HomeMy WebLinkAbout04-2945
I'
CITY OF ZEPHYRHILLS
5335-8th Street
(813) 780-0020
ELECTRICAL PERMIT
2945
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Contractor:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Wor Desc:
2945
ELECTRICAL MISC
ELECTRICAL MISC
NOT APPLICABLE
MORTON ELECTRIC
Address: 6349 ASHVILLE DR
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: SILVER OAKS VILLAGE
Parcel Number:
4/19/2004
44.00
44.00
4/12/2004
POWER SUPPLY FOR CATV
I
L
BRIGHTHOUSE CABLE
6349 ASHVILLE DR
ZEPHYRHILLS, FL. 33542
Phone:
,() 7 &v~ff~ 51-joy ~
y~ '3:5"</
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.I(.!:!:.LN::;l:'.!:!:C'! .LUN !".!:!:.!:!:::;: whe:tr--extra ~nspect:tofi-t:rJ.pS are necessary---aue to any oIte--or--tne
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
r--nwarn:lng----e-o-oWIler-:-----your fa1lure to record a Iiot:1ce of commencement may resurern your
, paying twice for improvements to your property. If you intend to obtain financing, consult
I 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.
~
PERMIT OFFI
FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TB St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
OWNER'S NAME ~ f'~' 0 V\, 1-
.
JOB ADDRESS ( () ~L-\ q
*,us~ ecA-\o l L
\-tS\\V\ \ \c u r
PHONE
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL ID # (y:) - ~Co ~ d-.-I ~ O;LOO -a)OOO 0 -n l "gO (OBTAIN 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
(J INSTALL
OMULTI - FAMILY
(J INDUSTRIAL
D# OF UNITS
D SWIMMING POOL
D MOBILE HOME
D OTHER
DESCRIPTION OF WORK
CJ RE1TAURANT & HEALTH DEPARTMENT APPROVAL
C ~,(\\U
BUILDING SIZE
SQUARE FOOTAGE
HEIGHT
PERMITS REQUESTED
& (1) SElENERGY FORMS.
FORMS .j/ /""----
/ /
/ /' ..---
(~
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
D BUILDING
~LECTRICAL
$
uo
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
D FLORIDA POWER
D
W.R.E.C.
o PLUMBING
o MECHANICAL
$
o GAS
o ROOFING
D SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
D OTHER
TYPE OF CONSTRUCTION: (J BLOCK
o FRAME
(J STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES D NO
C.'O.'. NTRAC'1'OR. ...........S. EC.. T. I. a.. N
~ ...., >' .'. ...' . c- '" c. .," ."_ -. . .. .." ", ..
. ",",'.' -'",', ,,-,- .... -,','
BUILDlER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
EI.OCmrCIAN ~... ~. ~~. ~. H" H" H..... :::::: fl1;;J~~" ~t Z
SIGNATURE-/ I ~:&. / / ~; STATE CERT OR REGIST # e ( - 07JlJ~U \.{,3
******************************************************************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
******************************************************************
MECHANICAL
COMPANY
SIGNA~URE
STATE CERT OR REGIST #
*******************************************************k*********
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" whi~h
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 indica~ion 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".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
,20_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _day of
by
acknowledged
,20_
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
C1ho is personally known to me, or
Dwho has produced
(type
and whoD did 0 did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid 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
OATfi::
CITY OF ZEPHYRI1ILLS - JllJlLlHNG 1)l~I'AR"'MKNT
R1!iJJJ'-OJ.' - WAXJ,lSfd'-ERMIJ
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