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Home My WebLink About92-2837 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.6611 Permit N<! 2837 Date r;2 -2- 'tv Property Owner: Job Address: Parcell.D, # ELECTRICAL ~~I~ MECHANICAL ~)(~ ~~2~~~ ~ -3 /~ _. -' - 0 __ - 5 Sewer Conn BUILDING Water Conn: Water Meter: T.I.F.'s: Zoning: Description of Work ~ Code: ,/'-;; J yr t1.."Y {rn Radon Gas: FINAL ~ -/;t- 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 City License Registration # State Certified License# /l~ , , Signature Company Address Telephone# BUILDING ELECTRICAL MECHANICAL Breakers Ducts Insl. 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 00/100 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. OWNER' S --::> IiAttE ~~ d€-r- ADDRESS tP L( I S R1. APPLICATI05 FOR pERKIT CI'IY OF ZEnlIKH II.T_c; BUIIJ)DiG DEPAR:I'ftr;Jft GYl!,rOLJqr- 6(Jj,,~ ~a0 r~ moD ~'~i~~""'- _,/ J~ '1.. '-- 7Rr -4 770 ~/U~ (ja.J('5 OWNER' S JOB ADDRESS LEGAL DESCIUPTIOlI: wr(s) BI:.OCK SUBDIVISIOR PARCEL I. D. f WORK PROPOSED :_lNJev Construction .-JYIdition _Alteration _Repair _Install _Sign _Move _ne.olish _~rcial _Indust. _, of Units _K/B _SwiJa. Pool ~rq/~~_Ot:her PROPOSED USE: single Faaily _KIF ~t:.auraIlt &: Healt:h ))epa.rt:.eIlt Approval BUILDDlG SIZE: x ~e Feet. Height RESIDENTIAL: COttttERCIAL : ATTACH (2) PLOt PLAlIS &: (2) SETS OF BUIIJ)TIiG PLAlNJS &: (1) SEI' ENERGY FORKS. ** A1TAaI (3) SETS OF BUIIJ)DIG PLDS &: (1) SEI' DRRGY FORKS.** **OOPf' OF OORTKACT KEQOIRED. PI11IlIf1TS "RJl'.OOESTED _BUILDING $ Valuation of Tot:a1 Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. ~CAL $ valuation of Hecbanica1 Installation _PLUKBDlG GAS KOOFDIG SPECIALTY TYPE OF OOIiSTIWCTIOR: _Block ~ _Steel ot:her FI' . IS PROJECT DI FLOOD ZONE AREA! FIllISBED FLOOR ELEVATIOIiS: YES NO ****************************************** aJIIJI'RACIOR SECTlOR Signature CDltPAJIY State Cert. or Regist. I City License Registration I ****************************************** RmT.DF.Il. RI.F.CTRICIAH CDltPMIY State Cert. or Regist. i Si..nature City License Registration f ****************************************** PUllBEK :~ ,A /! =~~fi;{i1~'-- p~~,~ Signature ~ ~~ ~ City License Registration f /~~<\ - *****.*--*~..-*~~~~~~~~~~*************** KEaIAlfiCAL aJIIPARY State Cert. or Regist. f Signature City License Registration f ***********.AA&a************************** flTRF.R COIIPAIIY State Cert. or Regist. f Signature City License Registration f ****************************************** APPLICATIOIi APPROVED BY pERIIIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The und~rsigned understa~s that this per.it ..ay be subject to "deed restrictions" which .ay be .ore restrictive than City' regulatIons. The undersIgned assu.es responsibility for co.pliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake MOrk, they .ay 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 contractor .ay be cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (913) 798-6611. Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) 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 .ay be an indication that he is not properly licensed and is not entitled to per.itting 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 - Ho.eowner's Protection Guide" prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the 'owner', I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the "owner' prior to co..ence.ent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infor.ation in this application is accurate and that all work will be done in co.pliance with all applicable laws regulating construction, zoning, and land develop.ent. Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a per.it and that all work will be perfor.ed to .eet standards of all laws regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended work, and that it is .y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to: f Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands, Water/Wastewater Treat.ent f Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Depart.ent of Health & Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environ.ental Protection AQency - Asbestos abate.ent I also certify that, if fill .aterial is to be used in Flood Zone "A" or 'A,etc.', it is understood that a drainage plan addressing a "co.pensating volu.e" will be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A per.it 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 t~hnical codes, nor shall issuance of a per.it prevent the Building Official fro. thereafter requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall becole invalid unless the work authorized by such per.it is co..enced within six .onths of issuance, or if work authorized by the per.it is suspended or abandoned for a period of six .onths after the ti.e the work is cOllenced. One 90 day extension of ti.e, .ay be allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection .ust be logged during each six .onth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IMPROYEMENTS iO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF C~"ENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCE"ENT". SIGNATURE: OllNER DR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19 _ by STATE OF FLORIDA COUNTY OF The foregoing instrument befc,re me this was acknc,wledged , 19_ by who is personally known to me or who has produced 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 PUBLI C