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Home My WebLink About96-5516 ~ :LD ~ ./ cR.O ~ ~:::~~~~:~e'f}xt;~~*.~~~ BUILDING PERMIT --. CITY OF ZEPHYRHILLS pe,m;tlll! i 5516.B (813) 788.6611 Date 1- 1;l-90 ~ ME~ Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Description of Work :rgy Code: I~ itJl, 7- Radon Gas: ~ /lJrxl1uA,6L"inJ""7t J~ FINAL DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector Permit Fee Signature' Company Address Telephone# ~7 %'J.. . D~ 1 p~~~, I.~ Valuation o~ 'I 1 no?',' ~ Contract Price (/ l./ I d 70 g:- ~.A.L Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In '/151 lelL rS~ S. 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 ($15.001 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 PERKIT CITY OF ZEPllYRllILLS BUILDING DEPARTKENT OWNER'S NAME A /tiel ~E W ;:j C Gill/{ L / /1,/ OIlIIIlR'S ADDlIESS In /</'l I? 74 _P 6('ic/( S JOB ADDRESS .... c:; a. /'/; e PHONE/--?/3 7?26' 70Y (JA/< S IcY-t=- hlfA' LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D.' (OBTAIN FROM PROPERTY TAX. NOTICE) WORK PROPOSED:_New Construction _Addition ~teration ~epair ~Install _Sign --1Iove _Deaolish PROPOSED USE: -Ls ingle F8IIily ~/F _' of Units _K/H _~ercial _Indust. _Swill. Pool _Other _Restaurant &: Health Departaent Approval DESCRIPTION OF WORK: X BUILDING SIZE: / :l X'/"j [) , L/ ff'{) 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. PERKITS REOUESTED ~BUILDING ~ELEcrRICAL $ Valuation of Total Construction AKP Service Florida Power Corp. W.R.E.C. .-JlEGllAliICAL $ Valuation of Kechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _B1ock _Fraae _Steel Other FIRISHED FLOOR ELEVATIONS: Fr. IS PROJECf IN FLOOD ZONE AREA? YES NO .......................................... CONTRACfOR SECTION RUTT.DER COKPANY State Cert. or Regist. . Signature City License Registration . .......................................... ELECTRICIAN COMPANY State Cert. or Regist. . SiooAture City License Registration . .......................................... PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration . .......................................... KECllANICAL COMPANY State Cert. or Regist. . Signature City License Registration . .......................................... OTRRR COMPANY State Cert. or Regist. . Signature City License Registration t .......................................... APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to .deed restrictions" which lay be lOre restrictive than City regulations. The undersigned assUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake IfOrt, they tay 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 tay be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licenSing requireaents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the nContractor 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 IfOrt. If the contractor wisbes you to sign as contractor that tay be an indication that be is not properly licensed and is not entitled to pertitting 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, bave been provided with a copy of .Plorida's Construction Lien Law _ HOIeOMner's Protection Guide" prepared by the Florida Departlent of Agriculture and Consuter Affairs. If the applicant is sOleOne other than the "owner", I certify that I have obtained a copy of the above described dOCUleDt and protise in good faith to deliver it to the "owner" prior to COllenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infortation in this application is accurate and that all wort will be done in cOlpliance with all applicable laws regulating construction, loning, and land developaent. Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no wort or installation has cOllenced prior to issuance of a pl!lllit and that all wort will be perfoI'led to teet standards of all laws regulating construction, City codes, loning 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 ty responSibility to identify what actions I lUSt take to be in coapliance. Such agencies include but are not litited to: t Departlent of EnviroDlel1tal Regulation - Cypress Bayheads, Wetland Areas and Invirolllelltally Sensitive Lands, Water /IIastewater Treatlent t Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t Arty Corps of Ingineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Services, InvirODleDtal Health Unit - Wells, wastewater Treatlent, Septic Tants t US InvirODleDtal Protection Agency - Asbestos abateaent _ r also certify that, if fill laterial is to be used in Flood Zone "An or "A,etc.", it is understood that a drainage plan addressing a .cOlpeDsating volute" will be subtitted which is prepared by a professional engineer registered in the State of Florida prior to pertit issuance. A perlit issued shall be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official fCOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pl!lllit issued shall beCOle invalid unless the work authorized by such pertit is COllellced within sillOnths of issuance, or if IfOrt authOriled by the pertit is suspended or abandoned for a period ofsillOntbs after the tile the wort is ~ced. One 90 day eatension of tile, lily be allowed for the pertit with fee charge of $15.00. The eatension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each siXlODth period, or the project will be considered abandoned. WARNIHG TO om:R: YOUR FAILURE TO RECORD A NOTICE OF C<IDIIlfCBllENT MAY RESULT IH YOUR PAYING fIIICE FOR IHPROVEHDrS TO YOUR PROPERTY. IF YOU IIffEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR IN ArroRm' BEFORE RECORDING YOUR IfOfICE OF COHHEHCBHBIft'. JOBS UNDER $2,500 IN VALUE 00 IO! IUD TO RECORD AID POST A "NOTICE OF COHHEICBIlENT". ~ 1A -, 1 . d~ ~/ldt> SI. 00: IIIIIER OR C STATE OF FLORIDA COUNJ'Y OF The foregoing instrument was aCknowledged before me this , 19____ by SIGNATURE: COIffRACrOR STATE OF FLORIDA COUNTY 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 oCJth. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC !.. .. ~ -3:.. , -~ ,,",..~,.. .'.... -"."" ~""W/ .-.".:,- , V'f~c~;-~~~ h:+ ......~... ;,;~ t ~ I I II I i ..-'---.-- .-... .. 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