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Home My WebLink About96-6176 BUIL~~t:~~HY~L~RM!! N! --617616 (813) 788-6611 Date /'0 ~:2-I- 9b . . .. '" C-~ILDING~_ EL~--' PLU~-' M~-' Sewer Conn Watm Conn: Pmp'rtyOwo", P4~ ~~ Job Address: 3J- tOt 51 - ~ tl~ Parcell.D. # IL=d_6 -;1( .p 01-/-..Jd. -J..?,;2Y Zoning:________~y Code: Radon Gas:--L--. Dose,;pt;oo of Wo,k_ ._l... /.) ,,~ ,..ti/i ~ t1 .. ~ t&!U. M) Water Meter: T.I.F.'s: rI ... (]~../~b~~ 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. Valuation or _ ~ . C; (.) Contract Pric!st+_.J;__t2_tJO - Permit Fee DATE Signature Company Address Telephone# City License Registration # /1' f {) State Certified License# c4~ftitf=72~, CS,BUILOING-----"ELECT~-- Ftr. Tp. Servo SLB Pre SLB Rough In Tub Set Lintel Meter Can Water FRM. Canst. Pole Sewer Insul. CL Pool Final WL Pre-Meter Final PLUMBI~-._. MKnANICAL 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT PHONE ~flc.~-!f)W OWNER'S ADDRESS &. =-t-IJ. S:SC JOB ADDRESS~, f~~w:-~ z;Jlt* 1M LEGAL DESCRIPTION: LO~(S) ~..::zs-:z, BLO SUBDIVISION PARCEL I.D.' If. 2{;,Z( OWNER'S NAME (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ::%;teratton _Repair _Install _Sign _Move Deaolish PROPOSED USE: _Single Faaily _M/F _' of Units _M/H _<=<-ercial _Indust. _Swi.-. Pool _Other _Restaurant &: Health Department Approval DESCRIPTION OF WORK:~U/\OkT1~ ~ BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AttP Service Florida Power Corp. W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: PT. IS PROJECT IN FLOOD ZONE AREA? YES NO .........*..*............................. COMPANY State Cert. or Regist. , City License Registration , * ...*......****.*........***.*...*....... ELECTRICIAN COMPANY State Cert. or Regist. , SianAture City License Registration , ......**.**.*.**.*.....***.***...********* PLIDIBER COMPANY State Cert. or Regist. , Signature City License Registration f .****.****..*********.***..******..*****.. MECHANICAL COMPANY State Cert. or Regist. f Signature City License Registration , *.*.........~*.*.......*...**...*.*.***..* omRR COMPANY State Cert. or Regist. t Signature City License Registration t **..*....**.*............*...............* APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to "deed restrictions" which lay be lOre restrictive than City regulations. Tbe undersigned assUles responsibility for cOlpliance witb any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they aay 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requiretents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (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 "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 tbe 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 (CHAPTER 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 Departlent of Agriculture and Conslller Affairs. If the applicant is sOJleOne other than the .owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the "owner" prior to couencetent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in tbis application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developaent. 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 pertit and that all work will be perfoIJed 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 goveI1lllental agencies aay apply to the intended work, and that it is .y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: t Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and Environtentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater 'freatlent, Septic Tanks t US EnviroDlental Protection Agency - Asbestos abatetent 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 volllle" 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 witb the work and not as authority to violate, cancel alter, or set aside any provisions of tbe 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 pertit issued shall beCOle invalid unless the work authorized by such pertit is COllenced within six IOnths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six IOntha after the tile the work is cOllenced. One 90 day extension of tile, lay be allowed for the pertit with fee charge of $15.00. Tbe 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 'f0 OWNER: YOUR FAILURE TO RECORD A NO'fICE OF COMMENCIMEH'f MAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMmS 'f0 YOUR PROPERTY. IF YOU IH'fEND TO OBTAIN FIWCING, CONSUL'f WITH YOUR LENDER OR AX AnORHEY BEFORE RECORDING YOUR NOTICE OF COHHENCEHEH'f. JOBS UNDER $2,500 IN VALUE 00 NOT HEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OIOfER OR AGENT SIGNATURE: COH'fRACTOR STATE OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA coum 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