HomeMy WebLinkAbout07-7326
CITY OF ZEPHYRHILLS
5335-8th Street
(813) 780-0020
ELECTRICAL PERMIT
7326
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Contractor:
Square Feet:
Est. Value:
Improv. Cost: 550.00
Date Issued: 12/17/2007
Total Fees: 35.00
Amount Paid: 35.00
Date Paid: 12/17/2007
Work Desc: SERVICE UPGRADE 200 AMP
7326 Address: 5140 10TH 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: 11-26-21-0010-19500-0030
Section:
Name:
Address:
McGUIRE, JOSEPHINE
5140 10TH ST
ZEPHYRHILLS, FL. 33542
813 788-1385
Phone:
ROUGH ELECTRIC
PRE-METER
FINAL/o1_ cP-? .,1) 7
~./
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.
-,
,~}~~O~RA~~U
~-~
PERM~
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
Owner's Address
Fee Simple Titleholder Namel
i r'L
Owner Phone Number
Owner Phone Number l
Owner Phone Number I
Date Received
Owner's Name
JOB ADDRESS
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sT"
LOT #
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Fee Simple Titleholder Address
WORK PROPOSED
El
PROPOSED USE D
TYPE OF CONSTRUCTION D
DESCRIPTION OF WORK I 5'e I< 1/ f e P':.-
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'.'1111...111..11111...,11....'................11...11...............111....1111.........111...1111.............11.......11'..........................
NEW CONSTR
INSTALL
SFR
BLOCK
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B
D
D
PARCELlD#1 \\ - '2(.,..2\..,. ~)O\O '~SDO
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE 0
D
D
D
DEMOLISH
SUBDIVISION
ADD/ALT
REPAIR
COMM
FRAME
OTHER
STEEL
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D
OTHER I
BUILDING SIZE
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sa FOOTAGE I
,;?oO A/'lip
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HEIGHT
D BUILDING 1$ I
[21 ELECTRICAL 1$ S !:o. g..s;2-- I
D PLUMBING 1$ I
D MECHANICAL 1$ I
D GAS D ROOFING D SPECIALTY D OTHER
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO
It,lllpll"'IIIIII"III,"""III"I',"""III,"',,11"111111:'11""""'111'1"111'1'111'111"1"111'11''11'11"'1'1"11"'1""'11""1"111'
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
D
PROGRESS ENERGY
o
W.R.E,C
VALUATION OF MECHANICAL INSTALLATION
COMPANY
REGISTERED
BUILDER
SIGNATURE
Y / N
FEE CURRENT
Y/N
Address
~~:;~:~~:N,~. ~ ~
Address __'
PLUMBER I
SIGNATURE
Address I
MECHANICAL I
SIGNATURE ,
Address I
OTHER I
SIGNATURE
Address I
1I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) 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 subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (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 wl.Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects, All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
11111111111111111111I111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111
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 with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
License #
-JJ ~
'I Y / ~'1' FEE CURRENT
Y/N
COMPANY
REGISTERED
License #
COMPANY
REGISTERED
Y / N FEE CURRENT
License #
Y/ N FEE CURRENT
License #
Y/N FEE CURRENT
License #
Y/N
COMPANY
REGISTERED
Y/N
COMPANY
REGISTERED
Y/N
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 fiI~ the area within the st~m ~all. .
If fill material is to be used in any area, I certify that use of such fill Will not adversely. affect a?Jac~nt
properties. If use of fill is found to adversely affect adjacent properti~s, the. ow~er 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 ~f the permlttln~ conditions s~t forth In
this affidavit rior to commencing construction. I understand that a s,eparate perm~t, may ?e reqUlr~d for elect~lca.1 work,
lumbin si Pns, wells, pools, air conditioning, gas, or other installations not speCifically 1n~luded,1n the application. A
p ermit i~~ue~ shall be construed to be a license to proceed with the work a~d not asauthorl~y ~o, vlol~t~, cancel, alter, or
p t'd rovisions of the technical codes, nor shall issuance of a permit prevent the B~II.dlng OffiCial from the~eaft~r
~: ~~iln e :%irection of errors in plans, construction or violations o! any codes. Every ~ermlt Issued. shall become. invalid
i ~ k authorized by such permit is commenced within SIX months of permit Issuance, or If work authorized. by
un ess .e .wor nded or abandoned for a period of six (6) months after the time the work is commenced: An extenSion
the p~rmlt IS sU~Pde 'n writing from the Building Official for a period not to exceed ninety (90) days and Will demodstrate
~=~fia~l~e:~:e ~o~ ~he exten'sion. If work ceases for ninety (90) consecutive days, the\~ob is considered abandone .
ECORO A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
WARNING TO OWNE~p:g~:,:~~~~ ~~~R PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT
~~J:;oi:I~~:g:R OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F~S. 117.03) (
CONTRACTOR .
Subscribed and s _ 0 ( affirmed) befor.e me thb'S , .
(7/17/07 b' ~-('h\\"\J2 A'\<, Q, r-e...
Who Is/are personally known to me or has/have pyodu~ed
~'-.{ "QQ.\,) f2.. W ~ as Identification.
~~ d-- ~ Notary Public
Comml"'~"~ Karen .L. Miller
:*: ;: com SSfOn # 00609664
""~ EllI':: ""'""'" 29, 2010
Name of Nola ,~""'IR" 1ll104I601OlI
"
~~ d-- ~_
Notary Public
Commission No.
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,
RlV F... .1t\'olr_. 1M 1IG04It-701.
Name of Notary typed. pri' ;...:
DISCLOSURE STATEMENTFOR OWNER
CITY OFZEPHYRHILLS - BUILDING DEPARTMENT
I,
provisions of this instrument.
have read and fully understand and agree to the
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.
2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes
pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will engage only
properly licensed subcontractors and will personally supervise such work.
4. 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.
5. 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.
6. 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.
7. 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.
8. That the owner shall comply with all the safety codes issued by the Florida Industrial
Commission.
9. 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 improve 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 $75,000. The
building or residence must be for your own use or occupancy. It may not be 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.CA and withholding tax and provide worker's compensation for that employee, all
as prescribed by law. Your construction must compiy with all applicable laws, ordinances,
building codes, and zoning regulations.
OWNER'S SIGNATURE ~)up ~
ADDRESS Y ,
PHONE
DATE
WITNESS
PERMIT
I/Masterforms/OwnersAffidavit/Nov07