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Home My WebLink About95-5468 BUILDING PERMIT .. CITY OF ZEPHYRHILLS Permit B!' (813) 788-6611 1~54a~~ Datl~ / cJ- - / '1- T..!::>- ~ ELECTRICAL PLUMBING MECHANICAL P..pertyOwne, ._~~~ ~ ~,,~ Job Address: --..5.1_~ _ _ _ Sewer Conn Water Conn: Water Meter: T,I.F.'s: Parcel I. D. # Zoning: Description of Work FINAL C.O. DATE NO OCCUPANCY BEFORE C.O. Complete Plans. Specifications and Fee Must Acco All wo,k shall be pe,fo,med In acco,dance WI~ 0 Valuation 0' N. \ Contract Price I c2. 7' b. 07~ \ T , ./ ~ DATE Inspector -iS~ .~, ,wr~ City License Registration # c:2/ J ~~- Address Telephone# BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB lintel FRM. Insul. CL WL Driveway IZ-l.c..€j) ~lb Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15.001 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 ZEPHYRHILLS BUILDING DEPARTMENT OWNER · S NAKE e~l-lff~ c~ -A6D~~ , {~O~ '-?~6r. ( 5' tf;/tJ~ t?~Jr;~NE ,/15J>-J?9Y 2.e//I7~A///J I OWNER' S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ---..Alteration ---.Jlepair _Install _Sign ----Hove _Deaolish PROPOSED USE: _Single Faaily ~K/F _' of Units _K/H _ec:-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departllent Approval DESCRIPTION OP llORk: P F: /V e L<-97 /0 / 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 Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. -'lECllAlUCAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... BIITIJ)ER CONTRACTOR SECTION COMPANY 2.egLv~ or:/l\/~dC;b~/y . ~ ?~ State Cert. br Regist. , D{ , ft. ~^ t:? / / City License Registration , .;;L/ / , .......................................... Signature F.T .RCTRICIAN COMPANY State Cert. or Regist. # City License Registration , .......................................... SilmAture PLUMBER COMPANY State Cert. or Regist. # City License Registration # .......................................... Signature MECHANICAL COMPANY State Cert. or Regist. # City License Registration , .......................................... Signature OTRRR Signature COMPANY State Cert. or Regist.' be /2-38 {S- City License Registration' Z_// .......................................... APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit laY be subject to "deed restrictions" which laY be lOre restrictive than City regulations. The 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, 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for tbe intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813) 788-6611. Furtherlore, if the owner has hired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the "Contractor Sections" of this application for whicb 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 tbat I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOIDer's Protection Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs. If tbe applicant is sClleOne other than the "owner", I certify tbat I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the "owner" prior to coaencelent. E. CONTRACTOR'SjOWNER'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 developaent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a perlit and that all work will be perforled to teet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other goveruental agencies laY apply to the intended work, and that it is IY responsibility to identify what actions I lUst take to be in cOlpliance. Sucb agencies include but are not luited to: t Departlent of KnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDJentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, EnvirODJental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US EnvirODJental Protection Agency - Asbestos abatetent . I also certify that, if fill laterial is to be used in Flood ZOne "A" or DA,etc.", it is understood that a drainage plan addressing a 'cQJpensating VOlUleR will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued sball be construed to be a license to proceed with tbe 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 perlit issued shall beCOle invalid unless the work authorized by such perlit is cOllBnced within sil IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of sil IOntha after the tile the work is ~ced. One 90 day l!Itension of tile, laY be allowed for the perlit with fee charge of $15.00. The l!Itension 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 COIIMDCKlllNI MAY RESULT IN YOUR PAYING TWICE FOR IMPROVIMKNfS TO YOUR PROPERlY. IF YOU INlEID TO OBTAIN FIWCING, CONSULT WITH YOUR LBIIDER OR AI AftOHm' BEFORE RECORDING YOUR MariCE OF COMMKMCEMKN'l' . JOBS OlDER $2,500 1M VALUE 00 NOT NEED 1'0 RECORD AID POST A "NOTICE OF C(JOIENClMEN'l'". SIGNATURE: OWNER OR AGEN'l' SIGNATURE: CON'l'RACTOR STATE OF FLORIDA COUM'I'Y OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC SEMINOLE FORM 1596 14!Jh '7'12. t/3ejC, PROPOSAL ,!.., ,5 fY7c k~ II d.-e AJ ~-f. 3<)"~g &IVJt&..Lj ~j. Ze~ (' JL'..I /r:. ; r:i 3_5~- tJ) , '"1l?cJ - .5-.3 1"01- PHON' 1 g -3rn '1 'I I DAlf / / ~ 7/1:f' JOB NAME: ("I C~ ~'J t9 n1 STREET : Page No, of Pages PROPOSAL SUBMITTED TO: ._--~- NAME: ~ Ii ~ t;.asf t\S~"_,__ S~QC___aQm_~e I1LTCJes STREET: ~Q~__.=__z_lL: Sf-, CITY: 2&1)1 L 'II . _ - A.A..{ r lLA..- ..s ) I _,V STATE: j.- L . '-A I 3 3 -~- tJ CITY: _______1 STATE: We hereby submit specifications and estimates for: It) IX 9'3 I .z:J I ,~ f.-..3 0 I '-I -, /)rLvetu {~ '> - S/tJex:.Uc7! /G ( (!~IUl,eETE We hereby propose to urnish labor and materials - complete in accordance with the above specifications, for )he sum of: ()NL 7/1~ ANi> 'C~V&J~1l _~i. ~!!!..!f~'~rs ($ 1~'./-71o .() 0- P:JmetL+ L~,{j t2l)nf.fJkh~ ~;J 7t,. OV e& ) with payment to be made as follows, All material is guaranteed to be as specified, All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs, will be executed only upon wriflen orders, and will become an extra charge over and above the estimate, All !J:,O days and is void The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified, Payment will be made as outlined above, ACCEPTED: Date '//e?/, rl 7. , I /7~ Signature Signature ,. t Y:: IiI JJ (j C:))k' (>(J I? 1 . ._, -- ,1;~' .' ----.-- -. ..-.--,..--- . -" .--- -T ,. NE \-,J Dr< I V F \i'VI)~' / / /' / ...~ r l' / r.t L..._/ s 0 ~t~ 7 5 T/( Fie r 33:: '-10 z.... 1+' L L / '-. /0 -/, ~ i I i / A rp /( 0.1) I~ /-1 '" \ 7 (;{f\r rr