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Home My WebLink About95-4682 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit ~ 4682/1,1 Date ;l - f"-- 9S- BUILDING :Lo - d7J GLECTRICA~ PLUMBING .3 tfJ . 1ft) GC~A~IC~ Sewer Conn Water Conn: :~~:::,~:.ne'? ~fA1?/i{:: Water Meter: T.I.F.'s: Parcell.D, # Zoning: Description of Work d Energy Code: ,~ A-/ L Radon Gas: NO OCCUPANCY BEFORE C.O. FINAl~ -11f-@:J DATE Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances, DATE Inspector Permit Fee Signature Company Address Telephone# ,-S'o-d7J L c-.A/(),. II- (/ Valuation or Contract Price ~s-O-V # u-o , City License Registration # 7 I State Certified License# PLUMBING ,~M,J1 ~ MECHANICAL BUILDING I ~;4ret~ -- ELECTRICAL /-.!> I Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Serv. Rough In Meter Can Const. Pole Pool Pre-Meter 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 ZEPIIYRBILLS BUILDING DEPARTKENT JOB ADDRESS ;-f .J~AJ ftJ& ~ Is ?? ?;{ A l:""- s c;; t4- . .5' I</?vt s? PHONE 7,g.;? - ? I .? C} OWNER' S NAHB OWNER' S ADDRESS LEGAL DESCRIPTION: LOT(S) B~SUBDIVISION (OBTAIN FROM. PROPERTY TAX NOTICE) PARCEL LD.' WORK PROPOSED:-----Rew Construction ---^ddition ~teration ~pair ._Install _Sign ---lfove ---->>eaolish PROPOSED USE: ~ingle Faaily --1.4/F _' of Units --1.4/H _ec-ercial _Indust. _Swia. Pool _Other ---Restaurant Ii: Health Departaent Approval DBSCll1PT1OR OP 1llIIllC: ~ (cnu 41 C- BUILDING SIZE: x Square Feet, Height RESIDERTIAL: COttHERCIAL : ATTACH (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. ArlACII (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FOlUlS. PROPERTY SURVEY llEQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REQUESTED ~UILDING $ Valuation of Total Construction RT.RCTlUCAL AIIP Service Florida Power Corp. W.R.E.C. ..--JIECllAllICAL $ Valuation of Kecbanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUcnON: .-Jloclt _Fraae _Steel Other FIIUSBBD FLOOR BLEVAnORS: FT. IS PROJEC'l IN FLOOD ZONE AREA., YES NO .......................................... CONTRAC'lOR SEC'lION COHPANY State Cert. or Regist. . City License Registration . .......................................... RIJTI.DER Signature ~ ~~' CotIPANY "F'/~ <;; ( (1 /.A s ~ 1:.. Ie c'i:J ; c:: ~. ~ I State Cert. or Regist.'. C)oll S 1..2. _ "" "" ur ' " ,!1'"' / City License Registration' ,( <;""'7 . -" ".......................................... PLUMBER COKPAHY State Cert. or Regist. , Signature City License Registration . .............................~.....*..*.** JlKCllAllICAL COIIPAIIY 1.(;; A/~ c" -- c/,J State Cert. or Re st.' 0<::> s-r ('.:z. Signature City License Registration . 7 __ .......................................... OTRRR COKPANY State Cert. or Regist. . Signature City License Registration . .......................................... APPLICAnON APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS rbe undersigned understands tbat this penit lily be subject to Ideed restrictions I wbic.b lily be lOre restrictive than City regulations. !he undersigned assUl8S responsibility for co.pliance with any applicable deed restrictiOll8. . B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas Ilired a contractor or contractors to under tate wort, they lilY be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the OIfIIer and contractor lilY be cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertain as to what licensing requir8lenta lilY apply for the intended wort, they are advised to contact the City of Zep!lyrlli]]s Building Deparl:lent, (813) 788-6611. Furthenore, if the OIner bas bired a contractor or contractors, be is advised to baYe the contractor(s) sign portions of tbe ICon tractor Sections~ of this application for whic.b they will be responsible. If you, as the OlDer sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wishes you to sign as contractor that lilY be an indication that he is not properly licensed and is not entiUed to penitting privileges in the City of Zepbyrhills. _ 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 IPlorida's Construction Lien Law _ JGeoImer's Protection Guide' prepared by the Florida DepartJent of Agriculture and COIlSUI8I' Affairs. If the applicant is SOIeOIle other than the lowner', I certify tbat I have obtained a copy of the above described docUleDt and pr~se in good faith to deliver it to the "owner I prior to COllellCuent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and tbat all wort will be done in COIpliance with all applicable law8 regulating construction, loning, and land developlent. Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify tbat no IIOrt or . installation has cmlenced prior to isauance of a penit and that all IOrk will be perfoIlecl to leet standards of all laws regulating construction, City codes, loning regulations, and land deyeloplll!Jlt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveruental agencies lilY apply to the intended wort, and that it is .y respollSibility to identify what actiollS I .ust tate to be in cmpliance. Suc.b agencies include but are not lutted to: t Departllent of Bovirol1lental Regulation - Cypress Bayheada, Wetland Areas and BoviCODleDtally Sensitive Lands, Water/Vastewater rreatJeot t Southwest Florida Water Hanag8lent District - lIe]]s, Cypress Baybe., Wetland Areas, Altering Watercourses t Al'IJ Corps of Bogineers - Seawalls, Docks, lavigable Waterways t Deparf:lent of Health & Rehabilitative Services, InvirODllDtal Health Unit - Wells, Wastewater freat:lent, Septic fants t US InvirODll!J1tal Protection Agency - Asbestos abateleJlt I also certify that, if fill literial is to be used in Flood lone IAI or II,etc.I, it is understood that a drainage plan addressing a IlDpeDSating YOIUl81 will be sublitted whic.b is prepared by a professicmal engineer registered in the State of Florida prior to per.it issuance. A pmit issued shall be COllStrued to be a license to proceed with the IOrt and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor sball issuance of a penit prevent the Building Official frell thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery penit isaued shall beCOle invalid unless the wort authoriled by suc.b penit is COIIenced within sblODths of i88uance, or if IOrk authoriled by the penit is suspended or abandoned for a period of sil IODths after the tile the wort is co.enced. One gO day utension of tile, liy be allOled for the penit with fee c.barge of $15.00. The utension shall be requested in writing to the Building Official. An approved inspection lUSt be logged during eac.b sil IODth period, or the. project will be considered abandonec1. 1IA111ING TO (JfDR: YOUR FIILUHI TO UCORD I IOIIC! OF aIIIIIlCmr MAY RlSOLf IX YOUR PAYUG !IIIC! FOR DIPROVIIIIII'S TO YOUR PROPBRrY. IF YOU IIDJD ro oarw PllIAICI.G, COISOLf IIITH YOOR LIIDIR OR All AnoRIIY BIFOU RICOIDIIG YOUR IOrIC! OP ClIIHDCIHIHr. JOBS UlDIR $2,500 II VALUI 00 lor ffIID ro UCORD AID POST A '.OIIC! OF aJllllCllllftI. SIGlAfURI: (IOIJR OR AGIJII SIGlAruRI: COIWC'fOR srArl OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by SrArE OF FLORIDA COOllY OF Tbe foregoing instrument was acknowledged before me this , 19_____ by who is personally known to lie or who has produced 8S 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 Dot take an o~th. (Signature) (Namp. Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Hue Typed, Printed or Stamped) HOTARY PUBLIC """~~~.",~........;~;.",,,...;o-.c-~_., .:,-~,~.",,~-: ~'.~ - ..... ..' _. _. ..~~. .-- -. --~ Kinsey Central Heat It Air-Conditioning 7718 Fort King Highway . p.o. Boat 2209 Zephyrhllls. Aorlda 33539-2209 (813) 782-2300 IWIE s- ADORESS CITY MME IIlIOEl 1EJUM,1IO. ~IMATE o CASH o CHARGE NATURE Of .......... SERVICE a.,/ REQUEST ;; DESCRIPTION PRICE AMOUNT QUAM. PART NO. SERVICE PERFORMED lOTM. 1IAlBUM. 18aUL IEIMCE TIlE TAX ?'-' 11-' DAlt c:aMI'I11IIl CASH ::0--+ mAL TECHNICIAN\ L ( ) CUSTOMER'S SIGNATURE ? ~ ..J V..~ ~ '.), '7 -/~/