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Home My WebLink About94-4436 BUILDING PERMIT Permi,t N\~ CITY OF ZEPHYRHILLS (813) 788-6611 4436 (3 Date //-;)"'-l'Y ELECTRICAL PLUMBING MECHANICAL Sewer Conn Pmp'''yOwn" i~}~b;4 --~ Job Address: 'JI CJ ~ Parcel I,D, # / f - d b- ..2..2." - Water Conn: Water M.!lter: T,I.F.'s: Zoning: Description of Work E1Y C~ Radon Gas: -Lhc - ~~Y- 1/ NO OCCUPANCY BEFORE C.O. FINAL /1- 09_ 94 DATE Complete Plans, Specifications and Fee Must Accompany Application, All work shall be performed in accordart::'e with City Codes and Ordinances, c.o. DATE Inspector Permit Fee tk t./i) Signature /f..L. t{). Company Address Telephone# ;t~ Valuation or Contract Price / ...s - tnJ . c/O I , , i-I City License Registration # ~_ State Certified License# /J~A' ~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter 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. APPLICATION FOR PERKIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT (tJkl' ZtNJ&) If . 'k ,~ OWNER'S NAME SK'I'llIe ClrI C!~srr,:/ CITY pF Z-J.lIUJ OWNER'S ADDRESS 3 9 'ISo So u11j- I}1IIf Z - HIt IS , ,e--L JOB ADDRESS 40 L/'/CJ ef}op/cei ltf LEGAL DESCRIPTION: LOT(S) BLO~ SUBDIVISION / g -2/;;.5- zz. (;- e/}~(!E( 5 t::} r 6 PARCEL I.,D.t-f1rPnws of 1l:'IJf!T5 1f:,-Y/- io5-jf-(Ol-fc '3 ~ !t:>7: (OBTAIN FROM PROPERTY T~ NOTICE) WORK PROPOSED :_New Construction _Addition ----.ftlteration _Repair X-Install PHONE 9/ 3 -7J'~-7J'.J/ .3.1S ~o _Sign --.JIove _Deaolish _M/F _' of Units _M/H -'-Other /J7Jt/TY S~ PROPOSED USE: _Single Faaily _eo..ercial _Indust. _Swiat Pool ____Restaurant & Health Department Approval DESCRIPTION OF WORK: SeT -vfJ of ~-~~~ S"7DUG& S"~ (US~~ BUILDING SIZE: /2- X zit. @ Square Feet.IO~3'~eight_~b~ 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. ~LDING _ELECTRICAL _MECHAliICAL PERKITS REOUESTED $I'~ /t/). 00 vVC/ Valuation of Total Construction sn6e*".e 1'~/r AKP Service Florida Power Corp. W.R.E.C. $ Valuation of Mechanical Installation SPECIALTY _PLUMBING GAS ROOFING TYPE OF CONSTRUCTION: _Block XFraae _Steel Other FT. IS PROJECT IN FLOOD ZONE AREA? X NO FI..NISHED FLOOR ELEVAnONS: BUILDER. Signature ~=pr~ PLUMBER. Signature MECHANICAL Signature OTHF.R Signature YES ****************************************** CONTRACTOR SECTION ~& . . coitF~ 31!a t>>hP-tlc:J/?,1 p./C i . . . s?'te ~ert. or Regist..f C~D'II"" I C1ty L1cense Registrat1on' 2S1 , ~***************************************** x X X I COMPANY State Cert. or Regist. t City License Registration t ****************************************** COMPANY State Cert. or Regist. , City License Registration , ****************************************** COMPANY State Cert. or Regist. , City License Registration t ****************************************** x COMPANY State Cert. or Regist. f City License Registration t ****************************************** APPLICATION APPROVED BY PERKIT OFFICER. CONrITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perait lay be subject to Ideed 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 tbe owner bas bired 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 lay be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirements lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor 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 wisbes you to sign as contractor that lay be an indication that be is not properly licenSed and is not entitled to perlitting privileges in the City of Zephyrbills. 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 - HOIeOKDer's Protection Guide" prepared by the Florida DepartJent 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 coaenceaent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developaent. Application is bereby 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 perlit and that all work will be perforaed 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 goveIDIental 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 Environaental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US EnvirODlental Protection Agency - Asbestos abateaent 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 sublitted 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 tbe work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall beCOle invalid unless the Nork 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 perait with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO ,~ECO~ A, NOTICE OF COKHE~CEHENT KAY RESULT IN YOUR PAYING nllCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IH'l'EHD TO OBTAIN FIHAHCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COHIIEIICEIIIl T. J S 1lIIDBIl '50011000 Il/l lEBO TO RICOIIIl ~ M~ SIGNATURE: CONTRACTOR STATE OF FLORIDA /'I COUNTY OF rCiLXl---C--O The foregoing instrument was acknowledged before me this 0 c..r 2. 7 ' 191L by tL/~~7-' -<Y. /..3a--c~ who is personally known to me or who has 'produced- ---''----- as identification and who did/did not take an O~hLl~~ L J L/U~ (gg,nature) " _ _ - I/E (..3/5 11 ~~?tE ~~ I,\?~~ 7-.s (Name. Typed, Printed or Stamped) NOTARY PUBLIC ~~:rO~FFLORIDA f1/:.--\1_C~O The foregoing instrument was acknowledged before me this air oP7 , 19~ by -Zc/~.e.~ f) ,(-3 Of-C_.l:_~ who is personally known to me or who has produced as identification and who did/did not ~a~e.ClIl_oatl1_~ d~-~.~.~r-LU!j:; (Signature) _ ~ E /7 /')"J I+,St( C. .,5'? /j7 E E ;-.s- (Name Typed, Printed or Stamped) NOTARY PUBLIC Nataty ~l;hi.i, ;.,'..' My cOlnnu'::j ';" 'j;i J "k ,,' C. C 1T /5 C, ;) 7,y ~t';~:'~1t:.mC:~$i &Iy t:Omm. fil.~;h,;':,;; Oct 29 f ~5 ^k', ' " ff c(' /5'--..2~'I