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Home My WebLink About95-4930 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N'? 493011 Date ~-/ / -Y-.s- BUILDING ELECTRICAL PLUMBING ~NI~ S,w" Conn Water Conn: Property Owner: )'Jft?~ p-~ Job Address:~'~~ .2'1 >>t {' r~ c..t- Parcell.D. # Water M.!lJer: T.I.F.'s: Zoning: Description of Work A /2'9Y cf!/ ~ cJ (;J Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 5-J~..4) DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. Inspector City License Registration # State Certified License# Y'j p~rmit fee 3~.~. ~- '\ ~ ~ Slgnatur~~ ~ Company Address Telephone# Valuation or Contract Price ;L 'I cTlJ . o-v , /~A}-(Ju;:'-^~F Ud;v BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final t!Y-1 '6 '~1 5 .&;1'1 SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Canst. 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 ($1 5.00) 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. . @. 040% Pre..coo.umer Content . 10% P~.conaumer Content Jrupu!iul Page No. of Pages .' ';;>"~"";1;;;'~!4U,). "'~~~n,~..~~~~~ft(i~."~",,,~.,,.",, .... APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT 6..JJ V \ Rb,uMEAJT:A-LUD,vtRA <L'rt)~ ADDRESS PHONE 76j t' r23f)~ OWNER rv1..a ~ y Si:em /Ht) JOB LOCATION S{p;}. <--I /J1 t f!Or<,! t.r.. LOT SIZIL-X LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION AREA SQ. FT. PARCEL 1. D. ~~ WORK PROPOSED:____New Construction ----Addition ~lteration ~epair ____Install ____Sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____~~ 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.**- **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ____MECHANICAL $ 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. # City License Registration # ****************************************** BUILDER Signature Company f~l<mfl1J S0.\~~ rE~ IIU~ State Cert. or Regist. ~~ ' C) a? ity License Registration # ****************************************** ( . PLUMBER Company State Cert. or Regist. # City License Registration # ****************************************** Signature Signature Company !3o //:Cft! Dl:!Lm EjfJfI!f ~7:- State Cert. or Regist. # () ;;2. 9 ~ y License Registration # 'IV ****************************************** OTHER Company State Cert. or Regist. # City License Registration # Signature ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. ... CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands ~~at this perlit lay be subject to "deed.restrictions" which aay be lore restrictive than City regulatiDns. The undersigned assules responsibility for cOlplianc! with any applicable deed restrictions. ''''..'";! :;'ill'-~"i': "W r ~;'~ '"rz -Jj ,~. ,,;.. -Ii,' B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ONner has hired a contractor or 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 aay 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 Departlent, (813) 788-6611. Furtherlore, if the ONner 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 lay be an indication that he is not properly licensed and is not entitled to 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 "Florida's Construction Lien Law - HOleowner'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 doculent and proaise in good faith to deliver it to the "owner" prior tD .collenceaent. 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 installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be performed to .eet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies lay apply to the intended work, and that it is IY responsibility to identify IIhat actions I lust take to be in co.pliance. Such agencies include but ~I e not 1 iaited to: I Departlent of Environlental Renulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive ldilds, Water/Wastellater Treatlent I Southwest Florida Water "ananelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlV Corps of Ennineers - Seawalls, Docks, Navigable Waterways I Depart,ent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treat~ent. Septic Tanks I US Environ,ental Protection Anencv - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.., it is understood 1113t a d,.ainage plan addressing a "colpensating volule" lIill be sublitted IIhich is prepared by a professional engineer reqisteied 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 Yioj~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perlit pr~vent the Building Uffi{i~1 fr~1 thereafter requiring a correction of errors in plans, construction, or violations of any code. Every per.lit issued ;hall becole invalid unless the work authorized by such penH is cOllem:ed within six lonths of issuance, e.r if Hork auth(Il Ized by the perlit is suspended or abandoned for a period of six lonths after the tile the work is cOlmenced. One 90 day e~tEn~ioli of tile, lay be allowed for the perlit with fee charge of tI5.00. The extension shall be. requested in Hritinq to the Building Offitial. An approved inspection lust be logged during each six lonth period, or the project will be considered dbdlidoned. 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__________________ ...