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Home My WebLink About92-2140 BUILDING PERMIT Permit 2140 j~ d.. -/f- 9:2 .. CITY OF ZEPHYRHILLS (813) 788-6611 N<] Date ...'.:::::::---., ~ E~L 0LUMB~ M~ P<aperty Ow"e'~ ~ ,!';b"'-1- Job Address: 0 ~~ j-, Parcell.D. # Zoning: Energy Code' ~.A -J!-d:~ Gas: Description of work',::/t..A.J' i..?- "E-..;"Vt ~~ Sewer Conn Water Conn: Water Meter: T,I.F.'s: NO OCCUPANCY BEFORE C.O. FINAL C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Inspector DA~ Pe'm;t Fee~ q-'{) ~ Signature" . ~ L?P~ - L!<-f Company Address Telephone# Valuation or Contract Price /~A City License Registration # i '5 Y / State Certified License# Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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. OWNER --~Sk I:: 11;,)) E 12- .:;-fpdy (! A~/E Li- --JDA N IV E- S /<..E IU /) {:;JL JOB LOCATION ,AS-td t/ {! A;:? IE (:7 I' 2 I' JCSC/lh i I I . './ () t4 /....' IV E- APPLICATION FOR PERMIT CITY OF ZEP~qILLS BUILDING DEPARTMENT APPLICANT ADDRESS PHONE ;7 j7..l- -3/-5-.1.. / /-1, / Is LOT SIZE X AREA SQ.FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. 4~ WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install ____Sign/Temp. __Sign _Move ____Demolish PROPOSED USE: ____Single Family ~/F ____4~ of Units _M/H ____Commercial ____Indust. ____Swim. Pool Other ____Restaurant & Health Department Approval BUILDING 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 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. ****************************************** CONTRACTOR SECTION Company State Cert, or Regist. # City License Registration # ****************************************** BUILDER Signature Silmature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRTCIAN Company State Cert, or Regist. # City L~cense Registration # ****************************************** PLUMBER Signature Company State Cert. or Regist. # City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration # OTHER Signature ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PER~IT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit .ay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrittions. B. UNLICENSED CONTRACTORS AND CONTRAC10R RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in actordante with state and local regulations. If the contractor is not licensed a5 required by law, both the owner and tontrattor 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 Zephyrhills Building Departlent, IB13} 788-6611. Furtherlore, if the owner has hired a contractor or cGntractors, h~ is advised to have the contractor Is} 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 respon~i~ie 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 (CHAPTE~ 71~, F'nRIDA STATUTES, AS AMENDED) I certify that I, the ~pplicani, nave been provi~ed with d copy of "Florida's Construttion Lien Law - HOleowner's Protettion Guide" prepared by the Florida Departlent of Agriculture and Consu.er 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 cO'lencelent. 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 develop.ent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I tertify that no work or installation has cOI.enced 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 'y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not lilited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treatlent f Southwest Florida Water "anaQelent District - We115, 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 user. in FloDd Zor,p "A' or 'A,etc.', it is understo~d that a ~rainage plan addressing a 'colpen~ating volule" Nill be sub.itt~d which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A perlit issued shall be construed to be a license to proceed with the Nork and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuante of a perlit prevent the Building Officijl frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid unless the Nork authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of tile, lay be alloNed 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 Month period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY rlESULT IN YOUR PAYING TWICE FOR IHPROYEHENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDEH OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COH"EMCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COH"ENCEHENT'. . . /~I ~,~ '~:' /". ~ . " ..... "L..AJ --SiGN~~~~ --~---------------- STATE OF flORIDA/' COUNTY OF ____;i~~_____________________ The foregoing instrument was acknowledged before me thi~=:~~_____, 19_7~ by C' '. J / /1 ____::tLi(.~~~!~~------------ who ~s personally k~own to me or who has produced ~~_~,25..;L<ttJl.'&_2!._~'t.!- as identification and who did/did not takZ7~ofath(L L.~~ (~;)__~~L~~_-_-------_-----_-_-- _~f~l:-_C~_~~b~5_~~---------------- (Name Typed, Printed or Stamped) NOT ARY PUBLI C ON EXPIRES AUG. 1. 1. MY COMMtSSI . --~~A'TOR------ STATE OF FLORIDA CnUnTV aF _____~~_____________________ Th~ foregoing instrument was acknowledged before me this ~JL-LSL---, 19j12-_ by _r=jJL~~__--_~~_tt~~_t~~l~__-__---- who is personally known to me OF who has produced _~~10_~~~__-~L~~!L~~--- as identi ficatic.n and who did/eH8 not take an oath. ... ::U~____'Cl~~_-_~~------ (Signature) _}2~~~~___rfl__~~~JtL_----~-------- (Name Typed, Pl- i nted or StamPl?d) te c~ FIOrlOa NOTARY PUBLIC Notary ~u~hC, s~a '2 C'~ My CommiSSion Expires F6~, 9, 19.1\ , l.