HomeMy WebLinkAbout14-15528 \`
, _ - CITY OF ZE HYRHILLS
5335-8t Street
(813)7 0-0020 155 8
ELECTRIC L PERMIT
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Permit#:15528 Issued: 7/29/2014 Address: 5527 GALL BLVD
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: 500.00 Total Fees: 40.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 40.00 Date Paid: 7/29/2014 Parcel Number: 11-26-21-0010-09000-0020
CONT.R�A`�C�TOR�INFO:RIVI�►TIO�fV��`-�����:�����..:= r�`�"�:< : 'OWNERr:IN�F�ORMA�TION`�. .�'� �
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Name: MARTIN ELECTRIC Name: EISENBERG, DEBORAH S
Addr: P.O. BOX 437 Address: P.O. BOX 326
DADE CITY, FL 33525 LAND O LAKES FL 34639-0326
Phone: (352)521-3319 Lic: Phone: 813-263-7689
Work Desc: ELECTRICAL REPAIRS
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ELECTRICAL FEE 40.00
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ROUGH ELECTRIC
CONSTRUCTION POLE
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REINSPECTION FEES: Reinspection fees will comply ith Florida Statute 553.80 (2)(c)when extra inspection
trips are necessary due to any one of the following re sons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections n t made when inspection called d)work not ready for
inspection when called e) permit not posted on jo site� plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this permit, ther may be additional restrictions applicable to this property that
may be found in the public records of this couniy, and ther may be additional permits required from other governmental
entities such as water manageme , state agencies or federal agencies.
"Warning to owner: Your failure to record a notice f commencement may result in your paying twice for
improvements to your property. If you intend to ob ain financing,consult with your lender or an attorney
before recording your tice of commencement."
Complete Plans, Specifications and Fee Must Accompany Ap lication. All work shall be performed in accordance with City
Codes an Ordinances.
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CONTRACTOR � PER OFFI
PERMIT EXPIRES IN 6 MONTHS ITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - HOUR NOTICE REQUIRED
PROTECT CAR FROM WEATHER
813-780-0020 City of Zephyrhil s Permit Application Fax-813-780-0021
Buildin Department
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Date Received Phone Contact fo Permitting --
Owner's Name �C( Owner Phone Number
Owner's Address Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ���� � � LOY# �
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEw CONS7R e ADD/AL Q SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q
DESCRIPTION OF WORK �( G, C' r�'�
BUILDING SIZE SQ FOOTAGE HEIGHT
QBUILDING $ VALUATION F TOTAL CONSTRUCTION
QELECTRICAL $ ���(� AMP SERVIC 0 PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ �'��
� 1S
QMECHANICAL $ VALUATION F MECHANICAL INSTALLATION
QGAS Q ROOFING Q . SPECIA � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ONE AREA QYES NO
BUILDER CO PANY
SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N
Address License#
ELECTRICIAN CO PANY 9 � i�� �� /�/G
SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N
Address License#
PLUMBER CO PANY
SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N
Address License#
MECHANICAL � CO PANY
SIGNATUI2E REGI TERED Y/ N FEE CURRE� Y/N
Address License#
OTHER CO PANY -
SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N
Address � License#
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster,Site Work Permit for su divisions/large projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sa ety Page;(1)set of Energy Forms.R-O-W Perm(t for new construction.
Minimum ten(10)working days after submittal date. Re uired 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 construc lon.
' Directfons:
Fill out application completely.
Owner&Contractor sign back of application,notar(zed
If over E2500,a Notice of Commencement is requlred. (A/C upgr des over 57500)
•• Agent(for the contractor)or Power of Attomey(for the ovmer)would b someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMI7TING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A!C Fences lot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
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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 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 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. ( 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, WateNWastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercou�ses.
- 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 permifted 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 COMMENCEMENT.
FL-ORIDA JURAT(F.S. 117_03) - _- - _ - -. --, - --`-----—
OWNER OR AGENT CONTRACTOR
Subscrlbed and swom to(or affirmed)before me this Subscribed and swom to(or affirmed)before me this
by by
Who is/are personally known to me or has/have produced Who Is/are personally known to me or has/have produced
as Identlficabon. as identification.
Notary Public Notary Public
Commisslon No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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