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Home My WebLink About92-2112 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.6611 Permit )(~ 211 a8 Date .1. - 0-- ~ ~ C~ E~ PL~ ME~L P,"perty owne' ;!b~ xh 21 ~~ Job Address: Y' _ _ __~' Parcell.D. # Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: En~ Code: . Description of work'J/a. ~~---,.. 4A- - Radon Gas: FINAL NO OCCUPANCY BEFORE C.O, Complete Plans, Specifications and Fee Must Accompany Application. C.O '"! All work shall be performed in accordance with City Codes and Ordinances. Inspector Permit Fee r!2-CJ.~ Signature ~~ ..?2.~ I jJ~ Company Address Telephone# Valuation or Contract Price .ytJ7)~cTD City License Registration # ..3 7 7 State Certified License# ELE~L ~ PL~NG """ ME~CAL -. Breakers Ducts Insl. Compressor Final FRM, Insul. CL WL SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const, Pole Pool Pre-Meter 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction, c, Repairs or corrections not made when inspection called, d, Work not ready for inspection when called. e, Permit not posted on job site. f, Plans not at job site, g, Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same, APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT A55oc/~reO ELtCt/2tcAI.. s.'E/C(,I(Ce~,..;:iuc. , (IfA~L(E j).~/fL ADDRESS !f&;q/ o-/CEetf/FtEc..2 ~r1IUE 2E/WV~If(t.L~ R: 3354/ PHONE 783.- 3.;2$'5: ,. OWNER :lEe lfoAJ ~ F/2AlJcD illOrr/{5 PH',..:tb- 78g - '+8 10 JOB LOCATION q71 g (;-Ae-t- 8LGlO. 2c/'If'dYflc..t5 ~Hrrl4Ct+<=f) LEGAL DESCRIPTION: LOT(S) BLOCK , LOT SIZEI31.09 X I SO AREA SQ. FT. SUBDIVISION PARCEL I.D.# WORK PROPOSED:_New Construction _Addition _Alteration _Sign/Temp. VSign _Repair _Install _Move _Demolish PROPOSED USE: _Single Family _M/F _IF of Units ._M/H _Commercial _Indust. _Swim. Pool Other _Restaurant & Health Department Approval I BUILDING SIZE: L.f'1 X Jlo.3S, Square Feet, I 15 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.H **COPY OF CONTRACT REQUIRED, ~LDING PERMITS REOUESTED $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. _h'.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLlJMBING 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 SiQnature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature OTHER 516-.'-1 Signature (h~ /(, dJ..~ Company 4-5Soc14TeO ~c.8??C(C* 5P,e(/ICc-5",:Taf, State Cert. or Regist. IF G/-OOOc)oB3 City License Registration 4fr , ? 7 7 , APPLICATION APPROVED BY ~**********~************************ . ,~ "P..AA.l'l...) 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 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 Mork, they may 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 lisdeaeanor violation under state laM. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended Mork, they are advised to contact the City of Zephyrhills Building Departlent, (BI3) 7BB-bbll, 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 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 LaN - HOleONner's Protection Guide' prepared by the Florida Departlent 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 cOlaencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all Nork Nill be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent, Application is hereby aade to obtain a perait to do work and installation as indicated, I certify that no work or installation has cOltenced prior to issuance of a perlit and that all work will be perfBrled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. 1 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 aust take to be in cOlpliance. Such agencies include but are not lilited to: I Departaent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treataent I Southwest Florida Water "anaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health & Rehabilitative Services. Environlental Health Unit - Wells, WasteNater Treatlent, Septic Tanks I US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.', it is understood that a drainage plan addressing a "colpensating volule" will be subaitted which is prepared by a professional engineer registered in the state of Florida prior to perait issuance. A perait 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 frol thereafter requiring a correction of errors in plans, construction, or violations of any code, Every perlit issued shall becole invalid unless the work authorized by such perait is cOlaenced within six lonths of issuance, or if work authorized by the per.it is suspended or abandoned for a period of six aonths after the tile the work is coatenced, One 90 day extension of tile, lay be allowed for the perait 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 COMMENCEMENT "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'. ~~~ SIGNATURE: OWNER OR AGENT (;1~ /! 1f)~ SIGNATURE: CONTRACTOR STATE OF FlORIDf\-.., . _ COUNTY OF rcc5 C 0 The foregoing instrument before me th i s reb 5 fr~rJte 5 who is personally produce as identification and take an ath. was acknowledged , 19 ~ by STATE OF FLORIDA COUNTY OF The foregoing instrument befclj-e me th is PrL5 C 0 o - was acknowledged , 19~ by ( (Name yped, Printed NOT ARY PUBLI C (Name ,ped, Printed NOTARY PUBLIC NOTARY PUBLIC, STATE OF FLORIDA MY COMMISSION EXPIRES: Marcb 6 1;95 BONDED THIlU NOTARY PUBLIC UNDEllwRrmaS. NOTARY PUBLIC. STATE OF FLORIDA, MY COMMISSION EXPIRES: Marcb 6, 19115, BONDED THIlU NOTAJlY PUBLIC UNDUwarraRS. . 1.--((.....__ !t-, '. -, ~ . ,. ~..!..... ,.. 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