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Home My WebLink About97-6642 ~-s-. tttJ BUILD1~9Hy~!RM!! N' 664aJ3 (813) 788-6611 Date i- / / - <; 7' ?-1J.. UV ~CTR~:::> PLUMBING MECHANICAL Sewer Conn Water Conn: 0UI~ P,operty Owne' ~ 4A-~ ~f3z1- Job Address: .3 ) - /.. av-r<- Water Meter: T.I.F.'s: Parcel I. 0, # Zoning: Description of Work Energy Code: Radon Gas: J..A1'7;U~"-- f(~/f~/l/~~ FINAL DATE NO OCCUPANCY BEFORE C.O, Complete Plans, Specifications and Fee Must Accompany Application. C,O, All work shall be performed in accordance with City Codes and Ordinances. DATE Valuation or Contract Price I?- 07J . / cro Inspector Permit Fee ~......, ~i) ;.' Signature .1,/ i ,.' {/\..( L I j Ie /~ Company Address Telephone# ;'/ City License Registration # State Certified License# BUILDING ~ /..A.k> / 70 I ELECTRICAL (",~A PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. 4--14 -G'" Insul. CL WL Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final 12.u.. (J Tp. Servo Rough In 4~\~-q'1 ~ Meter Can Const. Pole Pool Pre-Meter 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. 1\ ~ \,~ ..(.) (. >~ ',~-\ ~ ~, ~.-t ~ ..:::.... l:. ~,,~ ~') ~~"'-o. .........,. ..... , , '. , ." ... " .', ~...) 3- :>..u ~ n .....~ ~ -~. --; \i "',- ... :.,~ ,""'- .,.:-.... .r' \) -\ -<. \r- ( ",", ~.~ '\ ~ ,1'1"':: .. "'(j ..,-:.... ~ \~ ~. -J <:,J \ ... 0:..' -\. .~ I.." .~ ,-- ..'-' ~~-_..__._, ...,' 1~ . ~''- i' ~, V'" I . ,.,/,-_._'^~._' " ~, ..~ ~> I ~ -c: \r~\ ')c.l ) ~~'., c., ~ \\; '; '>\) ,,0 t:l ~ \". " " '4 " ~ ,:;0.' \ " .. \..1 -- ~ ~ ...., 1:; ".:c: \ , .... ,~ ~ '\ '- " '" .:A.. .~ '\, .t \\.. \^ ~ ~ <1: rJ '1 'J ~ 0. 'D ~" 'N ~ ,E q '!J (~ ? f! ~ ~ * ,'.I. -t oJ :e.. .J l- .. ,.~ '~ ~ ) ............ ..:. \ . ~: ~. " ~ , ~~ .~ ~ ~ ~ ':'j,"'I<it. \'.\ :""<.. ~., \1 ': , ). , I \.. .... " .'.... " ('.. J '-.. ! ! ~ i ~ T :Jii -J",I ".2> ~ '.'t 'i... '~ ~ , !~ ~ J ~ \.) 't ~ ~. ~. ::it:8t:e \#erl:. or Keg1sL, tf ~ '~ ~ II) '" ~ . ~ 0 ~ ($-. I '~ ~ ''-J ~ . l~ 't \~ '~ ~ ,-' \C ~ ~~ ~ ~ ,,0 t I~ . ~ . \~ \: V\ 1:::- ~ ~ C- ~ -.: ~ ~ ~ .\$ ~ ''" \~ ~ V) \0 ,~ ~ ~~ k. \(j \ .:\ <t '" ~ l' ~ '.t W,} ~ ~, c\ ~ " '1-.. ~ t APPLICATION FOR PERKlT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT OWNER'S NAKE ,) ('nj)19 OWNER'S ADDRESS ..:x:PO..'\-/ ~ L/~e A:: /~ -G- #1/7: PHONE j 7 7 / - cJ '} c;I / . :2: zrtj7/-r~///...r 1,7 JOB ADDRESS '\. \ ~ 1_ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D. f (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Si~leF~ily _M/F _' of Units _M/H _~ercial _Indust. _Swia. Pool _Other _Restaurant &: Health Departaent Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square F~et. 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 $ IQcro. 07~ , Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. -"ECIIAHlCAL $ Valuation of Mechanical Installation _PLUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr~e _Steel Other FDiISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER ~1 .' COMPANY / <> /C.d' :J State Cert. or Regist. f Signatur ~\...'--;r ~~~./ City License Registration f ?/ ****************************************** F.T.R.CTRIClAH COMPANY (\ A 1 ~ State C~. or Regist. f icense Registration f ********************************* CJD Dc? v ,?U PLUKBER COMPANY State Cert. or Regist. f Signature City License Registration . ****************************************** MECHANICAL COMPANY State Cert. or Regist. t Signature City License Registration f ************~***************************** OTIIF.R COMPANY State Cert. or Regist. t Signature City License Registration # ****************************************** APPLICATION APPROVED BY PERKlT OFFICER, CONDITIONS OF PEI~IT 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 OWDer and contractor liy be cited for a lisdeleanor violation under state law, If the owner or intended contractor are uncertain as to what licenSing requirOlents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the owner has hired a contraclor 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 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~' , D. CONSTRUC'!'ION LIEN OOW (CHAPTER "/13, FLORIDA STATUTES I AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ HoJeowner's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs, If tbe applicant is sOleone otber 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 co..enCOlent, 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, zoning, and land developlent. 1\ Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or installation has cOllenced prior to issuance of a perlit and that all work will be perf OIled to Ieet 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 olher goverDlental 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: t Departlent of EnviroDJental Regulation - Cypress Hayheads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water HanagOlent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Bngineers - Seawalls, Docks, Navigable Waterways t Departlent of Health' Rehabilitative Services, BnviroDlental Health Unit - Wells, Wastewater Yreatlent, Septic Yanks t US BnviroDlental Protection Agency - Asbestos abatelent 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 volUle" will be sublitted which 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 tbe 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 frOJ thereafter requiring a correction of errors in plans, construction, or vioiations of any code. Every perlit issued shall beCOlB invalid unless the work authoriled by such perlit 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 eatension of tile, la' be allowed for the perlit with fee charge of $15.00. Tbe extension shall be reguested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARMING TO OIINER: YOUR FAILURB TO RBCORD A NOTlCR OF COHHBNCBHENT HAY RESULT IN YOUR PAYING RICE FOR IHPROVIIIBn'S TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDBR OR AN AnORffEY BBFORE RBCORDING YOUR RO'IICK OF COHHENCHHENT. JOBS UNDBR $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A "NOTICB OF COHHENCHHBBY". SIGNATURE: OWNER OR AGENT , I 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) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC