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Home My WebLink About96-5925 BUILDING PERMIT 0 -- 5.. CITY OF ZEPHYRHILLS Pennit N · 592/1 !:E (813)788-6611 _ .--- Date h-L1-9b nV _.!.LQ--_' · C7\- -' ---." ,~) ~----- ~CHANI~ ~~~(f~d~:~ - ~.. Property Owner: Job Address: Parcel 1.0, # Sewer Conn Water Conn: Water Meter: T,I.F:s: Zoning: Description of Work Energy Code: ~ _5 / Radon Gas: /q? </ In )('uJQi~ / ~ NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Valuation or Contract Price '1/-- J/, /00' / f?/~ , ~ Permit Fee. Signature Company Address Telephone# Dc;) FINAL C.O. 9- 30- DATE DATE Inspector City License Registration # State Certified License# Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp.SeN. Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Driveway Breakers Ducts Ins!. Compressor Final 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 ZEPHYRBlLLS BUILDING DEPARTMENT OWNER' S NAME ...~8~,or ~ 1?;~Q PHONE ?B02-t/;l7,?1.. OWNER'S ADDRESS JOB ADDRESS '6 D6 6/4l1 i? (ueV ' LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL LD.' 02- ;;.. G. til-I- 00 t' 0 - O~& OO.t!)a;zo (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign _Kove _Deaolish PROPOSED USE: _Single Faaily _KIF _' of Units _K/H _ec:-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: S 76,J ;p/ c- BUILDING SIZE: x Square Feet. Height RESIDENTIAL : COMMERCIAL ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING 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. _MEGIIAIflCAL $ 1(~ Valuation of Kechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FDiISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA T YES NO .......................................... CONTRACTOR SECTION COMPANY State Cert. or Regist. t City License Registration . .......................................... RUn.DER Signature ~~~,/ - . COMPANYA~ct:4/i?O CKff..u:l4L( ELecTk,..c.:;..L CCM)T, . / 0 /' State Cert. or Regist. t onAtur / .t'-r"~K (.A!-d>~..&-d City License Registration t () 7"z ......................................**.. COMPANY State Cert. or Regist. , City License Registration f .....................*..........*...*.***. PLUMBER Signature Signature C a.vih-../ State Cer . or Re ist. t <:90 S- City License Registration , ...............................*.....**.* COMPANY MECHANICAL COMPANY State Cert. or Regist. t City License Registration t ~~~......................... OTRF.R Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this penit lay be subject to Hdeed restrictions" which lay be lOre restrictive than City regulations. fhe undersigned assOles responsibility for COIpliance 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 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 what licensing requireaents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813) 788-661I. FurtherlOre, if the owner has hired a contractor or contractors, be 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 tban 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 penitting 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, have been provided with a copy of "Florida's Construction Lien Law _ HOIl!OImer' s Protection Guide" prepared by the Florida Departtent of Agriculture .and Conslller Affairs. If the applicant is soaeone other tban 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 "ownerH prior to couenceJent. 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 penit to do work and installation as indicated. I certify that no work or installation has cOlleDced prior to issuance of a penit and that all work will be perfolled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developtent regulations in the jurisdiction. I also certify that I understand that the regulations of other governaental agencies laY apply to the intended work, and that it is IY responsihility to identify what actions I lUst take to be in cOlpliance. Such agencies include but are not liJited to: * Departtent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands, Water/Wastewater !reatJent * Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * Any Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater !reatJent, Septic ranks * US Environaental Protection Agency - Asbestos abateJent 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 "coapensating volOle" will be suhlitted which is prepared by a professional engineer registered in the State of Florida prior to perlit 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 tbe technical codes, nor shall issuance of a penit prevent the Building Official froa 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 perlit is cOlleDced within six IOnths of issuance, or if work authorized by the penit is suspended or abandoned for a period of six IOnths after the tile the IfOrk is cOllenced. One 90 day extension of tile, laY be allowed for the penit with fee charge of $15.00. !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. WARlHNG TO MER: YOUR FAILURE TO RECORD A NOflCE OF COMHBNCEMEH! MAY RESULT IN YOUR PAYING DICE FOR IMPROVEHEn'S TO YOUR PROPERfY. IF YOU IHTEND TO OBTAIN FlHAHCIffG, CONSUL! WUB YOUR LENDER OR Alf AnORDY BlFORE RECORDING YOUR NorlCE OF COMMENCEMENT. JOBS UNDER $2,500 Iff VALUE 00 NOf NEED TO RECORD AND POST A "HOfICE OF COMHENCEMEHT". STATE OF FLORIDA COUH'J'Y OF The foregOing instrument was acknowledged before me this , 19____ by '~~/? ' SIGNA~, COHTRACTO,- L/- STATE OF FLORIDA ~ COUHfY OF l:::T' ~ The foregoing instrument was acknowledged before me this /87ZfJVNEi 19~ by -~ \ SIGNAfURE: OWlfER OR AGEH! who is personally known to me or who has produced as identification and who did/did not take an oath. /) "-0 who is p produced as identification and who did/did not take~. '*' ~,94Q4Z (Si~~~;Jr- ~'~ S,WFTL/1Ab (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC ....~'\~~!iJ;:", 1IaJ.J.J_ i,/'~';'~'" MY -- S. Swetland ?J:'.1!!!:b..~~ COMMISSION # CC534m EXPIRE' -.?, ;;.. .<t.~" February 22 2000 ' '..r"r.;. BONDED THRu ",,", 0 . 'nUT rAIN INSllRANCE, INC - l.,., ~--"-_..."".~.....,...,,.....~:::--..,~~.....~...,....-_..._' ,. ~...-.~.__.,~~----- CASH ::m*-+ ~~~ .' -' \.. / ...-.rs '- . " 'liJ t'. d , " \. /t '-../ . /' ,Central -conditioning . P.O. Box 2209 33539-2209 -2300 .. ADORtSS CITY - IIOIIEl IERIM. 110_ NATURE Of SERVICE ~ REQUEST QUAN_ PART NO_ DESCRIPTION OciJ.- - C)oi.O SERVICE PERFORMED IOTM. MATEIIW. 1lQIICM. IEIMC( TM .. ?~ 1p./ Ilo\Tt COIII'U1Bl TECHNICIAN, I """'-- ./ . DATE Of ORDER DATE ~D APARTMENT o ESTIMATE o CASH o CHARGE PRICE AMOUNT TAX mAL ----;1 tih7