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Home My WebLink About92-2260 BUILDING PERMIT Permit 2260/1, "I-9-Yd- CITY OF ZEPHYRHILLS (813) 788-6611 N~ Date -~~ ~.. :~~:::,~s:~2 J!;;I~~;:A ~- Parcel I. D. # Zoning: Energy ~odf: Radon Gas: DescriPtionofWork"~ -j./ (7-.7 ~1"~ . /LA1-(-' ~Nlc~ewer Conn Water Conn: Water Meter: T.I.F.'s: Complete Plans, Specifications and Fee Must Accompany Application, All work shall be performed in accordance with City Codes and Ordinances. FINAL C.O. DATE NO OCCUPANCY BEFORE C.O. DATE Inspector Pe'mlt Fee ~ ~ Signature~_ ~ ~ - Company Address Telephone# Valuation or a - Contract Price ~ / 7:...s . cTO City License Registration # 9' / State Certified License# _ ~NG -----. Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final ~ICAL -------. -~ING ----- 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 ($15.001 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. JOB LOCATION APPLICATION FOR PERNIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT UJ~ S-73 - ADDRESS OWNER LOT SIZE x AREA SQ. FT. LEGAL DESCRIPTION: BLOCK SUBDIVISION PARCEL 1. D. iF WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~ ____Install ____Sign/Temp. ____Sign _l'love ____Demolish PROPOSED USE: ____Single Family ____M/F ____iF of Units _____H I 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 & (l) SET ENERGY FOID-1S. ** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction $ AMP Service 111~ Florida Power Corp. _\-l.R.E.C. _ELECTRICAL ~ECHANICAL 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 ETFCTR1CIAN Company State Cert. or Regisc. # City License Registration # ****************************************** Si!!nature Company State Cert. or Regist. " City License Registration 1 PLL'MBF.R Signature ****************************************** MECHANTCA:-:2J. ~ Company ~~,.).w. Signature ~~~***.*,;~*.;~~~:;.~;;;~::;:;;;~;;~~;~'~C~S-~~~ Company State Cert. or Regist, # City License Registration # OTHER Signature APPLICATION APPROVED BY ~*~~~***~**;JL**~~***~~~~~~~~~~~~~~**~~*~ ....~... ~_................,............... G PERMIT OFFICER. CONDITIONS OF PERMIT AFFIuAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit may be subject to "deed restrictions" which may be lore restrictive than City regulations. The undersigned assules responsibility for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they may 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 contra~tor lay be cited for a lisdeleanor violation under state IaN. 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 Department, (813l 788-6611. ~, Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sl 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 Suide" 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 docu.ent and promise in good faith to deliver it to the "owner' prior to cOIQencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all Hork 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 performed 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 governmental agencies may apply to the intended work, and that .it ,~~ IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited ~~ f Department of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, .~ Water/Wastewater Treat.ent f Southwest Florida Water KanaQe_ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Ar_y Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Depart_ent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environ.ental Protection AQencv - Asbestos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" or "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 perait 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 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 perlit is cOllenced within six Bonths of issuance, or if work authorized by the permit is suspended or abandoned for a period of six .onths after the tile the work is cO&aenced. 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 must be logged during each six lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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 RECORD I OUR N E OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE F COM ENT". SIGNATURE: OWNER OR AGENT STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument befon? me th i s l<'Jas ac knol<'J 1 edged , 19__ by who is personally known to me or who has produced as identification and who did/did not take an oath. l<'Jho is persol;!'-ll,y knc,wn. to me or who has produced'. . as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC of"'" Wf:ST PAUil BEACH 1387 N, KJliWol lAKE PNlI<, FL ~ PAU.4 BCH,: &46-1407 MARnN: ~~ ST, LUCIE: 0461-'J271 =iAlr .\,,OJ iUUI ~y tiUC,"U II.;;) Southwest Inc. COf\PORAtt OFFICE 6280 ARC WAY, FORT MYERS, FL c.39' 2 FL WATS: 1 (800) 432-5562 FORT lIYE!\S 6280 AAC WAY FT, MYERS, FL ~1 2 CHARLOTTE: 6:l~ LEE: 275-8720 COWER: 5Il7-1ll9O PASCO 845-1212 SEKVICE INVO CE .----;- / ~~ "'" <. FOAT LAUDER All 500 S,W, 2111 TERR, B 103 FORT lAUDERDALE, FL 33312 DADE: 621-&412 BROWAAD: 7$1-5e06 BOCA RATON: 3M-17~ TAMPA ST. PETERS.VAG ~4 1 1144h TERR. N, CLENlWATER, FL 3-4622 Cl..ENIWATER: 57~ TAMPA: 225-137; lAKELAHD 1147.00e5 ~Tl\Tf n n fli:D CACO 354 <,:If. SARASOTA 365-427g DATE 4"6) - 9.( WORK TO BE DONE SOURCE COST OTY. )/J6C/~ (// 0- b?//.// /ITEM _n .., ~ /'-;/l- h-e::'1 L' >" ';"'It ~~/t''''4/;-k ,/ / - 5~~-~4~#fL'A: /0 c/11'//-- vr7'.4/~v5~/ ~tJK) .-cf4/~ iv &~ /A?~ c7P ;1'5---- C;Z/'i/[~C) 'pLEASE PAY FROM THIS INVOICE i~ (OU Af~E Si~TISFIED \!\IITH THE SEW/iCE TODAY TELL p, FRIEi\JD !F i,jOT f')LU:Sf~ : t: , C)U S :CF ~~_D ,,-' : " 1m. ~tf..) P'nt ()" 'I " I I v ~O~ Eg> TO // -' FROM TIME DEPARTED TIME DEPARTED SERVICE PARTS SERVICE LABOR ,I J '" <;:" /".< TRAVEL TIME: TIME ARRIVED TIME ARRIVED TERMS: NET DUE ON COMPLETION o 6 Thl$ inVOIce IS SUbjllCl to a FFOilnce Charge 01 1.1 2% per month, Annual Percenlage Rale of 18~ wh,cll IS. allowed by law It IS &gret!d ane' understood by the partIe' that all eq\.Hpment and p,uts which are sold pursuant hereto shall NOt ""',"'" become fIxtures or paft of the real estate where they are placed Said parts and equIpment shall at all limes ,"'/;:...... remain personll properly and the utle th.reto shall remain In the seller until paymenllll lutlls received Burer 0 I hereby a~rel;!:' thai all parts and equlpml;!nt rllay be lepossf"ssed of) the "'''t.'11l ot non.p(l~'llenl See Je"er~e s,de ,. 101 warranty and IIlSlfuCt,ons -:.)-t II 1 I,.tve authollt, to or~""zllt! ark as outlined above I <I~ree 10 P<JY ,111 C(1~IS and J"',l'iOnabl,: ilth)lnf'Y S let~ ,j 11\ s ,n,o,c, "P'0C<7'''. h. ,of, ."oon~o, ;;;;;"on , ',: , i/ rJ1l,uL 7!/!tt~j7\...- ", I TECHNICI~/?kRE~ ./ JR;/It/. /! --K . (~, '~UST .R'S~ATURE t./ " j '-ARD EXP !&~ . ~O. DATE' -,--' CUSTOMER DISCOUNT 0 TOTAL CHARGE //9)$.../ ,~~ DEPOSIT $ /1"') "- BALANCE DUE $ /Coo .-