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Home My WebLink About92-2147 BUILDING PERMIT Property Owner: Job Address: Parcell.D. # CITY OF ZEPHYRHILLS (813) 788-6611 r3-U ,..-' .-"~".. ~~B~2 Ylfs/3t~~) 9TL! ,5T Permit N~ 214iP Date c2- ~/-7'~ BUILDING ---"- ELECTRICAl ---'-' MECHAWC'"1XL ~ Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Description of Work ( DATE 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. DATE Inspector City License Registration # State Certified License# ~~' Permit Fee Signature Company Address Telephone# c~.- ~ ~.I~ ~~ Valuation or Contract Price ---... ......~,~ ydtJ4S BUILDING ELECTRlCAl PLUMBING ---'-_.,'" ---~ ~..'~~ -" -- Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Serv, 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. "'c. APPLICATION FOR PER~IT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT / ,..L. 0 Lit 5 ,SI.iL C;; iC J 7 -If 17-v ,," If/oS ~~ 0'03.0 ~j) .... ?'7 --,t,~/.I/'( 1/, I PHONE Ii) --t.5CY ADDRESS 3 ft~b OWNER Jir;:,": JOB LOCATION 9 'tJ! ~5T: LOT SIZE_X AREA SQ,FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.~F WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp, ____Sign _Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____IF 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. ****************************************** Signature CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Sie:nature L PLUMBER ,~ jJ Jutflc..- Company State Cert. or Regist, # City License Registration # ****************************************** Signaturte-'. ) c~ Q( MECHANICAL Signature Company State Cert, or Regist. # City License Registration # ****************************************** OTHER Signature Company State Cert. or Regist, IF City License Registration # ****************************************** APPLICATION APPR~VED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this peraitlay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned assules responsibility for coapliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they tay 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 aisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireaents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (8131 788-6611. Furtheraore, 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 aay be an indication that he is not properly licensed and is not entitled to peraitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~ 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 - Hoaeowner's Protection Guide" prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docuaent and pro.ise in good faith to deliver it to the "owner" prior to coaaenceaent. 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 coapliance with all applicable laMS regulating construction, zoning, and land developaent. Application is hereby lade to obtain a pertit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perait and that all work will be perfor.ed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other governaental agencies aay apply to the intended work, and that it is IY responsibility to identify what actions I tust take to be in coapliance. Such agencies include but are not lilited to: I Depart.ent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treatlent I Southwest Florida Water "anaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Arty Corps of EnQineers - SeaMalls, Docks, Navigable Waterways I Departaent of Health l Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks I US Environlental Protection AQency - Asbestos abate.ent I also certify that, if fill aaterial is to be used in Flood lone "A" or "A,etc,., it is understood that a drainage plan addressing a "colpensating volute" 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 Mork and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perait 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 coaaenced Mithin six aonths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six tonths after the tiae the Mork is cOllenced. One 90 day e~tension of tile, aay be allowed for the perait Mith 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 aonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCE"ENT KAY 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"KENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". I ??,\" ^ - ~ "(..~, ~ SIGNATURE: CONTRACTOR / STATE OF FLORIDA ~ COUNTY OF ~ ~~: The foregoing instrument was acknowledged '-/')C..Lt:. Ct') b befc1l-e')me this/~t I , 19~ Y x:-<-,~ Le e~~,~ who is personally known pl-oduced ,<.../..k.-~_d . './ l..--' as identification and who didl id not a an oat.( ;), - / /i a _' ~;Cl!,l, LL'Tl-z......... (27 "iC<-<:<{l (Signatu' e) S J'd L. IN If F:! '/ ('II T/-I[K'/ ~Je h-; ,7'1 1<: (' ?J /7/1<; (Name Typed, Printed Dr Stamped) NOTARY PUBLIC STATE OF FLORjpA COUNTY OF fA s ~ 0 The foregoing inrt,rumen~ was acknowledged befclre me thi9--~. ) 'i , 19-1d by -:JfFFR~f L. AhrON who is pel-sclna 11 y known to me €or '.Jtu:. has ~QElYced a5 id~ntification and who-d-i.d..ldid not tak~~. !J (?~ (S~aturE;?)_ /).. ~.i3.f;) E ..J ' ~ 0 s t3;Jf (Name Typed, Printed or Stamp) _ NOT PJRY ...E1!BL leG.. (L. 0.3 ~ I 0 ~ is' It). r t/- Im"A1ff lJIUBlIC STATE OF Ft~rr>> r~v r.,.,'..nssr~~ EXF AUG. 18,1994- 'f~~:.".0C.1 1f~e: ~ U~~,..~ ~