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Home My WebLink About94-4086 BUILDING PERMIT Permit N.~ C.TY OF ZEPHYRHILLS (813) 788-6611 4086 ~ Date t-/-j'~ BUILDING ~E~TRI~ PLUMBING MECHANICAL Sewer Conn Water Conn: P,"pe~y Own", ~y~~ ~~ (J ~'_"N-q- Job Address: ~ _' _F4 -~ ParceII.D.# /1-;211 -~/- O()/O{)-~ /Y6o/J- 0030 Water M.ejer: T.I.F.'s: Zoning: ,rgy Code: Description of Work O~ .A .II...AA..u: lL ;::(:;. :a:~~ - -#-_.;- -=----v </"~ NO OCCUPANCY BEFORE C.O. FINAl-0''-/O. q DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordaro::-e with City Codes and Ordinances. DATE Inspector City License Registration # State Certified License# !J'-D Permit Fee ~ Sign'ature.% -:.~) Company Address Telephone# ~A - Valuation or Contract Price ~k BUILDING \. 5(u ELECTRIC~ PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final Tp. Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final &-~'Cl'i ~ 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 ($15.001 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 PERMIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAME 1(;;;:tt\ (JJ, c,~~~ IA(P~ OWNER'S ADDRESS~ N'\~r \t ~ t;y S~ ) 8'" 5\- PHONE 2-h:((~ 5S~l/ S~I gJ-'7S JOB ADDRESS LEGAL DESCRIPTION: LOT(S) 5~ t.-) BLOCK J 1./ b SUBDIVISION PARCEL I.D..-1 J -21,.,-)\ ~ 00100 i'1 l:IJn {'JC, ~o (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction ~ddition _Alteration _Repair _Install _Sign _Move _De.olish PROPOSED USE: _Single Family _K/F _, of Units _K/H _eo..ercial _Indust. _Swu.. Pool ___Other _Restaurant & Health Depar~ent Approval DESCRIPTION OF WORK: Ovlcl ~ <;.p '- I ,rlJ...IC e \ (") (1~~o.~ BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ -I no $ AMP Service L/ Florida Power Corp. W.R.E.C. Valuation of Total Construction _ELECTRICAL _HECHAlUCAL Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _FrUle _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. . City License Registration . **************......*****.*.******..**..** Signature ELECTRICIAR ~/~~ Si~Ature /' L ...-- COMPANY 1--- ~ ~ ~ State Cert. or Regist. t 2;-) ~.A'" City License Registration # .1'# ***** *******.*..**..*********..****.***.. PLUMBER 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 APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS !he undersigned understands that tbis perlit JaY be subject to 'deed restrictions I which JaY be lOre restrictive than City regulations. the undersigned asSUJeS respcmsibility for COIpliance witb any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If tbe owner has hired a contractor or contractors to undertake IIOrk, tbey JaY be required to be licensed in accordance witb state and local regulations. If tbe contractor is not licensed as required by law, botb tbe ower and contractor JaY be cited for a lisdelleallor violation under state law. If tbe ower or intended contractor are uncertain as to wbat licensing requiruents JaY apply for tbe intended IIOrk, they are advised to contact tbe City of Zepbyrhills Building Departlent, (813) 788-6611. FurtbeIlOre, if tbe OIfIler has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of tbe 'Contractor Sections' of tbis application for which tbey will be responsible. If you, as tbe owner sign as the contractor, you are indicating that you, ratber than the contractor, are responsible for the IIOrt. If tbe contractor wishes you to sign as contractor that JaY be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, tbe applicant, have been provided witb a copy of 'Florida's Construction Lien Law - lkIIeoImer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUlll!I Affairs. If tbe applicant is sOJleOl1e otber than the 'OIfIler', I certify tbat I have obtained a copy of tbe above described docuIent and prolise in good faitb to deliver it to tbe 'owner' prior to COlleDCuent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all tbe inforaation in tbis application is accurate and that all IIOrt will be done in cOlpliance witb all applicable laws regulating construction, loning, and land developent. Application is hereby Jade to obtain a peIlit to do IIOrt and installation as indicated. I certify that no IIOrt or installation has ~ced prior to issuance of a perlit and that all work will be perfoIled to .et standards of all laws regulating construction, City codes, loning regulations, and land develOpllellt regulations in tbe jurisdiction. I also certify that I understand that tbe regulations of otber gove11lleDtal agencies JaY apply to tbe intencJed work, and that it is If responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to: t Departlent of BnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and BnviroDleDtally Sensitive Lands, Water/Wastewater !reatlent t Southwest Florida Water Managuent District - Wells, Cypress Bayheac1s, Wetland Areas, Altering Watercourses t AIIY Corps of Engineers - Seawalls, Docks, Jravigable Waterways t Departlent of Healtb i Rehabilitative Services, Bnvirouental Healtb unit - Wells, Wastewater !reatlent, Septic 'anks t US Bnvil'ODleDtal Protection Igency - Asbestos abatuent I also certify that, if fill Jaterial is to be used in Flood ZOne "A' or MA,etc.', it is understood tbat a drainage plan addressing a 'cOQeDSating volue' will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to peIlit issuance. A perlit issued shall be construed to be a license to proceed witb tbe IIOrt and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent tbe Building Official frOl tbereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becoIe invalid unless the IIOrt authoriled by such perlit is co.enced witbin sillODths of issuance, or if IIOrt authoriled by the perlit is suspended or abandoned for a period of sil IOnths after tbe tile tbe IIOrk is co.enced. one 90 day stension of tile, JaY be allowed for tbe perlit witb fee charge of $15.00. Ihe stension shall be requested in writing to the Building Official. In approved inspection lUSt be logged during each sillODtb period, or tbe profect will be considered abandoned. WAIUlING !O (MER: YOUR FAILURE 10 RECORD I JrO!ICE OF COIIIDCBIIm MlY RESULI III YOUR PlYING DICE FOR DIPROVIIIDIS ro YOUR PROPER'IY. IF YOU IrmD ro OB!W FIWCIJrG, COISULI WI'IH YOUR LlllDBR OR III InomY BEFORE RiCORDIIIG YOUR DICE OF alfMDCBID!. JOBS UMDIR $2,500 IN VALUE DO D DID 10 RECORD AND POSI A 'JrO!ICE OF ClItMBJrCBIID'l'. SIGJlAfURE: (MIIJI OR AGB! SIGRlfURE: comIAC!OR SllfB OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by SIAIB OF FLORIDA coum OF 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 oath. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC