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Home My WebLink About95-4702 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ 470W dl--/?-9~ Q Pm pert, Owne, ~T. ?f6.f- Job Address: --.$-7-.5,-" ~- Parcell.D, # 11-t:9.-6 -c!J-.J - 3 Y - / f- - /7' , Date ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Water M~Jer: T,I.F:s: Zoning: Energ~de: Description of Work (''-. L " 'JA\.P 0 Radon Gas: ,3....... / NO OCCUPANCY BEFORE C.O. FINAL ~;J - .;) DATE Complete Plans. Specifications and Fee Must Accompany Application, All work shall be performed in accordance with City Codes and Ordinances. c.o. DATE Inspector City License Registration # State Certified License# Pe,m;, Fe~ ~_. ~~ Slgrrature ~ J Company Address Valuation or Contract Price ,S -.:::.s (:J . crt) Telephone# ((13 -1<6-3 -2.289 a'v..~ ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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 PERKIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER · S NAME (/Q} ( 'T"C, I iJni t p I OWNER · S ADDRESS , 5'1t..;:y-, B-J-n ~Y- JOB ADDRESS \t)"Ajn 8fh \)f PHONE 7Xi cJd8Q LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL I.D.' !J - d-b - ~/ -3 'I-~ Irr - / 'j SUBDIVISION (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition --^lteration -.Jtepair _Install _Sign --"ove _Deaolish v'~~('r PROPOSED USE: eX Single Faaily --"IF _' of Units _M/H _~ercial _Indust. _Swill. Pool _Other _Restaurant & Health Depart.ent Approval DESCRIPTION OF WORK:-/} /Jr.}' fj<J r& BUILDING SIZE: x Square Feet, Height RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTAGB (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total COnstruction _ELECTRICAL AKP Service Florida Power COrp. W.R.E.C. _HEGllANICAL $ Valuation of Mechanical Insta1lation _PLtJHBING GAS ROOFING SPECIALTY TYPE QF GONSTRUGTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION" IIlllLDER ~ COIIPAIIY \h \ ~~ State Cert. or Regist. . Signature O...U City License Registration' ~ ******* ********************************** RT .RCTRlGlAR COMPANY State Cert. or Regist. . City License Registration . ****************************************** Silmllture PLUHBER COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature tlECHANIGAL COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature omRR COMPANY State Cert. or Regist. f City License Registration f ****************************************** Signature APPLICATION APPROVED BY ':11 ~ /4..J'J- PERKlT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this perlit lay be subject to "deed restrictions" wbieb laY be lOre restrictive than City regulations. Tbe undersigned assUleS responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If tbe owner has bired a contractor or contractors to undertake IIOrk, they oy be required to be licensed in accordance witb state and local regulations. If the contractor is not licensed as required by law, both the mmer and contractor IiY be cited for a lisdelH!anor violation under state law. If the mmer or intended contractor are uncertain as to what licensing requirelents laY apply for the intended IIOrt, they are advised to contact the City of Zepbyrbills Building DepartleRt, (813) 788-6611. FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of tbe "Contractor Sections" of this application for wbicb they will be responsible. If you, as the mmer sign as the contractor, you are indicating that you, rather than tbe contractor, are responsible for the work. If the contractor wisbes you to sign as contractor that oy be an indication that be 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 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - BOJeOIDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUIBI Affairs. If the applicant is sOlBODe other than the . "owner", I certify that I bave obtained a copy of the above described dOCUll!llt and premise in good faith to deliver it to the "mmer" prior to cOllBDcelH!nt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforotion in tbis application is accurate and that all IIOrk 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 perlit and that all work will be perfoIJed to leet standards of all laws regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other goverDJeDtal agencies laY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: t Departlent of EnviroDlBRtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDJeRtally Sensitive Lands, Water/Wastewater TreatleRt t Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health i Rebabilitative Services, EnvirORJental Health Unit - Wells, Wastewater TreatleRt, Septic lanks t US EnvirODlental Protection Agency - Asbestos abatetent I also certify that, if fill oterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "cOJPBDSating volUle" will be sublitted wbieb is prepared by a professional engineer registered in the St~te of Florida prior to perlit issuance. A pe~it issued sball be construed to be a license to proceed with the IIOrk 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 frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issued shall becoJe invalid unless the work authoriled by such peIlit is COJJellced within sillOnths of issuance, or if IIOrt authoriled by the perlit is suspended or abandoned for a period of sil IOnths after the tile the work is co.enced. One 90 day eztension of tile, IiY be allowed for the perlit with fee ebarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An approved inspection lust be logged during eaeb sillOnth period, or the project will be considered abandoned. WARKING TO OIINER: YOUR FAILURE TO RECORD A NOt'ICE OF C(JIIINCBIID1' lilY RESULT IN YOUR PAYING "'ICE FOR IMPROVBIIBI1'S TO YOUR PROPBRTY. IF YOU IJl'fBIfD TO OBTAIN FIWCING, CONSULT WITH YOUR LBIDIR OR AI AnORRBY BBFORE RBCORDING YOUR JlarICE OF COHHBlfCBllBHT. JOBS UNDBR $2,500 IN VALUE DO NOt' MBlD fa RICaRD AID POST A 'NOt'ICE OF C(JUIINCBItBJI'f". SIGNATURE: OIfHIR OR AGEJI'f SIGHATURB: CONTRAC'fOR STATE OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA coum 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 Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Naae Typed, Printed or Stamped) NOTARY PUBLIC OWNER CITY OF ZEPIIYRIULLS (iln J Jr)/// (JIFYIt1 , ,~13J R+h 0t- BUILDING DEPARTMBNT JOB LOCATION PARCEL I.D. # SHON ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SBTBACKS. 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