The URL can be used to link to this page

Home My WebLink About92-2065 BUILDING PERMIT Permit 2065 g 1-:LI-?:2..., CITY OF ZEPHYRHILLS (813) 788-6611 .....T 0 ...1:., . Date ~D~ E~ ~. <""-t~ ~ Pmperty Owne" ~ Job Address: ~:S - 6' LI- M~ Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcell.D. # ~:::~~t;on of W;';- /?., ~nz::; Radon Gas: FINAL cP-"-f~ J1 DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances, c.o. DATE Inspector City License Registration # '-- ? () State Certified License# Permit Fee Signature Company Address Telephone# ~-:-cn> ". A-o--L ~ r- Valuation or Contract Price } . 9' 7~-:' (/() ./ K~~~ -4~" ~-- C BUILDING --- ELE~CAL PLU~ ~ M~NICAL "' Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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 ,L-tJ /) fr /)1// ;Vi /) .' a. {) [;/7;vt.::. . ;fL~ j 7; OWNER Ii!. CJ 7 PHONE ADDRESS JOB LOCATION 1).1- (; -- )/ .2 -/--/ LOT SIZE x AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. ~t WORK PROPOSED:____New Construction ----Addition ~lteration ~epair ____Install ____Sign/Temp. PROPOSED USE: ~Single Family ____S ign _Move ____Demolish ____M/F ____~~ of Uni ts .-M/H ____Commercial ____Indust. ____Swim. Pool Other ----Eestaurant & 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. ____BUILDING $ ~9l) ()f) AMP Service PERMITS REOUESTED Valuation of Total Construction _ELECTRICAL Florida Power Corp. _W.R.E.C. ~ECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS i ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVAlIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER SiQIlature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRTCTAN Signature Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER MECHANICAL Company State Cert. or Regist. # Signature City License Registration # ~~ 7 - ****************************************** OTHF.R ,/~, ~/L--~- Company &-/ii/, t/' f'c1iJJ/r/f' Ii < State Cert. or Regist. # KL (JoCjt 2 '7/ Signature <""- t:"-- City License Registration # APPLICATION APPROVED BY ********************** 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 OMner has hired a contractor or contractors to undertake Mork, they lay be required to be licensed in accordance Mith state and local regulations. If the contractor is not licensed as required by laM, both the OMner and contractor lay be cited for a lisdeleanor violation under state laM. If the owner or intended contractor are uncertain as to Mhat licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, 1813) 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor 15) 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 Mith a copy of "Florida's Construction lien laM - HOleowner's Protection Guide" 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 cOllencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all Mork 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 Mork 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 Treatl~nt f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health l Rehabilitative Services. Environlental Health Unit - Wells, WasteMater Treatlent, Septic Tanks f US Environaental Protection AQency - Asbestos abateaent I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "coapensating volule" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A per.it 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 perlit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid unless the work authorized by such per.it is cOI.enced within six lonths of issuance, or if work authorized by the perait is suspended or abandoned for a period of six .onths after the tile the work is cOllenced. One 90 day extension of tiae, aay be allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection .ust be logged during each six lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IKPROVE"ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CDK"ENC~ENT. JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND PO~N~CE OF CO""E~CEKENT.. . fd~ - SIGNATURE: OWNER DR AGENT SIGNATURE: CONTRACTOR was acknowledged , 19_ by STATE OF FLORIDA n COUNTY OF r A Sc 0 The foregoing instrument before me this ~, was acknowledged , 19~ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this who is personally known to me or who has produced as identification and who did/did not take an oath. Q ," c.. k G p.. LJ \ .u who is personally known to me or who has produced f:\ \)('{Jl~ l--.1c.c..V\~ as ident' icaticiO and who di Idid not. :> take an ath. (Signature) 'If-(l ~ ( , n~e)-- IJ .~~~t<J t1;\( ~(!)Uu ....- (Name Typed, Printed or Stamped) /';IDTARY PUR 1 C , c-"'" -No:rARY PUBLIC, STATE OF FLORIDA.- MY COMMiSSION EXPiriES: Afl-llL 16, 199!. BONUED TrlRU NOTARY PUBL.IC UNDERWRITERS.,] (Name Typed, Printed or Stamped) NOTARY PUBLIC PROPOSAL /' ~ Proposal No. .' r' ; Sheet No. :' ~jc":~ ,/ /<::/' " /' :/J ~,,' -- , f,' Date Proposal Submitted To Work To Be Performed At Name Street City State Telephone Number .t. J ,: } .,' ~ ...-. . J. Street '. . ,.'/" c~/r' City Date of Plans Architect State ,.. ., /"y We hereby propose to furnish the materials and perform the labor necessary for the completion of , ./ )( " ./-:~ ( I" k.. ;l< c/ , '.. ( ., . . !'{ .-' . ...-f..'... ( f'~~ . .' -.. . '{./, rt J- ;f/>~, ,.,i'- ,'j..- ~ /..,,~./ ) : /,-_.( ) c' ",,t.j :~./ '-/' " l' ," ,d . ~f ,,' I_f~'"r-~ ,''; (- "")0' , ,.' .L/ All material is guaranteed to be as specified, and the above work and specifications submitted for above work and completed in a with payments to be made as follows: " /:"......-.. to be performed in accordance with the substantial workmanlike manner for the 'J Dollars ($ / / .' drawings sum of .',.. ," r ~ L. /~;, ). Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work, Workmen's Compensation and Public Liability Insurance o/l above work to be taken out by f:.' Respectfully submitted_~ //" '.-.-- '..--.-..... ---- Per ~~____ --"'-~~ Note - This proposal may be withdrawn '/, ,.~" ~ ".:4'; by us if not accepted within .-' days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby acceptec;L You 'are authorized to do the work as specified, Payment will be made as outlined above. Date , /'//" jJ / ./ >r c Signature.. ./:'~ --'=--_:'"----==, d' - . . ]-' /"< -/..' .- ., ," - S' t . ;/ j! ..I1>1J. ,1.'-kt.Z-...... . -----.-,-- Igna ure ---fJ. ~. ---:f----'""""-.. /r --~, TOPS FORM NO. 3750 LITHO IN U.S,A.