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Home My WebLink About97-6468 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N! - 64688 Date J} - J '? - 9 "} ELECTRICAL PLUMBING MECHANICAL Sewer Conn P<aperty Own.' 7f/1; ,,:... v~, 1?~ "O~ Job Address: l '3 / ,- th Parcel 1.0. # J;). - ~ b ~- d-/ . Water Conn: Water Meter: T,I.F.'s: Zoning: . Energy Code: Description of Work "'P.z _""__ J? Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL })1 '17 DATE Complete Plans, Specifications and Fee Must Accompany Application, C.O. All work shall be performed in accordance with City Codes and Ordinances, Inspector DATE ol? Permit Fee ~ 0- t?-i) Signature~1,r~ ~-~"1'1~ Company Address Telephone# Valuation or Contract Price & Y;;2-g-v City License Registration # State Certified License# ~ 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 PERMIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER' S NAKE LU ,lit '2 n1 OWNER' S ADDRESS J 'i / I 7 JOB ADDRESS 3 CJ II 7 LEGAL DESCRIPTION: LOT(S) PARCEL 1.D.' Jd -~ b '-02 / - .L rn ~a,12-j- h 7F /JcJe. 6 # /lv+>, ]) u fJU/I I PHONE 7g:>J~oJ..r BLOCK SUBDIVISION (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction ~Addition ----^l.teration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single Faaily _H/F _' of Units _M/H _~ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: fu71M4 I BUILDING SIZE: X (./.0 Y.JrlJ/~c:~ -P-e/7ce f p 7" 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 REOUESTED _BUILDING $ 6 7;:2. ...r-o Valuation of Total Construction _ELEGTRI.CAL AMP Service Florida Power Corp. W.R.E.C. _MEGIIANlCAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY 'nPE OF CONSTRUCTION: _Block _Fraae _Steel Other FDlISBED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA., YES NO ****************************************** CONTRACTOR SECTION BUTT.DER Signature -YW/t-t::h:n COMPANY ( \ , State Cert. or Regist. . J--.j~/"UJ City License Registration t ***** ************************************ F.T.F.GTRICIAB COMPANY State Cert. or Regist. t City License Registration . ****************************************** SianAture PLUMBER COMPANY State Cert. or Regist. t City License Registration . ****************************************** Signature MECHANICAL COMPANY State Cert. or Regist. # City License Registration . ************~***************************** Signature OTRF.R COMPANY State Cert. or Regist. . City License Registration t ****************************************** Signature APPLICATION APPROVED BY PERMIT OFFICER. " CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands tbat this peIlit lay be subject to .deed restrictions" wbicb lay be lOre restrictive than City regulations. The undersigned assUles responsibility for coapliance witb any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents laY apply for the intended work, they are advised to contact tbe City of Zepbyrhills Building Departlent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the .Contractor Sections. of this application for wbich 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 wisbes you to sign as contractor that laY be an indication that be 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 ~AW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of .Florida's Construction Lien Law - HoIeowner's Protection Guide" prepared by the Florida DepartJent of Agriculture and Consuaer Affairs. If the applicant is sQJeOne other than the .owner", I certify that I have obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the .owner" prior to cOlleDceaent. E. CONTRACTOR'SjOWNER'S AFFIDAVIT I certify that all the inforaation in tbis application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developaent. Application is bereby 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 peIlit and that all work will be perforJed to teet standards of all laws regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governaental agencies tay apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to: * Departlent of Environaental Regulation - Cypress Baybeads, Vetland Areas and Environaentally Sensitive Lands, Vater/Vastewater Treatlent * Southwest Florida Vater Managelent District - VeIls, Cypress Baybeads, Vetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departaent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treataent, Septic Tanks * US EnvirODlental Protection Agency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone HA" or "A,etc.", it is understood tbat a drainage plan addressing a .cQlpensating volUle" will be subaitted wbich is prepared by a professional engineer registered in the State of Florida prior to perlit, issuance. A peIlit 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 tbe technical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCOle invalid unless tbe work authorized by such perlit is cOllBDced within sil IOnths of issuance, or if work authorized by the peIlit is suspended or abandoned for a period of sillOntbs after the tile the work is co.enced. One 90 day extension of tite, laY be allowed for the peIlit with fee charge of $15.00. tbe extension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each sillOnth period, or the project will be considered abandoned. WARMING TO OWNER: YOUR PAl LURE to RECORD A NOtICE OF COMMDCBMIlft' MAY RESULt IN YOUR PAYING nllCE FOR IMPROVIIIIIft'S to YOUR PROPERTY. IP YOU INfEND TO OBtAIH PlNAlCING, COIfSULT VITH YOUR LENDER OR AIf AnoRIfEY BEFORE RECORDING YOUR HOfICK OF COMMEIfCKMBNf. JOBS UNDER $2,500 IN VALUE DO NOf NEED TO RECORD AND POST A "NOfICE OF COIIIEHCEMEIft'''. SIGNATURI: OIfNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA COUIfTY 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 o~th. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC ~ =-' It ~ .... .s~ 70 ) .. ~ 28,0' ~ ~ ... :-0 r~ '" ~ ~~ ~ ~ .: i LI~ f\ ' " ~~ ~ ~I /~. 1 ~I~ ~ ~, ~~ tlll~ ..2J7.B ~I 'i, ~ I I III 'I ';5'" ~ \Q ~ ':'l -..... ~ l'\ 'I .... 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