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BUILDING PERMIT
Permit N~
:-
CiTY OF ZEPHYRHILLS
(813) 788-6611
413113
Date ~ }7 -/ -77'"
~~ ELECTRICAL PLUMBING
::~:::,~:~:~ fi"J!)J!
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Parcell.D. #
Zoning: Energy Code:
Description of wo~<4? ~7
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL ~7*"Z 9-- 9
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordar<::,e with City Codes and Ordinances.
c.o.
DATE
Inspector
Permit Fee ;;2...IJ. c:ru
Signature
Company
Address
Telephone#
Valuation or
Contract Price
7/.JCJ ' c77J
.
City License Registration #
State Certified License#
~
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
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.
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPBYR81LLS BUILDUG DEPARTMENT
I,
to
~ U/h~ '
th provisions of this instrument."
have read and fully understand and agree
The undersigned states and affirms
renovating, adding to or reroofing
occupy, or will occupy by
sale. That he or she shall comply
that he or she is desirous of constructing,
his or her own domicile, that he or she actually
said domicile, and same is not for rent, lease or
with the following conditions:
1. That the owner and he or she alone shall act as the builder for all phases
of construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work.
4. That in the event the Building Inspector shall require corrections to be
made, the owner will assume full responsibility to insure they are made, and
upon completion will call for a reinspection before proceeding with the
building.
5. That the owner shall assume full responsibility for the construction and
will not expect supervision of his work from the City of Zephyrhi.lls
Building Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard
to social security, workman's compensation, lien laws, etc., where
applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You
have applied for a permit under an exemption to that law. The exemption
allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction
yourself. You may build or improve a one-family or two-family residence or
a farm outbuilding. You may also build or improve a commercial building at
a cost of $25,000 or less. The building must be for your own use and
occupancy. It may not be built for sale or lease. If you sell or lease
more than one building you have built yourself within 1 year after the
construction is complete, the law will presume that you built it for sale or
lease, which is a violation of this exemption. You may not hire an
unlicensed person as your contractor. Your construction must be done
according to building codes and zoning regulations. It is your
responsibility to make sure that people employed by you have licenses
required by state law and by county or municipal licensing ordinances.
DATE:
J-j- 9' i
71~4~
DATE: /7_ / -- 9;('
" "
OWNER: ~ <<4:~~
ADDRESS: ~ 6 din S"f j." 57
PH: ;7.3' 5 - d,S'cfJ 2-.-.-
WITNESS:
WITNESS:
PERMIT ~F