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Home My WebLink About95-4810 BUILDING PERMIT 0 CITY OF ZEPHYRHILLS Permit N". (813) 788-6611 481011 Date 3.-3 CJ - y:.s- d ". CJl.) PLUMBING ~.--- tfV ~A~ Sewer Conn BUILDING ~ECTRIC~ P,op,rty Own,,,. ,~ <?j' ~ Job Address: If:, / () Water Conn: Water Meter: T.I.F.'s: Parcell.D. # Zoning: Energy Code: Description of Work '--11 t?.A.-. ') A-/ L: Radon Gas: FINAL~Y~~ - DATE NO OCCUPANCY BEFORE C.O. Complete Plans. Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Permit Fee Signature Company Address Telephone# -5fi:J: ,~ Valuation or Contract Price ~ 3 9~ '. OV City License Registration # J Y State Certified License# BUILDING ~i? ~~hff ELECTRICAL dl Y lJ /1~ ~PJdL PLUMBING MECHANICAL 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER -~ l1J01 Pauf De~M()(t- LQt01 fl:arL APPLICANT ADDRESS PHONE F/3 '1~f~1qy::) JOB LOCATION LOT SIZE_X AREA SQ,FT, PARCEL I,D.4F " ~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION _Sign _Ins tall WORK PROPOSED:_New Construction _Addition _Alteration _Sign/Temp. _Move ~De~olish _Commercial _Indust. _Swim. Pool __M/H I1/C =~tdr~er PROPOSED USE: _Single Family _M/F _# of Units _Restaurant & Health Department Approval BUILDING 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 ~LECTRICAL _MECHANICAL $ Valuation of Total Construction AMP Service Florida Power Corp. _W,R,E.C. $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel _Other FINISHED FLOOR ELEVATIONS: FT, ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. 4F City License Registration # ****************************************** BUILDER Signature 1 /-" ::'::::::A~; c':~:5: Company ~dc A:-r.u:J LK-H-tv,JhL State Cert, or Regist. 4F City License Registration # ****************************************** kj t!:c7/< rc.A- L C€J AI Tte,f-e-?(;/( 62- 1/ () Company State Cert, or Regist, # City License Registration # ****************************************** PLUMBER Signature MECHANICAL Signa ture !Je;JJ~~A.- r9l_~N Company f?xj,;, PrO(lfPU- W <1 ~1?. /:1ne~ State Cert. or Regist. # CAC04-~q4f City License Registration # 11 ****************************************** Company State Cert. or Regist. # City License Registration # OTHER Signature ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to "deed restrictions. which may be more 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 Dr contractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (813l 7B8-6611. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl sign portions of the .Contractor Sections" of this application for which they will be responsible, If you, as the owner sign as the contractor, 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 not entitled to permitting 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 "Florida's Construction Lien Law - HOleowner's Protection Guide" prepared by the Florida Department of Agriculture and Consuler Affairs. If the applicant is sOleone other than the .owner', I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner' prior to cOlmencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land development. Application is hereby lade to obtain a perlit to do work and installation as indicated, I certify that no work or installation has comlenced prior to issuance of a perlit and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in trllllpliance, Such agencies include bllt ~ie not lilited to: I Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitiv~ LdAds, Water/Wastewater Treatlent I Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways f Departlent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatment. Septic Tanks I US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.', it is understood t~it a drainage plan addressing a .colpensating volullle' will be sublitted which is prepared by a professional engineer reqisteied in the State of Florida prior to permit issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to viol~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Offici~J frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit"issued ihall becole invalid unless the work authorized by such penH is cOlllenced within six months of issuance, (Ir if 1'lCtrk authftl lzed by the perlliit is suspended or abandoned for a period of six lonths after the tile the work is commenced. One 90 day e~tE~sioii of tile, lay be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official, An approved inspection lust be logged during each six 110 nth 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 FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A1TORNEY BEFORE RECORDING YOUR NpTICE pF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED'TURECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE SIGNATURE ---------------------------------- OWNER OR AGENT CONTRACTOR DATE DATE --------------------------------------- NOTARY AS TO OWNER OR AGENT NOTARY AS TO CONTRACTOR MY COMMISSION EXPIRES MY COMMISSION EXPIRES