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Home My WebLink About96-6151 BUILDING PERMIT N~ Permit CITY OF ZEPHYRHILLS (813) 788-6611 .6151/1 Date /0 - 9 --y~ J-6.o-o BUILDING (ElECTR~ PLUMBING Pmpert'( Owne' tJyf 7 Job Address: ?i 6. . - L? ~, Parcel I. D, # .3 () L (J7) <::&iECHANI~ SeWHr Conn Water Conn: Water Meter: T.I.F.'s: Valuation or Contract Price FINAL Zoning: Description of Work ;2 'f9s": tT7J co p nY(AP1ll1f~on. iw Codes l)I1d Ordinances, d- . / \ \p DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and F e M All work shall be performed in accord c.o. DATE Inspector Pe'm;t F~.jl~ ~~- Signature .. ~ ~ c;;...(~ c- .tf/~ Company Address Telephone# City License Registration # '71 State Certified License# ~~ 7;z. a~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Serv, 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 PERK.IT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER · S NAKE PHONE OWNER'S ADDRESS JOB ADDRESS LEGAL DESl.'RIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I. D. . (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign --"-ove _Deaolish PROPOSED USE: ____Single Faaily _KIF _' of Units _M/H _C~ercial ____Indus t. ____Swim. Pool ___Other ____Restaurant Ii Health Department Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORKS. ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED ~UILDING $ Valuation of Total Construction _ELECTRICAL AtIP Service FJ.orida Power Corp. W.R.E.C. -"ECHANICAL $ VaJ.uatioll of Mechanical 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 Signature COMPANY State Cert. or Regist. . City License Registration . *.****..******......**..****************.* ..-1 ELECTRICIAN /' COMPANY Ir// c ~ Ml.4 CieArv-d/lt.'::: ~ ..f /' ~ State Cert. or Regist. . Sianature ,/ .c /~'-?$l C/2&~j/~~ City License Registration . . ***.***************.********************** f/",;; C T,k"/ C -i L C"d It;/~M "'.:: ,. "'It> (/70:<. PLUMBER Signature COMPANY State Cert. or Regist. . City License Registration f ******.*********************************** . MECHANICAL Signature COMPANY State Cert. or Regist. , City License Registration . ****************************************** OTRRR Signature COMPANY State Cert. or Regist. f City License Registration t ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. . . CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this pemit lay be subject to "deed restrictions" wbich lay be lOre restrictive than City regulations. fbe 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 lilY be cited for a lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he 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 wisbes you to sign as contractor that JaY be an indication that be is not properly licensed and is not entitled to pertitting 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 IFlorida's Construction Lien Law - HOJeOImer's Protection Guide" prepared by the Florida DepartJent of Agriculture and Conslller Affairs. If the applicant is sOJeone other than the "owner", I certify tbat I bave obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to cOlleDceJent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land develo.-ent. Application is bereby lade to obtain a pemit to do work and installation as indicated. I certify that no work or installation bas COllenced prior to issuance of a pemit and that all work will be perforted to leet standards of all laws requlating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governtental agencies lily apply to the intended wort, and that it is If responsib,ility to identify wbat actions I lUst take to be in cOlpliance. Such agencies include but are not liJited to: * DepartJent of EnvironJental Regulation - Cypress Baybeads, Wetland Areas and EnvironJentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * Al'IY Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Qebabilitative Services; Environtental Health Unit - Wells, Wastewater TreatJent, Septic Tanks * US EnvirODleDtal Protection Agency - Asbestos abatl!leDt I also certify that, if fill laterial is to be used in Flood Zone IAI or "A,etc.", it is understood that a drainage plan addressing a .cOlpensating volUle" will be subtitted wbicb is prepared by a professional engineer registered in the State of Florida ~rior to perlit. issuance. A perlit issued shall be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a pemit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball beCOJe invalid unless the work authorized by such pemit is C08eDced within six IOntbs of issuance, or if work authorized by the pemit is suspended or abandoned for a period of six IOnths after the tile the work is c.-enced. One 90 day extension of tite, lilY be allowed for the pemlt with fee cbarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An approved inspection lUst be logged during eacb six IOntb period, or the project will be considered abandoned. WARNING TO OIlIER: YOUR FAILURE TO RECORD A NO'I'ICE OF C<lfHENCEMEN'f HAY RESULT IN YOUR PAYING DICE FOR IHPROVEHD'fS TO YOUR PROPERTY. IF YOU IHmm TO OBTAIN FINANCING, COIfSULT WITH YOUR LIlfDER OR All A'f'fORDY BEFORI RECORDIIfG YOUR NO'IICE OF COMHEIfCEMEN'f. JOBS UlfDER $2,500 IN VALUE DO NO'I' NEED TO RlCORD AJfD POST A IINO'I'ICE OF COMMENCEIIEJI'f". SIGJlATURE: OIfIIER OR AGENT SIGNATURE: CON'fRACTOR STATE OF FLORIDA coum OF The foregOing instrument was acknowledged before me this , 19 by -,or-- STATE 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) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC