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Home My WebLink About97-7031 BUILDING PERMIT .7031 CITY OF ZEPHYRHILLS (813) 788-6611 Permit f Date /0,-7-7? BUILDING ~~ PLUMBING Property Owner: ~~ /H~ Job Address:~.::(- 9~ Parcell.D. # Zoning: ~~g~ Code: Description of Work C~ ~---r~ MECHANICAL Sewer Conn Water Conn: Water Meter: T.I.F.'s: Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C.O. I b - 'f- DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector Valuation or Contract Price 1/A- Permit Fee Signature Company Address Telephone# G~t:;:: -- City License Registration # State Certified License# r1f~ /J>? BUILDING ELECTRICAL PLUMBING MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/1 00 Dollars ($ ~) shall be made for each trip for each trade: .;t~';t.J'D 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT LOT OWNER'S NAME E' K\ ~r~ l c{ OWNER'S ADDRESS 3 ~ b 0 J- SAm~ *7(- LEGAL DESCRIPTION: LOT(S) .2 Pc.'>; 1"\ +-e- C <::;.'" P . A-rY\.E t hy 5 't PHONE .-c'o- ' t. ~ ~ - -:l ( Y s.- WU--i" I JOB ADDRESS BLOCK SUBDIVISION PARCEL 1.D.# (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install ____Sign ~ove ____Demolish PROPOSED USE: ____S ingle Family ____M/F ____, of Units ____M/H _COIDIlercial _Indust. _Swim. Pool _Other ____Restaurant & Health Department 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. PERMITS REOUESTED _BUILDING $ Valuation of Total Construction ~ELECTRICAL ----1fECHAlUCAL 100 AMP Service Florida Power Corp. _W.R.E.C. $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION Signature COMPANY State Cert. or Regist. # City License Registration t ****************************************** BUILDER :::::IAN &G%~ COMPANY/( ~ a~ r etLzt;-' State Cert. or Regis t. # f:.-S 0 "00 it'> Ii an u e '^. J CJ2cw City License Registration t ) g 7 ****************************************** PLUMBER COMPANY State Cert. or Regist. t Signature City License Registration # ****************************************** MECHANICAL COMPANY State Cert. or Regist. # Signature City License Registration # ***********~****************************** OTHER COMPANY State Cert. or Regist. t Signature City License Registration # ****************************************** APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pellit lay be subject to ndeed 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 lay be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements lay apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813) 788-6611. Furthermore, if the owner bas hired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of the "Contractor SectionsU of this application for wbicb 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 tbe contractor wisbes you to sign as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of 'Florida's Construction Lien Law - HOIBowner's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the 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 couencBlent. 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. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit and that all work will be perfolled to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in t4e jurisdiction. I also certify that I understand that the regulations of other goveIDIental agencies lay apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: t Departlent of Environlental Regulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands, Vater/Wastewater Treatlent t Southwest Florida Water HanagBlent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable.Waterways t DepartJent of Health & Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US Envir011.lental Protection Agency - Asbestos abatement I also certify that, if fill laterial is to be used in Flood Zone "A" or "A, etc. II , it is understood that a drainage plan addressing a ucolpensating VOlUlen will be submitted 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~uance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pellit issued shall hecOle invalid unless tbe 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 tile the work is cOllenced. One 90 day extension of tile, .ay be allowed for the pellit with fee charge of $15.00. The extension sball 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 '1'0 RECORD A NOnCE OF COHHENCHHElff HAY RESULT IN YOUR PAYING 'flfICE FOR IHPROVEHEIITS '1'0 YOUR PROPERTY. IF YOU IHTEND TO OBTAIN FINANCING, CONSULT WIrH YOUR LENDER OR AX ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AXD POST A "NonCE OF COHKENCHHEHT". SIGNATURE: OWNER OR AGElff 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 o~th. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC _... _..--.-. -. -,-,~,."",--~'~,,,,-- --.~""~"o:':~ - -, - - -- ,-' - - --. --'----"-"'-1 f ... I~ 110~1 "):1 rill. . . ,J 1--~~ \ ,../l~ '"""'''". .~,JJ ~' ./ , ~~ . tJ~(f1~r t/ ::EN T PP.L F't~F;:rl Ir'r II'JU PASCO COUN1Y, FLORI0A un Tt: ~ '.i ,.: / :1.:: / ';'::r 1l"!E: :, (1 : 4::~ F' ('1 C"F~ ~ j :,)F- :~ :UI\jT!;:n(TCI:~ '11' ~ NAM~: ~UDY & DANA FORD (iCi[IF,: ~ ::~: ;/_. ~.:: ~;,'21"'OOOO'-OU 1 uO-007 '! (;sr: Ll 71 EMERALD POIN1E I ::::::;UL OFF I I.;:'. : L ~~:~~E~C:E:. I F'l' r~t!J"fbfo~;: (:'\Y.;~:':) 17:5:5 UFF I iF: : Dt:'IDL (I T \' Le.H' !:.:I..IECi :it J J (,:=: I. III :r. / H 1 L L :::: TCiTtlL (.'!r'10Ut.n: -if ~5. )' :;~~ (:j C,: C. hi T c. Oiv;F:'r.-J\ ("'CC'Ci:L!r.,~~r CEt'ITCF: ;':d"iOlJrIT De;::Ch:lF'fJUI'.I,if'E.F;:f'rr [)(1T;~\ UF</CH /1. '~" ),:: .jH:' -\1' ):;. ,'H: :;:.0 L I n tH'I:~ T E: FT,: E !". () \.1': t.:':;'!::i~) ~". :.:; (::. :~; ':! I:)~) F:L:CF. I 'fLU I ,/ ':.: '/ ....!..L"';....L:<, CL{;L. ~_ ...! I , /J ~. / /,. ,.. /'r '('" r I "{ /. / / It'. .. .- I .._. L ,..._ .u..._ ..... _.. _ __ _.. .._