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Home My WebLink About95-4789 BUILDING PERMIT Permit ~ CITY OF ZEPHYRHILLS (813) 788-6611 4789B Date 3 -;l.:L -9";;- e ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Property Owner: ~ i ~ .~/V\ A A- ~.?R--L/t) 7 L 7? ~~'- ~ E. Water Meter: T,I,F's: Job Address: Parcell.D. # Zoning: Energy Code: Description of wor;- R~. ~ Radon Gas: ~ / NO OCCUPANCY BEFORE C.O. FINAl___3-;).. 9~ 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 LJ City License Registration # State Certified License# ~J... :~~~~::'Gf$~--=- Company Address Telephone# Valuation or ~ / Contract Price 7" 1~ ----r:; . cTU ~~'YUA- (;~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPAR7MENT OWNER ~~4.Yl ~Q~ bDl.QAAd~ ll)ar~cu.s.e L,(< sLi ~-\ L,\h.JL,PHONE b()\~.er :so.. yY\ ~ l~~ "~~VCJ APPLICANT ADDRESS JOB LOCATION LOT SIZE_X AREA SQ.FT, LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D,# o d. - a ~ . d l - GO \ 0 ... 0 S ~oO - 00 \ ~ WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign _Move ____Demolish ____Commercial ____Indust, ____Swim. Pool _____M / H ~ "^-nt~b-Other PROPOSED USE: ____Single Family _M/F ____# of Units ~ _Restaurant & Health Department Approval Bu:hD"fNG SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S,** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction _ELECTRICAL .I ____MECHANICAL $ AMP Service Florida Power Corp, _W.R.E,C. Valuation of Mechanical Installation GAS ~ROOFING SPECIALTY ____Block _Frame _Steel Other _PLUMBING TYPE OF CONSTRUCTION: FINISHED FLOOR ELEVATIONS: FT, ****************************************** Signature ~ CO~T~~~~n~ECTTON State Cert. or Regist. # City License Registration 4F / ****************************************** BUILDER :::::::AN :~ Company State Cert. or Regist. # - - ***..****........~~~~.;~;:~~:*~:~~~~~:~~~~ iI X- X Company State Cert. or Regist. 0 Signature / City Lice'nse Registration ,~ ~c{)~ . * * * * * 1: 1:* * * *** ** ** *** ** * * ** * of: * of:,~ * ,', * * *1:'~ 1: 1: ,', 1: OTHER~ ~ Company ~ r~1zG -.' ~/ .' State Cert. or Regis, # ~ I~~ Signature -- L ~ City License Registration iF 4.2 -- ~ - Signature Company State Cert. or Regist. iF City License Registration # **********************m******************* PLUMBER MECHANICAl ****************************************** APPLICATION AJ;>PRQVED BY PERMIT OFFICER, CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlitlay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. . B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance _lth state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lav bE cited for a lisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as to what lic~nsino requirelents aay'apply for the intended work, they are advised to ,contac.t the City Df Zephyrhills Building Deparhent, (8131 7BB-bbll. Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions Di the "Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contracb:, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sIgn as contractor that lay be an indication that he is not properly licensed and is nDt entitled tD perlitting privileges in the City of Zephyrhills. 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 .FIorida's ConstructiDn Lien Law - HOleowner's ProtEction Suide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than th~ "owner., I certify that I have obtained a copy of the above described document and promise in gODd faith to deliver it t" the .owner. prior to cOlaencelent. :~. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all wDrk will be dDne in co.pliance with all applicable laws regulating construction, zoning, and land developlent. I Application is hereby lade to obtain a perlit to do work and installation as indicated, I certify that no work Dr installation has cOllenced prior to issuance of a perlit and that all work will be perforled tD leet standards Df all laNs regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies aay apply to the intended worK, and that it is IY responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not limited tc,: I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treataent I Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering WatercDurses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I De artlent of Health & Rehabilitative Services Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks I Environlental Protection AQency - Asbestos abatelent I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.., it is understood that a drainage plan addressing a .co.pensating voluse" will be sub.itted which is prepared by a professional engineer registered in the State of Florida 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, caocel altEi, 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 cDde.. Every perlit issued shall beCDle invalid unless the work authorized by such perlit is cOllenced within six sooths of issuance, Dr if work authorized by the per~lt is suspended or abandoned for a period of six lonths after the tile the work is comienced. One 90 day extension of tile, ~2f be allowed for the pertit with fee charge of SI5.00. The extension shall be requested in writing to the Building Official. An approved inspection aust be logged during each six lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOP. IMPROVEMENTS TO ;OUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCINS, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM CEMENT. J S UND ,500 IN VALUE DO NOT NEED TO RECORD AND P "TICE OF COMMENCEMENT". STATE OF FLORIDA~ COUNTY OF ~D The foregoing ins~lument was acknowledged before me this. a-d-., 19~ by ~ ') 0",""," Do\ -e..na.e.r who is persc.na 11 y known to me Or Wi'L' has ~-6dL.I,-""J as identification and who take an oath. STATE OF FLORIDA ~ ~ COUNTY OF I"lJt . The foregoing instrument befc,,-e me th i 5 ,1/ ;}- d- lo'Jas ack\,~l edged , 19~ by who is personally pl6duc.:ed as identification take an oath. (Signature) (SignatLn-e) (Name Typed, Printed or Stamped) NOTARY PUBLIC ~~.. ....'~ ". ~ g JUDITH L. SCHAPER Notory PubliC. State of Rorlda My Comm. Exp. June 6. 1997 No, CC 292357 (Name Typed, Printed or Stamped) NOTARY PUBLIC ..~..., ."." o ~ z Pi JUDITH L. SCHAPER Notary PubliC. State of FIorfclo My Comm, Exp. June 6. 1997 No. CC 292357 :1 I. Ii ,\ II !i II II II i I' I 11250 South Highway 98, Dade City, Florida 33525 :11 I Phone 4* (904)567-8580 I Bonded and Insured : II I ;;;~~i~t~~=~;{~~~t-~- ~:~n:~~~~~\~: ~~-'J:~~:~I i 3'0 Y'i 7 ttvy S-i E- ~.jh WS/+ cJvt.J,,~...~e. \i I ~;h;':~~~~f:ca~:~~;: a;~- e~t;::tes for:-;lRooF --Ii -- NUMBER OF f:3QUARES -W- !I \1 II ~ o&,l I NEW WOOD ALLOWANCE, -=D-~f""""'V ' \' - I hl~3T ALL NEW ~_ I-:El" FEL T DRY - I N ~ ~ l e... G/' f l", ~ ~4.0\ ll.1lF. I' I I \ \1 il i: 'I il ~. ;'._;..:;;;:~.::;.;;...,;.;.:=::.;~.;..~....~;..:. ..~.. ...:.;.;.-:.;.;;;-_:.':";:'~'::;";..~':o;..:.;;';'.- :._. ~~_....:._,_.:~_;..~..,,:;':';_:""_;"";":~;":''':':-......_._..............,....-.....-......-,-....- _. ... ..-.--.. 0,-. . .,' ,- .....-,..., ..... ....-..-...-. ...----....--.....-...-. _.~_...-........._-- ~\ - ! I II II I, I' I F"ALJL, SCHAF"E_FO: L-::ONS""3TRUC." J: ()N CQ... RESIDENTIAL & COMMERCIAL Registered Building Contractor Reglstered Rcoflng Contractor RB 0032524 RC 0056763 _ REMOVE EXISTING SHINGLES, DRIP EDGE, AND DAMAGED WOOD -- INSTALL NEW VALLEY METAL AND FLASH.J;G \ __ INSTAL.L NEW ~~l.~ ~(bW~lt~......""'"'- ~I~ ;DGE II. - INSTALL NEW VENT BOOTS I NST ALL 2~'7<'R l M~F ACTURERS WARRANT U'J) F I ilER~:t:::H INGLES BRAND : ~_ COLOR: ~~~ f\ ----- - ClJl"lF'LETE TRASH REMOVAL ~~UNTY PERMIT INCLUDED - 5-YEAR CONTRACTOR'S LEAK WARRANTY I il tI '1 ~,9 JQt.il.i ii .:".. I, '>;:~:"Xf '~:i': :1 , , '1~, : I 'I 'tooO~ Ii 1-p~ .L:~.qt4~~-.Mi=""'I-~~B~~Jb:&: ::F COMPL.ET I ON 'I , ' f)Q [,,,,< L (Ot.)f "5D J~.s. :: --------- ni~'''- GOq~l' - _ ____ __ PAUL". APER, CONTRA~TOR _ ,/,/ /g I ACCEY I ~D'. _ ",,,-",,- ~ J",/ { of --Is i gna t~~ -- j/ 0 ~ l~~~~~~ _ _ Sign~~ -- TOTAL COST: ,- ;;..-...-..' ~..;~ ~~~~ ~_~;.--.r~ '~.'\",-,'_I!-"" .-~~___"'.................-.......-.. --...~_.......~._. -.1.-: "1,1 \ i I. I ., :i ~ I ,___n il II ............-...