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Home My WebLink About02-1004 BUILDING PERMITN~ 1004 CITY OF ZEPHYRHILLS (813) 788~6611 Permit Date .:L - j20 -u.:2- c~ Property Owner: Job Address: Parcell.D. # E~f.IB1.cAt: PL~ "MECIIAN1CAL G:~~~~~~t!Y .. Sewer Conn Water Conn: Water Meter:. T.I.F.'s: Zoning: DescriPtion of Work Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL ,... ~7-0 ::2-. DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. C.O. DATE Valuation or Contract Price Company Addr ov ~g }/PSD . City License Registration # ~ '7'.-!:r- State Certified License# " elephone# UILDI~' ELEC~t ..;;.----- P~- MECHANf€AL 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 Ins!. Compressor Final Driveway 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 inspection fees shall be made before any further permits will be issued to the person owning same. APPLICATIOli FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT DATE RECEIVED PLANS REVIEW FEE OWNER'S NAME 0,} J~ nfu')f!.5 ~1e6;'1 Dv1 5b.nol_ PHONE it1(J- ~ 3 JOB ADDRESS @ r~(~-" Flw~ . LEGAL DESCRIPTION: LOT(S) BLOCK $UBDIVISION PARCEL ID # WORK PROPSED:ONEW CONSTRUCTION OSIGN {OBTATN FROM PROPF.RTV TAX NOTICEl o ADDITION OALTERATION o REPAIR o INSTALL o MOVE o DEMOLISH PROPOSED USE: DSGL FAMILY DWELLING o COMMERCIAL DMULTI - FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING }?OOL , o MOBILE HOm q OTHER , ~ BUILDING SI~E o RESTAURANT "O~ -:g€- (0<2~ & HEALTH DEP~TMENT APPROVAL DESCRIPTION OF SQUARE rOOTA~E HE+GHT RESIDENTIAL: COMMERCIAL :. ATTACH (2) PLOT PLANS & (2) SET~ OF BUILDING P~S & (1) SE~ ENERfY FORMS. ATTACH (3) SETS OF BUILDING PLAils & (1) SET ENERGY FORMS. PROPERTY SURVEY REQUIRED FORALJ:, NEWCONST~UCTION. ., o BUILDING PERMITS REQUESTED $ 3/ ltS () VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL AMP SERVICE o FLORIDA POWER o W.R.E.C... o PLUMBING ,/ o MECHANICAL $ o GAS o ROOFING o SPECIALTY VAl.UATION OF MECHANCIAL INSTALLATION o OTHER \~ TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO BUILDER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** ELECTRICIAN SIGNATURE COMPANY. STATE CERT OR REGIST # CITY PROCESSING # " * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * *.* * * * f.; PLUMBER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE '0.'. . ..~. .t.. ~.1" <.: :~ ldECHANICAL ***********~****************************************************** II COMPANY. STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** ***************************************************************** COMPANY~~~ ~~LlrL (/C ATE CERT 0 REGIST # . ..~. cr TY PROCES S rNG # ;;;;;r-? P') . . .. .':.' :: i I , , i The undersigned understands that this permit m.ay be sub~ect to "deed ,-est"t:~_c'::'_o!'.s" 'N'1:'.c'1 'may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any appl~cable 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 b'e licensed in accordance with state. and'local regulcLtions. If the cont:rac:tl:lr is not licens~d as required by law, both the owner and contractor may be cited fOl: a misdem,?:anor violation under state law. If the owner or intended contractor are uncertain as to 11'lhat 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 contractorsr 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 contractorr you are indicating that you, rather than the contractorr 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 I,D. ..CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) ,'.', I certify+that I, the applicantr have been provided with a copy of "Florida's Construction lien Law.-i- Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consu&er Affairs. If the applicant is someone othe~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 Servicesr 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 drainag~ 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, cancelr 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". ,6dk~ ,~. ,~~~ SIGNATURE: o~~- SIGNATURE: c~~~ _ .---.: STATE OF FLORIDA /2,. ~ /"'\ STATE OF FLORIDA I~ COUNTY OF ~ COUNTY OF The foregoing instrument wasracfnowledged . The foregoing i~ument wa~c~owledged Before me this..;)f.;L day of!::1....t;;). , ~~efore me this ' . day of ~~ , ~~ by by (name of person acknowledged) (name of person acknowledged) ~hO is personally known to mer or ~o is personally known to me, or o who has produced 0 who has produced (type of identification) (type of identification) did not take an oath. ~id not ,ta \ --- S Name Name typed,