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Home My WebLink About97-7354 BUlL!:?! ~ !;:HY~L~~RM!! .7354 y6 (813) 788-6611 Date /;J-g/-97 , ~LDI~ EL~AL ::::~,~:~.~~ 11.s1- Parcell.D. # ~ MEC~IC^l ~Jir1/k~/ Sewer Conn Water Conn: Water Meter: T_I.F:s: Zoning: Description of War NO OCCUPANCY BEFORE C.O. FINAL I 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 &;11 Permit Fee Signature Company Address Telephone# Valuation or 00 Contract Price 1 TIJ [) . - City License Registration # c.;( / ~ State Certified License# '7!}~ (7 fJ;n~~. ~~ t BUILDING ELECTRI~ / PLU~ MEC~ICAL . 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 ($ ~ S.0~ shall be made for each trip for each trade: ~tJV Wrong Address Condemned work resulting from faulty construction. Repairs or corrections not made when inspection called. Work not ready for inspection when called. Permit not posted on job site. Plans not at job site. Work not accessible. a. b. c. d. e. f. g. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERKlT CITY OF ZEPBYRBILLS BUILDING DEPARTMENT '2. u.. c.) - OWNER'S NAKE \- \ I)(~ J ~ OWNER'S ADDRESS ~\ ~C; JOB ADDRESS 3R /3') ~ C~\f\\( ~lWW b9qN\'t' ~i\f~rl .~rc. BLOCK Jr,. '3)n~!. PHONE e)'?l )79 ~ . ,Sl \ Z.\1'l\\~ 2t fV\y r l.," \ l.s. ~L. \ LEGAL DESCRIPTION: LOT(S) SUBDIVISION PARCEL I.D.' (OBTAIN FROK PROPERTY TAX NOTICE) Wd~ WORK PROPOSED:_New Construction ____Addition ____Alteration ~Repair ____Install ____Sign -1love ____Deaolish PROPOSED USE: _S ingle Family ____"IF ____' of Units ____"/8 _ec:-ercial _Indust. ____Swia. Pool _Other ~Restaurant 1& Health Department Approval DESCRIPTION OF WORK: F\At !<no{:. l).;U' (2Sf...21., ') BUILDING SIZE: x Square Feet, Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS 1& (2) SETS OF BUILDING PLANS 1& (1) SET ENERGY FORMS. ATTACH (3) SETS OF BUILDING PLANS 1& (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REOUESTED ~UILDING $IJ100.0() Valuation of Total Construction _ELECTRICAL AKP Service Florida Power Corp. W.R.E.C. _KECIIAIIlCAL $ Valuation of Kechanical Installation _PLUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: ____Block _Fraae ____Steel Other FINISHED FLOOR ELEVATIONS: FT. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION BUILDER COKPANY State Cert. or Regist. , City License Registration . ****************************************** Signature ELECTRICIAN COKPANY State Cert. or Regist. # City License Registration # ****************************************** SilmAture PLUKBER COKPARY State Cert. or Regist. . City License Registration , **~*************************************** Signature KECHANICAL COKPANY State Cert. or Regist. # City License Registration t ****************************************** Signature OTHER COKPANY~ CJM!..trud10iJ I In( . ~y~ State Cert. or Regist.' Rl, 1~7.1\:" Signature . .. y ~. City License Registration t . ****************************************** [,//. APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PEI~IT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understand~ Lhat thiSjieiijt lilY be subject to "deed resLrictionslt whiell lay be lOre restrictive than City regulations. The undersigned assllles responsibility Cor cOlpliance wiLh any applicable deed restrictions. B. UNLICENSED CON'l'RAC'l'OnS AND CON'I'HAC'I'On HESPONSIBILrl'IES If the owner has IIired a contractor or conLracLo18 to undertale work, they lay be required Lo be licensed in accordance with state and local regulations. If the conLracLor is not licensed as required by law, ~oLh the owner and contractor lay be cited Cor a lisdeleanor violaLionunder state law. If the owner or intended contractor are uncertain as to what licensing requirl!Jlents lay apply Cor Ule intended worl, Lhey are advised to contact the City of ZepJlyrliills Building Depart.ent, (813) 788-6611. FurtheClore, if the owner has Jlired a contractor or contractors, lie is advised to have tile 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, ratller tllan 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 Zephyrllills. C. 'l'Iu\NSPon'I'ATION IMPACT FEES AND UTILITY CONNEC'l'ION FEES " " D. CONS'l'RUC'l'ION LIEN L'I\W (CIIAP'l'ER '/13, FLOIUDA s'rA'rUTES, AS AMENDED) I certify tha~ihe applicant, have been provided with a copy of "Florida's Construction Lien Law _ HOleowner's Protection Guidelt prepared by the Florida Departlent of Agriculture and Consuler ncCairs. If the applicant is sOleone other than tbe "oNnerlt, I certify that I have obLained a copy of the above described doculenl and prolise in good faith to deliver it to tbe "owner" prior to co..enCelent. E. CONTRAC'l'On' S/OWNER' S AFFIDAVI'I' I certify that all the inforlation in this application is accurate and tbat all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. 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 that all work will be perforled to leet standards of all laws regulating eonstruction, City codes, zoning regulations, and land deveIoplent regulations in the jurisdiction. I also certify that I understand that the regulations of other governJental agencies lay apply to the intended work, and that it is IY responsibility to identify what actions I lust tale to be in cOlpliance. Such agencies include but are not lilited to: · Deparllent of Environmental Regulation - Cypress Bayheads, Wetland Areas and EnvironJentally Sensitive Lands, Water/Wastewater Treat.ent · Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses · ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways A DepartJent of I/ealth , Rehabilitative Services, EnviroDlental Healtb Unit - Wells, Wastewater TreatJent, Septic Tanks t US EnvironJental Protection Agency - Asbestos abate.ent I also certify that, if fHl laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating voIllIelt will be sublitted wbicll 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 perl it prevent tile Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued shall becOIe invalid unless the work authorized by such perlit in cOllenced within six lonths of issuance, or if work authorized by the perlit is suspended or abandoned Cor a period of six IOnths after tile tile the work is cOllenced. One 90 day eltension of tile, Jay be allowed for the perlit with Cee 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. WARHIHG TO OWHER: YOUR FAILURE TO RECORD A HOTICH OF COKHEHCKHHHT KAY RESULT IH YOUR PAYIHG TWICE FOR IHPROVEKKHTS TO YOUR PROPERTY. IF YOU IHTEHD TO OBTAIH FIHANCING, COHSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RBCORDIHG YOUR NOTICH OF COKHENCEHENT. JOBS UNDER $2,500 IH VALUE IJO NOT NEED TO RECORD ANU POST A "NOTlCH O~OKHHHCHHBNT". / /~ ~1f ~ ____ u<"_ SIGRAruft~ER OR IGB~ ~~ SIGKA'U~OR'RACI ~ STATE OF FLORIDA COUHTY OF p,,-, ,0 The foregoing instrument was acknowledged before me this J 2.. J 2.9 , 19!LL by who is ~e~i~na~y Ijf~!