HomeMy WebLinkAbout13-14680 CITY OF ZEPHYRHILLS
5335-8th Street
(813)780-0020 14680
ELECTRICAL PERMIT
Permit#:14680 Issued: 10/29/2013 Address: 39511 MEADOWOOD LP
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: 240.00 Total Fees: 40.00 Subdivision: MEADOWOOD ESTATES
Amount Paid: 40.00 Date Paid: 10/29/201 Parcel Number: 13-26-21-0140-00000-0690
Name: MDS ELECTRIC LLC Name: INSIDEOUT COMMUNITY MINISTRIES
Addr: 9742 RIVERCHASE DR Address: P.O. BOX 17633
NEW PORT RICHEY, FL 34655 CLEARWATER, FL 33762-0633
Phone: (727 514-5442 Lic: ER13014861 Phone: 813)541-2431
Work Desc: TIGHTEN LOOSE WIRES IN PANEL REQUESTED BY DUKE ENERGY
ELECTRICAL FEE 40.00
ROUGH ELECTRIC
CONSTRUCTION POLE
PRE-MET
AL
v °
, 3 D �� �� -�J� �-
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 t� plans not at job site g)work not acaessible.
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 wmmencement 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 Ciry
Codes and Ordinances.
CONT C PER OFI
P IT 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
Buiiding Department
Date Received �� �C 3 Phone Contact for Permittin �7 z � S/7 -- y�j,�
Owner's Name l �Si C,t e o v� C��n,m�.z.• ��,r�,���(,f.,j Owner Phone Number O /.3' .S ��/3i
Owner's Address � �7 (�(p �j � „.�ti- ""( `3 7 (oa. pyy�er Phone Number
Fee Simple Titleholder Name \ Owner Phone Number
Fee Simple Titleholder Addresa
JOB ADDRESS �9� \� �2C,c��r�%UCc� �oo LOT# ��
SUBDNISION ►'leCclJ�.JCYJCJ! �����5 PARCEL ID# I3't��o- ��- DI�{O r (�Op O ' d(o�rD
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEw CONS7R ADD/ALT � SIGN Q Q DEMOLISH
INSTALL 8 REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME [� STEEL Q
,
DESCRIPTION OF WORK �c�p�e ;;�� �,� ,n Q\ -Y, i,��{,� �� J��� �� e,,,
BUILDING SIZE �--� SQ FOOTAGE C� HEIGHT
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
`�ECTRICAL $ .� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
. a y�
�PLUMBING $
OMECHANICAL $ VALUATION OF MECHANICAL INSTALIATION
QGAS Q ROOFING Q SPECIALTY �] OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
BUILDER COMPANY
SIGNATURE ___ ReGISrERED Y/ N FEE CURRE� Y/N
Address License#
ELECTRICIAN _ COMPANY /'��� ��`c �L.�
SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
Address License# �
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL 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 Fonns;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilitfes&1 dumpster;Site Wo�lc Permit for subdivisionsAarge 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 8 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 constructlon.
Directions:
Fili out applicatfon completely.
Ovmer&Contractor sign back of app8cation,notarized
If over t2500,a Notice of Commencement is required. (A/C upgrades over=T500)
"" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from ovmer authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/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 fvr 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 witl 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 buildi�gs, 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 fu�ther 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 p�oject 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, t
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'SIOWNER'S AFFIDAVIT: I ce�tify that ail 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 instailation 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 identffy 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 8 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 fo�th 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 f�om 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 08TAIN FINANCING, CONSULT
WITH YO R LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTI E F C ENCE
FLORIDA JURAT(F.S. 117.03) � ��
OWNER OR AGENT CONTRA
Subscribed and sworn to(or affirmed)before me this Subs b n s�n� b �e this �.
by bY
Who is/are personally known to me or has/have produced Isl e ersonally kn wn to me or has/have pT uc
as ldentlficatlon. as identHicad n. r
� 4� y
,- / /
�
Notary Public I � � Public
Commissi !�'� �B�ES. ��
Commission No. :'E ����February 22,2016
>>s
Name of Notary typed,printed or stamped Name of N
Invoice
. - . ,2
MDS Electric LLC 727-514-5442 �, . October 17,2013
9742 Riverchase Drive
New Port Richey,FL 34655 NET 0
ER 130�4861 � ' �• ' October 17,2013
727-514-5442
mdselectric2013@idoud.com
• Lori
39511 Meadowood Loop
33540
813-541-2431
�- . . • .
Repair all loose wiring in panel box and install wires under breakers,ground,and neutral bar. 1 $200.0 $200.0
ower com an can roceed to install meter and wer to the dwellin .
'Indicates non-taxable item
Subtotal $200.00
TAX(0.00°/a) $0.00
Total $200 00
Paid $0.00
Balance Due a200.00
— ------- ------- ---- -- -- - - --- -- -- - - ------- - -- --- �
Please detach and send v-nth remittance to
REMITTANCE ADVICE FOR Invoice#12 on Oct 29,2013
MDS Electric LLC 727-514-5442
9742 Riverchase Drive Balance Due: $200.00
New Port Richey,FL 34655
ER 13014861
Amount Paid:
Received From:Lori
1/