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HomeMy WebLinkAbout10-10508 CITY OF ZEPHYRHILLS 5335 -8th Street (813)780 -0020 10508 ELECTRICAL PERMIT Permit Num 10508 A 582 ' EXCEL ST Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL. Class of Work: ELECTRIC SERVICE REPLACEMENT Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Contractor: PAGE ONE ELECTRIC INC Book: Page: Square Feet: Subdivision: TREE LANE VILLAGE Est. Value: Parcel Number: 10- 26 -21- 0000 - 00100 -0000 Improv. Cost: 250.00 ° : 1' Date Issued: 5/20/2010 Name: TREE LANE LTD C/O TERRACE VILLAG Total Fees: 35.00 Address: 10912 N 56TH ST Amount Paid: 35.00 TEMPA TER ' CE FL 33617 Date Paid: 5/20/2010 Phone: (813) >' Work Desc: CHANGE OUT 200 AMP METER ,2 _ / , . ./n. s ELECTRICAL FEE 35.00 R ELE CONSTRUCTION POLE PRE f=kIVAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection trips are necessary due to any one 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 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." Complete Plans, Specifications and Fee Must Accompany Application. All work shall be perform( in accordance with City Codes and Ordinances. S/z _ 1�/j / � /' , r ' . ' t/r - — 662- Ifir CONT ' TOR PERMIT OFFI FR R T EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - s HOUR NOTICE i!EOTfim PROTECT CARD FROM WEATHER G''ITY OF / / NOTICE BUILDING ZEPHYRHILLS DEPARTMENT OF ADDITION OR CORRECTION DO NOT REMOVE ADDR � b1( 21° DATf PERMIT,, - 7 ( CF2-L /1/7/ THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be mode before the job will be accepted. S 4 r) i P A S t t L-1 [IN en f / - -'r( -LC.`/ 14 fiND volsq strazw re_ro/al c, S 91 (j L C 1, (fi_LsErrAle--) pgitm (,) rz_siJ In . It is unlawful for any Carpenter, Contractor, Builder, or other persons, to AFTER CORRECTIONS ARE MADE CALL cover or cause to be covered, any part of the work with flooring, lath, earth 780 -0020 FOR RE- INSPECTION or other material, until the proper inspector has had ample time to approve the installation. OFFICE HOURS 7:30 AM - 5 PM MON. -FRI. INSPECTOR z 4 ► � MAY. 20. 2010 10:18AM A. KILBRIDE INSURANCE, INC, N0. 1651 ;P, 1/1 ,,,,,,x, A` cI D CERTIFICATE OF LIABILITY INSURANCE 5/20/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON 'THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certflcate holder is an ADDITIONAL INSURED, the pollcy(lee) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s . PRODUCER N Eric Maples A .KILBRIDE INSURANCE INC PHONE p 7t 1. (813) 931 -7467 1 FAx rarC.No1 932 -7336 1401 V. Busch Boulevard Ma Tampa, 21,33612 CUSTO E R I DSk INSURR(sl APFOROINO CovERAGE NAICW INSURED INSURER A: Bankers Insurance Comgany , Page One Electric Inc INSURER 6 6424 North 49th Street INSURER C • Tampa, .FL 33610 INSURER 0 INSURER E • INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INIR TYPE DP INSURANCE AWOL NSR Mnro POLICY NUMBER ( Y YVY) ( MM l oO l1 YYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE S 500,000 X COMMERC. GENERAL LIABILITY PR UU occurrence) S 100,000 I CLAMS-MADE I_.I OCCUR MED EXP (Any one person) S 5,000 A 090005337177502 03/19/10 03/19/11 PERSONAL aAOVINJURY $ 500,000 GENERAL AGGREGATE S 1 , 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 500,000 X POLICY. PRO- LOC S AUTOMOBILE LIABILITY COMBINED SINGLE Mil S (Ea aeeaen) ANYAUTO BOOILY INJURY (Per parson) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE S _ HIRED AUTOS (Per accident) NON -OWNED AUTOS $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ + EXCESS LIAR �I CLAIMS•MADE AGGREGATE $ DEDUCTIBLE .- `r RETENTION S ' $ WORKERS COMPEN$AT10N TORY LI I TS I I AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PAWTNERNIXECLmVE ❑ NIA E.L. EACH ACCIDENT $ _ oFr 10ERMENBEt EXCLuoEm (Meneuery In NR) E.L. DISEASE • EA EMPLOYEE S If yes. d und er E.L OISFASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS Wow DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Altaw ACORD 101. Addilionel Remarks Schedule, if more space is required) Electrical Contractor License Qualifier: Eugene McDowell EC13002356 CERTIFICATE HOLDER CANCELLATION City Of 2.phyrhills Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 5335 8th Street THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Zephyrhills , FL 33542 AUTHORIZED REPRESENTATIVE Fax: 813.780.0021 r te' )17.164W%' © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD25(2009 /09) The ACORD name and Togo are registered marks of ACORD 813 - 780 -0020 City of Zephyrhills Permit Application Fax 813- 780 -0021 d( e Building Department V ° Date Received Phone Contact for Permitting 1 -- IlIIIII111iii1111G j. Owner's Name 1 A.x"^' Ld S aw.R o C G 0 SS a N % --aumber c e u dt, Owner's Address j 0 I) Z 1V S 6 S tom., "y-D,, 4D & -To„ Owner Phone Number 3 [ 33a/7 3 78. Fee Simple Titleholder Name � Owner Phone Number Fee Simple Titleholder Address 3 3 ( 2 JOB ADDRESS S D 2 C � � C Q l r /�, LOT # SUBDIVISION i '€ . e.. vi I ktjr -' PARCEL ID# 1 0 Z� - 2- -w - 0 lob' 690 U (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT I SIGN I I I I DEMOLISH INSTALL REPAIR PROPOSED USE I t -1 - SFR 1 I COMM I I OTHER I TYPE OF CONSTRUCTION I I BLOCK n FRAME 1 1 STEEL I I DESCRIPTION OF WORK C7o BUILDING SIZE SQ FOOTAGE HEIGHT BUILDING $ VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ ^� AMP SERVICE I PROGRESS ENERGY I 1 W.R.E.C. IPLUMBING $ (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION (GAS I 1 ROOFING I I SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES NO BUILDER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURREN I Y/ N I Address License # ELECTRICIAN ,{ �, COMPANY P P ° OS ; I ' C -N( ' SIGNATURE (Act 1 REGISTERED I Y/ N I FEE CURREN / I Y/ N I / e )V� Address 6 N (Act f `5+ �i 4A '23 D t License # �(�! o PLUMBER P COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I Address License # MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N 1 Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N j FEE CURREN I Y/ N I Address License # 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 w/ 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. Illllllllllllllllllttlllltlllllllllllllltllllll lllll llllllllll tIIIIIIIIIIIIIIIIIIIItIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItt llllllllll Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is requ (A/C upgrades over $7500) ** 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 if shingles Sewers Service Upgrades A/C 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 Official for a period not to exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (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 YOUR NOTICE OF COMMENCEME T. FLORIDA JURAT (F.S. 117.03) / OWNER OR AGENT CONTRACTOR VW Subscribed and sworn to (or affirmed) before me this Sub crib Mnd sw t umed) before me thC b — b v , N< � D Va Y Who is /are personally known to me or has /have produced Who Is /are person ly known to m or has asaden ifi at o as Identification. Notary Public Notary Public , vh - ' BOGES ry =.; •� : * : C o m ssion DD 621833 Commission No. Commssi% No. �: ra,i ,• ,.. !!:.:••!! ,• -_ a: ' '.'�,'� 4: ,.• Bonded Thrtr Troy Fein Insurance 80438C*7U19 Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped