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Home My WebLink About92-2610 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N'? 261013 Date ~- 3) - 7'2 EL~ PL~ P,"perty Owne, !11:! f~~~ Job Address: ..? ___ _ _ -~- Parcell.D. # ~L Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: Radon Gas: DescriPtionofwork'?'J~d.Jp .A-7.f' _<..~rI?A.4.rft _-C.A.A_ ~C':A'--d .~ __" ~ A .e ~ A.., ./"w,.,.~ FINAL c2 -:;>.. Y - 92 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 Valuation or Contract Price t I 37. crv Permit Fee ,\i::((:.~R- City License Registration # State Certified License# 7/ . Signature Company Address Telephone# ~:7;~ ~ -- B~'LDI!:'~ ~ ~ _.... PLCJ~ ---....... ME~AL -- Breakers Ducts Ins!. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final 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 00/1 00 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. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER 11f-))~a 3'f ..3X ~ ~~ tJ~f.t)~/(40 ~ U7lf- I"W 6. PHONE ~"l :S63v APPLICANT ADDRESS JOB LOCATION LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. ~F tt.( -2(" -2f 5a /0 L1/lo-o O1J/o WORK PROPOSED:_New Construction _Addition _Alteration _Repair VInstal1 WIIIIro/,J<f _Sign/Temp. _Sign _Move _Demolish PROPOSED USE: _Single Family _M/F _IF of Uni ts __M/H _Commercial _Indust. _Swim. Pool Other ,10 .. ____Restaurant & Health Department Approval BUJLDING SIZE: X_, Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR..I1S. ,,,': ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ,',.{: **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING $ IJ37'~ Valuation of Total Construction _ELECTRICAL .f _MECHANICAL AMP Service Florida Power Corp. _\';.R.E.C. $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signature S'v~ 4cd~:'iU10NT~~~~:n~ECTION /7 _ State Cert. or Regist. # 'tt...- ~ City License Registration if ****************************************** BUILDER 7/ ELECTRICIAN Company State Cert. or Regist. # City License Registration # ****************************************** Signature Signature Company State Cert. or Regist. 1~ City License Registration ~ **********************ft******************* PLUMBER Company State Cert. or Regist. # City License Registration 4 ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration # OTHER Signature ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perait aay be subject to .deed restrictions. which lay be lore restrictive than City regulations. The undersigned assuaes responsibility for cOlpliance with any applicable deed restrictions. . B. UNLICENSED CONTRACTORS.AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contra~tors to undertake workl th;Y-may-be reQui;;dl~icensed in accordance .lth state and local regulations. If the contractor is not licensed as required by lawl both the owner and contractor lay be cited for a aisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensina requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 7BB-bb11. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions Df the .Contractor Sections. of this application for IIhich they will be responsible. If you, as the owner sign as the contracte", you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to Slg0 as contractor that aay be an indication that he is not properly licensed and is not entitled to peraitting privileges if 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 Lall - HOleollner's Protectloo Guide" prepared by the Florida Departaent 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 promise in good faith to deliver it t" the .owner. prior to co.aencelent. ., ( E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and I applicable laws regulating construction, zoning, and land developlent. that all work will be done in cOlpliance with all 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 perfor.ed to leet standards of all la,s 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 .y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: I Department of Environmental ReQulation - Cypress Bayheadsl Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatlent I Southwest Florida Water ftanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docksl Navigable Waterways I De artlent of Health & Rehabilitative ServiCES Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks I Environlental Protection 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 volule" Nill 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 frol thereafter requiring a correction of errors in plans, construction, or violations of any code.. Every permit issued shall becole invalid unless the work authorized by such perlit is com.enced within six months of issuance, or if work authorized by the per~it is suspended or abandoned for a period of six lonths after the tile the work is cOI.enced. One 90 day extension of ti~e, edV 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, or the project will be considered abandoned. \lARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHIIENCEIIENT IIAY RESULT IN YOUR PAYING TIIICE FOR IHPROVEI'IHHS TO 'tDUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT IIITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COIIIIENCEIIENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COMI'IENCEIIENT". SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT was acknowledged , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this STATE OF FLORIDA COUNTY OF The foregoing instrument befct)-e me th i s was acknowledged 19_ by who is personally known to me or who has pl-oduced 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 'rupunul Page No. of Pages .,>\.\. 8!.UI~!j {c:t" - ~'J/K""{) SUN STATE AlUM!Nt'M, INC. 37528 Hwy. 54 West ZEPHYRH,LLS, FLORP)A 33>::' 1 (813) 788.7308 , STREET PROPOSAL SUBM.!TTEf,D, 'TO \ f\. \ .,\u'\) -~v~\--~ \ <~ Co, P,I;ILll)'c-,_, _ -:2..-. :2 / (.) L- ~-::..~I...--.> JOB NAME DATE /" i \ \ \ ,). t-. ..-l '-' Ci \ (,- "J. C ':.."?, -A -'"j (..; J.J j / CITY. STATE AND ZIP ODE .-., \\ " .-.... - +4 \ L_ \. ARCHITECT ,.L.\i\-" f'. ~\.....9. ~ ~;;;:'>lfu --..- DATE OF PLANS \ .'..1:'\ JOB LOCATION "--, JOB PHONE We hereby submit specifications and estimates for: \ '\, \ \ '\ s-'~ \..),.:' __ ".,...J ' '-J ~l . r \-.......::, \"f' ,>" .:::, D1 \"'\~()'0 \ , '.J ,\ ,>~(::;",\~~ (-- ~s \', /\ C\-~~S.) {'---.._ Lf~ ('-t- L_ '\...-. ---; ~ , \ (\ ') .:;-.:: '-.:...' .,;.--- ( 'o_~ x' -J C'\-~' f, {.,) I ~ I X I~~ -') L-~ L, : I -\,- / LL ! \~.'(;;.II~- c..,J ,... .'> ~. - Lj I /' ,-', ' ,-'+ ,l--2.- S -c- f \. ( ~'L ') '\ .r:-- r< -- C:l. to_::;>] ()__;,t.. C: 'f ~.....,... \~. ..) -<: ('" ~ '_....-' \, ('"- --=- i::.) ("<) L.l(:. k -; L=~~~-,' lOIU' l,\.Ji .C x r:, \J ....--:.:..~) \ \ ''{ ) -h ; I .\ ( 111' JrupU!i1' hereby to furnish matenal and labor - complete In accordance with above specifications, for the Um of: '=-:::'.. ~ ~;.,"'~~ '0- " ~ ~~, M~ ~, ~,;i ($ \ \ ~ i ~ .~ ) Payment to be made as follows: ........'~ ---~ days, 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. Atttptuntt nf JIrnpnnul-The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payme~t will be made' as outlined above. Signature Date of Acceptance: Signature PRODucr 118-3 L!\IE'@.lnc"Greton, Mass 01471 To Order PHONE TOLL FREE 1 +800-225-6380