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Home My WebLink About96-5598 BUILDING PERMIT-- an OF ZEPHYRHILlS po"""lll! '-5~98f1 (813) 788-6611 Date ~~/b -9'6 BUILDING ELECTRICAL PLUMBING ~ANlcpsowe' Conn Water Conn: Property Owner: ~E 2/~L.d Job Address: ...s '0..3 0 - ijJ'-zz ~ Parcell.D. # /1-:2 {; - d-I- ()~/ () ... /5'70() -- {) /<..? 0 Water Meter: T,I.F.'s: Zoning: Energy Code: Description of Work '-/1,tki) ijr_ 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. City License Registration # State Certified License# I &:, f:1 Permit Fee Signature Company Address Telephone# Valuation or Contract Price dl.. () lTr?, cr-o " {l~~~ /I..J-~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In 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 ($15.00) 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 ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME pAIL (jJOOl) IL/&/ ( 15T S\ LIs T PHONE OWNER'S ADDRESS d I I Q7 JOB ADDRESS 'S'O .~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL LD.' /J 2(;, d-I oo/n /g7/Y) of 3D (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~teration ~epair _Install _Sign ----.fIove _Deaolish PROPOSED USE: ~~eF~i~ -.Jt/F _' of Units -.Jt/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant &: Hea1th ~par~ent DESCRIPTION OF WORK: ~ It! r: s . '{J J:::t<J ( CvdlZlL - BUILDING SIZE: x Square Feet. Height RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED ~UILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. --1IECBAIlICAL $ ;)600_ r Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRucnON: _Block _Fraae _Steel Other FIllISHED FLOOR ELEVAnONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... CONTRACTOR SECTION RIJTT.DRR COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature F.T.RCTRICIAR COMPANY State Cert. or Regist. , City License Registration , .......................................... SianAture PLUMBER COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature Signature '!tk (2IC1f- N State Cert. or Regist. t City License Registration f .......................................... COMPANY MECHANICAL OTRRR Signature COMPANY State Cert. or Regist. t City License Registration t .......................................... APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS fbe undersigned understands that tbis perlit JaY be subject to 'deed restrictions" wbich Jay be lOre restrictive than City regulations. !be undersigned asSUles responsibility for COIpliance witb any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If tbe owner bas bired a contractor or contractors to undertake work, tbey JaY be required to be licensed in accordance witb state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractor .y be cited for a lisd_anor violation under state law. If tbe owner or intended contractor are uncertain as to what licensing requirl!lents laY apply for tbe intended work, tbey are advised to contact tbe City of Zepbyrbills Building Departlent, (813) 788-6611. FurtberlOre, if tbe owner bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe IContractor Sections I of tbis application for wbich tbey will be responsible. If you, as tbe owner sign as tbe contractor, you are indicating that you, ratber tban tbe contractor, are responsible for tbe work. If tbe contractor wisbes you to sign as contractor tbat JaY be an indication tbat be is not properly licensed and is not entitled to perlitting privileges in tbe City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify tbat I, tbe applicant, bave been provided witb a copy of IFlorida's Construction Lien Law - HfIIeOIIIler's Protection Guide" prepared by tbe Florida Departlent of Agriculture and ConsUlleI' Affairs. If tbe applicant is SOII!OD8 otber than the lownerl, I certify tbat I have obtained a copy of tbe above described dOCUlent and pfOlise in good faitb to deliver it to tbe "owner" prior to cOlleDceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all tbe inforaation in tbis application is accurate and tbat all work will be done in cOJpliance witb all applicable laws regulating construction, zoning, and land developent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify tbat no work or installation bas ~ced prior to issuance of a perlit and that all work will be perfol'led to leet standards of all laws regulating construction, City codes, zoning regulations, and land develoPleJlt regulations in tbe jurisdiction. lalso certify that I understand tbat tbe regulations of otber goveruental agencies laY apply to the intended IOrk, and that it is If responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lillited to: * Deparuent of EnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water IWastewater !reatlent * Southwest Florida lIater Hanaguent District - lIells, Cypress Baybeads, IIetland Areas, Altering lIatercourses * ArlY Corps of Engineers - Seawalls, Docks, Mavigable lIaterways * DepartJent of Healtb & Rehabilitative Services, EnvirOllleDtal Healtb Unit - IIells, IIastewater !reatlent, Septic !ants * US Envil'ODlel1tal Protection Agency - Asbestos abatuent I also certify that, if fill laterial is to be used in Flood ZOne "AI or "A, etc. ", it is understood tbat a drainage plan addressing a .cOlpeJlSating volllle' will be sw.itted wbich 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 witb 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 tbe Building Official ffOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued sball becoIe invalid unless tbe work authorized by such perlit is COIIeIlced .itbin six IOntbs of issuance, or if work autborized by the perlit is suspended or abandoned for a period of sillODtbs after tbe tile tbe work is ~ced. One 90 day eltension of tile, Jay be allowed for tbe perlit .itb fee charge of $15.00. 'fbe eltension shall be requested in writing to the Building Official. An approved inspection .lUSt be logged during each sillODtb period, or tbe project will be considered abandoned. IImllfG 'f0 OIIHER: YOUR FAILURE 'f0 RECORD A lO'flCE OF aJlMDCEIfBIf'f MAY RESUL'f 1M YOUR PAYIMG NICE FOR DIPROVIIID!S !O YOUR PROPER'fY. IF YOU IJI!EIiD 'fO OMAIM FIW'CIHG, COMSUL'f WI'fH YOOR LEliDER OR 111 A'f'fORm' BEFORE RBCORDIMG YOUR MorICE OF COIIIJICIIIJlII. JOBS IlIDIII $2,500 II VALUE 00 IIOT mil '10 IlIIllIIID lID POST I 'IIOTI OF C i T" f~,?v~~M .1\11\ SIGJfAtURE: OR AGm SIAIE OF FLORIDA COUH'fY OF The foregoing instrument was acknowledged before me this , 19____ by SIAIE OF FLORIDA COUHTY 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