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HomeMy WebLinkAbout92-2836 BUILDING PERMIT Permit 2836~Pl I Date )2--J--9~ CITY OF ZEPHYRHILLS (813) 788-6611 N? Property Owner: Job Address: Parcell.D. # ELECTRICAL ~M81~ MECHANICAL t; t/-~~f?~~ p. Sewer Conn Water Conn: BUILDING Water Meter: T.I.F.'s: Zoning: Energy Code: De,e';"';o" of wo"'~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. DATE City License Registration # State Certified License# e-tJ 6 -- Permit Fee Signatu~ ,,-:- Company Address Telephone# Valuation or Contract Price Ftr. Pre SLB Lintel FRM. Insul. CL WL 1~',#so6 PLUM I Breakers Ducts Insl. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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 ($15.00) 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 PEmlIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT ~.~ ADDRESS .~~ \0 Pc.?~\ocJc.. L-~,~ OWNER c;.l-\- a ~ u ~ LA. \c:. \' \. 'w--" \ "'C IA. 't"l cn..J. 2. ~t..h\ \~ lZ'L\A.. .~ ~ ':)'" ( PHONE 1 <N-q ~ 3 b JOB LOCATION 6"1 ~b \4UVl.11 \\,\\,,\011\\ \.~Y' "'2.'M \\\s . LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION S\ \ veVL rJ"'\<; 5 PARCEL 1. D. ~F WORK PROPOSED:____New Construction _Addition ____Alteration _Repair ____Ins tall _Sign/Temp. _Sign _!'love ____Demolish PROPOSED USE: ____Single Family ~/F ____iF of Units ' _____1'1/ 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 FORHS,H **COPY OF CONTRACT REQUIRED. EF.RMTTS 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 0ECTTON Company State Cert. or Regist. # City License Registration a ****************************************** J3UILDER Signature Company State Cert. or Regist. 0 City License Registration a ****************************************** ELECTRTCTAN Si!lnature Company ~LJ~ '\ic..; \. v-V \. ~ ~\ \ OV\l State Cert. or Regist. # v City License Registration IF ~\"JO ****************************************** Signature Company State Cert. or Regist. # City License Registration # ****************************************** t1ECHANICA1. Signature Company State Cert. or Regist. # City License Registration # OTHER ****************************************** PERtIIT OFFICER. APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The.undersigned understands that this per.it .ay be subject to "deed restricti~ns" which may be ~ore restr.ictive than City regulations. The undersigned assules responsibility~for co.pliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR R~SPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in acco'rdance 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 .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply felr the intended work, they are advised to 'celntact the City of Zephyrhil,ls Building Depart.ent, (8131 789-6611. Further.ore, if the owner has hired a contractor or contractors, he is advised to have the c~ntract~r(sl sign portions of the 'Contractor Sections' of this application for which they will be responsible. If y~u, as the ~wner sign as the c~ntractor, you are indicating that you, rather than the contractor, are responsible for the w~rk. 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 permitting 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 Constructi~n Lien Law - H~leowner's Protection Guide" prepared by the Fl~rida Depart.ent of Agriculture and Consumer Affairs. If the applicant i~ s~le{.ne other than the "owner", I certify that I have obtained a copy of the above described de,cullient and pre,mise in good faith to deliver it to the "owner" prior to cOlllencellent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be d~ne in coapliance with all applicable laws regulating c~nstructi~n, z~ning, and land development. Application is hereby lade to obtain a per.it to do work and installction as indicated. I certify that no work or installation has c~llenced prior to issuance of a per.it and that all work will be perf~r~ed to meet standards of all laws regulating constructi~n, City codes, 20ning regulations, and land development regulati~ns in the jurisdicti~n. 1 also certify that I understand that the regulations of other governmental agencies ~ay apply to the intended ~ork, and ~hat it is my responsibility to identify ~hat actions I lust take to be in colllplianc:e. Suc:h agencies include bill ~l e m,t lillited to: .'" I also certify that, if fill laterial is to be used in Flood Zetne "A" or "A,elc.', it is understc.c<d tJ.~t a drainage plan addressing a 'co.pensating volullle" will be sublitted which is prepared by a professional engineer regist2ied in the State of Florida prior to perlit issuanc:e. A perllit issued shall be construed to be a license to proceed with the work and n~t as authority t~ yiol~te, c:ancel alter, or set aside any pr~visions of the technical codes, nor shall issuance of a permit prevent the Building Official fr~1Il thereafter requiring a c~rrection of errors in plans; construction, or violations of any code. Every per~it issll~d ihall bec~.e invalid unless the work authorized by such permit is comlenced within six months ~f issuance, or if w~l.k authol lled by the per.it is suspended Dr abandoned f~r a period of six .onths after the tiJe the work is commenced. One 90 day c:lensioll of tile, lay be all~Hed for the permit with fee charge of $15.QO. The extension shall be requested in writing to the Building Official. An approved insp.'ectie,n J!lust be le,gged during eac:h six lIonth period, e,r the pr~jed \ii\J be cc,nsidered db.;llde,ned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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 UND $2 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCE SIGNATURE__~E~------------ SIGNATURE DA TE _____~.cl=b=.9.~----------------.------- DATE NOTARY AS TO ~ ~ .~. OWNER OR AGENI~~-----~-~- MY COMMISSION EXPIRES______________________ NOTARY AS TO CONTRACTOR___~~-~---- .. MY COMMISSION EXPIRES__________________ Notary 'ublle, Btata of f10rlda J,,'.:Ei BLACKWELL M~ Comm. Exp. 9-18.96 Comm. No. CC 228545 ',6,' Notar~ Public, Stole of Florida J",."n BLACKWELL M~ Comm, Exp. 9.18.96 Comm. j~o. CC 228545