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Home My WebLink About07-6965 CITY OF ZEPHYRHILLS 5335-8th Street (813) 780-0020 ELECTRICAL PERMIT 6965 Permit Number: Permit Type: Class of Work: Proposed Use: Contractor: Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: 35.00 Amount Paid: 35.00 Date Paid: 8/21/2007 Work Desc: UPGRADE FROM 1 OOAMP TO 200AMP 6965 Address: 5215 16TH ST ELECTRICAL MISC ZEPHYRHILLS, FL. ELECTRIC SERVICE REPLACEMENT Township: Range: SINGLE FAMILY RESIDENTIAL Lot(s): Block: HOMEOWNER Book: Page: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 11-26-21-0010-19500-02a6 Section: 700.00 Phone: . \ ROUGH ELE RIC CONSTRUCTION POLE PRE-METER 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. , ~~ '1Z_~ -/:' 'l,/<' // '/i, ~ r {/I-, / ~ONTRACTO) PERMIT OFF I R / ~ PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER Date Received City of Zephyrhills Permit Application Building Department Fax-813-780-0021 813-780-0020 Owner's Name Owner's Address S Z , 5 Fee Simple Titleholder Namel Owner Phone Number Owner Phone Number I Owner Phone Number I JOB ADDRESS Fee Simple Titleholder Address I 1521S I 110ft? 6"tI2f:tT 2f!J;')YI2.J+/Us. J A- I LOT# I PARCEL ID#W ~ j).r 2..,~-Oo( 0...1 Q.5ob -f) 2..#\-~ (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D I o NEW CONSTR E3 ADD/All D D INSTALL REPAIR PROPOSED USE D SFR D COMM D TYPE OF CONSTRUCTION D BLOCK D FRAME D DESCRIPTION OF WORK I uP Gf!.ME ID W AmP 5t-te V teL rfVJ ! JO Am P BUILDING SIZE I SQ FOOTAGE I I HEIGHT I 111111111111'111111""1111'1111111""111111'11111111""1'11111111111111111111111111111111111111111111111111111111111111111111111'111'1111111111 SUBDIVISION WORK PROPOSED DEMOLISH OTHER STEEL I D OTHER I 1$ I 1$ -; 00 dJO I 1$ I 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 11111111111I11111111111111111I1111111111I1111111111111111111111111111111I11111I1111111111111111I11111111111111111111111111111111111I11111111111111 D BUILDING D ELECTRICAL D PLUMBING D MECHANICAL VALUATION OF TOTAL CONSTRUCTION AMP SERVICE D PROGRESS ENERGY D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION Y/N I I I I I I I I I I BUILDER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT COMPANY REGISTERED License # I l-fom E OuJN brL I Y / N I FEE CURRENT Address ~lG~;:~~;N! ~ ~ 7c!, Address . Y/N License # PLUMBER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address 111111111111111 RESIDENTIAL License # 111II1111I111I1111111111I111II1I1111111111I111111111111I111I11I111II1111I1111111111111111111111111111111111111111111111I111I111111 Attach (2) Plot Plans; (2) sets Df Building Plans: (1) set Df Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance Attach (2) sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construction. COMMERCIAL SIGN PERMIT DI~~~ti~~~': I . I I I . . I I . . . . . I . . I I I I I I I I . I . I I . . . I I I I I I I . I I . I I I . . . . I I I I I . I . I . . . . . . I I I I I . . I I I . I I . . I . I . . . I . I I . I . I I I . . . . I . . I I I I . . . . I I . . I I . I I I I I I I I I I I I I I I I 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 with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. 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 Pasco County Building Inspection Division-Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and 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 amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the "owner", I certify 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. 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, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government 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 Protection-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. 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. If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. 