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Home My WebLink About95-4928 BUILDING PERMIT Permit m CITY OF ZEPHYRHILLS (813) 788-6611 4928 t3 Date. 0--/0 -7'.S- ~~; ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Pmperty Owne" .'A:, ~ gA-- Job Address: -3 ~ ------=- ..:.J 0 Parcell.D. # Zoning: Energy Code: Description of Work~f2 ;,,~ Water Meter: --f!/ T.I.F.'s: Radon Gas: FINAL 5-/ \" 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. ~~ p~rm~t ~~!;- :TV Signature - _ ~ ~ Company Address Telephone# Valuation or Contract Price /1 /r), cJ7J , City License Registration # State Certified License# _d!cL"r" BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Ins!. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final FtL ~ Pre SL . ~~~~' .. ~,~~~c; Insul. CL ') 3 V WL , Iv " 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 ~~QeD- Co~~~",,~~ ADDRESS ~\2SD 5 "-..Not ~ 1~ C~'1 OWNER K<C..\>(>~R. JOB LOCATION 5<03:) 'd:::)~ ST . -z..~ , PHONE :Sl~"-l-~~~. '. LOT SIZE x AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.t~ WORK PROPOSED:____New Construction ____Addition ~Alteration ____Repair ____Install ____sign/Temp. ____Sign ____Move ____Demolish PROPOSED USE: ~Single Family ---11/F ____t~ of Units . _M/H ____commercial ____Indust. ____Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOro-IS. *i< **COPY OF CONTRACT REQUIRED. x Square Fee t I Height pERMITS REOUESTED _BUILDING $_' \ ICJ ~ CC> Valuation of Total Construction _ELECTRICAL AMP Service Florida power Corp. _W.R.E.C. _PLUMBING GAS Valuation of Mechanical Installation >< ROOFING SPEQIALTY __MECHANICAL $ .... . TYPE OF CONSTRUCTION: ____Block ____Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. BUILDER Signature / / :: ::::~,:: Atl / / / PLUMBER / / Signature , MECHANICAL / / Signature , ****************************************** ~ONTRACTOR SECTION Company State Cert. or Regist. i~_ City License Registration # ****************************************** Company State Cert. or R~gist. # City License Registration # ****************************************** Company State Cert. or Regist. # City License Registration # ****************************************** Company State Cert. or Regist. i~____ City License Registration # ****************************************** OTHER ~Q;>~\~ Signature ~( o::\.~ Company ~(la ~.~~ State Cert. or Regist. # ~~ ~n"'<O::' City License Registration i~ .4.'2.. ****************************************** PERMIT OFFICER. APPLICATION APPROVED BY CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . Th! und!rsign!d und!rstands that this p!rlit lay b! subj!ct to "d!!d r!strictions" which lay be lore r!str.icti~! than City r!gulations. Th! und!rsign!d 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 b! required to b! lic!nsed in accordanc! with state and local regulations. If the contractor il not lic!n5ed as required by law, both the owner and contractor lay b! cit!d for a lisd!leanor ~iolation under state law. If the owner or intend!d contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are ad~ised to contact the City of Zephyrhills Building Departlent, 18131 788-6611. Furtherlore, if the ONner has hired a contractor Dr contractors, he is ad~ised to have the contractorls) sign portions of the 'Contractor Slction.' of thil application for which they will b! 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 perlitting pri~ileges 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, th! applicant, ha~! b!!n provid!d with a copy of "Florida's Construction Lien LaN - HOI!own!r's Protection Guid!" pr!par!d by th! Florida D!partl!nt of Agricultur! and Consul!r Affairs. If ih! applicant is sOle6ne oth!r than the "owner", I c!rtify that I hay! obtain!d a copy of th! above d!scribed doculent and prolise in good faith to deliver it to the "own!r" prior to cOllencelent. 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 cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and install~tion as indicat!d. I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be performed to leet standards of all laws regulating construction, City codes, zoning regulations, an~ land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental ~gencies lay apply'to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include bllt ~Ie not }jlited to: . tI.#- t Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive ldnds, Water/Wastewater Treatlent t Southwest Florida Water "anaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways t Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlen~. Septic Tanks t 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,,~t a drainage plan addressing a .colpensating volule" will be sublitted which is prepared by a professional engineer reqist~iod 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 viol~te, cancel alter, 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 code. Every pertit issll~d ,hall becole invalid unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authol 11ed by the perlit is suspended or abandoned for a period of six lonths after the t)Je the work is coelenced. One 90 day e~t~~sioli 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 lust be lc,gged during each six lonth period, or the prc.ject wi I I be nnsidered ilbdlldoned. 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT ~O RECORD AND POST A "NOTICE OF CO~E SIGNATURE~ ~ SIGNATURE ~-~- 'tLLV'l'-~------ 0 - -- ---------------- 1.. \c VV\C lDr-+:;CO DATE ~J~I~ DATE ~ 1~ ~-------------- NOTA:~-:~Iti~~--~i ;--.------- NOT~~~- - -V ~i/ OWNER OR AGENT CONTRACTOR__ - - -~ - ----- - - -- - ~ ---~- .. MY COMMI MY COMMISS ~~ : J:jIIU'is R~~JUDITH l. SCHAPER . JClbTary-PaI:ll~~o'TFTOrloo My Comm. Exp. June 6. 1997 No. CC 292357 ~~, I jjIIU" JUDITH L. SCHAPER NotOlY Public. State of Florida My Comm, Exp, June 6. 1997 No. CC 292357 i....'. i , . ~ \, I.: . j ! ! i\ :1 'I I' ,I i\ ;\ if ,i " ii ! ~ " :j :1, :1 , :1 ,j !! , !! ,! I; :1 :1 II :; i! ij , II il ;1 l\ , " I :\ Ii :f ,j II ,I ~ l :i jl ,I ii " 11 . tll'''ll.. \\1 :j",:." :1;\... I \.', ,~I, ':,,'iC:: II ,{'III' 'f-II:',; Ii ,: It,.~ I:"',u :!C",,'r I,: :,: 0..,..111[;' j, (.:)I:",.j: RESIDENTIAL & COMMERrlAL ~. 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