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Home My WebLink About02-1170 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N2 1170 (813) 780-0020 BUILDING ELECTRICAL Date </ -I tf-o .:z PLUMBING MECHANICAL Sewer Conn Water Conn: P,"perty Owne, Ii!'~ ~ Job Address: ~ I (p 7. . ; . Parcell.D. , Water Meter: T.I.F.'s: Zoning: DescriDtion of Work Energy Code: R~-~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL C,Q, -tl,2 DATE Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. Valuation or Contract Price ~ ~~S' ~ ;;2.S/O City license Registration # State Certified license# flJl'~ ~ BUILDING Ftr, Pre SLB lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final / i I I I ! / / Driveway DATE Inspector /';~:6 ~~ ) C, ....... .G-ompany Address 'xrelephone# ~;;-? - \ '4-. LD s,- ....---. PLUMBING MECHANICAL SLB Tub Set Water Sewer Final Breakers Ducts Insl. Compress Final I f REINSPECTlON 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) shaH 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. OWNBR' S N~ --1-k l-ef\ ~ ~ Q.. \.D('0N\be~ JOB SITB ADDRIISS~ J ';:> ~ l 0 (" ; ('; n '{ if, Il(11) CITY or zmpSYRHILLS PBRHiT APPLICATIO. ~ ~ BUILDIBQ DBPARTMBHT 9]38 8~ STRWwr ZBPRTRBILLS. FL 3iseo PhoneI813-780-0020 .axI813-780-0021' bATII 1uIcIIJ:VJID, PLUS RlIYI_ nil . LBGAL DBSCRIPTION, LOT(S) BLOCK PmMR ICT 7&g -Ilero ?XPhy r-ht I k 8} c.ol3lP i=1- k:(r9~ SUBDIVISION PARCBL ID ,. WORK PROPSBD: oNBW CONSTRUCTION (OBTAIN FROM PROPBRTY TAX NOTICR) oSIGN o ADDITIOt{ o MOVE D ALTBRAT ION o DBMOLISH D RBPAIR D INSTALL PROPOSBD USB: DSGL FAMiLY DWBLLING D COMMBRCIAL DMULTI - FAMILY D INDUSTRIAL Off OF UNITS DSWIMMING. PbOL o MOBILB HOMII o OTHRR QBSCRIPTION OF WORK O'RBSTAtJRANT Ii HIlALTH DBPARTMBNT APPROVAL SQUARB FOOTAGB HBIGHT BUILDING SIZR RBSIDBNTIAL: COMMBRCIAL: ~TTACH U) ~LOT PLANS & (.:it). SRTS OF BUILDING PLANS Ii (1) SRT IIHBRGY FORMS, ATTACH (3) SBTS 011' BUILDING PLANS Ii (1) SIT IINIIRGY FORMS. PROPBRTY SURVEY RBQUIRED FOR ALL NEW CONSTRUCTIQN, o BUILDI~G RBRlUTS RBQUI'TBD . VALUATION OF TOTAL CONSTRUCTION o RLB.CTRICAL o PLUMBING AMP. SIIRVICil o FLORIDA POltRR o It.R,B,C. o MBOHANICAL $ VALUATION OF MBCHANCIAL INSTALLATION o GAS o ROOFJ,NG . 0 SPBCIALTY. 0 OTHBR Typg oir CONSTRUCT lOll: tJ. BLQCK o FRAMB o STBHL o OTHIIR FINISHED FLQOR BLBVATIONS IS PROJBOT IN FLOOD ZONB ARBAo YBS 0 NO G~hd ~ CO~PANY W l ctnf> f.. <( Oc>+; nj STATB CIIRT.OR RRGIST ,. CITY PROCBSSINQ 41 .::J 51 () . . , BLBC'l'RJ:CJ:AH ~.................***.*..*.**...................*..........*.*.... SIGNATURill .... COMPANY STATB CBRT'OR RaGIST ,. CITY PROCRSSI~G ,. PLUllBBR ............................**................***.*...*.......*... IIBCIlARICAL' .*.......*****.*.************.*.***.****.*********..*.*.****.***.. COMPANY' STATB CBRTOR!~GIST ,. CI'rYPROC!ESSIHG ,.. , SIGNATUlUI COMPANY. STATE CBRT OR ~GIST. ,. CITY PROCBSSING ,. SIGNATURB 01'SII. . ********..............*..*....................................... SIGNATURE .*..*..**.*....*..**..*..**...........................**..**.**.. COMPANY STATE eRRT OR RaG 1ST ,. CITY PROCBSSING ,. A, NOTIC~ OF DEED RESTRICTIONS The und'ersi"'gned understands t~at this pexDLit; m,:ty be subject ::to "deed restrictions" which may be more restrictive than City' J;"egulat:ions. The lmdersi.gned aSllumes responsibility tor cOlDpliance with any applioable deed rostt:ici:iol1s. B. UNLICENSED CONTRACTORS AND CONTRAGTOH RmsPoNsIBIl.ITIIl:S If the owner has hired a contractor OJ~ conb:aclcors to undertake work, they May b~ required ,to be licensed in accordance with state Iilnd looal regulations. If the contractor is not licensed as required by law, both the owner and contraotor may be oi.ted for a mdsdemeanor violation under state law. If the owne:r; or in1:ended contraotor are unoertain as to what licensing requirehlents may apply for the intended work, they are advised to contact the City of Zephyr-,ills Building Depart~ent, 8U'-708-6611. Furthermore" if the owner has hired a cont.rclotor or: contractors, he is advised to have the contraotor(s) sign portions of the "Contractor Seotions" of this application for whioh they will be responsible. If you, as the owner IligllS as 'the contr,otor, you are indicating that you, rather than the oontractor, are responeible for the work. If the contractor wishes you to sign as contractor that may be an 1ncUclltion that he is not properly l1censed and is not entitled to perntl.tting pri-Vileges in thel City of Zephyrhills. C. TRAH~PORTATION IMPACT FBBS AND UTILITY CONNECTION FI!:ES D. CONSTRUCTUION LIEN LAW (CHAPTEI\ 113, FLORIllA. STATUTE~, M>>fENDED) 'I certify that I, the applicant, have been p,roVided with a copy of "Florida' II Construction lien Law - Homeowner's Protection Guide" pre'paJ:ed by the Florida Department of Agriculture and Consumer Affa1rs. If the applicant is so~ione other that the "owner", I cerify that I bave obtained a copy of the above described doclument and promise in good faith to deliver it to the "owner" prior to commenoement. E. CONTRACTOR' S/OWNER' S AFIl'IDAVIT I certify that all the information in this application Is accurate and that all work will be ~one in compliance with allap'plicable laws regUlating construction, zoning, and land development. App11cation is hereby made to obtain a penm1t to do work and installation as indicated. I certity that no work or installation has oommenced prior to issuanoe of a permit and that all work will be perfor-med to meet standards of all laws regulating construction, City codes, zo~in~ regulations, a~d land development regulations in the jurisdiotion, I also certify that I understand that the regulations of other gover~ntal agencies may apply to the intended work, and that it 1.s my responsibility to identify what actions I must take to be in complianoe. Such agencies include but are not limited to: *Departhlent of Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment, ' *B.outhwest I'lorlda Water Management Dilltriat'-Wells, CypJ:ellS Bayheadlll, Wetland Areas, Altering Wateroourses *Army Corps of Ilngineers-Seawal.ls, Docks, Na'lTigable Waterways *Department of Health , Rehabilitative Services, EnVironmental Health Uni~-Wells! Wastewater Treatment, Sept~c Tanks *u. s. Environmental Protection AgenoY-AIIbestl:>s iabatement I also certify that, if ;till material ia to be Illsed in Flood Zone ~'A" or "A, etc. II # it is understood that a drainage plan addressin9 a "clompensating volume" will be submitted whioh is prepared by a professional engineer registerll!d in the State of Florida prior to pe.r:mit issuanae, A permit issued shall be construed to be a llcenae to proceed with' the.work tlnd not as author1ty to v10late, cancel, alter, or set asiele any provisions of the teohnioal codes, nor IIhall issuance of a permit prevent the Building Official from thereafter requiring a correction of' errors in plans, construotion, or violation. of any oode. Bvery.permit iSllued ahall beQome invalid unless the work authorized by 8uch pe~t is commeno~d within six months of i..uance, or if' work authorizecl by the permit is SUspended or abandoned for a period of six months after the time the work ia oommenced. One 90 day extension of ti~e ,may be allowed for the pe~t with f.,.e oharge oj~ $15.00. The extension shall be requested in writing to the Blll1ding Offioial.An appl~oVod inspeqtion .ust be logged during e.ach six month period, or the projeot will be considel~d abandoned. \ ' WARNING TO OWNBRa YOUR FAILURE TO RBt;::ORD A NOTICB OF CONMBNCBHIlNT MAY RBSULT IN YOUR PAYING TWICE rOR IMPROVEMMTS TO YOUR PROPERTY. IF YOU INTI!lHD TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDIR OR AN ATTOIUfIY BlrolUS RICORDIHH YOUR NOTICE OF COHMBHCIMENT. JOBS UNDER $2,500 IN VALUE DO NOT HElD TO RECORD AND POST J,- "NOTICE OF COHHENCI!:HI!:HT"'. vvnu~r~w~~ OF P~RMIT AFFIDAVIT SIGNNrURill OWNER OR AGENT flIGHATURill CONTRAcTOR .r,'" STATE Oil' FLORIUA COUNTY OF , The foregoing instrument was Before me this _ day of by ac)J:nowledged , 19~ (name of person aoknotfledged) 'q who is p~rsonally known to me, or acknowledged , I!L- flTATIl OF FLORIDA GOUNTY OF . 'Jlhe foregoing instr..ent wa. Eletore Ille this ~ay of by o who has produced (type of identification) and whoOdid Odid not take an oath. (name of person acknOwledged) [Lha is personally known to me, or o who' has produce~ , (type of identifioationl and who Ddid DUd not take im oath. Signature of person tak1ng acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, pr1nted or stamped ~ I ~ I~ I~ ~ I, ~ I, ~ I ..... I~ ~ I ~I !' ~, I~ I~ I~ I~ I~ 1 )~ IW I- J- J il Iw' I- = .' ;-. ; ~, I~ ;" I~ I" I- I~ I~ I~ I. 1-; I~ I- l1a 11- Il~ I~ II'. _:.a - ( '? I , \. / 1 ~ 'I No, J I 1Ir/o~ I I [=rom 4 cJ~/:', 37lf37 L~~~ ~ D~ (J.l~ { 7( Proposal Submitted Iro: I i I I I I l Slieet I\io, Work To 8e Performed At: Date i i I ) ;s- 4f- ~!7-l/~ 3TAL3 Q~F .s~ ~r~~ q~7-/2)7 7K3 - to IS'-} Respectfully submitted ~.vJ~ , Per Note- This proposal mav be withdrawn by us if not accepted within, clays.