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Home My WebLink About97-6633 .,~ ~) BUILDcr!t:~9Hy~!RM!,! N! -6633,i3 (813) 788-6611 Date '1- 9 - 77 ELECTRICAL PLUMBING MECHANICAL Sewer Conn ",operty Owne, H <L.r!!:. Job Address: .~ b ~ ~//,--p~ Water Conn: Water Meter: T.I.F.'s: Parcel I. D. # Zoning: Description of Work En7 Code: _~/D Radon Gas: NO OCCUPANCY BEFORE C.O, FINAL Complete Plans, Specifications and Fee Must Accompany Application. C,Q, All work shall be performed in accordance with City Codes and Ordinances, DATE Inspector City License Registration # State Certified License# 70 Permit Fee Signatur~ Company Address Telephone# v~ Valuation or Contract Price R"";).. :L ~~-~~ BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr, Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl, Compressor Final 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 f:/fI(. L LeA-v / c{ OWNER'S ADDRESS 3 9, :X) C~~V 0-4v r-2 ~ ~~ !}.Rh~ OWNER'S NAME PHONE 7~';'6 71 rJ ~ ~ J6i'/!JY- JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL LD.t .2 <f ';Ub,:;L( IfMD ()O/OO ~ (OQ~IN FROII PROfJ:RTY T~TICEl WORK PROPOSED:_New Construction _Addition --.Alteration _Repair _Install _Sign _Hove _Demolish PROPOSED USE: _Single Family _H/F _' of Units _H/H _Commercial _Indust. _Swilll. Pool _Other DESCRIPTION OF WORK: _Restaurant & Health Department Approval b \('3 /?eL 17?13 5'~ 77) (A:JS7)t-C...c BUILDING SIZE: b x~ '-f'<t 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, <6~ .cJ0 PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _HECHAHlGAL $ Valuation of Hechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO BUILDER CONTRACTOR SECTION ~~=--==~8 COMPANY 5' o,v 5'~ /---~~,_/.. State Cert. or Regist. , ~/; ~-=--<....... City License Registration' ' ",,...-"- ****************************************** A-u Qf / /lJ tJ I( 7(') Signature ELECTRICIAN COMPANY State Cert. or Regist. # Si2nature City License Registration # ****************************************** PLUMBER, COMPANY State Cert. or Regist. # 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 perlit 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 has 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 lisdBleanor violation under state law, If the owner or intended contractor are uncertain as to what licensing requirements lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Furthermore, 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 owner sign as the contractor, you are indicating that you, rather than the contractor, are responsihle 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 - HOIeowner's Protection Guide" prepared by the Florida Department 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 docUlent and pro.ise in good faith to deliver it to the "owner" prior to couenceJent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all ~ork will be done in cOlpliance with all applicable laws regulating construction, zoning, and land development, Application is hereby lade to obtain a permit to do work and installation as indicated, I certify that no work or installation has cOllenced prior to issuance of a permit and that all work will be perf oIled to leet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in th~ jurisdiction. I also certify that I understand that the regulations of other goveInlental agencies may apply to the intended work, and that it is my responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not limited to: t Department of Environmental Regulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater TreatJent t Southwest Florida Water Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Services, Environmental Health Unit - Wells, Wastewater TreatJent, Septic Tanks t US EnvironJental Protection Agency - Asbestos abateJent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc,", it is understooc that a drainage plan addressing a .cOlpensating volUle" will be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to permit, 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 issuance of a permit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code, Every per.it issued shall becOle invalid unless the work authorized by such permit is co..enced within six months of issuance, or if work authorized by the per.it is suspended or abandoned for a period of six IOnths after the tile the work is cOllenced, One 90 day extension of tile, aay be allowed for the per.it with fee charge of $15,00, The extension shall be requested in writing to the Building Official, An approved inspection must be logged during each six lonth period, or the project will be considered abandoned, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKHENCEMENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, COKSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COHmC<KEHT~_~~-:L~ DO~ HEED TD RECORD AHD ~~.~ C ,//" (H" ~_C~:==_H "') ~:E.::::~:::H_-'--'-- - SIGNATURE: OWMER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA ;jJ COUNTY OF 1/ 4-- S- C-l) The foregoing ins~~;nt was acknowledged before me this --'f~' 19:11- by STATE OF FLORIDA ~ COUNTY OF r ,f-S'" c -c.J The foregoing insttument was acknowledged before me this . L/(/ .2- , 19.!l1- by who is personally known to me or who has produced as identification and who did/did not take an oath~ ~.. (Signature) who is personally known to me or who has produced as identification and who did/did not take an oath. ~./K ~--e.. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC "'''''' KEITH CORREIA 416 ~t-""',l'Si~\ MY COMMISSION' CC 461 ~*!~:*~ EXPIRES: May 13. 1999 .~ .'J: P\IIIIC \nIIlWIftIIII ~1~' , . ~.: IIOIIdId tllnI NaIIIY ~,Rftl~' (Name Typed, Printed or Stamped) NOTARY PUB . T r KEITH CORREIA /P;,a;' :v.'~\ MY COMMISSION' co 451416 i*! :*~ EXPIRES: May 13. 1999 ~;., , t~! IIOIIdId tllnI NalIIY PuIlIC \hIIIWIIlIII 'Ji,p,f" , SITE 1'I...A.N (RESIDENTIAL USE ONLY) j PARCEL I. D~. ( TWl' P-I RNG &f1~ () o(.)!L SUBD ?,,/I{); (:)01 ()'"O BLOCK ;};b LOr 2t SEe ;u; PROPEHTY MEASUREMENT CUIUU-Xl' OWN EHS ~L- ~MVI 'IT DATE shall L_ drawn to scale for nll parccl~ or lots five acrc~ or less~ All drnwlngs LX.: <q6 '1 /oJ 9flfu.- /f7J G ~Il 6' b '? <j{ fu &If> 5'~ l..L:- 10 .' ... SHOW ALL EXISTING AND PROPOSED STRUCTURES GIVlllG DDi.ENSIONS AND SETBACKS, ALSO, INDICATE ANY BODIES OF WATER AND ROADWAYS (INCLUDING NAMES) ADJACENT TO THE PHOPEHTY. INDICATE THE SIZE, YEAR, k~D N~~E OF MOBILE; SUCH AS 12' x 60'. 1981. FLEETwOOD, All "EASEMENTS". "RIGHT-OF-WAY" and "JURISDICTIONAL LINES" must be shown on all site plans.