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Home My WebLink About92-2106 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.6611 Permit NC! 2106J.Z Date :l. -.y' -7 ~ ~G ~R'~ ~ ::~:::,~,:~'c;i!!/KJ6r~ "f ME~L Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcell.D. # Zoning: Description of Work Energy Code: ~.;r _4-L i~ Radon Gas: ~/A- //-Q City License Registration # ~ L State Certified License# DATE NO OCCUPANCY BEFORE C,O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Valuation or Contract Price Telephone# B~G " \. ~~ ~ ~-::C; J C ELECTR'C~ p~~ Tp. SeN, SLB Rough In Tub Set MehrCan Wahr Canst, Pole Sewer Pool Final Pre-Meter Final M~ICAL "'" Ftr. Pre SLB Lintel FRM. Insul. CL WL Breakers Ducts Insl. Compressor 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 f(e tY tI etA ~ \/?'? It/; S~/ 9 GIlI/ TIl..Jd /YlAIGY I-IAyf'oRd PHONE ADDRESS OWNER JOB LOCATION <:) 4 /Y') ~ 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 Units __M/H _Commercial _Indust. _Swim. Pool Other _Restaurant & Health Department Approval BUILDING SIZE: X_I 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 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. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # **************~*************************** '0 .- &rfI ompany tate Cert. or Regist. # l~ _ity License Registration # . ~ **************************** BUILDER PLUMBER Company State Cert. or Regist. # Signature City License Registration ;fr ****************************************** MECHANICAL Company State Cert. or Regist. # Signature City License Registration ;~ ****************************************** OTHER Company State Cert. or Regist. # Signature City License Registration # APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit 'Iay be subject to "deed restrictions. which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor Dr contractors to undertake work, they tay 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 tisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requiretents tay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (8131 788-6611, Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s) 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 tay 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 Departtent of Agriculture and Consuter Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and promise 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 cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade 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 perlit and that all work will be perforaed to teet 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 governaental agencies lay apply to the intended Mork, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not liaited to: I Departtent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands, Water/Wastewater Treatment I Southwest Florida Water KanaQetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departaent of Health & Rehabilitative Services. Environaental Health Unit - Wells, Wastewater Treataent, Septic Tanks I US Environaental Protection AQency - Asbestos abateaent I also certify that, if fill aaterial is to be used in Flood Zone "A" Dr "A,etc,", it is understood that a drainage plan addressing a "coapensating volule" will be subtitted which is prepared by a professional engineer registered in the State of Florida prior to pertit issuance. A perlit 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 perait prevent the Building Official froa thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beeole invalid unless the work authorized by such perlit is cOllenced within six tonths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six lonths after the tiae the work is cot.enced, One 90 day extension of tile, lay be allowed for the pertit 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 lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROVEKENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH LENDER OR AN ATTORNEY BEFORE RECOR INS YOUR NOTICE OF CO"KENCEKENT, JOBS UNDER $2,500 IN VALUE DO NOT NEED TO CORD ND POST A "N F COMMENCE 1( -P~ t!. fd ~ IGNATURE: OWNER OR AGENT STATE OF FLORIDA ~ COUNTY OF ~~ The foregoing ins~~n~ was acknowledged before me this ~~__~~ 19~ by y~ 1it~;;;?.i. whb is persona ly known to me or who has produced as identification take an 0 tho STATE OF FLORID~ COUNTY OF --tt::::-~ --,t/ The foregoing in~um nt bef- - me th i 5 '-L :.4. personally produced as identification take an~a (Signature) ,Not Public, lci,e '" . .!l1J:omm, .Exp, Mar, 7. 1995 (Name Typed,-~rinted or Stamped) NOTARY PUBLIC