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Home My WebLink About92-2114 BUILDING PERMIT Permit 2114E ..;2 ~ ~ - 9;~- CITY OF ZEPHYRHILLS (813) 788.6611 )f"'! ~G eJO/ .....-----... @ECTRIr.~ ~-,--p ME~wer Conn ~ /~ Water Conn: Pwpertyowne" ,--j~ (~~$f)ct- /-)~)i~~Wate'Mete" --Q A C:' - /J 0 cr. ~, ' . Job Address: ~.2> I ~! 0"- - ,==--<. y . T.I.IF. s. /1-,:2(p-~/- 00/0 - Olbt.JO-OO~O DatE~ Parcel I. D. # (7~J.Jl~_) Zoning: Description of Work ,..." NO OCCUPANCY BEFORE C,O, FINAL 2r 7- , 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 City License Registration # State Certified License# as I fI~g. Permit Fee Signature Company Address Telephone# Valuation or Contract Price .- Bu~(f ./ (::?7f!:;~cjfi(f'~ PL U M BI.bJ.G-"'" ---- MECHAN~" ~ Breakers Ducts Insl. Compressor iFinal 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 PER~IT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT Qaqfdtr I ~ LG-Cmt C- 7 J t.j €. l4-ou./1t-t"UO A-lle- Oil-OC: C, r Y PHONE ~ 21 ~. ro ~ z r -15m tV4-tfo.J c! K~uIJ QUIlN(," JOB LOCATION 6'QJQ 02o.H 'ST. LOT SIZE_X AREA SQ.FT. LEGAL DESCRIPTION: LOT(S) ifr} 111JIif' BLOCK '-1<\ -SUBDIVISION PiA,8cok I P't.c Y () ~ Ifilli'd f- u r 3 ~ EA>r ff/ttr d F (tJf 'f PARCEL I.D.4F 1/ '~;;'.l~ - 2/-60 to -d yJ-OO ~ tJo (l{) ADDRESS OWNER WORK PROPOSED:____New Construction _Addition _Alteration ____Repair ____Ins tall _Sign/Temp. _Sign _Move ____Demolish PROPOSED USE: _Single Family _M/F Z 4F of Units ____M/H _Commercial _Indust. _Swim. Pool Other _Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, Height RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S,** COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED, PERMITS REOUESTED ____BUILDING -i-ELECTRICAL ____MECHANICAL $ Valuation of Total Construction AMP Service :>\ Florida Power Corp. _\~.R,E.C. $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION BUILDER Company State Cert. or Regist. # Signature City License Registration # A~ . I ~~~~;:"*""::::::~~;;*;'*E;fCmC ::::::::: ~ ~ ~**....******..***m~:~~m~; :~=;;;;;~~ ;;~ 7tZ ~~/,2 Z? 'j PLUMBER Company State Cert. or Regist. # City License Registration # ****************************************** Signature MECHANICAL Signature Company State Cert. or Regist. # City License Registration # ****************************************** Signature Company State Cert, or Regist. # City Lice ~egistration j '7"~.. OTHER APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit 'Iay be subje~t to "deed restri~tions" which lay be lore restrictive than City regulations, The undersigned assules responsibility for ~olplian~e with any applicable deed restrictions. . B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a ~ontractor or contractors to undertake work, they lay be required to be licensed in accordance with state and lo~al 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 law. If the owner or intended contractor are uncertain as to 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 contractorlsJ 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 indi~ating that you, rather than the contractor, are responsible for the work, If the contractor wishes you to sign as contractor that may 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 FEE2. 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 Constru~tion Lien Law - HOleowner's Protection Guide" prepared by the Florida Departaent of Agriculture and Consumer Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to coalencelent. 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 aade to obtain a perait to do work and installation as indicated, I certify that no work or installation has cOlaenced 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 coapliance. Such agencies include but are not lilited to: f Departlent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treatment f Southwest Florida Water "anaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environaental Protection AQen~y - Asbestos abateaent 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 "coapensating voluae" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perait 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 perlit 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 per.it is cOlaenced within six months of issuance, or if Nork authorized by the perlit is suspended or abandoned for a period of six lonths after the tiae the work is cOltenced, One 90 day extension of tile, .ay 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, or the project Nill be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCE"ENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEKENTS TO YOUR PROPERTY. I YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN AT Y BEFORE RECORDING YOUR NOTICE OF COKKENCEKE , JOBS NDER $2 IN VALUE DO NOT NEED TO RECORD AND POST A"N IC OF "EHCEKENT", STATE OF FLOR~ COUNTY OF ~---D The foregoing instrument before me this ~L) was acknowledged , 19..2?2 by STATE OF FlOR~~ COUNTY OF ~:>__ The foregoing instrument was acknowledged before me this ~ , 19~ by who is personally known 1;.D me or who has produc~d ~YC-/""'S Lc~~cC as identification and who did/did not t.k~p':~ ~-;tv~ (Si~% c ~ .. 6?~ ,rl'/r . W/I"u (Name Typed, Printed or Stamped) NOTARY PUBLIC IIIOTAaY PUBLIC STAT! OF FLOiio' ~ OOMHISSION EXP. MAR,19.1994 aoNDBD THRU GENERAL INS, UNO. who is pel-sonall y knownz Ill!? en' whc, has produced ?~-I y~ . C!~.5 G as identif'cation and who did/did not take al flIt)'1' AIrY PT. IW QO 7BtlC S'l'A'l'l'!' 0 .8Otm :l'tMISSION ,~';p " l' ?WR11h1 ,.liD JtfRI} Ch:'i;'~'~1 NAP, 1 q,; :)')4' , .., '. ~ [!>,i.(; II;;:>.