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Home My WebLink About96-5784 BUILDING PERMIT:- CITY OF ZEPHYRHILLS Permit II! '.;)0 (813) 788-6611 t~ c9 D'-- ~--- BUIL~- 6i~ p~-<- MFCHAN::> S,we' Conn ~ ~ Water Conn: ::""Ad~::~" -~jJ t=7& ~~),.~ ;~:~:,~e'" -;-578tl1( DatEl 1/ - - -q () - 7'~ Parcell.D. # ZonIng, . ':;t:'.. Cod" Description of wor~ 0t~'~ ~'y Radon GasC7 : ~ P9t?~~. y~ ~ NO OCCUPANCY BEFORE C.O. FINAL (, 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 ~ ~~f~()'~ 7~ Permit Fee Signature Company Address Inspector City License Registration # State Certified License# BU Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool ,Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Ins!. 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 ($15.001 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT . . .. OWNER'S NAKE Robert Chadwell PHONE 782-2522 OWNER'S ADDRESS 5324 16th St. Zephyrhills, FL 33540 JOB ADDRESS 5336 16th st., Zephyrhills, Fl 33540 11-26-21-0010-17200-0190 LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.' 11-26-21-0010-17200-0190 (OBTAIN FROM PROPERTY TAX NQTICE) WORK PROPOSED:_New Construction _Addition ~A1teration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: 2-.s Ingle F8.IIily _M/F _, of Units _M/H _~ercial _Indust. _swta. Pool ___Other _Restaurant & Health Department Approval DESCRIPTION OF WORK: TnstRll r.p.ntrRl HP.Rt ~ Air 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 -LELEC'lRICAL AtIP Service Florida Power Corp. _W.R.E.C. ~HEGHANIGAL $ 2450.00 Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BIJTI.DER COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature ELE::=C::~ COMPANY k!<:-h Me 17 C PA'.;vcULL I.?LLGT/t?-/c'".,L C'(,A./7'R4<oMt<{? : '/"'..... _ State Cert. or Regist. , Si ~.( ~ City License Registration . d 7.:1. ****************************************** PLUMBER COMPANY State Cert. or Regist. , City License Registration # ****************************************** Signature HEGBANlCAL ~. ~.. COMPANY Craddock's Air Condi tioninq ~ State Cert. or Regist. . Sigoaturet~ . c::::;:., ~ City License Registration' 71 ****************************************** OTRF.R COMPANY State Cert. or Regist. , Signature City License Registration , ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. .',' .' CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this pemit lay be subject to -deed restrictions- "bich lay be lOre restrictive than City regulations. fhe undersigned assDles responsibility for COIpliance "ith 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 "ith state and local regulations. If the contractor is not licensed as required by la", both the owner and contractor lay be cited for a lisdeleanor violation under state la". If the owner or intended contractor are uncertain as to wbat licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections" of this application for "hich they "ill 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 wishes you to sign as contractor that laY be an indication that he is not properly licensed and is not entitled to pemitting privileges in the City of Zephyrbills. 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 "ith a copy of IFlorida's Construction Lien La" - HOIeOWDer's Protection Guide" prepared by the Florida Departlent of Agriculture and Conslmer Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the "owner" prior to couencelent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforJation in this application is accurate and that all work will be done in cOJpliance with all applicable la"s regulating construction, loning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a perlit and that all "ork "ill be perfolled to leet standards of all la"s regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governJeDtal agenCies laY apply to the intended work, and that it is IY responsibility to identify "bat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * Departlent of EnviroDJenta1 Regulation - Cypress Bayheads, Wetland Areas and EnviroDleDta11y Sensitive Lands, Water/Wastewater freatlent * Southwest Florida Water Managelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * Amy Corps of Engineers - Sea"alls, Docks, Navigable Waterways * Departlent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater freatlent, Septic fanks * US EnvirODJeDtal Protection Agency - Asbestos abatelent I also certify that, if fill lateria1 is to be used in Flood Zone "AD or lA, etc. ", it is understood that a drainage plan addressing a .cQlpensating vollme" "ill be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued sball be construed to be a license to proceed with the "ork and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor sball issuance of a pemit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall beCOle invalid unless tbe work authorized by such perlit is COll8Dced within six IOnths of issuance, or if work authorized by the pemit is suspended or abandoned for a period of six IOnths after the tile the work is c~ced. One 90 day extension of tile, laY be allowed for tbe pemit with fee cbarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An approvecl inspection lUst be logged during each six IOnth period, or the project will be considered abandoned. WARNING TO OIINER: YOUR FAILURE TO RECORD A NOTICE OF COMMBNCEMBNT MAY RESULT IN YOUR PAYING "'ICE FOR IMPROVEMENTS TO YOUR PROPERTY,. IF YOU INTEND fO OBTAIN FIMAM'CIMG, COMSULT WITH YOUR LENDER OR AM' AftORNEY BEFORE RECORDIMG YOUR MOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMBNCEMENT". SIGHAfURE: OWIIRR OR AGENT SIGHATURE: COlllRACfOR STATE OF FLORIDA COUlfJ'Y OF The foregoing instrument was acknowledged before me this , 19____ by STAlE OF FLORIDA coum 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