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Home My WebLink About97-6826 BUILDING PERMIT ., Permit CITY OF ZEPHYRHILLS (813) 788-6611 6826/3 L9 PmpertyOwne, ~~~_~~~ Job Address: , ~ S 0 Parcell.D. # Date 9- ~-77 ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: ~Z Code: Description of Work :~ ;- -r r Radon Gas: -K~ FINAL 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. City License Registration # State Certified License# Permit Fee Signature Company Address Telephone# DATE Valuation or Contract Price A{/A- ~r J r~ )jf A.A~<f BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Canst. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final Driveway ~.,J: ~l4.t' 4v.. P '7 ~ h7 ()~ f ( 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 GITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAKE HmeYtc"ClJ') 1 eJI 6/1 OWNER'S ADDRESS 53'/0 g+Vi ~ 5+ . JOB ADDRESS 53'-/0 g+h &-. PHONE Zeph4Y j;,; / /5 . t:/a, 2efJhjrh,JIJ /" Flct c=S 3,<;cf/ 3:3e;t.l1 LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARGEL I. D. f (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition --...Alteration _Repair _Install _Sign --1Iove _Deaolish PROPOSED USE: _Single Faaily _KIF _, of Units --1I/H _eo..ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent 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 FORKS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Gorp. W.R.E.G. ---1IEGBAIIICAL $ Valuation of Mechanical Installation _PLUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _B1ock _Fraae _Steel Other FINISHED FLOOR ELEVAnONS: FT. IS PROJECT IN FLOOD ZONE AREA? ****************************************** YES NO BUTT .DER GONTRACTOR SEGTION COMPANY leph'jl' mason VLj () ~" State Gert. or Regist. f fn.J/U .. l1JL Gity License Registration f ****************************************** (!6VfShru.t -h~V\ Signature !J)? F.T.RGTRIGIAN GOMPANY State Gert. or Regist. f SiDnAture Gity License Registration , ****************************************** PLlJMBER COMPANY State Gert. or Regist. f Signature Gity License Registration f ****************************************** MEGllANlGAL GOMPANY State Gert. or Regist. f Signature Gity License Registration , ****************************************** OTRRR GOMPANY State Gert. or Regist. f Signature Gity License Registration , ****************************************** APPLICATION APPROVED BY PERMIT OFFIGER. 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 CONTRACTOU RESPONSIBILITIES If the owner has hired a contractor or contractors to/undertale worl, 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents lay apply for the intended worl, tbey are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. Furtberlore, if the owner has hired a contractor or contractors, be 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 OlDer sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes 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 l{ D. CONSTRUCTION LIEN L~W (ClffiPTER 713, FLORIDA STATUTES~ AS AMENDED) I certify that 1, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOMDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsWler Affairs. If the applicant i8 sOl8ORe other 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 COllenCelent. 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, loning, and land developlent. I Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or installation has cOlleDced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all 1118 regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other govefDIental agencies laY apply to tbe intended IOrk, and that it is IY responsibility to identify what actions I lust tale to be in cOlpliance. Such agencies include but are not 11lited to: · Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/Wastewater Treatlent · Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses · ArlY Corps of Engineers - Seawalls, Docks, Havigable Waterways · Departlent of Health' Rehabilitative Services, BnviroDleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks · US EnviroDleDtal 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 "cOlpeDsating 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 the technical codes, nor shall is~u~nce of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit Issued shall becoIe Invalid unless the work authorized by such perlit is cOllenced within sil IOnths of issuance, or if work'autboriled by the petlit Is suspended or abandoned for a period of sil IOnths after the tile the work is cOllenced. One 90 day eltension of tile, I8Y 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 sil IOntb period, or the project will be considered abandoned. WARNIHG TO OWHER: YOUR FAILURE TO RECORD A NOTICE OF COMMBNCIHKHT MAY RESULT IH YOUR PAYIHG !WlCE FOR IHPROVIMBITS TO YOUR PROPERTY. IF YOU IHTEHD TO OBTAIN FINAHCING, CONSULT WITH YOUR LEHDER OR AN ATTORREY BEFORE RECORDIHG YOUR MOriCI OF COKHEHCKHENT. JOBS UNDER $2,500 IH VALUE DO HOT NEED TO RBCORD ABD POST A "HOTICE OF COKKKHCKHIHT". , I' SIGHATURK: OWNER OR AGENT SIGHATURB: COHTRACTOR STATE OF FLORIDA COURTY OF The foregoing instrument was acknowledged before me this , 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