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Home My WebLink About94-4262 BUILDING PERMIT Permit N~ CaTY OF ZEPHYRHILLS (813) 788-6611 4262 L3 Date ft-<.50.-9Y , ~~DI~ ELECTRICAL PLUMBING Property owner:'---P ~ ''H- :..-tA Job Address: '-.~!i/:? 7': 5: d ~ Parcell.D. # MECHANICAL Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Description of wo;;-j? J2 Energy Code: '--1~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL ~j~, 'I 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 City License Registration # State Certified License# Pe,m;' Fee ~ Signature~~p;;~~ Company Address Valuation or Contract Price 0(J?J , o-v 7 ;f 7- J 7 / ~ Telephone# (7) _fYiOA BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final 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 ZEPHYRBILLS BUILDING DEPAR'1'HENT OWNER'S NAME p OJ..J I'J.- 1) OWNER'S ADDRESS Yb'l2- p~ l3~ eJ. 7 K ~A/. PHONE "8 /3-78'i5 -9979 ~~'PL 7-f-, ~~/O ~jfA "9L- JOB ADDRESS . 83 ~13 7 LEGAL DESCRIPTION: LOT(S) BLOCIL--.SUBDIVISION PARCEL LD.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction ---^ddition -..Alteration ---..Repair _Install _Sign ---.JIove ->>eaolish PROPOSED USE: _Single Faaily ---1f/F _' of Units _K/B _ec-ercial _Indust. _Swia. Pool _Other _Restaurant &: Bealth Departaent Approval ((~ Square Feet. IO'12-Beight RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. ArlACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKITS REOUESTED _BUlLDIliG $ Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. ---1IEClWllCAL $ Valuation of Mechanical Installation _PLUHBIliG GAS J'>(" ROOFING TYPE OF COIlfSTRUcnON: ----..Block X Fraae _Steel SPECIALTY Other FIlIISHED FLOOR ELEVAfiOIlfS: Fr. IS PROJEct IIi FLOOD ZONE AREA? ~ YES NO ****************************************.* CONTRACTOR SECTION RIITT.DER. COMPANY \v~ /J ~ State Cert. or Regist. .------- ~/ signature~4.-~~ City License Registration .~/ ___ ****.*******....**......*******.*.**....*. F.T.RC'l'RICIAN COMPANY StateCert. or Regist. , SiDnAture City License Registration . ***************.*....*...******...*.*...** PLUHBER COMPANY State Cert. or Regist. . Signature City License Registration . ****************************************** MECHANICAL COMPANY State Cert. or Regist. . Signature City License Registration f ****************************.************* OTIID COMPANY State Cert. or Regist. . Signature City License Registration . ***************.****************.********. APPLICATION APPROVED BY PERHIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS !be undersigned understands that this pemit .ay be subject to Ideed restrictionsP wbich JaY be lOre restrictive than City regulations. !be undersigned assUJeS 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 c-ontractor is not licensed as required by law, both the owner and contractor IilJ be cited for a .isdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirl!lents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the IContractor Sections I of this application for wbieb 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 wisbes you to sign as contractor that JaY be an indication that be is not properly licensed and is not entitled to perJitting 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, have been provided with a copy of IFlorida's Construction Lien Law - HCIIeOWDer's Protection Guidell prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOIeODe other than the lownerP, I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the "owner I prior to COIIBDCel8Dt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIJation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land develo~t. Application is bereby Jade to ohtain a pemit to do work and insWlation as indicated. I certify that no work or installation bas C08enced prior to issuance of a pemit and that all work will be perfoIled to Jeet standards of all laws regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governJental agencies JaY apply to the intended work, and that it is .y responsibility to identify what actions I JUSt take to be in COJpliance. Such agencies include but are not liJited to: t DepartJent of EnvirODJeJltal Regulation - Cypress Baybeads, Wetland Areas and Envirol\lentally Sensitive Lands, Water/llastewater !reatJent t Southwest Florida Water Hanagl!lent District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses t Amy Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - lIells, lIastewater freatJent, Septic fanks t US EnvirODleDtal Protection Agency - Asbestos abateleDt I also certify that, if fill laterial is to be used in Flood Zone lAP or "A,etc.l, it is understood that a drainage plan addressing a 'COIpeIISating volUJeI will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to pemit issuance. A PeIlit issued sball 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 sball issuance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid unless the work authorized by such pemit is c~ced within sillOnths of issuance, or if work authorized by the peIlit is suspended or abandoned for a period of sillOntbs after the tile the work is C08enced. One 90 day l!Itension of tile, lilY be allowed for the pemit with fee charge of $15.00. !be l!Itension sball be requested in writing to the Building Official. An approved inspection lUst be logged during each six IODth period, or the project will be considered abandoned. IIARNING fO OIINER: YOUR FAILURE fO RECORD A lorICE OF COMMDCBMBn' MAY RESULf II YOUR PAYING WlCE FOR IMPROVEIlmS fO YOUR PROPEm. IF YOU IBEID TO OBTAIN FIIAlCIIG, CONSOLT III'lH YOUR LEIDER OR AI AnORRlY BEFORE RECORDING YOUR IfO'flCE OF COMHEICEHEI1' . JOBS UNDER $2,500 IN VALUE 00 Nor NEED !O RECORD AND POSf A 'NorICE OF COMHEICEmI'. X ~~~~~A/-L SIGNA .OIINERJ OR AGEl! "'- / SIGNA'I'URI: COI'I'RAC!OR S'I'AT! OF FLORIDA P coum OF ~ Tbe foregoing'irent ..as acknowledged before me this ~ r ,19ft. by PO.ulrt D_ (Jf)Wer<3J who is person ly known to or who has produced as identifi take an SfA'I'! OF FLORIDA Per coum OF dCCJ The foregoing ins~~t was acknowledged before me this 15 Z. , 19-.2L by / EOJ2L-Y J-)ClAJ/J~12- who is person ly known 'to e 0 who has produced as identification and who take an oa (Si JE:- .5 OFFICIAL NOTARY SEAL PEDRO M QUINONES NorARY PUBUC STATE OF FLORIDA COMMISSION NO, CC244913 MY COMMISSION EXP, DEe. 7.1996 OFFICIAL NOTARY SEAL PEDRO M QUINONES NorARY PUBLIC STATE OF FLORIDA COMMISSiON NO. CC244913 MY COMMISSION EXP. DEe. 7.19% . , DISCLOSURE STATEMERT FOR. OWNER CITY OF ZEPIIYRIIIu.5 BUILDIliG DEPARTMENT I, ifJc.-[J;?~ to the 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. S. That the owner shall assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhills 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: ?5 /079 /9fr/ I ~~:!::::-L~;t DATE: c;J'::J:JCfY ~~ WITNESS: ) OWNER: WITNESS: ADDRESS: PERMIT ~~ PH: