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Home My WebLink About98-7672 BUILDING PERMIT 1D BUILDING CITY OF ZEPHYRHILLS (813) 788-6611 ~D PLUMBING - 3j- ELECTRICAL ctl.5' MECHANICAL ~:::~:::~.~~~~~~1f; Zoning: Description of Work Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Valuation or kd ~ - Contract Price r;:~ 0 Ot} , City License Registration # 41 State Certified License# Permit Fee Signature Company Address Telephone# Permit 7672~ ~-/3- gy/ Date Sewer Conn Water Conn: Water Meter: T.I.F.'s: 9Y~o - DATE o 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 Driveway Breakers Ducts Insl. Compressor Final REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Fifteen and 00/1 00 Dollars ($ 'HT:6Ot shall be made for each trip for each trade: ~""t7V 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. I , i f I r I itl I /0 I AC -I S \'"~ i -20 I I , I I T I( APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT OWNER'S NAME 1J'1/l./V ~-- OWNER'S ADDRESS PHONE JOB ADDRESS L. G / S /tI8 S"' ;J 10 I Sc 0 -r; "'" LEGAL DESCRIPrION: LOT(S) PARCEL LD.' 10 2." -...1 BLOCK 1_99 Lcf"iS' SUBDIVISION (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install _Sign ~ve _Deaolish PROPOSED USE: _Single Family _M/F ./ _' of Units (./'" MIH _<=<-ercial _Indust. _Swia. Pool _Other _Restaurant & Health Departaent Approval DESCRIPrION OF WORK: Mt7b ,~/ " H"-'hf- BUILDING SIZE: / Y X S-Q, 70-<' 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 $ 3~~ Valuation of Total Construction _ELECTRICAL AMP Service . Florida Power Corp. W.R.E.C. _MECllAlUCAL $ Valuation of Mechanical Installation ~LUKBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block _Frame _Steel Other FINISHED FLOOR ELEVATIONS: Yr. IS PROJECT IN FLOOD ZONE AREA? YES NO ****************************************** BlJTI.DER CONTRACTOR SECTION COMPANY p~ ~ State Cer<. or Uegist. . Wo.r--P... City License Registration' ** *************************************** Signature ~~ Signature COMPANY :3~ ~ ~ State Cert. or Regist. . .t7~ City License Registration t ~**************************************** COIlPAIIY .- ,e7~ ~ State Cert. or R ist.' ~ City License Registration f yy **************************************** COMPANY ~ 1./ ~ ~ A ojO.4;v 2 ...t.- ~ te Cert. or Regist. f CAL:O Y3Y Y $ City License Registration' /7 ****************************************** ELECTRICIAN SianAture t..AJ' ~ PLUMBER Signature L-J~ MECHANICAL OTHER COMPANY State Cert. or Regist. t City License Registration . ****************************************** Signature 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 .ore restrictive than City regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CON'I'RAC1'On RESPONSIBILITIES If the ONner 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 lhe owner or intended contractor are uncertain as to what licensing requirelents lay apply for the intended work, lhey are advised to contact the City of Zephyrhills Building DepartJent, (BI3) 788-6611. Furtherlore, if the owner has hired a contraclor 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, ratller 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. CONSTRUC'I'ION LIEN L1\W (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ HOJeOWner's Protection Guid~" prepared by the Florida Departlent of Agriculture and ConSUler Affairs. If the applicant is sOJeone other than 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 co.-encelent. E. CONTRACTOR'S/OWNER'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 developlent. I Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no worl or installation has cOllenced prior to issuance of a perlit and that all work will be perforJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other goverDlental agencies lay apply to the intended worl, 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: I DepartJent of EnviroDlental Regulation - Cypress Bayheads, Netland Areas and EnviroDlentally Sensitive Lands, , Nater/Nastewater TreatJent I Southwest Florida Nater Hanagetent District - NeIls, Cypress Bayheads, Netland Areas, Altering Watercourses I ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways I DepartJent of Health & Rehabilitative Services, EnviroRlental Health Unit - Wells, Wastewater TreatJeot, Septic Tanls I US EnviroRlental 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 "co.pensating volUle" will be sub.itted 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 autbority to violate, cancel alter, or Bet aside any provisions of the technical codes, nor shall is~u~nce 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 beCOlB invalid unless the work authorized by such per.it is cOllenced within six IOnths of issuance, or if work authorized by the pellit is suspended or abandoned for a period of six IOnths after the tile the worl is cOllenced. One 90 day 91teo8ioo of tile, laY be allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building OffIcial. An approved inspection .ust be logged during each six IOnth period, or the project will be considered abandoned. WARNING TO ONNER: YOUR FAILURE TO RECORD A NOTICE OF COHHBNCEHBH'f HAY RISULT IN YOUR PAYING TIIICR FOR IHPROVKJIED'S TO YOUR PROPERTY. IF YOU IHTIND TO OBTAIN FINANCING, CONSULT NITH YOUR LENDER OR AN ATTORlBY BlFORB RBCORDING YOUR NOTICB OF COKHENCEHENT. JOBS UNDIR $2,500 IN VALUE DO NOT NBED TO RICORD AND POST A "NOTICE OF COKHINCKHEH'f". SIGNATURH: OWNER OR AGENT SI~~ a~~ . I STATK OF FLORIDA COUNTY OF The foregOing instrument before me this was acknOWledged , 19_ by STATI OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 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 bas produced as identification and who did/did not take an o~th. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC