HomeMy WebLinkAbout05-5252
CITY OF ZEPHYRHILLS
5335-8th Street
(813) 780-0020
ELECTRICAL PERMIT
I"
5252
ermit Number:
Permit Type:
Class of Work:
Proposed Use:
Contractor:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 12/15/2005 IL WILLIAM
Total Fees: 35.00 5327 19TH ST
Amount Paid: 35.00 ZEPHYRHILLS, FL. 33542
Date Paid: 12/15/2005 Phone: 813 715-7682
Work Desc: REMOVE FUSE PANEL-INSTALL BREAKER PANEL
5252
ELECTRICAL MISC
ELECTRIC SERVICE REPLACEM
SINGLE FAMILY RESIDENTIAL
ZEPHYRHILLS ELECTRIC SERVI
Address: 5327 19TH ST
ZEPHYRHILLS, FL.
NT Township: Range:
Lot(s}: Block:
Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number:
Section:
/ n~ ..1 oS
y-\ \ ~\v p---
REINSPECTION FEES: When extra inspection trips are necessary due 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 acc
The payment of inspection fees shall be made before any further permits will be issued to th
person owning same
"Warning to owner: Your failure to record a notice of commencement may result in your payin
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.
q-o~J
CALL FOR INSPBCTION - 8 HOUR NOTI:CB
PROTBCT CARD FROM WEATHBR
~M~
RBQUI:RBD
CI~Y OF ZEPHYRHILLS PERM~T A~~~~~A~~V~
BUI:LDING DEPARTMENT 5335 8u st, Zephyrhills, FJL 33542
813-780-0020 FAX: 813-780-0021
~I
DATE RECEIVED
"td-I \'3/05
PHONE CONTACT FOR PERMITTING <i?r3 -7~2 131=3
OWNER'S NAME W t l... L. \ ~ ~ ""TC-+ ~ L-...
JOB ADDRESS ~"3 ?-.-Ij - \. ~ ~ S l'
PHONE 'I ,/ )- -'7& 8;-:L
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL ID '*
WORK PROPSED: DNEW CONSTRUCTION
DSIGl\I
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
(OBTAIN FROM PROPERTY TAX NOTICEl
o ADDITION
o ALTERATION
J<(REPAIR
o INSTALL
o MOVE
o DEMOLISH
DMULTI-FAMILY
o INDUSTRIAL
Oi OF UNITS
o SWIMMING POOL
o MOBILE HO~
o OTHER
c:J RESTAURANT & HEALTH DEPARTMENT APfROVAL
DESCRIPTION OF WORK ~\3t-(.....;.'J:. t:,,-s b. \' ~l.Ul?-L- (oJ;'1I<l.LL ~ n6"AA 6"1> Pv\-1LJ8L,
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 PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
'jir. ELECTRICAL
o PLUMBING
o MECHANICAL
$
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o Progress Energy 0
W.R.E.C.
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOO~ ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
~'-'--'----'7T--'-------- - --------. -- -- -. - - ,---~------.-.----- -'1" -.... ------- ----------:""---
" \ II (' . I 1
I "1 I r ' - I r ~ I ,I ' '
~~_...:.:.ll__+___~____~_~_~__~._~~_~___ ----~-------~--- - --"------~-~----~-
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST '*
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COMPANY-z.. ~ ~ll..L", 'C:LE:<: 't. Sei\. U L, L C.
STATE CERT OR REGIST # ("""A"J6"2.... Uor
*****************************************************~************
PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIS'}' it
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MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST it
*************************************************~***************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST it
A. NOTI~E OF DEED RESTRICTIONS
Th~ 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 contr~ftors 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 maybe 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 "Gohtractor Sections" of this ~pplication 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 CONNECTI.ON FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES,' AS AMENDED)
I certify that I, the applicant, hay~ 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. .
Appliqation 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 wiil 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 inolude but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, wetiand 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 ~nd not as
authority to violate, .cancel, alter, or set aside any provisions of the technical codest
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 for la
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 ~O 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 \tNOTICE OF COMMENCEMENT".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
a'cknowledged
, 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)
[1ho is personally known to me, or
o who has produced
(type
and wlioO did 0 did not
of identification)
take an oath.
o who has produced
(type of identification)
and. who Odid [}:lid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped