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Home My WebLink About96-5908 BUILDl~9HY~L~RM!!N~ ~-590~15' (813) 788.6611 Date t - -..s-- ~ Yb ~~II nl~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn I Water Conn: ::~::'::~3[4;/~J ~J~ ~~:~:s~.t., Parcell.D. # /1-;). b - J-/ - tJ 0/0_ ;;'0 ~ 00 -... 0 IS 0 Zoning: Energy Code: Rado:;zn Ga . .-'! ~ _ A J ~/ +-dDi/ DescriptionofWork'.7~.p...ttO _r . J J~ ~ -- 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 c2...o cr-iJ Signature Company Address Telephone# Valuation or Contract Price (3 0lJ. OD City License Registration # State Certified License# ~ BUILDING ELECTRICAL PLUMBING MECHANICAL Tp. Servo 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAKE (~ ~ , PHONE OWNER' S ADDRESS 1./1..7 3cPS41 ~, LEGAL DESCRIPTION: LOT(S) 13- /Lr PARCEL 1.0.' // 2.. b :2 /00 /0 JOB ADDRESS BLOCK 2. Q '7 SUBDIVISION .2. o? 0 t? 0 1.30 (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign ____Move ____D eao I ish PROPOSED USE: ____S ingle Family ----1i1 F ____, of Units ----1i/H _C~ercial _lndust. _Swim. Pool ___Other ____Restaurant & Health Depart.ent Approval DESCRIPTION OF WORK: ~ BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUl.LDING PLANS & (1) SET ENERGY FORKS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction, _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. -"EGHARlCAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____FrDe _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE ~? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. , Signature City License Registration . ************.***.*.***...**........***.... ELECTRICIAN COMPANY State Cert. or Regist. , Sianature City License Registration . ..******.*******.*****......*............. PLUMBER COMPANY State Cert. or Resist. . Signature City License Registration , ................*......................... MECHANICAL COMPANY State Cert. or Regist. f Signature City License Registration . .*.**.*..*.*.*..****.**.*****.*.**..*..*.. OTHF.R COMPANY State Cert. or Regist. t Signature City License Registration , **..*.*....*.............................. APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this peflit lay be subject to "deed restrictions" which lay be lOre restrictive tban City regulations. The undersigned assWles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If tbe contractor is not licensed as required by law, both the owner and contractor laY be cited for a lisdeleanor 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 tbe City of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the owner has bired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of tbe "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 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 perlitting privileges in the City of Zepbyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (ClrnPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docWlent and prolise in good faith to deliver it to the "owner" prior to cOllenCelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in tbis 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 has cOllenced prior to issuance of a perlit and that all work will be perfofled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand tbat the regulations of otber goverDIental agencies lay apply to tbe intended work, and tbat it is IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: * Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent * Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Healtb & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks * US EnviroDlental Protection Agency - Asbestos abatelent 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 volUle" will 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 witb tbe work and not as autbority 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 autborized 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 IOnths after the tile tbe work is cOllenced. One 90 day extension of tile, laY 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 IOnth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCHHBNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVHllHN1'S TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHHBNCEMBlfT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA COUNTY 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 r !; "f, -, ~ '\ ~ % ~ . I~ \--. V) IJ . 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