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Home My WebLink About94-4161 BUILDING PERMIT Permit N~ CiTY OF ZEPHYRHILLS (813) 788-6611 4161/17 7-/f?-9~ .......- ,:AJ)-_._-~ 3D - B~ ~;C_TRICAV P~ €.~~;~ Sewer Conn ~:::~:~~s:~e~i_J~rtr~_itij!~~ ~~;::?:.:, Radon Gas: !!g1-?~ &d!5;i~taZ~ FINAL .~ - L.f - 9 Date Zoning: Energy Code: Dese,;.';on of Wo,k ~ J~ -: fl i;~ <-~:::;: r NO OCCUPANCY BEFORE C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordar~e with City Codes and Ordinances. DATE Inspecto ~ -0 D-'L Pe,m;t Fee '!:' -? "" '- ~~:::u:~ l. ~ './~ (/- Address Telephone# ~ " Valuation or t1L 0 cJ Contract Price ~ ~ ~ () 0 . ~ City License Registration # 7'/ A / {' _ / State Certified License# BUI~LD~- ~~7'. PLU~ -~ v~~~ / CH-ANI~~ Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Canst. Pole Pool pre-Me~r Final - 'i -1t./ SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final B--'-I-q'/ ~ &h 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. '''' ..... .." '" ~,..---- _.....~..~ '.r. ~~,....,.... T'l'1 Kinsey Central Heat &: AIr-Conditioning 7118 Fort KIng Highway . p.o. Be.- 2209 ZephyrhiDs, Aorida 33539-2209 (813) 782-2300 , ....,?& -;t 2 <7 IIIlTEPIlOIIISa) ADlIRU8 N'AlllIIBlT CIlY ... IIOIlB. -., j TIMATE , ; NATURE OF -=:> o CASH , SERVICE o CHARGE I REGUEST I QUAN, PRICE AMOUNT 3 I CO(.J"P -~O/Ot:> - t!J 1~ 7A..Je u SA..,p ey.t" ' (~~ 12~#(/~J; E& ~;7 ~/ ill 0 &/.J!. ~I :r QV tc54-. t 5 6? (. .1l.1~ ;".t,. R Q;?Cf;- y 7'-1-,.., IMTECIlII'U1iii CASH ::u--+ /0 ,. .. tlITllI. IIIllBlML na.caa. I8MCI '- TAl mAL TECHNICIAN) ---~4t~~ APPLICATION FOR PERMIT CITY OF ZEPBYRHILLS BUILDING DEPARTMENT OWNER'S NAKE ch Qv /.t2A 3.& 7 ~o ~a I/n (? ~~~y )t',Jj__ ~ ,4./ ~ PHONE "/ 8~ ... ;;2.. dJ... C; .5 OWNER'S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BWCK SUBDIVISION I 08;0 PARCEL I. D.' /. .- ;2. tP - ~ J - 0 0/ c> - ,;z 0 J o-t:> - (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign ____Move _Demolish PROPOSED USE: ____Single FaBtily ____M/F ____, of Units ____M/H ____C~ercial _Indust. ____Swim. Pool ___Other DESCRIPTION OF WORK: ____Restaurant & Health Department Approval "3 -4 Y#>tJ /}/c / BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PWT 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 $ Valuation of Total Construction _ELECTRICAL L.m:CHAlUCAL $ AMP Service cZ. S- C'"tJ,... CJO Florida Power Corp. _W.R.E.C. Valuation of Mechanical Installation ____PLtJHBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _FraBle ____Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER ELECTRIClAB COMPANY State Cert. or Regist. , City License Registration' ****************************************** ! / / 7 COMPANY /VJo f-1DJ ~~ State Cert. or Regist. # City License Registration , ****************************************** Signature ure e It~~ltl<e ~1 PLUMBER t~ COMPANY ,r{,' <l\J~~ C .s:>?V ~ State Cert'. or Reg . ## C/O c ;;J., City License Registration , 7 I ****************************************** ~ , Signature COMPANY State Cert. or Regist. t 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 'fbe undersigned understands that this perait laY be subject to Ideed restrictions I wbich laY be lOre restrictive than City regulations. 'fbe undersigned assllleS responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired a contractor or contractors to undertake work, 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 0III1er and contractor laY be cited for a lisdelleallor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirl!llenu laY apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813) 788-6611. FurtheIlOre, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the IContractor Sections I of this application for wbich 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 work. If the contractor wishes you to sign as contractor that laY be an indication that be is not properly licensed and is not entitled to peraitting 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 IFlorida's Construction Lien Law - lkIIeoImer's Protection Guidel prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If the applicant is 8OMOI1a other than the lownerl, I certify that I have obtained a copy of the above described dOCUleDt and pIOlise in good faith to deliver it to the lownerl prior to C08enCl!llent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in COIpliance with all applicable laws regulating construction, loning, and land developleJlt. Application is bereby lade to obtain a perait to do work and installation as indicated. I certify that no work or installation baa CDleDced prior to issuance of a perai t and that all work will be perfoIJeCl to Jeet standards of all laws regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other gOYeIJIIeIltal agencies laY apply to the intended wort, and that it is If responsibility to identify what actions I lUst take to be in COIpliance. Such agencies include but are not liaited to: . Departlent of BnviIOllllelltal Regulation - Cypress Baybeads, Vetland Areas and Envirolllelltally Sensitive Lands, Vater ,Vastewater treatlent · Southwest Florida Vater Managl!ll!l1t District - VeIls, Cypress Baybeads, Wetland Areas, Altering Watercourses · AIIY Corps of Engineers - Seawalls, Docks, Mavigable Waterways t Departlent of Health' Rehabilitative Services, Env1rODlelltal Health Unit - Wells, Wastewater treatlent, Septic tanks t US BnviIOlllental Protection Agency - Asbestos abatl!llent I also certify that, if fill Jaterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan addressing a lCOIpeIl8ating vol_I will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to peIlit issuance. A PerJit 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 perait prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perait issued &ball beCOle invalid unless the IIOrk aUthoriled by such peIlit is COIIIlDced within sillOnths of issuance, or if work autboriled by the perait is suspended or abandoned for a period of sil IODtbs after the tHe the work is co.enced. One 90 day stension of tille, laY be allowed for the perait with fee charge of $15.00. tbe stension shall be requested in writing to the Building Official. An approved inspection at be logged during each sil IODth period, or the project will be considered abanc1oned. WARIIIMG YO 0VIfER: YOUR FAILURE YO RECORD A MOtICH OF CCIIMDCBIIIR'J' MAY RESULt lIf YOUR PAYIMG DICE FOR IMPROVEIIBI!S to YOOft PROPER'IY. IF YOU III!BIfD to OBIIIM FlMAlfCllfG, COMSOLt IUtH YOOR LDDII OR U InORIIY BIPORE RICORDIMG YOUR JOrlCE OF aJOIDCEMBIfI'. JOBS IJIfDER '2,500 1M VALUE 00 lOt IfEED 10 RECORD un POSt A 'NOtICE OF C<llllElCEm!I. -- S OF FLORIDA /J StAtE 0 IDA /J comm OF r pL ...J' C. <.J Coutm OF ~...o c. ) The foregoing instrument was acknowledged The foregoing in trument was aCknowledged before me thi(jp/rf~ ' 19~ by before me this , 19~ by J1 /D<! L u ?J. /(j..,~ .7_ who is personally kn to me or who has wh is personally known to me or who has produced,/.o c.. /( ..Io<.o -fJ/ 7' -~-() produced" I,(J L.. /( ~r ~ 0 -(</ # -or / -..1 yfl-d as identification and who did/ d n as identification and who did/did not ~~~~ ~€~2~ (Hame Typed, Printed or Stamped) (Hame Typed, Printed or Stallped) HOT . _ HOTARY PUBLIC ,,'~rr.~'r~", LISA L, EDMISTON l! ''f~ MY COMMISSION' CC 349593 ~~. g EXPIRES: March 3. 1998 ~.::~ Bonded Thn.I No1BIY PublIc ~ ~ ....~rr.~t;:.."~.., LISA L. EDMISTON I{f" .'t~ MY COMMI~ION , CC 349593 <f: EXPIRES. March 3. 1998 " .,- Bonded thill Nollly Public lJndeMIIlIII