The URL can be used to link to this page

Home My WebLink About96-6180 BUILDING PERMIT N! Permit CITY OF ZEPHYRHILLS (813) 788-6611 6180 (3 Date /tJ ,()!) -7'6 c9/ Pmperty Owne, 13~~ Job Address: .5 ~/- ,-.5' . ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T,I.F.'s: Parcel 1.0, # Zoning: -A--Energy C~~~: ~ Description of Work ~4- . Ra?~ .A ~ /I^-! Le_ -/ ~..e.- NO OCCUPANCY BEFORE C.O. FINAL //- /.4/- 9 DATE Complete Plans, Specifications and Fee Must Accompany Application, All work shall be performed in accordance with City Codes and Ordinances. c.o. DATE Permit Fee Signature Company Address Telephone# Valuation or ':LL. Contract Price .,.~ T\ City License Registration # J -.S ':.3 State Certified License# ~ JJ, )0, BUILDING 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. r . APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER' S NAME PHONE OWNER · S ADDRESS JOB ADDRESS /;;)..11 S- +) S ir~-e T LEGAL DESCRIPl'ION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign _Move _DeJlolish PROPOSED USE: _Single Faaily _M/F _' of Units _M/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Department Approval DESGRIPl'ION OF WORK: 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 AHP Service Florida Power Corp. W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fralle _Steel Other FINISHED FLOOR ELEVATIONS: PT. IS PROJECT IN FLOOD ZONE AREA? .****.*.********.**.*.**.***************** YES NO BUILDER CONTRACTOR SECTION Signature COMPANY State Cert. or Regist. , City License Registration . ****************************************** "553 ELECTRICIAN COMPANY State Cert. or Regist. , SianAture City License Registration , .****.*****.****************************** PLIDIBER COMPANY State Cert. or Regist. , Signature City License Registration # ****.**************************.********** MECHANICAL COMPANY State Cert. or Regist. , Signature City License Registration . **.*****.***~***************************** OTllF,R COMPANY State Cert. or Regist. , Signature City License Registration # *****.*****.****************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pemit lay be subject to "deed restrictions" which laY be lOre restrictive than City regulations. The undersigned assOles 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 lisd8leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requir8lents laY apply for the intended work, they are advised to contact tbe City of Zepbyrbills 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, ratber 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 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 tbat I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOw.Der's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsOler Affairs. If the applicant is sOftone other than the "owner", I certify that I bave obtained a copy of the above described docUlent and prOllise in good faith to deliver it to the "owner" prior to couenc8lent. 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 pemit and that all work will be perfoIled 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 goverDIeDtal agencies laY apply to the intended work, and that it is If responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to: * DepartJent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater 'I'reatlent * Southwest Florida Water Hanag8lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic 'fanks * US Environlental Protection Agency - Asbestos abatBlent I also certify that, if fill laterial is to be used in Flood Zone "An or "A, etc. ", it is understood that a drainage plan addressing a .cOllpensating volOle" 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 frCl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pemit issued shall becOle invalid unless the work autborized by such perlit is cOllenced within six IOnths 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 cOllenced. One 90 day extension of tile, 1Iil' be allowed for the pemit with fee charge of $15.00. The extension shall 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 '1'0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHBNCEHENT HAY RESULT IN YOUR PAYING 'l'WICE FOR IMPROVEMEMrS '1'0 YOUR PROPERTY. IF YOU INTElfD '1'0 OB'I'AIH FINANCING, CONSULT WITH YOUR LElfDER OR AN ATTORNEY BEFORE RECORDING YOUR HO'l'ICE OF COHHIiHCKHENT. JOBS UNDER $2,500 IH VALUE DO NO'l' HEED '1'0 RECORD AND POST A .NOTICE OF COHHDCEMBN'l'''. SIGJlA'fURE: OWIfER OR AGENT SIGHA'I'URE: CONTRACTOR STATE OF FLORIDA COUNTY 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