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Home My WebLink About94-3851 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N ~ 3851)1 Date d.2 - J) - f y BUILDING ELECTRICAL PLUMBING ~CHANI""@ Sewer Conn Water Conn: Pmperty Owne' h:4~#L- Job Address: tt r /' Parcell.D. # eJ. - d-h -~/ -r-o Water Meter: T.I.F.'s: Zoning: Energy COdet": Description of Work ~(.L r ;~ Radon Gas: 1:f~ ) J' / Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. FINAL C.O. DATE DATE Inspector Permit Fee Signature Company Address Telephone# ~~ Valuation or Contract Price 1 t ;;...5.-:' tri) City License Registration # ~ State Certified License# :l:t -!?yy E ~)~~ A~~ BUILDING ELECTRICAL PLUMBING MECHANICAL 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 ($15.00) 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 PERl"lIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT ADDRESS 1?tth('.? ProptU'lt tJL6 ~ 444' AlU-n Ra. DOl1ttl cl S~LL ..f-fer JOB LOCATION "'df~ PeM' Oa.k'SIM Ale, Jn~ APPLICANT PHONE 7g;). - SO,:3 OWNER LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.# WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign ____Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____# of Units .____M / H ____Commercial ____Indust. ____Swim. Pool Other .~ ____Restaurant & Health Department Approval BUJLDING SIZE: x_. Square Feet. Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~~S.** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL ,~ ____MEt:HANICAL AMP Service Florida Power Corp. _H.R.E.C. $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** ~ ::::::~:~ : 9 CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # """'*"*""":::::::*"*'~~~'(:JC:u,~ ~C~ ~ a State Cert. or Regist. ,! _ City License Registration ;F /57 ~~ . ~~ A ~ ~~~~ ~~~~~~~~~~~ h'" * .. ...*..**.*.**..**.**. h......"" ....""""".. Company State Cert. or Regist. # City License Registration ~ **********************t-******************* BUILDER Signature PLUMBER Signature ~ Signature ~~ Company ~r'~ PrOptUle GttG ~ A!C-h "J:hc State Cert. or Regist. l? CACo4Bq"l City License Registration ~ )( MECHANICAl ****************************************** Company State Cert. or Regist. # City License Registration # OTHER Signature ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perait aay be subject to "deed restrictions" which lay be lore restrictive than Citi regulations. The undersigned assuaes responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake Nork, they lay be required to be licensed in accordance .ith state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay b~ cited for a aisdeaeanor violation under state IaN. If the owner Dr intended contractor are uncertain as to what licensing requireaents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, i813l 788-6611. Furtherlore, if the ONner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions (;f the "Contractor Sections" of this application for which they Nill be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the NorK. If the contractor Nishes you to 51g0 as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges ir 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 Nith a copy of "Florida's Construction Lien LaN - HOleoNner's Prot~ction Guide" prepared by the Florida Departaent of Agriculture and Consuler Affairs. If the applicant is sOleone other than tce "owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it ti' the "oNner" prior to co.aenceaent. ., i E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all Nork will be done in coapliance with all a~plicable laNs regulating construction, zoning, and land developaent. , Application is hereby aade to obtain a perait to do Nork and installation as indicated. I certify that no NorK or installation has co.aenced prior to issuance of a perait and that all Nork Nill be perforled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other governaental agencies aay apply to the intended NorK, and that it is ay responsibility to identify what actions I lust take to be in coapliance. Such agencies include but are not liaited to: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/WasteNater Treataent f SouthNest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable WaterNays f De artaent of Health & Rehabilitative Services Environaental Health Unit - Wells, WasteNater Treatlent, Septic Tanks f Environlental Protection AQency - Asbestos abateaent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage pla;i addressing a "colpensating volule" will be sublitted Nhich is prepared by a professional engineer registered in the State of Florida prior to pertit issuance. A pertit issued shall be construed to be a license to proceed with the NarK and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a ~erlit prevent the Building Official froD thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole ir,valid unless the NarK authorized by such pertit is coatenced Nithin six lonths of issuance, or if work authorized by the perm1t is suspended or abandoned for a period of six lonths after the tile the work is cOltenced. One 90 day extension of tile, ~a, be alloNed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection aust be logged during each six to nth period, or the project will be considered abandoned. IIARNING TO OIlNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR PAYING TI/ICE FOR IMPROVEMENTS TO ',OUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT IIITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COHMENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: CONTRACTOR SIGNATURE: OIlNER OR AGENT was acknowledged , 19_ by STATE OF FLORIDA COuNTY OF The foregoing instrument befctl-e me th i s STATE OF FLORIDA COUNTY OF The foregoing instrument before me this vJa.s ackno\.jledgE.d , 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 Dr who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed Dr Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC