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Home My WebLink About95-5224 BUILDING .:2 0 . u'tJ -"-~ ~TRICAGI P<aperty Own." ~4 ~ Job Address: d.f- 'Y--S-j --S ~y L: BUILDING PERMIT: CITY OF ZEPHYRHILLS Permit N. (813) 788-6611 --522fH PLUMBING ( 1> fr Date 0 - .:5/ -7...s- I~. cro ~HA~ Sewer Conn Water Conn: Water Meter: Parcell.D, # Zoning: Description of Work T.I.F.'s: . Energy ~ ~/ r r=.hLJ rP Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances, Permit Fee Signature Company ,/ / Address Telephone# 7?.2 -3:M-3' Valuation or Contract Price / t ;;J.:;ly. d-o ?r' City License Registration # State Certified License# BUILDING J ~~ jJ~~; ELECTRICAL /0 PLUMBING ~Ao ,f~ MECHANICAL Ftr, Pre SLB Lintel FRM. Insul. CL WL Tp,Serv, 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 Oollars ($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. APPLICAnON FOR PERKIT CITY OF ZEPIIYRBILLS BUILDING DEPAR'llIENT ~s/x/c" M~hS r:BeJJ / I ~ z- .s' pul JI /Zt6 j),#- L//tfJ/ ~y /y// /v,h 7Z ~3.rl/9' 3R4/[/ 5L/e Z-lIfL. 35.510 .~ '.. 1'ouj6 OWNER I S ~F ONE OWRER I S ADDRESS JOB ADDRESS LEGAL DESCRlPTION: LOT(S) BI.OCL--SUBDIVISION PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:---.Jiew Construction --."Addition ---Alteration ~pair _Install _Sign -.JIove -Deaolish PROPOSED USE: -8iDgle Faaily --1J./F _' of Units --1J./H _ec-ercial _Indust. _Swia. Pool _Other ---..Restaurant & Bea1th Departaent Approval DESCRIPTIOB OF WORK: Kef LACF- Ex IS/JtJC, A IlL GJJ J) JTlv tV ) t0~ BUILDING SIZE: x Square Feet, Height RESIDDTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET DERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~UlLDING :* /1 Z 29' ~ PERMITS REOUESTED Valuation of Total Construction RI-ECTRICAL AIIP Service Florida Power Corp. W.R.E.C. --..HECllAllICAL $. Valuation of Hechanical Installation -PLUHBIlfG GAS ROOFIlfG SPECIALTY . TYPE OF COBSTKUcnOB: --Block _Fraae _Steel Other FIlUSBED .FLOOB. ELEVAfiOBS: Fr. IS PROJEC'l IB FLOOD ZONE AREAl .......................................... YES NO CONTRACTOR SECTION .. Bun.DER aiHPAIIY State Cert. or Regist. . City License Registration , .......................................... Signature RT.IlCTIIICI.AII ~ COIIPAIIY ':2. ~l,-\ , '-.....s. S '-~C:-~ ' ~~=~~: ~~. ffi State Cert. or Regist. . Ot.:ll~~\~ e. City License Registration' l D . .. .. ................................. PLUMBER COMPANY State Cert. or Regist. , Signature City License Registration . .......................................... IlECBANICAL COKPANY c AI State Cert. or Regist. . Signature City License Registration . ............................... omRR COHPANY State Cert. or Regist. . Signature City License Registration . .......................................... APPLICATION APPROVED BY PERKIT OFFICER. ... ~ \- .. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS 'l'be undersigned understands that this perlit lilY be subject to 'deed restrictions I wbieb lilY be lOre restrictive than City regulations. !be undersigned asSUle& responsibility for allpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the OIRler bas bired a contractor or contractors to undertake workr they lilY be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by lawr both the mmer and contractor lilY be cited for a .isdeJeanOr violation under state law. If the mmer or intended contractor are uncertain as to wbat licensing reguireJellts lilY apply for the intendedlOrkr they are advised to contact the City of Zepbyrbills Building Departaent, (813) 788-6611. FurtherlOrer if the OIIner bas bired a contractor or contractorsr be is advised to bave the contractor(s) sign portions of the IContractor Sections I of this application for wbieb