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HomeMy WebLinkAbout93-3091 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N'! _ 309115 ~-/6-7'S Date L-:-~/ ~AL PLU~-" ME~- Sewer Conn Water Conn: ',- Zoning: Description of Work Water Meter: Property Owner: Job Address: Parcell.D. # T.I.F.'s: Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. FINAL C.O. -/7"---1 DATE NO OCCUPANCY BEFORE C.O. DATE Valuation or Contract Price .~ /~,~':;D' 0-2- L C;ty Ucense Reg;s".';on . .!J- /1'/ ~" La Stat Certified License# / , Signature Company Address Telephone# ~ ~6..b 7k 5 I ,. BUILDING ELECTRIC,A;t::/ ---- PLU~'G -' ~L Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter 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. b. c. d. e. f. g. Wrong Address Condemned work resulting from faulty construction. Repairs or corrections not made when inspection called. Work not ready for inspection when called. Permit not posted on job site. Plans not at job site. Work not accessible. G }\o' t The payment of inspection fees shall be made before any further permits will be issued to the person owning same. - APPLICATION FOR PERtIIT CITY OF ZE:J.lHYRIIILLS BUILDING DEPARTHRINJT OWNER' S RAKE ~"i h r:.ncl 6::fLw-y Sizl//'-€ .5 MIONE r? 13 - 0 OZ / - Ocx 00 OWNER'S ADDRESS ~c:;:.~ t:D1t{'/ A2fp7p1C-/ ~t/r..eS , / JOB ADDRESS # S -4 aL1 (l K'a ~ i/1 l./ <;"'72:J Y...P S- f LEGAL DESCRIPTION: IDr(S) BI..OCK St:mDIVISIO~ PARCEL LD.# WORK PROPOSED :_If\Tew Construction _Addition _Alteration _Repair _Ins tall ~Sign ~I!fove _De.-olish PROPOSED USE: Single FaDlily _KIF _, of: Units _H/H ,~~~ ~~,Other _CoImercial _Indust. _Swi.. Pool _Rest:aurant & Health DeparhDent Approval BUILDING SIZE: X Square Fee t. He igh t ~ RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SEJ'S"()F-iUII.DING PI.MS & (1) SET~ERGY FORHS. ** COHKERCIAL : .....--ATTACH (3) SETS OF BUILDlllG PLANS & (1) SET ENERGY FOIt."'IS.H **COPr OF CONTRACT RIl'Qm:RED. Y-- S16f1) _BUILDING PERmTS REQIW_'iTED $ Valuation of: Total Construction _ELECTRICAL MfP Service Florida. Power COrp. W.R.E.C. _MECHANICAL $ Valuation of: Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCI'IONf: _Block _FraIIe _Steel <) (6'11) Other FINISHED FLOOR ELEVATIOlliS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO *****~~~*~*~**~*~********~**************** CONTRACTOR SECTION nUILDY.R CDIlfPMIIY State Cert. or Regist. 4# City License Registration # ****~*~****~~*~*************************** Signature EI.ECTRICIAN CO!IPMW State Cert. or Regist. , City License Registration f ~***************************************** Si!mature PLOKBER COItPABY State Cert. or Regist. I CitY'License Registration I ****************************************** Signature MECHANICAL CDIlfPMW State Cert. or Regist. f City License Registration I **************.*************************** Signature r- OTHER SI't9N"~ COlD'An kiP9<-&.<<fn-/ ,V/lL= 4k; State Cert. or Regisr:. 1# ES- C)c::)c)O ~ Signature ~ ~ . /a::;~ City License Registrat:ion , . . 9fC{-. .... . ~ * **** **************************** i.:8 fr."!:: ~ I u, ruut:.-./ / APPLICATION APPROVED BY PEIt.~T OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit .tay be subject to "deed restrictions' which lay be lore restrictive than City regulations. The undersigned assutes responsibility for co.pliante with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contracto~ or contractors to undl!rtake work, they may be required to be licensed in accordance with state and local regulations. If tlii!' c'bnfractor is" not'ilicensed as required by law, both the owner and contractor tay be cited for a tisde.eanor violation under state IaN. If the owner Dr intended contractor are uncertain as to what licensing requiretents tay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (8131 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sl sign portions of the 'Contractor Sections" of this application for which they ~~II 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 aay be an indication that he is not properly licensed and is not entitled to peraitting privileges in the City of 2ephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~ 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 Departlent of Agriculture and Consuaer Affairs. If the applicant is soaeone other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to coaaenceaent. 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 developaent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has coamenced 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 ~urisdiction. 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 Departtent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treat.ent f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Aray Corps of EnQineers - Sea"alls, Docks, Navigable Waterways f Departaent of Health ~ Rehabilitative Services, Environ.ental Health Unit - Wells, Hastewater Treatlent, Septic Tanks f US Environ.ental Protection AQency - Asbestos abate.ent I also certify that, if fill material is to be used in Flood Zone "A' Dr "A,etc.', it is understood that a drainage plan addressing a "colpensating volule" 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 froa thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beeole invalid unless the work authorized by such perlit is cOllleneed within six tonths of issuance, Dr if workauthc'Ihed by the perllit is suspended or abandoned for a period of six tonths after the tiae the work is comuenced. One 90 day extension of tiie, lay be allowed f~r the per.it 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 OHNER: YtlUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING THICE 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 $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT", S~,"l STATE OF FLORID~ COUNTY O{ -!-o.s CO The foregoing instru~ent was acknowledged before me thismdr9:l I( , 19...12 by D=-\ m 0-.$ C ~'\ ~ \ ~~____ ~ who is personally known ~o me Dr who has produced f\ ~'\ \. d"h c9 '\\ '-.:Ie r"s , \ t-e nS q. as identification and ..,hc. ,~did nc,t take an oaG ~ (-;f WL~_ (Signature) L I . I " n ~ f;:)r-t:: e 17 . . vv \J ~ c.J (Name Typed, Printed or Stamped) NOTARY PUBLIC SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument befc.re 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. (Signature) (Name Typed, Printed OJ Stamped) NOTARY PUBLIC ;~\ii\~:r;:t... DOREEN L. 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