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HomeMy WebLinkAbout92-2107 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.6611 Permit ~f() ..c.. . 2107E j , .3 (J..O"D 0'L~ PLU~ ::~:::,~s:~~~1t~":'9.[~ Date :J.. - '( - 7 cl MEC~ Sewer Conn Water Conn: Parcel I. D. # Water Meter: T.I.F.'s: Zoning: Description of Work NO OCCUPANCY BEFORE C,O, FINAL 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 Valuation or Contract price~ O?:J . c:ru Pe,m;' F~ . OV Signatur ~r-:., Company Address Telephone# C4?j City License Registration # State Certified License# Tp, Servo Rough In Meter Can Const, Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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. MECHANICAL l.i~ Company () State Cert. or Regist. # ;V!) ~~L--- City License Registration ;F ** ************************************** Signature Company Cert. or Regist. # City License Registration # Signatu **************************~*************** APPLICATION APPROVED BY PERMIT OFFICER. ~. ,., ~!".;":;',, _,~ ':t~~ .. ,~ , r. '. .tr:>~,~', ",..;~j- 'fr_,'~1f+" :"'i:''''\o~~',,, lilIW, '(;:~~!r' .... ,,"~e,,, '1 11.~ j'\I!;-IP4~.~' , /,,",,,,:.:2' 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 or contractors to undertake work, they lay be required to be licensed in accordance Nith state and local regulations, If the contractor is not licensed as required by'laN"both the ONner and contractor lay be cited for a lisdeleanor violation under state IaN. If the owner or intended contractor are uncertain as t~ what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 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 ~~sponsible. If'you, as t~,own!r 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 lay 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 Departaent 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 pro.ise 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 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 perforled to leet 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 governlental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance, Such agencies include but are not lilited to: I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally 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 ~ Rehabilitative Services. Environlental 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 "colpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to vinlate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perait prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violatinns of any code. Every perlit issued shall beeole invalid unless the work authorized by such perlit is eOlleneed within six lonths of issuance, or if work authori~ed by the perlit is suspended or abandoned for a period of six lonths after the tiae the work is cO.lenced, One 90 day extension of tile, lay be allowed fnr the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official, An approved inspection aust be logged during each six lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COK"ENCEKENT "AY 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 CO""ENCE"ENT, JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT", STATE OF FlORID~ COUNTY OF , ~) The foregoing ins~ment before me th15,~ F;./J was a~nOWledged , 19 L by cJ... ftuLI/ Id u FrS r /-1 TLE Ii!. l17T.f{ who is personally known to me or who has produced Fl)J-.-tJ: Q ,~OO-~ - 55-'/O( as identification and who did/did not take al10a~ ~~ (Si~ture) ~ L . NfTI'f _ ~WI J (Name Typed, Printed or Stamped) NOTARY PUBLI C NOTARY PUBLIC, STATE OF FLORIDA My commission expires J.;n. 23, 1995 Bonded thru Patterson - Elecht Agel1~ ~~E. ~~ SIGNATURE: CONTRACTOR STATE OF FLORIDA ~ COUNTY OF . ~_ The forege. i ng i ns tl~nt l>Jas ac kncll>ll edged befcll-e me this '-~ --- hA., i9 9'.;L. by LA-U/lfl flUFF ST{.,( rL€-,i (rJfl77y who is personally known to me or who has produced FD.;t'+I C 3 00 - S ':;;"J--- 5'5":; 70( as identification and who did/did not tak~~~ ~ ~~_ (Sig~ture) ~ 4.Q Be. ,Z1l'1 !d. .. (Name Typed, Printed NOTARY PUBLIC NOTAF?Y ru',! !:Y Commie.'.;c,,; onded t!;liJ LewfJ 01- Stamped) .;; !\fE OF FL . .. , CRIU, ~,..) .Jd;~ ] a'~;:- HlS~tH Ag~;l~:: i~ \' \ ;~~ 'i: ;;- ',;.- ~ 'to ~ ... ,}- \:.) ; > ..... '- \ " ~V" .-0 <. ., ~~ _ G "\~,~j '~'> ~,t... 7-- ~: ?' ;..-w_- / -~ \, \ o~ '-'I t. ) , ~ ,~ \J,..\- '" .. .... "l .:. ""' -\';. .-.) "''' o I I' f'\ tl I ~ ~.-!'-. i +- r----' I ,_ 0" ~ I i:.. cY -:: .... ,- ( ,:':"'-~ ,.~ ;~~ ~ ... o,_\." r1-..... ,.f.~~:'-==-' 0-0 -Q to ~ r ~ T""'" , + <;: .. '- " ~ J' ;::r> ---0 r.) ~..., ~ 'i>- Q -. _....-<::\ -0 .,.. c; Q . .f ..... 'Y'''' ~ :>~ CJ~ ~~ \ ' I II "\ ~I ~..;. ) j: 10 ~ IcIJ ' ';.:,- ... I ) Ji,o( i ,,~ ___~,_IL.,.. (~".;~'::.~ \ I jl n-- - J .- . 1\\ /. -L l ~ ._-~ \ vtfYVT. {!.C?11('-"f'~.:;' - <5flJOl' , \ . .._._-~ \" ~\ ~ ~ (-;7 ,. ;- pJ' ... t.; ~ ) /6' ; I --1- ------",.- ; "" d:4:~- '.....o~-t_.;:. ~~ 0{:. ~- Ie- ~/~ ~~ i~O ..lit .4-: ("J ~"7 ." .,~ .~. (.~-~- <{.. ').'- ~ :.' I' .... .... >,,,,- ,...m..__' . \r -- \ -....... Jl-UJ f' ~ c.. 0--'1 re ~ +ra--f fD\.LI't.,ct ~ 1!\- 1-0 \ tVl.-t~ l t D"'"'f' ~~ 8" x-\" Bolt 4" -DC . . d we ( dr; {/f'J sf ee.l 0 0/ \ , +-".. _ c.. /' I YJ.-k-e I C.Du.. (' 5P ) "\.. t D L. 'U i ~~ '-~.J' ( Optional Metal Shoes or PT Plate dur~icane Anchor Truss Anchor ........ 1-#5 or 2-#4 Rods Continuous ~ over openings ""Inspection Hole ,,,,,,I \"",lA)~~ l , "[ ( L~ t W rJ..-) ~.(' (' OM rpo...\\ -t"'"t'e J ("l f!+fl.J . + 0 0 ('0 f d <;, '[ q e (..;,' S.-/- ~ '" ) 1 - 8x8x16 Cell Block A. 1-t15 Rod -5+e I? 1 d,.: 1\ eJ .~ : 'r p~1) Header Block ) Barrier Natural Solid Ground ~.~ '~.~~, Compac ted Fi 11 Poison SoU 8" r:-~~iJ 16" Rods in footer on upprovi:d ('1V1 irs ( All €orners ) ~._. - .--.- -..- a" __ h_ __ 0 0 12". 0 . 0 / 1< 16 II -)/ /~1211" I I ~16 r 1 RESIDENTIAL A. I-t15 Rod Bent and stubbed out of footing all corners. B. 2-#5 Rods in footer C. Rods in footers shall be place on approved chairs placed a max.imum of b' o.c, and Tied. '. D. Where rods are t"apped. shall be a minimum of 24" distance with two ties. FORM 1000-C.91 SMALL ADDITIONS AND RENOVATIONS FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Section 10 - Residential Prescriptive Compliance Method Department of Community Affairs Climate Zones CENTRAL 4 5 6 COMPLIANCE WITH SECTION 10 OF THE FLORIDA ENERGY EFFICIENCY CODE MAY BE DEMONSTRATED BY USE OF FORM 1 OOOC-91 FOR ADDITIONS OF 600 SOLARE FEET OR LESS. AND RENOVATIONS TO SINGLE AND MULTIFAMILY RESIDENCES. ALTERNATIVE METHODS ARE PROVIDED FOR ADDITIONS BY US FORM 1000A-91 or A-91 BUILDER: RENOVATION ADDITION MULTIFAMILY ATTACHED D SINGLE-FAMILY DETACHED D 5060 ~ PROJECT NAIIE AND ADDRESS: 2. OWNER: ~ FOR ADDITIONS ONLY: PERCENTAGE OF GLASS TO FLOOR UNDER ATTIC: R c SINGLE ASSEMBLY R = GJ(j, D ITJ,D Ro ITJ,D NEW GLASS AREA AND TYPE CLEAR T1NUILM,SOLAR SCREEN SO SINGLE- ITIIJ SO FT PANE FT SO DOUBLE- ITIIJ SO FT PANE FT FLOOR TYPE AND INSULATION WOOD MASONRY RAISE~ ~ ITJ. D RAISE~ = DJ.D COM~O~ ITJ. 0 COMMRO~ []] SLAB-ON- _ IT] V1 GRADE. R - ,~ IF MULTIFAMILY, NUMBER OF UNITS COVERED BY THIS SUBMITTAL ITIJ CONDITIONED ' FLOOR AREA PREDOMINANT EAVE OVERHANG LENGTH PORCH OVERHANG LENGTH URJ% WALL TYPE AND INSULATION WOOD FRAME MASONRY EXTER~O~ CD. D EXTE~O~ [RJ.D ADJAC:~ CD. D ADJA~E~T CD. D COMMO~ CD D COMMO~: rn R , R . CEILING TYPE AND INSULATION COMMON: DUCTS COOLING SYSTEM HEATING SYSTEM HOT WATER SYSTEM IN ~. CENTRAL D NONE D ELECTRIC STRIP D HEAT PUMP D ELECTRIC D SOLAR UNCONDITIONED D D D NATURAL GAS D HEAT RECOVERY SPACE: R = ROOM NATURAL GAS ROOM/PTHP rnJ. [(j D PTAC D OTHER FUELS D NONE D OTHER FUELS D OED HEAT PUMP IN CONDITIONED D NO NEW SYSTEM D NO NEW SYSTEM D NO NEW .f} SF/EF 0 D.ITJ SPACE: R 0 ~.~ COPIHSPFIAFUE = DrT-~ SYSTEM EF = ITJ,D SEERI EER = NUMBER OF BEDROOMS - rn ReView of plans and speCIfications co~ered by this calculation Indicates compliance with the Flonda Energy Code. Before constr ction is completed. this bUilding will be inspected for compliance In aCCO~d~n Ith Ion 553.908. F.S. ~ BUILDING OFFICIAL' ________ ), - tf - cr &- DATE I hereby certify that the plans and specifications covered by the calculation are In compliance With the Florida Energy Code. TABLE 10A[ MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQUIREMENTS CHECK WINDOWS 904.1 Minimum of 0.34 CFM per linear foot of operable sash crack (includes sliding glass doors). ~ EXTERIOR & 904.1 Maximum of 0.5 CFM per sq. ft. of door area: solid core, wood panel, insulated or glass doors only. 'I. ADJACENT DOORS EXTERIOR 904.1 To be caulked, gasketed, weatherstripped or otherwise sealed. -/... JOINTS & CRACKS SOLE & TOP 903.2 Sole plates and penetrations through top plates of exterior walls must be sealed. ~ PLATES INFilTRATION 903.2 Infiltration barrier must be installed in exterior walls & raised wood floors. 'f BARRIER INTERIOR 903.2 All openings in interior surfaces of ceilings and exterior walls must be sealed. '1-. JOINTS/CRACKS FIREPLACES 903.2 Fireplaces must have flue dampers, glass doors and outside combustion air intakes. A)1f EXHAUST FANS 903.2 Exhaust fans vented to uncondi1ioned space shall have dampers, except for combustion JM devices with integral exhaust ductwork. WATER HEATERS 904.2 Comply with efficiency requirements in Table 9-7A. Switch or clearly marked circuit breaker (electric) iliA or cutoff (gas) must be provided. External or built-in heat trap required. SWIMMING 904.3 Spas & heated pools must have covers (except solar heated). Non-commercial pools must have a Nfl POOLS & SPAS pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78%. HOT WATER 904.4 Insulation is required only for recirculating systems, including heat recovery units. 111 such cases, AlIi PIPES piping heat loss shall be limited 10 a maximum of 17.5 BTUH per linear foot of pipe. SHOWER HEADS 904.5 Water flow must be restricted to no more than 3 gallons per minute at 80 PSIG. AlP HVAC DUCT 904.6 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached, IA CONSTRUCTION, sealed, insulated and installed in accordance with the criteria of Section 904.6. Ducts in unconditioned INSULATION & space and air handlers located in attics must be insulated to a minimum R-4.2 (R-6 after 1/1/92). INSTALLATION HV AC CONTROLS 904.7 Separate readily accessible manual or automatic thermostat for each system. I' RENOVATIONS 1003.0 Meets the requirements of sec. 1003.0. See step 3 of page 2 of this form. 'I,. ONLY GLASS -1 - CLIMATE ZONES 4.5 ~ TABLE 10B. Prescriptive Requirements for Small Additions (600 Sq,Ft. and Less) and for Renovations to Existing Buildings, COMPONENT MINIMUM INSULATION INSULATION INSTALLED Concrete R-5 Ri..,- !) Wood frame, 2' x 4' R-l1 ..... Wood frame. 2' x 6' R-19 ~ Common, Wood frame' R-1l Common. Masonry' R-3 In Under attic R-30 f<'30 <:I z: Single assembly R-19 ~ w Common. Wood frame' R-1l 0 In Slab-on-grade No Minimum () a:: Ra ised wood R-1l 0 9 Raised concrete R-5 .... Common. Wood frame' R-11 0 In unconditioned space 1991 1992 f{~ ~ R-4.2 R-6 0 In conditioned soace No Minimum 'Common components are those which separate two conditioned living units in a multifamily building. TABLE 10C, Prescriptive Requirements for Glass Areas in ADDITIONS ONLY (Renovations see 3 below) EQUIPMENT MINIMUM INSTALLED EFFICIENCY EFFICIENCY 1991 1992 ...J = 10, Q) 0 Central NC SEER = 9.0 10.0 SEER 0 () Room unit or PTAC EER = 8.5 8.5 EER = c:l Electric Resistance ANY z j:: Heat Pump HSPF = 6.4 6.8 HSPF <( = - w :::c Room unit or PTHP COP = 2.6 2.7 HSPFI = ~ w HSPF = 6.1 6.1 COP () <( a.. Gas, natural or propane AFUE = .70 .78 AFUE = en - Fuel Oil AFUE = .76 .78 AFUE = a: ~l...! w Electric Resistance EF = .88 EF I- = -...L!... <( 3: Gas, natural or propane EF = .54 EF = I- - 0 :::c Fuel Oil EF = .54 EF = Maximum percentage glass to floor area allowed is selected by type, overhang length, and shading coefficient. See below. Maximum % ~stallif %= JrJ GLASS TYPE, OVERHANG, AND SHADING COEFFICIENT (TINTING) REQUIRED FOR GLASS PERCENTAGE ALLOWED UP TO 20% UP TO 30% UP TO 40% UP TO 50% Single Double Single Double Single Double Single Double OH - SC OH - SC OH - SC OH - SC OH - SC OH - SC OH - SC OH - SC l' - 1.0 0' - .90 2' - 1.0 l' - .90 3' - 1.0 2' - .90 4' - 1.0 3' - .90 0' - .86 l' - .86 0' - .70 2' - ,86 l' - .70 3' - .86 2' - .70 2' - .65 0' - .65 l' - .65 0' - .50 l' - .45 l' - .50 0' - .45 0' - .35 0' - .40 Shading coefficients (SC) may be obtained from the manufacturer of the glass. Typical shading coefficients are: single-paned clear SC = 1.0. double-paned clear SC = .90, and single-paned tint SC = .86. Form 1000C may be used to comply the following types of construction SMALL ADDITIONS TO EXISTING RESIDENCES, Additions which have 600 square feet or less of conditioned area may comply with the Energy Code using this form. The prescriptive requirements in Tables 10A, 1 OB and 1 OC apply only to the components of the addition, not to the existing building. Space heating, cooling, and water heating equipment efficiency levels must be met only when equipment is installed specifically to serve the addition or is being installed in conjunction with the addition construction, Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels, RENOVATIONS. Residential buildings undergoing renovations costing more than 30% of the assessed value of the building must comply with the Energy Code using this form. The prescriptive requirements in Tables 10A and 10B apply only to the components and equipment being renovated or replaced. GENERAL DIRECTIONS: 1. On the left side of Table 10B in the column titled "INSULATION INSTAllED", indicate the R-value of the insulation being added to each component. On the right side oITable 10B indicate the efficiency levels of the equipment being installed in the column titled "EFFICIENCY INSTAllED" All R-values and efficiencies installed must meet or exceed the minimum values prescribed in the preceding column for that component. Components and equipment neither being added nor renovated may be left blank 2. ADDITIONS ONLY. Determine the percentage of new glass to conditioned floor area in the addition as follows, Total the areas of all glass windows, sliding glass doors and glass panels in doors which are more than V3 of the area of the door. Double the area of all non-vertical roof glass and add it to the previous total. When glass in existing exterior walls is being removed or enclosed by the addition, an amount equal to the total area of this glass may be subtracted from the total glass area, Divide the adjusted glass area total by the conditioned floor area of the addition. Multiply by 100 to get the percent. Find the largest glass percentage under which your calculated percentage falls on Table 1 DC. For example, 29% glass would qualify for the "Up to 30%" column. Prescriptives are given by the type of glass (Single or Double pane) and the overhang (OH) paired with a shading coefficient (sq, Any pair within the selected "Up To " category is acceptable. For a given glass type and overhang, the maximum shading coefficient allowed is specified, Indicate the category into which the percentage falls in the box at the top titled "Maximum % = ". In the next column titled "Installed", indicate the calculated percentage of glass in the addition. Actual glass windows and doors previously in the exterior walls of the house and being reinstalled in the addition, do not have to comply with the overhang and shading coefficient requirements on Table 1 OC. All new glass in the addition must meet the requirements for one of the options in the glass percentage category you indicated. The overhang (OH) distance is measured perpendicularly from the face of the glass to a point directly under the outermost edge of the overhang. 3. RENOVATIONS ONLY. Only glass areas which are being replaced as part of the renovations need to meet the following requirements. Any glass type and shading coefficient may be used for glass areas which are under at least a two foot overhang and whose lowest edge does not extend further than 8 feet from the overhang. Glass areas being renovated that do not meet this criteria must be either single-pane tinted, double-pane clear, or double-pane tinted. 4. Complete the information requested on the top half of page 1. 5. Read "Minimum Requirements for Small Additions and Renovations", Table 10A on page 1, and check to indicate your intention to comply with all applicable items. 6. Read, sign and date the "Owner/Agent" certification statement on page 1. 2 APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT L AU (Uq. e:. Co '-H-y 631'- .s~jsqmA DR OWNER -H -AfW J d -s-, 9r- UU R-A 6, c.. 'H<.; JOB LOCATION 53/ (., Sp;f~u f71FJ bf2, 21IJi / /.> LOT SIZE/ ()() X PHONE 7?~-/j-:3 "/ ADDRESS AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. # WORK PROPOSED:____New Construction ~dition ____Alteration ____Repair ____Install _Sign/Temp. PROPOSED USE: ~le Family _Sign _Move _Demolish _M/F _IF of Units _M/H _Commercial _Indust. _Swim. Pool Other ____Restaurant & Health Department Approval / / BUILDING SIZE: /0 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, /' ____BUILDING ~CTRICAL PERMITS REOUESTED $ Valuation of Total Construction 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 # ****************************************** BUILDER ~ ELECTRTCTAN Company State Cert. or Regist. # City License Registration # ****************************************** Signature PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** Signature l.i~ Company () State Cert. or Regist. # ;'Vl) ~:4'.c--- City License Registration l~ ** ************************************** MECHANICAl. Company 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 perlitlay be subject to 'deed restrictions' which lay be lore restrictive than City regulations. The undersigned assuaes 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 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 lay be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as t~ Khat licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (B131 7BB-6611. , Furtherlore, if the owner has hired a contractor or contractors, .he is. advised to have the cDntractDr(s) sign portions of the 'CDntractor Sections' of this application for which they .ill be ~~sponsible. If you, as t~,owner sign as the contractDr, you are indicating that you, rather than the contractor, are responsible for the work. If the cDntractDr wishes you tD 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 ConstructiDn Lien Law - HOleowner's PrDtection 6uide' prepared by the Florida Departaent of Agriculture and Consuler Affairs, If the applicant is SDleDne other than the 'owner', I certify that I have obtained a copy of the above described doculent and prDlise in gDod 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 .ade to obtain a per.it to do work and installation as indicated. I certify that nD wDrk Dr installation has cOlaenced prior to issuance of a perlit and that all work will be perforled to leet standards Df all laws regulating constructiDn, City codes, zoning regulations, and land developlent regulatiDns in the jurisdiction. I alsD certify that I understand that the regulations of other governlental agencies lay apply tD the intended wDrk, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are nDt lilited to: f Depart.ent of Environlental ReQulation - Cypress Bayheads, Yetland Areas and EnvirDnlentally Sensitive Lands, Water/Wastewater Treatlent f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY CDrps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent Df Health ~ Rehabilitative Services. Environlental 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 FIDDd ZDne 'A' Dr 'A,etc.', it is understood that a drainage plan addressing a 'coepensating volule" will be sublitted which is prepared by a prDfessiDnal engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the NDrk and nDt as authority tD viDlate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a pereit prevent the Building Official frol thereafter requiring a correction of errDrs in plans, construction, or violations of any code. Every perlit issued shall beeDle invalid unless the Nork authorized by such per.it is cOleeneed within six eonths of issuance, or if wor~ authori~ed by the perlit is suspended or abandoned for a period of six lonths after the tile the work is cOI.enced, One 90 day extension Df tile, lay be allowed for the perlit with fee charge of $15.00. The extensiDn shall be requested in Nriting to the Building Official. An approved inspection lust be IDgged during each six lonth period, or the project will be considered abandDned. WARNIH6 TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IKPROVE"ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCIN6, 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 CO"KENCEKENT', ~G 6NATURE: OWNER DR A6ENT ~ d~~. SI6NATURE: CONTRACTOR ~.' , ----- STATE OF FLORID~ COUNTY OF . f162e.I) - The foregoing ins~ment before me th 15 , ~ F.II.IJ was a~nOWledged , 19 L by STATE OF FLORIDA ~ COUNTY OF . 'O~.-.J_ The foregc<ing instru~nt I-Jas acknc'I-,ledged befl)l-e me th i s '-~ ~ h/;., i 9 9'.;;J.- by ~ Au~1/ Id U FrS T I--{ rLE,e C17T.'I who is personally known to me or who has produced F))J--J;i Q _~OO-~ - ~~5-70( as identification and who did/did not take an 0 t) h,.~ ~'-~ (Si~ture) ~. L ' N F'TJIf _ ~ CJ.) I ,,\ (Na~e Typed, Printed or Stamped) NOTARY PUBLIC LRUIlf+ !dUFF STU. rL€..l ('7/l~ny who is personally known to me or who has produced PD/He 300 - 5~J-.- SS':; 70( as identification and who did/did not ta~~~~ A <c~- (Sig~ture) 4 4Q,BCtZTJ1 !d- (Name Typed, Printed NOT ARY PUBLI C Lew(J or Stamped) NOTARY PUBLIC, STATE OF FLORIDA My commission expires J.,n. 2 b, 1995 Bonded thru Patterson - Becht Agen~ NOT,^\!~y ru.! My Commie,.,..:" Bonded tiliu.' ;, !J,jE OF F . ..3 ;". .) ,LOR/c.;, flC'. 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