The URL can be used to link to this page

Home My WebLink About92-2786 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N<l 27868 /1- 1.;1 -;1 d- Date GLDIN~) ELE~ PL~_ MEC~ Sewer Conn Water Conn: Pmperty Owne" t4~~ '-!1t. J"2:2v W"e, Mete" Job Address: -3_ - b _ ____ -e..- T.l.f.'s: Parcell.D. # /~ -:2 6 - .;)..j.... (j a ..1 A - 60.).. cJ 0 ,- c;- b.;L 0 Zoning: (,_--Energy 5fd~: / ~ Radon Gas: ~----;J De,c"p.''" of Wolk A~ ~"', ~ {t !f:r, T ~-~ 4C-~ e.... 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. E Valuation or Contract Price ~A Permit Fee '- c..'t!J # ~ 'Signature';::; t:"74 ? /~~ -A/\ ./ t. Company Address Telephone# City License Registration # t6 0 5 State Certified License# 1J .~ -I-J &r..dA~~ ~UILDIN~ Ftr. Pre SLB Lintel ELE~AL --- PLU~ ~L Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned wark 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 PERKIT CITY OF ZEPIIYRHILLS BlIIIJlIB'G DEPAR'IKEXI' OWNER'S NAME ~~ ~4- /d ~ mONE . ' OWNER'S ADDRESS d't?Z /R -<A-V<.~ ?;(;;;t-_ ,6'~~ ~hI b=.~ 74e~ y--:>}o~ .JOB ADDRESS S 7 CJ 5. <? 6' "~ c:'t<.'-f \ U~4( LEGAL DESCRIPTION: LOT(S) B.L.OCK SUBDIVISION(/':::;7 _L-:t~ PARCEL LD.' I;<-/?b -.J./-oo;,<A-&o,;Zt::Jo,oo.;;Zo . ~ WORK PROPOSED:_~ew Construction _Addition _Alteration ,--Repair _Install ~lish _Sign _Hove PROPOSED USE: Single F3IIily _KIF _It of Units ~/H _~rcial _Indust. _S~. Pool Other _Restaurant &: Health Depan:.ent Approval BUILDING SIZE: c; r X r2 57 f5 75- Square Feet.. d ," / . , Height RESIDENTIAL : COttKERCIAL : ATTACH (2) PLOT P.I.AliS &: (2) SETS OF BUILDING PLOS '&: (1) SET ENERGY FORKS. ** ATTACH (3) SETS OF BlHLDDlG P.I.AliS &: (1) SEI' ENERGYFORHS. ** **COPY OF C01'ITRACl" lUlllUJIRED. PEmnTS REQUESTED _BUILDING $ Valuation of Tot:al Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. _MECHANICAL s Va1\!.i.&t:ion of :fechanic:d Installation _PLUKBING GAS ROOFlliG SPECIALTY TYPE OF CONSTRUCTION: _Block _Fra.e _Steel Other FIlIUSHED FLOOR ELEVATIOlNlS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONJTRACIOR SECTION BUILDER Signature COIIPMilY State Cert. or Regist. 4/f City License Registration #I 69 J') < ****************************************** Si!m3ture COIIPMiY State Cert:. or Regist:. It City License Registration I ****************************************** ELECTRICIAN Signature COIIPMiY State Cert:. or Regist:. It City License Registration I ****************************************** PLUKBER MECHANICAL Signat:ure COIIPMiY State Cert. or Regist. I City License Registration I ****************************************** OTHER S ignat:ure COIfPMiY State Cert:. or Regist.. #F City License Registration I ****************************************** APPLICATION .:f'" ,....,<;."\.-:'.'<;,... }" .,'~"".. ','.p. EliCIQ'T ~.,' ~...." ER. '-1.tJ,i1 !'."'. 'i' CONDITIONS OF PER~IT AccIDAVI~ A. NOT I CE OF DEED REST25..I (J::_LQI\I~:; The undersigned understands that this perlit lay be subject tn 'deed restrictions" which may be lore restrictive than City regulations. The undersigned assules responsibility for coapi.iance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or c~nt~~~;~'t~d;;i~;;-;~;k:~~y~y-b"';-;;Quired 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 lisdeleanor violation under state law. If the owneT 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 Depart.ent, 18131 78B-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 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 - Hoteowner's Protection Guide' prepared by the Florida Departtent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the 'owner', I certify that 1 have obtained a copy of the above described document and promise in good faith to deliver it to the 'owner' prior to (ot.encetent. 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 compliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby tade to obtain a pertit to do Mork and installation as indicated. I certify that no work or installation has cOltenced prior to issuance of a pertit 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 lay apply to the intended work, and that it is ty responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to: f Departtent of Environtental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment I Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArtY Corps of Enqineers - Seawalls, Docks, Navigable Waterways f Departlent of Health ~ Rehabilitative Ser~ces. Environtenta~~lth Unit - Wells, Wastewater Treatlent, Septic TanKS f US Environ_ental Protection Aoency ~ Asbestos abate.eM I also certify that, if fill taterial is to be u:ed in Flood Zone <A' Dr "A,etc.', it is understood that a drainage plan addressing a 'colpensating volule' Mill 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 perlit issued shall becote invalid unless the work authorized by such permit is cOltenced within six lonths of issuance, Dr if work authorized by the permit is suspended or abandoned for a period of six tonths after the tile the work is commenced. 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 lust 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 HAY 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". ~ /J,~/~~ ~~TURE: CONTRACTOR STATE OF FLORIDA . ~ COUNTY OF f/ ~ The foregoing instrument was acknowledged before me this //- /62 , 19..u.. by .PcYtJJ d) ma()/I'Yt who is perso~a)ly known to me or who has produced ~J?/e?U/J as identification and who did/did not taY/=J~i~p(} (9iBnature) k. n /-I-d / ~Jr . (Name Typed, Printed or Stamped) NOTARY PUBLIC ~ STATE OF FLORIDI\r:::;/ COUNTY OF / .',.. ~-6/ The forego i J~1:j instrument vias ac knovJ 1 edged befol-e me this '//-/-2 , 19~ by ))0)1 /" )~ who is pel-son5lyly known to me or \'lhc. has prDduced ~~~ as identification and who did/did not ta~~~ (}1 (SiwwtJ',-e}-h II Tr. (Name Typed, PriJlted or Stamped) NOTARY PUBLIC R. .. HILL, JA. St8l8 of Florida My eomm. Exp. Oct. 6. 1996 Comm, # CC 233803 , II. .. ........ 8bdI 01 FIOItda My Comm. &lID. Oct. 8. t. Comm, . CC 233803