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Home My WebLink About95-5428 BUILDING PERMIT-- / g::---- OTY OF ZEPHYRHILLS P.,mil N!. ~b " (813) 788-6611 ;~542~ Date Ir;l-.I - 9~~ ~ ELEC~ PLU~ ME.(;HANIGAL Sewer Conn Water Conn: Property Owner: Job Address: Parcell.D. # Zoning: Description of Work _f:;;; ~:3?1~~~ Water Meter: T.I.F.'s: NO OCCUPANCY BEFORE C.O. FINAL I;J. - /4..... DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. .t<~:L Permit Fee Signature Company Address Telephone# .co Valuation or 4 ~.) ~ Contract Price ,If ~J '700' ~ City License Registration # State Certified License# EL PLUMBING Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Serv. 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. APPLICANT : ~ (. .fu,r~t>K~ 7~ &~m ADDRESS . 5<=1 t} ~ I 3 -\:A. .skt:.* . ~~E '19 ~ Fd.%o.~-~r~~~ JOB LOCATION ..~~ OWNER AFPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT .' ..' ..~'~ ~"Y, '~'_"~.':':" -'..~LtJw '. LOT SIZE x - ...- AREA SQ. FT. BLOCK . SU'8DIVISION LEGAL DESCRIPTIO~: LOT(S) PARCEL I.D.~~ WORK PROPOSED:____New Construction ----Addition ____Alteration ____Repair ____Install ____Demolish ____sign/Temp. ____Sign _Move ~/F ____~~ of Uni ts " . ._M1H ~(~~~ Other PROPOSED USE: ____Single Family BUILDING SIZE: RESIDENTIAL: COMMERCIAL : ____BUILDING ____ELECTRICAL _MECHANICAL ____PLUMBING ____Commercial .......;..;..-Indust:. _Swim. Pool ____Restaurant & Health Department Approval x Square Feet. Height ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** ATTACH (3) SETS OF BUILDING PLANS & {I) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMTTS REO tiES TED $' 3"1~.~ Valuation of Total Construction AMP Service Florida Power Corp. _W.R.E.C. $ Valuation of Mechanical Installation ~ ROOFING SPEQIALTY GAS Other TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel FINISHED FLOOR ELEVATIONS: FT. OTHER ~\~Ir- Signature - ~ (,,..1 ~ Signature Signat~re MECHAN1CAL Signature ************************************** / I- I . . CONTRACTOR SECTION / Company . State Cert. or Regist. # ,/ City License Registration~ ***************************************** 'company , . / State Cert. or Regist. # / City License Registration~ ****************************************** Company / . State Cert. or Regist. # /' City License Registration~ /' ****************************************** ~ Company / State Cert. or Regist. 4~ / City License Registratio~4~ ****************************************** Company ~elA:~~ State Cert. or Re ist. # ~~OOCO f9,CD 3 City License Registration # -till "2.B'"L ****************************************** , PERMIT OFFICER. APPLICATION APPROVED BY " . CONDITIONS O~ PERMIT AfFIDAVIT A. NOTICE OF DEED RESTRICTIONS The und~rsigned understands that this penH lay be subject to "deed restrictions" IIhich uy be lore'restr.ictive than City regulatIons. The undersigned assules respDnsibility:for cOlpliance lIith any applicable deed restrictions. . . B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES . If the ollner has hired a contr~ctor or contractors to undertake 1I0rk, they lay be required to be licensed in accordanc~ lIith st.te 'nd loc.l regulations. If the contr.ctor il not licensed al required by lall, both the ollner and contractor lay be cit~d for a lisdeltanor violation under state lall. If the ollner or intended contractor are uncertain as to IIhat licensing requirelents lay apply for the intended 1I0rk, they are advised to contact the City of Zephyrhills Building Departlent, 1813) 798-6611. Furtherlore, if the ollner has hired a contractor Dr contractors, he is advised to have the contractor!s) sign portions of the "Contractor Sections" of this application for IIhich they lIill be responsible. If you, as the ollner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the lIork. If the contractor Nishes 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 "Florida's Const~uction Lien LaN - HOleollner's Protection Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is SOleone other than the "ollner", I certify that I have obtained I, copy' of the above described doculent and prolise in good faith to deliver it to the .Ollner" prior to cOllencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all 1I0rk lIiII be done in cOlpliance lIith all applicable lalls regulating construction, zoning, and land developlent. Application is hereby .ade to obtain a perlit to do Mork and. install~tion as indicated. I certify that no 1I0rk or installation has COllenced prior to issuance of a per_it and that all work lIill be perforled to leet standards of all lalls regulating construction, Ci ty codes, zoning regulations, and land develop_ent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern_ental agencies lay apply'to the intended work, and that it is IY responsibility to identify IIhat actions I lust take to be in COlpliance. Such agencies include bllt ill e 1I0t hlited to: It ~.I#- I Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive ldnds, Water/Wastewater Treatlent f Southwest Florida Waier' "anaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses f Arlv CorDS of Enoineers - Seawalls, Docks, Navigable Waterways f DeDartlent of Health L Rehabilitative Services. Environlental Health Unit - Wells,' Wastellater Treatlent. Septic Tanks I US Environlental Protection AQency - 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 "colpensating volule" Nill be sublitted which is prepared by a professional engineer regist~icd 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 viol~te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, Dr violations of any code. Every per.it issll~d ;hall bee ole invalid un,less the.lIork authorized by such penH is cOI..nced within six lonths of issuance, or if work authc'i lied by the perli t is suspended Dr abandoned for a period of sil lonths after the tiae the Nork is co.,enced. One 90 day c~t~"siou of tile, lay be allolled for the perlit Nith fee charge of SI5.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six lonth period, or the project will be considered ab.lldoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, . CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF C~~ENT". _ SIGNA~~~~___-=----- DATE________~LQL~L'i~---- ------------ NOTAR~ . / PI .A CONTRACTOR____ ~~JL-- " MY COMMISSION --------------- MY COMMISSION ....^' ....~55'ON-----I-- --- L66l '9 eunr 'dJC3 'WWO:) AVII ~ ~IO e~~s 'OlIQnd AqON ~~ ! ~3dVH:>S 1 HllCnr ". ~.... ~ ~ ~c:. " n JUDITH '-. SCHAPER Notary Public. State of Florida My Comm. Exp. June 6,1997 No. CC 292357 .-, .. .. . .-.....-......,-, --- '.. ....,... .~~_._-_.._-----~.._. , I':"" I. Ii I.... E3 Ii.: ~ .\ ~:':k r::' L:~ r.. ~:.=: ~... t ::'.., ~::=. "f. n-:-'~ LI c:: "'I~ . I: iL~]1 U "~l ~::::; '..::::' - ~ ; F,E;3 I DEI\jT I i:';L ~. [,DMI"IEFd: I AL .',"'..: .1.:;. ,,-,:! 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