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Home My WebLink About95-5455 BUILDING d-fJ - tTz) ..-~ ~G/ P<aperty owne'~?~/ y.~#; Job Address: '" "} 3. - / Parcell.D. # /I-(;Lb - J./ __ (J 0/ V - / 0 0 ~ BUILDING PERMIT - CITY OF ZEPHYRHILLS Permit IV! (813) 788-6611 ...,30.H ~~~ Sewer Conn Water Conn: -;~.545QH Date / d '- / /- 7~ -- PLUMBING Water Meter: T.I.F.'s: oD-.Su Zoning: Description of Work Energy COde:2=" J1_/A-") ./]-~ Radon Gas: FINAL--.L2-~- f5 DATE NO OCCUPANCY BEFORE C.O. Complete Plans. Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. DATE ~j5 Inspector City License Registration # State Certified License# /8'-?- Perm;' Fee -.s b - ffZ) ~ S;gnaMe 9 N Company Address Telephone# Valuation or Contract Price c2 s ~. (). {;-v '" J<'". {)~u/~ >ol- BUILDING ELECTRICAL PLUMBING ')(~J ~ MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo 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 PERMIT CITY OF ZEPllYRllILLS BUILDIRG DEPARTMENT OWNER' S NAME rP."9~ ( 6, (?~cf ( oJ/ -5;;J..s-S /(~s f , ~;l.15 I ?~5f, PHONE 7B~-S/6? OWNER'S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.' 11- ~ - (?t( -OtPt'o- 196&0 -O~s-c(OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~ew Construction -^ddition --...Alteration _.J.epair _Install _Sign --.JIove ->>eaolish PROPOSED USE: _Single Faaily ---1t/F _' of Units _H/H _~ercial _Indust. _Swia. Pool _Other -Restaurant Ii Health Departaent Approval DESCllIPTIOII OF li01IIC: I 15 7 -'7V ~ c- .BUILDIRG SIZE: x Square Feet. Height RESIDEI1TIAL: 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. PERKITS REOUESTED ~UILDIRG $ Valuation of Total Construction _ELECTRICAL AIIP Service Florida Power Corp. W.R.E.C. -.-JIEalAIlICAL $ Valuation of tt.echanical Installation _PLUtlBIRG GAS ROOFING SPECIALTY TYPE OF COIlSTRUCTION: _Block _Fraae _Steel Other PINISHED FLOOR ELEVAnONS: Fr. IS PROJECT IN FLOOD ZONE AREA? YES NO ..................................*....... CONTRACTOR SECTION BIITT.DER. COMPANY State Cert. or Regist. . City License Registration . .......................................... Signature RT.RCTRICIAN ;' COHPANY~"7c-Itf-;LA1 C/~-+A/AJ"'LL ELk,,? ,--~~~^__ ~. /? State Cert.. or Regist. . SignAture .Vrc.t'~.......?y Ltc:;.-z.-.z&u-"/ City License Registration' 70<:- .......................................... PLlIIBER COMPANY State Cert. or Regist. . City License Registration . .......................................... Signature Signature COKPANY (e ,....7 c State Cert. or Re st.' City License Registration . .......................................... MECHANICAL OTRRR COMPANY State Cert. or Regist. . City License Registration . ...................................**..*.* Signature APPLICATION APPROVED BY PERHIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS 'l'he undersigned understands that this perlit laY be subject to Ideed restrictions" which lay be lOre restrictive than City regulations. !be undersigned asSUles responsibility for capliance with any applicable deed 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 law, both the OImet and contractor JaY be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirl!lents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813) 788-6611. FurtheIlOre, if the OImer bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the 'Contractor Sections. of this application for which they lIill be responsible. If you, as the OIIIler sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign as contractor that laY be an indication that be is not properly licensed and is not entitled to peuitting 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 lith a copy of IFlorida's Construction Lien Law - HQEOIIDer's Protection Guide" prepared by the Plorida Departlent of Agriculture and ConsWler Affairs. If the applicant is sOleOlle other than the vowner", I certify that I bave obtained a copy of the above described dOCUJent and prOlise in good faith to deliver it to the 'owner" prior to cOlll!llcl!lent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIlition in this application is accurate and that all work lIill be done in cOlpliance with all applicable la1l8 regulating construction, loning, and land developleJlt. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas COIIenced prior to issuance of a peuit and that all work will be perforJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlf!Jlt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveI1llelltal agenCies laY apply to the intended wort, and that it is If responsibility to identify IIbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDleDtally Sensitive Lands, Water/Wastewater 'l'reatlent t Southwest Florida Water Managl!leDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rebabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatlent, Septic 'l'anks t US EnvirODleDtal Protection Agency - Asbestos abatl!leDt I also certify that, if fill aaterial is to be used in Plood ZOne "A" or 'A,etc.", it is understood that a drainage plan addressing a "cOIpensating 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 sball issuance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every peuit issued sball beOOle invalid unless the 1I0rk authorized by such perlit is cOllellced within sillODths of issuance, or if work authoriled by the perlit is suspended or abandoned for a period of sil IODtbs after the tile the work is co.enced. One 90 day stension of tile, aay be allowed for the perlit lith fee charge of $15.00. 'l'be stension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each sillODth period, or the project will be considered abandoned. WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COIIMBRCEIIIIft' MAY RESULT IN YOUR PAYING !VICE FOR IMPROVIIID'l'S TO YOUR PROPERTY. IF YOU IIft'BJID '1'0 OBfAIN PIWCING, CONSULT WID YOUR LBHDIR OR AN A'l"l'ORDY BEFORE RECORDING YOUR NOTICE OF COMMENCEIIIIft'. JOBS UNDIR '2,500 IN VALUE 00 NOT NEED '1'0 RECORD AND POST A "NOTICE OF COHMENCBMm". SIGllAflJRB: OWNER OR AGBIl'I' SIGNATURE: CONTRACTOR S'I'A'I'E OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by S'I'A'I'E OF FLORIDA coum OF The foregoing instrument was aCknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oi$th. (Signature) (Namt! Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC - fir~r~ ?~J5.- C; B '>! Kinsey Central Heat &: Air-Conditioning 7718 Fort King Highway . P.O. Box 2209 Zephyrhills, Florida 33539-2209 (813) 782-2300 -7If.. J?~ L >r?< N'ARllIENT _ss CITY - _l 1ER1M.1IO. o ESTIMATE o CASH o CHARGE NATURE OF SERVICE ~ REQUEST DESCRIPTION PRICE QUAN. PART NO. lCE PERFOR~ / ,,? c' VC<- r ,'. ~ ~ ....I;1.1? (t:c~yc.,. . J J) ?' .I ,.. I t r;:~ I~ Ie:. t4-? v- tt:..Jl e"WtI r:;> ~'o/J C f · L- F/r!1;Ir1 !?(~v6/? L'tAIJ'/ C'~/ ~/fI, r, TOTM. IM-. 1tCIlIICM. I8MClTlllE TAX I r- -t- 1-- '7"-' 1p.1 Of.1tCOlll'U1tD CASH ::m*.. mAL TECHNICIAN, CUSTOMER'S SIGNATURE