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Home My WebLink About96-6240 *. BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit Nt? 62401/ BUILDING ;;2 o. ",'r"{J ----=::::::--.. ~~~ PLUMBING Date /) - J 3 - 9' b 3Q'~ ~HANI~ Sewer Conn Water Conn: Pmperty Owne" '7'l.-<-J :]fh-a...d4d!!,"~ Job Address: .:s 6- b.!; a c2.A;LA~ Parcel I. D. # Zoning: Energy Code' Description of Work '--/! ~~ *7 C- Water Meter: T.I.F.'s: Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL Complete Plans. Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector f3 '-- Permit Fee 0 0, crt) s;gnaMe6\C4:)-r ~ Company Address Telephone# Valuation or Contract Price 02'111 c-v ./ City License Registration # / ~ ?- State Certified License# BUILDING ELECTRICAL PLUMBING k<obJ"ijaJ MECHANICAL ~~f1~ /'11, Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo 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 ($15.00) shall be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. C. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. '. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME /UIJ~ I<DU{;~Je ? f3 !J S-..z. hlV$"' AI V- 40 5R7-vte PHONE ?8o,..9 5'( 7' . OWNER'S ADDRESS JOB ADDRESS LEGAL DESCRlPl'ION: 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 _K/H _~ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION 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 _ELECl'RICAL _MECHAlIICAI. AKP Service Florida Power Corp. W.R.E.C. $ -<m~ ~ Valuation of Mechanical Installation _PLUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FDUSBED FLOOR ELEVATIONS: FT. IS PROJEct IN FLOOD ZONE AREA? YES NO ****************************************** /- CONTRActOR SECTION BUILDER Signature COMPANY State Cert. or Regist. , City License Registration , *~*************************************** .. . .../ ' COMPANY L.- State Cert. or Regist. ,c? 0 City License Registration . ********************************** F.T,'RCTRI~ I \. PLUKBER COMPANY State Cert. or Regist. , City License Registration t ****************************************** Signature Signature COMPANY Xc]v {; ~/ State Cert.' or Regist. t City License Registration . ***********~****************************** o t!).fY I';Z /~..< MECHANICAL / OTRll.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 peIlit lay be subject to "deed restrictionsn whichlilr be lOre restrictive than City regulations. the undersigned assutes 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 tbe contractor is not licensed as required by law, both 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 lilY apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner bas 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 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 that I, the applicant, bave been provided with a copy of nFlorida's Construction Lien Law - HOJeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and Consuaer Affairs. If the applicant is sOJeOne other than the .....- nlMler", I certify that I have obtained a copy of the above described docutent and prOJise in good faith to deliver it to the "owner" prior to cOJJenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infortation in this application is accurate and that all work will be done in cOJpliance with all applicable laws regulating co~truction, 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 COJJeDced prior to issuance of a peIlit 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 ~ regulations of other governaental agencies JaY apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * DepartJent of Environtental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Maviqable Waterways * DepartJent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater treatJent, Septic tanks * US EnviroDlental Protection Agency - Asbestos abateJent 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 .cOJpensating volute. will be subtitted wbich is prepared by a professional engineer registered in the State of Florida prior to perlit_ issuance. S FLORIDA COUHTY OF The foregDing instrument was acknowledged before me this , 19~ by A perlit issued sball 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 tbe technical codes, nor sball issuance of a peIlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCOJe invalid unless tbe work authorized by such peIlit is cOJJeDced within six IOnths of issuance, or if work authorized by the peIlit is suspended or abandoned for a period of six IOnths after the tite the work is COIIenced. One 90 day extension of tite, lilY be allowed for tbe peIliA: with fee charge of $15.00. tbe 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. WARN'IHG 'l'O OIIMER: YOUR FAILURE TO RECORD A MOTICE OF COHHBMCEIIEH'l' HAY RESULt 1M YOUR PAYIMG twiCE FOR IHPROVEIIDl'S to YOUR PROPERTY. IF YOU IHTEHD to OBtAIM FHIAIICIMG, COMSULt WItH YOUR L1~HDER OR All AttORNEY BEFORE RECORDIHG YOUR HOTICB OF COHHENCEHBHT. JOBS UNDER $2,500 1M VALUE DO NOT NEED TO RECORD AHD POST A "NOTICE OF COHMEHCEIIEH'l'". ~?z- SIG E' COHTIIAC'l'OR I StATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19_____ by I ~- WhD 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 CITY IMICE NATURE OF ~ SERVICE Lv' REQUEST OUAN. PART NO. SERVICE PERFORMED 7'-' ~I TECHNICINI'l fbr~~;f;;"-i- ;-; ~T_ -~ ~-~ Kinsey Central Heat &: AIr-COnditioning 7718 Fort King Highway . P.O. Box 2209 Zephyrhills, Florida 33539-2209 (813) 782-2300 PHOIIE ? (). - -',:)()':'"..>4 IIOIJ(L 1ERW. 11I_ DESCRIPTION TOTlll IIAIEIIIo1II. ~ IIEJMC( TIIIf MTt COIIPI.mD TAl mAl CASH ::unc-... CUSTOMER'S SIGNATURE . DATt~ APARTMENT BtSTIMATE o CASH o CHARGE PRICE AMOUNT - --.-..,