at
all times.
MAINTENANCE OF TRAFFIC
· All activities in accordance with this agreement will require confonnanoe to the "Manual of
Traffic Control and Safe Practices for Street and Highway Construoion. Main.tenanoe and
Utility Operations." (Chapter 316. Florida Statues)
· Pedestrian. bicycle and handicap traffic must be safely maintained and must not be redirected
into the roadway or into ditches. Use of sidewalks may oot be impaired or olosed for gIeater
that 60 minutes. When a sidewalk is to be removed means of rerouting pedestrians. bicyclists
and handicapped people must be constructed prior to sidewalk removal per Florida
Department ofTI81lSpOrtation (FOOD. Manual on Unllonn Traffic Control Revises MUTCD
and American Disabilities Act (ADA).
· No street shall be closed without the prior written permission of Pasco County Inspector. At
least 2 nonnal working days (Monday thru Friday) advance notice is required. All
maintenance of traffic plans are to be submitted to the Pasco County Iruipeotor for approval
prior to commencement ofcoostruction. Appropriate wor}{ zone safety is to be fono""eci at all
times,
· All construction activities shall include traffic control through the work zone in accordance
with FOOT" Roadway and Traffic Design Standards>> Indexes 600 Series titled .. Traffic
Control Through Work Zones.>>
Where it is discovered that a site specific permit will be required, i.e,. during excavation existing facilities
become less that 5 feet from BOCIEP.
1) The Construction Supervisor will not:ifY the Bright house Networks Engineer that a project
Cannot be canpleted under the GRP.
EXHIBIT .. B .. c:ont1nued
2) The Bright house Networks Engineer will notifY the Pasco COWlty Inspector of the situation
and schedule a field meeting. (Every effort will be made to arrange the field meeting within
a time frame that will not require the Construction Crew to leave the site and reshedu1e the
work.)
3) The Bright house Networks Engineer will be responsible tor notification all appropriate
personnel of the time and location of the field meeting,
4) A mutual understanding of the scope of work required to complete the project will be achieved
at the field meeting.
.
5) At the Pasco COMty Inspector's discretion, a verbal approval of the work may be issued
allowing work to resume.
6) The Bright house Networks Engineer shall apply for a .ite specific Permit inclusive of all
details as agreed upon at the field meeting. (If a V erbal ~proval was gIanted, the liite specific
shall be submitted as an" After -the-Fact" application.)
1) Upon completion of the work, the Pasco County Inspector shall be notified for a final
inspection of the project.
~-'-lUGHf OF WAY RESTORATION
· All disturbed areas in the right of way will be sodded wUess otherwise directed by Pasco
County Inspector. Sod must be maintained Mtil it roots, a minimum water of2 weeks.
· Vegetation, other than sod, will be restored to its pre-construcion condition
· Prior to disturbing sprinkler systems, plants and mailboxes that may be disturbed during
construction, notifY property owners. Replace those items that are damaged by pemli.ttce.
· The pennittee shall be responsible for handling all complaints regarding the construction
project.
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CITY OF ZF,PHVRIlILLS - Rt.1ILIHNG UEPARTJ\U;NT
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PERMIT#
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('lty nlllllllnl! I)pllntlmrnt, An,\" nl'I'"rAtlnn for nrl'I'O\'ol of Cnnofl'llrtlol1 ol1"rnflnn~ on AllY City IImlNI R1ghl~ nf WAY' ~hllll fllrnl~h n drtAIINI dran-'nl! ~hOt\'I"g
Ihe <'IIml'Irtl' ~r"I'1' nf Ihl' I1I'nflo~ed t\'otl< In ttlrUrAle to Ih\! omrr of Ihe nulI'''''j! Officlnl ror Arfl"n"AI flrlol' to Ihp I'nml11l'ncemelll of Any n'olk A rOfl)' nf thl,~
fI!'I'mlt I, hI he 1(l'llt rI'A,llly' 1I\'nlh,hll' AI thl' ~'Ie of IlIe t\'01'1( Al 1111 tllllp~,
PARCEL r.tJ. II --~~,~df!-~-?J~___g~.f.~:_~Dc~_<tqe=f}o30_ CITY ROAI)~;;Jk:.~'-:~:J;l:_r_~_______, IJAT~__~
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rl'r",I~~h," I~ I"'rl'hv lltAnll',1 tn__.,_____,~__________..___..__,____of _____ ______~_._________________,___
fill' IIII' rondl""'tlon'nnd ,"lIllltr;,~~~;;;r'---'---
. ----....-.~_._-------- - -....__.__._ n...____ __.______._..._____. _.. _. __,,,.________._ .____________~_______._____.
~_.__..__._______...h.__ ___.__.. __'__.n._. _ .---___.______h..__.______.~.__~.__.._~__._.__.___.__~________
;uj,j~~tfuji,~-f.;ii.;winR-~.;"filij,;n~----..--'-.------.------- ---.----------------------____________..____,__
.__.._------~_.__._------------_.._---_.-.-._._-----._-----_._--------------_..-_.._-~-_._--
1, Thl' ron~tl'llel'on A",I nutl"lp"",,el' nr ourlt IItllll)' ~hllll not Inlerfere with th'-'l1tOflrrt,1' RIllI I'l~hh of A "riot orellflAIII.
1.. A II mlll( ~"nll h" ,Innp In '(N'rln~ ,,,llh tltl' ~ln",lntfl~ of 'he Clfy ~ttl'l't~ Dpl1!1l"tml'nt AI1,IIIII(IC'1" Ihc~III'''J'\'I~lnll flf thl' Clt~. fllllld'nll Offirllll, who
wlll hC' nollO"d '" IC'A.I onl' .10)' 1'1"01' to rOmmCIJ('etn/ml nf eon~tl'llrtlm.,
.l, ^ III11AIC't!Ah 1IM11 C''1ulllllll'ltt ~h"III,,, qlll',IC'rt to IIl~pI'rtllln h,l' llrp CIf) Rullfllnll Officl"I,
1. n'"ln~ (~o"~hn<'flnn nil ,~nr"ty' ""llul"tlnn~ nf tit.. Ilrp",Imrnl "f TI'nn'floI'IAIh'll .hAII h" nhq"n",llIud IhC' CIt," .hnll hC' I'l'lInpd of All
l'r'llon~'hlllly rl'OI" ,IAlllllj!e nf IIn.\' nlltllr.. "rl~lnl( rl'!)'" thl~ I,ennll, illlh,lecl 10 thC' ~1I",e I"I''''~ AII,I rn",1I1lom, lire I'l'rmlt holdel" IUn~' tnltp ~11<'h ~I\f..t.'" l11en~"r~~,
,"(."..11111( I'IA<'II111; And dl.,,'ny' of rAllnlln ~11l"~' A~ It mlly' derm n('re~~J\J'.v In C'olHlnrf of <,on.hlll'll!)n An,1 mA'nlC'nllllre wfld< het'l'u",Iel'. If I~ Ihl' I'I'~roll~IIIlIIty, of
the fll'I'rnlllpl' hI P'ArP, IIlA'ntnln, 1111" ~UflC'n'I~p All ttllffi(' eonlrnl And de\'lcl'~,
5. "" 'II''''AI(' Anti 1111 ('lIy'l1l'ol1....I)' ~""1l h.. l'eqlol'ed In Ih orll(hlAI condition A~ fAr A~ I'I'ArflC'Allu Ihl' "11'"lon of Ihl' Clly' Bulldlnll Officlnl,
Ii, AlIllndC'!"llrmmd cro~~I"g In~tllllllH"n~ ~hl\lI h.. 'A'd III ~nrh llepth n~ mn~' he ~I'..dnrfl h~' Ih" Clh' ""l1d'nll Offidllt.
7, The ~hMI C'o\"l'llnR Ihr ,I"!I\"~ nf Ihl. 1".!l\lIr1tl.l'l ,.hllll hI' ",,,.1,, n pArI of Ihl~ permit. Thl~ prt'lI1H h j!rllnl",I t\'lth Ihp 11IId"l"~fnn,llng Ih'" Ih..
1\I'I'IIrl1nt hn. lIonn..,Il\1I oth",' nflllty' mN'~ III Ihr n"I'A .'nYN',.,1 h,l' n,,, "I'rm" I1nd 11\1(1" rnll rl'~l'o",thIllIJ fot "n~' ,lnmAlle Incllftpd hy' fll'lnt, '",hdlntln"~ n. II
I'emll of hl~ ",,"""Hnn" In ol<lrl' thAt Ih",\" "'I\~' "Af\! IIIIl....I IhC'''' lntel"r~!~,
R. It I~ r~rl'e~.l.I' .IIIIIIIIIIl'fllhAt t111~ 1'l'l'Itllt I~ A 11.."",1' for Jlrl'I1II.~hp mp nn'y 1\".1 thM Ihe l'fArlng of fl1dl"',.~ 1If1011 flllhllr flro"ert)' ,,"r~'H\nl 10 tllb
111'1'11111 ~hnlll1ot "11<'I'lIt.. 101'I'I'lIte 01' III n~1 AIIJ rrore. t,\' Illlltl III ~n'd holdrl".
