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Home My WebLink About96-6074 BUIL~t~!:Hy~!RM!! N~ -6074/"( (813) 788-6611 Date 9-J "7"b BUILDING ELECTRICAL PLUMBING ~I~'W" COM Water Conn: Property Owner: ~ /7 ~t:Lr~ Job Address06- YJ--S. - --.b 51 E Water Meter: T.I.F.'s: Parcell.D. # Zoning: Energy Code: Description of Work ~~..zt-J..f r/L.<l Radon Gas: ../~~ NO OCCUPANCY BEFORE e.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 Inspector Valuation or Contract Price -1-"j~ --t> Permit Fee Signature Company Address Telephone# 020- ~J ~- 9~.crv City License Registration # r2~ '- ( State Certified License# ~ c..-tt7;;it~~~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Canst. 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PE~~IT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER )$l.v).:J. I '2tPIJ '(f!It1Ll-5' . H-.. I J I-1Jt.... tV 01<-7 JOB LOCATION 30Y 3 J"-- E S--if 'Z.Cpl-J. pi- /J IV: /J r / <J J'./ ,..'j <- Lf r >-- 1..- ~ ,,)-0.. /}&J9IJ N€ APPLICANT ADDRESS PHONE 7J''L-7:3ry C" d" l4'V_ Q -- J'l't 10 <;"./ ~ LOT SIZE_X AREA SQ. FT . LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. ~F ~nstall WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Sign/Temp. ____Sign ____Move _Demolish PROPOSED USE: ____Single Family /commercial _M/F ____IF of Uni ts __M/H ____Indust, ____Swim. Pool Other ____Restaurant & Health Department Approval 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 FORMS.** **COPY OF CONTRACT REQUIRED. cr. Line ;;,..... PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ____ELECTRICAL AMP Service Florida Power Corp. _W.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING / GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel .Other FINISHED FLOOR ELEVATIONS: FT, ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature ETFCTRICTAN Company State Cert. or Regist. # City License Registration # ****************************************** S i sma ture Company State Cert, or Regist. # City License Registration # ****************************************** PLL'MRER Signature Company State Cert. or Regist, # City License Registration # ****************************************** MECHANICAL Signature OTHER ~~ Signature . ;-:;%? Company -LV Arl /);..; I}L P/&Jf?1J-+,/ ~ State Cert. or Regist. # 3bl.~ City License Registration IF · I ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions. which lay be lore restrictive than City regulations. The undersigned aSSUl15 responsibility for cOlpliance with any applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has 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 .isdeleanor 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 the City of Zephyrhills Building Departient, (813) 788-6611. Furthermore, if the owner has hired a contractor or contractors, he 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 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 permitting 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 - HOleowner's Protection Suide. prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the "owner., I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the .owner. prior to cOI.encelent. 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 perlit to do work and installation as indicated. I certify that no work or installation has co.aenced prior to issuance of a pertit and that all work will be performed to leet standards of all laws regulating construction, City codes, zoning regulations, and land development regulati~ns in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is .y responsibility to identify what actions I lust take to be in coapliance. Such agencies include bllt ill not limited to: I Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands, WaterlWastewater Treatlent I Southwest Florida Water Mananelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treat~ent. Septic Tanks I US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood thit a drainage plan addressing a "colpensating volute" will be sublitted which is prepared by a professional engineer fegiste,~d in the State of Florida prior to perait issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to vioi3te, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building OffiLidl fro. thereafter requiring a correction of errors in plans, construction, or violations of any code, Every permit issued ~hall becole invalid unless the lIork authorized by such permit is cnllellced within six months of issuance, (.r if work authclIlZed by the perMit is suspended or abandoned for a period of six tonths after the tile the work is LOlmenced. One 90 day e~tf~SJOII of tite, may be allowed for the permit with fee charge of $15,00. The extension shall be requested in writing to the Building Official, An approved inspection must be logged during each six lIonth period, or the project will be considered dbal~oned, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS 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 COMMENCEMENT". SIGNATURE SIGNATURE ------------------------------ ---------------------------------- OWNER OR AGENT CONTRACTOR DATE --------------------------------------- DATE___________________________________ NOTARY AS TO OWNER OR AGENT_____________________________ NOTARY AS TO CONTRACTOR_____________________________ MY COMMISSION EXPIRES MY COMMISSION EXPIRES ---------------------- .., ...J LL t I~"'" ~ ~ t,) \!) v..J -< . -I ~I- c;;:::..i..U---r- --- .4-, o l') '>- '. ...... ~:=1-Q ~ ~~-': Lu 0MN 1 I t ---..-..- ,- <0 ~ ~ :c. "4 is \'"" ~ ..J 1 -..) ~I ~ ~I ~ \...::: ~ ~I cL \.y I -:>- CL o .,;..\:~ :) ~ ~ ~ \-. . -:t. ,In U)"-/ ___\ C'\ ~~ 'C .- ,.-.~-, _\ ---I I L _ _ - -J I 0:d \) I ~ I ~ l~ V .i I .il, ~ ~ 'V w ~(! f,~ \.Q ~ r'\ ~, I~ ~ ~", \..( ~ ~ ~) ~ ~ ~ \ .~ \l)1 ~ ,} ~,-i ~ ~ I'- \ [\\ ~ ~ ~ 'V~~ ~ r{) 7/ f/ ~\ , 1..lJ : . I .Ji ".r "-. : tal v,' h I i t--l .c i ~ ::J- v., \:-- :;y- ~ 3 -J ~ l[, ~- ..... <- 'In .~ <t: ':t::. ~ ~ ~ ~- (