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Home My WebLink About96-6296 BUILDING PERMIT N8 CITY OF ZEPHYRHILLS Permit- (813) 788-6611 6296 ~ Date / 1- d-6 --,j?-6 ~ ELECTRICAL PLUMBING MECHANICAL P<aperty own~ 1/\ !~?~ JobAddress:_/O_ dY63ZJ (./ln~<I Parcel I. D. # Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: :zv Code: Description of Work ,~.-f~ Ad Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C.O. 5 -- / 3--- DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector r2P Permit Fee :1.".5'--. tTD Signature ~ J.Al.L1"1~()^ Company Address Telephone# Valuation or Contract Price /,D 77. , City License Registration # State Certified License# 3-"t>~f' >>1t<-Q BUILDING ELECTRICAL PLUMBING MECHANICAL /2. - H', /fep p~ Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Driveway JZ,/.?-~f{;~6 Tp. Serv. Rough In Meter Can Canst. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL WL 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 PHONE ~ lo9 BWCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign -",ove _Deao1ish . PROPOSED USE: _Single Faaily _KIF _' of Units _M/H _ec-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet. Height RESIDENTIAL: ATTACH (2) PWT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKlTS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. ---'fECIIANlCAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FDfISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** Signature CONTRACTOR SECTION COMPANY LephU V' YMuwYlr~ &vl~~hoY1 ~o ~ State Cert. or Regist. t 11. """" ll<) -;., "). .JIU'I .I.l.A City License Registration' .:l1l ****************************************** &>~ RITTI.DER ELECTRICIAN COMPANY State Cert. or Regist. . City License Registration . ****************************************** SillllAture PLUMBER Signature COKPANY State Cert. or Regist. . City License Registration f ****************************************** MECHANICAL Signature COMPANY State Cert. or Regist. f City License Registration . ***********~****************************** OTRF.R COMPANY State Cert. or Regist. , City License Registration # ****************************************** Signature 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 Jay be lOre restrictive than City regulations. rhe 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 JaY 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 JaY be cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireJents JaY apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (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 Jay 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 bAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of 'Florida's Construction Lien Law - HOJeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is sOJeone other than the "owner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the "owner" prior to cOlJeDceJent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforJation 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 leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in th~ jurisdiction. I also certify that I understand that the regulations of other goveI1llental agencies JaY 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: t DepartJent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Vastewater TreatJent t Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, EnvirODJental Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US EnvirODJental Protection Agency - Asbestos abateJent 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 volUJe" will be sublitted wbich 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 perJit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becOJe invalid unless the work authorized by such perlit is cOJJenced within six IOnths of issuance, or if work authorized by the perJit is suspended or abandoned for a period of six IOnths after the till! the work is cOJJenced. One 90 day extension of tile, JaY be allowed for the pertit 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. WARMING TO 0WlfER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPIlOVEMENTS TO YOUR PROPERTY. IF YOU INTEHD TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN AnORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 1M VALUE DO NOT NEED TO RECORD AND POST A "MOTICE OF COMMENCEMENT". SIGNATURE: O'rIllBR OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregOing instrument before me this was aCknowledged , 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 CbM(} f\J ~~ ~ ~ J ;or,. ~ "'aso<'~ p.o. Box 1 003 Crystal Springs, FL 33524 (813) 782-5657 TO EHERA.LD POINI'E 39630 CF-E\'\fCEY RD. '7.:EPHYRHILLS j FL . JOB SPECIFICATIONS: > LABOR & MhTERIAL FORt''1 l\.'\[O POUR Sl.AE:I > For the sum of $ Page No, ___ of Pages ~ubcontract ~greement (/ JOB PHONE I DATE ~ 1_ 1 /26/96 JOB NAME/LOCATION f1)-:" j:)9 JOB NUMBER I ARCHITECT dollars ($1 :)91 . 60 ), The above specified project is to be completed in strict conformance with all specifications and conditions relating to this agreement In addition, the project is to be performed in compliance with OSHA regulations and local, state and national building codes. Although the contractor has control over the quality of all work relating to this project, the subcontractor is an independent contractor in all respects; the subcontractor is responsible for his employees, his subcontractors, materials, equipment and all applicable taxes, benefits and insurances, The subcontractor is responsible for coordinating his activity with other trades and promptly cleaning up any surplus or refuse which was created by his work, Payment will be made as follows; C;QHPLErION OF JOB Contractor ,~, (',., (...""1.'" -'... .. "'-. t....<J d J':'rc\.r:,:~' Authorized Signature Cj/ . .j ~.\. c-J.. I.' '.' ~J": -t-. , Date Ii _ ... .! <>l.t,."-'-}(",, Subcontractor Zr'1r:~T . ) ".,i \. . f- ,\-C (1)\_ Authorized Signature i ,~ -r r, fl" '~ J' ^~, .f'..",.. 1 Date ll/26F)6