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Home My WebLink About92-2092 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit W<! 20921j' }-3/- 7',:;) Dale Property Owner: Job Address: ..3 Parcell.D. # E~ PLU~ M~ rf~~ 6-.sh m ~~ Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Energy Code: Description of W~ ff ~ ~~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL a. - \ DATE 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# Pe'm;t Fee ~ cJ<) Signature. t7~ Company Address Telephone# ~ Valuation or Contract Price 1...5~iJ?J - c::r-v Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT ~4~ e C~./ ADDRESS '3 910 :J 6 9~-ddtrv~L l. ~ PHONE 7cf }[--0 /CJJ OWNER JOB LOCATION LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.4F 1$ -,2 b - Ot./ - I'T - 0 - WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/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. ~UILDING PERMITS REOUESTED $ / S......07:J . 0() Valuation of Total Construction / ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS X ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Signature PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration # ****************************************** OTHER Signature L?et/z;t'~~ f! c!~/ Company State Cert. or Regist. # City License Registration # APPLICATION APPROVED BY PERMIT OFFICER. . CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perait .ay be subject to .deed restrictions. which lay be lore restrictive than City regulations. The undersigned assuaes responsibility for coapliance with any applicable deed restrictions. B. 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 lay be cited for a aisdeaeanor violation under state law. If the owner or 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 Depart.ent, (B131 7BB-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sJ 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 aay be an indication that he is not properly licensed and is not entitled to peraitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE2, 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 - Hoaeowner'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 work will be done in co.pliance with all applicable laws regulating construction, zoning, and land developaent. Application is hereby aade to obtain a perait to do work and installation as indicated. I certify that no work Dr installation has cOllenced prior to issuance of a per.it and that all work will be perforled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in coapliance. Such agencies include but are not li.ited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treat.ent f Southwest Florida Water KanaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departtent of Health L Rehabilitative Services. Environtental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone .A. or .A,etc.., it is understood that a drainage plan addressing a .cotpensating volule. will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to pertit 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 per.it prevent the Building Official fro. thereafter requiring a correction of errors in plans, construction, Dr violations of any code. Every perlit issued shall becole invalid unless the work authorized by such perlit is cottenced within six lonths of issuance, or if work authorized by the permit is suspended or abandoned for a period of six lonths after the tile the work is cOlienced. One 90 day extension of tile, lay 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 lust be logged during each six lonth period, Dr the project will be considered abandoned. YARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT 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., ~.f ~ h ,/L~,/ (/hJ-?t__ SIGNAT~ : OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF F~A COUNTY OF 50 0 The foregoing instrument was acknowledged befol-e me this~V1UQI\'j 3/, 19U- by (' C?~ V\ . who is ersonally known to me or who has produced F LQ ~ \ (\Q........ \") V' ~,'-H'''''~ ~ \. ~ < as identification n ' did/did not t k an 0 t STATE OF FLORIDA COUNTY OF The foregoing instrument befol-e me th i s was acknDwledged 19_ by who is personally known to me or who has produced as identification and who did/did not take an oath. (~nat~l-e) ~ \r\ Va... ,Name Typed, Printed or Stamped) NOT ARY PUBL I C f0"~~!'; ri,l. ~k, 5ich c~ 71dda r". f..", ;,' :;0, 1995 h'~ ~,.",..".. , ' ilo"dod 'fhru Trot [QIn .1"wr""oQ In"" - (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC ~"";':~:~~,~~r_~i~~~~.~~~-""'''''~~V''''~~'''",,~!,~~~~~~~'