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Home My WebLink About95-5325 BUILDING PERMII- ]I! CITY OF ZEPHYRHILLS Permit (813) 788.6611 ~-5325 E - - -~ --- C- Date /0 - a..s - 7 ,~ Pmp'rtyOwne, C.. C fJ!:if~fJ~ ;;4+) Job Address: .3l?" J.s'LJ J1 PLUMBING MECHANICAL Sewer Conn Water Conn: BUILDING Water Meter: T.I.F:s: Parcell.D. # Zoning: Description of Work ~?lY ~ode: d~don Gas: !l ~~ A~ Complete Plans. Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. FINAL C.O. .- NO OCCUPANCY BEFORE C.O. ') DATE DATE Inspector City License Registration # State Certified License# pe'm~ Signature~/ Company Address Telephone# ;/3'3- :2?/3 Valuation or Contract Price f/4 6..!>-- C'oj C ~ 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 Jo.-lbf s- fl:>B . 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 ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAKE ~~Jf '-...\o~~~o r-i PHONE OWNER'S ADDRESS JOB ADDRESS 3' rJS/'O ;vtJ~Jh /11/-<' LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. t (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign ____Move ____Deaolish PROPOSED USE: ____Single Family ..JS-ec-ercial ____M/F ____' of Units _M/H _Indust. ____Swim. Pool _Other ____Restaurant & Health Department Approval DESCRIPTION OF WORK: 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 $ _ELECTRICAL AKP Service Valuation of Total Construction X Florida Power Corp. W.R.E.C. _MECllAliICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block ____Frame ____Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECI IN FLOOD ZONE AREA? .+ (/'.rI~ EiC,'+ jr,J;.J~ cr"':'S 19 " / ~~{.< {',.{crS' ****************************************** .oJ S/?UA. < !oJ YES NO CONTRACTOR SECTION Signature COKPANY State Cert. or Regist. f City License Registration t ****************************************** BUILDER ::::1AN ~ COMPANY J't1 ~ck,(: flI1 :~L ~ ~~:~eL~~~~eo~e:~:~:~~i:n t ****************************************** PLUMBER COMPANY State Cert. or Regist. t Signature City License Registration # ****************************************** MECHANICAL COMPANY State Cert. or Regist. * 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 peIlit lay be subject to "deed restrictions I which lay be lOre restrictive tban City regulations. !be undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, tbey 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 lisdeleanor 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 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 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 RFlorida's Construction Lien Law - HOIeowner's Protection GuideR prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If the applicant is sOleone other than the "owner", I certify that I bave obtained a copy of the above described docUJeDt and prOlise in good faith to deliver it to the "owner" prior to coaenCelent. 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 developlent. Application is bereby lade to obtain a peIlit to do work and installation as indicated. I certify that no work or installation bas COIIenced prior to issuance of a peIlit and that all work will be perforwed to Jeet 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 governtental agenCies laY 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: * Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent * Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater rreatlent, Septic ranks * US EnviroDleDtal Protection Agency - Asbestos abatetent I also certify that, if fill laterial is to be used in Flood ZOne RAil or RA,etc.", it is understood that a drainage plan addressing a "c~sating volUle" 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 work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued sball beCOle invalid unless the work authorized by such perlit is couenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOntbs after the tile the work is cOlleJlced. One 90 day extension of tile, laY be allowed for the peIlit with fee charge of $15.00. The extension sball be requested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARJlH1G TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHEHCEHEHT HAY RESULT IH YOUR PAYIHG twICE FOR IHPROVHHEn'S TO YOUR PROPERTY. IF YOU InEND TO OBTAIH FIHAHCIHG, COHSULT WITH YOUR LENDER OR AM AnORHHY BEFORE RECORDING YOUR HOTICE OF COHHENCEHEHT. JOBS UNDER $2,500 IH VALUE 00 HOT HEED TO RECORD AND POST A "NOTICE OF COHHEHCEHEHT". SIGNATURE: OWHHR OR AGEHT SIGHATURE: COHTRACTOR STATE OF FLORIDA COUny OF The foregoing instrument was acknowledged before me this , 19____ by STA!E OF FLORIDA coum 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