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Home My WebLink About96-5866 BUILDING PERMIT 0 -;-5866A CITY OF ZEPHYRHILLS Permit N · (813) 788.6611 '- L/ Date ~ -,;;J. / - 7' -b CSUI-~~ ELECTRICAL PLUMBING P,opertyOwne" 13 -;!i ~'J-w:T Job Address: \. S- tJ 3.S - / _ _ Parcel 1.0. # MECHANICAL Sewer Conn Water Conn: Water Meter; T.I.F.'s: Zoning: Description of Work .!2 ERergy Code: V~ cr- Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C.O. t. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Inspector ~a~ City License Registration # State Certified License# Permit Fee ,..;} ". v-v Signature Company Address Telephone# Valuation or Contract Price d &CJ I o-v tl"'tA /h t"/l___ BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Serv. Rough In Meter Can Const. 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. -. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S ADDRESS ~th \>Oc..,~ty\(L)V\\t 50~~ L.:Jr-\, St- Sf)~S \ I rh Sr PHONE -J~ ~-- dD 1 U OWNER'S NAKE JOB ADDRESS ~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FRO" PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition --..Alteration _Repair _Install _SigO. -"ove _Deaolish PROPOSED USE: _Single Faaily _"IF _' of Units _M/H _<=<-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet, Height RESIDENTIAL: ATTACH (2) PLOT PLANS it (2) SETS OF BUILDING PLANS it (1) SET ENERGY FORMS. COMMERCIAL: 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 _MECllAll::iCAL AMP Service Florida. Power Corp. _W.R.E.C. $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF GORSTRUGTIOR: _Block _FrSlle _Steel Other FIIUSBED FLOOR ELEVATIORS: F1' . IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION RUn.DER Signature~ COMPANY State Cert. or Regist. , City License Registration , ****************************************** F.T .RCTRICIAR COMPANY State Cert. or Regist. , City License Registration . ****************************************** SilmAture PLUMBER COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. . City License Registration , ***********~****************************** Signature OTRRR Signature COMPANY '---b r" " ~- n --,State Cert. or Regist. , .L~ l ) uuo--.tJ'\ U:,)-L-:JCity License Registration t ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. -~ CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to udeed restrictionsu which lay be lOre restrictive than City regulations. fhe undersigned assDles 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 lilY be cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. FurthellOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the .Contractor Sections" of this application for which 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 he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills. 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 - HOIeOImer's Protection Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs. If the applicant is SOROne other tban the "owner", I certify that I bave obtained a copy of the above described docUleDt and prolise in good faith to deliver it to the "owner" prior to co_ncetent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance 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 work or installation bas cOlleDced prior to issuance of a perlit and that all work will be perfolled to teet standards of all laws regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveIDIeDtal agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: t DepartJent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, HnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US HnvirODlental Protection Agency - Asbestos abatetent 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 DCQlpensating volDleD will be sublitted wbicb 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 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 peIlit issued shall beCOle invalid unless the work authorized by such perlit is cOllHlnced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day extension of tile, lay be allowed for tbe pelJit with fee charge of $15.00. rbe 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. WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING !WICE FOR IHPROVHIIDt'S TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FIMABCING, CONSULT WITH YOUR LINDER OR AM AnORm' BEFORE RECORDING YOUR NorICE OF COMMHNCHHHNT. JOBS UNDER $2,500 IN VALUE DO Nor NEED TO RECORD AND POST A "NOTICE OF COMMHNCHHHlft'H. c) . r). -F)~ '-'\JJ:-h '~ (\ -~l (.1...:' SIGRArURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUlft'Y OF The foregoing instrument was acknowledged before me this , 19~ by srArE 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