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Home My WebLink About95-5254 BUILDING PERMIT ...... CITY OF ZEPHYRHILLS Permit l\W (813) 788-6611 -;-5254,& Date 9 -c2;;J. -9S- ~~ ELECTRICAL Pmperty Owne" -It, ~ Job Address: "-- ? r Parcel I. D. # Zoning: Description of Work PLUMBING MECHANICAL Sewer Conn Water Conn: ,('-7" E -->~4 ~ Water Meter: T.I.F.'s: FINAL C.O. DATE DATE Inspector Valuation or Contract Price ~ J7 07J J o-u City license Registration # State Certified license# J-.!>3 / , Signat Company Address tl TelePho~~3) 75~ - 7~ 8 g mJ;lL7h~LJ.AlM BUILDING ELECTRICAL PLUMBING - 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 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 OWNER'S NAME Al/. .54'I'T#. OWNER' S ADDRESS ;2 707- to, A:0/ 0/#-73 ~/ ,c/=E~ JOB ADDRESS .i38~c;S n'~y SsLE Ze.l'h"M/LL.!7' PL.. ./ PHONELgJ~) 7S).- ~ flo~ ,& 4vI,VTCdY LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. t (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition --Jlteration _Repair ~Install _Sign -.JIove _Deaolish PROPOSED USE: _Single Faaily ~M/F _' of Units _M/H _eo.tercial _Indust. _Swia. Pool _Other _Restaurant &: Health Departaent Approval DESCRIPTION OF WORK: I BUILDING SIZE: c30 X 90 , 27D C> Square Feet, 'to 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. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELEC'fRICAL AHP Service Florida Power Corp. W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS X ROOFING . SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BUlI.DER . ~ COMPANY .N'67.4L ;)YSTa-f.G /AYc. /f} '" State Cert. or Regist. .Cl7C OO~87J Signaturef~ ~ City License Registratiop' /53/- C ****************************************** ELECTRICIAN COMPANY State Cert. or Regist. , SiQDAture City License Registration , ****************************************** PLUMBER COMPANY State Cert. or Regist. t Signature City License Registration , ****************************************** MECHANICAL COMPANY State Cert. or Regist. t Signature City License Registration . ****************************************** omRR COMPANY State Cert. or Regist. . Signature City License Registration , ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to "deed restrictions" whieb laY be lOre restrictive than City regulations. The undersigned assUles responsibility for COIpliance 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 owner and contractor laY be cited for a lisdeJeanor 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 Zepbyrbills Building Departlent, (8!3) 788-6611. FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections" of this application for wbieb they will be responsible. If JOu, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for tbe 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 pertitting privileges in the City of Zepbyrbills. 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 - HOJeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is aeone other than the "owner", I certify that I have obtained a copy of the above described dOCUJeDt and prOJise in good faith to deliver it to the "owner" prior to cOllel1celent. E. CONTRACTOR'SjOWNER'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 pertit to do work and installation as indicated. I certify that no work or installation bas cOlleDced prior to issuance of a pertit and that all work will be perforted to leet standards of all laws regulating construction, City codes, zoning regulations, ~d land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governJental agencies laY apply to the intended work, and that it is If responsibility to identify what actions I lUst take to be in cOlpliance. Sueb agencies include but are not lilited to: * DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnvironJentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArtY Corps of Engineers - Seawalls, Docks, Kavigable Waterways * Departlent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks * US EnvirODJeDtal Protection Agency - Asbestos abatelent 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 volllle" will be subJitted whieb is prepared by a professional engineer registered 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 violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beCOle invalid unless the work authorized by such perlit is cOlleDced within six IOnths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six IOnths after the tile the work is cOBel1ced. One 90 day eztension of tile, laY be allowed for the pertit with fee ebarge of $15.00. Tbe eztension 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 OWKER: YOUR FAILURE TO RECORD A HOT ICE OF COMMEIfCEMEKI MAY RESULT IK YOUR PAYIKG TWICE FOR IMPROVEMBlft'S TO YOUR PROPERTY.. IF YOU IIl'fEKD TO OBTAIK FIIWICIKG, COKSUL'I' IU'I'H YOUR LBKDER OR All AnORRBY BEFORE RECORDIKG YOUR KOTICE OF COMMEKCEMENT. JOBS UlDER $2,500 IN VALUE 00 HOT HEED '1'0 RECORD AIID POS'I' A "HOT ICE OF COMMENCEMEKI". SIGIIATURE: COXTRACTOR SIGlfATURE: OWKER OR AGEXT S'I'ATE OF FLORIDA COUltTY OF The foregoing instrument was acknowledged before me this , 19____ by S'I'ATE OF FLORIDA COUK'I'Y 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 oath. wbo is personally known to me or who bas 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