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HomeMy WebLinkAbout94-4025 BUILDING PERMIT Permit N~ CiTY OF ZEPHYRHILLS (813) 788-6611 _40254 5"//-fr ,- 3D ~ EL~ PL~ M~;w:,cooo . ~ . ;:)"cooo Pmp'''Y own"q Rl'~- ~~- ~ ': Met" Job Address. TI.F, s, Parcell.D. # Date Radon Gas: Zoning: Description of Work NO OCCUPANCY BEFORE C.O. FINAl~~2b DA E Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordar~e with City Codes and Ordinances. DATE Valuation or Contract Price f ~ A-52-.Q.Y , c::I ~ '" Permit Fee Signature Company Address Telephone# ......--- ~J-tf's~c) PLUM MECHA Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp, Serv, Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Ins!. Compressor 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, APPLICATION FOR PERNIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT y~ .:s~ r ::::55 ~.~~~ \ t: ~~~~;~ 7 "I (\ v _ t JOB LOCATION '3 (f\ta 5 , \\{)('''t.-h ~. PHONE ~-::! D jJU)vr-e- ftlG- / M'''-R~r!er LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) 0'2 - 2&- Z-/ BLOCK SUBDIVISION PARCEL I.D.# O{)8D~ 00/00"- OIz.O WORK PROPOSED:____New Construction _Addition ____Alteration _Repair _Install _Sign/Temp. _Sign _Move _Demolish PROPOSED USE: _Single Family _M/F ____IF of Units _____M / H _Commercial _Indust. _Swim. Pool Other , ____Restaurant & Health Department Approval BUILDING SIZE: x Square Feet. Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~~S.*e: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction ____ELECTRICAL ..' _MECHANICAL 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. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature ELECTRTCTAN Company S ta te . C~rt ',' 0,1' Regis t. ;~ City License Registration # ***********************~****************** Signature Company State Cert. or Regist. ~ City License Registration # **********************ft******************* PLUMBER Signature OT~f~ ~o~ l~ Signature Company \., State Cert. or Regist. # City License Registration 1 *****************************************~ . Company ----po...J. ~<:.h~ KQ~~ .~ State Cert. or Regist. ;; Itbw 7 City License Registration if $::-l./.;1. MECHANICAL Signature ****************************************** APPLICATION APPROVED BY PERt-lIT OFFICER. \ CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions" which aay be lore restrictive than City regulations, The undersigned assules responsibility for cOlpliance Nith any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ONner has hired a contractor or contractors to undertake Nork, they lay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by laN, both the ONner and contractor lay be cited for a lisdeleano! violation under state IaN. If the ONner Dr 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 Departlent, IB131 788-6611. ' Furtherlore, if the ONner has hired a contractor or contractors, he is advised to have the contractorlsl sign portions of the "Contractor Sections" of this application for Nhich they Nill be responsible. If you, as the oNner, sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the Nork. If the contractor Nishes 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 FEE2, 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 Protection Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the "oNner" , I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the "oNner" prior to cOllencelent. J E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all a~plicable laNs regulating construction, zoning, and land developlent. I Application is hereby lade to obtain a perlit to do work and installation as indicated, I certify that no Nork or installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all la~s regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies lay apply to the intended Nork, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not liaited tc,: f Departtent of Environlental Requlation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treat.ent f Southwest Florida Water Kanaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways f D art.ent of Health ~ Rehabilitative Services Environ.ental Health Unit - Wells, Wastewater Treataent, Septic Tanks f Environlental Protection Aqency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" Dr "A,etc,., it is understood that a drainage plan addressing a "colpensating volute" will be sublitted Nhich is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. . A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alifi, or set aside any provisions of the technical codes, nor shall issuance of a ~erlit prevent the Building Official frol theredfter requiring a correction of errors in plans, construction, or violations of any code., Every perlit issued shall becote i0~alid unless the work authorized by such perlit is cOltenced Nithin six lonths of issuance, or if work authorized by the permit is suspended or abandoned for a period of six lonths after the tile the work is cOI.enced. One 90 day extension of ti~e, ~3t 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 lust be logged during each six lonth period, or the project Nill be considered abandoned. WARNING TO OIlNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT I'IAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO;C'UR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COKKENCEKENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COMMEN KENT.. SIGNATURE I OIlNER OR AGENT /.A!.ncre.-- m ~/q1L STATE OF FLORIDA~ 0 COUNTY OF ~ <=- The foregoing inSj'ument was ~~, ,wledged befclj-e me this 5"; If ,19 by J nA~J.-; I.'^-, I .11, tJJ/kJ j-..Q70f'-L" I , W ,- who is per nally known to me or ho has produced i:>L : fJ: WSI (p -533' d7-~ClD as identification and who d' /did not take, an 0 th STATE OF FLORIDA --p A-::J . COUNTY OF r. () _ , The forego i ng i ns tn~ent vJas ac knovJl edged befol-e me this ~. / ( , 19~ by r Clj- Stamped) who is Dr who has pl-oduce as identi~~ion and who didldid not takeanc~rn '~ (SignatLrre) ~-- (j (Name Typed, Printed Dr Stamped) NOTARY PUBLIC (Name Typed, Printed NOTARY PUB~ll.. ~~ JUDITH l, SCHAPER Notary Public, State of Florida My Comm. Exp, June 6. 1907 No, CC 292357 I ~.,.f"0.""." SUSAN M. AlMV ;' .' 'Z:,;;~ 61 N:tery Public, State of FIorfdo . '"',, t..'f Comm, Exp. Mat. 25. 1998 l_~'!"~ ' N.. 359632 F-A~,JL_ S. C H If::; F- .=.'::; R ............,,_.......... ..._,_ __.'........... ..... ...."",. ........ .._....._...._...............__.......w....... . .__ ....,.~_...........'.... ,_h ....._.... ...~ ._........ ....,.... -- ........-.-.....-.,,-.- ....---..-.. -," ....~- .--..-.-. ......... .............. ,- -. ..._'..-.- ..---..... -.. ...-.--- . ~~__....__.........~_..._.__....___M...~.._.__..W_____H_._.__.__h._.______.___..___.___~._..__...__..~.....~___-------.;...-..~ \ i' C9- COI"-iSTRUCT I ION RESIDENTIAL & COMMERCIAL Fee,:; l~. tel"'e,j F\>29 l.::; t e t-ea BU11dlng Contr~ctor RGotlng Contractor 11250 South Highway 9~,Dade CIty, Phone # (904)567-8580 Bonded and Insured :25 yfl- 7)ltU~t'H~ rxltff/3 30 ~. /\ JI RB 003252~ j;:C 0056 7 6~. Flot~ida 33525 ii Ii " " :1 if (i " ii II 'I II "