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Home My WebLink About96-6122 .. J;ri!UILDa!t~~9Hy~!RM!! N~ 6122,8 (],~~ ~ (8~~'2!.8-6611 Da'e 9 -1<S-9~ d' tLo ~ BUILDING ELECTRICAL PLUMBING Sewer Conn Job Address: Parcell.D. # ter Meter:J21( 8-YO. hJ"7-3D~ T,I.F.'s: Zoning: 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 Inspector City License Registration # c2 f~ ~~:~(3(;e;; ;;76 Permit Fee Signature Company Address Telephone' ~ //.0/ ~ lot>>- ~ '71----, . ~ ~ PLUMBING ~ Valuation or i ~ Contract Price. 000)000. BUILDING Ftr.!:b\ '~68(. ,~\ Pre SLB \l....f,d 11-6.'~(~ Lintel FRM. Insul. CL WL ELECTRICA Tp. Servo SLB !~.. Rough In Tub Set Meter Can - / Water Const. Pole q -,;} 7- Q" .fi:d3Sewer Pool Final Pre-Meter Final Breakers Ducts Insl. Compressor Final Driveway '!{e: b:2f-~ /3 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 ZEPIIYRJlILLS nUILOING DEPARTMENT f!o1 UWNER'S NAHE ~_kM >~jl/:tt.AAO ,jjAJ) ~ PIIUNE 65,,{6' -..2~ UWNER'S A!J!JRESS -306~ ~ : /1j 41~- ~UD ADDRESS r71!:i7) -. ~ ~ -, _ _ LEGAL DESCRIPTION: LOT(S) nLOC~ SUDDIVISION .?/7.5! PARCEL 1. D. it WORK PROPOSED:-KNew Cons truc Lion _Auultion _Alteration _Repair _Ins tall _Sign _Move _Demolish PROPOSED USE: _Single family _M/p _ff of Units _M/H _Commercial _Indus t. _Swim. Pool _Other (ODTAIN FRON PROPERTY TAX NOTICE) /lESCRIPTIUN UP WUR:~Slaur:;~~~men~ ~ DUlLDING SlZE: X ,;58 :.? Square Peel. lIeighl /~ - / RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF nUILlHNG PLANS & (1) SET ENERGY FORtIS. COMMERCIAL ATTACH (3) SETS Of nUILDING PLANS & (1) SET ENERGY fORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED --L-DUILDING $ ':? tJ~o./ t1O(), Valuation of Total Construction _ELEc.'TRICAL AMP Sel-vice Florida Power Corp. _W.R.E.C. _MECHANICAL $ Valuation of Mecl18nical Installation _PLUMI3ING GM HOOFING TYPE OF CONSTRUCTION: _Dlock SPECIALTY _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO Signature DUILDE~ ~ ~ COMPANY A~ '6.a...\\2 l<:::'- \'T\..Jc-, ~ State Cert. or Regist. # EC.c....'<..-c(:)lfB~ City License Registration It -.l7L ***************************************** = PLUMIl~ ~ COMPANY1~,(:p~ A1 E~7IA'v/c~t. ~A"'P~//"'# State Cen. or Regist. # (!PQ/JJ)h. ~() [' -);71 /,?Y't: Cily License Registration II ';;~'3 ****************************************** ~ f S iglla ture tf.ECllANICAh~ GUHPANY ~u,.e /1l,ft',,;r~ e6~# C' J..?A State Cert. or Regist. # ..neo ~ ~ : Signature Co, /rt~ , City License Regislration n :3 f?:? ~************~*************~*************** .Q.Il.lli.R Signature COMPANY_ State Cert. or Regist. It City License Registration # ****************************************** APPLICATION APPROVED DY .. PERMIT OFFICER. ~-. . . . CONDITIONS OF PERM!'l' AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perllit lay be subject to "deed restrictions" which lay be lore restrictive than City regulations. The undersigned assUlles responsibility for cOllpliance 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 lisdelleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirellents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Deparl:llent, (813) 788-6611. I , Furthefllore, if the owner has hired a cuntractor 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 Olfner 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 contraclor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPAC'l' FEES AND U'I'ILI'l'Y CONNECTION FEES D. ~ONS'I'RUC'I'ION LIEN LAW (CHAPTER 713, FLORIDA S'l'A'rU'I'ES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOleowner's Protection Guide" prepared by the Florida Departllent 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 prolise in good faith to deliver it to the "owner" prior to CODencellent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforllation in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a permit to do work and installation as indicated. I certify that no work or installation has cOlmenced prior to issuance of a permit and that all work will be perfoued to Deet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies lay apply to the intended work, and that it is IIY responsiQility to identify what actions I lust take to be in compliance. Such agencies include but are not Hlited to: * Department of Envirollllental Regulation - Cypress Bayheads, Wetland Areas and Envirollllentally Sensitive Lands, Water/Wastewater TreatNent * Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArllY Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Rehabilitative Services, Envirollilental lIealth Unit - Wells, Wastewater TrealJlent, Septic Tanks * ~~nvironllental Pro~~~!Q.!!-~genci' - Asbestos abatement 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 "compensating volWle" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to perllit 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 shall issuance of a pertit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every peClit issued shall becole invalid unless the work authorized by such perllit is cODenced within six months of issuance, or if work authorized by the penit is suspended or abandoned for a period of six lIonths after the tile the work is couenced. One 90 day extension of tile, lay be allowed for the per~it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection Dust be logged during each six lonth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITII 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". ~~~I ~VlI~ -SiGKM STATE OF FLOllIDA -4 COUNTY OF ~~~~ The foregoing instrument was acknowledged before me this ~j?, 19 J~ by 7 ).I61111?~ E .:?it ~,J who is personally known to me ~tHLba& produced ac; i ggntHication and who EH:tJ./did not take an ?1JJJ.ziYO (Signat~t-"" STATE OF FLORIDA COUNTY OF .;;)E41/"v'#e The foregoing ins:~ent was ac~n9wledged before me this 9_~_,_, 19~_ by t!#/l~;/.ff J) -7?0AE who is personally known to me produCed ________________ ___ a.& -3.tlonU'ficatioft-- and who dtd-/ id not n (Name Typed, Printed or Stamped) NOTARY PUBLIC ~~.. CHll,RLcS 0 POOLE ~ r.h Commle.ion CC346l107 * * E~;>ir.. Feb. 14, 1lXl8 ~ II- 8<'nded by HAl ?f~Of"''''~ aOO-.4~.165es ~,~~'(" .. t' DEBBIE 9AOOI<IiNa'-QUQIol * * My Comml8elOn 00:13aM' "'.. ~.. Expires Nolo' 28.1997 ""OF F~O"~ I ,-, /::, (f -/l.yY- ""==-., APPLICATION FOR PERMIT {j ;' q r?fZ f:-'J :/~~' CITY OF ZEPIIYRlIlLLS' J \4b 1,10 1-"\0 {~~ BUILDING DEPARTMENT ~ ~~ ~ / . b~ r r? OWNER'S NARE ~nJ&,~ ~,~ PIIONE tf~tJ --2#", \~~~ OWNER'SADDRESS "j(;O~~~/:t 4~ &. ;'//.5/ t JOB ADDRESS 73s() _ _--;g_ _ ~ _ _ ~ _ if j LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISIOM ~~ /3 '0'0) \ . kAR~EL . I. D. t g 5"- /JIY a (- -7)0/ ZJ - tJ" 9 t) [) - tJtJ :;2 0 (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~New Construction --Addition _Alteration _Repair _Install _Sign -"ove _Demolish PROPOSED USE: _Single Family _M/F _, of Units _M/H _Connercial - Indus t. _Swim. Pool _Other _Restaurant & lIeaHh ,::"ent Approval DESCRIPTION OF IiORK, -f'~./~ BUlLDlNG SIZE' X .~t3. ~ squar~ Feet, lIeIght /~ RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTA~'1 (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED -L-BUILDING $ '1 tJ~o., ,/JDt). Valuation of Total Construction _ELEL"TRlCAL AMP Service Florida Power Corp. W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _FrUle _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** BUIIJ)ER ~~ COMPANY State t. or Regist. t City Lie nse Registration , ****************************************** ~ Signature "7 f}-D' ELECTRICIAN Si2llature ~ COMPANY State Cert. or Regist. # City License Registration t ****************************************** .oc> <> 1PPLUHBER COMPANY State Cert. or Regist. t City License Registration # ****************************************** Signature~ KECHANICAL COMPANY State Cert. or Regist. t City License Registration f ****************************************** Signature OTHF.R COMPANY State Cert. or Regist. t City License Registration I ****************************************** Signature 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 assUles 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply [or the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (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 perlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (ClffiPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeowner's Protection Guide" prepared by the Florida DepartJent of Agricultur~ and ConsUler Affairs. If the applicant is sOleane other than the "owner", I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the . "owner" prior to couencl!lent. 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 cOllenced prior to issuance of a perlit and that all work will be perforaed 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 governJental agencies lay apply to the intended work, and that it is IY responsiyility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent * Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks II US BnvironJental 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 .colpensating volUle" 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 shall 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 the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, laY be allowed for the perlit with fee charge of $15.00. The 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. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICB OF COKHENCEHBNT HAY RESULT IH YOUR PAYING twlCB FOR IHPROVBHEKTS TO YOUR PROPERTY. IF YOU INTHND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDBR OR AN ATTORNEY BHFORB RBCORDIHG YOUR HO'fICH OF COKHENCEHBHT. JOBS UNDER $2,500 IN VALUE DO NOT NBBD TO RHCORD AND POST A "NOTICE OF COHHENCEHEHT.. (~~~ ~~~- -SiGN~ STATB OF FLORIDA ~ COUNTY OF ~~l'~ The foregoing instr~ent was acknowledged before me this ',g, 19 , f. by 7 ,-{/{)ArI9~ E .:?;, ,,#.J who is personally known to me gr whn has PR>dtleed as id9RtifieatioR and who ~/did not take a~~ (Signature) STATB OF FLORIDA COUNTY OF ~~I.'~~ The foregoing inst~~t was aC~Wledged before me this ~ , 19 ~~ by / .. t#/I~,tg .J}. ~AE who is personally known to me pr6du~ea. _______ ___ as 4d0RtifiGatio~and who n (Signature) Debbie Bock nbr u h (Name Typed, Printed or NOTARY PUBLIC ........, ,tI...." · if. · OEB8'E....,.,-..... * * My eornrn-on CC33all "'... ~'" Expir.. Nov 28. ''"" "'" OF fl.''- (Name Typed, Printed or Stamped) NOTARY PUBLIC #'~ "" CHARLE.S 0 POOlE . rV'~ Commlnion CC346lI07 * * E;;>iretl Feb, 14, 1988 Bonded by HAl ~.,,..~ 800-422-1556 \jZ '~ '~..i'. j; t. ~,'i' .~ l ~ (){ '1-' /' '" ,.\~L'.., .../ ......... 11/ . N , " N ~ S ~ r---------v- " :z.\< '0--. D,"f" ~ ~ ~ 1)-\;7 :.---- __IJIi--- '1-------- -~~----- OI.~~-l~-.-. ------ ------------:. eZ,lI.oo ............... ~ ,i; ,I '~~, .~.' i "L' '1'" ;~.., 'k' .1 ';; .,.,~(' .}l r. l~ <':.i:~' ,:'i.. . or' ~, i "i~; l t '~~'., "'~ , , ~~i:, I~: . , ,~.. ~ ~ ~ C\J l ..... . " - \0'-- (1-'"' 'VY ~~~-~ ~ \(!)'-'Z.-~- Q~ ~~~~-'l\O~~ ~C).B I b -2.'; ~ 'i c." f~ ~_~ fJdj3 IO~~~....q~ f~~~~~ t3l~ I 0 -'30 - q (, f~~_~ .BoB Jl-S"- 9~ f~~_~ ---- fj(!)8 /1, <J, 9~ f~ ~~.aWr- CoB 1/,./ (L{ -q lp f~~_~ DuB P~~4-~ $'0\3 ~--1L,. q~ f~ 4.~ gf~L /'/ZZ,-9~ t?~~~ .gt>$ tl.-3-Qea l~.r ~ r~~~ ~~5 f~~ ~? Id-' ~-qb f~ ~At-~ JS~ tz. ~-g ~ ~..e V'd\.v\... ~ l(l. ') ~ t~ 5e[5 2.~ l"2rcr ~ ~~~-~ '6ll.L ~~ ~'LL l(-t~qf) ~4~~ QL~