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Home My WebLink About97-6412 BUILDING PERMIT Nt? 6412]: CITY OF ZEPHYRHILLS (813) 788-6611 Permit Date 1- ~Lf -7'~ BUILDING ~ PLUMBING MECHANICAL Sewer Conn Water Conn: P.oportyowno" f)~ _KJM~:~~ Job Address: ~ /' ? {p .~ . ~ Water Meter: T.I.F.'s: Parcel 1.0. # Zoning: Energy Code: Description of Work "V ~ -7 Radon Gas: ~~;~ _~..~-ffJ 1-'}'9-7'? 9.'3 7 ~Z-- h Vi1. FINAL ~ 7>~ ;I?~ 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 Valuation or .///' 1 Contract Price 7- tt: City License Registration # / '7 {, / State Certified License# Signatu Company Address Telephone# ~J'P.A,. ~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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. APPLlCAnON FOR PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTKERT OWNER'S lWmOAlL W^ 1 ~~ PHONE ~7S~- <3'410 OWNER'S ADDDSS 73'35 r~1UL till;:=> 'L-"lttLl..S JOB ADDRESS OAIL 12JN .~~ ee0C LEGAL DESCRIP'llON: LOT(S) BLOCIL--SUBDIVISION PARCEL I. D..--..1if - t 5 - Z I - t:J{)OO .- rn 5Lf) '-0/1 D (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~ew Construction ---Addition ---..Alteration .--Jlepair _Install _Sign --'love ->>eaolish PROPOSED USE: _Single F_ily ---.J4/F _' of Units _K/H _ec:-ercial _Indust. _Swia. Pool _Other .--Jlestaurant Ii: Health Departaent Approval DESCRIPTIOII OF WORK: .~ rip JEe(~kl<v~ WGLL- BUILDIIIG SIZE: x ~uare Feet, Height DSIDEIITIAL: ATTACH (2) PLOT PLAIIS Ii: (2) SETS OF BUILDIIIG PLAHS Ii: (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDIIIG PLAHS Ii: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION. PERKITS REOUESTED ~UILDIIIG ~ELECTRICAL --lIEClWlICAL ~UHBIIIG $ Valuation of Total Construction ~ Service KFIorida Power Corp. W.R.E.C. $ Valuation of lIechanical Installation GAS ROOFING SPECIALTY TYPE OF OOliSTRUCTIOII: _Block _Fraae _Steel Other FDJISIIED FLOOR ELEVAnOIlS: F'I' . IS PROJEct III FLOOD ZOIlE AREA? YES NO .......................................... CONTRActOR SEctION BIJTl.DRR COIIPAIIY State Cert. or Regist. . City License Registration . ....................................... Signature COIiPANY gj)jJ AAlN r;~cre~L State Cert. or Regist. . City License Registration . .......................................... /4-(" ( . PLUHBER COIIPANY State Cert. or Regist. . Signature City License Registration . .......................................... IlECBARICA.L COMPANY State Cert. or Regist. . Signature City License Registration * .......................................... OTRRR COMPANY State Cert. or Regist. . Signature City License Registration f .......................................... APPLlCAnON APPROVED BY PERMIT OFFICER. .. .. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS 'l'be undersigned understands that this perait laY be subject to "deed restrictions" wbich lay be lOre restrictive than City regulations. !he undersigned assUJes responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas 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 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. Furtheraore, 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 peraitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOII!OI01er's Protection Guide" prepared by the Florida DepartJent of Agriculture and COnsWler Affairs. If the applicant is sOJeone other than the "ownerR, I certify that I bave obtained a copy of the above described docUJellt and prOJise in good faith to deliver it to the "owner" prior to co.enCetent. 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 cQIPliance with all applicable laws regulating construction, loning, and land developJellt. Application is hereby Jade to obtain a perait to do work and installation as indicated. I certify that no work or installation bas C31enced prior to issuance of a penlit and that all work will be perfol'led to leet standards of all laws regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also certify that I understand that the regulations of other goverJllelltal agencies laY apply to the intended wort, and that it is IJ responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to: t Departlent of Bnvirontel1tal Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands, Water /Ifastewater 'l'reatlent t Southwest Florida Nater Hanagetent District - Nells, Cypress Baybeads, Wetland Areas, Altering Watercourses t AllY Corps of Engineers - Seawalls, Docks, Ravigable Waterways t Departlent of Health & Rehabilitative Services, BnvirOlllel1tal Health Unit - Wells, Wastewater 'l'reatlent, Septic 'l'anks t US BnvirODlelltal Protection Agency - Asbestos abatetent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.R, it is understood that a drainage plan addressing a "COIP8Dsating voluteR will be sublitted wbich is prepared by a professional engineer registered in the State of Florida prior to perait issuance. A pertit issued sball 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 perait prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Bvery pertit issued shall beCOle invalid unless the work authoriled by such perait is COllllJlced within six IOnths of issuance, or if wort authorized by the perait is suspended or abandoned for a period of sil IOntha after the tile the work is COllllJlced. One 90 day extension of tile, laY be allowed for the pertit with fee charge of $15.00. 'l'be extension sball be requested in writing to the Building Official. An approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned. WARlUMG '1'0 OWIBR: YOUR FAILURE '1'0 RECORD A RorICE OF COIHBRCBIlBIf'I MAY RESUL'I' 1M YOUR PAYIRG 'l'WICE FOR IHPROVBHBR1'S '1'0 YOUR PROPD'I'Y. IF YOU IJl!BIfD '1'0 OB'I'AIR FIIW1CIRG, COIfSUL'I' WI'I'B YOUR LlllDBR OR All A'I"I'ORIBY BEFORE RECORDIRG YOUR IIO'I'ICE OF COHHEIfCEHBN'I'. JOBS UNDIR $2,500 1M VALUE 00 lor REID '1'0 RECORD AID POS'I' A "lorICB OF COHIIBIfCBHm'". SIGIA'I'URI: OIOIIR OR AGEIf'I' SIGIIA'I'URI: COII'I'RAC'I'OR S'I'ATB OF FLORIDA coum OF The foregoing instrument was acknowledged before me this , 19____ by S'I'A'I'B OF FLORIDA COUN'I'Y 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) (Rame Typed, Printed or Stamped) ROTARY PUBLIC (Signature) (Rame Typed, Printed or Stamped) ROTARY PUBLIC