The URL can be used to link to this page

Home My WebLink About96-5844 BUILDING PERMIT 0 ~- CITY OF ZEPHYRHILLS permitN. I 58441'/ (813) 788-6611 ___ Date -...5 -I b - 9 (", BUILDING ELECTRICAL PLUMBING ~~ANICV Sewer Conn Water Conn: ~ Property Owner: Job Address: c: ...3 . - Parcel I. D. # Water Meter: T.I.F.'s: Zoning: Description of Work Energy ~: lIL ~ ~if Radon Gas: 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. Permit Fee Signatur Company Address Telephone# Valuation or Contract Price / --s -- J> s '- o-v ./ City License Registration # & 0 State Certified License# c~; /t;/ L. BUILDING ELECTRICAL PLUMBING 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 Insl. 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 ZEPHYRBILLS BUILDING DEPARTMENT OWNER · S NAKE S D? H f E- t::Lc Ut:~ OWNER'SADDRESS bl 30 J-,A~~sT JOB ADDRESS Co ( '3 Q h A (<.. \< S T PHONE <J' ["3' - 7R 8 ~ f"~7 8. 2-{'-{ ( (Ls ZE:: My f2~; l(s, LEGAL DESCRIPTION: LOT (S) BLOCK SUBDIVISION 0 A- ~ ~, \ d.E ,'V\ o6{ I f:- P" 2- r.. PARCEL I.D.' OJ, J-4> ()... r 00;;..0 D 0300 D 0\ U (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~lteration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Faaily _H/F _' of Units -LM/H _ec:-ercial _Indust. _Swia. Pool _Other _Restaurant it Health Departaent Approval DESCRIPTION OF WORK: 'Re:-plr'tc.€: 1{-~~TuJ,J t CouL,~ Pf\-C:..~1'f-3~ (A.l""K. BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS it (2) SETS OF BUILDING PLANS it (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS it (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. -.M...MEGllARIGAI. $ /5"7S/~ Valuation of Mechanical Installation _PLUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FDiISHED FLOOR ELEVATIONS: F'f . IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature ELECTRICIAN COMPANY State Cert. or Regist. , City License Registration , .......................................... SiRllature PLUKBER COMPANY State Cert. or Regist. , City License Registration f ................................... Signature COMPANY ColE- '-7 A-fc f f.(t?'4~~1 . State Cert. or Regist. f C ~~o 4.2...(,(" 7 City License Registration f ~D ...........~.............................. OTRRR COMPANY State Cert. or Regist. # Signature City License Registration t .......................................... APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned' understands that this perJit lay be subject to "deed restrictions" wbich JaY be tore restrictive tban City regulations. rbe undersigned assOles responsibility for coapliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents aay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner bas hired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of the "Contractor 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 wisbes you to sign as contractor that aay be an indication that be is not properly licensed and is not entitled to perJitting privileges in the City of Zephyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify tbat I, the applicant, bave been provided with a copy of .Florida's Construction Lien Law - Hoteowner's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsDler Affairs. If the applicant is soaeone otber than the .owner", I certify that I bave obtained a copy of the above described docuaent and pro.ise in good faith to deliver it to the "owner" prior to couencelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify tbat all the inforaation in this application is accurate and that all work will be done in coapliance with all applicable laws regulating construction, zoning, and land developaent. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has COIIenced prior to issuance of a perlit and that all work will be perforaed to teet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other governaental agencies tay apply to the intended work, and that it is If responsi~ility to identify wbat actions I lUst take to be in cOlpliance. Sucb agencies include but are not litited to: * Departtent of Environaental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Vastewater TreatJent * Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses It ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways It DepartJent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater TreatJent, Septic Tanks It US EnviroDlental Protection Agency - 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 .co.pensating volute" will be sublitted wbicb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perJit 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 tbe technical codes, nor sball issuance of a perlit prevent the Building Official fro. thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perait issued sball becote invalid unless tbe work authorized by such pertit is cOJJenced within six IOnths of issuance, or if work autborizedby the perJit is suspended or abandoned for a period of six IOnths after the tite the work is C08I!JIced. One 90 day extension of tite, tay be allowed for the pertit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each six tonth period, or the project will be considered abandoned. WARMING TO 0VlfER: YOUR FAILURE TO RECORD A NOflCE OF COHMEIICEHEIft' MAY RESULT IN YOUR PAYING !VICE FOR IHPROVEMEIft'S TO YOUR PROPERTY. IF YOU IIft'END TO OBTAIN FINANCING, CONSULT WITH YOUR LEMD An BEFORE RECORDING YOUR NOflCE OF COMHENCEMEN1'. JOBS UNDER $2,500 IN VALUE 00 NOf NEED TO RECORD POST A. CE CEHm" SIGNArURE: OWNER OR AGE1ft' STATE OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by srATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me Qr who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an Oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC CVLI:'i ..u~ CV~()ITIV~I~f7 4N() tiUTI~f7 37338 Kossik Road Zephyr hills, Fl 33541 (813) 783-3723 PROPOSAL No. Date 5-/3-9b, St. Cert. 'CAC042667 Sheet No. Name Street City State Phone Work To Be Performed At: ;-') A >(Y\. f- . Proposal Submitted To: 4~ I -3 0 'f:"'{~iL S't. /- <=-.--{) HI...f e i ,'..f l...:. I . ~ C"'.:l It I c)7 .,'\ 'j? , ~ '- -7 B e. ~ I ;;.t.-j 8 Street City Date of Plans Architect { .J,... 14 ."J ~-y o ""L, Y b'\ (L 8"ttL ( U LA Bo\t. (57 C'r,(G'S Ale J. ~t~ I /....,. "",: 1.L.o.J' ~ 1\ c\...l. -L;) IJ('-L '1- 'tr:: A l'- {U IFl r.~-{\...-h ....'\.,)N\...-~.....L ~-~,lLE _ All material is guaranteed to be as specified. and the above work to be performed in accordance with the drawings and specific~oRs submitt~d f~r above .w.ork and 1:ompleted in a substantial workmanlike manner for the ~~~ of ()Ne: l I...Jl~L~~~,-<O f.lvV-Q 1-\'-\1___(L,-_O .t.~.,.J1 p-"u-~ ~ ~~""' '- Uollars [$ 15 7 5" ~ 1. with payments to be made as follows: "c '" 501\:1 ,c.:::- l07S,L:'~ ~ ki S lJ)/ '--' f C tl ,J \ 1l~47 . U"-J ~ OIY\JJ (r.oO frJ........... , g 1lJ~ (t.,,~:JV rA'lG. e posal may be withdrawn by us if not accepted a o ,days. Any alteration or deviation from ebove specifications involving extra costs. will be executed only upon written orders. and will become an axt.... charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire. tornado and other necessary insurence upon above work. Work. men's Compensation and Public Liability Insurance on above work to be taken out by Re~pectfully submitted Note- This within ACCEPTANCE OF PROPOSAL The abolte prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. P"ment will be made as ou'lin'" ab<wa Signatu," . ~. )4 ~/ )- //1- <7;' Date I. 'J - /0 - ~~ Signature \. "