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Home My WebLink About93-3097 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ _3097 f 3-/<6'-9'3 Date Property Owner: Job Address: Parcell.D. # EL~ ~ <f:~~h~~-# ~.. Sewer Conn Water Conn: ~.... {J~ Water Meter: T.I.F.'s: Zoning: Description of Work Energlde: ~ e~.IJ.t1A - C/V:::G"q~-6~_4M~L - - ..:2-.s- - .3 FINAL 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. Valuation or Contract Price iff- . Permit Fee Signature ~t~M.e e(,-,,- Company Address City License Registration # State Certified License# ELECT ---' ----- Tp. Serv: Rough In Meter Can Const. Pole Pool Pre-Meter Final PLUMBING Breakers Ducts Insl. Compressor 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 ($15.00) 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. '~'._'. ..~" k~ .~'o~ . '_'''__ .~..__ '"".n, ""..-,"" - .. ' APPLICATI05 FOR PERI/'lIT CITY OF ZEPJIYRllllLS BUILDI5G DEP~HE!i'T OWNER'S NAKE L.JM f5 II- f'12- P110NE OWNER'S ADDRESS vu(Y1 Bit-pI<.. sO-At.{ S 6 ~'-1 /11/-e.... JOB ADDRESS !:> ~ f. '-15 b -th ;1v~ LEGAL DESCRIPTION: LOT(S) B.L.OCK SUBDIVISION PARCEL I. D .1 IOORK PROPOSED:_Miew Construction _Addition _Alteration ~Repair _Install _Sign _l!fove _Deaolish PROPOSED USE: Single Fanily _KIF _, of Units _H/H _eo-ercial _Indust. _Swi.. Pool Other _Restaurant &: Health Departlllent Approval BUILDING SIZE: x Square Feet. Height RESIDENTIAL: COKKERCIAL : ATTACH (2) PLOT P!...MiS &: (2) SEI'S OF BUILDING PI...OS &: (1) SET ENERGY FORMS. ** ATTACH (3) SEI'S OF BUILDIJIilG PLANS &: (1) SET EOOERGY FORJ.~S.** **COPY OF CONrRACl" REQm:RJID. PERK Its REOUP_'iTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power COrp. W.R.E.C. _MECHANICAL ~UKBING s Valuation of Mechanical Installation GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION!: _Block _Fr~ _Steel Other FINISHED FLOOR ELEVATIm~.S: FT. IS PRO.JECT IN FLOOD ZONE ARE..\? YES NO ****************************************** COlln'RACTOR SECTION COI!fPAHY St:ate Cert. or Regist. 4# City License Registration 4# ****************************************** BUILDER Signature Sismature CO'!IPANY State Cert. or Regist. 4# City License Registration # ****************************************** RT..ECTRICTAN PT,UKBER :t . COlfPAOtY CoP{ I'/l PI V~.6/1- ~ SL.ci.<:-€- Gc~:;~ ~-;:: Rebi~t. i# tu<.f ~ City J"icense Registration ****************************************** Signature CO!IPANY State Cert. or Regist. # City License Registration I *"''''***************'''***********''''''********** MECHANICAL Signature COlfPANY State Cert. or Regist. j Cit,y License Registration # .********************.***.**...*.***..*.*. OTIJER. Signa ture APPLICATION APPROVED BY PERJ."fiT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this per.it ..ay be subject to .deed restrictions' which lay be lore 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 contractD~, or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If tn!~tb~actor i~,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 for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, [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 Mill 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 - Ho.eowner's Protection Guide. prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the 'owner', I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the 'owner' prior to COllencelent. 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 developlent. Application is hereby .ade to obtain a per.it tD do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a per.it and that all work will be perfor.ed 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 tay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies includ~ but are not lilited to: f Departlent Df Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally 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 Departlent of Health ~ Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks f US Environlental Protection AQency - Asbestos abate.ent 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' will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit 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 technical codes, nor shall issuance of a per.it prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violatiDns of any code. Every perlit issued shall beco.e invalid unless the work authorized by such perlit is cO.lenced within six tonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six lonths after the tile the work is com~enced. One 90 day extension of tiDe, .ay be allowed f~r 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: ytlUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVE~ENTS_TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF eO'KENe"'NT. JOBS OND'R '2.5DO IN V.lU' 00 NOT ",'0 TO R,eORO :::;:~::"'"e"'NT" SIGNATURE: OWNER OR AGENT STATE OF fLORIDA COUNTY OF The foregoing instrument before me this STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19____ by was acknowledged 19_____ by who is personally known to me Dr who has produced as identification and who did/did not take an oath. who is personally known to me Dr 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