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Home My WebLink About97-6575 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N! - ,..- 6575 It:. Date .3,- f g- - r /' BUILDING GLEC;~~ ::::::~eJ?!L~U Parcell.D. # PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Description of Work t!k~ LJ~ , c:2:~() Radon Gas: FINAL DATE ?J/(EA ~ .! -~-r;7 NO OCCUPANCY BEFORE C.O. Yl ;111 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 Signature Company Address Telephone# ::LtJ_cTV ~~,~~ City License Registration # State Certified License# ,~A- /g-t] Valuation or Contract Price tJ~ {~~ 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 PERKlT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT LOT OWNER · S NAME GILLmORE- LOT ~ ~ E Y)\e..('~\J, ~<..J PHONE OWNER · S ADDRESS Pt:l\ n -\- G JOB ADDRESS LEGAL DESCRIPTION: LOT(S) ~lo BWCK SUBDIVISION PARCEL 1.D.# (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ~epair ____Install ____S ign ~ove _Deaolish PROPOSED USE: _Single Family ~/F _, of Units ____M/H _Commercial _Indust. _Swia. Pool _Other _Restaurant & Health Department Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PWT 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 $ Valuation of Total Construction ~ELEC'fRlGAL 100 AMP Service Florida Power Corp. W.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr8JIe ____Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FWOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION COMPANY State Cert. or Regist. I City License Registration , ****************************************** BUILDER Signature ::::~7$pp . COMPANY-,( t:2u a~ r etIf State Cert. or Regist. "f:.-S OOOct!:> 'i City License Registration" ) g 7 ****************************************** PLUMBER COMPANY State Cert. or Regist. I Signature City License Registration # ****************************************** MECHANICAL COMPANY State Cert. or Regist. # Signature City License Registration # ***********~****************************** OTHER COMPANY State Cert. or Regist. # Signature City License Registration , ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perJit lay be subject to .deed restrictions. which lay be lOre restrictive than City regulations. The undersigned assUles responsibility for cOlpliance with-any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas 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 lay be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requireaents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813) 788-6611. FurtberlOre, if the owner has bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the 'Contractor Sections I 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 he 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 - HOIeow.ner's Protection Guidel prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the lowner", 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 cOllenceJent. 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 co.pliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perJit and that all work will be perforJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in ~e jurisdiction. I also certify that I understand that the regulations of other governtental agencies lay apply to the intended work, 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: t DepartJent of Environlental Regulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Kanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable,Waterways t Departlent of Health & Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US Environlental Protection Agency - Asbestos abateaent I also certify that,' if fill laterial is to be used in Flood Zone "A' or "A, etc. " it is understood that a drainage plan addressing a .colpensating volUlel will be sub.itted'whicb 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 is~uance of a perlit prevent the Building Official frCl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall becOJe invalid unless the work authorized by such perJit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, JaY be allowed for the perJit with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. An approved inspection lust be logged during eacb six IOnth period, or the project will be considered abandoned. WARNING TO OIiNER: YOUR FAILURE TO RECORD A NOTICE OF COHKEHCEKEHf KAY RESULT IN YOUR PAYING '!'WICE FOR IKPROVEKEHfS TO YOUR PROPERTY. IF YOU IHfEND TO OBTAIN FINANCING, CONSULT WIrH YOUR LENDER OR AN AnORHEY BEFORE RECORDING YOUR NOTICE OF COKKENCBKEHf. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COKKRHCHKRHf". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY 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) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC