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Home My WebLink About94-4134 BUILDING PERMIT Permit N4? CiTY OF ZEPHYRHILLS (813) 788-6611 413411 BUILDING ;;L 6. ,rf) ~EC~R~ Date ~-3tJ-7Y PLUMBING s C). 0-0 ~HANIC~ Sewer Conn Pwperty Owne, _-;:ja, ;';iJc Job Address: ~ a - ) / .-1';- Parcell.D. # ;2 -;;L6 -d-/ - tJ l)cf-o ~ () D/ 00- t!)/6 cJ Water Conn: Water Meter: T.I,F.'s: Zoning: Energy C~: Description of Work ~ (' C d AI (f P Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 7- /:]. 9Af DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordarr:-e with City Codes and Ordinances. c.o. DATE Inspector Permit Fee ..s(). de') Signature OI~ cl3~Ct:;.(rl...../ Company Address Telephone# Valuation or Contract Price ~~ ~---O. tTV City License Registration # If if 7 State Certified License# BUILDING o~ ~ ~~~~Z~1Yt I '/? ELECTRICAL b..J PLUMBING ,a~h~~ MECHANICAL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final Breakers Ducts Insl. 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 PERKIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S ADDRESS /)I(h H~ 003;- //7-7s7 ,5'~ PHONE ;"Jf?1- 7 J ~~- OWNER'S NAKE JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.0.' (!J J... - ~ ~ - :2.. ( ...... 06 &"0 ~OO/OC>-O/60(OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Family _M/F _, of Units _M/H _<=<-ercial _Indust. _Swim. Pool ___Other _Restaurant & Health Department Approval DESCRIPTION OF WORK: }:/t/S7/J-LL. 1137<1'/11 ;J!cc.-,A.-:T !J,vjw/;'c +lC~ )/,iJ, uc7hc--fC ./ BUILDING SIZE: x Square Feet, 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. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING ~LECTRlCAL L/itECBAlUCAL $. Valuation of Total Construction AMP Service Florida Power Corp. _W.R.E.C. $. ;).. .5-5"0.00 Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr88le _Steel Other FlNIS8ED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************.************* CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. . City License Registration . .**...***.***************........**..***** Signature ELECTRICIAN COMPANY f) c e ~ C-PJ-" Cj ;;: It-- <.. IJ I. --'J< if /J ~ / /J fJ~ State Cert:. or Regist. 4( F 5 (;:, 00 00 <0 ( SiQfla.ture ~ I~ ':f::J. c.~ aN'- City License Registration f (." :3 *****************.****.******************* PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration t .***************************************** f}c ~ /Jt>-fh. '1 MECHANICAL COMPANY C /?cc- () ;j /OJ I.. A ..Ih'State Cert. or Regist. # J Cf'75;..5 Signature ...a~ (.( 13~ P)'C-/t#"tf? PiIY~ty License Registration' '1'1- ? *...**.*****.******.*******.*.***********. OTHER COMPANY State Cert. or Regist. # Signature City License Registration , ****..********.**************.*****.****** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS file undersigned understands that this pertit lilY be subject to 'deed restrictions' .hich lilY be lOre restrictive than City regulations. the undersigned asSUles responsibility for CCIIpliance .ith any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lilY be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by la., both the owner and contractor lilY be cited for a lisdeJeallOr violation under state law. If the owner or intended contractor are uncertain as to "hat licensing requirl!lellu laY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the 'Contractor Sections' of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the IIOrt. If the contractor wishes you to sign as contractor that lilY be an indication that he is not properly licensed and is not entitled to pertitting 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, the applicant, have been provided .ith a copy of 'Plorida's COnstruction Lien La. - Imemmer's Protection Guide' prepared by the Florida Departlent of Agriculture and ConsUlll!I' Affairs. If the applicant is 8OI8OI1e other than the 'owner', I certify that I have obtained a copy of the above described docuIent and prOlise in good faith to deliver it to the "mmer' prior to COll8llCl!l8llt. E. CONTRACTOR'S/OWNER"S AFFIDAVIT I certify that all the infoIlation in this application is accurate and that all wort will be done in cOJpliance with all applicable IDS regulating construction, loning, and land developlent. Application is hereby lade to obtain a petlit to do work and installation as indicated. I certify that no IIOrt or installation has COIIenced prior to issuance of a pertit and that all wort will be perfoIJed to leet standards of all Ian regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also certify that I understand that the regulations of other gov8IDll8lital agencies la' apply to the intenc1ec1l1Ork, and that it is ., responsibility to identify .hat actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to: t Departlent of KnvirOlllM!lltal Regulation - Cypress Bayheads, Wetland Areas and EnviIOll.lentally Sensitive Lands, Water/Wastewater !reatlent t SoutlHrest Florida Water Hanagl!lellt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t AIIY Corps of Engineers - Seawalls, Docks, Ifavigable Waterways t Departlent of Health i Rehabilitative Services, InviIOJlllental Health Unit - Wells, Wastewater !reatlent, Septic !ants t US KnvirODl8lltal Protection Agency - Asbestos abateJl8Jlt I also certify that, if fill laterial is to be used in Flood ZOne "A' or DA,etc.', it is understood that a drainage plan addressing a 'cOlP8Jl8ating volUle' .ill be sublitted .hich is prepared by a professional engineer registered in the State of Florida prior to petlit issuance. A petlit issued shall be construed to be a license to proceed with the IIOrt and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a petlit prevent the Building Official fIOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCC118 invalid unless the IIOrt authoriled by such petlit is co.enced within sil IOnths of issuance, or if IfOrt authoriled by the pertit is suspended or abandoned for a period of sillOnths after the tile the work is COIIenced. One 90 day atension of tile, lilY be allowed for the perlit with fee charge of $15.00. the atension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each sillODth period, or the profect will be considered abandoned. WARlfIIfG !O <*lID: YOUR FAILURI !O RECORD A 1f00ICE OF allMDCEIlDf MAY RESULf IIf YOOI PAYllfG fllCE FOR IIIPROVIIIIIl'S ro YOUR PROPEm. IF YOU 10IIfD !O OBfIIJl FlIfJlfCIIG, COJISUL! 111m YOUR LIIfDIR OR 111 IftORIIY BlFORI RICORDIJlG YOUR alCE OF mDlEJlCEHm'. JOBS UlDIR '2,500 IIf VALUE DO IIO! IfDD !O RECORD lIfD POSf A MIfO!ICE OF aJIIHIICIIID!'. Ch~ cf]dI~ SIGIiA'fURI: OOIR OR AGm c/;~ C/Jdt~ SIGIIA!URI: COJI!RACfOR /) , SfAfE OF FLORID~; ,} / coum OF [1/ -f"/:.$ The foregoing instrum, ent was a9~OWledged before me thi&~ / <~ q, , 19 ( by / (t'h 'l/zj.,Y s e . z)~ /Ie- u/.f who is personally ~~~~~ or who has produced as identification and who did/4id nQt take an ...~~th.)~ _ (', __>;/ yi , / Z//c-< ,to "-j~ ;(OUl-t.-d'7'.t (Signatur~) :) , 1/'1/(''- (. .L 1\ {;; (< )/,<1 /,' J (Name Typed, Printed or Stamped) NOTARY PUBLIC Notary PuVIf. Stat. of FlortcIa My Commission Expires Sept. la, 1994 Ionded Thru Troy fain. Inluro_lnc. S!AB OF FLORIDA /J ,,/J- coom OF L!::v/r<.. The foregoing inst~t was acknowledged before me this &:~ ' 19..i..L by /~ h~41C- /-t' c; (I. &//2 0: ,", r who is personally known to me or who has produced as identification and who did/did not take~o~:~h. I) ( 7) ,; ~t..I.' C c...L ,-:y - ~7f(c-uL/a< /1 (Sigg.jiture) /) I' - r'C/N' (L. /< ~ U ,"1 Ii. c/ (NillIe Typed, Printed or Sta.mped) NOTARY PUBLIC ....- Wotary 'uYrr. !taf. of fiorile My Commission Expiros Sept. 18, 1994 Bonded Thru Troy Fain. Insvronce Inc.