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Home My WebLink About92-2116 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.6611 Permit :N'! 2116/3 Date cJ. - 7 -?:L. C:-9 E~ p~ ME~ Pmpertyowne, i~4_~~~~~7(~ Job Address: ~ ~_ =---.2~ Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcel I. D. # Zoning: Description of Work Energy Code: ---;1 ~X /v ~ocR Radon Gas: NO OCCUPANCY BEFORE C,O, FINAL Complete Plans, Specifications and Fee Must Accompany Application. C,O, All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Permit Fee ~ c:T7.) S;gnatu,e -g J( ~ Company Address Telephone# Valuation or Contract Price / r?J ' ~ City License Registration # State Certified License# C:~ Ftr, Pre SLB Lintel FRM, Insul. CL WL ~ ~ PLU~ ME~ICAL ~ ~ ~Breakers Ducts Insl. Compressor Final Tp. Servo Rough In Meter Can Canst, Pole Pool Pre-Meter Final Tub Set Water Sewer 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 PER~IT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT '5 'Et/CN. L '::f4D; rH A ADDRESS ~-) 2 f.J - I cp ~ ~ 1- OWNER ~ ..., Eve-Iv. I.... -=\4 0 i 7-1-) f4-. 'A?{.( ~s.. ell JOB LOCATION !;.-7?<t {71ft "b.1-~<?J;;- LOT SIZE~X 60 Rf/S.s E 1/ PHONE ; I .3 - ?&,ff- 7'c1d<f AREA SQ. FT. 7' r9 () (J LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.# WORK PROPOSED:~New Construction ____Addition ____Alteration ____Repair ~Install ____Sign/Temp. ____Sign ____Nove ____Demolish PROPOSED USE: ____Single Family ____M/F ____IF of Uni ts _____M / H ____Commercial ____Indust. ____Swim. Pool Other ____Restaurant & Health Departmer.t Approval BUILDING SIZE: r;-I I L X /0 , /3d Square Feet, /d J 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 ____ELECTRICAL $ / tJO. "5 f.2- . Valuation of Total Construction AMP Service Florida Power Corp. _\~.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ~Steel Other II FINISHED FLOOR ELEVATIONS: ~ FT, ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER ELECTRTCTAN Cor:pc;.n.:..... _ Signature State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration ~ ****************************************** OTHER rYl-t~ Signature t.l~ APPLICATION APPROVED BY Company ~ ' ~/ State Cert. or Regist. iF o \.A~~ City License Registration 4; PERNIT 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 assul!s responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTR(~CTOR RESPONSIBILITIES If the owner has hired a contractor or 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 Dr 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, (BI3) 78B-6611. Furtherlore, if the owner has hired a contractor Dr 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 ZephyrhilIs. 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 promise in good faith to deliver it to the "owner" prior to cO.lencelent. E. CONTRACTOR'S/OWN~R'S AFFIDAVIT I certify that aU the infonaholi 111 tiii~ il"li;~Lii~iLoil i:o ;;~i;i"ti= ~iiil that all i1Gr~ ;;il~ be d01l1? in cOilpliance with all applicable laws regulating construction, zoning, and land dev210plent. Application is hereby aade to obtain a perait 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: f Departlent of Environlental R~Qulation - Cypress Bayheads, W~tland Areas and Environlentally Sensitive Lands, Wat~r/Wastewater Treatlent f Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environ.ental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,ete.', 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 perlit issuance. A perlit 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 is~uance of a per.it prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or vlolations of any code. Every perlit issued shall becole invalid unless the work authorized by such perait is cOI.enced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six aonths after the tile the work is cOllenced. One 90 day extension of tile, lay 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 will be considered abandoned, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT KAY 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 COKKENCEKENT, JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORf AND POST A "NOTICE OF COMKENCEKENT", (J~ SIGNATURE: CONTRACTOR STATE OF FLORIDA ~ COUNTY OF i ~ The foregoing insjtrument was acknowledged before me this ~ ~ , 19~~ by SteveN L. f(l.lSSflf..- '+- J:r.I,'tA A. ~uSSfl( who is per~ly known to me or who has who is personally produced ---- produced as identification and who did/did not as identification ~~~~ rn _ !~ take an oath. ~ture) (Signature) L. ofZ.i B E1-11 l:h. ~(,( sJ [ (L (Name Typed, Printed or Stamped) NOTARY PUBLIC STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19_ by known to me or who has and who did/did not (Name Typed, Printed or Stamped) NOTARY PUBLIC Notary Public, State 01 Florida at Large My Commission Expires Aug, 28. 1994 CITY OF ZEPHYRHILLS BUILDING DEPARTMEN'1' OWNER S'ITt/CIv. .::r "lp,7tf f.?V';" JC II JOB LOCATION .1.' 7d~ I C; -d/~ 7'" 2 C-~H.J"'lH.'''/I.I LEGAL DESCRIPTION/SUB DIV. BLK. LOT Show all existing and proposed structures giving dirnerlsions & setbacks. t< "' ~ '-9.- >t ... ~t '- , ~t ~ CJ'~ ~ - l' ~ Do "0 "1 ~ (j) 8el back5 for 'R-' J "R-z. ~ J?-3 , :Zoning Note ~ 1< bO' k Street ~ @ \{ \.';.." ,FRONT PROPERTY LINE ~' "'" NO TE EXAMPLES 1 &. 2) ~ 00'- >i , 10 . ....._ ..~.r I !5' 8 e+ 6a..l! ks fot" ~-,4- ~C::Hrl H~ q., r'~ I e. en- 1lJ... pC1i.t 11"'0.... af/eLf WfU::'+ hC) ve 1.5 I s'\!.f&s><!..k.. 'u!;(,1i .6uib{.h<r.=SIJ1c.'sl ~~~ s;'t.e Ff' IO~lAj.... c::J {tO~ . EJ(,;:5.ti 11<1 \0 --.. /10' EK i::. -,-/11 '7 - /0' . \\) I 10' \~ , t;..O I 1 1 Pro p..::. eel /ldd i+I'o.., 30' sf~e} __~ ."___.__Et?'Jt~, /015 sf s"re~ _...__...'"'''' _,Er''?.~.____ _ / 0 rjy st >