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Home My WebLink About92-2066 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit )l~ 206G)1 , 1 Date / - :J.. / - 'I ;L ~~L ~ ::~:;:'~:~01r; #~ J:L-:$ Parcell.D, # ~HANlc9 Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: : Description of Work A. / L C k '.A1. r , Radon Gas: -~ NO OCCUPANCY BEFORE C.O. FINAL '2...:-1 'i -,L DATE Complete Plans. Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances, DATE Inspector ..~ Valuation or Contract Price 3 tf' ..50 ~ cru -' ~...- -......- City License Registration # / / tJ State Certified License# Permit Fee Signature Company Address Telephone# J...s-.. tr'D ~C? -+- 7(7. tnJ ~G ---- k' ~L - ~G 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 ($15.00) shall be made for each trip for each trade: a, Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. .- APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT .S~L74i!~1 'o~ /I~"F'~,,'.c?q ~ e;O~~9 ~ /- ~c , v ADDRESS ;;lIY / ~~y /~.5' ..s-rRee7'- cJ~.M.,.-e ~t1 ...Yt".6"7~HONE 3$"'1'- jllr? ~ 78.7 -75"0' OWNER A~,( C~ 9"# , JOB LOCATION .5"607 /6'''''''5/ Zy/~//./"/.6 r~ .7..bY'1 LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D .it WORK PROPOSED:____New Construction ----Addition ----Alteration ~Repair ____Install ____Sign/Temp. ____Sign ____Move ____Demolish ____Commercial _Indust. _4t of Uni ts .--M/H _Swim. . Pool .A~ C'.t"'1f! 6Jqr- Other PROPOSED USE: _Single Family ~/F ____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 FOR}lS.** **COPY OF CONTRACT REQUIRED. PF.RMITS REOUESTED _BUILDING $ ValUation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ~MECHANICAL $ .185"0~ 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 # **************************************~*** BUTT.DER Signature Signature Company State Cert. or Regist. # City License Registraciuu " ****************************************** FT.F.r:TR1 C1 AN --..".--.-" .,.-------:. Company State Cert. or Regist. # City License Registration ~ ****************************************** PLUMJ3ER Signature Signature ~~ . Company 5i.:/~~I'O~ ~//~ ~a,C'4;w.9 ~r~C', State Cert. or Regist. IF t:"'/fcofl''I ;;1'7/ ~ City License Registration IF *****************************************. MECHANICAL OTHER Company State Cert. or Regist. # City License Registration # Signature APPLICATION APPROVED BY ~*********~************************ ~.A<J ~~ PERMIT OFFICER. IJlIlIf --- CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to 'deed restricti~ns" which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restriction~. 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 contractor is not licensed as required by law, both the owner and contractor lay be cited for a aisdeleanor 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 Departaent, (813) 788-6611. Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the 'Contractor Sections" of this application for which they will be responsible. If you, as the ~wner 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 t~ perlitting privileges in the City of ZephyrhiIls. 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 teen provided with a copy of 'Florida's Construction Lien Law - HOleowner's Protection Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is SOle~ne other than the 'owner', I certify that 1 have obtained a copy of the above described doculent and prolise in good faith to deliver it to the 'owner" prior to COlaenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforsation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developsent. Application is hereby lade to obtain a perlit to do Mork and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perait and that all work will be perforMed t~ leet standards of all laws regulating construction, City codes, zoning regulations, and land developtent 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 t[, identify IIhat actions 1 tust take to be in cOlpliance. Such agencies include b\lt :ile liCit lilited to: I Departl~t of Environ.en.:! ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive ldflds, Water/Wastewater Treatlent I Southllest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, AlterIng Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatcent. Septic Tanks I US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill taterial is to be used in Flood Zone "A' or "A,etc,", it is underst~od tt.3t a drainage plan addressing a "colpensating volule: will be sublitted which is prepared by a professional engineer registried in the State of Florida prior to perlit issuance. A pertit issued shall be construed to be a license to proceed with the work and not as authority to vi~late, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issll~d ~hall becole invalid unless the work authorized by such perlit is cOllenced within six tonths of issuance, Dr if wor~ authol Ized by the perait is suspended or abandoned for a period of six lonths after the tile the wClrK is cO.lenced. One 90 day c~tt"SIOIl of tile, lay be allClNed for the perait with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six lonth period, or the proiect will be considered dbalJdoned. 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. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". MY COMMISSION EXPIRES SIGNATURE__~~-~l::---- ~ CONTRACTOR 1- L OJ< c... f 1?<774 1 S~00 (p l E; 9~) DATE_~i~?_L~~~~------------------------ NOT ARY AS TO i--~ J-H h /"". CONTRACTOR__ _____~_~~1-------- I::)o~A C\, -SU 11 o~ MY COMMISSION EXPIRES__________________ ~IGNATUREK-~.. -----~--~--- . OWNER OR AGENT ( DATE_______________________________________ NOTARY AS TO OWNER OR AGENT_____________________________' ---------------------- ^:)ua~v llpag - uosJanl?d nJ\.\l papuQd S661 '8(; 'Ul?r s<J.J!dXa UO!ss!uIW03 '" VOIClOl.:l .:10 31V1S ';.)Il8nd ACl'iflO~ \;'j; , ':)l~)' SERVICE INVOIce' ".'" , ~' Sup ..' ., <' ~ 'i" '..; :,: , is I " j. ;~/i: ':';:' .~ I ~, .";.> ':',": .r.,. '.' ....1 ~' .' '-, :,~:., ~ <L ::z...:j..:c, .' .CACO 49271., ',' , '\:>;AI~.( ..~~ 8.IIFIED i., ,:",<,:","'::;~'...;.::"~,,. ." """,' 'tJQRK TO BE DO..NE,~"i,.... ", .' ',..' . .:..,,' i)' y' :' y,,,~ 1>. ....... ,...., . .:. : ii:.: '<:":,'".: ['X..' ':,. ;;': .. ..'.'... ;,:, ";J '.:,,;,, ','.: ..... ;-:."',, ,'i':, "';;,, ';'T: I: ,> ".,:.",: ", ;..;:t: ,:;;c:', ~";;C" '......,..;,,' :':.,. ':':;" ii, :,," :';',~";"~,,,"'::":,, ' '. ,," ;,'or:..'?.....!-;:. . ,.' "'. . ,...." , 'SOURCe; :'.CO,ST": QTY, . ,.,<<,.ITEM : '''',.:. ,': Ii",:..:,....:.>.';; :,,:,. 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'IF YOU ARE SATISFIED WITH THE SE:RVf(jE,yOU .'TODAY TELL A FRIEND, IF NOTPLEASEiELL [ :;, ..> !",gl'i: TRAVEL 'TIME: TO FROM1!r ' .' i .,';.",'. ". TIME, ','J DEPARTEO"" TIME '.:':,' DEPARTED'. '.\'i':' SERVICE PARTS,:.:~r:. ,;,., SERVICE LABOR ';);" . ": . ". CUSTOMERDISCOUN!' " ...f. . ',TOTALCHARGEf,z: ...... ",} DEPOSIT'; .'. , .' "!"'.";:;:';BA. LANCE DUE'...,.'E . , '.., ,,-?,~,;, c. '." .,....~n.- . . "d<.";f~i1i;,:: ,: :.;.D";.,'Lli<;" '-'" < " ".' .. '."';' , "';'. .: , , . TIME ARRIVED TIME ARRIVED' · , .' . . ;~ '. '~ ,;" . , . " '" ';:, ~ ' ':~:'\"'(';"": ,/,;" >, . . " .'. . ," .,;p ....', """Wi\,,\\~,,,~}''1'f~'':''''~'''!t~'J>tf(~~\#~,W.lIJw,J,."+U'l\ilD~!gl~ 11 '. '. ,. . . ,'ating,&Coohng ~ tj~ & _.' . . : '.:. ':'~.'" . , " i~ment,Inc~ . !,'t~glaiSir~~t"': . " :\kASuite'10." , Florida '34677 . " . " i 854- 3449':;;78~7S09 Zeph.. '. DATE -1- ,.~ r'- ')::< ;1!!li CUS~~)~~)..';M/.At?/ r/lr;r-:, ::~':;, t 'f '.~T..REEl. ,/ ,.,....".-;.'. '.' , 1.C9,S,r">: ',. I P~~~~ .,' '. I,; " ,":~OLJ~:.~. Y-"-',/U~.", . .. 'I' 7::,-)--, "~,,',, : ",'. I CITY".. -') ',.': ! ' , ...' _,/SJATE. . ,_-:;> ,..;,.' ZIP..'...: fr:: EA/ ',;, " ;' ,,;;;.',"T'{/I. .3.~Y'/ I;' j CQNTlW;f NO,' I CUSlOMER NO, '. & ' .' BILL TO .' .~-, . .' . NAME .... <.: '.. ...: . . : Ii Ul STREET.:, ,....,/7 ~ ,-:,,' '. I PHONE ,it! ............... >', r/b ~." .', . ..' ~ C~l'Y ....~.........:"";/ 1 ../ /' / f. . STATE., ,;. .. ZIP . . lfl .'~"" ."(J.~' '. .'. .;,,', , '. ';"'0 ~'.,..... '.;,.'," ';"TIME & .:.:..-...~. ":0 ::' :""':""'AEPl..AcE 0 ,.,i.\ ,'; ~,.'''''''''','' .:: ... ...,""......' ..... :";' .:.. ,c' '.. "O~,D,,",,;iNEWlNT;D ... CoNTRACT 0:,' "c.aD' +~ TECHNICIAN: " .:' '.::, ;" " ",-, MAKE.... MODEL . SERIAL NUMBER . ...., . ", .... CD 11"690 ,,: .-, in un! ". 1 'l!'; 11;11,1,: tf\lU~ ",. ,', ' ". '.,., '....:...,...: , "':. . . DESCRIPTION OF WORKPERFQRMED,. " ' ...,.. , lh~;i~ .>DATE . '.. "Jj{1 ".,' ') ~'g,:~~,:.,.'.:,. 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TERMS:,,!ET DUE ON COMPLE110N ....' ......,,':....' ..1' "j ~ f' :.! -~ thiS ~ is ~ to a Ftnance Chat~ cJ ",:' oer month AMlJiIl Petc~~ Rotte or"8<:~hrl\'~)~ by -' '-,:<',', , ~i' ,~{ ~!~ ~ ~; . . ' , . .. ,'~:};:: ';~ :, " ,; r :tL ';';" t It'iS aorwd ,~. ul"lderstoOd 'by "'" oar,.s 'It'Ial all ecAlornen1 ilnd oartS wncn are' SOld pUAU.~ .,....~.t)..~ tI.IOT,-:-'-" ~ ,:', 'become hdures or p<\rt of the real estate where theV are pIac:ed SatO oart& ar1d ~ v.,n ct :.. "nPS ~ ,'. personal prooerty~..an<S the htSe thereto Shaft reml:tn tn rhe seI~r unhl oayment'tn tun tS receMi"O ~ ~W' aQrf'f'S I . ::~:;.it......, ;-- _ be ~....sea ., .... ....,. ot ",",__noem_ - .... "':-:'0"'> ,~. ....... I' 1 . thaw a'ufl'1onrv '~~ the WQttl as.oufl.ned above I agree 10 DaY all eosts 'and-rPasr.naClt' attl:)mf'o,. ~ ~ tf tf'la '. .--',',: C L ~~3~;'7r7/~;;-' " 0 .'.. '. ... ., ,,?-O ,~Gl-1NlCIAIIl,..8IGN.l;f:URE .;" ";.,.-;- ~ '. €revOM~~:S SK3NA~~~~/// .~.,' // a" ~~ b....,'CARD '., EXP. :~ ......NO,... .' DATE . ['i ':;' 1'; '"' ",' \\ ., ,: ,;;,:' . .' r"i :~' V;~~ '.' iil ~:j' ~f1.~ ..'. ::~'?r :~;, .... '<ii: '.' ., ~',' :hi,.; ,. " l .. f' ...;..... ! 'J),..t \ )." ',,'t'.:, ,,_ ..,.... ' ' . . , ,~. . ~ ~ ~ (, :~.~~ Ii...",. . .' ! ~. SF- '," ";i lo, l " . ,,\ "",>d,' ,