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Home My WebLink About01-0869 BUILDING PERMITN~ 0869 CITY OF ZEPHYRHILLS (813) 788~6611 Permit BUI~ ;)Sr~ ELEC~ PL~ 3 ~~ ME2HANICAL Date I;). -d..~ - 0 ( ~t<(o1S Sewer Conn Water Conn: P,"pert\' owne"Vj J b.w- -t Job Address: ~_ C2J rA/ Parcel I. D. # Zoning; Energy Code: Radon Gas: DescriPtion of Work ~\,o:;-t'~ ~'tW lJli\~T <t L.Jlrl'~ lJl'\ ~ r Water Meter: T.I.F.'s: 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 ::J71f7 Inspector ~E- ~r-,IFO Permit Fee <oJ .::J S;gnalu,. ---- ~J ,r:J{b /) Company Address Telephone# S I q -- <-::.c C(CJU Valuation or Contract Price ~ I, -o;>..o.~ . City license Registration # State Certified license# BUILDING f} A ~ flN..UJn Nl.. ELECTRICAL -I::t CJ..f iO PLUMBING 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 Breakers Ducts Insl. Compressor Final Driveway REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Twenty Five and 001100 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. OWNER'S NAME :Dew+ ~\<'t n ";. JOB SITE ADDRESS 4 0 ( Cora ( S+ CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DBPARTMBNT 5335 8~ STRBBT ZBPHYRH:ILLS, P4 33540 PhoneI813-780-0020 FaxI813-780-0021 DATB RBCB:IVBD /:1-,;; ~ - 0 I PLANS RKV:IBW PRB # 08'6 C; PHONE CONTACT{ / S -'7 1(;,3 LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION PARCEL ID # (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: [JNEW CONSTRUCTION o ADDITION [JALTERATION o REPAIR [JSIGN o MOVE o DEMOLISH PROPOSED USE: [JSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS ~ HOME o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER D RESTAURANT & HEALTH DEPARTMENT APPROVAL DESC~rPTION OF BORR IO~ LD \) (l( ~ [ ^ 1\ \ \- l if' ~+a [y lA.)\. \L~~ LJ.-Y'- \. ~ BUILDING SIZE SQUARE FOOTAGE 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. o BUILDING ~ECTRICAL PERMITS REQUESTED 6() $ \ 0 d 0 VALUATION OF TOTAL CONSTRUCTION ) . ~ Lv '" e \ 0. II.\- AMP SERVICE L..' n o FLORIDA POWER o W.R.E.C. o PLUMBING ~HANICAL o GAS o ROOFING $LoaJ f o SPECIALTY <00 VALUATION OF MECHANCIAL INSTALLATION o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAO YES 0 NO BUILDBR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** BLBCTRICIAN COMPANY If\ 0- :\OfC 00--CC on~ TATE CERT OR REGIST # 'F3 P 6 2) /~ :;) B CITY PROCESSING # ;;J 8-gi) SIGNATURE ***************** *********************************************** PLUMBRR COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE SIGNATUR ***********************************************~*~*********** . COMPANY (' ~ ...L- . . STATE CERT OR REGIST # e MJ' f'I ~ (L:) 7r <I (). CITY PROCESSING # d-I n ( ************************************************ OTHBR SIGNATURE COMPANY STATE CERT OR REGIST # CITY PROCESSING # ***************************************************************** CONDITIONS OF ~ERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit :nay be subjec1: to "deed restrictions" which may be more restrictive than City regula1:ions. The undersigned assumes responsibility for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIE,S 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, t.hey are advised to contact the City of Zephyrhills Building Department, 613-766-6611. 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 responsi.ble for the work. If the contractor wishes you to sign as contractor that may be an indi.cation that he is not properly li.censed 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 provi.ded 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. 1 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 01 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 $2,5 IN VALUE DO NOT NE Tq RECORD AND POST A "NOTI F COMMENCEMENT". ~ STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this -----pay of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _ day of by acknowledged , 1!L- acknowledged 19 (name of person ackno~ledged) Dwho is personally known to me, or (name of person acknowledged) C1ho is personally known to me, or o who has produced (type and whoO did Odid not of identification) take an oath. o who has produced (type of identification) and who Ddid [}lid not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped