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Home My WebLink About97-7243 .. BUILDING PERMIT -- CITY OF ZEPHYRHILLS (813) 788-6611 Permit 7243 ~ Date I/-;)Y- /~ BUILDING ~--::> PLUMBING P,"pertv Own., &n~ J n:t-:t' Job Address: ~ ~3 Parcell.D. # MECHANICAL Sewer Conn Water Conn: Water Meter: T,I.F.'s: Zoning: ~de; DescriPtion of Work ~~ ~ / Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 1/ C.O. 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 ,AI/ k /f7 Permit Fee Signature Company Address Telephone# ~F thJ (J.~~;- City License Registration # State Certified License# ~~ 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 00/100 Dollars ($"'HT.'O'O) shall be made for each trip for each trade: ~'-.t7D 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 f ('(\ -c. r "- \ c.( 3,4<P0d-. S C\ t"'<\ -e- Pc: t--,;-<..- C Q r t<:), ~~'e.-t-klil'Sf 0('-.v , ( PHONE ! ....7 f r - ~ II{ ) OWNER'S ADDRESS JOB ADDRESS LEGAL DESCRIPTION: LOT(S) 1~3 BLOCK SUBDIVISION PARCEL LD.t (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ____Addition ----Alteration ____Repair ____Install ____Sign --1fove ____Deaolish PROPOSED USE: ____Single Faaily ____KIF ____, of Units ____M/H ____Comaercial ____Indust. ____Swia. 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 ~ELECTIUCAL roo AKP Service Florida Power Corp. W.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block ____Fraae ____Steel Other FI.NISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COMPANY State Cert. or Regist. , City License Registration . ****************************************** Signature =IAN~~~ COMPANY'f,.. C2a- Ct~ r eILzt; State Cert. or Regist. # t:--S 0000" ,/ ex. J 6V-w City License Registration ## J g 7 ****************************************** PLUMBER COMPANY State Cert. or Regist. , Signature City License Registration # ****************************************** MECHANICAL COMPANY State Cert. or Regist. I Signature City License Registration I ***********~****************************** OTHER 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 to udeed 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 bas 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 lilY be cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireJents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813) 788-6611. FurtherlOre, if the owner bas 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 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 Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - HOIeowner's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other tban 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 couencelent. E. CONTRACTOR'SjOWNER'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. Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws regulating construction, City codes, loning regulations, and land developlent regulations in ~e 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. Sucb agencies include but are not lilited to: t Departlent of EnviroDlental Regulation - Cypress Baybeads, Vetland Areas and EnvironJentally Sensitive Lands, Vater/Vastewater Treatlent t Southwest Florida Water Hanagelent District - VeIls, Cypress Baybeads, Vetland Areas, Altering Vatercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable,Waterways t Departlent of Health , Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks t US EnviroDlental 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 uCOlpensating 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 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 frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle 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, laY 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 six IOnth period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHEHCEHEHT MAY RESULT IN YOUR PAYING TWICE FOR IHPROVEKKNTS TO YOUR PROPERTY. IF YOU IHTEKD TO OBTAIN FIHANCING, CONSULT VITH YOUR LENDER OR AM ATTORHEY BEFORE RECORDING YOUR NOTICE OF COKHENCEHEHT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A uNOTICE OF COHKEHCEHENT". SIGNATURE: OWER OR AGEH'l SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA coum 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) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC