HomeMy WebLinkAbout07-6355
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
6355
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost: 1,100.00
Date Issued: 1/08/2007
Total Fees: 35.00
Amount Paid: 35.00
Date Paid: 1/08/2007
Work Desc: SERVICE UPGRADE
Address: 39028 3RD AVE
ELECTRICAL SERVICE CHANGE ZEPHYRHILLS, FL.
ELECTRIC SERVICE REPLACEMENT Township: Range: Book:
SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 12-26-21-0010-00100-0080
Name: SAMPSON, ANNA
Address: 39028 3RD A V
ZEPHYRHILLS, FL. 33542
Phone:
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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 inspections 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 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."
NO OCCUPANCY BEFORE C.O.
~. - ~.
SIGNATURE PERMIT OFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
City of Zephyrhills Permit Application
Building Department
FaX-813-784il~ ,~
Date Received
V~
Owner Phone Number
Owner Phone Number ,
Owner Phone Number I
Owner's Name
Owner's Address
Fee Simple Titleholder ~ame'
JOB ADDRESS
Fee Simple Titleholder Address 'I
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I LOT # I
I
PARCELlD#112-2~-ZI- OOIO-DOI O()- D68u
(qBTAINED FROM PROPERTY TAX NOTICE)
o SIGN 0 MOVE 0
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SUBDIVISION
WORK PROPOSED
DEMOLISH
OTHER I
STEEL 0
OTHER I
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I
~U1LDING SIZE
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ELECTRICAL
AMP SERVICE ,;zCO
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PROGRESS ENERGY
D
W.R.E.C
D
PLUMBING
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MECHANICAL
VALUATION OF MECHANICAL INSTALLATION
Address
LIcense #
ELECTRICIAN
SI~NA TURE
r-
4t~//;~ EkC"4~ J=",c-
Y/N J 'FEECURRENT Y/N I
L1cense#/Z::c 131:)0/3 ~3
Address
PLUMBER
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
Address
MECHANICAL I
SI(;NA TURE ,
Address I
OTHER I
SIGNATURE
Address I License #
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII! 111111/111111111111111111111111111111111 i IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIJ 1 11111111/11111
RESIDENTIAL Attach (2) Plot Plans; (2) St;lts of Building Plans; (1) set of Energy Forms
Minimum ten (10) working days after submittal date. Requ/i'ed onslte. Construction Plans, SanItary Facilities & 1 dumpster
Attach (3) sets of Building Plans; (1) set of Energy Forms.
Minimum ten (10) working days after submittal date. Required onslte, Construction Plans. Sanitary Facilities & 1 dumpster
All commercial requirements must meet compliance.
Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111.11 111111
Directions: ",
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000)
.., Agent (for the contractor) or Power of Attorney (for the owner) would be someone wtth notarized letter from owner authorizing sam"".'
OVER THE COUNTER PERMITTING (Front of Application Oniy)
, Reroofs Sewers Service Upgrades AlC
License #
COMPANY
REGISTERED
YI N
FEE CURRENT
Y/N
License #
COMPANY
REGISTERED
I YI N 'I
FEE CURRENT
Y/N
COMMERCIAL
SIGN PERMIT
Driveways
Fences (Plot/Survey/Footage.
NOTICE OF DEED RESTRICTIONS: The undersigned underslands that th," permit may be subject to 'deed' restrlcllons'
which may be more restrlcllve than county regulatlons- The undersigned assunies responsibility fur compliance with any
. applicable dee(jrestrictions. ..
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: II the oWller has hired a contractor or
contractors to undertake work, they may be required ,to be licensed In aceoroanc<l with state and local regulations- 11 the
contractor Is not licensed as required by law. both the owner and contractor may be cited for a misdemeanor violation
understate law-' lithe owner or Intended contractor are uncertain as to what licensing requlremen," may apply for the
Intended work, they ere advised to contactth,e pesco County Building Inspection Dlvlslon--Llcenslng Section at 727-847-
8009- Furthermore, 11 the owner haS htred a contractor or contractors, he Is advised to have the contractorls) sign
portions of the 'contractor Block" of Ihls application fur which they will be responslble- If you. as the owner sign as the
conlractor. that may be an Indication that he Is not properly licensed and Is not entllled to permitting privileges In Pasco
County, '
TRANSPORTATION IMPACTIUTlI,.ITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees end Recourse Recovery Fees may apply to the construction of new buildings, change of
use In existing buildings. or expansion of existing buildings. as specified In PasCO county Ordinance number 89-07 and
90-07. as emanded- The undersigned also understends, thai such fees, as may be due. wl1l be Identified at the time of
permlttlng- Ills further understood that Trensporla\lon Impact Fees and Resource Recovery Fees must be paid prior to
receiving e 'certlflcate of occupency" or tinal power release- II the project does nollnvolve a certmcate of occupancy or
tinal power release. the lees must be paid prior to permlllssuance- Furthermore. II Pasco CountY Water/Sewer Impacl
fees are due, they must be patd prior to permlllssuance In accordanc<l with applicable Pasco County ordlnances-
CONSTRUCTION LIEN LAW (Chapler 113, Florida Slatules, es amended): 11 valuallon of work Is $2,500-00 or more, I
certify thet I. the applicant. have been provided with a copy of the 'Flortda Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Oepai1menl of Agrtculture and Consumer Affairs- II the applicant is someone
other than the 'owner", I certify that I have oblalned a copy of the abQve described document and promise In good faith to
deliver it to the .owner" prior to commencement. '
C?NTRACT?R'SIOWNER'S AFFIDAVIT: I certify that all the Information In this application Is accurale and that all work
w,lI be done ,n compliance with all appllcablelaw9 regulallng construction. zoning and land developmenL Application Is
hereby made to obtain a permit to do work and Installation as Indicated, 'certify \\1al no work or Installation has
commenced prior to Issuance of, a permit and that all work will b rf d t
construcllon. County and City codas zoning regulallans and lan~ ~e "rme ~ meel standards 01 all laws regulating
certify thai I understand that the regulations of other ov';"nment a e~e opmen regulat'on~ In the Jurlsdlctlon- I also
my responsibility to identify what actions I must take t; be In comp'Ii;~;~lesSUmChaYa9apPI~ tolthel Idntebndted work, and that it is
_ D rt t' fE' - enc,es nc U e U are not limited to'
epa men 0 nvlronmental Protection-Cypress Bayheads, Wetland Areas and Environm t 11 S ',t'
Lands. Water/Wastewaler Treatment en a yens, ,ve
southwest Florida Water Management District-Wells, Cypress Bayheads Wetland Areas, Alter,'ng
Watercourses. I
Army Corp~ of Engineers-Seawalls, Docks, Navigable Waterways.
Dep~rtment of Health & Rehabilitative Services/Environmental Health Unit-Wells Wastewaler Trealment
Septic Tanks- ," ·
US Environmental Protection Agency-Asbestos abatement.
, Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
'_ Use of fill Is not allowed In Flood Zone .V" unless expressly permitted. '
~ Ihe fill m~terlal Is t? b,e used In Flood Zone 'N, It Is understood lhal a drainage plan addressing a
compensating volume Will be submitted at tIme of permitting which is prepared by a professional engineer
IIcense~ by the State of Florida.
, If the fill ,material !s to be, used In Flood Zone 'A" In connecllon with a permitted building using stem wall
construction, I certify that fill.wl\l be used only to fill the area within the stem wall.
If till m,alertal Is to be used In any ~rea. I certify Ihat use of such till will not adversely alfect adJacenl
prOpert,e;': If use of fill Is ~ound to ,adversely atfect adjacent properties, the owner may be clled for vlolaling
the condlt,ons of the building permn I,ssued under the atfached permit appllcallon, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required,
IIlarn the AGENT FOR THE OWNER, I promise In good faith to Inform the owner of the permitting condlllons set forth In
this affidavit prior to commencing construcUon- I undersland that a separale permit may be required for eleclrlcal work,
plumbing, signs, wellS, pools. air condlllonlng, gas. or other Inslallatlons not specffically Included In the appllcatlon- A
permit Issued shall be conslrued 10 be a license to proceed wllh lhe work and nol as authority to vlolale, cancel. alter, or
set aside any provisions of the technical codes, nor shall Issuanc<l of a permit prevent the Building OffIcial from therealter
requtrlng a correcllon of errors In plans. construction or violations of any codes- Every permit Issued shall become Invalid
unless the work authorized by such permit Is commenced wllhln six months of permit Issuance, or If work aulhorlzed by
the permit Is suspended or abandoned for a period of six (6) months atfer the time the work Is commenced- An extension
may be reqUested. In writing, from the Building Offlc\aI for a period nol to exceed ninety (90) days and will demonslrale
justtflable cause for the e~tenslon- If work ceases fur nlnely (90) consecutive days, the job Is 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 YOU NOTl E C E EMENT,
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT
Subscribed and swom to (or afflnm:id) before me thIs
by
Who Is/are personally known to me or haslhave produced
as IdenUflcaUon;
Notary Public
Notary Public
~
commIssion No.
;h Name of Notary typed, printed or stamped
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