The URL can be used to link to this page

Home My WebLink About97-6925 BUILDING PERMIT Nt Permit CITY OF ZEPHYRHILLS (813) 788-6611 6925)/ P--;lS- 9) Date BUILDING ELECTRICAL PLUMBING ~ANI~ Sewer Conn Water Conn: ~::::~:~.~- ~~~ '9 ~ ...1f-" =-;;- Parcel I. D. # Water Meter: T.I.F.'s: Zoning: Description of Work ~Energy Code: ~cf~ A/L f M",adon Gas: ~Z NO OCCUPANCY BEFORE C.O. FINAL C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Permit Fee Signature Company Address Telephone# jtj~ Valuation or Contract Price tJ.0.. ---0. /-'i~ City License Registration # c:Lo 1. State Certified License# BUILDING ELECTRICAL PLUMBING J~ MECHANICAL Breakers Ducts Ins!. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Con st. 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 ZEPllYRHILLS BUILDING DEPARTMENT OIINER'SIWIB 6l:7~~ N~:a~ OWNER'S ADDRESS JOB ADDRESS '0- 7 I, '? -- 9 .,.4 PHONE LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL 1. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition ----.Al.teration ~epair _Install _Sign --1Iove _Deaolish PROPOSED USE: _Single Fallily _KIF _' of Units _K/H _~ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: BUILDING SIZE: x Square Feet. Height RESIDEBTIAL: 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 ~UILDING $ " Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. --1IECBANlCAL $ ;:2 ,S-lJ _ o-l) Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fralle _Steel Other FllIISBED FLOOR ELEVAITONS: FT. IS PROJECf IN FLOOD ZONE AREA? YES NO .......................................... CONTRACfOR SECfION RUTI.DRR COMPANY State Cert. or Regist. , City License Registration , .......................................... Signature RT.R.CTRICIAN COMPANY State Cert. or Regist. , City License Registration , .......................................... SilmAture PLmtBER COKPANY State Cert. or Regist. , City License Registration . .......................................... Signature IlECHANICAL h .,c" " --J, ~ ").. ' COMPANY ,../ t:'J A/ ..t/ (/ S Dl 7 ~c.J7V1 if",,/, J~-W1 ~ ti}.. State Cert. or IIegist. . ~ C?' City License Registration , 'J.. ~ Cp , ~... .................................. Signature OTRRR COMPANY State Cert. or Regist. , City License Registration . .......................................... Signature APPLICATION APPROVED BY PERKIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to Rdeed 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 ONner 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 laY be cited for a lisdel8anor violation under state law. If the owner or intended contractor are uncertain as to what licensing requir8lents 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 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 wort. If the contractor wishes JOU 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. CONSTRUC'!'ION LIEN L1\W (CHAPTER 713, FLORIDA STATUTES I AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOIDer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is BOIeORe other than the .ownern, I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the .ownern prior to COllenC8lent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in tbis application is accurate and that all wort 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 wort and instailation as indicated. I certify that no worl or installation has COll8Dced prior to issuance of a perlit and that all work will be perf oIled to Jeet standards of all lils regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of otber govefRIental agencies laY 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: t Deparllent of Envirolllental Regulation - Cypress Bayheads, Wetland Areas and BnviroDl8Dtally Sensitive Lands, Water/Wastewater Treallent t Southwest Florida Water Hanag8lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalts, Docks, Navigable Waterways t Deparllent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic ranks t US Envirolllental Protection Agency - Asbestos abat8lent I also certify that, if fill laterial is to be used in Flood Zone nAn or nA,etc.., it is understood that a drainage plan addressing a .cOIpeDsating volUle" will be sub.itted 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 the technical' codes, nor shall is~u~nce of a per.it prevent the Building Official frOt thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issued ahall beCOle invalid unless the wort authorized by such per.it is cOllenced within sil IOnths of issuance, or if work authorized by the PBIIit is suspended or abandoned for a period of six IOnths after the tile the work is couenced. One 90 day eJtenaion of tile, IilJ 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. WARRING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR PAYING TlUCI FOR IHPROVllllftS TO YOUR PROPERTY. IF"YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDER OR AN AnORIfEY BEFORB RECORDING YOUR MO'lICI OF COHHENCKHENT. JOBS UNDER '2,500 IN VALUE DO NOT NEED TO RBCORD AND POST A "NOTICB OF COHHENCIHINT". . : I' SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregOing instrument before me this was acknowledged , 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