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Home My WebLink About94-4004 BUILDING PERMIT Permit ~ CiTY OF ZEPHYRHILLS (813) 788-6611 4004A Jf-d-9-9Y Date ~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Pmperty Owne' ~!fg ~'::::L; Job Address: L? 7 6 ~ f-s/\1-z"-J Parcell.D. # l.i-:Jh-~/- OJVO-O CJ &Do -o'~ 90 Water I'y1~Jer: T,I,F.'s: Zoning: Energy Code: De,e"ptlon of Wo" R~ ~:;I ~ ->h-" Q Radon Gas: / I . It? ,-L.~../'v? A.A J NO OCCUPANCY BEFORE C.O. 1[/ /;)---7- FINAL DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordart:'e with City Codes and Ordinances. DATE Inspector Valuation or Contract Price --.5 t::r-ZJ - t/O Pe,mlt Fee 020. ~ Slg';a,",~"'~ - _ ~ .;,. /7.h -VD Company Address Telephone# City License Registration # State Certified License# ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final Tp. Serv. Rough In Meter Can Canst. 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 ($15.00) 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. --~~_._--_.. -----------------.-. -'-- ,.....,. / __------~- I ~ 6:) @ (~/.9 @ -- ~ -<;;~-< ...~ "-----------------~~- ~-," (:.=:J /" ICl ;.5) "~/ .~/ ~>t:(;; , ,.-:;" / (~~ if '6 ,/ :'1\ (?:\j /, \Q) v: ' @) $6) ! '''~ ~r.. i ",0 t5) i~) ~ II} J@ (g) < _ c( I /li' _ :y /.; ,,-'... Cd;;.. '~., "" ,:..Ii c~ I I'" / ' f2 pn Vt), c y r<'':V1 C~ troy ~' i<~lly Z;vY1~-cC 3Cf 672 t1-e..cJ..d 0woocf Lcop Zephyrl'II/f')j Fk~ 335CfQ ':f/ARLE/ ). /3-JJirJ.l-01t./D .OWQD-OJ.1. i : (\ ) i }.- ! $ s: c~) i-l- i \i) s: """ \.\ - "" tl 19 QJ ~,'~ E;-- I ~ 1.-7'( - -7 t3 ..Q -.s: .~ \1 s;: " APPLICATION FOR PERKIT CITY OF ZEPIIYRBI.I.lS BUILDING DEPAR.1lIEIiT OWNER'S lWtE r4 G L L Y kl, 2, M M ~ J2.... OWNER' S ADDRESS ~ t~ '7 a t:t bA- Do WOCl D - JOB ADDRESS ~ 1 r.r- 0017 PHONE ~ l,~ -7Z8 -,.:) Df:;-} Zer~vh \ ) \.... '-J I .33 ~o LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.0.' I.?> -ril{'l-aJ -D(4l) -oOOoo-o~'to WORK PROPOSED:_Nev Construction _Addition _Alteration _Repair _Install _Sign _Hove _DeIIolish PROPOSED USE: Single Fmlily _H/F _' of Units _HIH _ec-ercial _Indust. _Swia. Pool Other _Restaurant 6: Health Depar~t Approval BUILDING SIZE: x ~re Feet. Height RESIDENTIAL: COfIHERCIAL : ATrACH (2) PI..OT PIARS 6: (2) SETS OF BUILDING PLAliS 6: (1) SET ENERGY FORMS. ATrACI (3) SETS OF BUILDING PLANS 6: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL IiEW CONSTRUC'l'ION. PERKITS REOOESTED _BUILDING $ ~oo . 0 D Valuation of Total Construction _ELECI1UCAL AIIP Service Florida Power Corp. W.R.E.C. _HECBARICAL $ Va1uation of Hechanica1 Inst:a1lation _PLUHBING GAS ROOFlliG SPECIALTY TYPE OF COtiS'lKUCl'ION: _Block _Fralle _Steel ..,/" Other FINISHED FLOOR ELEVATIONS: FI' . IS PROJECI' IN FLOOD ZONE AREA? YES NO ****************************************** GONTRAcroR SECI'ION BUILDER COItPANY State Cert. or Regist. , City License Registration , ****************************************** Signature F.I.ECI1UCIAIi COMPANY State Cert. or Regist. , City License Registration , ****************************************** Sirm~ture PLUHBER COMPANY State Cert. or Regist. . City License Registration , ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature OTRF.R COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature APPLlCAnON APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this perlit lily be subject to "deed restrictions" wbieb lily be lOre restrictive than City regulations. !be undersigned assUIeB responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the OIRIer haa bired a contractor or contractors to undertake wort, they JaY 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 JaY be cited for a .isdeJeanOr violation under state law. If the OIRIer or intended contractor are uncertain as to wbat licensing requirelellts lilY apply for the intended wort, they are advised to contact the City of Zepbyrhills Building Departlent, (813) 788-6611. J Furtherlore, if the OIRIer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for wbieb they will be responsible. If you, as the OlDer sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wisbes you to sign as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HCIII!OIfJler's Protection Guide" prepared by the Plorida Departlent of Agriculture and ConsUJer Affairs. If the applicant i8 SOIeOne other than the "owner", I certify that I bave obtained a copy of the above described docuIent and prOJise in good faith to deliver it to the "owner. prior to COlleDCeJellt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIJation in this application is accurate and that all wort will be done in COIpliance with all applicable laws regulating construction, lOlling, and land develo~t. Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no wort or installation bas CDlenced prior to issuance of a perlit and that all wort will be perfol'led to _t standards of all laws regulating construction, City codes, loning regulations, and land developll!llt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveruental agencies laY apply to the intended work, and that it is If responsibility to identify wbat actions I lUSt tate to be in COJpliance. Sueb agencies include but are not li.ited to: I Departlent of EnvirOJ1lelltal Regulation - Cypress 81Yheads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/llastewater Treatlent t Southwest Plorida Water Managel8llt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t AIIY Corps of Engineers - Seawalls, Docks, lIavigable Watenays t Departlent of Health & Rehabilitative Services, EnvironJeJltal Health Unit - Wells, Wastewater Treatlent, Septic rants t US BnviroDlental Protection Agency - Asbestos abateJent I also certify that, if fill Jaterial is to be used in Plood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "co.pensating volllle" will be sublitted wbieb is prepared by a professional engineer registered in the State of Plorida prior to perlit issuance. A peIJit 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 frOJ thereafter requiring a correction of errors in~plans, construction, or violations of any code. Bvery perlit issued ahall becoIe invalid unless the work authoriled by sueb perlit is COIIeIlCed within sil IODths of issuance, or if wort authorized by the Perlit is suspended or abandoned for a period of sillODtbs after the tile the wort is COIIeIlced. One 90 day utension of tile, lilY be allowed for the perlit with fee ebarge of $15.00. !be utension shall be requested in writing to the Building Official. An approved inspection lUSt be logged during eaeb sil IODth period, or the project will be considered abandoned. WARlIIIIG TO OIlIER: YOUR PAILURE TO RECORD A OICH OP C(JlMllCIIIIlIT MAY RESULT III YOUR PAYIIIG filCH FOR DIPROVIIID!S TO YOUR PROPEm. IP YOU IIlDlID TO OBfAIJI FIIIBCIIIG, COlISULT wlm YOUR LIJIDBR OR lJI AnoRIIY BBFORE RBCORDIIIG YOUR IIOtICH OP alDlBlICItIBlIf. JOBS UlDER '2,500 III VALUE DO IIOt NBBD TO RECORD lJID POST A "NOtICE OF aJOIBlICBMDf-. SIGlIAfURI: 0IftfBR OR AGm' SIGIIA'IUIIB: CON!RACfOR SfATB OP FLORIDA coum OP The foregoing instrument was acknowledged before me this , 19____ by STArE OP FLORIDA COUlIIY OP The foregoing instrument was acknowledged before me this , 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 o~th. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC ..'il>',1~""''lI(..'';!,','''",,,,,,;~,,_,,,, R-= '312.50' SCJ.~' 'S"~\'-I"" :. ~S&er-''''''' I I \' ~ -\ ~ 1 ~ ..4 o \)\, C) bf"'l:~ ' ",?-rO fZ.-I 0.... E-- ~ (2-1 ,,^,...sP r-' <...c::.. ~.c.""\ pE. 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