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Home My WebLink About92-2058 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 (5 () . Permit N~ 20581f Date / - / 7 - 9 d... BU~ EL~ P~ fi~ $ ~1' Property Owner:' ~ . Job Address: {;;' . -../. , Water Conn: Water Meter: T.I.F.'s: Parcell.D, # Zoning: Energy Code: ::: Description of Work 1-/ c (~ a .L? 7 (f Radon Gas: ~ NO OCCUPANCY BEFORE C.O. FINAL -<72- DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances, c.o. DATE City License Registration # / ) () State Certified License# -Ct3 C 0 '17.2 7/ Permit Fee Signature Company Address Telephone# . n.....L - Inspector Valuation or Contract Price ;2.'1 t1lJ . crv " <~~~)/(U~ + /~ GCHAN~~ Elreakers Ducts Insl. Compressor Final ~ EL~ .............., P~ ") Tp, Serv. Rough In Meter Can Const, Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15.001 shall be made for each trip for each trade: 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. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT SC/ ~ E? ,,?/~ 0 /~ , ~c/'7,';":J ~~,/ aO/N..J /ry~ _~/c. S~ #4-/0 o/61,y/~,.fa IN'''--?HONE 8.s-y - ~Y'P"9 ~/<"".:t./ S'. /f'/' 57! .2riK.LA" M' LOT SIZE x AREA SQ. FT. ADDRESS ;;1 ~ / a,?(<./ h 5 ;/ OWNERS'7:.? "..y4/ /. JOB LOCATION ti//t::? /0"' 7;.( LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. # WORK PROPOSED:____New Construction ----Addition ----Alteration ~Repair ____Install ____Sign/Temp. ____S ign _Move ____Demolish PROPOSED USE: ____Single Family _M/F ____41 of Units .-M/H ____Commercial _Indust. ____Swim. Pool ~ C'X(wyca70ther 7'- ~;c:7?1 c:l'A.:.Jt' ~)4)7'~ ____Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL ~ECHANICAL AMP Service Florida Power Corp. _W.R.E.C. $ ~ f'oa Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature Silnlature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature MECHANICAL Signature k-4J/ a: Company ..5Z'/I~~/c..<" #./,r;.;""i' ""':c-<~;"9 #Jtj/'_Z;;c .. r./ -. .- . State Cert. or Regist. 4t c-f,CO-,?,rt?7/ c.U~ City License Registration 4~ . *~*******'******************************** Company State Cert. or Regist. # City License Registration # OTHER Signature APPLICATION APPROVED BY ~*********~************************** ~ -f" ~ o../j./. ^'^ -;- PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit 'Iay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If the tontractor is not licensed as required by law, both the owner and contractor lay be cited for a lisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, 18131 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s} sign portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law" HOleowner's Protection 6uide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the "owner" prior to cOlleneelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lUst take to be in cOlpliance. Such agencies include but are not lilited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Metland Areas and Environlentally Sensitive Lands, Water/Wastewater Treatlent f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docts, Navigable Waterways f Departlent of Health ~ Rehabilitative Services. Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environlental Protection AQency - Asbestos abateaent I also certify that, if fill aaterial is to be used in Flood Zone "A" Dr "A,etc.., it is understood that a drainage plan addressing a .colpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, caneel alter, Dr set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter requiring a correction Df errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid unless the work authorized by such perlit is coalenced within six lonths of issuance, or if work authorized by the perait is suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of tile, lay be allowed for the perlit iJith fee charge of tI5.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six aonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"~NCEftENT "AY RESULT IN YOUR PAYING TWICE FOR I"PROYE"ENTS TO YOUR PROPERTY. IF YOU INTEN~ TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COft"EMCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF CO""ENCE"ENT". SIGNATURE: OWNER OR AGENT ,~C?: ~74<<4~ SIGNATURE: CONTRACTOR STATE OF FLORIDA COUMTY OF PA'Sc...o The foregoing instrument before me this was acknowledged , 19 _ by STATE OF FLORIDA COUNTY OF PAS <:..0 The foregoing instrument was acknowledged befc.re me th i s \,~~ Tit,.,., 19 ~ by who is personally known to me or who has produced as identification and who did/did not take an oath. R\c.."~~t> ~. Q.~ f\~mA~ who is personally known to me or who has produced ~L bR.\\JER.IS Llc...E"~SE' as identifica . In and who did/did not ,e an oath (Signature) ....u It; ::.fAfl:. uf flORIU' .UII-\.K'r ~ ". 2 1992 'ny r-nmmission expires oct. , (Name Typed, Pf"t'ntll!\:tl'- PM~&,..:nt AAellv' NOTARY PUBLI C (Name Typed, Printed or Stamped) NOTARY PUBLI C C\;j'ti ,', {l \.~~.li,., C:l .'.fI"no <!: ~ 'If (.{ ~ .>I'b CD 11576 ",..J 1:3_:~.. 1'r}(:"l"~ lnc. D:,-~~..~2L1S ~~:.r~CL ., ., ,r' 'I) , ,--1,1'",\ (1 ; .... l 1-''' .~J I : ~ 1...1, l . ~ ..-'-;.. ,-_J U' ~ '...... .:.. rnar~ }-:iorida -"I ~ -'" -- .-. .)-+0 j , L"'T l', --= Cc: r'T:=!= \" .2), r., I.- 1.-11 i;, '._0 -:,,:',':053898 'x ' .." S'':;; ,1 -:'" 9 \. <.., 1 _)) ~ _,.- -,..,.....,. DAT" / -I ~ --:;:J-.. ~ .-:: / - ."";- .. ~-5:~<r~-'- ,-' ~ ,r-r T CU:::~:':,}..iER r.G i J. .-~~----~ ..-,-r.~ -1 i I -i I \ I I ::::..:.. ... ;=- I ' 1,. -. ,>,. ~.j[ .~~U::.[;)Mt:.~ >;>-<[~; ,,-",-:, /. ...:-. L ,A "'::-,1 'i' "";?.. 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