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Home My WebLink About96-6325 BUILDING PERMIT N~ Permit CITY OF ZEPHYRHILLS (813) 788-6611 6325P Date /J..-11-7t. BUILDING ELECTRICAL G'MBIN0 MECHANICAL P<aperty Owne' ),j -;fi ~ .. JObAddress:<3P63 ~/1 -:7?/.. /27/D J Parcel J.D. # Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: Description of Work ~-4A ~A ~ A ~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL l2--l DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector L- Permit Fee Signature Company Address Telephone# ;1 D. D~~ r Valuation or Contract Price .d//A City License Registration # State Certified License# BUILDING ELECTRICAL MECHANICAL Breakers Ducts Insl. Compressor Final SL 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 ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAME \-\ l-\ ~ L (" -t W ~ ,<; t PHONE 6~1.o30 L~'\Y'I.~<\f RoC\ of .:it- 10,\ OWNER'S ADDRESS I JOB ADDRESS 9\ Y'l \:... A~ A G0Vl~ LEGAL DESCRIPTION: LOT(S) ~ ) Dq BLOCK SUBDIVISION PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~lteration _Repair _Install _Sign _Move _Deaolish . PROPOSED USE: _Single F8Ilily _KIF _' of Units _K/H _<=<-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: se.We. r I, (\G BUILDING SIZE: x Square Feet, Height RESIDENTIAL : COMMERCIAL : ATTACH (2) PLOT PLANS It (2) SETS OF BUILDING PLANS It (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS It (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _MECBAHlCAL $ Valuation of Mechanical Installation - ~UKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel Other FINISHED FLOOR ELEVATIONS: Fr. IS PROJECT IN FLOOD ZONE AREA'l YES NO ****************************************** CONTRACTOR SECTION Signature COMPANY State Cert. or Regist. . City License Registration f ****************************************** BUTT.DER F.T .F.CTRICIAN COMPANY State Cert. or Regist. . City License Registration . ****************************************** Sill'nAture PI.tDtBRR 0 W \\, -e.-I[" Signature ){lJ~Q W~ COMPANY State Cert. or Regist. . City License Registration . ****************************************** MECHANICAL COMPANY State Cert. or Regist. . Signature City License Registration . ****************************************** OTRRR COMPANY State Cert. or Regist. t Signature City License Registration . ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. . .. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to IIdeed restrictions II which Jay be lOre restrictive than City regulations. fhe 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 JaY be cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licenSing requireJents lay 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 II 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 pertitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN ~AW (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 "ownerll, I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the lIownerll prior to cOJJenceJent. 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 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 perlit and that all work will be perf OIled 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 goverDJeDtal agencies JaY apply to the intended work, and that it is IY 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 Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - 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. II, it is understood that a drainage plan addressing a uCOlpensating volUle" will be subJitted 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 tbe 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 pertit 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 six IOnths after the tile the work is coaenced. One 90 day extension of tile, JaY be allowed for the perJit with fee charge of $15.00. The 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. WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING nICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IHTBND TO OBfAIN FIWCING, CONSULT WIfH YOUR LENDER OR All AnOIlRlY BEFORE RECORDING YOUR NOTICE OF COMHENCEMEHT. JOBS UNDER $2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A "NOTICE OF COMMENCEMENT". x ~~AJ- (f2 WeJ-- SIGMATURE: O'rIllBR OR AGENT SIGNATURE: CONTRACTOR STATE OF FWRIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by STArE OF FWRIDA COUM'lY 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