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Home My WebLink About97-6371 BUILDING PERMIT N~ Permit CITY OF ZEPHYRHILLS (813) 788-6611 - -6371/1 Date /-3 --?7 ~ ELECTRICAL PLUMBING MECHANICAL P"'perty own.'0'~A fdl-::fi Job Address: ~ ;;J.;;..s- /!. _ __~ Parcel 1.0. # II - ,:2 t ._~/- I:) vI 0 - / 7Jt:JO - 0 iJ / D Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Description of Work /};e~ode: Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 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 ~I }1o Permit Fee Signature Company Address Telephone# ~~ Valuation or Contract Price It:, ?/. c:ro , City license Registration # State Certified license# .L~ :r-Zz BUILDING ELECTRICAL PLUMBING MECHANICAL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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 PERKIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER' S ADDRESS ~(Cl~ 0~;;-S- B/~tfL. I (..,.e. S'r PHONE '7/5: 0ogs-" OWNER · S NAKE JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK 061 b / SUBDIVISION 00/0' PARCEL I. D.' dO WORK PROPOSED:_New Construction _Addition --Alteration _Repair _Sign _Kove _Deaolish . PROPOSED USE: _Single Faaily _KIF _' of Units _K/H _<=<-ercial _Indust. _Swia. Pool _Other DESCRIPTION OF WORK: _Restaurant & Health Departaent Approval I ;l..~/~ ~ , 78 I-(/STI/-<A- I d- x..i.!L.. I~ ~ Square Feet. s~. BUILDING SIZE: Height RESIDENTIAL: COtIKERCIAL : 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. _BUILDING $ .00 Ibfl ~y , PERKITS REOUESTED Valuation of Total Construction _ELECl'RICAL AMP Service Florida Power Corp. W.R.E.C. --1IEGBANIGAL $ Valuation of Kechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA 'I YES NO ****************************************** Signature COMPANY State Cert. or Regist. . City License Registration . **************************************** CONTRACTOR SECTION SdAJ~ JI- L () 111 ~uiJf "Z:..,; 70 1UITT.DER RT.F.Cl'RICIAN COMPANY State Cert. or Regist. . SianRture City License Registration . ****************************************** PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration . ****************************************** MECHANICAL COMPANY State Cert. or Regist. f Signature City License Registration . *********************.*.**.**............. OTRF.R COMPANY State Cert. or Regist. . Signature City License Registration , ....***.****..*.*.**.*..**..*...........** APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictions" which Jay be lOre rest~ictive lhan City regulations. the undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired 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 lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813) 788-6611. FurtherlOre, if tbe owner has bired a contractor or contractors, he is advised to bave 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 peIlitting privileges in the City of Zephyrbills. 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 - HOJeOWDer's Protection Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs. If the applicant is SOJeOne other than the "owner", I certify that I have obtained a copy of the above described dOCUJeDt and prOJise in good faith to deliver it to the "owner" prior to COIleDCeJeDt. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify tbat all the inforaation 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 couenced prior to issuance of a perlit and that all work will be perfol'led to .eet 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 govel1llental 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: * Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater !reatlent t Southwest Florida Water HanageJeDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArJY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - NeIls, Wastewater !reatlent, Septic ranks t US EnvirODlental Protection Agency - Asbestos abatelent 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 .cOJpeDsating volllle" will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to perlit. issuance. . 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 the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall becOle invalid unless the Ifork authorized by such perlit is cOllBnced within sillOnths of issuance, or if Ifork authorized by the perlit is suspended or abandoned for a period of sillOnths after the tile the work is COIIeDCed. One 90 day extension of tile, JaY be allowed for the perlit with fee charge of $15.00. !be 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. WADING TO OWNER: YOUR FAILURE TO RECORD A NO'J'ICE OF COHHDCEIlllNt' HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEIlllIl'S TO YOUR PROPERTY. IF YOU INt'BMD TO OBTAIN FINAIICIRG, COKSULT WITH YOUR LENDER OR All AnoRDY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "KOTICE OF COMMENCEHEIfI". SIGIIAIURE: ~'J. STATE OF FLORIDA 0 coum OF r 1/-8CD The foregoing instrument was acknowledged before me this I /;;L , 19U by I who is personally known to me or who has produced as identificati not take an oa (Name Typed, Printed or Stamped) NOTARY PUBLIC KEITH CORREIA MY COMMISSION' CC 451416 EXPIRES: May 13. 1999 Bonded l11m NoIlUY PubIlc Und8rNl\llllS STATE OF FLORIDA ~ coum OF F ;(96 () The foregoing inst~t was aCknowledged before me this I , 19-22- by who is personally known to me or who has produced as identif~d. who did/did not take an Oa '. ,C ~:a- (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC CORREIA \ , .......r.....' KEITH15S,^", . CC 451416 , ~.~, MyCOMM M' . l~~~';. EXPIRES' May 13. 1999 ~ ~.: :~: . \JIIdlIlWlI\8IS ~. '/i>~ n_~....d l11m NoI8IY P\IIlllC "~~,Rf.~~..~ DUlftIVU (RJ:.5IDPJUIAL USE ONLY) . r'ARCtL I.. D. I( SEe ~ ~ :L( 00(0 /?S-oo I'ROPEHTY 11EASUHEHENT 5)-)-;- ~ct1~); lU~C K _ / ('3 / . SUUU ----'- . ULOCK: OOro ~ LOT ~ T\H' ~ CUIUU::f~T b~NEHS J3/~fI L,' . IwrE .~ "or olll'inrce.ls or .lo.to f'ive. acres or le:;s. All Cira\iings dwll be drn\lfl to Denle 1. I , ~O 10 (It,) 57"tf-C-.-C t- tfrJCifd( /'J.-- 'f( f P~1/:8 5' ~ -I r l::> IT E-y... ('5 T 1,u0 ~ tf-f-r) . fEY-1ST; ~ c-, I~ 11.4.- -T1 3 ,f;t/c If ~ 87 SHO~ ALL EXISTING J\ND PROPOSED STRUCTURES GIVlliG DIH.E.HSIOHS J\ND SETBACKS. I,LSO, INDICATE MI' BOIJIES OF HATER AND RO/illHAYS (INCLUDING NAMES) ADJACENT TO TilE PHOPEHTY. INIJIC/ITE THE SIZE, YEAR, "~"l!) !-l!'_~E OF ~0InLE: SUCH AS 12' ^ 60'. 1:181. FLEETwOOD. All "EASEMENTS", "RIGHT-Of-HAY" arid "JURISDICTIONAL LINES" must be shown on all sire plans. f1() tlC1T r~:rp()^rll ]I:TI1 'If" ".r-F'<I-':T 'IIT.. . ...'1"...."...,