HomeMy WebLinkAbout12-13438 � CITY OF ZEPHYRHILLS
5335-8th Street
(813)780-0020 13438
ELECTRICAL PERMIT
Permit#:13438 Issued: 9/11/2012 Address: 39110 SOUTH AVE
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRICAL MISC Township: 26 Range: 21
Proposed Use: NOT APPLICABLE Lot(s): Block: Section: 13
Sq. Feet: Est. Value: Book: Page:
Cost: 221.00 Total Fees: 40.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 40.00 Date Paid: 9/11/2012 Parcel Number: 13-26-21-0000-00500-0000
Name: CARLYLE ELECTRIC Name: ZEPHYRHILLS DEPOT MUSEUM
Addr: P.O. BOX 251 Address: 39110 SOUTH AVE
CRYSTAL SPRINGS, FL 33524-0251 ZEPHYRHILLS, FL. 33542
Phone: Lic: Phone:
Work Desc: RETROFIT SERVICE METER REPAIR- TAG'S FEE WAIVED
ELECTRICAL FEE 40.00
ROUGH ELECTRIC
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 any one of the following reasons: a)wrong address b)condemned work resulting
from faulty wnstruction 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 'ob 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.
"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 performed in accordance with City
Codes and Ordinances.
CONTRACTOR PER OFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
- ' . _r r____"'_" _ ' _' "_
Building Department
Qate Received
Phone Contact for Permittin
Owner's Name
� Owner Phone Number
ONrner's Address .� ,j� ' r ��s .�/
Owt�er Phone Number
Fee Simple Titlehoider Name �
Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS .. 9 - s �
LOT#
SUBDIVISION PARCEL ID#
(OBTAINED FR�OM pROPERTY T��NOTicE)DEMOLISH
WORK PROPOSED B NEW CoNS7R B ADD/ALT �_] SIGN
INSTALL REPAIR
PROPOSED USE Q SFR �] COMM �� OTHER
T1fPE OF CONSTRUCTIOM [� BLOCK Q FRAME [�� STEEL Q
DESCRIPTION OF WORK
BUILDIN(i SIZE SQ FOOTAGE� HEIGHT
QBUILDING $
VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE PROGRESS ENERGY
e B� 0 Q W.R.E.C.
OPLUMBING $
S�� �-�C ( �`f�P^^
QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ' ,����
[�]GAS Q ROOFING Q SPECIALTY C] OTHER � �3 �1`� "
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
sUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# —�
ELECTRICIAN COMPANY � j
SIGMATURE REGISTERED N FEE CURRE� Y/N
Address
License#
PLUINBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
INIECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �—
OTHER COMPANY
SIGNATURE 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,
Mlnlmum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilitles�1 dumpster,Site Work Permit for subdivisionsllarge proJects
COMMERCIAL Attach(3)complete aets of Bufiding Pians plus a Life Satety Page;(1)set of Energy Fo�ms.R-O-W Permit Sor 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 commerc(al requirements must meet compliance
SIGIN PERMIT Attach(2)sets of Engineered Plans.
"""PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner&Contractor sign back of application,notarized
If over 52500,a Notice of Commencement is requfred. (AIC upgrades over E7500)
'" Agent(for the contractor)or Power of Attomey(for the owner)would be sameone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A!C Fences(Plof/Survey/Footage)
Driveways-Not over Counter if on pubiic 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
contracto� 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 (nspection 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.
TR/�►NSPORTATION IMPACTIUTILITIES 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 fo
receiving a "certificate of occupancy" or flnal power release. If the project does not involve a cert�cate 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(Chapte�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.
CONTRpC70R'SIOWNER'S AFFIDAVIT: I ce�tify 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
cerfify 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, WaterlWastewater 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 Nealth Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
t 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, 1 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 include� 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 pe�mit is commenced within six months of permit issuance, or if work authorized by
the pe�mit is suspended or abandoned for a period of six(6) months afte�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 wil) demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUIt FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IIV YOUR
PAYING TVNICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CON5�ILY
1NITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S. 117.03} �
OWNER OR AGENT CONTRACTOR —
Subscribed and swom to(oG firmed)befor this Subscribed and swom to+( r afflrmed)bef e t ls
by by
Who is/are personally known to me or has/have produced Who islare personally known to me or has/have produced
as iden8fication. as identifica6on.
Notary Public f� Notary Public
Commission No. Comm s on `�'°'•,
';�; :•= Commission#���ES
Name of Notary typed,printed or stamped Name of No "' �i �'P� royF��n�2��14
�00-3857019