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Home My WebLink About95-4845 BUILDING PERMIT Permit ~ CITY OF ZEPHYRHILLS (813) 788-6611 4845/1 Date. )I_/eJ- -9~- BUILDING 2.!;;--' 0-0 ~ - _.- Peap."V Own.e '~"~6~ l1-a-lL Job Address: ...!> ~ ""'-- ....( . L - .A... Parcel 1.0. # Id.- - db .2/-0030 - 00 yoo - cJOb 0 ~I d7J ~) .... -- PLUMBING Sewel' Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: Description of Work ~/A--1.j Aj./ c Radon Gas: FINAL ~--11",~ NO OCCUPANCY BEFORE C.O. 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 tv' Peem;' Fee iiP~' fIt:-. fJ:a ~ Signature" ( _J. eM. ( 17~ / 4'-/' Company Address Telephone# Valuation or Contract Price City License Registration # State Certified License# ! ~ ,_)~-' t-TD .,2)1/ / BUILDING jj~~IU-.J 'J? .v.e-4-C2 ELECTRICAL PLUMBING (!'-v,./Yl.Q "'-- MECHANICAL Breakers Ducts Insl. Compressor Final 5- J ,~q 5"" &.h SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final .S...I'7~i) &Ji= 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 ($15.001 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. APPLlCAnON FOR PERMIT CITY OF ZEPIIYRIIILLS BUILDING DEPARTKERT OWNER'S lWIE ( )e~\.{ l~~ Kn.JCP\, f-1eJ \:n PHONE --r8~--)<3yqO OWER'S ADDUSS (~~d ~~Ur. U{)~/,"",~\\~ \J~l. 3~f) 8nJY\v LEGAL DESCRIPTION: LOT(S) (0 B~SUBDIVISION PARCEL LD.t V J ~ -:2.6 - 02/ - 0 D36 - ~ 0 YD 0 - 666 D (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:__ew Construction ~ition ---Alteration --Repair ~nAtall JOB ADDRESS _Sign PROPOSED USE: V-:i.ng1e Faaily --1I<>ve _De-.olish ----1f/F _' of Units ----1f/H _ec-ercial _Indust. _Swia. Pool _Other -..Restaurant Ii: Hea1th Departaent Approval DESCRIPTION OF WORK:_H'\.S ~\ \/ C<s(\ ltc'\ \ ~ 0{ 0\ If . Co l'"\Cll T() f\ 1 ~ BUILDING SIZE: x . 1100 " Square Feet, Height RESIDERTIAL: COMMERCIAL : ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL HEW CONSTRUCTION. PERMITS REOUESTED .-BUILDING $ Valuation of Total Construction RT.RCTlUCAL ~awnCAL AIIP Service Florida Power Corp. W.R.E.C. $ I L'") <)<) ~o 0 Valuation of llecbanical Installation ----..PLUMBDiG GAS ROOFIRG SPECIALTY TYPE 9F OORS'l'RUCl10N: _Block _FraIIe _Steel Other F1IIISBED PLOOll ELEVAnOIlS: rr . IS PBOJEC'l IN FLOOD ZONE AREA' ~ YES NO .......................................... CONTRACTOR SECTION COMPANY State Cert. or Regist. , City License Registration , .......................................... BIITIDRR Signature Rl-llOD1Wll <mPAIIY \j~( ~;(." ~ D~ ~ ~ ~ State Cert. or Hi 1st. f. C)\\C,j SiirnAtur ~ City License Registration , ') "1 ") .......................................... Signature COMPANY State Cert. or Regist. , City License Registration . .......................................... PLUMBER IlECllARICAL Signature ~~ ~ <mPAIIY State Cert. or Regist. , 7 City License Registration . .......................................... COMPANY State Cert. or Regist. . City License Registration , .......................................... IlTRRR Signature APPLICATIOll APPIIOVED BY /7CUth;J ()J ~~ PERHIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS file undersigned understands that this pemit lay be subject to 'deed restrictions" wbich 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 the owner bas bired a contractor or contractors to undertake wort, 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 laY be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirl!leDts laY apply for the intended wort, they are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the 'Contractor Sections' of this application for wbich 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 wort. If the contractor wisbes you to sign as contractor that lay be an indication that be is not properly licensed and is not entitled to pem1tting 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 - HoIeoJmer's Protection Guide' prepared by the Plorida Departlent of Agriculture and COnsUller Affairs. If the applicant is 8OIIeOI1e other than the 'owner', I certify that I bave obtained a copy of the above described docUIent and pnmse in good faith to deliver it to the "owner" prior to co.enCeJIeDt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infomtion in this application is accurate and that all wort will be done in cOlpliance with all applicable laws regulating construction, loning, and land developient. Application is hereby Jade to obtain a pemit to do wort and installation as indicated. I certify that no wort or installation bas CDlenced prior to issuance of a perlit and that all wort will be perfoIJed to aeet standards of all laws regulating construction, City codes, loning regulations, and land develOpleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveruental agencies laY apply to the intended worl, and that it is If responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to: t Departlent of EnvirOllleDtal Requlation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater treatlent t Southwest Plorida Water Hanagl!leDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t Ally Corps of Engineers - Seawalls, Docts, Kavigable Waterways t Departlent of Health i Rehabilitative Services, EnvirOJllental Health Unit - Wells, Wastewater treatlent, Septic tants t US EnvirODllelltal Protection Agency - Asbestos abatl!leDt I also certify that, if fill aaterial is to be used in Plood Zone 'A' or II,etc.", it is understood that a drainage plan addressing a 'COIpen.Bating volUJe' will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A P81lit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official f1'Ol thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued sball beCCIIe invalid unless the wort authorized by such pemit is ~ced within sillODths of issuance, or if wort authoriled by the perlit is suspended or abandoned for a period of sil IODths after the tile the wort is ccamced. One 90 day l!Itension of tile, laY be allowed for the perlit with fee charge of $15.00. file l!Itension shall be requested in writing to the Building Official. An approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned. WARKING !O omR: YOUR PAILURB !O RECORD A KOlICH OF COIMDCDIDl' HAY RESULt IK YOUR PAYIKG flfICH FOR DIPROVBIIBI1'S !O YOUR PROPERlY. IF YOU ImIfD !O OB'IAIB PIWCIHG, COHSOLt WID YOUR LlllDIR OR All AftORDY BIPORE RECORDIKG YOUR DICH OF COHHDCIHEHf. JOBS UlfDER $2,500 Ilf VILUE DO KOf NKED to RECORD AIID POSt A "KOlICH OP COHHDCBIIIIif". --~~ ( SIGlAtURB:. OR AGBJI1' SIGIfA'I'URB: COlf'I'IIAC'I'OR S'I'AtE OF PLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by S'I'A'I'E 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) (Name Typed, Printed or Stamped) NOTARY PUBLIC DISCLOSURE STATFJIElIT FOR OWNER CITY OF ZEPIIY1UIILLS BUILDDlG DEPARTKERT I, to {dtJAR-M &.nlu! 0<< --' the provisions of this instrument." have read and fully understand and agree The undersigned states and affirms renovating, adding to or reroofing occupy, or will occupy by sale. That he or she shall comply that he or she is desirous of constructing, his or her own domicile, that he or she actually said domicile, and same is not for rent, lease or with the following conditions: 1. That the owner and he or she alone shall act as the builder for all phases of construction. 2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3. That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector shall require corrections to be made, the owner will assume full responsibility to insure they are made, and upon completion will call for a reinspection before proceeding with the building. 5. That the owner shall assume full responsibility for the construction and will not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office shall constitute an official notice to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc., where applicable. 8. That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial building at a cost of $25,000 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have built yourself within 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. 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