The URL can be used to link to this page

Home My WebLink About94-4169 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N~ (813) 788-6611 4169 Date BUILDING ELECTRICAL PLUMBING MECHANICAL SeW'9r Conn Pmperty Owne' ~~ ~ tf1~ uS Job Address: .L7:. _ _ ~_ ~ Parcell.D. # Water Conn: Water Meter: TI.F.'s: Zoning: Description of Work ,Ener9.!-Code: k- Radon Gas: II )&~ /;W. U(< NO OCCUPANCY BEFORE C.O. FINAL 7-- 2i:Jr-C;L{ 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 Valuation or Contract Price Inspector City License Registration # State Certified License# 1;)-7 f Permit Fee ;2(9 ~ Signature ~L (~- Company Address Telephone# ~~~ BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr, Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Canst. Pole Pool Pre-Meter Final SLB Tub Set Water? - 2.D r-t:(c..f grL 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 PERKlT CITY OF ZEPBYRHILLS BUILDING DEPARTMENT OWNER' S NAME 59 iMfJ tI1 S, COfA-'fRf.ctJ()kl-VS/!PI1/1t/'_t/S PHONE 1 ~~ t - 6 6~ 6' OWNER · S ADDRESS JOB ADDRESS $$0'1 ST_~ ~ + LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. t (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign _Hove _Deaolish PROPOSED USE: _Single Faaily _H/F _, of Units _H/H _~ercial _Indust. _Swia. Pool ___Other _Restaurant & Health DeparbBent Approval DESCRIPTION OF WORK: (:jJ;/J-<. W#f",(. io v/l S -M':~5 /~.d.--e kf'cvf , /, 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. PERKlTS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _MECHANICAL ~UKB~NG $ Valuation of Hechanical Installation GAS ROOFING SPEC~TY TYPE OF CONSTRUCTION: _Block _~e _Steel Other FlRISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. t City License Registration . ****************************************** Signature ELECTRICIAR COMPANY State Cert. or Regist. # City License Registration # ****************************************** SianAture PLUMBER t4;,// COIlPANY /;,m&t P 1v_.6/.-""1 / --- State Cert. or Regist. t <-' . -;;:JMT"A City License Registration t .. ****************************************** Signature MECHANICAL COMPANY State Cert" or Regist. f City License Registration t ****************************************** Signature OTHER COMPANY State Cert. or Regist. t City License Registration t ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to "deed restrictions" which lay be lOre restrictive than City regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions" B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor aay be cited for a lisdeieanor violation under state law. If the owner or 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, (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 work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to pertitting privileges in the City of Zephyrhills. 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 with a copy of "Florida's Construction Lien Law - HOIeowner's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to COlEncelellt. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlefit. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a pertit and that all work will be perf oIled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governtental agencies laY apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: t Departlent of Environlental Regulation - Cypress Bayheads, Wetland Areas and Environtentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, Environlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US Environlental Protection Agency - Asbestos abatelellt I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc"", it is understood that a drainage plan addressing a .cOlpensating volUle" will be subtitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit 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 perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beCOle invalid unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, lay be allowed for the pertit 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 sillOnth period, or the project will be considered abandoned. WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT 1M YOUR PAYING TWICE FOR IMPROVKMKNTS TO YOUR PROPERTY. IF YOU INTElID TO OBTAIN FINANCING, CONSULT WITH YOUR LEIIDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UllDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: CONTRACTOR SIGNATURE: OOIlR OR AGENT STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA COUNTY 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