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Home My WebLink About92-2095 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.6611 Permit N.o , . 2095-6> DatE! I - S / - ? ot "' I ~I~ ELE~ ~ P<opertyOwne, ~1"1-B~~ Job Address: "/ fL. -------4.- ___ ParceII.D.# 3S--:LS-~/ - ~A - 0- M~L Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: ~ / ~~ Description of Work g- X / 0 --4~ ~ NO OCCUPANCY BEFORE C.O. FINAL .;:1-F;J.- DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE InspectCi'~ Permit Fee Signatu'r;fd.."'..L. Compan Address :L().th) ~~~~ / Valuation or Contract Price <. 7 CJ/:J . a-D City License Registration # State Certified License# Telephone# EL~CAL ~ P~NG ..... M~ICAL - ---- Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insi. Compressor Final 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. CITY OF ZEPHYRHILLS BUILDING DEPARTl\'IENT ..' . OWNER JOB LOCATION ~EGAL DESCRIPTION/SUB DIV. BLK, LOT Show all existing and proposed structures giving dimensions & setbacks. t< >1 ''- ~ ., ..') (j) 8ef back5 fOf 'R-', Ii-;?, f/ 1?-3 , Aonlng Nofe ~ too' \~.'':, . ,FRON '.) K _. I -, S tre e t I @ ~ &0 . >t I !5' I r ~I NO TE EXAMPLES 1 & 2) 1< >i , 10 "Pro po:::' ed Mdi1/ol1 8e.+ ba.<!ks fot ~-,4 ~ Cllll H~ . \0 Ex is -r-/i/f 'J -' /0' Q ~ r" CJ 1 e. en' l?u r pc ,.t fl"'O~ a(/elj mU~+ hr9 tie us I s'efbc><!..K. "U!;(,li bU',!Jh<r.:s /I1r..sl .:shc~ s;'t.e. < loet\J- C3 {IC>VI , Ex: i.:s .ti 11'1 \0 I 110' \~ 10' I ~o 1 1 Pro p. c:> ':0 e. d. I/dd ifl'Ol1 ?So' sf~e'J- .___. "_.____Et9"t~, 10 tf, sf $-1 re7f _ _.~_ ""_.~._, _Er~!1_____ 10 ~ 5+ . i i ;1 , I l , \.~,~.... , , '. \ / / I i i \ \. \ , ,~ L~, -( \\,"( , '----.- ..~ ,/ !'l- I I I I j ! f \-\ \ \ - ---~ \ (\ I \ '- ~ \ \ -- \, '\ '\ 7~ " 10 --. \.-- - Monday. . . - Tuesday... - - - Wednesday - Weekly Scheduler - Month - Week of - Thursday. . . - Friday. . . - Sat./Sun. . . . I~---- ---------- .-- -- 01 - / __._~...._~_______ ._..__ _.,.,,__. _, ~.__._ ,,_,_,_,_ u_._.',_ ----~--,.._.._~.._-~._-_._.~._-~_.._~-~--~ - + I ...__.._....._...__,~.._..~_ o.....,...~._._,_ _,'__' ....--.,.-- _.~ -,-. --.-.-..-.--.-.--- I I i I \ \ t \ I I I i \i 4 t \. ], \I \ \ \ ....--.---..-.--......- -.-..." -----.--...-;--..'.. ) .1 ~ " i I I 1 ..--...--- "ff - - Monday. . . - Tuesday... - Wednesday - Weekly Scheduler -.- Month - Week of - Thursday. . . -.- - Friday. . . - - Sat./Sun. . . . APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT -/ ~:') .';.t- F" I /1 / l ,,' r i ADDRESS /" PHONE . OWNER f ,'~ to, ,/' . ' JOB LOCATION LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.# WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp, ____Sign - Move ____Demolish PROPOSED USE: ____Single Family _M/F _l~ of Uni ts ._M/H 7' _Commercial _Indust. ____Swim. Pool ! r Other " _Restaurant & Health Department Approval BUILDING SIZE: x Square Fee t, .<~ 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 V-;UILDING $ d t7?:> . crV 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 # ****************************************** BUILDER Signature ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Signature Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert, or Regist. # City License Registration ~ ****************************************** MECHANICAl Signature OTHER (J'L.-..I"v1 /JA _ Company . State Cert. or Regist: # Signatur~"'7.L .? ~~ ~1tJ ,fA.......... City License RegistratioTl'tF '"". . APPLICATION APPROVED BY ~~::~..~~~:;******.**..*.**.**" ;ERM;T OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions. which lay be lore restrictive than City regulations. The undersigned assu~s responsibility for cOlpliance with any applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or 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 aay be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireaents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, IB131 7BB-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 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 Guide" prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is soaeone 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 inforaation in this application is accurate and that all work will be done in coapliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perait to do work and installation as indicated, I certify that no work or installation has coalenced prior to issuance of a perait and that all work will be perforled to aeet 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 governmental agencies aay apply to the intended work, and that it is ay responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not liaited to: I Departlent of Environaental Requlation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive lands, Water/Wastewater Treat.ent I Southwest 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 Treataent, Septic Tanks I 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 .colpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A pertit issued shall be construed to be a license to proceed with the Mork 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 froa thereafter requirinq a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becoae invalid unless the Mork authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six lonths after the tile the work is co.aenced, One 90 day extension of tile, 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 lust be logged during each six lonth period, or the project will be considered abandoned, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COM"ENCEMENT "AY RESULT IN YOUR PAYING TWICE FOR IKPROVE"ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CO""ENCE"ENT, JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COMMENCEMENT., ~ ' , ,,_~ 4-11,~ ( SIGNAT~E: OWNER OR AGENT - SIGNATURE: CONTRACTOR STATE OF FLORIDA rp)t 'i'" COUNTY OF ~ t. 0 The foregoing instr~ent was acknowledged before me this Z, 1 :.fAN 19 '5 L-by ;T 05~t. M )//~hDlsGN who is persln~l~f~nown toJme or who has produced "C..V'- ~ fC:v..j l.... as id~t" i~t'on and ho" "d t take n a ' ~ (Signature) 0 U (, a 10 or ~... Expires Dee. 29, 1995 (Name Type" .~I'!IfMS~~)- NOTARY PUBLI~ STATE OF FLORIDA COUNTY OF The foregoing instrument befol-e me th i s \l'Jas acknowledged , 19_ by who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature).. (Name Typed, Printed or Stamped) NOT ARY PUBLI C