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HomeMy WebLinkAbout04-2946 I- I" CITY OF ZEPHYRHILLS 5335-8th Street (813) 780-0020 ELECTRICAL PERMIT 2946 Permit Number: Permit Type: Class of Work: Proposed Use: Contractor: SquaN! Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: POWER SUPPLY FOR CATV 2946 ELECTRICAL MISC ELECTRICAL MISC NOT APPLICABLE MORTON ELECTRIC Address: 38217 S.R. 54 WEST ZEPHYRHILLS, FL. Township: Range: Lot(s): Block: Section: Book: Page: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 4/12/2004 44.00 Name: BRIGHTHOUSE CATV Address: 38217 S.R. 54 WEST ZEPHYRHILLS, FL. 33542 Phone: i I l_____.'_ .I(.!:!:.LN::;l:'~CTIUN i".!:!:.!:!:::; :---wYien extra J..rtsfpeCl:Yorr--E'r-:r-ps are necessary Que to anyone of the following reasons, a charge of Thirty-five dollars ($35.00) shall be made for each trip for each trade: (a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when inspection called (d) Work not ready for inspection when called (e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible The payment of inspection fees shall be made before any further permits will be issued to the person owning same -nwar:i1J:ng--eo owner:---Y-our~a-J.lure1:o--record a notJ.ce or-c-ommencement may result J.n your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. 1.L___, ~d/ ./ldJ7 ,. CONTRACTOR CALL ~ PERMIT OFF I FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8R St, Zephyrhills, FL 33542 813-780-0020 FAX:813-780-0021 DATE RECE IVED PHONE CONTACT FOR PERMITTING OWNER'S NAME /l-GlJil/Pl/.// (Jilt/.-- 3 'Z 1'7 .$ If. 5't/ We. 51 PHONE 1ft, iZ;11 JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # ' WORK PROPSED: ~~ CONSTRUCTION OSIGN (OBTAIN FROM PROPERTY TAX NOTICE) o ADDITION o MOVE o ALTERATION o REPAIR o INSTALL o DEMOLISH 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 c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL 6f) AM' je~~~~1 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 00 AMP SERVICE o FLORIDA POWER o o BUILDING ~~CTRICAL $ VALUATION OF TOTAL CONSTRUCTION o PLUMBING o MECHANICAL $ o GAS o ROOFING o SPECIALTY VALUATION OF MECHANCIAL INSTALLATI 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 CQ~Qg:ro~i$ECTION BUILDER COMPANY SIGNA1TURE STATE CERT OR REGIST # SIGNATURE ****************************************************************** 1~~'**~::~**** *** **** *::~~:~~*;~;~*~~:~~~~ ~{~ ELECTRICIAN 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" whi2h may be more restrictive than City regulations. The undersigned assumes responsibility =or 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 "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 , 2~ 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 o who has produced (type and whoD did 0 did not of identification) take an oath. 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