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Home My WebLink About92-2090 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit Ne.! 2090~; I Date / -.3 0 --9 ;:J~ C~ EL~t PL~ ME~ Sewer Conn Water Conn: Property Owner: Job Address: Parcell.D. # Water Meter: T,I.F.'s: Zoning: . 'R~~91 FINAL .- L-/ ~ c; 2- DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances, Inspector Pe,mit Fe~~ ~ Signature '- ) ~ ~~~ / Company , Address Telephone# Valuation o~ -f /~ -. Jl<2 Contract Price ~ . City License Registration # ~ S~ertified License# . ( cJ bd77.~/t) BUILDING ELECTlUCAL --- PL.1JMBlNG -- ~AL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Canst. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL WL 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 ZEPHtRHILLS BUILDING DEPARTMENT APPLICANT .~ ' ADDRESS PHONE f.-i /J, .-c: IJ ) OWNER / ) LmtD \,V....-IZ2AAt(,.('bJV JOB LOCATION S /~-I ';?t.;}-i'J l~ LEGAL DESCRIPTION: LOT(S) ~ BLOCK LOT SIZE X AREA SQ. FT. SUBDIVISION PARCEL 1. D.,~ WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install ____S~\,gn/Temp . __Sign _Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____# of Units _M/H ____Commercial ____Indust. ____Swim. Pool Other ____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 ~UILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ____MECHANICAL $ 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 # ****************************************** ",.."-, / I ' BUILDEUj tJfi..LA ) Signature Si(ffiature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRTCTAN Company State Cert. or Regist. # City License Registration # ****************************************** PLtJMRER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City l.icense Registration 4~ OTHER Signature APPLICATION APPROVED BY PERMIT OFFICER. . CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The und~rsigned understa~ds that this peuit.ay be subject to "deed restrictions" IIhich uy be .ore restrictive than City regulations. The underSigned assu.es responsibility for co.pliance lIith any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ollner has hired a contractor or contractors to undertake lIork, they .ay be required to be licensed in accordanc, lIith state and local regulations. If the contractor is not licensed as required by lall, both the ollner and contractor .ay be cited for a .isde.eanor violation under state lall. If the ollner or intended contractor are uncertain as to IIhat licensing require.ents .ay apply for the intended 1I0rk, they are advised to contact the City of 2ephyrhills Building Depart.ent, (813) 788-6611. Further.ore, if the ollner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for IIhich they lIill be responsible. If you, as the ollner sign as the contractor, you are indicating that you, rather than the contractor, are respo~sible for the Nork. If the contractor IIi shes you to sign as contractor that .ay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the City of 2ephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE$ D. CONSTRUCT T ON L I EN ...L t!U (CHAPTER 7 t ?, FL OR I DA (':IT A TUTES , AS AMENDED) I certify tbat I, the applicant, have been provideu Nitb a copy of "Florida's Construc~ion Lien Lall - Ho.eoNner's Protection 6uide" prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the "ollner", I certify that I bave obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the "olln!r" prior to co..ence.ent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infor.ation in this application is accurate and that all 1I0rk lIill be done in co.pliance lIith all applicable lalls regulating construction, zoning, and land develop.ent. Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no 1I0rk or installation has co..enced prior to issuance of a per.it and that all Nork lIill be perfor.ed to .eet standards of all Ialls regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.entaI agencies .ay apply to the intended lIork, and that it is 'Y responsibility to identify IIhat actions I .ust take to be in coapliance. Such agencies include but are not li.ited to: f Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands, Water/WasteNater Treat.ent f SouthNest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Ar.y Corps of EnQineers - Seallalls, Docks, Navigable Waterllays f Depart.ent of Health & Rehabilitative Services. Environ.ental Health Unit - Wells, Wastellater Treat.ent, Septic Tanks f US Environ.ental Protection AQency - Asbestos abate.ent I also certify that, if f;ll .aterial is t~ hp usef i~ F100~ Znfl~ "~. ~r "A;etc.", it i5 understopd that a drainage plan addressing a "co.pensating volu.e" Nill be sub.itted Nhich 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 Nith the Nork and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Officijl fro. thereafter requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall beco.e invalid unless the Nork authorized by such per.it is co..enced lIithin six .onths of issuance, or if 1I0rk authorized by the per.it is suspended or abandoned for a period of six .onths after the ti.e the lIork is co..enced. One 90 day extension of ti.e, .ay be allolled for the per.it lIith fee charge of sis.oo. The extension shall be requested in writing to the Building Official. An approved inspection .ust be logged during each six .onth period, or the project will be considered abandoned. WARNIN6 TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR I"PROYE"ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCIN6, CONSUlT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COft~E"ENT. JOBS UNDER $2,SOO IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COM"ENCE"ENT". SI6NATURE: CONTRACTOR ~~~yO~FF~~~~~~~______________________ The foregoing instrument was acknowledged before me this ~L~~____, 19~)_ by ________~Jw~~_~~~tirl~~_________ who is personally known to me or who has produced _______________________________ as identification and who did/did not ~:~:_::_::~~~~~--~--- (Sig~ture) ~ -\- ~ ____~-~LCCij-_-~-L~--~l~---C.~,.-J:..~ (Name Typed, Printed err Stamped) 0 '\~S:) NOTARY PUBLI C NOTARY PUBLIC, STATE OF FLORIDA. MY COMMISSION EXPIRES: Dec. U, 1994- BONDED THIlU NOTARY PUBLIC UI'IDIIIlWlll1'&~ STATE OF FLORIDA Cnul:TY OF __________.--------------------------- The foregoing instrument was acknowledged before me this ___________, 19_____ by ~h~-i~-p;~~~~;lly-k~~~~-t~-;;-~~-~h~-h;~ produced _______________________________ as identification and who did/did not take an oath. (Signature) (N;;;-Typ;d:-p~i~t;d-~~-St;;P;d)-------- NOTARY PUBLI C