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Home My WebLink About96-5965 BUILDING PERMIT 0 CITY OF ZEPHYRHILLS Permit N · (813) 788-6611 ~- 5965!1 DatEl 7-:2-7L ~_Jf~O BUILDING .;LD. cTD ELECTRICAL PLUMBING c30.v-J MECHANICAL Sewer Conn Water Conn: P,"p'rtyOwne, ~jJ ~ . Job Address:~-7 / -.2. ~ Water Meter: T.I.F.'s: Parcell.D. # Zoning: Description of Work Energy cOZL A:./ C {! 4--" (t t? Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C.O. 7- I "'!- <i DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE City License Registration # State Certified License# ~ Inspector Permit Fee a-O. c::.r=v ? Signatur~ C=.::> -~- Company Address Sc Valuation or Contract Price "'- .:2. if 7'0 ~ crv " ~~~J1::L Telephone' ELECTRICAL PLUMBING ~ BUILDING MECHANICAL 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 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 PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER' S NAKE PHONE OWNER' S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.D.' (OBTAIN FROM PROPERTY TAX. NOTICE) WORK PROPOSED:_New Construction _Addition ----..A1teration ~epair _Install _Sign --.JIove _Deaolish PROPOSED USE: _Single Faaily --.JI/F _' of Units _M/H _~ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet. Height RESIDENTIAL: COMMERCIAL ATTACH (2) PLOT PLARS & (2) SETS OF BUILDING PLARS & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLARS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKITS REOUESTED _BUILDING $ Valuation of Total Construction _ELEG'fRICAL .AMP Service Florida Power Corp. W.R.E.C. ~GllANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fralle _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... CONTRACTOR SECTION BUTT .DER COMPANY State Cert. or Regist. . Signature City License Registration . .......................................... RI.RG'fRICIAN COMPANY State Cert. or Regist. , SianAture City License Registration . .......................................... PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration , .......................................... MECHANICAL COMPANY State Cert. or Regist. t Signature City License Registration . ...........~.............................. OTRRR COMPANY State Cert. or Regist. f Signature City License Registration I .......................................... APPLICATION APPROVED BY PERKIT OFFICER. . ' CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this pertit lay be subject to "deed restrictions" wbicb lay be lOre restrictive than City regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired a contractor or contractors to undertake work, tbey 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 mmer and contractor lay be cited for a lisdeJeanor violation under state law. 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 Zephyrhills Building Departlent, (813) 788-6611. 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 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 the 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 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 - HOIIeOIfIler's Protection Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs. If the applicant is sOlleone other than the IImmer", I certify that I bave obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to cOllencl!lent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforaation in tbis application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land develop.aent. 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 work will be perforted 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 goverDJental agencies laY apply to the intended work, and that it is If responsibility to identify wbat actions I lUst take to be in cOlpliance. Such agencies include but are not lilited to: t Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Soutbwest Florida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rebabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater TreatJent, Septic ranks t US EnvironJental Protection Agency - Asbestos abateJeDt 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 IIcOlpellsating volUle" will be subJitted wbich 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 pertit prevent the Building Official frOll thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beCOle invalid unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day l!Itension of tile, laY be allowed for the pertit with fee cbarge of $15.00. !be l!Itension 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. WARNIHG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RlSULT IN YOUR PAYING rwlCE FOR IMPROVEMBIft'S TO YOUR PROPERTY. IF YOU INTBIID TO OBTAIN FINANCIRG, CONSULT WITH YOUR LEIIDER OR AI AT'fOIU1BY BBFORI RlCORDING YOUR )IO'lICB OF COMMENCEMENT. JOBS UJlDER $2,500 IN VALUE DO NOT NEED TO RlCORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNBR OR AGENT SIGNATURI: CONTRACTOR STATE OF FLORIDA COlllfY 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) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC