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Home My WebLink About94-3909 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N C! 3909 (5 b~~7J Date .3 - / / - ? l/ ~d~() ~~~ c;LECTR~ Pmpe"" Owne" ~ :31 Job Address: ~ . '. SA. Parcell.D, # PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: z.: Code: Description of Work ~~ (J ~ ../~~ J ;.:::~~ ,-t~-i. r-=- (; aA.#.A- NO OCCUPANCY BEFORE C.O. FINAL s DATE Complete Plans. Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Pe,mit Fee ~ cstf1 Signature '"fJ1... ^ /Ilt./f'1'l Company Address Valuation or Contract Price ~,. ~. (7Z) City License Registration # State Certified License# 8f J>d.- 9 3 96) - Telephone# tfW}U'/} PLUMBING MECHANICAL Ftr. 3 -lb-t;4 ~lLL Pre SLB Lintel . i FRM. tf- - Cf4 Insul. CL WL m Tp. Servo ~ Rough In rf-l-t(L/ :rb- Meter Can Canst. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor 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. Y\I\ t'\ rLYt L-AR-So/0 ~4 il rn~'e.Y4,v~ '0 R. VALUATiON ~ {aIDOO JlZ,5.';'0"f 2-4- 0 Sq II f-r: 1-l VI I" c.;, SqL FT. CrTHt:-~ &HLDING- ~1.5o H..uMBlN6 - .N/A se> ELELTf\l LA L - :;).l- M(:d.lAN tOlL - 1\11 Pr SU~lOTf\L'" qOt C () CRE-\)\T NIp, ICirltL PE~MlT : qo. oD CONN E:.LTION P,=.E-S S~wM - WA-r~ - Njrr fY\E-~ - 7O-r/iL : RADvN bAS - ~ 240 SjLrr '~AN5po~:rATlorJ I Mpl'rc...-r FEE- N/A 7077tL: qz,l-fO ". APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT PI CAr k kr50~ OWNER 5LJ II p I~(,K , Q.("\de.r ;lIvt.. )......a..rs Cf\ 6" PHONE .'B;).-.Q?J-Q2 ADDRESS JOB LOCATION 51.111 ~ }Ol V...~eCif'-l2.. ~"" LOT SIZE x AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. ~t WORK PROPOSED:____New Construction ~ddition -Alteration _Repair _Install ____Sign/Temp. _Sign _Move _Demolish PROPOSED USE: ____Single Family _M/F _4t of Units ._M/H _Commercial _Indust. _Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: ; J.. X ;(0 . ~1JO Square Feet, RF+ 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 FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED 'f BUILDING -1-ELECTRICAL $ Valuation of Total Construction 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. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. 4F City License Registration 4F ****************************************** BUILDER Signature F.T.F.CTRICIAN Company State Cert. or Regist. 4F City License Registration 4F ****************************************** Silm.ature Signature Compimy State Cert. or Regist. 4F City License Registration 4F ****************************************** PLlJMRER Company State Cert. or Regist. 4F City License Registration # ****************************************** MECHANICAL Signature Company State Cert. or Regist. # City License Registration 4F OTHER Signature APPLICATION APPROVED BY ~*******~**************************** ALl'C] oMw- PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this per.it ..ay be subject to "deed restrictions" Mhith aay be .orl rlstrittivl than City regulations. The undersigned assu.es responsibility for co.pliante with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by laM, both the owner and contractor .ay be cited for a .isde.eanor violation under state IaN. If the OMner or intended contractor are uncertain as to what licensing requireaents aay apply for the intended Nork, they are advised to contact the City of Zephyrhills Building Departaent, IBI3} 788-6611. Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractorls} sign portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the OMner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the Mork. 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 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 Law - HoaeoNner's Protection Guide" prepared by the Florida Departaent of Agriculture and ConsWler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the "owner" prior to coaaenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in coapliance Mith all applicable laws regulating construction, zoning, and land developaent. Application is hereby lade to obtain a perlit to do MOrk and installation as indicated, I certify that no Nork Dr installation has cOlaenced prior to issuance of a per.it and that all work will be perforled to aeet standards of all laMS regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies .ay apply to the intended Mork, and that it is ay responsibility to identify what actions I aust take to be in coapliance. Such agencies include but are not lilited to: . Departaent of Environaental ReQulation - Cypress Bayheads, Metland Areas and Environ.entaIly Sensitive Lands, Mater/Mastewater Treatlent I Southwest Florida Mater "anaQeaent District - Wells, Cypress Bayheads, Metland Areas, Altering Watercourses . ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways . Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks . US Environaental Protection AQency - Asbestos abatelent I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc,., it is understood that a drainage plan addressing a "coapensating voluae" 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 frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid unless the work authorized by such perait is coaaenced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six aonths after the tiae the Mork is coa.enced. One 90 day extension of ti.e, aay be allowed for the perlit with fee charge of tI5.00. The extension shall be requested in writing to the Building Official, An approved inspection lust be logged during each six aonth period, or the project Mill be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF Co~NCEKENT "AY RESULT IN YOUR PAYING TWICE FOR IKPROVEKENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT MITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CDftftfMCE~NT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COKKENCEKENT", SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT was acknowledged , 19 _ by STATE OF FLORIDA COUNTY OF The foregoing instrument befc1re me th i s STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 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 PUBLI C (Name Typed, Printed or Stamped) NOTARY PUBLIC _~/~ Y1~ ...t::..-> :::p 'I ~~. $:I ~r -\ L - I ;J V. (t) 0 ) q , c ~ ~ ! .20 ' / I 4P ..Ja- r~o{L SHf\LL tbE- 6ff~~ H~5~T y\s o\-he., L-\'{i.,vy U-\Lk. O(~ ~ct U~5 s .ViAtt! ~ If A-~\{~~ c..rDI-Wi\.) 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