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Home My WebLink About97-6558 BUILDING PERMIT N! Permit 655SE CITY OF ZEPHYRHILLS (813) 788-6611 Date :3 -)3 '-? 7 BUILDING ~~ PLUMBING Property Owner: ~~ ~ ~ Job Address: . -s.S ..2/ tl f LA. a.. ~ Parcell.D. # MECHANICAL Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: Energy Code: Description of Work r!JI3.4:"h~ ,~ c/ Radon Gas: .-410 NO OCCUPANCY BEFORE C.O. FINAL Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Valuation or Contract Price Permit Fee. ;a . zr-V S;gnaMe -;; _ ~_ Company _ Address Telephone# -f/ti c2...3 7 , City License Registration # State Certified License# ~YdL~ BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter 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 ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAKE ~ j {l e-P , OWNER'S ADDRFSS LIJ r '9 tJ ~ ~ JOB ADDRESS =55 Z I ~~. LEGAL DESCRIPTION: LOT(S) BLOCK PHONE 11/-tJ SUBDIVISION PARCEL 1. D,' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign _Move _Deaolish pmPOSED~E: _Si~leF~i~ _KIF _' of Units _M/H _ec-ercial _Indust. _Swia. Pool _Other DESCRIPTION OF WORK: _Restaurant & Health DeparbBent Approval ;;t~ duL BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COKKERCIAL : ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELEC'l'RICAL AMP Service Florida Power Corp, W.R.E.C. ---1IECIIANlCAL $ Va1uation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUC'l'ION: _Block _Fraae _Steel Other FlRISBED FLOOR ELEVAnONS: FT, IS PROJEC'l' IN FLOOD ZONE AREA? YES NO ****************************************** CONTRAC'l'OR SECTION Burl.DER COMPANY State Cert. or Resist. . City License Registration . ************************** ************* Signature ::=: ~ COMPANY . ?~ State Cert. or Regiat. . City License ReSistration . ~ **************************************** PLUMBER COMPANY State Cert. or Resist. . City License Registration . ****************************************.* Signature tlECllANlCAL COMPANY State Cert. or Resist. . City License Registration . ***********~****************************** Signature OTRRR COMPANY State Cert. or Regist. . City License Registration f *******.**.*.*********.**......**....*.... Signature APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A" NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to "deed restrictionsn which .ay be lOre restrictive than City regulations. The undersigned assUles respon8ibility for cOlpliance with any applicable deed restrictions. B" UNLICENSED CONTRACTORS AND CON'l'RAC'l'on RESPONSIBILI1.'IES If the ONner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordance with state and local regulations. If the contractor i8 not licensed as required by law, both the owner and contractor lay be cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirl!Jlents lay apply for tile intended work, they are advised to contact the City of ZephyrhiIJs Building Depart.ent, (813) 788-6611. FurtherlOre, 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 ONDer sign as the contractor, you are indicating that you, rather than tIle contractor, are responsible for the work. If tbe contractor wisbes you to sign as contractor tbat lay be an indication that he is not properly licensed and is not entitled to perlitting privilegl8 in the City of Zephyrhills. C, TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES ,~ D, ~ONS'l'RUC'l'ION LIEN LftW (CIIAP'l'ER 713, FLOIUDA STA'l'UTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ HOIeOIDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOleDne other than the .owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the "owner" prior to couencl!Jlent. E. CONTRACTOR' S/OWNER' S AFFIDAVI'l' I certify that all tbe inforlation in tbis application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, loning, and land developlent. I \ Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no wor1 or installation bas cOllenced prior to issuance of a perlit and that all work will be perfolled to leet 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 otber govefRIental agencies lay apply to tbe 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: * Departlent ot EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent * Soutbwest Florida Water Hanag8lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * Arl' Corps of Engineers - Seawalls, Docks, Navigable Waterways * Departlent of Health & Rehabilitative Services, BnviroDlental Health Unit - Wells, Wastewater Treallent, Septic rants * US BnviroDlental Protection Agency - Asbestos abatelent I also certify that, if fIll laterial is to be used in Flood Zone nA" or nA,etc.., it is understood that a drainage plan addressing a .colpensating volUleR will be sublitted which is prepared by a professional engineer registered in tbe State of Florida prior to perlit, issuance. . A perlit 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 sball issuance of a perlit prevent the Building Official frUl thereafter requiring a correction of errors in plans, construction, or vioiations of any code. Every perlit issued shall beCOle iDvalid unless the work authorized by sucb perlit is cOllenced witbin six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six lanths after the tile the work is c..enced. One 90 day utension of tile, lay be allowed for the perlit with fee charge of $15.00. Tbe extension sbal1 be requested in writing to the Building Official. An approved inspection lUst be logged during eacb six IOntb period, or tbe project will be considered abandoned. WARNING TO OWNER: YOUR FAILURK TO RKCORD A HOTICK OF COHIfEHCKHKHT HAY RBSULT IN YOUR PAYlHG TWICE FOR IHPROVIIIDrS TO YOUR PROPBRfY. IF YOU INTBND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDBR OR AN ATTORIIY BIFORI RlCORDIMG YOUR MO'lICE OP COHHHNCEHKNT. JOBS UNDER $2,500 IN VALUR DO NOT NEID TO RICaRD AND POST A .NOTICK OF COMMRNCIMIHT.. SIGNArURB: OWNIR OR AGINT , I SIGNATURE: CONTRACTOR STArl OF FLORIDA COUNTY OF The foregOing instrument before me this was acknowledged , 19_ by STATK 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 bas 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