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Home My WebLink About92-2099 8UILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ 2099Jl1 :J.. -.3- PO- i DatE! .-- ~ ~ J~::~,~:~:'?f;d -1r~ GECHAN1CA~ Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcell.D. # Zoning: Description of Work Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. FINAL C,O, DATE NO OCCUPANCY BEFORE C,O, DATE Inspector Permit Fee Signature Company Address Telephone# dO--e:rD b~ /(':--. ( Valuation or n Contract Price T t::J?) ~ d[) City License Registration # 7 I State Certified License# ~' ~ . ~~AN,~7) Breakers Ducts Insl. Compressor Final - BUILDING - ~L -- ~ING --- SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. 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 ($15.00) 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 PER~IT CITY OF ZEPHYRHILLS BCILDING DEPARTMENT APPLICANT ((iN ~~- C~.~h 4 /' 7 7 ;2 Z F';: /~'-~ ..--- Ca. Y II ( / t!'l.,t',..A.,- Q r /3 Cf 2.. 0 /1/ /Iv A... . PHONE fB/r- "./8;2-';< 7" c> ADDRESS OWNER 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 _~~ of Uni ts ._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 FOR~S.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED, PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _MECHANICAL $ AMP Service atJ ~gz? Florida Power Corp. _H.R.E.C. _ELECTRICAL Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration iF ****************************************** BUILDER ELECTRTCTAN Company State Cert. or Regist. iF City License Registration iF ****************************************** Sil?nature Signature Company State Cert, or Regist. ;ft City License Registration # ****************************************** PLUMBER Signature ,/.. Comp~r..y /' ( '" s. -eJ S ta te Cert. or Regi's t. ~,! City License Registration # ****************************************** c ~/'-R /</ftS- erO? 0 7/ MECHANICAL Company State Cert. or Regist. # City License Registration iF OTHER Signature APPLICATION APPROVED BY PERMIT OFFICER. - CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this per.it.ay be subject to "deed restrictions" which .ay be .ore restrictive than City regulations. The undersigned assu.es responsibility for co.pliance with any applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they .ay 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 .ay be cited for a eisde.~anor violation under state law, If the owner or intended contractor are uncertain as to what licensing require.ents .ay apply for the intended work, they are advised to contact the. City of 2ephyrhills Building Depart.ent, IB131 788-6611, Further.ore, 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 eay 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 - Ho.eowner's Protection Guide" prepared by the Florida Departaent of Agriculture and Consuler Affairs. If the applicant is so.eone 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 coeeenceeent. 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 coapliance with all applicable laws regulating construction, zoning, and land developeent. Application is hereby eade to obtain a pereit to do work and installation as indicated. I certify that no work or installation has coeaenced prior to issuance of a pereit and that all work will be perforled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developeent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies eay apply to the intended work, and that it is IY responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to: , Departlent of Environ.ental Requlation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands, Water/Wastewater Treataent , Southwest Florida Water "anaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Arey Corps of Enqineers - Seawalls, Docks, Navigable Waterways f Departeent of Health L Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environeental Protection AQency - Asbestos abateeent I also certify that, if fill eaterial 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 per.it issuance. A perlit 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 per.it issued shall beeole invalid unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six lonths after the tile the work is cOlleneed, 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, Dr the project will be considered abandoned, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IMPROVEKENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR 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". STATE OF FLORIDA~ _ ._ _I COUNTY OF ~v The foregoing in~tJ~ent before me this~;;;: L- ev was acknowledged 19l..;L by was acknowledged 19iE::- by (/~tC" SIGNATURE: OWNER OR AGENT ~ Notary Public. State rli9d~5 MY Comm, Exp. M . 1 , (Name Typed, Printed or Stamped) NOT ARY PUBLI C "t,:,' Notary Public. Sta .\\If\,Il~ , My. Comm. Exp. M 7, i~9j (Name Typed; Printed or Stamped) NOTARY PUBLIC ~ "~Y!I'._~_.;.-,."'''''''''--'.,: , . "':::'''~~;'~,~:~''.",'o~~~:':~''"::/~.. ~ , ~.. .:" ".-;"'"..... 'Kinsey Central Heat & Air-Conditioning 7722 Fort King Highway. P.O. Box 2209 Zephyrhil/s, Aorida 33539-2209 (813) 782-2300 /- DATE PROMISED APARTMENT SERIAl. NO. NATURE OF r-I\. SERVICE --V REQUEST o ESTIMATE o CASH o CHAR"GE OUAN. PART NO. OESCRIPTION PRICE AMOUNT 'I 'r ? t7/ /lof .;2 5..60 -/ ~' Cr f-'..~, ::> SERVICE PERFORMED TOTAl. MATERIAL TECHNICAl. SERVICE TIME 7~~1 TAX DATE COMPlETED CASH ::~~ETlON-+ TOTAL /) C- ,'. I TECHNICIAN -~~: :.= 71 / /7. ' CUSTOMER'S SIGNATURE ( w.L/~A'r' ( .' / ;:' t.' " '(,/ J LC, . ". I . I ! 1 I I ! 1 I