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Home My WebLink About01-0333 BUILDING PERMITN~ 0333 CITY OF ZEPHYRHILLS (813) 788-6611 Permit Date 5 / 2 1- /01 b7.~ BUILDING 'IS. ~ ELECTRICAL PLU~ING MECH\NICAL Sewer Conn Water Conn: Property Owner: ":t" r \ ~ r 4, vCr 00 k. Job Address: 48 s-1 IlfL S+. Parcell.O,# 1"f-2(;,-ll- 0010- 02..100-0010 Water Meter: T,LF.'s: Zoning: Energy Code: DescriPtion of Work add (Jorc.l- 1..oJ .~ Radon Gas: 1, bO 9/(;. 'lj,) (~ ,'..dow ... NO OCCUPANCY BEFORE C.O. FINAL DATE Complete Plans, Specifications and Fee Must Accompany Application. C.O. All work shall be performed in accordance with City Codes and Ordinances. Inspector Permit Fee 0 . !.E. xS;gnaMe ~/I'J X CA~4- Company _ Address A.Telephone# g J .3 ~ 1 go .- b 91f'6 '"1 8"~ ' "33 If ~ ' Valuation or Contract Price ,-- ~ ~,O<.)o City License Registration # ~ State Certified License# G/~ 6 \.VN . o~ Ftr. Pre SLB Lintel FRM. ~~- 3/-0 I 5~' Insul. CL WL r/N,4'- 1-//-0J 51!. Driveway Tp. Serv. Rough In y '1/-01 ~ f. Meter Can Const. Pole Pool Pre-Meter Final 9 - 11- 1) I 5'e. SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compressor Final BUILDING ELECTRICAL REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Twenty Five 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 inspeetion fees shall be made before any further permits will be issued to the person owning same. CITY OFZEPHYRHILLS PERMIT APPLICATION \ 1~\\eJ (;(ZZ(1)( BUILDING DEPARTMENT 5335 8th STREET ZEPHYRHILLS, FL 3354~ . Phone:813-780-0020 Fax:813-780-0021 DATE RECEIVED PLANS REVIEW FEE OWNER'S NAME _I R L F. ct- JOB SITE ADDRESS lfg 5 3 'M A A.J IIT"'- L. S/, CR.ooK- PHONE CONTACT 7 g 8 - 3 3 if ~ 7 g () - 6 '11ft lu.~~t:. PARCEL ID # BLOCK d I SUBDIVISION /06 - 00/0 /if ;}'(,,-.J. J -60/0 _O~ (OBTAIN FROM PROPERTY TAX NOTICE) ~oD((E6 Ad LEGAL DESCRIPTION: LOT(S) WORK PROPSED: DNEW CONSTRUCTION l1JADDITION o ALTERATION o REPAIR o INSTALL DSIGN o MOVE 0 DEMOLISH PROPOSED USE: 9\SGL FAMILY DWELLING DMULTI - FAMILY 0# OF UNITS o MOBILE HOME o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER D RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK A~~ fop-e-h. wI 31'-'.55 BUILDING SIZE Id. Y. ~() SQUARE FOOTAGE 3bo HEIGHT 7 - 7/~ fr. , 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 REQUESTED ~ BUILDING ~~LECTRICAL o PLUMBING $ ~,ooo VALUATION OF TOTAL CONSTRUCTION AMP SERVICE fiQ FLORIDA POWER o W.R.E.C. o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL I:Q/OTHER 1/ J u fI'l, tv u W\.. FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES )4" NO BUILDER """ ~ < '.. ..~ '!./~ , {. (___r;-r/ COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE .' ~ rv; ii1-1;1 **(~************************************************************** ELECTRICIAN " ~ , - /)'? " . I / L." ?i' " '. ~....".." /T ~'" / C;0' COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE /:;:>- . ..,"". / *****~*W********************************************************** PLUMBER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** MECHANICAL COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** OTHER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The ,undersigned understands that this permit Inay be subject to ~deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any applicable deed rest:rictions. 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 is not entitled to permitting 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 permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit 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, Wetland 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 permit issuance. A permit 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 permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of issuance, or if work authorized by the permit 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 permit 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". J)j~ SIGNATURE: OWNER OR ~~),-. ~ O(~ STATE OF FLO~ C A<'fl-.. COUNTY OF ~ ~ The foregoing instrument was acknowledged Before me this 16 .~ day of rnA'I ' :1:-9-_/ by ::r:..~L ~R[)OK 6l!Jn , (name of person acknowledged) )iCwho is personally known to me, or o who has produced (type of identification) not take an oath. SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____day of by acknowledged 19 (name of person acknowledged) C1ho is personally known to me, or o who has produced (type of identification) and who Ddid Diid not take an oath Signature of person taking acknowled ement 1<. AN)) ERSoA. I NaIIIr ~~ FlorkII Name typed, printed or s...,.... expo Mar. 22. 2003 Comm. No. CC8174<<J Signature of person taking acknowledgment Name typed, printed or stamped '. '" ItA ft{L'j U2.Gc K tfCPCi3 i 7 +"^' ~+ SQ. FEET PRICS . p , . IIAIN OR LivING A_.a $ OTHER.AREA UNDER ROOF $ -...-. VAUJATION $ ~ oofJ . ~i\, , , I BIIaJmIIG: $ b7. '-; C CREDIT: $ tJJ~ ELEC'1'RICAI.: $ 35~ ~~ PUJlBNG: "$ fli1 IIECHAMCM..: $ tV/ii 3f00 "5: f-f R-'DQN $ 3. bG ~ lJ4-t- ~(Ob.(t I TJ F'S :1 s }J 1/1 I DISCLOSURE STATEMENT FOR OWNER CITY OF ZEPIIYRHILLS BUILDING DEPARTMENT I, ~(} 71 1-,- (' ~o,-,~ to the provi ons of this instrument." have read and fully understand and agree The undersigned states and affirms renovating, adding to or reroofing occupy, or will occupy by sale. That he or she shall comply that he or she is desirous of constructing, his or her own domicile, that he or she actually said domicile, and same is not for rent, lease or with the following conditions: 1. That the owner and he or she alone shall act as the builder for all phases of construction. 2. That the owner will comply with all provisions of the City of Zephyrhills ordinances and codes pertinent to the building. 3, That in the event various phases of construction are subcontracted, he will engage only properly licensed subcontractors and will personally supervise such work. 4. That in the event the Building Inspector shall require corrections to be made, the owner will assume full responsibility to insure they are made, and upon completion will call for a reinspection before proceeding with the building. 5. That the owner shall assume full responSibility for the construction and will not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office shall constitute an official notice to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws in regard to social security, workman's compensation, lien laws, etc., where applicable.. 8, That the owner shall comply with all the safety codes issued by the Florida Industrial Commission. 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial building at a cost of $25,000 or less. The building must~e for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one bUilding you have built yourself within I year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. Your construction must be done according to building codes and zoning regulations. It is your responSibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. DATE: ,~/~/;/ OWNER, ~ ~ SA~ ADDRESS: ~ ~ 77, 0 . PH: ~/J -7/5 -3.1Y..2- 7?O - 6PY.b' DATE: WITNESS: WITNESS: PERMIT f~ (l) ()wners of properly when acting as their own conlr actor and providing all ,naterial supervision them- selves, when building or irnproving fann outbuildings or one-fa,nily or lwo-.fa,nily residences on such property · for lhe occupancy or use of such owners and not offered for sale or lease, or building or irnproving commercial buildings at a cosl of under $25,000 on such property for I he occupancy or use of slIch owners and not offered for sale or lease. In all action b,ought under Ihis part, proof of the sale or lease, or offering for sale or lease, of any such structure by lhe owner-builder within 1 year after co,npletion of saffle creales a presurnption thai the conslr lJction was underla'~en for purposes of sale or lease. This subsection does nol exernpt any person who is e,nployed by such owner and who acts in the capacity. of a contraclor. For II ,e fJurposes of Ihis subsection, the tenn "owners of properly" includes the owner of a mobile horne situated on a leased lol. To qualify for exemption under this subsection, an owner 'nust personally appear and sign the building pennil application. The local per- ,nit ling agency shall provide the person with a disclo- , sure state,nent in substantially the following form: . .I P~R F.S. 1993 CHA~TER 489.103 (7) /' ~ ~ I ~ ~ " ~ () ~ 'i 'I.. ~ r ~ " t\ t l. ~ . ~ .. !'-. ~ 30 I ~ -, ~ ~ I 'i . ~ /~?' ~ " llQ ~ 6. /~~~~tC"), r~//1'~I#ZJ.J ,.,...,;;~ il:IH ~ ,/,y - .:Ii r /..,,,;;' A"c:w::o r' NN"''''' nVNP4T/,a,v /a?t<:?' CA..-'" C,.!f'JCJP' ~'1 .~ , .. ~~ ~ ~ t · ~ ~ 6tJ' $'Q:, ' :\ .~ ",.J ~ -,,_II lP . ~ ~ ~ , 7;',7;.-::. :~'.':'7'::~ I".. ','.,...." ~'" '.' ~':: ..~ l' . ~ ~., . ~ ~ . , " ~' , . , '" ~ () . r. te O. 30.00' ~o,o' ~ ~ ~~, " } ~ ~ ~ ~ ~ , . ~O,O' 5'0' . , ,:50'( ,t:;t;;(:a::;; " "'~;f"/"N ~ % ~~~~ 8. 30.00' cf"".7 /""'o::w ~ r ,/'V c",~ ., ~4 /?'? ~ . t4l " 9 8. , ti(tI' A'''''N'',,4?, /lvr"""~r ) fX:) , 47"k /7TN S'T~c~r ,I 0 C ':,'. ""," ~ -./........ ~ C( ~/1 + L 8<2., 3 'f-J- \-11 r L C ROo/<