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Home My WebLink About96-5860 BUILDING BUILDING PERMIT 0 CITY OF ZEPHYRHILLS Permit N. (813) 788-6611 -.fiJ ~~ Sew" COM --5860H Date .s-- J3 - 7'-& PLUMBING Water Conn: Pmperty Owne' !}f *'~ . Job Address: ,.5-:--.5 - - p-:- ~ Parcel I. D. # Zoning: EnergY)1o>>e: Description of Work A / ;~ (J.dA1 if L- Water Meter: T.I.F.'s: Radon Gas: FINAL NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector DATE ~~. City License Registration # State Certified License# ~o p~'mitFee~# S'gnat2..... _ Compa Y-:- Address Telephone# Valuation or Contract Price / <1 ?~-: c/V " /~t!/~ /'/-b L4 A-/ L. , SLB Tub Set Water Sewer Final MECHANICAL BUILDING ELECTRICAL Breakers Ducts Ins!. com~ Final ... 'i-1. Ftr. Pre SLB Lintel Tp. Servo Rough In Meter Can Const. Pole Pool pre-~ Final bJg '~.:::.rl, Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. C. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT JOB ADDRESS VM" ~f"D?? L.l OOI?- 5v1-J\1u..e.sT ? S 3 7 8 i-f.- S T PHONE 5 ~) - 3. 713 OWNER · S NAKE OWNER.' S ADDRESS DR, LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.' 11-;2.lP<U-on/o- O~CJOO- D oCa U (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Faaily _H/F _' of Units _H/H _<=<-ercial _Indust. _Swill. Pool _Other _Restaurant it Health Departaent Approval DESCRIPTION OF WORK: c:.... ~-A 1-1 j E: o'^-+ A-j c- cll{.a$r-7. ~ j BUILDING SIZE: x Square Feet, Height RESIDENTIAL : COMMERCIAL : ATTACH (2) PLOT PLANS it (2) SETS OF BUILDING PLANS it (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS it (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service 5 o'::l $ 1~1 ,.- Florida. Power Corp. W.R.E.C. ~GBAMiCAL Valuation of Mechanical Installation _PLUMBIBG GAS ROOFING SPECIALTY TYPE OF GOBSTRUCTIOB: _Block _Fraae _Steel Other FIliISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. , Signature City License Registration , ****************************************** C MPANY n:.,.,~r c*~ R~c T- te Cert. or Regist. f City License Registration' (~~ ******************************** PLUMBER COMPANY State Cert. or Regist. t Signature City License Registration , ************************** COMPANY (,;)k-;- I!(c /4~ State Cert. or Regist. . oC/.-:;;l 6 G "/ S City License Registration' (.D .**********~****************************** OTRRR COMPANY State Cert. or Regist. . Signature City License Registration , ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this penit lay be subject to udeed restrictions" which Jay be lOre restrictive than City regulations. fhe undersigned assUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they .ay 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 lilY be cited for a .isdeaeanor 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 bired a contractor or contractors, be is advised to have the contractor(s) sign portions 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 tbe contractor wisbes you to sign as contractor that lay be an indication that be is not properly licensed and is not entitled to penitting 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 _ HOJeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUlef Affairs. If the applicant is sOleOne otber than the -owner", I certify that I bave obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the "owner" prior to coaenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify tbat all tbe inforJation in this application is accurate and that all work will be done in cDlpliance with all appliCable laws regulating construction, zoning, and land developaent. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a penit and that all work will be perforaed to leet 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 governJental agencies JaY apply to the intended work, and that it is .y responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not liJited to: t Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Nastewater 'l'reatJent t Southwest Florida Nater Hanageaent District - Wells, Cypress Baybeads, Netland Areas, Altering Watercourses t Any Corps of Engineers - Seawalls, Docks, Navigable Naterways t DepartJent of Health & Rehabilitative Services, EnvirODJental Health Unit - Wells, Wastewater 'l'reatJent, Septic fanks t US EnviroDlental 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 uCDlpensating volllle" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A penit issued sball 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 tbe technical codes, nor shall issuance of a penit prevent the Building Official frCl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall beCOle invalid unless the work authorized by such penit is cOlleDced within six tonths of issuance, or if work authorized by the penit is suspended or abandoned for a period of six IOnths after the tile the work is coaenced. One 90 day extension of tite, Jay be allowed for the peQlit with fee charge of $15.00. 'l'he extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARNING '1'0 OWNER: YOUR FAILURE '1'0 RECORD A NOTICE OF COHHBRCEIlElft' HAY RESUL'I' IN YOUR PAYING 'I'IIICE FOR IHPROVIMD'I'S '1'0 YOUR PROPERTY. IF YOU Ilft'EJID '1'0 OB'I'AIN FINJlRCING, CONSUL'I' WUH YOUR LEJlDER OR AN A'I"I'ORREY BEFORE RECORDING YOUR NOTICE OF COMHENCEHBHT. JOBS UNDER $2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POS'I' A "NOTICE OF COHMENCEHElft'''. SIGlfA'I'URE: OWNER OR AGElft' SIGNA'I'URE: CONTRACTOR STATE OF FLORIDA COUlf7Y OF The foregoing instrument was acknowledged before me this , 19~ by STATE 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) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC PROPOSAL ~ Cf)LI:'~ ..u~ Cf)!IIllII)ITIf)!IIllII!IIllIf7 .....1) 1i1:4TI!IIllIf7 37338 Kossik Road Zaphyrhills, FL 33541 (813) 783-3723 No. Date !?-~ ~-<jlo St. Cart. 'CAC042667 Sheet No. "- Work To Be Performed At: Proposal Submitted To: ....., Street 553 '7 ,l(~ M . CityL ~ ~I~ 7 r h ~ 1I s. 8 , Date of Plans Architect Name Street City State Phone S,^I'-'\3,",~T \)~, .~7/3 4.., , 1\ ~CA d 1- '- OfJL ..~ (L( s il 1...,\<10 ~ ^ d~"\lol v". L r3 o.J ~"(4 t. Y , \- C"....{L l.ie rl')4 ~ In.A t..t \..<.f^t'-t"h ili- ~ c). ~) L'b'./'N'-o-{'t..L~5. n~ rn 0 t.{\ All material is guaranteed to be as specified. and the ebove work to be performed in accordance with the drawings and sp~pf/ications submitted for above work ani:! cosnpleted in a substantial workmanlike manner for the sum of (J.I11..E;:.. 7ltL'~L?~Zf1 /l/v1'~ ;l7t,t~t?tf'!-R~f 00?-('4?-~J- F~ f/.~ - Dollars ($ / 9 7S'~ J. with payments to be made as follows: Any alteratIon or deviation from above specifiC8tions involving extra costs. will be executed only upon written orders. and will become an extra charge over and above the estimate All agreements contingent upon strikes. accidents or delays beyond our control. Owner to carry f.re. tornado and other necessary insurence upon above work. Work.. men's CompensatIon and Public Liability Insurance on above work to be taken out by Respectfully submitted Note- Thi proposal may be withdrawn by us if not accepted within 3'0 days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby acce Payment will be made as outlined above. 5-;22-.-(11'- -~-~- Date Signature