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Home My WebLink About95-5279 BUILDING PERMII- CITY OF ZEPHYRHILLS Permit IT! (813) 788-6611 -:-~ 527Q 5. Date BUILDING ~CT:~ PLUMBING MECHANICAL Sewer Conn Water Conn: Pmperty Owne" 4 ~ Job Address: 7 Parcell.D. # Water Meter: T.I.F.'s: Zoning: Description of Work Energy Code: ~M lfI?r ~ ' .d NO OCCUPANCY BEFORE C.O. FINAL <'-0- 5 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 Pe,mit Fee ~ ~ ~ Sign~ture , ~ ,~ .~ Company Address Telephone# ~ q..O - 19 ') J- Valuation or Contract Price /.s'cro. tTO -' City License Registration # / -Do State Certified License# ~;?~ pg~ BUILDING ELECTRICAL PLUMBING 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. OWNER'S NAKE ~ h #J OWNER'S ADDRESS ~ ~ I ( JOB ADDRESS ~ '-/ ;2.. ?- P~L iJ /9- I bJU,L APPLICATION FOR PERKIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT A,;;;( irL PHONE ~ b . ') ~ I eo glob ~/f, ~ :?5b Ie I /J t1./D '2..t.r'M,:yL/7c i4.t m s s -J." '-f 0 , LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.' (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install _Sign --1Iove _Deaolish PROPOSED USE: _Single Faaily t/' eo-ercial _KIF _, of Units _K/H _Indust. _Swim. Pool _Other _Restaurant & Health Departllent Approval , DESCRIPTION OF WORK: //I.5t7J?L Fo~ erYlZ.~~" m"r ~y~~rn ON t-/7I?rlV) fJMIJ-U X Square Feet, Height Ii> s i'OC-~ fJ..oo~ 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. CO.N'fl1C- )'0 r2... S BUILDING SIZE: RESIDENTIAL: COMMERCIAL : PERMITS REOUESTED BUILDING ~CTRICAL $ Valuation of Total Construction AMP Service Florida Power Corp. W.R.E.C. _MECllAlfICAL $ Valuation of Kechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FlRISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION COMPANY State Cert. or Regist. f City License Registration , .........................~............. COMPANY ~~ ~L ~ State Cert. or Regist. f t;.(L OO~~'-I dO~ City License Registration f ~~. ~""'..rO ****************************************** BUILDER Signature ELECTRICIAN PLUMBER Signature COMPANY State Cert. or Regist. , City License Registration f ****************************************** MECHANICAL Signature COMPANY State Cert. or Regist. f City License Registration f ****************************************** OTHRR Signature COMPANY State Cert. or Regist. f City License Registration # ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to .deed restrictions II which lay be lOre restrictive than City regulations. !he undersigned assUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake wort, they lay be required to be licensed in accordance witb state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lilY be cited for a lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lilY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) 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 tbe contractor wisbes 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, bave been provided with a copy of -Florida's Construction Lien Law - HOJIeOImer's Protection Guide" prepared by the Plorida Departlent of Agriculture and Conslller Affairs. If the applicant is sOlleone other tban the "owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to coaencBlent. 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 develo~ent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has CDIIeDced prior to issuance of a perlit and that all wort will be perforwed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlt!Jlt regulations in the jurisdiction. I also certify that I understand that the regulations of other goverDleDtal agencies lilY apply to the intended wort, and that it is .y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * Departlent of HnviroDlental Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/Wastewater Treatlent * Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, lIastewater TreatJent, Septic Tanks * US BnvirODlental Protection Agency - Asbestos abatBlent I also certify that, if fill laterial is to be used in Plood Zone "All or "A,etc.", it is understood that a drainage plan addressing a .cQlPeDsating volllle" will be sublitted which 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 wort and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOll thereafter requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued shall beCOle invalid unless the wort authorized by such perlit is COllenced within six IOnths of issuance, or if work authorized by the peait is suspended or abandoned for a period of six IOntha after the tile the wort is cOlleDced. One 90 day extension of tile, lily be allowed for the perlit wit;b fee charge of '15.00. The extension sball be requested in writing to the Building Official. An approvetl inspection lUst be logged during each six IOnth period, or the project will be considered abandoned. WARMING TO OWlfBR: YOUR FAILURB TO RBCORD A NOTICE OP COHMEliCBllENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVBIIBlft'S TO YOUR PROPBRTY.. IF YOU INTBIfD TO OBTAIlf PINAlfCIlfG, CONSULT IIITH YOUR LlllDIR OR AN AftOHm' BBFORE RECORDIHG YOUR HOTICE OF COMHBNCBHElfT. JOBS lnlDER $2,500 Ilf VALUB 00 NOT ffEBD TO RECORD AND POST A "NOTICB OF COHMDCBlfENT". SIGNAfUR!: OIfIfER OR AGBNT SIGHATURK: CONTRACTOR STATB OF FLORIDA COUNTY OF The foregOing instrument was acknowledged before me this , 19____ by STATB OF FLORIDA COUNTY 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. 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