II, Whelll,'I"!" Ih.. Clt.r "pdde. In fllt"hel' r."lnlt the Clt,\' ~tllhh of Woy', nlly' 01' 1111."ld "nlr~, lI'lr'e~'lllrC'~, enhle~, or nfh.." rl\C"ltlp~ I1nd
AJlr"Helll\nee~ 11111"01'1'1",1 her'..,mder, dlAII h.. In""Plllnte',\" t<,mond ffllm ~AIII Rlllht~ of W",\". 01' re,.et ,,,. "ploellte.1 IhC'I'e!)n A. I'equll'ed hJ the City Blllldlnll
OmdAI lit Ihe C"fI..n~e of th" hn"'('I' of 1I1l~ flermlt.
HI. Thp ho"IN' ~hAII ~A\e All" 1(C'rl' IIle C1ly' hnnnlC'~. frmn fI"y' I1l1d nil dllmAlle~. rlnfm,~, 01' fnlnrl..~ tlmt m,,)' O~rnt hy' l'eA~!)n of thr ('omh'/IC't1on,
IIIAlnll'lInllr'\ 111111 nllemtlon of .lIld rArllll,\'.
II, 'I he h"III<'1" ~hAII ~omfll"l" Ihe !'1''1n..dr/1 wo"" within '___" ~,__ .Ioy', nt I"I~ "el'l',If.hAII hC'comr "'111 Anrl \'1)1,1. In Ihe eHII' Ihe ",,,,I( t('(lllp~ted
I, lII.t ('''Ill " 1"1,," ""I'nlh.. "'I'It'nlloll .IAte of Ih'~ fI"lmlt, tllf' ('It)' ~hnll hilI.. Ihe rlj!hl to C''''''pl"lp ~",'h "'orl( 0"" 10 ehArj!p the hnld"I' nf Ihr 1'''l'mlt fOI" nil ,,0.1~
1"~IIlTed In ('nl\tl,lrtlnll ~n'" ",,,,-Ie. .
t J., ThC' hol.I('I' "hAil "O~IA en"" 01' ~I1l'I'Iy' hnm' with n,,, ClIy' I\Innnll"l' In Ih"'''1ll of ~" __._ '____'n 'Inll"t,~ In ~/IntA/lIef' '1f'lfnl"ml1l1re nf tll.. nhll~"tlon~
h('\"<'I'" IInd 10 gllllmntel' IIIfllntf'llll"I'P nf Ihe r1j!hl-of-wA)' (Ie~erlh('(1 herein 'fOl'1\ flerln,1 of one (I) yrAl' follflwln~ rO"'III..lloII of Ihe rrq\tp~tetlln~III"Atlon, 'n the
eWllt A ~lIrrt~' h"'l(ll~ ,IMted, lite ~'lI'ely ''''lid ~hnll hI:' mA.le ""Jnhl" 10 tll.. City And ~hnll ohllllnte the ,utet,\" to ho'" Ihe Clly' hllrmle~~ In th" e\"ent Ih.. h..ldl'!" of
thl. flemllt ~hnn"l fnll to meC't AllY of It. f1h1I~Atlon' herenndn. The homl ,hAII nl.n tndemllt~\" Ihe CltJ fnl' All ~olllt ~n~t~ Anrll'''''~f1nnhle I1ttorney'~ fee~ In the
I'nnt lellnl Al'll"n ,~ I'e'lu"'ed to I'oll..rl nn ~nld hOIl,l,
0. 'lit.. 1'''l'mlUee "Imll Inne n 21 hooll' elll('l"llell~Y' 1'01ltA~t 111111I1' And lIlJmhl'!" U~led hl'low,
lPetltllttC'p)
SlJRMITTF:1l RV:
E~fJIrJ{~~)-9-_--,
SIj!nAllJl"e & Iltle
- --.- -.. ..._---~---_.- -.-...- .._----~.~ ._~----
-- _..-_._"-_.~~.__...._------ ---- ..---.-....- ._-- ~--
A.lrltp~,~_~
--._--_..__._---~--_._-~_..._.._-~--~--~._-------._-
Ph 0 lit"
..--.~.--~.-._ '_'_ _. .n_~~_ __._.~...._.._._._._._~__ ______ ..__~_,._ ,,_ ___'.'__'.__"'_'__,_,____ ____._
"rrRovr.I'RY:
CIlY OF ZFrTIYRIIIU$
""1"11111( Offirllll.__
Dnlp:
UIllllle. Sllflel'tl~or_ ~M':"_ n_____________,______.__,..__ ,_,
~;;;-~,-,;._;-~~~===--;--~-----==::;
City M""All(,I'._
Ont..:_,..,__._ __
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