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Home My WebLink About96-6138 BUILDING PERM) I CITY OF ZEPHYRHILLS (813) 788-6611 Permit N'! 613813 Date 'tJ-J--7i:. ~~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn :::::,~s:~e'k l~'~it T Parcell.D. # Zoning: ~JrE;,rgy Code: Description of Wo; y..J~ ~ ( Water Conn: Water Meter: T.I.F.'s: Radon Gas: NO OCCUPANCY BEFORE C.O. b FINAL Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector City License Registration # State Certified License# / I L/ Pe,m;t Fe~ Signature ~~~ Company Address Telephone# Valuation or Contract Price g+- r.s-. ()b %#~ //.JYtA'APL~ BUILDING ELECTRICAL PLUMBING MECHANICAL ~;:. SLB b11/PM Tp, Serv, Rough In Meter Can Const. Pole Pool Pre-Meter Final Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final Breakers Ducts Ins!. Compressor F:inal Driveway /{)".#/t".J~ 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 PERKlT (){-d '1- Ii.., CITY OF ZEPHYRHILLS BUILDING DEPARTMENT "I { OWNER'S NAME <::::;; ;" // .t:1 L P / ..IV , tal 'k, P /-.E /t~ Ph" r () A/< S ;' /)1= PHONE 7 g>. l7 --:r y:?,S-- OWNER'S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION CJ H/~ 'S; I /~ 6 PARCEL I.D.' (OBTAIN FROH PROPERTY TAX NQTICE) WORK PROPOSED: ~w Construction _Addition _Alteration _Repair _Install _Sign ---..Hove _Deaolish PROPOSED USE: _Single Faaily _H/F _, of Units _H/H _~ercial _lndust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: ?1I/7t) SJ. 1113 BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (l) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS & (l) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKlTS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _MECllAllICAL $ Valuation of Hechanical Installation _PLUHJ.lING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: PT. IS PROJEcr IN FLOOD ZONE AREA? ****************************************** YES NO CONTRAcrOR SECTION BIJTI.DER . ~ COMPANY ~/~ ~./v~!L'et<- ~ State .,;;;;f.1;,-;< Regist.. k J< () 0 S; :J S-7 Y Signature City License Registration i ****************************************** RI.RCTRICIAN COMPANY State Cert. or Regist. , City License Registration I ****************************************** SignAture PLUMBER COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. f City License Registration . ****************************************** Signature OTRRR COMPANY State Cert. or Regist. f Signature City License Registration I ****************************************** (- ~ ~ APPLICATION APPROVED BY PERKlT OFFICER. Theu. , regulations. CONDITIONS OF PERMIT AFFIDAVIT uEED RESTRICTIONS ~..~erstands that this perJit lay be subject to "deed restrictions" which lay be lOre restrictive tban City 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 lisdeleanor 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 Departlent, (813) 788-6611. FurtherlOre, 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 wbich 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 wisbes 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 - HOIeOWJler's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUll!r Affairs. If the applicant is llOIeOne other than the .owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the "owner" prior to cOllencelent. E. CONTRACTOR'SjOWNER'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 bereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a perlit and that all work will be perf oIled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveDllelltal agencies laY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: t Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Vastewater Treatlent t Southwest Florida Water Managetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArJY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US RnviroDlental Protection Agency - Asbestos abateJent I also certify that, if fill .aterial is to be used in Flood Zone "AI or "A,etc. I, it is understood that a drainage plan addressing a uCOlpensating volUll!R will be sublitted wbich is prepared by a professional engineer registered in the State of Florida p'rior to perJit. issuance. A peIlit 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 perJit 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 perJit is co.nced within six IOnths of issuance, or if work authorized by the per.it is suspended or abandoned for a period of six IOnths after the tile the work is cOlleDced. One 90 day extension of tile, laY be allowed for the perJit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lUst be logged during eacb six IOnth period, or the project will be considered abandoned. WARMING TO OOER: YOUR FAILURE TO RECORD A NOTICE OF COMMEIICEMEtIt' MAY RESUL'I' IN YOUR PAYING 'l'IlICE FOR IMPROVEIIBtIt'S TO YOUR PROPERTY. IF YOU ItIt'END '1'0 OB'I'AIN FINANCING, CONSUL'I' WI'I'H YOUR LENDER OR AN AnORJIEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEtIt'. JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AND POS'l' A "NOTICE OF COHMENCEMEtIt'". SIGNA'I'URE: OWNER OR AGEtit' SIGNATURE: COtlt'RACTOR S'I'ArE OF FLORIDA COUH'l'Y OF The foregoing instrument was acknowledged before me this , 19_____ by S'I'ATE OF FLORIDA COUlft'Y 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 OWNER ....... W'. __a ...............11I.._ ...._.._..._..._ _..._ ..........,...... . C/ )/( /71- PI IV' . ' ~ , JOB LOCATION PARCEL 1.0. , () ,4J{ ~.~/ D~ - SHOW ALL EXISTING & PROPOSID STRUCTURES-GIVING DIMENSIONS' SETBACKS. F(),{)~(' U-- I t' -€ UTILITY BUILDINGS MUST SHOW SIZE , FOUNDATION INFOR- MATION. ;f e BY! V . - S-6 -;p/ , I : , , I 7' : I I I I I I . FRONT PROPERTY LINE I (NOTE EXAMPLES 1 '2) STREET 1. SETBACKS FOR Rl, R2 ZONING 60' 10' P E--, R X 0 I 10'. P S 10' 0 T S I E N D G 20' '. _ ~RONT PROPERTY LINB T" 1, 2. SETBACKS FOR R3 ZONING 60' . 10' , , 10' EXISTING' 10' ; PROPOSE!) " 20.' SGL FAM 30'DUPLEX T 1. I 'I I I FRONT PROPERTy'LINB FOR CARPORTS OR LIKE STRUCTURES PLEASE,CQMPLETE THE FO~LOWING~ (1) DESCRIBE WHAT TYPE: . FREE' STANDING OR ATTACHED (CIRCLE ONE). (2) IF ATTACHED, HOW IS IT TO BE FASTENED TO STRUCTURE? (3) DESCRIBE POST SPACING' FASTENING (IF TO CONCRETE, IN WHAT KANNEl?) (4) GIVE DIMENSIONS OF CARPORT LENGTH, WIDTH, & HEIGHT: (5) GIVE AMOUNT or OVERHANG FROH STRUCTURAL SUPPORT: (6) COMPLY WITH REQUIRED SETBACKS AS GIVEN IN ABOVE REFERENCED PLOT PLAN. ~ . . '.