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Home My WebLink About95-5309 BUILDING PERMIT - CITY OF ZEPHYRHILLS Permit ]I!. (813) 788-6611 :~530Q C- BUILDING -~ ~ Pmperty Owne, ~ ~ Job Address: 73. . ~ Date j/J -I J-,9~- PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcel I. D. # Zoning: Description of Work Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 2-". Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector Valuation or Contract Price .A;/ II Permit Fee ~J ~ S;gnat~'e -()~ I-J . .'_ Company _ Address Telephone# City License Registration # /~ -7 b State Certified License# (!}JluYl ;yt~ ~ BUILDING ELECTRICAL PLUMBING MECHANICAL Tp. Serv, Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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 ZEPllYRllI.LLS BUILDING DEPARTMENT OWNER'S NAKE~IlA)E7f &,.)k~' OWNER'S ADDRESS13 Lf Lf 6 A- L ( '13 t vb PHONE JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM. PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction ~ddition -J\l.teration _Repair _Install _Sign --"ove _Deaolish PROPOSED USE: _Single Faaily _KIF _' of Units _K/H ~ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK:JAJstA-L( ~b(2-~ St=eu;lZU:-( LtC, ifTS FurL 4-rt"'l 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. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total constru:Jtftn AObe). -Lf-O() U P(oob L(I:, ,-\-TS CPb\rto~ l L() c:lll60 ~LECTRICAL AMP Service Florida Power Corp. W.R.E.C. _KECBARICAL $ Valuation of Kechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BlJII.DER Signature COKPANY State Cert. or Regist. . City License Registration . ****************************************** SilmAture COMPANY () (SO I\( ~l C.- eD. l ,.JC State Cert. or Regist.' E. c-<!:>oo 10 or L( City License Registration' I.C)"? {p ****************************************** F.I.RCTRICIAN PLUMBER COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature OTRRR COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this peIlit lay be subject to "deed restrictions" which Jay be lOre restrictive than City regulations. The undersigned assUles responsibility for cDlpliance 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 lay be cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireJents JaY apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813) 788-6611. FurtheIlOre, 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 the contractor wishes 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, have been provided with a copy of aFlorida's Construction Lien Law - HOJeOwner's Protection Guide" prepared by the Florida DepartJent of Agriculture and Conslller Affairs. If the applicant is sOftone other than the "owner", I certify that I have obtained a copy of the above described docUJent and prOllise in good faith to deliver it to the "owner" prior to coaenceJent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in cOllpliance with all applicable laws regulating construction, zoning, and land developleDt. Application is hereby lade to obtain a peIlit to do work and installation as indicated. I certify that no work or installation has cOlleDced prior to issuance of a perlit and that all work will be perf OIled to aeet standards of all laws regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governaental agencies lilY apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: t DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t AllY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US EnvirODlental Protection Agency - Asbestos abateJent 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 uc~pensating volDle" will be subJitted 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 work 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 frOJ 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 peIlit is cOlIBnced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOntha after the tile the work is COllenced. One 90 day extension of tile, lilY be allowed for the perlit 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 IODth period, or the project will be considered abandoned. WARMING TO OIUfER: YOUR FAILURE TO RECORD A NOTICE OF ClJDmIICEMENT HAY RESULT 1M YOUR PAYING TWICE FOR IHPROVEHBIft'S TO YOUR PROPERTY. IF YOU INTElfD TO OBTAIM FIMAlfCIMG, COMSULT WITH YOUR LElfDD OR AM AlTORHEY BEFORE RECORDIMG YOUR MorICE OF COMMENCEMENT. JOBS UffDER $2,500 1M VALUE 00 NOT MEED TO RECORD AlfD POST A "NOTICE OF COMMENCEMENT". SIGMATURE: OWlfER OR AGENT G;.~..,+. L ~ t SIGMATURB: ~ONTRAcrOR STATE OF FLORIDA coum OF The foregoing instrument before me this was acknowledged , 19_ by STATE 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) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC (3 '7--::' .........).__../ Barnett Banks , l , cli\i Location Cover Sheet 0 T c- t cL- Project Number 1195-3526 Bank ID# II 051 11 011 II 51 221 Branch NamellTOWNVIEW OFFICE Address 17344 GALL BLVD. City IZEPHYRHILLS Zip 133541 I Subontractor 10lson I Surveyor ISB I Comments II 'f'e:=tc,,^l\ Last Modification Date 8/11/95 RECEIVEO !4UG14:199S ':.'~SOi\j F~LECn'll( OPl.J\NOG Contractor To Install: Location Inventory Quan Item 400HPS WP 400HPS FL 400HPSWP 400M HWP 250HPS FL . . '. ....l 175MH CAN 250MH WP 400MH FL S 12 -F W ~ )/cJrJ M t+- F fOOD 250M H FL 175MH CA(V) 100MHCA(V} /' 2 TOTAL FIXTS Bu1IeU ..... ATM SealrltJ LfIbdnI Slaney r:-( - BranclllAnt Mala ~ 73++ )JJJ.- e-e &. Adchll CiIJ~~ q. :> - ~ "5'" u.:. IIraIU ~ TWIt olPaciJitv TV'IIe 0(1 nr:alinn .......,., r......... ~ ~,........hll 9-ATM o IteaIoCe A TM 0 s.rip Sbuw'.. c.... ~ AHD o PJdcJMMaU o omc.~ Mdi ra. S---Coauaaa o Dedicllllll Wadi<< OD S_ CIte r:rCteu o bioi.. o 0YeIcUt o full MOOD ATM Lipt I..neI M.......... 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