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BUILDING PERMIT
Permit N;C?
CITY OF ZEPHYRHILLS
(813) 788-6611
450613
Date J .2-- c:J - ;? Y
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Pmp'~Y Own" l~ ~;~ ~
Job Address: 0 !/ 9--5-0 A/ J-<- ~---- tAl
Parcell.D. #
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PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
tP1- )ner2de: <
r. fALif ~ LZt r
;7
Radon Gas: ~;Z {)
FINAL
1- 30 - q
DATE
NO OCCUPANCY BEFORE C,O,
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
C,Q,
DATE
Permit Fee
Signature
Company
Address
Telephone#
Inspector
Valuation or
Contract Price
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City License Registration # '-/ 7
State Certified License#
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BUILDING ELECTRICAL cl2 '7
Ftr. YrI 6~ 12-1"'~ ~lt- Tp, Servo
Pre SLB Yt f I>'f j r -II" c..f l~ough In
Lintel Meter Can
.\f Jd )J1J::LP
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Const, Pole
Pool
Pre-Meter
Final
FRM,
Insul. CL
WL
Driveway
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V\ l CJ-'~~ I Z - 2'1-14 &LL-
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,
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APPLICATION FOR PERKIT
CITY OF ZEPIIYlUIILLS
BUILDING DEPARTHENT
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1.0 /..d~-'YI +c:lu--- i6f/I"'€- PHONE? f'bl ~ ( P 26
&uvt &. Lqait;rA/I/J ,F! ift7~1-908'/
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LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION 'Lf;I ~g:;l J'A..'!:<f
PARCEL LD.' /~ - 76 - J.-' -LJ 0 / b - I ~ g- Z'6 _l5~~BTMN FROH PROPERTY TAX NOTICE)
OWNER'S lWtE J!~ bey{- It
OWNER'S ADDllESS 116, f 3
.'09
JOB ADDRESS
WORK PROPOSED:~ew Construction ~ition ---..Alteration ---....Repair _Install
_Sign --'love -Deaolish
PROPOSED USE: ~iog1e Faaily --It/F _' of Units ----1I/H
.-A...ec-ercial _Indust. _Swill. Pool _Other
----Restaurant &: Health Departaent Approval
DESCRIPTION OF WORK: 01/ t.k/fVf~' ~* .du,.'lc/ 0,1/1 \ /fp./er .e..-X/~f- ;(ppJ:-
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BUILDING SIZE: t;'v X /J.-? . no'-D Square Feet. It> Height
RESIDEIITIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.
cotIHERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ERERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION.
-BUILDING
$
RT.RCTRI.CAL
W.R.E.C.
---llECIIAlIICAL
$
Valuation of lIecbanica1 Installation
---...PLUllBIMG
GAS
ROOFING
SPECIALTY .
TYPE OF OOIJSTRUcnOR: --Bloclt
PIllISBBD PLOOll BLBVAnOIlS: ?1 Fl.
-LFraae _Steel LVH4i-,41/LJu ~ Other
IS PROJECT I.R I'L()(){ZONE AREA! L
YES
NO
..........................................
BUIT.DER
CONTRACTOR SECTION
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(7{ I N . ,A'1, /T ~, _ City License Registration' '17
..........................................
Signature
RT ,RCTRICIAII COMPANY t) 0 V C.-C-M ~ ()J E. sf- ':i.1'-<. ,
./ () () . ~ State Cert. or Regist. .
Simuaturei..' ~~2..: City License Registration' '1."'71
.... .....................................
PLUllBER
COtIPANY
State Cert. or Resist. .
City License Registration .
..........................................
Signature
IlECllANICAL
COMPANY
State Cert. or ReSist. .
City License Registration .
..........................................
Signature
OTRRR
t';} ~ COIIPANY J"k/f/,flite. A/Luh 1~~/F1-1
ie . ~ State Cert. or Resist. .
"k ,UP City License Registratioo . 7'7
..........................................
Signature
APPLICAnON APPROVED BY
.PEBHIT OFnCER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'l'be undersigned understands that this perlit lar be subject to "deed restrictions" wbich Iilr be Ere restrictive than Citr
regulations. !be undersigned assU188 responsibility for coapliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OIlIer bas hired a contractor or contractors to undertake IfOrk, ther lar be required to be licensed in accordance with
state and local regulatiOD,S. If the contractor is not licensed as required by law, both the owner and contractor lily be
cited for a lisdeleallOr violation under state law. If the owner or intended contractor are uncertain as to "hat licensing
reguirel8Dts lilY applr for the intended work, ther are advised to contact the City of Zepbyrbills Building DepartEnt, (813)
788-6611.
FurtherlOre, if the OIner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
"Contractor Sectioos" of this application for wbich ther will be responsible. If you, as the OIIIler sign as the contractor,
rou are indicating that JOu, rather than the contractor, are responsible for the work. If the contractor "ishes rou to sign
as contractor that lily be an indication that be is not properly licensed and is not entitled to peClitting privileges in the
Citr of Zepbrrbills.
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 "Plorida's Construction Lien Law - lIoEoImer's Protection
Guide" prepared by the Plorida Departlent of Agriculture and ConsUl8l' Affairs. If the applicant is 8OI8ODe other than the
"owner", I certify that I have obtained a copy of the above described dOCUleDt and prOlise in good faith to deliver it to the
"owner" prior to CoaeDC8IeDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIliltion in this application ia 'accurate and that alllfOrk will be done in COIpliance with all
applicable lawa regulating construction, loning, and land developlleDt.
Application is hereby Iilde to obtain a perlit to do work and installation as indicated. I certifr that no work or
installation bas ~ced prior to issuance of a perlit and that all work will be perfoClec1 to I88t standards of all laws
regulating construction, Citr codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certifr that I understand that the regulations of other govel1lleDtal agencies Iilr apply to the intended II01'k, and that it is
IY responsibility to identify what actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
I DepartJent of EnvirODJelltal Regulation- Cypress Baybeacls, lIetland Areas and EnviroDleDtally Sensitive Lands,
lIater/lfastevater 'l'reatlent
I Southwest Plorida lIater Managel8Dt District - lIells, Cypress Barbeads, lIetland Areas, Altering lfatercourses
I AIIY Corps of Engineers - Seawalls, Docks, Navigable lIaterways
I Departlent of Health' Rehabilitative Services, EnviroDJeDtal Health Unit - lIells, lIastewater 'l'reatlent, Septic lanks
I US EnvirODJeDtal Protection Igency - Asbestos abatuent
I also certify that, if fill Iilterial is to be used in Plood ZOne "I" or "I,etc.", it is understood that a drainage plan
addressing a "COJpenSating volue" will be s_tted wbich is prepared by a professional engineer registered in the State of
Plorida 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 sball issuance of a perlit prevent the Building Official f[QI thereafter
requiring a correction of errora in plans, construction, or violations of any coele. Bvery perlit issued &ball bec:me invalid
unless the work authoriled by such perlit is COIIeIlcedwithin sillOlltbs of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of ail IOIltbs after the tile the work is ~ced. One 90 clay utenaion of tile, Iilr be
allowed for the perlit with fee charge of $15.00. !be utension shall be requested in lIIiting to the Building Official. An
approved inspection lUSt be logged during each sillOllth PeriOd, or the project will be considered abandoned.
IIIRHING TO (JIRER: YOUR PIILURI 'l'0 RECORD A NO'lICE OF ~ lilY RESULI II YOUR PinK; !IIICE FOR IIIPROVIIIIIIS 'l'0 YOUR
PROPERlY. IP YOU IIIIID TO OBIIII iIlUCuG,.COJfSUL! 1I1'l'B tOOi LUDIR OR IIlftORDY BEPORB RECORDII; YOUR JOIICE OP
aJlMEJfClllBNl'. - JOBS UNDER. $2,500 IN VALUE DO NO! IEID TO RECORD IffD POSt I "IOllCE OF aJIIIItCBIIBII".
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SIGHA'l'URI: OOBR OR IGm
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SIGlllruRI:
S1'l'fl OP PLORIDI ~
coum OP .<fC()
The foregoing instrument was ~c~owledged
before me this)7~ ,;(,.;2.. , 19f.Z:.. by
"
",1)f:\~ KATHERINE M, BREWER
NI'Q'~*! !-8'f COMMISSION' CC317615 EXPIRES
~,~y September 26. 1997
"'~Rf.~\' ,'" BOtCJED THRU TII)V FAIN 1NSUIWa.INC.
l$.;:&~~~~~ KATHERINE M, BREWER
!*{ i*~ W COMMISSION /I CC317615 EXPIRES
~t, ,~~ 8eJltember 26.1997
-',.w..'r.I. . BONDED TIIRU TROV FAIN INSUIlANCE,Ir<<:.
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CUSTOMER TELEPHONE
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PHONE 782.5312
L.S. McKell Construction
35648 Chancey Rd,
Zephyrhills, Florida 34248
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CERTIFICATE OF COMPETENCY 4.5 TE1tMS
State Registered fJl.~ I'~.sll Cl/e:e>o.C-.:I,
Building Contractor RBOO12335
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~fJ~~E: -,;- ~~Kell Construction
guarantees Work against defects in workmanship
for a period of one year to the original
purchaser, The guarantee does not cover
damagell causc;d by high winds, tornadoes,
hurricanes, OJ' any other acts of GQd,
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AatIIoriled Repreeeatatlve
In event Seller has to sue for collection of all or any part of contract
price, purchaser agrees to pay collection costs including reasonable
Attorney fees.
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SALF.S TAX
RUlI.IlINC PF.RMIT
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CHAND TOTAL
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Please make all cheeks payeble to Lewis B, McKell.
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