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Home My WebLink About96-6291 BUILDING PERMIT N! Permit CITY OF ZEPHYRHILLS (813) 788-6611 6291? BUILDING ELECTRICAL Date / / - ;1~--7-b MECHANICAL Sewer Conn PcopertyOwne, q'P~ ~~A Job Address: ..5::S -- .".; ~/ Parcel 1.0. # Water Conn: Water Meter: T.I.F.'s: Zoning: Description of Work Energy Code: Radon Gas fcro (jd jA/2d~-R ~~ FINAL NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector City License Registration # State Certified License# ) 9 '>-J(j . f:ii /~ Permit Fee ., (./ ",i Signature ~ QA ~~ Company Address Telephone# Valuation or Contract Price / ~ -"..s D. cro /' /J d~~Z:t ~ 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. APPLICATION FOR PERKlT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT ... -.... JOB ADDRESS 5S)~ 80(~Q kC~ 11 B\ \Jet. ( &r<L-+i- ~L ) ~l~ -1~~-Co~d~ OWNER'S NAKE ('-hrl (' )es PHONE OWNER'S ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.' (OBTAIN FROH PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair ~tall _Sign _Hove _Deaolish . PROPOSED USE: _Single Faaily _H/F _' of Units _H/H Jec:-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Deparbaent Approval DESCRIPTION OF WORK: (;(ett~, *6-P 900 C)oil 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 AMP Service Florida Power Corp. W.R.E.C. _MECBARICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY S's. I'T i L Other TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO Bun.nER Signature~OJtG~/) CONTRACTOR SECTION aJIIPANY:f=n(~ ~ ~ ~ ~ State Cert. or Regist. . n__ I ~.' =-.:0CXl1~ ~~~ - . - City License Registration . ****************************************** F.T .RCTRlClAN COMPANY State Cert. or Regist. . City License Registration , ****************************************** SiQllAture PLUMBER COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature OTHRR Signature '.l;;bCJ./)tQQ..b ~ COIlPANY P-.eo/le-t1- ~;c.. State Cert. or Regist.' - D~I &) 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 restrictions" which laY be lOre restrictive than City regulations. The undersigned assUles 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 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 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 "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 hAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to coaencetent. 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 bas COlleDced prior to issuance of a peIlit and that all work will be perfoIJed 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 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 lilited to: * Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treattent * Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * AllY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks * 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 volUle" will be subtitted 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 is~uance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall becOle invalid unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of sillOnths after the tile the work is cOlleIlced. One 90 day eztension of tile, laY be allowed for the peIlit 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 TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEJIENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IH'l'END TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN AnORREY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A "NOTICE OF COMMENCEHENT". SIGNATURE: OWNER OR AGENT ~ ~QAACrlb SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by 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