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Home My WebLink About94-4424 BUILDING PERMIT NeO Permit '. CITY OF ZEPHYRHILLS (813) 788-6611 442413 ~o. dO Date /lJ "dl-f''f :2 -.S -:c:rz; ~~ C!FRI~ Pmpe'" Owne' {J;.-c// ~ Job Address: 3 ~ P"cell. D.' / b -oJ. 6 - ...;;...;-~ 0'" ;;l; ~ C) c:> C> C) C> ... PLUMBING MECHANICAL Sewer Conn Water Conn: Water Ml'l!er: T.I.F.'s: CJ f~ 0 Zoning: ~gy Code: Description of Work ~ t2 "- ~ ~~~ ~ Radon Gas: ~ ~-.,:/#~+-~ NO OCCUPANCY BEFORE C.O. FINAL C.O. /~~ K- "-"' DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordarce witn City Codes and Ordinances. DATE Inspector :~;~:~c~ Company ~_ Address Telephone# Valuation or Contract Price "- 6 ,{ t/t77:J. OV J OL- City License Registration # tL--.....;;1 State Certified License# -- fi'-r-v. a~ BUILDING JJ1 ~Y"l_ ~~ ELECTRICAL YI PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. II- ~(j,,~ ~H: Insul. CL J. '-ll:r ' ILL- WL //-/6 -1.1-/ gilL- Breakers Ducts Insl. Compressor Final Tp. Servo Rough In JJ"/J.f-~M- Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT /t; -..:??- y y .g:--.' SO A IV .. OWNER t S NAKE M ( \ "DO-e 0 OWNER t S ADDRESS 3\34 s CA(t\~t0 b~R~S~tQ..(; PHONE "1 E> ~. \,0.3 ./ JOB ADDRESS SA-rY\ t"' LEGAL DESCRIPTION: LOT(S) g~ BLOCK SUBDIVISION ~~Q:,-(u..JGCl~ ~~. <::::>1 ~ PARCEL I. D. # l (:) - ~~ g.,l - ry1 ~ G - OG:>c.:X) - 0 q 30 (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~teration ~epair _Install _Sign ---...Kove _Deaolish PROPOSED USE: ~ing1e F~~lY ---...KI F _' of Units ---...KIH _ec-ercial _Indust. _Swia. Pool _Other ~estaurant & Health Departaent Approval DESCRIPTION OF WORK: C...lD~e: ) f\::) BUILDING SIZE:~. \ 3 ~ D i I\J Y \ \Al hj DO v.J eoo """ Square Feet. Z)' Height RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~UILDING PERMITS REOUESTED $ 3 qq_S ~.::-- Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. ---"ECHAMICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block FIInSBED FLOOR ELEVAnONS: 'OS FT. )C. Fra.e _Steel Other IS PROJECT IN FLOOD ZONE AREA? A YES NO ****************************************** CONTRACTOR SECTION BUILDER . COMPANY 9 ~ VV\ A-r0 CON S+ I ~~ State Cert. r Regist. # C%C-03Sl34- Signature ~ v- .~ C^-. City License Registration # .s *************************************** ELECTRICIAN COMPANY fv\o~ C \ ec..+tG C 7 A l/J 11 I? /"\ State Cert. or Regist. # SiQTlAture . {./ Y (;i~ City License Registration' 4-1 ****************************************** PLUMBER COMPANY State Cert. or Regist. # Signature City License Registration f ****************************************** MECHANICAL COMPANY State Cert. or Regist. . Signature City License Registration # ****************************************** ornER COMPANY State Cert. or Regist. . Signature City License Registration . ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this perait lay be subject to Ideed restrictions. wbieb lay be lOre restrictive than City regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ower bas hired a contractor or contractors to undertate work, they laY be req)1ired 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 laY be cited for a lisdueanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requir8lents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the OlDer bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of the DContractor Sections I of this application for which they will be responsible. If you, as the ower 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 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, have been provided with a copy of NFlorida's Construction Lien Law - HOIIeowDer's Protection Guide" p{epared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone otber tban the lowner", I certify that I bave obtained a copy of the above described docUIIeDt and prOlise in good faith to deliver it to the "ownerl prior to couenCl!leDt. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify tbat all the inforlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, loning, and land developlent. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a perait and that all work will be perforted 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 goverDleDtal agenCies lay apply to the intended work, and that it is .y responsibility to identify what actions I .ust take to be in cOlpliance. Such agencies include but are not lilited to: t Deparuent of EnviroDlental Regulation - Cypress Bayheads, Netland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treauent t Southwest Florida Water Hanag8lent District - NeIls, Cypress Baybeads, Wetland Areas, Altering Natercourses t AIJY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US EnvirODlental Protection Agency - Asbestos abat8lent I also certify that, if fill laterial is to be used in Flood Zone "AD or "A, etc. N, it is understood tbat a drainage plan addressing a .cOlpensating VOIUIBI will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A per.it 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 per.it prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Bvery peIlit issued shall becOle invalid unless tbe work authorized by such peIlit is couenced within six IOnths of issuance, or if work authorized by the peIlit is suspended or abandoned for a period of six IODtbs after the tile the work is cOllenced. One 90 day 81tension of tae, lilY be allowed for the perait with fee cbarge of $15.00. The extension sball be r8C)uested in writing to the Building Official. An approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned. NARHING to omR: YOUR FAILURE TO RECORD A NOTICE OF COHMENCEMm HAY RESULT IN YOUR PAYING !VICE FOR IMPROVBMENt'S TO YOUR PROPERTY. IF YOU INtBHD to OBTAIN FINANCING, CONSULT WI7H YOUR LENDER OR AN AnORKEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENt. JOBS 2,500 IN VALUI DO NOT NEED TO RECORD AND POST A INO!ICE OF COHHENCEMEN!H. ~U!~~ ~~~. STATE OF FLORIDA STATE OF FLORIDA Ii COUmOF f~AJ CoumOF r~ The foregoing inptrument was acknowledged Tbe foregoing in~t~ent was acknowledged before me tbis1tf'1t, , 19J...!/- by before me tbis CJ~1"b , 19~ by e,~LJ~_t!h~ l?~tJ.L~ wbo is ~~~~l3;~OWD to me or wbo bas wbo is personall~~WD to me or wbo bas produced produced as identification and wbo did/did not as identification and wbo did/did not take~.'-'h1.~' take an oa~'-"h1. J-A/~~ (Signature) (Signature) ----- (Nam~ Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC ~1.ta' p~ .~ DONNA M SINCLAIR * * My Commission CC382618 do Expires Jun. 14. 1998 ~~Df~~ ~1.ta' ~ *#i ~M__ * My Commieaion CC38a018 .,.~ -:.A Expires Jun. 14. 1988 ~DfR.~ C Ar" ,--- r. 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