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Home My WebLink About92-2123 '-...~-. ..,-- BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 ~ c2().tJ7) ( BU~OI~~ ~ C ~-):> M~Al ::~:::,~:~? 5i;{ ~~ ~-C.. 0 Permit N<! 212~, Date .,.;L -i .1-- r c2.. Sewer Conn Water Conn: Water Meter: T,I.F.'s: Parcell.D. # Zoning: Energy Code' Radon Gas: Description of Wor~.A j ~ ~ ~( ~ 41.1f:1 ~ - NO OCCUPANCY BEFORE C.O. FINAL C.O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Inspector -~A-- City License Registration # J V / State Certified License# pe'm;tFee~~ Sigllature /- tf ~ Company Address Telephone# Valuation or Contract Price c.mJILDING ELE~L --- Tp, Servo Rough In Meter Can Const, Pole Pool Pre-Meter 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 ($15.001 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 f1 ) 5~-:-,/A ~;r>1 57 /;; 'JF/D~/~ ;8.--,"~/? f~--J) PHONE ADDRESS OWNER JOB LOCATION c~ l :5:.5 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 ____l~ of Uni ts _____M / H ____Commercial ____Indust. ____Swim. Pool Other ____Restaurant & Health Department Approval BQ'ILDING SIZE: x 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 ____MECHANICAL AMP Service Florida Power Corp. _W.R.E.C. $ 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 ELECTRICIAN Signature Company State Cert. or Regist, # City License Registration # ****************************************** Company 'Io.:t-.-----r7~/d--r4:;:;. ') State Cert. or Regist. C1fr City License Registration # ****************************************** Signature PLUMBER j a.A -' /y, ~/"',,-----, . :?7;/ 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 lay 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 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 to what licensing requirelents lay apply for the intended work, they are advised to contact the City'of 2ephyrhills 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 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 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 protise 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 li.ited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water "anaQelent 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 Environlental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone .A. Dr .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 pertit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, Dr 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, Dr violations of any code. Every perlit issued shall becole invalid unless the work authorized by such perlit is cOI.enced within six lonths of issuance, Dr if work authorized by the perlit is suspended Dr abandoned for a period of six lonths 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, Dr the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCE"ENT "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 YALUE DO NOT NEED TO RECORD AND POST A .NoTICE OF COMMENCEMENT.. STATE OF FLORIDA COUNTY OF The foregoing in~trument before me this~ Id-.- was acknowledged , 19 ~ by who is personally known to ~ or~ho has produced 1) Q) VE12 c::, U ttJ~ " as identification and who didi~ n~j) take an oath. ' " (Signa~ ~ /!- (Name Typed, Printed or Stamped) NOTARY PUBLIC ~ - "'tafy .ub11c, Stateo' florida " Commission bpirtS No.. 21, 1992 My Bon4ed lhru T,oy foin . I",urance lAC- r~/~~L-rd SIGNATURE: CONTRACTOR C7 STATE OF FLORI~ COUNTY OF - V/1SC-O . The foregoing ins~L1ment befcl}-e me th is r2 },:;l.. I - was acknowledged , 19~ by who is personally produced as identification take an oath. has (Name yped, Printed or Stamped) NOT ARY PUBL I C ", ...., YuYlc, Stat. .f .... .d (omnftssion bpktSHo.. 21, , My T- fain' Insurance tne., Ilonclecl ThN ... CITY OF ZEPHl'RHILLS BUILDING DEPARTJ\'IENT .~ ' O'r'JNER JOB LOCATION EGAL DESCRIPTION SUB DIV. BLK. LOT Show all existing and proposed structures giving dimensions & setbacks. pJ /tS-'~ ~ ~~'~//- 7.;;L t< >1 PERMIT NUMBER ;z; J. 3 P Approved By CITY OF ZEPHYRHILLS This Lcl Day 'Of~ 191Z<{ , Building InspectoR 4 ~~. cOo Utmtio< superv,s~ City Manager ~ ~ \ ) / " -....__...r.._...'...."-~'- ,-,.._-1" ( i f2LO :1""'1 \..';.." ,FRON k Street ~ ""I NO TE EXAMPLES 1 &. 2) @ (j) 8efback5 for 'R" J Ii-", ~ J? 3 :ZonIng Note ~ 00' \{ bO' >i 1< ~ 8e+6a..<!ks fo'f ~-,4- ~ C:lIl1 H~ I !5' , 10 EK i'::. -rfrl 'J /0' \0 110' . \\) 10' I \~ q., r'~ I e. CI;' 1lJ... pC1i.t 11"'0.... af/eLf WfU::'+ hC) v€ 16 I s'\!.f&s><!..k.. v!;(,1i .6u.,b{.hr,=s /S1c..sl ~hc~ s; 'toe Ff' IO~lAj.... c::J {tO~ . EJ(, ;:5"ti "'<1 Pro p..::. ecl /ldd i+(o'" 1 1 , t;..O 3d /015 sf /0 rf, st ' sf~e-J- _~" ,~_____Et?':I,t~,_ slre~ _ __~_ ,,_'...... _,Er9..~____