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Home My WebLink About96-5656 BUILDING PERMIT- CITY OF ZEPHYRHILLS permit]l! ,~' 5~5~J3 (813) 788-6611 Date 3' - /d.- -7' ~ ~ ELECTRICAL PLUMBING MECHANICAL :~:::,~::5-v ~6~~pel2li-~ Sewer Conn Water Conn: Water Meter: T,I.F.'s: Parcel J.D. # Zoning: Energy Code: Description of Wor-;- K ~ _~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL DATE 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# ~A~e -- Valuation or Contract Price / 3, !7 oz:; . 6"t-tJ ./ City License Registration # / 7 ;):L... State Certified License# a!t-\ ::/J'#l./.-L~ E /(7 . BUILDING E711TRICAL PLUMBING MECHANICAL - Breakers Ducts Insl. Compressor F:inal Tp. Serv, Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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 PERK1T CITY OF ZEPBYRBILLS BUILDING DEPARTKENT OWNER'S NAME Ct4/11 Iw./ ~~ ~M OWNER'S ADDRESS ~~ >Oc/~ ~; 1-. JOB ADDRESS ~~. 9- ~/,\,~ '~/Ud, PHONE LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ---"lteration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Faaily _M/F _' of Units _KID *ec-ercial _Indust. _Swia. Pool _Other _Restaurant &: Health Departaent Approval DESCRIPTION OF WORK: ?LfJ ~,/r1~- BUILDING SIZE: Ux, Square Feet, Beight 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 _MECBAlfICAL AKP Service Florida Power Corp. W.R.E.C. $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frlme _Steel Other FDU.SBED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. , Signature City License Registration , ****************************************** ELECTRICIAR COMPANY State Cert. or Regist. . SiQnAture City License Registration t ****************************************** PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration , ****************************************** MECHANICAL COMPANY State Cert. or Regist. t Signature City License Registration . ****************************************** OTRRR COMPANY State Cert. or Regist. . icense Registration # ************************* **************** APPLICATION APPROVED BY PERK1T OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this peIlit lay be subject to "deed restrictions" which JaY 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 la., both the owner and contractor JaY 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 DepartJent, (813) 788-6611. FurtberlOre, if the owner bas 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 tbe work. If the contractor wisbes you to sign as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting 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 tbat I, the applicant, have been provided witb a copy of 'Florida's Construction Lien La. - HOJeOWner's Protection Guide" prepared by the Florida DepartJent of Agriculture and Consuter Affairs. If the applicant is sOleone other than the "owner", I certify that I bave obtained a copy of the above described docUJeDt and prolise in good faith to deliver it to the "owner" prior to couenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in tbis application is accurate and that all .ork will be done in cotpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no .ork or installation bas cOllenced prior to issuance of a perlit and that all work will be perf OIled to leet standards of all Ins regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governtental agencies JaY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not litited to: t DepartJent of EnviroDJental Regulation - Cypress Baybeads, Wetland Areas and Environtentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water Manageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, Bnvironaental Health Unit - Wells, Waste.ater TreatJent, Septic Tanks t US Bnvirontental Protection Agency - Asbestos abateaent 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 "cOlpensating volute" will be sublitted whicb is prepared by a professional engineer registered in the State of Florida prior to peIlit issuance. A perlit issued shall be construed to be a license to proceed .ith the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Bvery perJit issued shall beCOle invalid unless the work authorized by sucb perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six tontbs after the tite the work is c_enced. One 90 day extension of tite, JaY be allowed for the perlit with fee charge of $15.00. Tbe 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. WARlfIMG TO OWMBR: YOUR FAILURE TO RBCORD A NOIICE OF COMMENCBHBlft' MAY RBSULT IN YOUR PAYING TWICE FOR IHPROVBIIBlft'S TO YOUR PROPBRTY. IF YOU Ilft'BIfD TO OBTAIN FIMAHCING, COMSULT WITH YOUR LElfDBR OR AM ATTORlfBY BBFORE RECORDING YOUR )fOlICB OF =':00:2,500 [RVn~ OO~ OW ro~Zk~ STATB OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLOR~ COUNTY OF ~ < -d The foregoing instrument was aCknowledged before me this .J - / ~ , 19~ by .Jk~ to me or who has produced cG -J/f? - $IY- J.O 7 - 0 as identification and who did/did not take~:;th. @J1fi/~1J ( Signature~ (Name Typed, Printed or Stamped) NOTARY PUBLIC who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC .:$':;.~:~"'~ Nancy A. Moody t*r~1~ ~ COMMISSION' CC534806 81Pt: ~~:~~ FebruaJy 21, 2000 'lJ,,1if..'r,.~ BONDED 1llRU lROV FAIN INSURANCE '