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Home My WebLink About12-12780 CITY OF ZEPHYRHILLS 5335-8th Street (813)780-0020 12780 ELECTRICAL PERMIT Permit#:12780 Issued: 2/07/2012 Address: 5413 11TH ST Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL. Class of Work: ELECTRICAL MISC Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: Book: Page: Cost: 400.00 Total Fees: 40.00 Subdivision: CITY OF ZEPHYRHILLS Amount Paid: 40.00 Date Paid: 2/07/2012 Parcel Number: 11-26-21-0010-15000-0010 Name: HOMEOWNER Name: KOVALESKI, WILLIAM JAMES Addr: Address: P.O. BOX 262 LAKE NEBAGAMON WI 54849-0262 Phone: Lic: Phone: (218)349-4273 Work Desc: UPGRADE EXISTING ELECTRICAL TO 150 AMP ELECTRICAL FEE 40.00 ROUGH ELECTRIC CONSTRUCTION POLE • -----__..__ PRE-I�AE-TER ` FI L / `� . • � _�. _ � � J � ` ' � . ,� � w ____ _ , 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 oonstruction c) repairs or corrections not made when inspection called d)work not ready for inspection when called e) permit not posted on job site� plans not at job site g)work not aocessible. 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. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your properly. 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. _ � , T CTOR PER OFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received phone Contact for Permittin -- Owner's Name Owner Phone Number � �� 2 Owner's Address l�1'� � �_ Owner Phone Number � Fee Simple Titleholder Name °.SQ'f`f�L°� Owner Phone Number � Fee Slmple Titleholder Addresa .�(,�m� JOB ADDRESS LOT# �[.d.1{.LL_J SUBDIVISION � ��,(�,� ,�- �"' PARCEL ID# - � - - - (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTRy� ADD/A � SIGN Q Q DEMOLISH INSTALL �Q REPAIR PROPOSED USE � SFR Q COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q DESCRIPTION OF WORK U �,Fi' '� e �� CL BUILDING SIZE SQ FOOTAGE� HEIGHT OBUILDING $ . — VALUATION OF TOTAL CONSTRUCTION �ELECTRICAL $ � � OD AMP SERVICE • � ROGRESS ENERGY Q W.R.E.C. 125�,'1� OPLUMBING $ �� MECHANICAL $ �- VALUATION OF MECHANICAL INSTALLATION QGAS Q ROOFING Q SPECIALTY �] OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO BUILDER � COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � —� X ELECTRICIAN ! < " COMPANY 7� D L� Q 1�� SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � PLUMBER COMPANY 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# C —� MECHANICAL COMPANY �— SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N Address License# � --� OTHER � COMPANY 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N 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 8 1 dumpster;Site Work Permit for subdivisionsAarge projects COMMERCIAL Attach(3)comptete 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 consUuction. Directions: Fill out application completely. Owner&Contractor sign back of applicatlon,notarized If over 52500,a Not(ce of Commencement is required. (A/C upgrades over;7500) " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized�etter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A!C Fences(PIoUSurveylFootage) 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 loca) �egulations. 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 "certiflcate of occupancy" or finai 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, Fiorida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the appiicant, 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 Iots 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 the ob is considered abandoned. justifiable cause for the extension. If work ceases for ninety(90)consecutive days, j WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR�OR AN ATTORNEY�EFORE RECORDING YOUR NOTICE OF COMMENCEMENT.' CONSULT WITH YOUR LEN�E FLORIDA JURAT(F.S.117.03) � OWNER OR AGENT . ^ CONTRACTOR � � Subscribed and swom to(or aHirmed)before me this Subscribed and swor to(or a rmed e m is by Z-�—IL bY�O��ll '.:un "�" �)f��. Who i lare personally known to me or haslhave produced Who Is/are personally known to me or has/have produced as identification. ��'�Q�� as idendficadon. Notary Public r� �� Notary Public A` "�'�"�� Commission No. mis �� ' 9GLaUEUNE�Af� :•: �.= Commission#EE 040520 ;�:: �be , Name of Notary typed,printed or stamped Name of o '.'��esio�s D2SCI,OSL7RE STATEMENT .FOR OWNER CZTY OF ZEPFiYiZHII�LS SVII+DSNG DEPARTi�NT _ • have read and fully understand and , agree •to the provisions of �this i.nstrument• .The undersigned .states and affirms that he or she is desirous of constructing, rex�ova�ting, adding to or seroofing his or her own domicile, •that he or she actually occupies, or svi11 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 owsier aad.he or she alone sha11 act as the buil.der for all phases of constsuction. 2. That the owner will comply with a11 provisions of the City of Zephyrhills ordinances and codes pertineat to the builcls.ag. 3. That in the event various phases of construction are subcontracted, he will en�age ozil.y •psopPSly liceased subcontractors and will personally sispervise such work. 4, That in the eveat the Building Inspector sha11 requ�.re correctioas to be made, the o�aner �vil1 assume full responsibility to ixisure •they are made, and upon completion will ca13 for a reinspectioa before proceeding with the building. 5, That the oovner sha11 assvme fu11 responsibility for the constrsiction and vTi11 not gxpact_ supervision of his work from the City of Zephyrhills Building Departmerit. 6. That prior to final inspection aay additional fees, including reinspection fees, must be paid ia full. A writtan requsst from this office sha11 constitute an official notice rto pay additiosia]. fees. . 7. That the owner sha11 comply with a11 City, 5ta.te and Federal laws in regasd to social sacurity, workman's compensation, lien laws, etc. , where applicable. 8. That the ovmer sha11 comply with all the safety codes issued by the Florida 2adustrial Commi.ssion. 9. State law re�,;res constrLiction to be done by licensed contractors. You have applied for a permit under an exemptioa to t�at law. The exemption allows you, as the owner of your property, to act as your owa contractor Fritfi ce*�-=;*+ restrictions even though you do not have a license. You must provide direct onsite supervision of the constructioa yourself. You may build or �.mprove a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial bvilding, provided your costs do xiot e�cceed $25,000. The building or residance must be for yovr own use or occupancy. It may not be built or substantially i�proved for sale or lease. If you sel.l or lease a building you have built or substasitially i�proved yovrself within 1 year after the constxuction is complete, the law will presume •t�at you built or substanti.ally improved •if for sale or lease, which is a violation of thi.s exe�ption. You may not hire an valic�nsad p2='soa to act as yovr contractor or to supervise people working on yovr bvilding. It is your responsibility to make sure that people employed by you have licenses rec�,;red by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervisi.ng work to a licensed contractor who is not. licesised to per£orm the work beiag doaa. Any person working on your building who is not licensed must work vnd�r your direct supervision and must be employed by you, which means that you must deduct E.I.C.A. and withholdiag tax and provide workers' compensation for that e�ployee, all as prescribed by law. Your construction must comply with a11 applicable laws, ord�siances, building codes, and zoning ra atioas. �- OWNER'S SIGLZATC7RE , Dp+'1'E C�'� — � � l� ADDRESS �� _ �j PHONE W2TNES5 PERMIT #