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Home My WebLink About97-6647 BUILDING PERMIT Nil - 664713 CITY OF ZEPHYRHILLS Permit ' (813) 788-6611 Date 11- / '1- 97 ~ ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: P<operty owne'A~~~ff- Job Address: b / / . ' Water Meter: T.I.F.'s: Parcel I. D. # Zoning: ~ Ef\..ergy Code: Description of wo;k / ...1'.L/i~~ r~fo ~- Radon Gas: FINAL ..LJ- 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 Inspector Permit Fee d) O. o-v Signature Company Address Telephone# Valuation or Contract Price .3~O. cTD City License Registration # State Certified License# /.JYlJ~ 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 PERKIT CITY OF ZEPBYRHILLS BUILDING DEPARTMENT OWNER'S NAME rf ~~:fL I 5c, i/ , r:z~~1 " 7' h .--:::z-1T PHONE r/ '3 - 75f'7r 7~ I ~ OWER'S ADDRESS JOB ADDRESS ~--"'~~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction -.-Addition -Alteration -.Repair _Install _Sign _Move _Deaolish PROPOSED USE: _Single FUlily _H/F _' of Units _K/B _~ercia1 _Indust. _Swia. Pool _Other _Restaurant & Health DeparbDent Approval DESCRIPTION OF WORK: ~~.-' - BUILDING SIZE: x 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. ~LDING PERKITS REOUESTED $ 35V.o9 Valuation of Total Construction _ELEC'l'RICAL AKP Service Florida Power Corp. W.R.E.C. _MECllAllICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUC'l'ION: _Block _FrUle _Steel Other FIliISBED FLOOR ELEVATIONS: FT. IS PROJEC'l' IN FLOOD ZONE AREA? ****************************************** YES NO CONTRACTOR SECTION BunnER Signature j(~/ , COMPANY ~ State Cert. or Regist. . City License Registration , ' **** ************************************* RT.RCTRICIAH COKPANY State Cert. or Regist. , SignAture City License Registration , ****************************************** PLUMBER COKPANY State Cert. or Regist. , Signature City License Registration t ****************************************** MECHANICAL COKPANY State Cert. or Regist. , Signature City License Registration , ****************************************** OTHRR COKPANY State Cert. or Regist. , Signature City License Registration , ****************************************** APPLICATION APPROVED BY PERHlT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT ' 'A.- NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject Lo "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 aay be cited for a lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. Furtherlore, if the ONner 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 responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication tbat he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills, C. TRANSPORTATION IMPACT FEES AND U'fILI'fY CONNECTION FEES "t D. ~ONSTRUCTION LIEN LnW (ClmPTER 713, FLORIDA STATUTES1 AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer'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 bave obtained a copy of the above described doculent and prolise in good faith to deliver it to the "owner" prior to couenCelent. E. CONTRACTOR I S/OWNER I S AFFIDAVI'l' 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. I Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no wort or installation has cOllenced prior to issuance of a perlit and that all work will be perf oIled to leet standarda of all 18la regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other govefDlental agencies aay apply to the 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: I Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treallent I Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses · ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways · Departlent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater rreallent, Septic Tanks t US EnviroDlental 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 the 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 fIOI thereafter requiring a correction of errors in plans, construction, or vioiations of any code. Every perlit issued shall beCOJe invalid unless the work authorized 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 tite the work is cOllenced. One 90 day 81tension of tite, tal be allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR PAYING nua FOR IMPROVlllBltS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORK RECORDING YOUR MoriCI OF COHHENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COKHENCKMIMT". . I SIGNATURE: ONNRR OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUM'lY OF The foregoing instrument before me this was acknowledged , 19_ by STATR 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