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Home My WebLink About96-6156 BUILDING PERMIT NC! Permit '. CITY OF ZEPHYRHILLS (813) 788-6611 - 615613 Date /0-/ 0-7-6 0=D~ Pmp'rty Own" .:f~ L.} ~~, Job Address: '-~Yd- - ~, a ___d ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Parcell.D, # Zoning:_Energy Code: Description of Work fi- 0 A~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL IO- DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances, c.o. DATE Inspector City License Registration # State Certified License# /r99 , Permit Fee ...J.. 0 - ~ Signatur~ ~ r'" Company Address Telephone# Valuation or Contract Price I, ~ . 0-0 .~ p~c ~ BUILDIN~ ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM, Insul. CL WL Tp, Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final 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 PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAKE L,~~ ~ OWNER'S ADDRESS S/ 7'" ::L ~iU7 G~lll/ / ::5l'"L 5 r PHONE yg-2- ~ JOB ADDRESS 7' a~-< LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION (OBTAIN FROM PROPERTY TAX NOTICE) PARCEL I.D.' WORK PROPOSED:_New Construction _Addition _Alteration ,.....k'-Repair _Install _Sign _Move _D~olish PROPOSED USE: _Single Faaily _M/F _, of Units _M/H _CoI8ercial _Indust. _Swim. Pool ___Other _Restaurant Ii Health Department Approval DESCRIPTION OF WORK: ~r rlgj- ~~C~ 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. PERKITS REOUESTED _BUILDING $ /C>lVCJ..~ - Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. _KECBAlUCAL $ Valuation of Mechanical Installation _PLUMBING 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. t City License Registration . ****************************************** Signature ELECTRICIAN COMPANY State Cert. or Regist. f City License Registration , ****************************************** SianSllture PLUKBER COMPANY State Cert. or Regist. , City License Registration , ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. , Signature City License Registration t *************~**************************** OTRF.R ~ COMPANY 8, ~ay...., c~ 1'~ r ~/(' ~ <::;- State Cert. or RegrSt., err- o/~ ~90 Signatur~ -?- ~ ~---,---. City License Registration 41 . ****************************************** ~ APPLICATION,APPROVED BY PERMIT OFFICER. ,.. - .'. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that tbis perJit lay be subject to udeed restrictions" whicb laY be lOre restrictive tban City regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with state and local regulations. If tbe contractor is not licensed as required by law, botb 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 requireaents lay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departtent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the DContractor 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 wisbes you to sign as contractor that lay be an indication that be is not properly licensed and is not entitled to perJitting privileges in the City of Zepbyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify tbat I, the applicant, bave been provided with a copy of uFlorida's Construction Lien Law - HOIeOWDer's Protection Guide" prepared by the Florida Departtent of Agriculture and ConsUler Affairs. If the applicant is sOIeone other tban the Downer", I certify tbat I bave obtained a copy of the above described docutent and prOlise in good faith to deliver it to the "ownerD prior to cOllenceaent. 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 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 perJit and that all work will be perforted to teet 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 governtental agencies lilY 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: t Departtent of HnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, WaterfWastewater Treattent t Southwest Florida Water Manageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Healtb & Rebabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US EnviroDlental Protection Agency - Asbestos abateJent I also certify that, if fill laterial is to be used in Flood Zone "AD or "A,etc.", it is understood tbat a drainage plan addressing a uCOlpensating volute" will be sublitted wbicb 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 frOt thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becOle invalid unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perJit is suspended or abandoned for a period of six IOnths after the tite the work is cOlleDced. One 90 day extension of tite, lilY be allowed for the perJit with fee charge of $15.00. Tbe extension sball be requested in writing to tbe Building Official. An approved inspection lust be logged during eacb six IOntb period, or the project will be considered abandoned. 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 All AnORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS lIHDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGHATURH: OWNER OR AGENT ~~s IGNATURE: CONTRACTOR ~ .---r STATE OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by wbo is personally known to me or who bas produced as identification and wbo did/did not take an oatb. STATE OF FLORID~ COUNTY OF ulk..t!o The foregoing instrument was acknowledged before me tbis Ie- octoby 19~ by t~< bAV; ":,. who is personally known to me or wbo bas produced P~.r>",JA-Ht K,vo<CAJ0 as identification and wbo did/did not ~~ (Signatur (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC ~,t~~'~~ "OFFICIAL SEAL. f?7;~,.\ Timothy D. Pendell ~~~~11 My Commission Expires 3/14/97 ""',,'"i 0' ,...~~ Commis&ion tee 265838 III,,,..,,,,\: