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Home My WebLink About97-6509 BUILDING PERMIT N! Permit CITY OF ZEPHYRHILLS (813) 788-6611 - 6509/1 BUILDING ~6_ ()I) ~~ECTo/ P<aperty owno' ~1 ~ . Job Address:,- "3 . fiA.Al~ PLUMBING j)l:>--' JD Date 3=3- '17 ~HAN~sewo' Conn Water Conn: Water Meter: T.I.F.'s: Parcel I. D. # Zoning: Description of Work cyf~O,g(1.t~~a Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 3- - 7Yl 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 Permit Fee ~ ---, crO Signature -aelt dr5hfJYl Company Address Telephone# Valuation or Contract Price _~A- i~- City License Registration # State Certified License# BUILDING ELECTRICAL PLUMBING tJE ;fr~t MECHANICAL f2. 0 (;LjJ ~ 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 PKRKIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME f=)Jsel ~o.rr\ BOn OWNER'S ADDRESS 0<:6 7dJ VlXC 1\(\ (' f JOB ADDRESS GCGJcXJ \( u\cc\n CS'. PHONE~(:\~.7<?2' CJ3(oC:f_ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION VI Hose I C1ove, PARCEL I. D. # (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~ew Construction --.-.Addition ---..Alteration ____epair /' Install c)A0- 'l\~ ~ O~)\- _Sign --"ove -PeIIOlish PROPOSED USE: _Siogle Faaily ----.Jf./F _' of Units /K/H _ec:-ercial _Indust. _Swia. Pool _Other ---Restaurant & Health Departaent Approval , DESCRIPTION OF WORK~~t01l 3-~-Q~)n \O'hL~ \--\ej l .(t( c ovd w,{e, Ale..! BUILDING SIZE: x Square Feet, Height RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTAaI (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKITS REOUESTED ~UILDING /' RI.RC'J'RICAL .LJmawnCAL $ Valuation of Total Construction AIIP Service $ {fJO'--\. 9) F10rida Power Corp. W.R.E.C. Valuation of tlechanical Installation ---.:PLUtIBING GAS ROOFING SPECIALTY TYPE 9F CONSTRUCTION: ~1oclt _Fraae _Steel Other FIIIISJIBD FLOOR ELBVAnOllfS: FT. IS PROJECT IN FLOOD ZONE AREA! YES NO .......................................... CONTRACTOR SECTION BIJTI.DER cotIPANY State Cert. or Regist. # City License Registration . .......................................... Signature RI.RCTRICIAII . COMPANY Nee Pi,. Or7~ ::: /ltd!. 'Iii ci: :iJ State Cert. or BeBist. , . ':dol .- " e DC . .~ City Liceose 1legi8tr8tioa' 1'67 ......................................... PLUMBER cotIPANY State Cert. or Regist. # City License Registration # .......................................... Signature HECBANICAL cotIPANYffce Ar on~ c;7'ev. 7Jr:. .It Lt~c1;., State Cert. or lle8ist.' ,OCl'lb,r Signature J C ~'J.. ()}( City License Registration' L{~ ......................................... OTRRR COMPANY State Cert. or Regist. . Signature City License Registration . .......................................... APPLICAnON APPROVED BY PBRKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to 'deed restrictions' wbich lay be lOre restrictive tban City regulations. The undersigned assDles 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 laY be reguired 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requiruents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813) 188-6611. FurtherlOre, if the owner has bired a contractor or contractors, be 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 be is not properly licensed and is not entitled to perlitting 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, have been provided with a copy of 'Florida's Construction Lien Law - BOIeOWDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the 'owner", I certify that I have obtained a copy of the above described dOCUleDt and prOlise in good faith to deliver it to the "ownerl prior to COlleDCeleDt. 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, loning, and land developlent. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation bas COBenced prior to issuance of a Perlit and that all IIOrt will be perforted to Jeet standards of all laws regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other gO'erDJeDtal agenCies JaY apply to the intended IIOrt, and that it is If responsibility to identify what actions I lUst tate to be in cOlpliance. Such agencies include but are not lilited to: t Departlent of BnviroDlental Regulation - Cypress Baybeads, Wetland Areas and BnviroDJeRtally Sensiti,e Lands, Water/Wastewater !reatlent t Southwest Florida Water HanageJellt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health i Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatJent, Septic Tanks t US BnvirODJental Protection Agency - Asbestos abatl!leDt I also certify that, if fill laterial is to be used in Flood Zone IA' or 'A,etc.', it is understood that a drainage plan addressing a 'cOJpeDsating volUJe' will be snblitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A p~lit 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 peIlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCale invalid unless the wort authoriled by such peIlit is co.enced within sillODtbs of issuance, or if wort authoriled by the perlit is suspended or abandoned for a periocJ of sil IODtbs after the tile the wort is coaenced. One 90 day eltension of tile, laY be allowed for the perlit with fee charge of $15.00. !be eltenaioD shall be requested in writing to the Building Official. An approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned. "mIlie '1'0 lMIR: YOUR FAILURE TO RECORD A NorICI! OF COIMBRCIlIIDIIlAY RESUL! Iii YOOK PAYING !IIICI! FOR IMPROVIIImS TO YOUR PROPER'IY. IF YOU mIlD '1'0 OBIAIN FIIlAKCIIG, CONSOLI WIm YOUR LlllDIR OR 111 AnoRIIY BIFORE RECORDING YOUR liorICI OF COHHINCIHIIft'. JOBS UNDIR $2,500 VALUE DO 10'1 tIUD fO RECORD AlfD POST A "NorICI! OF C(JlHINCIlIIIMTII. VUc/cetif SIGIA!URI: COII!RAC!OR ~~O~FFLORIDA &/i The foregoing i~~rument was acknowledged before me this ~ ~ ?' , 19.fL by w~iy ~ wbo bas produced as identification and who did/did not take an 3thJj , _# ;; /J ~LL.L.eJ\.-{2 ~ (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC ,''J.-:;'~:'f~t. FELICE I. ROWLAND {!'li..\;% MY COMMISSION /I GC390799 EXPIRES ~.~{~f September 18. 1998 ....7f.'if.:;...'<f...'" BONDED THRU TROY FAIN INSURANCe, INC. S!A!B OF FLORIDA // ;1 I~ coum OF / o.-GIZ Tbe foregoing instrument was acknowledged before me this.,r-: ;2 g , 19i7- by '-/J~ ~ wbo is persaiallY known to me or wbo has produced as identification and who did/did not ta~h:~' ~ ~~~ (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC FELICE I. 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