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Home My WebLink About96-5644 BUILDING PERMIT-" CITY OF ZEPHYRHILLS Permit :IV! (813) 788-6611 "j ~ 5644 13 Date ~-S- ~:9 -t. ~~~ ELECTRICAL PLUMBING ::::"::~jg1r A;?if~ MECHANICAL Sewer Conn Water Conn: Water Meter: T,I.F.'s: Parcell.D. # Zoning: Energy Code:A Description of Worr;( tf2 ..Mri' Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL q\c. DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Valuation or Contract Price ~3;;UY. Ui) City License Registration # / i 73 State Certified License# Inspector Permit Fee .;AS- ~ o-D Signature ;:--t'~ t.J c; Company Address Telephone# "'" r)/~ ~ BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr, Pre SLB Lintel FRM. Insul. CL WL Tp, Servo Rough In Meter Can Canst. 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. APPLICAnON FOR PERKIT CITY OF ZEPBYRBILLS BUILDING DEPARTMENT OWNER'S NAKE A) /rP A j ()12 /J m.J !1() r khf} R D-t PBONE 7 ~ 5S' - 705 / OWNER'S ADDRESS 3~ndl b- A\fP_ 7-\r)\\\~) '1="1 ;:)~:=~l.lO JOB ADDRESS '?-om e _ LEGAL DESCRIPI'ION: LOT(S) 9/ BI..OCIL--SUBDIVISION PARCEL I.D.' /4- :;U.P-~ J ~CJ:::>/() - 0/900 -CC> 9/ (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction ---.Addition --Alteration ~epair _Install _Sign _Hove _Deaolish PROPOSED USE: v5"'ingle Faaily --.J4/F _, of Units _K/B _ec-ercial _Indust. _Swia. Pool _Other DESCRIPTION OF WORK: _Restaurant &: Bealth Departaent Approval Rf?'- rCXJP BUlLDIRG SIZE: 3:;) X 4a. I ~~O Square Feet, Beight RESIDEIITIAL: COMMERCIAL : ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLARS &: (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLARS &: (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERK1TS REOUESTED ~UlLDIRG $ Valuation of Total Construction _ELEC'flU.CAL AIIP Service Florida Power Corp. N.R.E.C. -'lECllAlilCAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUcnON: _Block _Fraae _Steel Other PDI5BED FLOOR ELEVAnONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... BIITT.DER CONTRACTOR SECTION COMPANY L-Lbn)'J COS~, , State Cert. or Regist. , City License Registration , 10/7- :.( ................................... Signature IU.RCTRICIAR COMPANY State Cert. or Regist. , City License Registration , .......................................... SignAture PLlllBER COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature MECBABICAL COMPANY State Cert. or Regist. , City License Registration . .......................................... Signature OTHRR COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS !be undersigned understands that this perlit lay be subject to .deed restrictions" wbich laY be lOre restrictive than City regulations. !be undersigned assUleS responsibility for COIpliance 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 owner and contractor laY be cited for a lisd_anor violation under state lall. 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 Zepbyrhills Building Departlent, (813) 788-6611. Furthel'lOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portiona 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 wiabes fOIl to sign as contractor that laY be an indication that be is not properly licensed and is not entitled to peraitting 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 with a copy of .Florida's Construction Lien Law - JIoIeoImer's Protection Guidell prepared by the Florida DepartJent of Agriculture and ConsUller Affairs. If the applicant is SOIIl!OIle other than the .owner., I certify that I bave obtained a copy of the above described docuIent and proUse in good faith to deliver it to the lIowner. prior to cOllBDceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in COIpliance lith all applicable laws regulating construction, zoning, and land developlll!Jlt. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas c-.mced prior to issuance of a perlit and that all work will be perfoIJed to Jeet standards of all laws regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other goverDlleDtal agencies laY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in co.pliance. Such agencies include but are not lutted to: t Departlent of Envirolllelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllelltally Sensitive Lands, Water/Wastewater 'freatJent t Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArIJ Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Smites, bvir_ental Health Unit - Wells, Wastewater 'Ireat:lent, Septic !ants t US bvirODleDtal Protection Agency - Asbestos abateleDt I also certify that, if fill laterial is to be used in Flood Zone "Aa or "A, etc. II , it is understood that a drainage plan addressing a .cOlpellsating VOlUleIl will be subaitted wbich is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A petlit issued shall be construed to be a license to proceed with the IIork 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 pmit issued shall becoIe invalid unless the work authorized by such perlit is COIEIlced within sil IOnths of issuance, or if work authorized by the perlit is ' suspended or abandoned for a period of sillODtbs after the tDe the work is coaenced. One 90 day atension of tile, lay be allowed for the pmit with fee charge of $15.00. Tbe atension 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 abanc1oned. NARlHNG TO omR: YOUR FAILURI TO RECORD A NOTICE OF COHMDCBIIBH! MAY RESULT IN YOUR PAYING filCE FOR IMPROVIIID!S TO YOOB PROPmY. IF YOU IIIDMD fO OBt'AIN FIWCING, CONSULf WI'lB YOOR LBMDBR OR AM AnomY BEFORE RBCORDIIG YOUR DICE OF COHHBMCEHBMI. JOBS UNDER'2, 500 IN VALUE DO NOT NEED fO RECORD AND POS! A 'NOTICE OF COIIIDCBIIBH!'. XI~1mf~~4 SIGJlA!URI: COIl!RACTOR SfA!E OF FLORIDA ~ ^ A""" COumOF r~ The foregoing instrument was acknowledged before me this .~~ , 19~ by O/IJ~ ~RkhAJ€r::t who 1S p son ly known to me or who has produced as identification and who did/did not ta9i1~) /;) ffl!l!uL(~ (S1gnature) S'fA!E OF FLORIDA coum OF The foregoing instrument was atknowledged 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. (Name Typed, Printed or Stamped) NOTARY PUBLIC NS SHARON D. IllCUUI Notary Publtc - State of Florida Mycomm. ~xplres Jun 1, ,t..,.'. :1 CommiSSIon No. CC 29U" ed) Wood Const. Pasco Comty License 39134 Kendall Drive Zephyrhills. FI 33S40 N8lUe A-IletJ elf fY) II Bl Jr i< b:1Ld+ Job Title ~ -' r-() rl -P Parcel # Addre.. ~ );;2- Ave z:' FI 335<..K) Location Date 3..- /J- q lo Phone # Job D~scription: R~- rc09 ?B X LtG {J..)~-th 10h'\te ~\W~~~~~~e: (b~p ~~1ci(~ ~~C;; Payments to be made as follows; 'Pa~me~-t l)~ ('()('n0p.f-l0i) Total Cost , I ~ Q(').,CJO . Authorized S~~~~W ffi-~ --------------------------, --------------------~---------------------------..--------- Proposal A.cepllln.J~ 5~1 @'Date; ~ 12 I'i' r. o orl All proposals not accepted within 30 days may be RUbject to chBnge. ')fr n::..r". :'>;;.