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Home My WebLink About96-6020 BUILDING PERMIT , N. 0 CITY OF ZEPHYRHILLS Permit '. (813) 788-6611 6020 i3 Date t-;'-3/-7.b C~~~-) BUILDIN6 . ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Pcoperty Owne, _ .~~ i/I+ Job Address: 3tl~ ~ Parcell.D, # Zoning: , ,* Energy Code: Description of Work \. _~ (l ~ Water Meter: T,I.F.'s: Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C.O, DATE Complete Plans. Specifications and Fee Must Accompany Application, All work shall be performed in accordance with City Codes and Ordinances, DATE Signatur Company Address Telephone# ~NC~ ('0, Valuation or Contract Price pro, ('?) City License Registration # 393 State Certified License# C' ~~V~\-k~-,,~ 8UILDING ELECTRICAL PLUMBING MECHANICAL 8reakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter 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 PERKI.T CITY OF ZEPHYRBlLLS BUILDING DEPARTMENT OWNER · S NAME -/ ~/?'/ ,.4tt.I..t"''!'' PHONE .8'1.5 - 7/5:' _()67uv , OWNER' S ADDRESS 3c.CJ 7/2.- cwo; v (A ~ JOB ADDRESS s~ LEGAL DESCRIPTION: LOT(S) L BLOCK SUBDIVISION OAK CJF?~>T r"S:7A'7t"'S PARCEL I.D.' (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:~New Construction _Addition ~teration _Repair -A-Install _Sign. --1Iove _Deaolish PROPOSED USE: X"Single Faaily _KIF _' of Units --1IIH _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: , /)).5/Atl ~ c.vO()Z) ~/Vc-...e 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 $ 9 "60,00 Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. _MECHANICAL $ Valuation of Kechanical Installation _PL~ING GAS ROOFING SPECIALTY TYPE OF CONSTRUC'l'ION: _Block _Fraae _Steel Other FDlISHED FLOOR ELEVATIONS: Fr. IS PROJECT IN FLOOD ZONE AREA? YES NO .................................*******.* RUTT.DER CONTRACTOR SECTION v ;/( COMPANY --.7/..-u /0t.t. /,.9"?S hC',.- C&.. State Cert. or Regist. . CSP, 9;:<- /o:?6.S ~ ~. City License Registration' :~q~ *..*************************************** F.V~CTRIClAR SignAture COMPANY State Cert. or Regist. t City License Registration t **************************.*************** PLUMBER Signature COMPANY State Cert. or Regist. . City License Registration t ****************************************** - MECHANICAL COMPANY State Cert. or Regist. # City License Registration . ****************************************** Signature OTRF.R COMPANY State Cert. or Regist. t City License Registration # *****.*****.*******.********************** Signature APPLICATION APPROVED BY PERKI.T OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this pertit lay be subject to "deed restrictions" wbich lay be lOre restrictive than City regulations. Tbe 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, 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 lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licenSing requireJents JaY apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813) 788-6611. FurtherJOre, if the owner has bired a contractor or contractors, he is advised to bave 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 wisbes you to sign as contractor that lay be an indication that be is not properly licensed and is not entitled to pertitting privileges in the City of Zephyrbills. 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 tbe Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOIeOne other than the "owner", I certify tbat I bave obtained a copy of the above described docUJent and prOllise in good faith to deliver it to the "owner" prior to cOllenceJent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIJation in this application is accurate and tbat all work will be done in cOlpliance 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 bas cOllenced prior to issuance of a pertit and that all work will be perfolled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other goveI1llental agencies JaY apply to the intended wort, and that it is IY responsibility to identify wbat actions I lUSt take to be in cOlpliance. Such agencies include but are not lilited to: * DepartJent of EnviroDJeDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & R~abilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US EnvirODJeDtal 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 uCQlpensating volUJe" will be subJitted which is prepared by a professional engineer registered in the State of Florida p'rior to perlit, issuance. A perlit issued sball be construed to be a license to proceed with tbe 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 frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becOJe invalid unless the work authorized by sucb perlit is cOllBnced 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 cOllellced. One 90 day extension of tile, JaY be allowed for the pertit with fee charge of $15.00. Tbe 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 C<llMEllCEMEliT HAY RESULT IN YOUR PAYING TIIICE FOR IMPROVEIIBIft'S TO YOUR PROPERTY. IF YOU IliTEND TO OBTAIN FINAlfCING, CONSULT WITH YOUR LBNDD OR AIf A RBBY BBFORE RECORDING YOUR NOTICE OF ClIlIIJlICIIIm. JllIl8 _12,500 IN VlWI 00 NOr lIEIIJ to IIIICllIlIl AND POSI A' ;: ~ SIGNATURE: OWIfBR OR AGBliT NATURE: COliTRACTOR STATE OF FLORIDA COUNTY 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) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC JIM WilLIAMS FENCE CO. 934 East Rose St. lakeland, Florida 33801 Phone 688-1194 <r- I I I I I E' Ii (j) , I /z i Nrtt./ ________ to x / .c.. 7'""c;.- ~ .A'7l/,r' JOB . SHEET NO, CALCULATED BY CHECKED BY SCALE OF DATE DATE s-r "-ee; fp..cr1 ~ (.ooo,;) RA/c..,.. i ~ @ L 7D _p~'OP.p~7Y A-- U~ , 4- _ ~CX?{:) 5"/..0-<:' --t> De> T -.....