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Home My WebLink About97-6678 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit -- N! 6678l::. Date 'I-f)~ -7~ BUILDING ~TRIC.~~~? PLUMBING MECHANICAL Sewer Conn Water Conn: PmpertyOwne" ~~K~f!?1' Job Address: .:J... _ _ _ _ Parcell.D. # Zoning: ~rgy Code: Radon Gas: De,.nption of Wo'" t3 h~ 1A -"""- ' _L ,..-L-<- if'" '~L ~~ ~~~ i?~ Jj-;).3-Y7 iIJ.tro n"1 NO OCCUPANCY BEFORE C.O. t FINAL Water Meter: T.I.F.'s: Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Permit Fe Signatur Company Address Telephone# PA/~ City License Registration # / $I' b / State Certified License# Valuation or Contract Price ~A1 rLt,~ BUILDING ELECTRICAL PLUMBING MECHANICAL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final Breakers Ducts Insl. Compressor Final Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer 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 PERKIT CITY OF ZEPllYRHILLS BUILDING DEPARTMENT ,~ OWNER · S NAHE(/;t\ L .-",") I:::J 10 ~~\E-5 PHONE OWNER · S ADDRESS JOB ADDRESS r'-~}:AtL --PI II-...) I~ P\OTfV1ENT'~ LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1.D.' 94-1:'; -21 - i()(<"Y) .lSf"\3{)f) .~. DO<? D (OBTAIN FROH PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration LSign _Repair _Install ---..JIove _Deaolish PROPOSED USE: _Single Faaily .L~ercial _H/F _, of Units _H/H _Indust. _Swia. Pool _Other _Restaurant & Health Department Approval DESCRIPTION OF WORK:-1lf)nIL nt L~~H-Ts f1JL ~&~ .- (d) ANf ~i2U(cE 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. PERMITS REOUESTED _BUILDING 1ELEC'l"RICAL $ (ao AMP Service Valuation of Total Construction '{. Florida Power Corp. W.R.E.C. ---..MECHANICAL $ 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 ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. t City License Registration , ************************************* Signature COMPANY SAN ANN l3u~.qiZ.lL State Cert. or Regist. , City License Registration' ~~ ****************************************** "7" PLUMBER COMPANY State Cert. or Regist. , Signature City License Registration . ****************************************** HECHABICAL COMPANY State Cert. or Regist. t Signature City License Registration . ****************************************** OTIIRR 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 Lo "deed restrictionsW which lay be lOre restrictive than City regulations. The undersigned as sOles 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 lar be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licenSing requirelents lay apply (or the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (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 WContractor SectionsW of this application for which they will be responsible. If rou, 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 ZephyrhilIs. C. TRANSPORTATION IMPACT FEES AND U'1'ILI'fY CONNECTION FEES ,,<' D. CONSTRUCTION LIEN LnW (ClmPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HOIeOMDer's Protection Guidew prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOIeone other than the wowner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the "ownerW prior to COllenCelent. E. CONTRACTOR'S/OWNER'S AFFIDAVI'f 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 instailation as indicated. I certify that no wor1 or installation has cOllenced prior to issuance of a perlit and that all worl will be perfOrled 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 goveCDIental 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 Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Havigable Waterways t Departlent of Health i Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treablent, Septic Tanls t US Environaental Protection Agency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flood Zone WA" or "A,ete.w, it is understood that a drainage plan addressing a wCOlpensating volUle" will be sublitted wbicb 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 issuance of a perlit prevent tbe Building Official frOl thereafter requiring a correction of errors in plans, construction, or vioiations of any code. Bvery pt[Iit issued shall beCOl8 invalid unless the worl autborized by such perlit is cOllenced witbin six IOnths of issuance, or if work authorized by the peIlit is suspended or abandoned for a period of sil IOnths after tbe tile the worl is COllenced. One 90 dar 81tension of tile, IIr be allowed for the perlit with fee cbarge of $15.00. The eltension shall be requested in writing to the Building Official. An approved inspection lust be logged during each sil IOnth period, or the project will be considered abandoned. WARHING TO ONHiR: YOUR FAILURE TO RECORD A HOTICE OF COIDIHNCKHBlfT HAY RESULT IH YOUR PAYING TWICE FOR IHPROVIIIm'S TO YOUR PROPERTY. IF YOU IIITHND TO OBTAIH FIHAHCIHG, COHSULT WITH YOUR LENDER OR AH AnORNEY BHFORK RHCORDIHG YOUR HOliCK OF COHHEHCEHEHT. JOBS UHDER $2,500 IH VALOH DO HOT HiED TO RECORD AHD POST A wHOTICH OF COHMEHCKHKHTw. SIGHATURH: OWNER OR AGENT , I SIGHATURi: COHTRACTOR STATE OF FLORIDA COUNTY OF The foregOing instrument before me this was acknowledged , 19_ by STATE OF FLORIDA COUHTY 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