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Home My WebLink About95-5075 BUILDING PERMIT 0- CITY OF ZEPHYRHILLS Permit 'N II (813) 788-6611 1-5075/1 - - PLUMBING dt> # crD ~A~ Date 7 - ,5- - '1 S- BUILDING d.-6 # OV ~CTR~ Sewer Conn Water Conn: :::::~:~.y-f1r{ --i ih!tr.t Parcell.D. # Zoning: Energy Codtt: Description of Work AI c V~ Water Meter: T,I.F.'s: Aadon Gas: NO OCCUPANCY BEFORE C.O. / ~ ,,11/7 ,0 FINAL 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 City license Registration # State Certified license# ~~7SL cJ7J t? Valuation or Contract Price Signa Company Address Telephone# BUILDING .J4A1- ~ !hr~:'- , ELECTRICAL d~~ PLUMBING ~...~ ~j' MECHANICAL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo 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 Pft~\J \ OU S fer m I .h: l:t311 z:, 13 APPLICANT 6Q.1\c:LLA. De.u~ lqJ ('rl efl-L LC.> (Y\ pr-'.l~tj ADDRESS ld-?X) 3 U 'J f1u.J'i 3D I, tQdQ.. Ct ~ J FL. '3~5 OWNER ~e.ef - 0 - brOJ1 y ''::> JOB LOCATION-=1 3~'l f.yLl \ B\~ (l-turhl (lr;.-~IJ{lJt.lJ LOT SIZE_X PHONE AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.# WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install ____Sign/Temp. ____Sign _Move ____Demolish PROPOSED USE: ____Single Family ____M/F ____IF 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 LMECHANICAL AMP Service Florida Power Corp. _W.R.E.C. $ :3,hq2.~ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** Signatur CONTRACTOR SECTION Company :x...nd'i De-'-le\Dpn--e..-,",t.. Ccm(-lo..Nl'i i::nG. S ta te Cert. or Regis t. iF c... -0 C b ItA ,,)6 City License Registration IF **************************************** Company ~ khl ~iZ-1( ~ State Cert. or Regis t. 4F J 3 :::> (oC( City License Registration # ~().::: ****************************************** Company State Cert. or Regist. # City License Registration # ****************************************** PLUMBER Signature Company ~fr<--K!; 14(c ~H-{6' ~.FI. State Cert. or Regist. # G.ftCO~ /d 020 City License Registration # ~ , ****************************************** Signature Company State Cert. or Regist. IF City License Registration IF OTHER Signature ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The und~rsigned understands that this peraitaay be subject to "deed restrictions" which aay be aore restrictive than City regulatIons. The undersigned assuaes responsibility for coapliance 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 regulations. If the contractor is not licensed as required by law, both the owner and contractor aay be cited for a aisdeaeanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing reQuireaents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (813) 788-6611. Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) 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 aay be an indication that he is not properly licensed and is not entitled to peraitting privileges in the City of Zephyrhills. c. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~ 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 - Hoaeowner's Protection Guide" prepared by the Florida Departaent of Agriculture and Consuaer Affairs. If the applicant is soaeone other than the "owner", I certify that I have obtained a copy of the above described docuaent and proaise in good faith to deliver it to the "owner" prior to coaaenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developaent. Application is hereby aade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has coaaenced prior to issuance of a perait and that all work will be perforaed to aeet 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 governaental agencies aay apply to the intended work, and that it is ay responsibility to identify what actions I aust take to be in coapliance. Such agencies include but are not liaited to: I Departaent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands, Water/Wastewater Treataent I Southwest Florida Water ManaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I Aray Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departaent of Health ~ Rehabilitative Services. Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks I US Environaental Protection AQency - Asbestos abateaent I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "co.pensating voluae" will be subaitted which is prepared by a professional engineer registered in the State of Florida prior to perait issuance. A perait 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 shall issuance of a perait prevent the Building Official froa thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid unless the work authorized by such perait is coaaenced within six aonths of issuance, Dr if work authorized by the perlit is suspended or abandoned for a period of six aonths after the tiae the work is coaaenced. One 90 day extension of tiae, lay be allowed for the perait with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six aonth period, or the project will be considered abandoned. 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 CO"MENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument befc,re me this was acknowledged , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was ae knc.vJ} edged , 19_ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is pel-sona 11 y known to me Dr who has produced as identification and who did/did not take an oath. (Signatul-e) (Signature) (Name Typed, Printed Dr Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC