HomeMy WebLinkAbout04-2903
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CITY OF ZEPHYRHILLS
5335-8th Street
(813) 780-0020
ELECTRICAL PERMIT
2903
Permit Number: 2903
Permit Type: ELECTRICAL MISC
Class of Work: ELECTRICAL MISC
Proposed Use: NOT APPLICABLE
Contractor: MORTON ELECTRIC
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 4/05/2004
Total Fees: 44.00
Amount Paid: 44.00
Date Paid: 4/05/2004 I
Work Desc: 60 AMP POWER SUPPLY FOR CATV
Address: 6038 12TH ST
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
BRIGHT HOUSE CABLE
6038 NOAM I AVE
ZEPHYRHILLS, FL. 33542
Phone:
--,--___i___,.___ ______.__,___ _L..____-~. ._,__, ________. ___
~~ 6/~~ ~'/~f //S5
v~ ~-~ ~ ~ ST~~
-REINSP~(:l..LU.N l'~~~: When'exEra-inSpElct'.lohcrips---aren-e-cessary- aue-to- any--one.of-:-t:he.---.-.---
following reasons, a charge of Thirty-five dollars ($35.00) 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
The payment of inspection fees shall be made before any further permits will be issued to
the person owning same
--"Wa.rn1:D.ge-o-~owner:..--your--f'antirE!-to-r-E!-COraiCnot-:LcE!-of'-c:ommencemeIi.1:-Ifiay -reauTe-nCy'clur----- -
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.
~
_._..~.._--._._----._----._._--_.---_.._---_. ---- ---
CONTRACTOR PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
OWNER' S NAME~ ~JS<-- ~.J..'cie.-
JOB ADDRESS t a (J "3 D \1.\n f-J t- '2 - ~l ~
PHONE
Ai ()t:(fr\. ; Tl vi <- .
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID # f1d... -J..lo-::J l- N')Sl\ -ODO(}(~-~lOoBTATN FROM PROPF.RTY TAX NOTICE)
WORK PROPSED: nfNEW CONSTRUCTION
OSIGN
o ADDITION
o MOVE
OALTERATION
o DEMOLISH
o REPAIR
o INSTALL
PROPOSED USE: oSGL FAMILY DWELLING
o COMMERCIAL
oMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
DESCRIPTION OF WORK
CJ cR1'rTH DEPARTMENT APPROVAL
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.
0J()
PERMITS REQUESTED
VALUATION OFA';AL CONSTRUCTION
SERVICE 'FLORIDA POWER 0
W.R.E.C.
o BUILDING
o ELECTRICAL
$
AMP
o PLUMBING
o MECHANICAL
$
o GAS
o ROOFING
o SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAo YES 0 NO
CO~QTOa>$ECTION
BUILDBR
COMPANY:
SIGNATURE
STATE CERT OR REGIST #
************************************************ *******jt***~7**:~
ELECTRICIAN ~ ..pI/~ COMPANY otfO.v rf/(v/I v
SIGNATURE STATE CERT OR REGIST #
.. ~.~........ H........... H..... H H H.. H..........:..~ :.~ ~ () ztf ~
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 udeed 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 portions of the uContractor 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 uFlorida'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 Uowner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the Uowner" 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.
Appli~ation 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 UA" or uA,etc.", it is
understood that a drainage plan addressing a ucompensating 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 uNOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 20__
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
of identification)
take an oath.
Owho has produced
(type of identification)
and who Ddid [}jid not take an oath
D who has produced
(type
and whoD did D did not
Signature of person taking acknowledgement
Signature of person taking acknowledgment
Name typed, printed or stamped
Name typed, printed or stamped
DATE:
CITY OF ZEPHYRHILLS - BUILDING DEPARTMENT
RIGHT-OF-WAY USE PERMIT
PERMIT#
No construction under ground or abon ground of an~' facility shall be accomplished on an" CIty RIghts of Way wIthout written approval from the
CIty BuildIng Department. Any application for approval of constructIon operations on any CIty o1'lned RIghts of Way ~hall furnish a detailed drawing showing
the complete scope of the proposed work In triplicate to the office of the Building OfficIal for appronl prior to the commencement of any work. A copy of thIs
permit 18 to be kept readily available at the sJte of the work at all times.
PARCEL r.D. #
()2-:Z lb -21 '"I()05o~ooooo-. OOliTY ROAD Ai {J4111,'
A v/~ _
DATE
LOCATION (Legal Description):
Permission I~ hereby granted to
for the construction and maIntenance of
of
~ubJect to the followIng conditIons:
I. The construction and maIntenance of such utility shall not Interfere with the property and rights of a prlol' occupant.
2. All work shall be done In keeping wIth the dandards of the CIty Streets Department and under the supenldon of the CIty Building Official, who
will be notified at least one da,' prior to commencement of constructIon.
3. All materIals and equipment shall be subject to Inspection by the City BuildIng Official.
4. During con~tructlon all safety regulatlon~ of the Department of Transportation shall be obseM'ed and the CIty shall be relined of all
responsIbility from damage of any nature arIsing from thIs permit. Subject to the same terms and condltlon~, the permit holder may take ~uch safety measure~,
including placing and dIsplay of caution slgn~, as It may deem necessary In conduct of construction and maintenance work hereunder. It Is the responsIbility of
the permIttee to place, maintain, and supeM'lse all traffic control and devIces.
5. All prIvate and all CIty properly shall be redored to Its orIginal condItion as far as practical In the opInIon of the CIty BuildIng OfficIal.
6. All undergl'Ound crossIng installations shall be laId at such depth as may be specified by the CIty Building Official.
7. The sketch coverIng the details of thIs Installation shall be made a part of this permit. This permit Is granted with the underdandlng that the
applicant has notified all other utility users In the area covered by the permit and takes full responsibility for any damage Incurred b~' prior Indallatlons as a
result of his operatlon~ In order that they may safe guard their Intereds.
8. It Is expressly dlpulated that this permit Is a license for permlsdve u~e only and that the placing of facilities upon public property punuant to this
permit shall not operate to create or to vest any property right In said holder.
9. Whenever the City decides to further exploit the City ~Ights of Way, any or all said poles, wIres, pipes, cables, or other facilities and
appurtenances authorized hereunder. shall be Immediately removed from said RIghts of Way, or re~et or relocated thereon a~ required b~' the City Building
Official at the expense of the holder of thIs permit.
10. The holder shall san and keel' the City harmless from any and all damages, clalm~, or InjurIes that may occur by reason of the condructlon.
maIntenance, and operation of "aid facility.
ll. The holder shall complete the requested work within days or this permit shall become null and voId. In the ennt the work requested
I~ not completed upon the expiratIon date of this permit, the City shall han the rIght to complete such work and to cha'1le the holder of the permit for all costs
Incurred In completing said work.
12. The holder shall post a cash or surety bond with the City Manager In the sum of $ dollars to guarantee performance of the obligations
hereIn, and to guarantee maintenance of the rlght-of.1'I'ay described herein for a period of one (1) year following completion of the requested IndaUatlon. In the
event a sure~' bond Is poded, the surety bond shall be made payable to the City and shall obligate the surety to hold the City harmless In the event the holder of
this pennlt should fall to meet any of Its obligations hereunder. The bond shall also indemnIfy the CI~' for all court costs and reasonable attomey'~ fees In the
event legal action Is required to collect on said bond.
13. Thc permittee shall hal'e a 24 hour emergenc,' contact name and number listed below.
(PermIttee)
--fJ. SUBMITTED BY:
l~jkth~AA 0--
SIgnature & Title
Address
Phone
APPROYED BY:
CITYOFzEP~ ~
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- 813-780-0020
F"=ox:
1-800-679-8004
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- t;orn......._. THESE ""ILL Aj..L elE A RELEASE ON BRIGHT HOUSE CABLE FOR PCl'INER
SUPPL Y.S FOR CA. T'V _ .AD in the right or '\Nay
6002 PARKHILL TERRACE DR PERMIT#2886
387162"" Ave
Permit 1'#2827
313217 S.R. 54 VVest. Perrnrl:#294..f3
38635 South Ave
F='errntt#2B28
38349 C_R. 54 East ~;1#2947"
6504. Huntington Or
~il#2902
Pennit#2903
6038 Noami Ave
7425 G~ope Or
5840 1- $1:
591'3 12th St
Perrn;t#2904
Perrntt#29Q5
66:38 Dairy Rei
5709 6'" St
F'enni1#2906
Permrt#2927
Perrnrt#2926
38451 8m Ave
Per-rn i1#294.4.
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