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Home My WebLink About95-4824 BUILDING PERMIT Permit ~ CITY OF ZEPHYRHILLS (813) 788-6611 4824/1 Y"-S-f~ Date BUILDING ELECTRICAL PLUMBING C;::A~ Sew" Cone Water Conn: ::~:;:,~:ne',1! r-E-~~~ Water Meter: T.I.F.'s: Parcell.D. # Zoning: Energa: Description of Work -41 G / .d/h--r- Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL~I-~ 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 .:i;{j. tJ-i:) Signawre LVYLdv 1f:W-hJ Company Address Telephone# Valuation or Contract Price ~.~ - c::J'"l.--:J City License Registration # )7 fi/ State Certified License# ,L3~L'---Y!~+-/y'G BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor F:inal 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 APPLICANT ~tlh r '6 Pro paA1t ~s ~ 44til A\~ R&. ~lM3{Lret rilcktft 3g(odS S..}h ~ Ale ADDRESS PHONE 199-It1ob OWNER JOB LOCATION LOT SIZE_X AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.4F II - -~0 - ;<i - 00 10 i 0 4-00 -- ooti D WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign/Temp. ____Sign ____Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____4F of Units .____M / H ____Commercial _Indust. _Swim. Pool Other _Restaurant & Health Department Approval BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.'U **COPY OF CONTRACT REQUIRED, PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction _ELECTRICAL /MECHANICAL 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, iF City License Registration # ****************************************** BUILDER Signature Signature Company State Cert. or Regist. # City License Registration # ****************************************** ELECTRICIAN Company State Cert. or Regist, # City License Registration # ****************************************** PLUMBER Signature Mf.CHANTCA; ~ Signa ture X Company Btt.h( '5 PrDptLht ~tts ~ Alc) :1hG M.. _ A., , State Cert. or Regist, IF CAc.o.t1,3'1Al?; ~ City License Registration ;F '76 ****************************************** 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 perlit lay be subject to "deed restrictions" which ;ay 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 with state and local regul.ations. 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 requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, l813} 788-6611, Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractorls} 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 may be an indication that he is not properly licensed and is not entitled to periitting 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 - Homeowner's Protection Guide" prepared by the Florida Departlent 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 cO.lencelent, E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby tade to obtain a pertit to do work and installation as indicated, I certify that no work or installation has cOllenced prior to issuance of a pertit 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 governmental agencies may apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in compliance. Such agencies include bllt ~ie not lilllited to: I Department of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treat.ent I Southwest Florida Water KanaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Depart.ent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent. Septic Tanks I US Environlental Protection AQency - Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc,., it is understood th~t a drainage plan addressing a "colpensating volume" will be sublitted which is prepared by a professional engineer registEred in the State of Florida prior to periit issuance, A permit issued shall be construed to be a license to proceed with the work and not as authority to vioj~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Officidl from thereafter requiring a correction of errors in plans, construction, or violations of any code, Every permit issued shall beco.e invalid unless the work authorized by such penit is cOlmenced within six lIonths of issuance, Of if work auth{ll lzed by the per.it is suspended or abandoned for a period of six lonths after the ti.e the work is commenced. One 90 day e~t€hsioll of tile, lay be allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six tonth period, or the project will be considered dbciildoned, 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 NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD 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 ~- ~ }'-~c-:ry .-~ BAHR'S PROPANE GAS & AIC INC. Sales, Service & Installations 4441 Allen Road ZEPHYRHILLS, FL 33541 (813) 782-5013 SOLD BY DATE -5 NAME 'i"""~-'''''''''''''''' 19 q. _':j \' L(~) 1- Ii -, PHONE '{ \ \ ~ - V I U( QUAN. DESCRIPTION PRICE 2 3 500. 4 5 6 7 8 9 10 11 12 13 14 15 16 ,. .. }', RECEIVED BY "EMPST&~1. Heating and Cooling Products ~cy9W AMOUNT TOTAL - };