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Home My WebLink About96-5679 BUILDING BUILDl~~y~!RM!I~- '-567~A1 (813) 788-6611 DatE! -3 - :2.2 - 96 ----~ GECHA~) Sewer Conn ELECTRICAL PLUMBING ,"operty Owne" ~ - X : f Job Address: 3 _ _CL <- ,Ill /.LII ~ T J. Parcell.D. # Water Conn: Water Meter: T,I.IF.'s: Zon;ng' Ene'~' Description of Work,~--' ~ .Ja..l~..i ~.A .~Ga~ .- -(1 NO OCCUPANCY BEFORE C.O. FINAL ;.3......d DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. City License Registration # State Certified License# I~I 0 Inspector Permit Fee ~ tlU_ n Signature _ Co~~ ~ "- Company Address Telephone# Valuation or Contract Price I:J- IJ7J . e::/D ./ Irk-,~~~ BUILDING ELECTRICAL PLUMBING MECHANICAL - Tp.Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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 PERKIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME ~\\. - \L OWNER'S ADDRESS 3'0\0;- H~\lx..~"'I ~u.An ~ JOB ADDRESS ~c- PHONE LEGAL DESCRIPTION: LOT(S) BLOCK ..~. -.:.~. . ........ '~TI1' SUBDu~N ", (OBTAIN FR"bM. ..pROPERTY TAX NOTICE) PARCEL 1. D. t ~eration ..,. WORK PROPOSED:_New Construction _Addition _Repair.~~Install _Sign _Kove _Deaolish PROPOSED USE: _Single F8Ilily _KIF _' of Units _K/H ----ec-ercial _Indust. _Swim. Pool _Other Restaurant & Health Department Approval DESCRIPTION OF WORK: \28 c::CJc>.T:t=- S\U~-nJ~ <;:'C\..~(\.Hl R~ Jt:~A. r~ BUILDING SIZE: x 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. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction. _ELEC'fRIGAL ~CBAlfiCAL AMP Service Florida Power Corp. S , LaO ,00 Valuation of Mechanical Installation W.R.E.C. _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _FrUle _Steel Other FDlISHED FLOOR ELEVATIONS: FT" IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. t City License Registration t ****************************************** Signature ELEGTRICIAR COMPANY State Cert. or Regist. t City License Registration t ****************************************** SiDflAture PLUMBER COMPANY State Cert. or Regist. , City License Registration t ****************************************** Signature KEGllANIGAL COMPANY State Cert. or Regist. t City License Registration t ****************************************** Signature OTRRR J COIIPANY Co\< b"-C;; ~C'I"<X~ . W<- . ~ State Cert. or Regist. t DI~'.B2...CC)t:)I~r;:- Signature ~ C Ah. City License Registration # \-, \C) ** ************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City regulations. The undersigned assuaes 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 law, both the owner and contractor lay be cited for a lisdeteanor violation under state law.. If the owner or intended contractor are uncertain as to wbat licensing require.ents lay apply for the intended work,' tft~~r~dvised to contact the City of Zephyrbills Building DepartJent, (813) 788-6611. ,. .f' ~ Furtherlore, if the owner has' a ctor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sections. 0 ,reation for which they will be responsible. If you, as the owner sign as the contractor, you are indicati., father than the contractor, are responsible for the work. If the contractor wishes you to sign as co~t..r. a ..9f~..., ," ay bgari' indication that he is not properly licensed and is not entitled to perlitting privileges in the City.o.' bfifiTlls. / \\';,t" ~C" TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES ..... --........ / / D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Hoaeowner's Protection Guide" prepared by the Florida DepartJent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docuaent and prolise in good faith to deliver it to the "owner" prior to' coaenCeBIent. ( E. CONTRACWOR'S/OWNER'S AFFIDAVIT I certify that all' the inforlation in this application is accurate and that all work will be done in cOlpliance witb all applicable laws regulating construction, zoning, and land developlent. f!' Application is 'hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or in8tallat,10n has couenced prior to issuance of a perlit and that all work will be perfoaed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certi~~that I understand that the regulations of other govefDIental agencies lay apply to tbe intended wort, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: t DepartJent of EnviroOlental Regulation - Cypress Baybeads, Wetland Areas and EnviroOlentally Sensitive Lands, Water/Wastewater TreatJent · Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses · ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways · DepartJent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater TreatJent, Septic Tanks · US EnviroOlental Protection Agency - Asbestos abateaent I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a ucolpensating volute" will be subtitted which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A perlit issued shall 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 the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle invalid unless the work authorized by such perlit is cOllenced within six aonths of issuance, or if work authorized by the per.it is suspended or abandoned for a period of six aonths after the tile the work is couenced. One 90 day extension of tite, JaY be allowed for the perlit with fee charge of $15.00. The extension sball be requested in writing to the Building Official. An approved inspection lust be logged during each six aontb period, or tbe project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMHENCKHENT KAY RESULT IN YOUR PAYING twICE FOR IHPROVHMHKrS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, COBSULT WITH YOUR LINDER OR All AnOMEY BEFORE RECORDING YOUR NO'llCH OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHHENCHHKHI". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 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) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC