The URL can be used to link to this page

Home My WebLink About92-2104 BUILDING PERMIT Permit 2104/1 Date ,:;. -.3 - ? :J.. CITY OF ZEPHYRHILLS (813) 788.6611 -..110 .f., . B~ ELE~ PL~~ MECHANICAL' Sewer Conn ~~ Water Conn: P<aperty Own" ~ 1i1L~ _ ')Jf~ ~ Wote: MOl" Job Address: ~ _______ _ ~TIJ:s. Parcell.D. # // -;l b -~/ - () t:)/ 0 - .;l.O-g-~ {) - 46 {, 0 Zoning: Ene~Ode: Ra~ Description of Work~~ ( ~I~ ~"' ~~1 -7 NO OCCUPANCY BEFORE C,O. FINAL '2- 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 Pe,mi, Fee ~ ~ 5lgnature d. ~"t'A~ compa~ Address Telephone# Valuation or Contract Price 9~S. tJ7J City License Registration # ~.s-3 / State Certified License# ~~~~ M- AN'CAL_ Breakers Ducts Insl. Compressor Final MJII nlNG --- ~CTRICAL ---- ~BING ~ Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER .~-- JOB LOCATION APPLICANT ADDRESS PHONE S- ~ 7- -;7 5' L/O LEGAL DESCRIPTION: LOT (S) & -r 10 r::J . PARCEL 1.D,# //-2'(;-21 00/0 -~OXVO - ()c.)(;O LOT SIZE~~.bI.?--f AREA SQ. FT . BLOC~OgrSUBDIVISION WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install _Sign/Temp, _Sign _Move _Demolish _Indust. _# of Units ._M/H _Swim. Pool ~M ';.<!/~J Other PROPOSED USE: _Single Family /commercial ~/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 FORMS.** **COPY OF CONTRACT REQUIRED, PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL ~MECHANICAL AMP Service Florida Power Corp. _W,R,E.C, $ tJ-55':. oD , 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 ET.ECTRICIAN Company State Cert. or Regist, # City License Registration # ****************************************** Signature Company State Cert, or Regist. # City License Registration # ****************************************** PLUMBER Signature MEClfAIiJCAL Company xJ/<".I;:A ~-"- Cj:~~ d &. State Cert, or egist. iF '/J7'A~~~-Jonr)(?r7 Signature . ~ f'/~ City License Registration ~F 5'3/ ~ - ****************************************** Company State Cert. or Regist. # City License Registration # OTHER Signature APPLICATION APPROVED BY ~********~************************** Q .t'/\/lJ'v...)"- 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 lore restrictive than City regulations, The undersigned assu.es responsibility for cOlpliance with any applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If th, Dwn,r has hired a contractor or contractors to undlrtak. work, they .ay be required to be licensed in accordanc. 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 .isde.eanor 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 Zephyrhills Building Departaent, (813) 788-6611, Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) 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 .ay be an indication that he is not properly licensed and is not entitled to per.itting 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 Depart.ent of Agriculture and Consu.er Affairs. If the applicant is sOleone other than the 'owner', I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the 'owner' prior to cOllence.ent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infor.ation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land develop.ent, Application is hereby .ade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a per.it and that all work will be perforled to .eet standards of all laws 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.ental agencies .ay apply to the intended work, and that it is ,y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not lilited to: f Depart.ent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands, Water/Wastewater Treatlent f Southwest Florida Water "anaQelent.District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health & Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks f US Environlental Protection AQency - Asbestos abate.ent I also certify that, if fill .aterial is to be used in Flood Zone 'A' or 'A,etc.., it is understood that a drainage plan addressing a 'colpensating volu.e' will be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to perlit 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 Officipl frot thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becole invalid unless the work authorized by such per.it is co..enced within six tonths of issuance, or if work authorized by the pertit is suspended Dr abandoned for a period of six lonths after the ti.e the work is cottenced. One 90 day extension of tile, tay be allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official, An approved inspection tust be logged during each six .onth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COK"ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IKPROVEKENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COft"EMCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COKKENCEKENT'. ~~~----------------- ~~ -CONTRACTO,-------------------------------- i/.... STATE OF FLORIDA COUNTY OF ____________________________________ The foregoing instrument was acknowledged before me this __________, 19____ by ---------------------------------------- who is personally known to me or who has produced _______________________________ as identification and who did/did not take an oath. ----------------------------~------------ (Signature) ----------------------------------------- (Name Typed, Printed or Stamped) NOTARY PUBLIC STATE OF FLORIDA COUNTY OF ____y_~~_Q9___________________________ The foregoing instrument was acknowledged before me this Y~~_3J_____' 1931___ by Jay C Brown ---------------------------------------- who is personally known to me or who has produced _____~~J~~~~~~J_$~~~__________ as identification and who did/did not ~:~:_::_::~LiI~~~~-- (Signature) ______~oJL~i~~_115~~~~~~___________________ (Name Typed, F~r"-i 1'\.tedor Stamped) NOTARY PUBLIC' iIoTARY PUBlIC STATE OF FLORIDA MY COMMISSION EXI SEPT.17.1993 IONDED TtfRU GENERAl 1 HS. UNO. ~ ~ \ "'Q N' \ A~ c::-. 4. E-- Z ~ ~ ~ ~\ ~ ;=:J '. C!I ~. [.,..] ~ ,~ CJ;:J ~ ,~ ~ >-c .. .---! rX ~. ~ "'" ~i '-' [:i:l en [""\~ J] ~, " rr. Ul ~~ '-- ~, .- 1-':;-' ~ 1'. I -\., '" ~ . LI ! I l4 I 8 , :\.: ---.; "'\ \ --I -, i , i\ -- ~- O. ,,""'1:~ . z ~~~ I "~c..~-. i,.:., ~ '. I '\ . ".. "~'~.,""..,.._, I.. '~.-." ..,.-.. ""-,.~."'..~.",,' -."""""_","'",,,",,,,,=-,,,-'0.=-.,...:,,,. _~--="",,_ 0[' Z LL! [J:! 1l..1 _I III [[ U1W -<>- (:)[[ LL It IT: enw <;( >- l::J [[ lL in [[ en w <t )... Ci) [[ lL LU _J (J en (J <CH ~ 0::: CD UJ f- Of o}~ ~---r . Wn n- ~ LL a: o f- U w f- w o w ~. .J "} ~ . ~ Qj ~~ '~ 4~ . f>~ ~~ ~"'-'" " '" "- ~ I ~~ ~ .~ ~ l( ~~ ~ cr:, ~a~ j::1;:> r:z, j::1...;J o co r.ri u ...;J ...;J...;J ~ f-t ~...;J x <<~ u~~ O'J::I: ~o~ ~Ol-'--i E--i 4"") N (S1 (S1 0 LfJ (TJ m Ui a: o. w f- lIJ II 11l 01 ::J 0 ~ u . [J oil; ~ 0 lL m !l. :J 0 0 Z lL '! 0 '<l; z r: