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Home My WebLink About94-4451 BUILDING PERMIT Permit N'~ i)~ 4~ C ___'_m.,.. C~ e;;::- ~ CITY OF ZEPHYRHILLS (813) 788-6611 _ 44514 1/-,7)- :If Date Property Owner: Job Address: Parcell.D. # ~)L ~ /~~~~~~~~r Radon Gas: ~ ~ -.Jr 1..u1l;'-~ .~ . iL/~r I-/~~ DATE ~ewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Energy Code: De"',iption of Wo'k -~ .A'7:~ -PAJ."'-l_ '7;;) .I I ; )( .I;J. I NO OCCUPANCY BEFORE C.O. FINAL Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordarce with City Codes and Ordinances. DATE Valuation or ~ Contract Price - Inspector ~~~i' Permit Fee ' ~ Signatuce - - --J. iE.-l.AY.._ Company Address Telephone# ~ teg -'6 7 30 City License Registration e Certified License# ELECTRICA MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL 6M~ 1-13'i'} i3/u-- Driveway Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final 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 OWNER' S NAME L E J-. AN/) if th S H OWNER' S ADDRESS S ~ 0 R JE'tl cr- E.AI t= DR JOB ADDRESS $AME PHONE 7~~-0 730 LEGAL DESGRIPTION: LOT(S) I /7---.8 BLOCK SUBDIVISION S/A'r}/ A v~ frltJ,Bl..tE ci: PARCEL I.D.' (OBTAIN FROH PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction ---^ddition ~teration ----llepair _Install _Sign --.JIove _DeJIOlish PROPOSED USE: _Single Fallily _H/F _' of Units _H/B _<=<-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Department Approval ~ESCRIPTION OF W : ~~ ~ef' ~~ ~ . ~~~X~3~ R . ILDI E~ /I/x /.J,/. J ~ :2-' Square Feet. {<I/ 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. PERHITS REOUESTED _BUILDING $ Valuation of Total Construction _ELEC'fRICAL AH.P Service Florida Power Corp. W.R.E.C. _HEGllAlfICAL $ Valuation of Mechanical Installation _PLUKBING GAS TYPE OF GONSTRUC'l'ION: _Block ROOFING _Fralle V'Steel SPECIALTY Other FINISHED FLOOR ELEVATIONS: FT . IS PROJECT IN FLOOD ZONE AREA? / YES NO .......................................... BUILDER / COBTRA:::CSY~~~ /' t:eW ~State Cert. or Regist. . L City License Registration . .......................................... Signature "'.R~ ~ . COKPAllYE.7~.o,.J7J.~<<) , State Cert~ or Regist. . :=: L . ~ City License Registration' .......................................... PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration , .......................................... MECHANICAL COMPANY State Cert. or Regist. , Signature City License Registration , .................***.**.......*.*..*.....* OTRRR COMPANY State Cert. or Regist. . Signature City License Registration , ...*.....*......*......................... APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit laY be subject to "deed restrictions" which laY be lOre restrictive than City' regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance witb state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be cited for a lisdl!lleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. FurtberlOre, if the owner bas hired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of tbe "Contractor Sections" of this application for whicb tbey will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wisbes you to sign as contractor that laY be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 113, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of 'Florida's Construction Lien Law - BOIeOMDer's Protection Guide" prepared by tbe Florida DepartJent of Agriculture and ConsUJer Affairs. If tbe applicant is sOlH!Olle otber than the "owner", I certify that I have obtained a copy of the above described docUJent and prOllise in good faith to deliver it to the "owner" prior to cOlleDce.ent. E. CONTRACTOR'S/OWNER'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, loning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOlleDced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws regulating construction, City codes, loning regulations, and land develoPEDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies aay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: A Departlent of Envirou.ental Regulation - Cypress Baybeads, Vetland Areas and Envirou.entally Sensitive Lands, Vater/Vastewater TreatleRt A Southwest Florida Vater Hanage.ent District - VeIls, Cypress Baybeads, Vetland Areas, Altering Vatercourses A ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways A Departlent of Health' Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater TreatleRt, Septic Tanks A US EnvirODl!Dtal Protection Agency - Asbestos abate.ent 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 sball be construed to be a license to proceed witb tbe 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 frUl,tbereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued &ball beCOlB invalid unless the work authorized by such perlit is COll8llced within sillOntbs of issuance, or if work autboriled by the perlit is suspended or abandoned for a period of sil IODtbs after the tile the work is ~enced. One 90 day l!Itension of tile, aay be allowed for tbe perlit 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 six IOnth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHBICKIIKHI MAY RESULT IN YOUR PAYING TIIICB FOR IHPROVBHKII1'S TO YOUR PROPERTY. IF YOU III1'BW TO OBTAIN FIJlAHCING, CONSULT WITH YOUR LDDIR OR AN AnORIBY BIFORE RECORDING YOUR NOTICE OF COMHKNCKHBNT. JOBS UNDER $2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A "NOTlCE OF COIIHKNCKHKJII". SIGNAtURE: OWNER OR AGEIIT SIGNATURE: COIITRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this I 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 1yped, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC