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Home My WebLink About95-4707 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 () (). cTD ;;Lo _ o-V CSU'LD~ G~CT~ PLUMBING MECHANICAL ;:::~;~~,;n:6i1~ ~ili~Z:f! ~+'-Y Zoning: ~ . Energ.y CO,de: . ~adon Gas: De,c,;.';on of Wo,k , 1;; < -"-1 /'? ~./ ~~ P . NO ermlt '. 4707 Jj Date ~ -....21) - ?...s- Sewer Conn Water Conn: Water Meter: T.I.F.'s: NO OCCUPANCY BEFORE C.O. FIN A L -\",=3 - 2.. 2..: ) DATE Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances, Inspector Valuation or Contract Price Permit Fee /Y6l, Signature U-, Compan~ Address Telephone# f::s. O. c:rv J) LJ--v ~. '-K" ~--'Qz, ..- ? City License Registration # L;~ State Certified License# ~~ J~"Li BUILDING p. ~.tJ'/ .;L '/0 ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final :3- Z~q) %cb SLB Tub Set Water Sewer Final Driveway ~ \}'~.~ ~:) -~ "5 ~ L~ Breakers Ducts Ins!. 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 ZEPIIYRHILLS BUILDING DEPARTHENT OWNER'S IWIILt~ ~"" (0){\&\A. \4-u"Jfr ~U~S --:I ~ '" OWNER '5 ADDUSS'Sq \ D ?, f\D1:aLtC ~ \ ~ l~ \ JOB ADDRESS l:tr2..'; C<2~~(L er cl& 't", S~~e s PHONE 9l"S-lblS t~t\~ l I r-~ L :S~~l(O \ -~ LEGAL DESCRIPTION: LOT(S) PARCEL I.D.,IJJ- ~ 6 ~ J ( BLOClL-SUBDIVISION (!J cJ ~ () - (J U / c7 tJ '- 6J tJ ~ f) (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~ew Construction -Jddition ~teration --..Repair _Install _Sign -.JIove -Deaolish PROPOSED USE: ~iDg1e Faaily ---.Jt/F _, of Units ---.Jt/H -4ec-erCial _Indust. _Swia. Pool _Other -.Jlestaurant &: Health Departaent Approval DESCRIPTION OP WORK: T J'-I It- e l - IJ I'.... i2 t PJ lJ dE' / I' J--' 9- BUILDING SIZE: ,.s;- 0 X I a. (.l , Square Peet. Height RESIDERTIAL: AT'lACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. COMMERCIAL: AT'lACH (3) SETS OP BUILDING PLANS &: (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~UlLDING otJ_ $ ~ ..s- t:) ~-- PERKITS REQUESTED Valuation of Total Construction RI.RCTRICAL AIIP Service Plorida Power Corp. W.R.E.C. ---"ECHAlIICAL $ Valuation of Kechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OP CONSTRucnON: _Block _Praae _Steel Other PIllISBED FI.OOll ELEVAfiONS: Fl. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... .mUla. /! t(- Signature 0--" J -~ CONTRACTOR SECTION , COHPABY 0d ;( J-- ( " I.. " s: /-' ~. . -i 4. G tJ ,. ~.(" -/' ~-/e~tP7 State Cert. or Regist. ,_ ~4--'.. City License Registration' -* be') .......................................... 7 l RI.RCTRICIAR ,/1, COMPANY k/ (. Ii A,11. tJ C e A./II1.1 ji-e. i ;FL e < rL! i'rlf L ~ 1t/ T . './ / ~ /7 State Cert. or Regist. , SiItnAture&",t>tU~,./( {,,'-t/i/~^~(jJ City License Registration' a~Yo .......................................... PLUMBER COMPANY State Cert. or Regist. f . Signature City License Registration , .......................................... IlECllANICAL COMPANY State Cert. or Regist. , Signature City License Registration . .......................................... OTRRR COMPANY State Cert. or Regist. , Signature City License Registration , .......................................... APPLICAfiON APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS !be undersigned understands that tbis perait lilY be subject to .deed restrictions" wbieb lilY be lOre restrictive than City regulations. !be undersigned asSUle& responsibility for cmpliance witb any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If tbe owner bas bired a contractor or contractors to undertake work, they JaY be required to be licensed in accordance witb state and local, regulations. If t,be contractor is not licensed as required by law, botb tbe owner and contractor lilY be cited for a .isdeJeal1Or violation under state law. i If tbe owner or intended contractor are uncertain as to "bat licensing requirel8llts lilY apply for tbe intended work, they are advised to contact tbe City of ZepbJl'bills Building Departlent, (813) 788-6611. ' Furtberaore, if tbe owner bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe .Contractor Sections. of this application for wbieb tbey will be responsible. If you, as tbe owner sign as tbe contractor, you are indicating that you, rather than tbe contractor, are responsible for tbe work. If tbe contractor wishes you to sign as contractor that lilY be an indication that be is not properly licensed and is not entitled to perlitting privileges in tbe 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, tbe applicant, bave been provided witb a copy of .Florida's COnstruction Lien Law - lkIIeoImer's Protection Guide" prepared by tbe Florida Departlent of Agriculture and COIISUIIeI Affairs. If tbe applicant is SOlC!Olle otber than the .owner., I certify tbat I bave obtained a copy of tbe above described docuJent and pIOlise in good faitb to deliver it to tbe "owner" prior to co.enCl!lH!Jlt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in tbis application is accurate and tbat all work will be done in COIPliance witb all applicable laws regulating construction, loning, and land developlent. Application is hereby lade to obtain a peIlit to do work and installation as indicated. I certify that no work or installation bas ~ced prior to issuance of a perlit and that all work will be perfoIlecl to leet standards of all laws regulating construction, City codes, loning regulations, and land developlll!llt regulations in tbe jurisdictiCll. I also certify that I understand tbat tbe regulations of other goveI1llleDtal agencies lilY apply to the intended work, and that it is If responsibility to identify wbat actions I lUSt take to be in COI(Iliance. Sueb agencies include but are not lilited to: . DepartJent of EnviroDlll!lltal Regulation - Cypress Baybeads, Wetland Areas and EnvirOlllH!lltally Sensitive Lands, Water/Wastewater !reatlent t Southwest Florida Water Hanagl!lH!Jlt District - Wells, Cypress Baybeac1s, Wetland Areas, Altering Watercourses . ArJy Corps of Engineers - Seawalls, Docks, lIavigable Waterways . DepartJent of Healtb , Rehabilitative Senices, InviIODll!lltal Healtb Unit - Wells, Wastewater !reatlent, Septic lanks t US Envi1'OllleDtal Protection Agency - Asbestos abatl!ll!llt I also certify that, if fill Iilterial is to be used in Flood ZOne .A. or "A,etc.., it is understood tbat a drainage plan addressing a .cQlPeDSating volUlle. will be sublitted wbieb is prepared by a professional engineer registered in tbe State of Florida prior to peIllt 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 tbe technical codes, nor sball issuance of a perlit prevent the Building Official frOl tbereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beaIIe invalid unless tbe work authorized by sueb peIlit is COII8Jlced witbin silaontbs of issuance, or if work authorized by the perlit is suspended or abandoned for a period of sil aontbs after tbe tile tbe work is co.encec1. One 90 day atension of tile, lilY be allowed for tbe perlit witb fee charge of $15.00. !be t!ltensiOD shall be requested in writing to the Building Official. An approved inspection lUSt be logged during eaeb silaontb period, or the project will be considered abandoned. WAIUUHG 'fO 0IRfIR: YOUR FAILURE !O RECORD A 1I0000ICE OF COlMDCIIIEIft MAY RESUL! III YOUR PAYIIIG filCE FOR IMPROVIIIII!S !O YOUR PROPmY. IF YOU IIlDHD 'fO OB!AIII FIWCIIIG, COKSOLt WID YOUR LBIIDII OR 111 AnoRIIY BIFORI RICORDIIIG YOUR IIOI'ICE OF aJlMlIICBMm. JOBS UllDIR '2,500 III VALUE 00 110'1' ifili) 'fO RECORD lIID POS! A 'IIO'I'ICE OF crJIIIDClllElftI. SIGD!URI: COH'lRAC!OR SIGDtURI: (MIll OR AGm S!AD OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by S!AD 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 Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name, Typed, Printed or Stamped) NOTARY PUBLIC ':c- ) 1) ___ ) Terrv\ ) \Rih+ - Tele(tla'o ~ - i=c.\. ')c -~ . ~~'1' ~v- c ' ~R~ I .--- ~ ~<. lt~ IXm Dab) /' 8 OF9i(.t. I, "RtOrv\ . .-#-'1 S\ReSS, lEST _ iS~ B/rrH ~Li)MAN Offi L.f. s,,~ G-l{M Ji 7 '1i ~ ~~( r f. , "'t. (') ~~ o ~~ -r p' Nu,r8~~~dwrf': BjP ~ ~h .. 7 '.- +.,0 LOf3S~ rJ ~lAN!~, Q off( ~ ~"r ""---- ..1\) ~ .6> ~a.c ~ ...... 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