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Home My WebLink About97-6423 - , BUILDING PERMIT N~ Permit CITY OF ZEPHYRHILLS (813) 788-6611 - 64231J Date /-2(/ -7 7 ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Property Owne" ~~. . '--- Job Address: 33~ ,L.ti:, Parcel I. D. # Water Meter: T.I.F.'s: Zoning: Description of Work .!) E~ergy Code: _/jA.......r-P_~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Permit Fee Signature Company Address Telephone# ;Ll> - Ol-~ Valuation or Contract Price J I -..s '-0. (,)--b City License Registration # ) 98"0 State Certified License# c- ;/Ji BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final Driveway 1/11/q 1 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 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 ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAKE (\1 ~ 1- f<\,R S '33Q01 ~~~ CAIJ ~DAiY fW\Uc t\- (\ L PHONE N/A- OWNER'S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) 4b# BLOCK SUBDIVISION PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED: ~"N:w Construction _Addition ____Alteration _Repair _Install ____Sign ____Hove ____Deaolish PROPOSED USE: ____S ingle Fallily _KIF _, of Units ____M/H ____eo..ercial ____Indust. _Swia. Pool ___Other ____Restaurant & Health Department Approval DESCRIPTION OF WORK: V)(Z\\JL w' ~ ~/ BUILDING SIZE: x Square Feet, Height RESIDENTIAL : COHHERCIAL 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 REOUESTED ____BUILDING $ / I /~ () .&rJ Valuation of Total Construction ____ELEGTRlCAL AKP Service Florida Power Corp. W.R.E.C. _KECHANICAL $ Valuation of Mechanical Installat:ion ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUGTION: ____Block ____Fralle _Steel Other FDlISHED FLOOR ELEVATIONS: FT. IS PROJEGT IN FLOOD ZONE AREA? YES NO .......................................... BUILDER CONTRACTOR SECTION fJIL COMPANY iN..,! [) (0/</<;-/- State Cert. or Regist. , City License Registration , l'f eel .......................................... Signature F.T~GTRlCIAN COMPANY State Cert. or Regist. , City License Registration j .......................................... SiQllAture PLUMBER COMPANY State Cert. or Regist. , City License Registration . .......................................... Signature KECHANICAL COMPANY State Cert. or Regist. I City License Registration , .......................................... Signature OTRRR COMPANY State Cert. or Regist. t City License Registration t .......................................... Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this pecait .ay be subject to "deed restrictions" wbich tay be lOre restrictive than City regulations. Ybe 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, tbey .ay 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 .ay be cited for a .isdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licenSing requiretents .ay apply for the intended work, they are advised to contact tbe City of Zephyrhills Building Departlent, (813) 788-6611. FurtherlOre, if the owner bas hired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of the "Contractor Sections" of this application for whicb they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather tban the contractor, are responsible for the work. If tbe contractor wisbes you to sign as contractor that .ay be an indication that be is not properly licensed and is not entitled to peClitting privileges in the City of Zepbyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN bAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOWJler's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other tban the Downer", I certify that I have obtained a copy of the above described docUlent and pro.ise in good faith to deliver it to the "owner" prior to cOlleDcetent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infor.ation in this application is accurate and that all work will be done in cQlpliance with all applicable laws regulating construction, zoning, and land developllent. Application is bereby .ade to obtain a peClit to do work and installation as indicated. I certify that no work or installation bas couenced prior to issuance of a per.it and that all work will be perfoIJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land develop.ent regulations in th~ jurisdiction. I also certify that I understand that the regulations of other goveIlllental agencies tay apply to the intended work, and that it is If responsibility to identify what actions I .ust take to be in cOlpliance. Such agencies include but are not li.ited to: * Departlent of Bnvirontental Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses * ArtY Corps of Engineers - Seawalls, Docks, Mavigable Waterways * Departlent of Health & Rebabilitative Services, Environtental Health Unit - Wells, Wastewater Yreatlent, Septic Tanks * US EnviroDlental Protection Agency - Asbestos abatelent I also certify that, if fill .aterial is to be used in Flood ZOne "A" or "A,etc.", it is understood tbat a drainage plan addressing a DCOlpensating volUle" will be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to per.it. issuance. . A peIlit issued sball be construed to be a license to proceed witb tbe work and not as authority to violate, cancel alter, or set aside any provisions of tbe technical codes, nor shall issuance of a peIlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball beCOle invalid unless the work authorized by sucb peClit is cOllenced within six IOntbs of issuance, or if work authorized by the peClit is suspended or abandoned for a period of six IOnths after the tile the work is cOllellced. One 90 day extension of tile, tay be allowed for the peIlit with fee charge of $15.00. The extension sball be requested in writing to the Building Official. An approved inspection .ust be logged during eacb six IOnth period, or the project will be considered abandoned. WARMING YO OWMER: YOUR FAILURE YO RECORD A MorICE OF COMMEICEMIlIn' MAY RESULT 1M YOUR PAYING NICE FOR IMPROVEMIllft'S YO YOUR PROPE1m'. IF YOU IIn'EIfD YO OBYAIN FIlfANCIIG, CONSULY WITH YOUR LINDER OR AN AnOmY BEFORE RECORDING YOUR NorICE OF COMMENCEMEIfT. JOBS UNDER $2,500 IN VALUE DO lor MEED TO RECORD AND POSY A "MorICE OF COMMEIfCEMIlIn'". SIGJfATURE: OIINER OR AGBIn' STATE OF FLORIDA COUIn'Y OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA COUNTY OF The foregoing "nstrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC ~UI Lib CA#A/JAy ;~~ ~ /lIV\t AGH l1L .. (J)VZ; :)(). '17 / / / / / / / I I I ( I i I / , CO~~8E. p( 6~. fZ IYJ €5 H , 'K ~\ )I vJf\ i DfZ\ut. 00 . ", ~ -.~ -". - - -- -- f1LL-13:ID$-~ .;2. Cf. 4 ~ fY'At-~M I T[ Dr<. I I f> )C ~ I l~Jl\\-t "ll IV\~L 10 ~op\b (6 l\ 1~(.( <!>t- CON<~~'Eu) I I ~\ ~.l