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 codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Officia~ for a period not t~ exceed nin~ty (.90) da~s and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the\~ob 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 YOUR NOTICE OF COMMENCEMENT. FLORIDA JURAT (F.S. 117.03) ~~' CONTRACTOR ' S~;~~~~7d ~;om oIj ) e ore e . k I ;J~ Who Is/are personally known to me or has/have produced f./ (L-Y--~ as identification. ",;:;;'~:'f~"" G S Notary Public =*:. ....;:. Commission DO 621833 Com miss . .ki' r 1 2010 ~<t;,9~ ~~~~.., Bonded Thru Troy Fain Insurance 800.385-7019 Notary Public Name of Notary typed, printed or stamped ,1>.~f.~'fy'~< JACQYE~INE SOGES Commission No. .:*:~..*:. c.:omml!':!':lon no R?183-'3 ~... .:~"..ff Expires December 12, 2010 "'~iif.:&-r;..~'" Bonded Thru Troy Fain Insurance 800-385-7019 Name of Notary typed, printed or stamped DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT I, ~lIJ ~/J/1 K:::; Ju.- agree to the provisions of this instrument. have read and fu~~y understand and The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or reroofing his or her own domici~e, that he or she actua~~y occupies, or wi~~ occupy by said domici~e, and same is not for rent, ~ease or sa~e. That he or she sha~~ comp~y with the fo~~owing conditions: 1. 4. That the owner and he or she a~one sha~~ act as the bui~der for a~~ phases of construction. That the owner wi~~ comp~y with a~~ provisions of the City of Zephyrhi~~s ordinances and codes pertinent to the bui~ding. That in the event various phases of construction are Subcontracted, he wi~~ engage on~y proper~y ~icensed subcontractors and wi~~ persona1~y supervise such work. That in the event the Bui~ding Inspector sha~~ require corrections to be made, the owner wi~~ assume fu~~ responsibi~ity to insure they are made, and upon comp~etion wi~~ ca~~ for a reinspection before proceeding with the bui~ding. That the owner sha~~ assume fu~~ responsibi~ity for the construction and wi~~ not expect supervision of his work from the City of Zephyrhi~~s Bui~ding Department. That prior to fina~ inspection any additiona~ fees, inc~uding reinspection fees, must be paid in fu~~. A written request from this office sha~~ constitute an officia~ notice to pay additiona~ fees. That the owner sha~~ comp~y with a~~ City, State and Federa~ ~aws in regard to socia~ security, workman's compensation, ~ien ~aws, etc., where app~icab~e. That the owner sha~~ comp~y with a~~ the safety codes issued by the F~orida Industria~ Commission. State ~aw requires construction to be done by ~icensed contractors. You have app~ied for a permit under an exemption to that ~aw. The exemption a~~ows you, as the owner of your property, to act as your own contractor with certain restrictions even though you do not have a ~icense. You must provide direct onsite supervision of the construction yourse~f. You may bui~d or improve a one-fami~y or two-fami~y residence or a farm outbui~ding. You may a~so bui~d or improve a commercia~ bui~ding, provided your costs do not exceed $25,000. The bui~ding or residence must be for your own use or occupancy. It may not be bui~t or substantia~~y improved for sa~e or ~ease. If you se~~ or ~ease a bui~ding you have bui~t or substantia~~y improved yourse~f within 1 year after the construction is comp~ete, the ~aw wi~~ presume that you bui~t or substantia~~y improved if for sa~e or ~ease, which is a vio~ation of this exemption. You may not hire an un~icensed person to act as your contractor or to supervise peop~e working on your bui~ding. It is your responsibi~ity to make sure that peop~e emp~oyed by you have ~icenses required by state ~aw and by county or municipa~ ~icensing ordinances. You may not de~egate the responsibi~ity for supervising work to a ~icensed contractor who is not ~icensed to perform the work being done. Any person working on your bui~ding who is not ~icensed must work under your direct supervision and must be emp~oyed by you, which means that you must deduct F.I.C.A. and withho~ding tax and provide workers' compensation for that emp~oyee, a~~ as prescribed by ~aw. Your construction must comp~y with a~~ app~icab~e ~aws, ordinances, bui~ding codes, and zoning regu~ations. . =~~ s~~ ,~;;f~1{~2~ 'FL PHONE '25/ ~ c;q 7. - CJ~-1. ' , WITNESS 2. 3. 5. 6. 7. 8. 9. DATE 0hl/cJ7 , PERMIT #