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Home My WebLink About96-6129 BUILDING PERMIT N~ Permit CITY OF ZEPHYRHILLS (813) 788-6611 - 6129!J Date 9 ~.;o -96 GILDI~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: PmpertyOwne, >>~ <c2&~~~H )/~ Job Address: 37.3/ 0 ~ g- .4 /1;;:;:- ParceII.D.# I;;' -;Lb-dJ -0310 ~ 060<:) '-' ~ D 91/0 Water Meter: T,I.F.'s: Zoning: Energy Code: Description of Work c: Rt2 r....A ~ Radon Gas: FINAL NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Valuation or Contract Price ~"'Yb/' , cro Inspector' Permit Fee ~ -.. cTl:J Signatur~ ~ Company Address Telephone# ~ " City License Registration # State Certified License# /R-9? r-p~~~ &41 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 ($15.001 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 ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAKE j)OftDff,y 19" El:Jni-tl J./oyth, PHONE OWNER'S ADDRESS :J try /0 flft. A'/~ 7'f1P4>-,,i-fk- JOB ADDRESS ~~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL J.D.' J;l. - J(, ~ 2/- o.J/tJ-CoooCJ- CR/6 (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign _Kove _Deaolish PROPOSED USE: ~Single F8IIily _KIF _, of Units _K/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Department Approval DESCRIPTION OF WORKyflt,Al RooF ,5"~ I~, JL5 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. _BUILDING PERMITS REOUESTED $ .....5" Y b I. tF"iJ Valuation of Total Construction " _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _KEGHANlCAL $ Valuation of Kechanical Installation ~LUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. f Signature City License Registration I ****************************************** ELECTRICIAN COMPANY State Cert. or Regist. * SignAture City License Registration f ****************************************** PLUMBER COMPANY State Cert. or Regist. , Signature City License Registration * ****************************************** KEGHANICAL COMPANY State Cert. or Regist. # Signature City License Registration t *************~**************************** OTHRR COMPANY State Cert. or Re ist. # ~(~ Signature City License Registration # ****************************************** APPLICATION APPROVED , BY, PERMIT OFFICER.; . CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perJit lay be subject to "deed restrictions" which 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 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 for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813) 788-6611. FurtheClOre, 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 tbey 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 perJitting 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 - HOIeOlDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is sOleone other tban 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 coaaencelent. 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 aeet 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 otber goveI1llental agencies laY apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Bnqineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks * US BnviroDlental Protection Agency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone HA" or "A,etc.", it is understood that a drainage plan addressing a "coapensating volUleH 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. Bvery perJit issued sball becOle invalid unless the work authorized by such perlit is co-.mced within six IOnths 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 COlleJlced. one 90 day extension of tile, laY be allowed for the perJit with fee charge of $15.00. The 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 OWNBR: YOUR FAILURB TO RECORD A NOTICE OF COHHBHCEHBIII MAY RESULT IH YOUR PAYIHG TlIICH FOR IHPROVBMDIS TO YOUR PROPBRTY. IF YOU IIITBND TO OBTAIN FINANCIHG, CONSULT WITH YOUR LENDER OR AN ATTORIIBY BBFORB RBCORDIHG YOUR IIOTICH OF COMMENCEMENT. JOBS UNDER $2,500 IH VALUE DO NOT NBBD TO RECORD AND POST A "HOTICE OF COHHBNCBHEIII". ~/~' SIGIIIT . CO OR L~ - ~1A 6:1~ SIGNAr~ OWNER OR AGBIII STATE OF FLOR~ COUNTY OF ('7J{'O The foregoing in~rument was acknowledged before me thisj'o S(f7k>7A~-/' 19~ by l ,'~/4 )/~d I3r-UC1' bAu,'s, who is perSOnall~known to me or who has produced ~ t' r ..so rva. { v ){0o v,h) as identification who 'did/did not ake o~ (Signat J ~CJ v f) (>-'Nd'f7LL (Name Typed, Printed or Stamped) NOTARY PUBLIC (Si~atuJ"J!) ,\./ // L ~,ifhy v /'~~cFe L (Name Typed, Printed or Stamped) NOTARY PUBLIC ,"'1""" ~~~.' ~~_ "OFFICIAL SEAL" ff:.r'2i~l Timothy D. Penf:lell "~~ii My Commission Expires 3/14/97 '~~,?'r.,~~~,,,,$' Commission ICC 265838 ~\\"'""Ir. $~~"~'~ "OFFICIAL SEAL" i:i 1:. Timothy D. PenJjell \~'" ,;,? My Commission Expires 3/14/97 ~~gr.I~~""" Commission ICC 265838 PRIMARY CONTRACTORS INC. Michael Ratcliff VICe president 2847 Belcher Road PO Box 211 Palm harbor, FI 34683 T~one(813)725HB719 Fax (813) 725-0773 JOB AUTHORIZATION Date: 27~T9~ To: Bobie Swetland City of Zephyrhills Building Department From: Michael B Ratcliff PRIMARY CONTRACTORS INC. cgc-009556/ ccc-018990 Plea~se this document as our authorization for Bruce Davis to _submit plans Lapply for a building pennit on the following job: OwD.rp~ .. ~~~ PCIJobNo. R- ~~8 Sworn to and subscribed before me this ~f 0 day of Se P~t' rYI.~ r 199 -.k. 5?~~~ Notary Public my commission expires: ,\,'1I1"',,~ ~~.'t~~~ "OFFICIAL SEAL" I.:~.. '...~'i ~:( l:i Timothy D. Pendell \~'" ~$i My COmm!Ssion Expires 3/14/97 "'~~r.I~:"\\'" Comr'nllSion .ce 265838