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Home My WebLink About92-2378 BUILDING PERMIT Permit 2378 7. 5-:29- ~ CITY OF ZEPHYRHILLS (813) 788-6611 N<! Date Property Owner: Job Address: Parcell.D. # Zoning: Energy Code: Radon Gas: oe'eriPtl:;;"Jj)!:f~~<f~~ cy' I<-J:(/z;; E~L ~~ ~ \ ;Ai ~/t,- ~ ~. M~-" Sewer Conn Water Conn: BU~' Water Meter: T.I.F.'s: !~< 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. Valuation or Contract Price -' Permit Fee~ I -7! Signature ~4,.()'&/0 Company Address Telephone# ~7~' C;ty Ucense Reg;,,,.t;on' S'l c9 *' . State Certified License# _ _ ~ PLUMBING ANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers [)ucts 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 ($15,001 shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d, Work not ready for inspection when called. e. Permit not posted on job site. f, Plans not at job site, g. Work not accessible, The payment of inspection fees shall be made before any further permits will be issued to the person owning same. "..._-~'~.""._.. Jrnpnsal Page No. of Sag€S .' ,'. ci.,j H,liO PROPOSAL SUBMITTED TQ'-l PHONE STREET f' JOB NAME { v" ", CITY, STATE AND ZIP CODE JOB LOCATION ARCHITECT /, ( DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: I i,C_ v {/ /( ,... \- , \,. \ i "\A;l ) :L1J:_~''-' ....) ( . .-') '~;{ 1/ ;: r:- / U. .'..: ';'9 t../,!:: mr Jroponr hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: Payment to be made as follows: ~'.. I r::. dollars ($ ). All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifica- tions involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Authorized Signature Note: This proposal may be withdrawn by us if not accepted within days. Attrptuntr nf Jrnpnsul- The above prices. specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance: Signature APPLICATIOR FOR PERKlT CI'IY OF ZEPllYRllILLS BUILDlliG DEP~ OWNER · S lWfE UU 0 i~o77e~ ADDRESS 6615 /l)1 I \~y Ie ~ I') /2 3 9-fff .5"7 {3_~ S/UAf T z - )ii/s' :~ ilL/I.) F~ PIIOU ' FV AI' 7g'A-~ r;f;30 OWNER · S JOB ADDRESS LEGAL DESCRIPTION: WI'(S) BLOC({ SUBDIVISIOR PARCEL I. D. f WORK PROPOSED:_Rev Construction ---..Addition _Alteration _Repair ~Inst:all ~)/ae II~~ _Sign _!!love _Deao1ish PROPOSED USE: Singl.e Faai1y _"IF _, of Units _K/H _<=<-ercial. _Indust. _SwI.. Pool Other _:Rest:aurant &: Hea1t:h nepan:.ent Approval. BUILDING SIZE: x Square Feet, Height: RESIDEHTIAL: COHHERCIAL : ATTACH (2) PLOI' PLARS &: (2) SETS OF BUILDING PUNS &: (1) SET ENERGY FORKs.u ATI'ACH (3) SETS OF BUTI.DDiG PLUS &: (1) SEt' ENERGY FORKS. ** **COPY" OF CONTRACI' KIlJ!fITllED. PERIPIITS REOOESTED _BUILDING $ Val.uatioo of Tot:a1 Construction _ELECTRICAL AftP Service" Florida Power Corp. W.R.E.C. _HECHANICAL s Val.uation of Hechanical. Installation ..K..PLUHBTNG GAS ROOFlliG SPECIALTY TYPE OF CONSTRUCTIOR: _Block _~ _Stee1 Other FIIiISBED FLOOR ELEVA.TIONS: FI' . IS PROJECI' IN FLOOD ZONE AREA? YES NO ****************************************** CORTRACIOR SECI'ION CO!tPMUY State Cert:. or Regist. , City License Registration , ****************************************** BUILDER Signature ELECTRICIAN COIIPARY State Cert:. or Regist:. , City License Registration f ****************************************** SiPllature PLDtBER lDIPARY CItIZ/s /3#(( /~~ Uf/flb ,,(/6 Cj~k.tf/Jn::5 W Sta<e ~<. or R~is<. .. I< ro >0 <11.['1 f5 ~~ '1 C1t:y L~Lceose Reg:I.st:rat::I.on I (I)? ***********************a-****************** Signature CO!tPANY State Cert. or Regist. I City License Registration f ****************************************** KECHMfICAL Signature CO!IPARY State Cert:. or Regist:. It City License Registration f ****************************************** OTHER Signature APPLICATION APPROVED BY PERKlT 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 orc~tractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If the contractor is 1\'6't licensed as required by law,'both the owner and contractor lay be cited for a lisdeleanor violation under state law. If the c~ner 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) 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 ZephyrhiIIs. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE2. D. CONSTRUCTION LIEN LAW (CHAPTER 7!3, 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 prolise 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 regulati~q construction, zoning, and land developlent. Application is hereby lade to obtain a per.it 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 governmental 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 liaited to: f Departaent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/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 Departaent of Health ~ Rehabilitative Services. Environ_ental Health Unit - Wells, Wastewater Treat_ent, Septic Tanks f US Environ_ental Protpction AQency - Asbestos abatelent 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 volute" will be sublitted 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 issuance of a perlit prevent the Building Official fro. 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 cOI.enced within six _onths 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 comienced. 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 inspectiDn lust be logged during each six lonth period, Dr the project will b~ 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 RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". f21u d-1LfS. &~l SIGNATURE: OWNER OR AGENT SIGNATUR~~ACTOR was ar~nDwl~dgad , 19_ by STATE OF FLORIDA COUNTY OF Th2 foregDinq instrument befc'l-e me th i s STATE OF FLORIDA COUNTY OF The foregoing instrument befCtl-e me this was acknowledged , 19_ by whD is personally known to me or who has prc.duced as identification and who did/did not take an oath. who is personally known 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