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Home My WebLink About96-6326 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N<<1 6326 ::P Date / (). -II - Y 1, BUILDING ELECTRICAL GM~I-~~) MECHANICAL Sewer Conn Property Owner: Job Address: ...... ? Parcel 1.0. # f!;;f cf::!;;- j( -p Water Conn: ~'S.-I Water Meter: T.I.F.'s: Zoning: Description of Work =y Code: ~ ~ g~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL J'Z...- 12 - ~ 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 Permit Fee Signature Company Address Telephone# r20- ~ O~~~ Valuation or Contract Price .~//f City License Registration # State Certified License# (~A _ 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 PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAKE C h a r le-...<.:., V L il *" 0 h PHONE OWNER'S ADDRESS ~q b 3 2> Ch 6l1'\<:' -e y Ro~ c~ ::ti '5;Cj JOB ADDRESS SA Iy\ <- Ii S 1113 0 II 6- LEGAL DESCRIPTION: LOT(S) .J!. S-q BLOCK SUBDIVISION WORK PROPOSED:_New Construction _Addition ---..Alteration _Repair _Install PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) _Sign _Move _Deaolish PROPOSED USE: _S ingle F8Ilily _M/F _' of Units _M/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: ~Cwe.-r II V\-e~ 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 REQUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _MECHANICAL .xPLUKB~NG $ Valuation of Mechanical Installation GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FlBISHED FLOOR ELEVfTIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BUILDER COKPANY State Cert. or Regist. . City License Registration . ****************************************** Signature RJ.RCTRIClAN COMPANY State Cert. or Regist. I City License Registration . ****************************************** SilllUllture PUJHBHR OU) /). e r \ /- Signature y.j~ A~ COMPANY State Cert. or Regist. . City License Registration . ****************************************** MECHANICAL COMPANY State Cert. or Regist. . Signature City License Registration . ****************************************** OTRRR COMPANY State Cert. or Regist. I Signature City License Registration . ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perJit lay be subject to "deed restrictions" which JaY 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 ONDer 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" 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 ~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 SOJeODe 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 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 cOJpliance 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 perforJed 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 governJental 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 EnviroDJentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water Managetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArJY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rebabilitative Services, EnvironJental Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US BnviroDlental 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 "cOJpensating volUle" will be subJitted which is prepared by a professional engineer registered in the State of Florida prior to peflit. issuance. . A perJit 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 per.it prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perJit iSS8ed shall becOle invalid unless the 1Iork authorized by such perJit is cOJJenced within six IOntbs of issuance, or if work authorized by the perJit 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 pertit with fee charge of $15.00. The extension shall be requested in writing to tbe Building Official. An approved inspection lUst be logged during each sixlOnth period, or the project will be considered abandoned. WARMING TO OVNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMEIIt'S TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSOLT WITH YOUR LENDER OR AN AnOmy BEFORE RECORDING yOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". ~~~~V;:~ SIGNATURE: CONTRACTOR STATE OF FLORIDA coum 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