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Home My WebLink About02-1169 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N! 1169 (813) 780-0020 Date /f- /7-eJ~ c~ El~' P~- M~AL Sewer Conn Property Owner: Job Address: Parcel I. D. " 7;~~<~~~{h. ~9o~to Water Conn: Water Meter: T,I.F.'s: Zoning: DescriDtion of Work NO OCCUPANCY BEFORE C.O, FINAL C,Q. DATE Complete Plans. Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. DATE Inspector - 4_____, Valuation or Contract Price /'300 City license Registration # ~ /'{ / State Certified license# 7 <62 "I 7- It.( {!~ ~~' -'B~'LDING . "-......,.-... ........ !:LE~' PLU~' MFC'I-4.dI\.IIr.d1 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 lnsl. 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. OIOHRS'S HAMIl ~) () (7 e fi;2p Lit ,.J JOB SITR ADDRRSS ~ 9' -> ~ C( _ 8- 11 Oc..r~. CITY OF ZEPSYRHILLS PERMIT APPLICATION BUILDIRQ DBPAR~ 5335 8~ ST..aT ZBPRTRRXLLS. WL JJ5tO Pbone.81]-780-0020 Pox.81]-780-0021' . /1 1 ~ DATB IUICJlJ:VBD, 'i.-I' _- O.;.L-- PLAKS llBVJ:1Df rBB , PHORR CONT~f!'-Z-;;'~='?JJ. C.. . LRGAL DBSCRIPTION: LOT(S) PARCRL ID # BLOCK SUBDIVISION WORK PROPSBD: oNBW CONSTRUCTION (OBTAIN FROM PROPRRTY TAX NOTICR) oSIGN oADDITIO~ o MOVE o ALTERATION o RBPAIR o INSTALL PROPOSED USE: oSGL FAMiLY DWELLING o COMMERCIAL o DEMOLISH DMULTI - FAMILY 0# OF UNITS o SWIMMING- PboL o MOBILB HOMB o OTHRR o INDUSTRlJil. O'RIISTAURANT & HHALTH DRPAaTMENT APPROVAL .I!RSCRIP'rlOH OP HORR .~~ ~i. ~ BUILDING SIZE 3 ~:7- 5 6 SQUARB FOOTAGB I C? 0 D T RESIDENTIAL: COMMERCIAL: ~TTACH (2) PLOT PLANS & (2) ,SETS OF BUILDING PLANS & (1) SET BNERGY FORMS. ATTACH (3) SRTS OF BUILDING PLANS & (1) SBT HNRRGY FORMS, PROPERTY SURVEY REQUIRED FOR ALL NBW CONSTRUCTION, HBIGHT o BUILDI~G $ '1302J.~ PBRMITS RBaU.STBD D VALUATION OF TOTAL CONSTRUCTION o ELIllCTRICAL AMP SJlRVICIll o FLORIDA POWER o W,R,E,C. o PLUMBING o MRCHANICAL $ o GAS ~FJNG. 0 SPBCIALTY VALUATION OF MJlCHANCIAL INSTALLATION o OTHBR TYPB OF CONSTRUCTION: 0 BI,QCK o FRAME o STRRL o OTHER FINISHED FLQOR ELJlVATIONS IS PROJECT IN FLOOD ZONB ARBAo YHS 0 NO BUXLDBll ~ COMPANY DTI'1Il..I?.J.!Bh > . . . _ ...: /I . /7 ~ . STATE CHRT, OR RBaIST 1#. 005(5 Lf..2.~ __ SlGIIATORIl > A ,tt<.LL "-V\. CITY PROCBRsrllQ . ~ '7.1 , ~ ..............................~.................~........... BLBCTRXCJ:AH SIGNATURE COMPANY STATE CIllRTOR REGIST # CITY PROCESSING # PLUllBIIR **.*..*.*A**....***...*.*******.*******.*.**..**********.****.*... COMPANY , STATE CRRT OR,RRGIST # CITYPROGIllSSING # ' , " " SrGNATURB IOICIlAHICAL' ******...*.**..*******.*....*************.***...*..**.************ COMPANY. STATIll CHRT OR REQrST. # CITY PROCESSING # SIGNATURII OTaB. , *******************.***.**************.****..****.****.**....**** SIGNATURB COMPANY STATIll CERT OR RIIGIST , CITY PROCIllSSING , ************.*****************************.**.*.*************.*** CUNVITI0NS OF PERMIT AFFIDAVIT A, NOTICE OF DEED RESTRICTIONS The und'er~igned understands tqat this permit may be subject ::to "deed restrictions" which ~ay 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 contraotor 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 Depart~ent, 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 contr~ctor, 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 penroitting priVileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTEtI, 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 infonmation in this application is accurate and that all work will be done in compliance with all ap.plioable laws regulating construction, zoning, and land development. Application is hereby made to obtain a penroit to do work and installation as indioated, I certify that no work or installation has oommenoed prior to issuanoe of a penroit and that all work will be perfonmed to meet standards of all laws regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiotion, I also certify that'I understand that the regulations of other gover~ntal agenoies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance, Such agenoies include but are not limited to: *Department of Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment . *9.outhwest Florida Water Management District-Wells, Cyp.ress Bayheads, Wetland Areas, Altering Watercourses *Acmy 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 till material is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressin~ a "compensating volume" will be submitted which is prepared by a prQfessional engineer registered in the State of Florida prior to permdt 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 oodes, nor shall issuanoe of a penmit prevent the Building Offioial from thereafter requiring a correction of errors in plans, oonstruotion, or violations of any oode. Everyper:mit issued shall become invalid unless the work authorized by Buch per-mit 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 oommenced. One 90 day extension of time may be allowed for the permit with fee oharge of $15.00. The extension shall be requested in writing to the Building OffioiaL An approved inspection must be logged during each six month period, or the project will be oonsidered abandoned. . WARNING TO OWNER: YOUR FAILURE TO RE<:::ORD 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 BII'OIUi RICORDING YOUR NOTICE OF COMMENCIMINT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A uNOTICE OF COMHENCEHENT"~ SIGNATURE: OWNER OR AGENT SIGNATURE: CONT~OR r,Jt STATE OF FLORIDA COUNTY OF , The foregoing instrument was Before me this _ day of by acknowledged , 1SL- STATE OF FLORIDA COUNTY OF . The foregoing lustrqment was Before me this ~ay of by ac~nowledged , 19-:.... (name of person aoknowledged) Tt who is p.rsonally known to me, or o who has produced (type of identification) and whoO did Odid not take an oath. (name of person aCknowledg.d) [1ho is personally known to me, or Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped