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Home My WebLink About00-9686 BUILDING PERMIT BUIL~NG ELEC~ICAL PLUMtNG ()u.f.fe + g 'vel , (~ '~O. MECHANICAL 09686 Date '3/21/0.0 I CITY OF ZEPHYRHILLS (813) 788-6611 Permit Sewer Conn Water Conn: Property Owner: t)/,'1 ~~S Job Address: S ( ]D 6e; {I Water Meter: T,I.F.'s: Parcell.D. # Zoning: Energy Code: Description of Work ,y /I \.4 t I ; 0"$ ..(; .'~ Radon Gas: S'lf'I'ilH,' a'7 S y S..Ji7-. FINAL 9- (,-~C!J DATE NO OCCUPANCY BEFORE C.O. Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. Inspector DATE :lAC City License Registration # State Certified License# f)1f' ~:,~~ ~~;;7~ Address ~ _ Telephone# 72-7 -.372. -6'7'/3 j' 2") -<{2cJ -/2..>'0 / Valuation or Contract Price l1 00, c:=- ,":.r beL ..'-,' ..., ". h..~ " Ie r:-......~..J -- AL".J (c./~ MECHANICAL Ftr. Pre SLB Lintel FRM. Insul. CL WL ELE PLU BING , ... \ , \ \ \ Tp. Servo Rough In Meter Can Canst. 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 ($ 25.00) shall be made for each trip for each trade: 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, 08-01-2000 STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF EXEMPTION FROM FLORIDA WORKERS' COMPENSATION LAW This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation LIIW. EFFECTIVE DATE 07/22/2000 EXPIRATION DATE 07/22/2002 EXEMPTED INDIVIDUAL NAME LAUINGER JOHN C S.S. 131-36-7279 BUSINESS NAME MIRBEC INC FEIN 593613190 BUSINESS ADDRESS 4400 COUNTY BREEZE DRIVE NEW PORT RICHEY FL 34653 NOTE: Pursuant to Chapter 44tO.10(1),(g),2 F.S.. a sole proprietor. partner, or an officer of. corporation who elects exemption from the Florida Workers' Compensation Law may not recover benefits or compensation under Chapter 440. STATE OF FLORIDA DEPARTMENT OF LABOR AND EMPLOYMENT SECURITY DIVISION Of WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF EXEMPTION FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE DATE 07/12/2000 EXPIRATION DATE 07/22/2002 EXEMPTED PERSON LAST NAME lAIII~GER fiRST NAME 'OWN C SOCIAL SECURITY NUMBER 13 1- 3 6 7279 BUSINESS NAME MIRBEC 'NC PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE NOTE: Pursuent to chapter 440.1 0(1l,(g),2, F.S., a sole proprietor, pert"er, or off icer 0 f a corporation who elects exemption from the Florida WorKers' Compensation law may not recover benef its or compensation under Chapter 440. FEDERAL IDENTIFICATION NUMBER 593613190 BUSINESS ADDRESS 4400 COllNTY BR!:EZE DRI~ H E R E CUT HERE * C..ry bottom portion on the job. keep upper portion for your r.cords. APPLICATION FOR PERMIT CITY OF ZEPRYRRILLS BUILDING DEPARTMENT DATE RECEIVED 9,-- d2J- 6 0 PLANS REVIEW FEE JL/.# OWNER'S NAME '& 7""" JI/ :.r .$ t./;1=" ~/ PHONE JOB ADDRESS 5/3(!) 6~ ~" ;L'7'~tt'H 33.r</d LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # WORK PROPSED: [JNEW CONSTRUCTION [J SIGN (OBTAIN FROM PROPERTY TAX NOTICE) [J ADDITION [JALTERATION [JREPAIR ~TALL o MOVE o DEMOLISH PROPOSED USE: ~AMILY DWELLING COMMERCIAL ~TAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK .:?VJ/A-Lq,,/ 4"'-'..{"tJ.t-, /Z/e:>Z- 1oJ,- 30<::) ;;Z;~ S~~~~ ~~~ [JMULTI - FAMILY 0# OF UNITS o MOBILE HOME [J INDUSTRIAL [J SWIMMING POOL o OTHER BUILDING SIZE SQUARE FOOTAGE HEIGHT RESIDENTIAL: COMMERCIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. & (1) SET ENERGY ~O~~;l') FORMS. ~_ 1) ~rJL . --G ( 0 PERMITS REQUESTED O{)/t'-' Q'" ?-I"O , o BUILDING $ VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C. o PLUMBING ~HANlCAL VALUATION OF MECHANCIAL INST (]~1A it LS AREA 0 ,; rl'7'" &9/5 1{) 1/ ~ 10' . DC) g " ~ P- 9~ I ( YES 0 N ~ $ I tf' t:::; t:) ~ [J GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL [J OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZO BUILDER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ********************************************************.~********* ELECTRICIAN COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** PLUMBER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE * * * * * * * * * * *,* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * MECHANICAL COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE I COMPANy~/..c4<:"'c;'~. ~~c n.ct::Jr J~;;. STATE CERT OR REGIST # 72<t1.r37t:'J1!>~'pilTO CITY PROCESSING # ~j1~~ CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to ~deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they may 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 may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, 813-788-6611. Furthermore, 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 signs 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 may be an indication that he is not properly licensed and i~ not entitled to pe~tting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of ~Florida's Construction lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the ~owner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the ~owner" prior to commencement. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land development. Application is hereby made to obtain a pe~t to do work and installation as indicated, I certify that no work or installation has commenced prior to issuance of a pe~t and that all work will be performed to meet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: *Department of Environmental Regulation-Cypress Bayheads, Wet~and Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment *Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses *Army Corps of Engineers-Seawalls, Docks, Navigable Waterways *Department of Health & Rehabilitative Services, Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks *U.S. Environmental Protection Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone ~A" or ~A,etc.", it is understood that a drainage plan addressing a ~compensating volume" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to pe~t issuance. A pe~t 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 issuance of a pe~t prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every pe~t issued shall become invalid unless the work authorized by such pe~t is commenced within six months of issuance, or if work authorized by the pe~t is suspended or abandoned for a period of six months after the time the work is commenced. One 90 day extension of time may be allowed for the pe~t with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six month 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 acknowledged , 19_ STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____day of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____ day of by acknowledged , 19~ (name of person acknowledged) Dwho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or o who has produced (type and whoD did Ddid not of identification) take an oath. o who has produced (type of identification) and who Ddid Oiid not take an oath Signature of person taking acknowledgment Signature of person taking acknowledgement Name typed, printed or stamped Name, typed, printed or stamped :::t Z N m m .;:j .." ~ . wOe! ~ ~:o ....,... :Bcn~~m _m:OQ)'TI W:O-i>- ..:.s2c:~ ;jO~CDfto. ......m _Ir" _(')~CDcn t)>~ )> 9r-~ 'TI ...A,...'" m ~.. ~ ~ J-1~ '} G ';::0 I 11 I:r: )" .1- n- ,r-- "" 'r-- V) 1\ -,., Nil-- I " ;;r"..J o rt"l ( ~ 0 \) I. m F ~. ~ \ ' c' T - "'" [ fl T " "'" f f \It ... , 1 1 "'" r- I ~~ i ! i ~ .>> t r'\ t~ ,R- ~ 'b' '-' ~ l'- ~ (\ ~ ~~ ~ o H~ I ~ .r <\ ~ i;' ..&. ~ '" ~ ~ !=n ,. .. ~ \ r ~~ , J~ r~ ~ ~ r,\ \~ q r~ 1 r 1" -G'\. 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