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Home My WebLink About95-5441 :0. BUILDING PERMIT-- CITY OF ZEPHYRHILLS Permit lV! (813) 788-6611 1-5440 Date 12-:f)-9s- -~ ~ El~ PlU~ MEeH1<1IIlCAl Pmperty own~tf ;J <y ~- /l. c:ff.b~ Job Address: ~_ _ J 6< CZ::zf ---5 __ Parcel I. D. # Zoning: Description of Work Sewer Conn Water Conn: Water Meter: T.I.F.'s: "'-i 029'05.J' ~ I;J-//- 5' DATE NO OCCUPANCY BEFORE C.O. FINAL Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector -tZO :::~ ~?--4 Com pan Addre s Telephone# ~ Valuation or ~ ,.~ Contract Price 7 () 0 City License Registration # / 6~ 1 State Certified License# , lk--i..44~) (ffL<~~~ BUILDING EL~ -- PLU~ M~ll..AL - 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 Ins!. 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 PERKIT CITY OF ZEPBYRHILLS BUILDING DEPARTMENT OWNER'S NAME G~ v~ / cI W" E/J5 PHONE 'jf If' tll! # . OWNER'S ADDRESS 6-? J: C / ~ ~ ><7 "'" ~,.. .r JOB ADDRESS Z -e" ~',y'tr I; /is / ~/ , Y.?sYO LEGAL DESCRIPTION: LOT(S) / Z, /~, /7,t';2C> BLOCK 7/ SUBDIVISION PARCEL I.D.' 1/- -:J.t -~/-CJ% - d7/C7tJ-tJI70 (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition --...Alteration ~epair _Install _Sign _Hove _Deaolish PROPOSED USE: _Single Faaily \. _H/F _' of Units _H/H _~ercial _Indust. _Swia. Pool _Other _Restaurant Ii Health Departaent Approval DESCRIPTION OF WORK: If ~ J? /ciJ Co ~ R t1-;;~ ? e:? yo C " /' /d' ~ V- :l. V t? S't~ At: BUILDING SIZE: x Square Feet. Height RESIDENTIAL : COMMERCIAL : ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. _BUILDING $ 7.00 .,.cau PERKITS REOUESTED Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. --1tECBABICAL $ Valuation of Hecbanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FIRISBED FLOOR ELEVAnONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ....************************************** BIJII.DER CONTRACTOR SECTION COMPANY <"'u-r#fr~ h/l f Rfr r State Cert. or Regist. , ~'2fL2. City License Registration' ______ 7 *.**************************************** Signature SignAture COMPANY State Cert. or Regist. . City License Registration , ****************************************** PLUMBER COMPANY State Cert. or Regist. . City License Registration , ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. , City License Registration . *********.******************************** Signature OTRF.R COMPANY State Cert. or Regist. t City License Registration # ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this peIlit JaY be subject to -deed restrictions" wbich laY be lOre restrictive than City regulations. Tbe undersigned assUlles responsibility for co.pliance with any applicableudeed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired 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 lall, both the owner and contractor laY be cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirl!lents tay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813) 788-6611. FurtbeIlOre, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the IIContractor Sections" of this application for wbich 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 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 - HOIeOIDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is sOJleone otber than the -owner", I certify that I bave obtained a copy of the above described docUIIeDt and protise in good faith to deliver it to the "owner" prior to cOllencl!lent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the infortation in tbis application is accurate and that all work will be done in co.pliance with all applicable laws regulating construction, zoning, and land developtent. Application is bereby 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 teet standards of all lalls regulating construction, City codes, zoning regulations, and land developteDt 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 If responsibility to identify what actions I lUst take to be in COipliance. Such agencies include but are not litited to: t Departlent of HnviroDleIltal Regulation - Cypress Bayheads, Wetland Areas and HnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t AllY Corps of Hngineers - Seawalls, Docks, Havigable Waterways t Departlent of Health & Rebabilitative Services, HnvirODlBDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US HnvirODlental Protection Agency - Asbestos abatetent I also certify that, if fill laterial is to be used in Flood ZOne -All or IIA,etc.lI, it is understood that a drainage plan addressing a -cotpensating volutell will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to pertit issuance. A perlit issued sball 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 sball issuance of a perJit prevent the Building Official frot thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball becOle invalid unless the work autborized by such perJit is cOlleDced within six IOnths of issuance, or if work authorized by the peIlit is suspended or abandoned for a period of six IOntha after the tite the wrk is co.enced. One 90 day extension of tite, tay be allowed for tbe peIlit with fee charge of $15.00. Tbe extension sball 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. WARXING TO OWXER: YOUR FAILURB TO RECORD A HOflCE OF COMMDCEJIUT MAY RESULT IN YOUR PAYIHG TWICE FOR IMPIIOVEIIBJITS TO YOUR PROPERTY. IF YOU INTElfD TO OBTAIH FIIIAIICIHG, COHSULT WITH YOUR LlJlDER OR 1JI AftORMIY BEFORE RECORDIHG YOUR NOfleR OF COMMEHCEMBtn' . JOBS OMOER $2,500 IH VALUE 00 HOf HEED TO RECORD lJID POST A "HOfleR OF COIOIEIICEMDT". / _",d - ~- ,/f/ <: STATE OF FLORIDA coum OF ~,~~o The foregoing inst~~t was acknowledged before me this '- \~ , 19~ by H1GH J, CLASS NOTARY PuGUC, SH\lT OF FLORIDA My commissloCl e~p,r25 Iv1.:!,: 21, 1",,~/ Commission No. C C 2 7 0 3 8 1. LliROYENEWKIaK NOrARY PUBLIC STATE OF FLORID COMMISSION NO. CC336449 MY COMMISSION EXP. . 19!18 /Q HiRSONAlLY KNOWN BY ME C fROOUCBO 1.0 ~\.D.'" ~ \\-~ who is personally known to me Qr who has produced l\..\..'<)~ c.~ ~ as identification and who did/did not take~ \ ~b (Signa~ure) '----€-~ ~ "" ~ C,\~ ~~ (Name Typed, Printed or Stamped) NOTARY PUBLIC