HomeMy WebLinkAbout06-5506
CITY OF ZEPHYRHILLS
5335-8th Street
(813) 780-0020
ELECTRICAL PERMIT
5506
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Contractor:
Square Feet:
Est. Value:
Improv. Cost: 300.00
Date Issued: 3/02/2006
Total Fees: 35.00
Amount Paid: 35.00
Date Paid: 3/02/2006
Work Desc: UPGRADE SERVICE PANEL
Address: 38705 12TH AV
ELECTRICAL MISC ZEPHYRHILLS, FL.
ELECTRIC SERVICE REPLACEMENT Township: Range:
SINGLE FAMILY RESIDENTIAL Lot(s): Block:
HOMEOWNER Book: Page:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-0400-0070
Section:
Name:
Address:
OLSEN, THOR
38705 12TH A V
ZEPHYRHILLS, FL. 33542
813 788-3841
Phone:
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IJf \0 ,(91""
R UGH ELECTRIC
FINAL
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are
necessary due to anyone of the following reasons: 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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the 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.
..fo~
CALL FOR INSPECT:ION - 8 HOUR NOTICE
PROTECT CARD FROM WEATHER
~M~
REQUIRED
CI~Y OF ZEPHYRHILLS PERMLT A~~~~~A~~U~
BUIILDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE GONTACT FOR PERMITTING 7~3 ~g-f-/ .2-
OWNER'S NAME 11/0 K
JOB ADDRESS 'S '1<:1 () 5
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PHONE
76g-38L{ J
LEGAL DESCRIPTION: LOT(S) 1-)(- '1-( 0
PARCEL I D it () 1) (, 1. ( Del 0 n ~ ex)
BLOCK '-( 0
colD
SUBDIVISION -'
(OBTAIN FROM PROPERTY TAX NOTICEl
WORK PROPSED: D NEW CONSTRUCTION
o SIGN
PROPOSED USE: ~SGL FAMILY DWELLING
D COMMERCIAL
DADDITION
DALTERATION
D REPAIR
o INSTALL
o MOVE
o DEMOLISH
DMULTI-FAMILY
D INDUSTRIAL
Dit OF UNITS
D SWIMMING POOL
D MOBILE HO~
DOTHER
DESCRIPTION OF WORK
c=J RESTAURANT & HEALTH DEPARTMENT APfROVAL
(if 9\./""J, ~ S.-f: Iv\ c-€ iPl-\l\J~ \
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
s..:
D BUILDING $ )c'JO VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL 1.eo AMP SERVICE g) Progress Energy 0 W.R.E.C.
o PLUMBING
9 MECHANICAL $ VALUATION OF-MECHANCIAL INSTALLATION
D GAS D ROOFING D SPECIALTY D OTHER
TYPE OF CONSTRUCTION: ~ BLOCK
o FRAME
o STEEL
D OTHER
FINISHED FLOO~ ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAD YES 0' NO
E=L~;,~~' ~~__~~-~ '~=~~~_.~'_-~-__~_~~r-- - . -- i-- --~~_=~~~~ ~_L~~~~~~~~,-,-,',-,~:i~;~,~':!
BUILDER
COMPANY
SIGNATURE
STATE CERT OR REGIST it
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ELECTRICIAN ~~ .
, '/L-,
SIGNATURE .'
COMPANY ~cJvrl E. OLJ{1/f ~
STATE CERT OR REGIST #
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PLUMBER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
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MECHANICAL
COMPANY
SIGNATURE
STATE CERT OR REGIST #
***********************************.*************~***************
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A.' NOTI~E 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 contrqi?tors to undertake work, 'they may be required
to be licensed in accordance with state and iDeal 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 ~pplication for which they
will be responsible. If ydu,as ~he owner signs as the contractor,ydu 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, haYE;! 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 appLi.cant 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 indic~ted. I
certify that no work or installation has commenced prior to issuahce of a permit and that
all work wiil be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land developmerit 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 certity that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a;:'compensa,ting'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 prooeed 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, cons~ruction, 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 \a
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. JOSS UNDER
$2,500 IN VALUE DO NOT NEED TO RECbRDAND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
acknowledged
, 2 0..:.-
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
'.1 20_
(name' of person acknowledged)
Dwho is personally known to me, 'or
(name of persor acknowledged)
[1ho is personally known to me, or
D who has produced
(type
and wrioD did D did not
of identification)
take an oath.
Dwho has produced
(type of identification)
and who Ddid [):iid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
D:ISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRB:ILLS BU:ILD:ING DEPARTKENT
0\ SE J
:I, ~I--{ (j ~
agree to the provisions of this instrument.
have read and fully understand and
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his or her own domicile" that he or she
actually occupies, or will occupy by said domicile, and same is not for
rent, lease or sale. That he or she shall comply with the following conditions:
1.
That the owner and he or she alone shall act as the builder for all phases of
construction.
That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to 'the building.
That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.,
That in the event the Building :Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice. to pay additional fees.
That the owner shall comply with all City, State and Federal laws' in regard to
social security, workman's compensation, lien laws, etc., where applicable.
That the owner shall comply with all the safety codes issued by the Florida
:Industrial Commission.
State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain,
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourself. You may build or impr~e a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $25,000.
The building ,or residence must be for your own use or occupancy. :It may not
be built or substantially improved for sale or lease. :If you sell ;or lease a
building you have built or substantially impJ::oved yourself within 1 year after
the construction is complete, the law will presume that you built or
substantially improved if for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person to act as your contractor or
to supervise people working on your building. :It is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your construction must comply with all applicable laws, ordinances, building
codes, and zoning regulations.
S:IGNATURE ,,;Hog. (j~
2.
3.
4.
5.
6.
7.
B.
9.
OWNER'S
ADDRESS
PHONE
DATE
r
WITNESS
PBRM:IT #