~'g, me or who has produced as identification and who did/did not take an oatil. ' (Signature) STATK OF FLORIDA COUHTY OF ~Lil The foregoing instrument was acknowledged before me this 1"')'2.:':) , 1997 by ~Wl' L _. JlJi Nan who is personally k.nown to me or who has produced as identifi~. ti w W"~~~Wh~/did not take all oath~~ . (Signature) (Narne Typed, NOTARY PUBLIC (Narne Typed, Printe ~ NOTARY PUBLIC ..~ 1 A~LOri 10. ~ PulllC My ctmm. ftDl, ~ Comm~.~o, 't -. __~_n"_~~ ~~ ~ ~n .~'~_~_nne ~-~--~-- ... 4t.. 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"',IO. ...'",... .... . ..".....,..........M_. .................................... ----....... ....-.-...,,-. --'t.Qr ~rOJ.ld6t.~hQreby to furniSh~ial and tabor - c:molete i; ~;~~rda.nce w~;~;"SL)eCjfjCati-~:;--~:;-;:;:th;-~llm.~:f: _-:___~QNf.l W~ SEVEN Ht.JNDrtED .:._-~------______-4___~_~.___~_~___.:._ d'll _.. 1700 00 F-.:1i'mellt 10 be. made ae follows; (I aN; l~ _.._,_~__.___.___ ). '-. DUE I rPr'N (YJ.IPI ,'J:~IC<<.._--._.____^_.,_ . '---~..- I ~;:':;;i::',:;::~:. ::.::f=:.~ ""::.."':..::.::::::: =....~...:.. ..~.....:. . .J! ~_-,----"-" -._.'_.l..]i Irvo'v."lq ~'1rl '>osl; ..;q bll qXeCV1ed ~ upon wtllten or''''I. aM will bec0(T\8 Il exIr ~. _ _ o'';)'ge (l\'lJ' an':! It;,OVl/ 1119 &Slimal9 All a~"l1Itnt. conling.nl upon ttrlkn 8!;dwrl~ ~~ d9lej/!1 b9",nd C~r COI1It')l. O.....let 1<) o.v'Y nre. 10"'.00 end olher ne.:l6e38ry'inllUtanct . JNOc.':vitilropl;lMI j' JJr WC'I(i!{3 II" full; oovered by WI)o-k^'an'$ Cotropen8euon lnaur8l1c9. . WI~~~;:Y~~ '____ Oi:l~.:'; . ~:..::_.-....- ~ __~ . '. '0.., ..',,_..; '; AcccpbUICt of 'ropUllul =-The ab(M! ~mces. specitlC~,::;~:.~i,~~t". .. =-- - --==-="\_ S:10 >:o:J:,d.:iOO:i lire !lati$f"oJtory end .re her>:lb. '1. accepte.1. 'Ibu .($ '~~:.+.' ., II Ie:: l)~ Iii!' Wf)rk 35; specified. PaYI1'Il;m~ will be m~de 3S ou"ined abow. ,Il9 Date of Ar:c"planc9: ------.-........,.- F, .. .-.-....--. Mer JOB NO. L_L:~'. I " LUUt" lOWl. or ~ DATE 1'/ l'if'\I) . i , 1 hereby name and appoint ~)r~l ':\\,.", ,. '\ 'Y, .1 (.\ 'If \ i of \, I I\W ,f V: I 111\'1 ( .\ \ ,j r' r\ v) v , \ 1,1 ' to be my lawful attorney in fact to act for me and apply to /' \. \ \ \ \ " "- . - ,. - ) I" \ .\ , )i('11 \ \.'\ for . \ 1 ) to be performed a ,{ (. ,( U\) \ \ \ II permit for: wOt"k ,,\ at a location described as. Section Township Range Lot Block Subdivision ~' \ IJ'1 \ i\ ,\ (Owner , () ). ',\ ~, I I . '\' ) ~ ) '\ \J \ (l'l~- ~, {'" " () f C { ~, (Addreuof Job) fV1Pc\1 ((\\ ,(\\\\\ ( of Property and Address) \~ 'h , ~) \ ,I . L1 U' __ _ il4h-- and to sign my name and do all things neces.ary to this appointment. \1~~(L L- fY\\.\~ Type Or Print n~~)(of Ce 1fied / RC 0 OSS 21-C Contractor, Ltcense # Acknowledged: Personally known to me Sworn to and .ub.crt~.d before me thiS -,.~ '\ l.' Day of \\', " \1,11 - A.D. 19 ','J Notary Public, State of florid;-' (Seal ) My Commission t.pires: ~~' ...(. '" .- o -:: & n OLIVIA A. LOVETT Notary Pu:.lic, Stale of Floilda My c~mm, expires July 28, 2000 r:m!'1 N). GG572916