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Home My WebLink About97-7300 BUILDING PE.RMIT 7300 ,t CITY OF ZEPHYRHILLS (813) 788-6611 Permit Date / d.- - g--7 '7 , BUILDING ~TR95J PLUMBING MECHANICAL Sewer Conn P,operty Ow~' ~ 'a ~ /Lli;:E~ Job Address: <-3 ~ __ __ -- / Parcel 1.0. # Water Conn: Water Meter: T.I.F.'s: Radon Gas: Zoning: i'lI /i -~g~ Code: . A .. ~ r- DescriPtion of Work ~~ ~ / 1.2. -I? -Cf "t JJ7? t::- c.. ~ I: If / /I hi NO OCCUPANCY BEFORE C.O. FINAL C.O. 12- 9- DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Permit Fee Signature Company Address Telephone# 2<! ~~ cf:~~~ Inspector Valuation or Contract Price A(/k IV'? City License Registration # State Certified License# {bfL. BUILDING ELECTRICAL PLUMBING MECHANICAL Breakers Ducts Insl. Compressor Final Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer 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 00/1 00 Dollars ($ 1-5-:-66) shall be made for each trip for each trade: ~.......O'O 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 ZEPBYRBILLS BUILDING DEPARTMENT LOT - OWNER'S NAKE_I:: rn -e r 1I , J ~ ~ <-.:::> ~ ~Avn-e- I PC;t n T-<'- G ~(" f=>. f1N\~ -t-~ Y st PHONE ''I <t(- S( - .:t.l "t r OWNER'S ADDRESS LJdY , JOB ADDRESS LEGAL DESCRIYl'ION: LOT(S) BLOCK SUBDIVISION PARCEL I.D.f (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:____New Construction ----Addition ____Alteration ____Repair ____Install _Sign --"ove _Deaolish PROPOSED USE: _Single Faaily --"IF _' of Units _M/H ____C~ercial _Indust. _Swia. Pool _Other _Restaurant lie Health Department Approval DESCRIYl'ION OF WORK: BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS lie (2) SETS OF BUILDING PLANS lie (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS lie (1) SET ENERGY FORMS. . PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. . - PERMITS REOUESTED ____BUILDING $ Valuation of Total Construction ~ELECTRICAL 100 AMP Service Florida Power Corp. W.R.E.C. _MECBARICAL $ Valuation of Mechanical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER Signature COMPANY State Cert. or Regist. , City License Registration t ****************************************** =C:&:0.~~ COMPANY')( t::la- a~ r C(ff State Cert. or Regist. f l:--S Ot:JOC6 ,/ r . J tyU~ City License Registration t ) g 7 ****************************************** PLUMBER COMPANY State Cert. or Regist. , Signature City License Registration' ****************************************** MECHANICAL COMPANY State Cert. or Regist. , Signature City License Registration , ***********~****************************** OTHF.R COMPANY State Cert. or Regist. f 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 "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 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 lay be cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813) 788-6611. Furtberlore, 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 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, have been provided with a copy of uFlorida's Construction Lien Law - HOIeOWDer's Protection Guideu prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the uowner", I certify that I have obtained a copy of the above described docUlent and pro.ise in good faith to deliver it to the "owner" prior to couencl!lent. 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, zoning, and land develop.ent. 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 perforaed to leet standards of all laws regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also certify that I understand that the regulations of other goverDIental agencies lay apply to the intended work, 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 Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands, Water/Wastewater Treatlent t Southwest Florida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses 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 abate.ent I also certify that, if fill laterial is to be used in Flood Zone "A" or "A, etc. ", it is understood tbat a drainage plan addressing a ucolpensating volUle" will be sublitted whicb 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 perait issued shall becOle invalid unless the 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 aonths after the tile the work is couenced. One 90 day extension of tiae, lilY be allowed for the perlit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An approved inspection lUSt be logged during each six aontb period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO' RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT 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 oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC