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Home My WebLink About01-0019 BU~ING BUILDING PERMIT Permit 00019 D..e~ ;/3/0( CITY OF ZEPHYRHILLS (813) 788-6611 ? 5. q::: ELEC~ICAL /' tlU ~:>.- MECHANICAL PLU~NG Sewer Conn Water Conn: Property Owner: f;J.c,.rd C' 720 '? ,,_(;1 Job Address: .;} ~__ .1.. Parcell.D, # ~c,r~-'e .u- S+. Water Meter: T.I.F.'s: Valuation or Contract Price Energy Code: A / c. ..... -I-\eu. of . Radon Gas: E--/€t.-h-;t l1P9 ro.de Zoning: Description of Work ""'-.)'. -\i.... FINAL NO OCCUPANCY BEFORE C.O. DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances, c.o. DATE :) 9~~. ~ Permit Fee Signature Company Address Telephone# Inspector bO,~ City License Registration # State Certified License# '2e Ak Ftr. Pre SLB Lintel FRM. Insul. CL WL Driveway ELECTRICAL q~ MECHANICAL PLU ING Tp, Serv, Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final 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 00/100 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, APPLICATION FOR PERKIT CITY OF ZEPBYRBILLS BUILDING DEPAR'l'HENT OWNER' S NAHK .f: t' A/J/( j) 6.3'0/0 ~/Pe- :!JAkl74- /I .3 ~// .f..Qe>C' 7'- PHONE OWNER' S ADDRESS 7 0 /L .::-.--,.." r.?... ,-? ~~-~.:..; JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCIL--.SUBDIVISION PARCEL LD.' (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPOSED:~ew Construction ---..Addition ~teration ---Repair _Insta11 _Sign ---.JIove --.J)eIIo1ish PROPOSED USE: ~iog1e F8Ilily ---lt/F _' of Units ---lt/B _ec-ercia1 _Indust. _Swill. Pool _Other ---.Jlestaurant &: Health Depart:llent Approval DESCRIPTION OF WORK: /;V~ ~LL ,f/C ~ &4/ 11/ /EkC~G ~~"f'4Pe., " BUILDING SIZE: x Square Feet. Height RESIDEIITIAL: AtTACH (2) PLOT PLARS &: (2) SETS OF BUILDING PLANS &: (1) SET ~ERGY FORMS. COMKERCIAL: AtTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERKITS REOUESTED ~UILDING $ 'ff7V 295'3- Va1uation of Tota1 Construction RT .R.C'l'RI.CAL AIIP Service Florida Power Corp. W.R.E.C. -.JIECIIAI[(CAL $ Va1uation of lIechanical Installation -PLUllBIRG GAS ROOFING SPECIALTY . TYPE OF CONSTKUCTION: _____lock -"r8lle _Steel Other FDfISJIED .FJ.OOll ELEVAfiONS: FT. IS PROJECT IN FLOOD ZORE AREA? YES NO .......................................... CONTRACTOR SECTION ,. WllPARY State Cert. or Regist. . City License Registration # .......................................... BIITTJlER Signature RT.R.CTRICIAR COKPARY 7-:=. \""\'-'-, \2:.. ~'-"' - $'~ \ ~~' ~ State Cert. or Regist.' oou:)...... l ~ <tr Signature ~. ~ e . City License Registration. # q (p , .......................................... PLUllBER COtIPARY State Cert. or Regist. . Signature City License Registration # .......................................... IlI!aIAIIICAL /:7 ,...;:;:____ V COIlPAIIY ;2Q~ T &.-z/AE ~ -I A..- Sigoa-.o L~/~~ ~~eL~o~.:~~~~: Plf/,~/J ... ..................................... OTIIRR COIIPARY State Cert. or Regist. . Signature City License Registration . .......................................... APPLlCAfiON APPROVED BY PERHlT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS rbe undersigned understands that this penit lilY be subject to 'deed restrictions' which lilY be lOre restrictive than City regulations. rbe undersigned assU188 responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas hired a contractor or contractors to undertake IIOrt, they lilY be required to be licensed in accorclance with state and local regulations. If the contractor is not licensed as required by law, both the 0IIJleI and contractor lilY be cited for a liscleleanor violation under state law. If the owner or intended contractor are uncertain as to wbat lic8D8ing requireJIents lilY apply for the intended wrt, they are advised to contact the City of Zepbyrhills Building Deparblent, (813) 788-6611. Furtbenore, if the OIOler bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the 'Contractor Sections' of this application for wbich they will be responsible. If you, as the mmer sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the IfOrt. If the contractor wishes you to sign as contractor that lilY be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILI'1'Y CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of 'Plorida's Construction Lien Law - BoIeoImer's Protection Guide' prepared by the Florida Depart:lent of Agriculture and ConsUJl8I' Affairs. If the applicant is 80180I18 other than the 'mmerl, I certify tbat I bave obtained a copy of tbe above described docuIent and prOlise in good faith to deliver it to the "owner" prior to COlleDCeJl8llt. E. CONTRACTOR1S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and tbat all IIOrt will be done in COIpliance with all applicable laws regulating construction, loning, and land develo(lRllt. Application is hereby Iilde to obtain a perlit to do work and installation as indicated. I certify that no IIOrt or installation bas C31encec1 prior to issuance of a perlit and that alllOrt willbe perfOIlecl to IIl!8t standards of all laws regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also certify that I understand that the regulations of other goverDll!JltBl agencies lily apply to the intended IfOrt, and that it is IY responsibility to identify wbat actions I lust take to be in COIpliance. Such agencies include but are not liaited to: I Departlent of EnvirODl8lltal Regulation - Cypress Baybeacls, lIetlandAreas and EnviroDleDtally Sensitive Lands, lIater/llastewater 'Ireatlent I Southwest Florida later Hanagl!lellt District - lIells, Cypress Baybeads, Wetland Areas, Altering lIatercourses I AIly Corps of Engineers - Seawalls, Docks, lavigable Watenays t Departlent of Health i Rehabilitative Services, InvirODleDtal Health Unit - lIells, Wastewater 'IIeablent, Septic rants t US InvirOlllental Protection Agency - Asbestos abatl!leJlt I also certify that, if fill I8terial is to be used in Flood Zone 'AI or IA,ete.', it is understood that a drainage plan addressing a 'COIP8D8ating voluel will be sublitted which is prepared bya professioUl engineer registered in the State of Florida prior to peIlit issuance. . A perlit issued shall be construed to be a license to proceed with the wrt and, not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a PeIlit prevent the. BuildiDg Official fIOl thereafter requiring a correction of errors in plans, construction, or violations of any coda. Ivery perlit issued shall becme invalid unless the IfOrt authoriled by such perlit is COII8Ilced within sillODtbs of issuance, or if wrt authoriled by the perIIit is suspended or abandoned for a period of sil IODtbs after the tile the IOlt is ~cec1. One 90 day 81tension of tile, Iilr be allowed for the perlitwith fee charge of $15.00. !be 81tension shall be requested in writing to the Building Official. An approved inspection lUSt be logged during each slllODth period, or the project lill be considered abandoned. NARlING '10 OIIIIR: YOUR FAILORI TO RECORD A IIO'fICE OF allMDCIIIIU HAY RESULT II YOUR PAYIIG nICE FOR IIIPROVIIImS fO YOOR PROPIR'fY. IF YOU mIlD fO OBUII PIIWlCIXG, COISUL'I lID YOOR LBMDIR OR lIf AnomY BIFORI RICORDIIG YOOR 1O'fICE OF OJIHIIClMBI'f. JOBS UlDIR $2,500 1M VALUI DO 1O'f IfDD fO RECORD lIfDl'O$I"l~1 OF WlllllCIIIm'. .. .,... /~ // ,./ . / SIG.NAfURB: OOIR OR AGBII'I who is personally known to me or who has produced as identification and who did/did not take an oath. ..,.-----.... SrArB OF FLORIDA<'1-__--? . coum OF j r'L "l a .J) The foregoing instrument was acknowledged before me th~~gd!<A1 , :3 . , &;200 I by o:lf .~~/ , ..ho, . pe~: ~~r wbo bas pr ced as " . ication and wh~ did no't take an i.' C~. ' \.._-~. / . , ~~tu e . .... C/ c..;:i~ )n~/1Nn (N, . ~ed, Printed or Stallped) NOTARY PUBLIC srArB OF FLORIDA coum OF The foregoing instrument was aCknowledged before me this , 19____ by (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC ....~".." Bobble Swetland E.1Jl:""'~~ MY COMMISSION # CC893160 EXPIRES ~. :~l February 22. 2004 _ '~i",,"~~ BONDED THRU TROY FAiN INSURAI\ICE, INC ~~',Rfllfr\\ .