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Home My WebLink About97-7051 BUILDING PE,RMIT 7051 Permit CITY OF ZEPHYRHILLS (813) 788-6611 IV{ PLUMBING dO . tro ~~ Date / () -1.3 --77 , BUILDING ~~ o-v ~CTFll~ Pmp'rty Own'" ~ Job Address: ~ - ' ~~ .e"o- Parcel 1.0. # Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Energy Code: ' DescriPtion of Work "--f7.; ~ ,~/ c.. Radon Gas: 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 City License Registration # State Certified License# - ~~ P~rmit FeecL [fp tro Signature lllo.. Company Address Telephone# Inspector Valuation or Contract Price ~ 7' 91. c/O BUILDING a~ ir!,L(f Iff) ELECTRICAL o~ () ~'L.- PLUMBING MECHANICAL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor 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 ($ ~I 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 PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTKENT 1/71 19./ J OWNER'S NAKE L.c:u\ G.ri1 ~ OWNER'S ADDRESS 3<\S5L(o R e:rraiCA. JOB ADDRESS ~'fY'\ "2..._ PHONE LEGAL DESGRIPTION: LOT(S) BLOCK SUBDIVISION ~\~P\6 \~~OW (OBTAIN FROM PROPERTY TAX NOTICE) PARCEL I. D.' WORK PROPOSED: ............ew Construction _Addition ----..Alteration _Repair _Install _Sign -.JIove _Deaolish PROPOSED USE: _Single Faaily -.JI/F _' of Units ~/H _~ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPTION OF WORK: \~~-\OJJ- ~'\d- -\e)n IO\<:w ~~L0'il~ W\{e.ft(c BUILDING SIZE: x Square Feet, Height RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED _BUILDING /' ELECl'RIGAL /MEGllANIGAL $ Valuation of Total Construction $ AKP Service /OcCJ / . 0~/ Florida Power Corp. W.R.E.C. Valuation of Mechanical Installation -PLUHBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other FDUSHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA., YES NO ****************************************** CONTRACTOR SECTION BIJTlJlRR GOKPANY State Cert. or Regist. . City License Registration . ****************************************** Signature , RT.RGTRICIAN COMPANY_Ace... {tr ( ()rrQ~:c _ SJ",,~~(jC'LlJnrJ.0Oh ~~;\~~o~:::~::~i:" ': ,^~7 / V ~************************************** PLUHBER COMPANY State Cert. or Regist. . City License Registration . ****************************************** Signature MECHANICAL f COMPANY;YCe 4'1 {n~ J 67~~c- ~cfjdL c;P.. :lJ. State Cert. or Regist.' Y"q S9/:? Signature / r= I?Yz.. City License Registration' 4/6"- ****************************************** ~ OTRRR 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 per.it .ay be subject Lo "deed restrictions" which .ay be .ure restrictive than City regulations. The undersigned assWles responsibility for co.pliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they .ay 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 IiY be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireaents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 188-6611. 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 OlDer 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 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'l'ION LIEN L'I\.W (CHAPTER 713, FLORIDA STA'rUTES.I AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOI801Der's Protection Guide" prepared by the Florida Departlent of Agriculture and ConSWler Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deUver it to the "owner" prior to couenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the. inforlation in this application is accurate and that all work lill be done in cOlpliance with all applicable lals regulating construction, zoning, and land develop.ent. I Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no work or installation has cOllenced prior to issuance of a perlit and tbat all lork lill be perfoIJed 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 other goverDlenlal agencies lay apply to the intended worl, and that it is IY responsibility to identify Ihat actions I lust take lo be in co.pliance. Such agencies include but are not lilited to: · Deparllent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent · Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses · Arl' Corps of Engineers - Seawalls, Docks, Navigable Waterways · Deparllent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastelater Treatlent, Septic Tanks · US EnviroDleDtal Protection Agency - Asbestos abateaent I also certify that, if fIll .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "co.pensating volOle" will be subtitted which is prepared by a professional engineer registered in the State of Florida prior to per.it. 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 perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Iverr perlit issued shall becoJe invalid unless the work authoriled by such perlit is cOllenced lithin sil IOnths of issuance, or if IOrt authoriled by the perlit is suspended or abandoned for a period of sil IOnths after tbe tile the lork is COllenced. One 90 day 81tension of tile, III be allowed for the perlit lith fee charge of $15.00. The extension shall be requested in Iriting to the Building Official. An approved inspection lust be logged during each sil IOnth period, or the project lill be considered abandoned. WARKING TO ONIER: YOUR FAILURE TO RECORD A NOTICE OF COIfHENCBHBNT ItAY RESULT IN YOUR PAYING !lIICK FOR IHPROVlllllrS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN AnORHIY BEFOHI RlCORDIIIG YOUR DICE OF COMMENCEMENT. JOBS UNDBR $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHKBNCBKBNT". . I SIGNATURE: OWNER OR AGENT SIGNATURB: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19_ by STATB OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19_ by who is personally known to me or who has produced 8S identification and who did/did not take an oath. who is personally known to me or wbo bas 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 C.::J cn C,] (Y) Ii:'') "",J Ii :~ ' I c: , .1')...) , '-< ^'. . )' ., ::)' .. .J -J". '\ .', ',) ',' I " \ ( \) ': " / i I I <~ (' . ..)~ \, \ ':~\l.. ".) <\ I k ! I , I ! I ! l'~ ! ~.:: ! 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