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Home My WebLink About98-7498 BUIL~~!:HY~L~_RM!! 7498~ (813)788-6611 Dote ~-LJ, -91 Property Owner: Job Address: Parcell.D. # ELECTRICAL ~ MECHANICAL ~ ~# . 1 .f · 7f ( ~~ C\.6~ Sewer Conn BUILDING Water Conn: Water Meter: T,I.F.'s: Zoning: Description of Work C ~ergy C~e: ~ />~;;J 1), Ra,d, on 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 Valuation or Contract Price ~ /OD' Q.1? Permit Fee v- ~....L/'2- Inspector .0<> Signature Company Address Telephone# City License Registration # ~ ./ 4 State Certified License# B~' .- .......sZL )~ /E~ ~u~ M~' - Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Servo Rough In Meter Can Const, Pole Pool Pre-Meter 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 ($~) shall be made for each trip for each trade: c2....!>--:~ a. b, c. d, e, f, g, 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, The payment of inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATION FOR PERKIT CITY OF ZEPHYRBILLS BUILDING DEPARTMENT JOB ADDRESS I ullln r~~ ~ / IJ. ,-uce C v II~ ,'\ ":;. I glJ )J'L~l f1, (JOw". r JrcJ..'1 \ PHONE '99(-)1({ OWNER'S NAKE OWNER'S ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION S, (,e r- 0<1- ~ ~ PARCEL I. D.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PRoPOSED:LNew Construction _Addition ~teration _Repair _Install _Sign ~ove _DeIIOlish PROPOSED USE: _Single Faaily _KIF _' of Units _M/H _Swill. Pool )-- Other _eo.aercial _Indust. Restaurant & Health Departllent Approval DESCRIPTION OF WORK: S;'p1 If\. ~ i~I S l; Sit V"f"".. 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 $ /IO()~6D Valuation of Total Construction _ELECTRICAL AMP Service Florida Power Corp. W.R.E.C. _MECHANICAL $ Valuation of Mechanical Installation ROOFING Y SPECIALTY _PLUMBING GAS TYPE OF CORSTRUCTION: _Block _Frtllle _Steel Other FDiISHED FLOOR ELEVATIONS: Fr. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** CONTRACTOR SECTION Signature COMPANY State Cert. or Regist. . City License Registration . ****************************************** BUILDER ELECTRICIAR SiMlAture COMPANY State Cert. or Regist. . City License Registration . ****************************************** PLUMBER Signature COMPANY State Cert. or Regist. , City License Registration , ****************************************** MECHANICAL Signature COMPANY State Cert. or Regist. , City License Registration . ****************************************** Signature COMPANY .....\........)0'" ,.ff' "lIe] ~~ I ~' State Cert. or Regist. ~ ? J) ~ lj k' City License Registration f ~ / t ****************************************** OTRRR APPLICATION APPROVED BY PERKIT 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 assWles 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 lisdeleanor 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 Zephyrhills Building Departlent, (813) 788-6611. Furtber.ore, if the own~r bas bired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of the "Contractor Sections" of this application for whicb tbey 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 IOU to sign as conlraclor that lay be an indication tbat he is not properly licensed and is not entitled to per.itting privileges in the City of Zephyrbills. C. TRANSPORTATION IMPACT FEES AND U'I'ILITY CONNECTION FEES "" D. CONSTRUC'I'ION LIEN Lnw (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HoIeoMner'. Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsDler Affairs. If the applicant i8 sOIeDne other than the "owner", I certify that I bave obtained a copy of the above described docWlent and prolise in good faith to deliver it to the "owner" prior to COllenCelent. E. CONTRACTOR' S/OWNER r S AFFIDAVI'I' I certify that all the inforlation in tbis application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land deve~oplent. Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certiff that no wort or installation has cOllenced prior to issuance of a per.it and tbat all work will be perfoCl8d to leet standards of all lils regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of otber govelDlental agencies lay apply to the intended wort, and that it is IY responsibility to identify what actions I .ust take to be in cOlpliance. Such agencies include but are not Iilited to: I Deparllent of finviroRlental Regulation - Cypress Baybeads, Wetland Areas and BnviroRlentally Sensitive Lands, Water/Wastewater Treallent I Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses I ArlY Corps of Bngineers - Seawalls, Docks, Navigable Waterways I De arllent of Healtb &"Rehabilitative Services BnviroRlental Health Unit - Wells, Wastewater rreallent, Septic ranks I US finvirODlental 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 "colpensating volOle" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit" issuance. . A perlit issued sball be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or Bet aside any provisions of the tecbnical codes, nor shall is~u~ce of a perlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall be_ invalid unless the work authorized by sucb perlit is cOllenced within Bix IOntbs of iBsuance, or if wort authorized bl the per.it is Suspended or abandoned for a period of six IOnthB after the ti.e the wort is cOllenced. One 90 day 81tension of tile, la' 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 IUBt be logged during eacb six IIOntb period, or tbe project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEMENT HAY RESULT IN YOUR PAYING RICE FOR IHPROVBIIII1'S TO YOUR PROPERTY. IF YOU INTfiND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOHI HlCORDIlfG YOUR BorICI OF COHHENCEHBIfT. JOBS UNDBR $2,500 IN VALUB DO NOT NEBD TO RECORD AND POST A "NOTICB OF COHHBNCKMINT". SIGNATURE: OWNBR OR AGBNT I SIGNATURB: COif TRACTOR STATE OF FLORIDA COUNTY OF The foregOing instrument before me this was acknowledged , 19_ by STATB 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 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