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Home My WebLink About96-6039 BUILDING PERMIT Nt? 60391:: CITY OF ZEPHYRHILLS (813) 788-6611 Permit Date Y-/<;'-7b BUILDING GCTRI~ P<operty Owne" IJr ~ .' Job Address: hi; _ ~_4.-1?.t Parcel I. D. # PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: ~rgy Code: Description of wC;;;- t,!/ aAs ( fJ 4 AA~ ~ Radon Gas: L.(/\~~~ ~UrO_~h}/~- Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. FINAL C.O. DATE NO OCCUPANCY BEFORE C.O. DATE Inspector Permit Fee ;l. O. (J'l) Sig natu re --'1:JL.. V JJ.e.v.o Company UlP' Address Telephone# Valuation or Contract Price City License Registration # J gr? l' State Certified License# jJA~r~ /;6J"k-;~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers 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 PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S ADDRESS M-Vt, () Co {PS-t2- (bALL8}0v~ Sffl)\C PHONE i~t5 ~~~- IS-t>. L OWNER'S RAKE JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.' (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 _Swia. Pool ~Other _ec-ercial _Indust. _Restaurant & Health Departaent Approval DESCRIPTIO. OF IiORK: 'l{epl'i <-L t. i<: sl , '" J CAr I>J 'U k. F Cl J .. P (,J! NeW BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKITS REOUESTED _BUILDING $ 1000 ~ Valuation of Total Construction ~ELECl'RICAL 2.001 U5f- .AMP Serv'ice Florida Power Corp. W.R.E.C. _MECHAIUCAL $ Valuation of Kechanical Installation _PLUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO .......................................... CONTRACTOR SECTION RUTT.DER. COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature ~.~GTRIGIAN COMPANY El4.sT- lJ,Je;)T fl-e,--+~'\ c.. J :LNL- 8tJ Y\ ~ State Cert. or Regist.' C'c:. 000 N<j,j SilmAture ',;-y. j )"l~ City License Registration , /rk ~ .......................................... . PLUMBER COMPANY State Cert. or Regist. , City License Registration t .......................................... Signature .. MECHANICAL COMPANY State Cert. or Regist. . City License Registration , .......................................... Signature OTRRR COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this perlit aay be subject to "deed restrictions" wbich lay be lOre restrictive than City regulations. the undersigned assUles responsibility for COIpliance 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 lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing reguirl!lents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813) 788-6611. FurtbeIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections" of this application for wbicb 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 aay be an indication that he is not properly licensed and is not entitled to peIlitting 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 - HOIeOf.Der's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConslJler Affairs. If the applicant is SOftOJ1e other than the "owner II , I certify that I have obtained a copy of the above described docUlellt and prOllise in good faith to deliver it to the lownerl prior to COIleDCeleDt. E. CONTRACTOR'S/OWNER'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 develoPftllt. Application is hereby lade to obtain a peIlit to do work and installation as indicated. I certify that no work or installation has c~ced prior to issuance of a perlit and that all work will be perfoIJed 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 that the regulations of other govetnleDtal agencies laY apply to the intended work, and that it is If responsib,ility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not li8ited to: t Departlent of EnviroDl8Dtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands, WaterjVastewater TreatJent t Southwest Florida Water Managl!lent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t AIIY Corps of Engineers - Seawalls, Docks, Navigable Watellfays t DepartJent of Health & qebabilitative Services; EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US EnvirODlental Protection Agency - Asbestos abatl!lent I also certify that, if fill laterial is to be used in Flood Zone "A" or IA,etc.", it is understood that a drainage plan addressing a .cOlpeDsating volUlen will be sublitted 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 the technical codes, nor sball issuance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid unless tbe work authorized by such peIlit is COlleDced within six IOnths of issuance, or if work authorized by the petlit is suspended or abandoned for a period of six IOnths after the tile the work is co.enced. One 90 day extension of tile, lily be allowed for the peIl~.twith 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. WARMING TO OWNER: YOUR FAILURE TO RECORD A NorICE OF ClJDIENCBIIENT MAY RESULT IN YOUR PAYING 'NICE FOR DIPROVEMII1'S 'to YOUR PROPERTY. IF YOU INTElfD TO OBTAIN FIIWICIlfG, CONSUL! WITH YOUR LODER OR IN Al"lORIJEY BEFORE RBCORDIIG YOUR NOTICE OF COMMENCEMEHT. JOBS UNDER $2,500 II VALUE DO NOT NEED '1'0 RECORD AND POSf A "NorICE OF COMMEICEMEH'lN. SIGHAIURI: OWIIER OR AGENT ~l> ;1~ SI : ONTRAC'tOR S'l'A'fE OF FLORIDA coum OF The foregOing instrument was acknowledged before me this , 19 by -- Sf ATE 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