they will be responsible. If you, as the OlDer sign as the contractor r you are indicating that your rather than the contractor r are responsible for the IOrt. If the contractor wishes you to sign as contractor that lily be an indication that be is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILI'l'Y CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that Ir the applicant, bave been provided with a copy of 'Plorida's Construction Lien Law - lIoIeOIIner's Protection Guide' prepared by the Plorida Departlent of Agriculture and ConsUller Affairs. If the applicant is SOl8Olla other than the 'OIDer. r I certify that I bave obtained a copy of the above described docUIent and proalse in good faith to deliver it to the "owner 1 prior to CQIIeDCeleDt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIliltion in this application is accurate and that all IIOrt will be done in cOlPliance with all applicable laws regulating constructionr loning, and land developl8llt. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no IIOrk or installation bas ~ced prior to issuance of a perlit and that all work will be perfoIlllll to Het standards of all laws regulating constructionr City codesr loning regulationsr and land developlellt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveruental agencies lay apply to the intendedlOrt, and that it is IY responsibility to identify wbat actions I lust take to he in COJpliance. Sueb agencies include but are not liaited to: t Departlent of Invirol1lel1tal Regulation - Cypress Baybeads, Wetland Areas and Invirolllelltally ~ensitive Lands, Water/Wastewater 'l'reatlent I Southwest Plorida Water Managelll!l1t District - Wells, Cypress Daybeac1s, Wetland Areasr Altering Watercourses t ArlY Corps of Engineers - Seawallsr Docksr Navigable Watenays I Departlent of Health' Rehabilitative Senices, InvirODleDtal Health Unit - Wells, Wastewater 'l'reatlent, Septic Iws t US InvirDDlel1tal Protection Agency - Asbestos abatuent I also certify thatr if fill Iilterial is to be used in Flood Zone 'A' or lA, etc. I r it is understood that a drainage plan addressing a 'co.pensating volue' will be saittedwbieb 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 IIOrt and not as authority to violate, cancel alter, or set aside any provisions of the tecbnical codesr nor shall issuance of a perlit prevent the Building Official fIOl thereafter requiring a correction of errors in plans, construction, or violations of any code. bery penit issued shall becoIe invalid unless the IIOrt authoriled by sueb peIlit is COIIeIlcedwithin slllOlltbs of issuancer or if IIOrt autboriled by the penit is suspended or abandoned for a period of sil IODtbs after the tiae the IOrt is~. One 90 day atension of tile, lily. be allowed for the perlit with fee charge of $15.00. Ibe 81tension sball be requested in writing to the Building Official. An approved inspection lUSt be logged during eaeb sillODth petiodr or the project will be considered abandoned. "ARNUG '1'0 OWR: YOUR FAILURI '1'0 RlCORD I 10lICE OF aIlMDCIIIIIft' MAY RESULT IN YOUR PIYUG DICE FOR IMPROVIIIIIIIS '1'0 YOUR PROPERlY. IF YOU 111110 '1'0 OB'I'AIN iIllAlCIIG, CONSUL'I' WI'I'H YOOR LllDBR OR 111 AI'I'ORIBY BBPORB RICORDIlIG YOUR JOIICE OF ~ D111D111 ~l.500 II VILUI ~ 101 IBID 10 IIIaIID lID lIIS! I/~ IIIIIIIICIIIII!'. t Vtf1 (~(--= ,/ SIGJlAIURI: (MIll OR AGIIIt' 81 S'I'A'I'E OF PLORIDA '7 coum OF 1$eo The foregoing instjUment was acknowledged before me this /tl/b- 2f, 199fby S'I'A'I'E OF FLORIDA . / coum OF //1'.5 e C) The foregoing in~t was acknowledged ~efore me this ~ 2Y, 19 9950y who ~ersoo;ll! kn~;:to me or who has produce ... . . as identi ation and who did/did not take an