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Home My WebLink About97-6413 BUILDJt~~~HY~L~RM!! N! -641313 (813) 788-6611 Date ) .-.:l '1- 7 '? ~ P,"perty owno,rf?,LrfZ1 ~ ~d ~~ Job Address: .3 ?-?___-:!!!!~~_ P~rceII.D. # .,,:L-{)b -;)../ - / I~ ... 0 - '-0 r Zoning: Energy Code: Radon Gas: . Dooc';ptlonofWo,k !;~Lr-f ~.?-1/ ~ A;~ '4Ar/~/...~~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: NO OCCUPANCY BEFORE C.O. FINAL ~ ,7 17 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.t Permit Fee 62-b -~,t?-~ ' Signature~ Yn (_~ Company Address Telephone# Valuation or Contract Price E-crz> ~ th) City License Registration # State Certified License# OJ..... 1}-"l..a.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. APPLICATION FOR PERKI.T CITY OF ZEPHYRHILLS BUILDING DEPARTMENT / /;lS - 77 OWNER'S lWIE Q~ J!, ~ Chw.. In. W~ PHONE 8' I d - 17'1- '1 (J ~ / OWNER'S ADDRESS 3R 7 J7 V~C-d/t<../ &~ JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL LD..,;J ~ de. .- ;).../ - J D- 0 - Lo "7 SUBDIVISION (OBTAIN FROK PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ~Alteration _Repair _Install _Sign ~ove _Deaolish . PROPOSED USE: _Single Faaily _KIF _' of Units _K/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK. g~, ~ ~ fk1;;( ~ ~ 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 FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKI.TS REOUESTED -X.BUlLDING $ g- cJ7J . ,7(/ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _MECHAlU.CA.L $ Valuation of Hechanical Installation _PLUMBING GAS ROOFING SPECIALTY 'fYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS 'PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY /) 'v,..... ~. A " State Cert. or Regist. t Signature(~' r \ ~~ City License Registration' ****************************************** ELECTRICTAN -t)7' ~,-~)~A~a COMPANY State Cert. or Regist. f SiQnAture City License Registration . ****************....*.****..************** PLUMBER COMPANY State Cert. or Regist. . Signature City License Registration . *********************.*************.*****. MECHANICAL COMPANY State Cert. or Regist. t Signature City License Registration . **********************.******************* OTRRR COMPANY State Cert. or Regist. , Signature City License Registration f ********************************.********* APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perait lay be subject to "deed 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 lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requireJents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building DepartJent, (813) 788-6611. FurtbeIlOre, if the owner bas hired a contractor or contractors, be 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 tbe contractor wishes you to sign as contractor that JaY 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 oLAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of -Plorida's Construction Lien Law - HOJeOIDer's Protection Guide" prepared by the Plorida DepartJent of Agriculture and Conslller Affairs. If the applicant is SOJeOJle other than the -owner", I certify that I bave obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to cOlleDcelent. 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 cOlpliance with all applicable laws regulating construction, zoning, and land developllent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas cOlleDced prior to issuance of a perait and that all work will be perfolled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developJeDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governJeDtal agencies JaY apply to the.intended wort, 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: I DepartJent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater freatJent t Soutbwest Florida Water HanageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t Aray Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health & Rehabilitative Services, EnviroDJeDtal Health Unit - Wells, Wastewater Treatlent, Septic Tants t US EnviroDlental Protection Agency - Asbestos abateJent I also certify that, if fill Jaterial is to be used in Flood Zone "A. or "A,etc.., it is understood tbat a drainage plan addressing a .cOJpeDsating volllle" will be subJitted 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 perait prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or VIolations of any code. Every perJit issued sball beCOle invalid unless the wort authorized by such perlit is COllel1ced within six IOnths of issuance, or if wort authorized by the perait is suspended or abandoned for a period of six IOnths after the tile the wort is couenced. One 90 day I!Itension of tile, JaY be allowed for the perait 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 IOntb period, or the project will be considered abandoned. WARlHNG TO OWHER: YOUR FAILURE TO RECORD A NOTICE OF COIlMENCKMHH1' MAY RESULT IN YOUR PAYING fIIlCE FOR IMPIlOVEMENl'S TO YOUR PROPERTY. IF YOU IH1'EHD TO OBTAIH FIlWlCIHG, CONSULT WIm YOUR LEHDER OR AM AnDRJlEY BEFORE RECORDING YOUR MOTICE OF COMMENCEMEliT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AIfD POST A "NOTICE OF COIlMENCEMEH1'". SIGJlATURE: OVIIER OR AGEH1' SIGMATURE: COH1'RAC'fOR STATE OF FLORIDA COIJN1'Y OF The foregoing instrument was acknowledged before me this , 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 vI . . (, / ' . , . \I /, /' Ir) t!;;;. 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