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HomeMy WebLinkAbout95-5039 BUILDING PERMII- CITY OF ZEPHYRHILLS Permit N! (813) 788-6611 "i~503~ /!; Date ~ -OlJ -9~- ~ ELECTRICAL PLUMBING Pmperty owne'-&-,_ Z4: ~ Job Address: ---s ~ _ ~ _ _ _ Parcell.D. # MECHANICAL Sewer Conn Water Conn: Water Meter: T_I.F.'s: Zoning: ~ ~ne~~~~: Description of Work _~L- ,[J . Radon Gas: <Ja4- NO OCCUPANCY BEFORE C.O. FINAL C.O. -qS DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector City License Registration # State Certified License# 6-..5'-/r Permit Fee ~ o-i) Signature ('. . St.JJn.,J~ L..... Company Address Telephone# Valuation or Contract Price / :J. cJ7J - OV , ~~~I J1~ BUILDING Ftr. - J - '" rZ'?~ f 8ilL Pre SLB Lintel FRM. Insul. CL WL ELECTRICAL PLUMBING - MECHANICAL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final 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 PERKIT CI IT OF ZEPlIYRlllLLS BUILDING DEPARTKKNT OWNER · S ADDRESS_i~ ~v i M 0.. 'i S mORE lRl \ ~ uS, ,"",lOr Ltl 1ST Zf Phy",h(\\ S BLOCK / () SUBDIVISION . ~cLS-te"r hoc)k-1 - f\JI \-\~~ 9yr ?:SyS Lot \~ -5 L.- T"Z 33-><-;( OWNER'S lWtE_KlQ.."~\6~ JOB ADDRESS r;~4o LEGAL DESGlUPrION: WT(S) PARCEL 1.D.' ZfQ~~~~ \\ S ~a~~ ~~y WORK PROPOSED:_Nev Const.ruction _Addit.ion _Alt.erat.ion ---.Jlepair _Inst.all _Sign _Hove _D~lish PROPOSED USE: Single F-.ily -Leo.aercial _"'F _, of Unit.s _H/H _Indust. _Sill i.. Pool Other _Rest.aurant 5: Health DepartJIent. Approval BUIWING SIZE: ;Z (:) X Lf 6. 100 Square Feet.. 0---- 12. Height. RESIDENTIAL: CotIlfERCIAL : ATI'AGH (2) PLOT PLMS 5: (2) SETS OF BUII.DING PLANS 5: (1) SET ENERGY FORMS. A'n'AGH (3) SETS OF BUILDING PLANS 5: (1) SET ENERGY FORtIS. PROPERrY SURVEY Rlr.QUIRlID FOR ALL NEW CONSTRUcrION. PERKITS RROUESTED _BUlWING $ /,;z L?CJ o~ Valuation of Total Construction _ELECTRICAL .AlIP Service Florida Pover Corp. W.R.R.C. _HEGIJAIIIlCAL $ Valuation of HeChanical Installation _PLlJfIBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCl'ION: -A-B1ock. _Fr-.e _St.eel Other FINISHED FLOOR ELEVATIONS: FI' . IS PROJEcr IN FLOOD ZONE AREA? YES NO ...........***..*****...*..*.*..*......*.* CONTRACIOR SECIION BUIWER COflPANY State Ceet.. or Regist.. , City License Registration , .........**.**........*..*.*.........*.... Signat.ure ELECIR.lCIAN COKPARY Stat.e Cert. or Regist. , City License Registration' **.*.**..*.**.*******.**.*..**.*.*.*.**.** SilUJature PLUHBER COHPAPiY Stat.e Cert. or Regist. , City License Regist.ration , ******.**.***.****.*.*..*.*..*.*..*.**.*.. Signat.ure !t.ECHANICAL COMPANY St.at.e Cert. or Regist.. , Cit.y License Registration , .*******...*.....*..*.....**.....*...*.... Signat.ure omF.R ." COMPANY t.U ') Stat.e Cert. or Regist. , City License Registration , ***..*...*.*.*...**.**.*.*..........**.*** APPLICATION APPROVED BY PERtlIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to 'deed restrictions" whieb laY be lOre restrictive than City regulations. Ibe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas 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 O1IIler and contractor lilY be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing reguirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the O1IIler has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for wbieb 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 wisbes you to sign as contractor that laY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrhills. 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 - HOIeOIDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOIeODe other than the lowner", I certify that I bave obtained a copy of the above described docUlellt and prOllise in good faith to deliver it to the "owner" prior to COlleRCeleDt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in tbis application is accurate and that all work will be done in cOllpliance with all applicable laws regulating construction, loning, and land developlent. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas cOlleDced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws regulating construction, City codes, loning regulations, and land developl8Rt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveIDIeDtal agencies laY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in colpliance. Sucb agencies include but are not Iilited to: . Departlent of EnviroDle8tal Regulation - Cypress B8yheads, Wetland Areas and EnviroDJeDtally Sensitive Lands, Water/Wastewater Ireatlent . Southwest Florida Water Hanagel8Rt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses . ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways . Departlent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic lanks . US EnviroDlental Protection Agency - Asbestos abateleDt I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a 'cQlpeDsating volUle" will be subtitted wbieb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued sball 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 frOll thereafter requiring a correction of errors in plans, construction, or violations of any code. Bvery petlit issued shall beCOle invalid unless the work authoriled by such perlit is cOll8Dced within sil IOnths of issuance, or if work authoriled by the perlit is suspended or abandoned for a period of sll IOntha after the tile the work is cOBenced. One 90 day utension of tile, laY be allowed for the perlit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An approved inspection lUst be logged during eaeb six IOnth period, or the project will be considered abandoned. WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHINCEMEIff MAY RESULT IN YOUR PAYING "'ICE FOR IHPROVIKIIft'S TO YOUR PROPERTY. IF YOU IIIIDD TO OBTAIN FINAIICING, COMSULT WITH YOUR LBItDIR OR All AnORIIY BEFORE RECORDING YOUR NOIICH OF COKMEMCIMRIff. JOBS UNDER $2,500 1M VALUE DO MOT MEED 'f0 RECORD AND POS'f A "NOTICE OF COIIMIHCIHEItI.. SIGHA'fURI: COMTRACfOR SIGHA'fURI: OWIIIR OR AGE1ft' STATE OF FLORIDA COURTY OF The foregoing instrument was acknowledged before me this , 19____ by STATE 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 o~tb. 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 ~r6 ~ ~. ~ , \ \ ~~ -, -.f: '<' . ~7 ~ ""0+ ~'" f""'b ~ - \ _ ...0' , ~- "P , ~ Q'\ s -C'~ J . ^J~ \;) \l \~ --81>~ ) co ~ G 4 c( ,s. \ r) ft) ~ rtI 'jJ ~ '1) '\) d G) ~ ~ rc> () r: 6) ~. .3:~ o , \ ~f\ '(~t...L1 rL 5t-\'Al.-L ()\P\l,.r r"lt-.\ AU-- .5'L\~ ~~ ~ y.L C:::. '2- Z. aN( ~&- 3D I fii.jL, ~T 01 ~ .sl~L 2.D t fG..&.. 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