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Home My WebLink About02-1208 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N2 1208 (813) 780-0020 Date Y3 - () ~ BUILDING ELECTRICAL PLUMBING MECHANICAL Sewer Conn Pmperty Owne. rY) (ch4 f:. 1!0 ~ to Job Address: 3c; /53 3 r AJ<<. . Water Conn: Water Meter: T,I.F.'s: Parcel 1.00 , Zoning: Energy Code: OescriDtion of Work~ l&..c./ ~C5 Radon Gas: 7 W ,rvfuiA) ~) FINAL NO OCCUPANCY BEFORE C.O, Complete Plans, Specifications and Fee Must Accompany Applicationo C.O. All work shall be performed in accordance with City Codes and Ordinanceso DATE Inspector Valuation or Contract Price ~ <1 Permit Fee ~ignature ~..ur6I' Company Address ~ ~{5 . &:0 ( City license Registration # d C; I V State Certified license# t::6/3- 2Y7-13ccJ VTelephone# 1<rnA ~ So-r~, Ftr. Pre SLB lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. P e Pool Pre- Fina PLUMBING Breakers Ducts I Co FMlal .// BUILDING SlB Tub Set Water Sewer 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: ao 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 siteo g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning sameo OWNER'S NAME (f) /(~ qel ' C i JOB SITE ADDRESS :3 9 / ,r; 3 CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DBPART~ 5335 8~ STRBET ZBPRYRBILLS. PL 33540 . Phone.813-780-0020 Pax.813-780-0021' 'c;" _ "2 0' Y) DATR lUICRIVBD -:/ Z ./ oS. PLAHS RBVIJOf FRR , Roh ~t' f-s 3~d Ave/}U( LEGAL DESCRIPTION, LOT(S) PHONE CONTACT "'0/ 3 -"} 7 3- ~ JtF :z e IJ 1; ( l' h, /1 <;"" I" v BLOCK PARCEL ID # SUBDIVISION WORK PROPSED: ONEW CONSTRUCTION FROM PROPERTY TAX NOTICE) OSIGN o ADDITIO~ o MOVE o ALTERATION o REPAIR ~ INSTALL o DEMOLISH PROPOSED USE: O(sGL FAMI~Y DWELLING o COMMERCIAL OMULTI - FAMILY 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER o INDUSTRIAL DESCRIPTION OF WORK o RESTAURANT & HBALTH DEPARTMENT APPROVAL 7 tej)/qC r: Mf' J1; W/l1dcJld<i /5/.2. t: /(J/' ~/~ I" , BUILDING SIZE SQUARE FOOTAGE HEIGHT RESIDENTIAL: COMMERCIAL: ~TTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS ATTACH (3) SETS OF BUILDING PLANS & (1) SE~ ENERGY PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. L/.?> I 5 oQ: PBRKITS RBOUaSTBD &~ () T ENBRGY FOR . ~L\~ ' FORMS. o BUILDING $ VALUATION OF TOTAL CONSTRUCTION o BLECTRICAL AMP SERVICB o FLORIDA POWBR o W.R.B.C. o PLUMBING o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING o SPECIALTY o OTHER TYPB OF CONSTRUCTION: 0 BLqCK o FRAMB o STEEL o OTHER FINISHED FLQOR ELBVATIONS IS PROJECT IN FLOOD ZONE ARBAO YBS 0 NO BUILDBR ff~~/IAA-fl/\~ COMPANY Th~ IIlytJ~day~ i/Joiq/kd ~9;;<) STATE CERT, OR REGIST # C~C 05"'Y,~OO(JJ CITY PROCESSING ~/~ SIGNATURB ~***************************************************************** ELBCTRICIAN SIGNATURE COMPANY STATE CERTOR REGIST # CITY PROCESSING # PLUJlBBR ****************************************************************** COMPANY STATE CERT ORREGIST # CITY PROCESSING # . ." ". SIGNATtmE IIBCllAHrCAL ***************************..*.***.**.**************************** COMPANY STATE CHRT OR REGIST. # CITY PROCESSING # SIGNATtmE **************.*****.**..**.*.*...**....***..****.*..*.***.*.*... OTHER SIGNATURB COMPANY STATE CERT OR REGIST # CITY PROCESSING # **************.**************.*****.*********..******.*******..*. CONDITI0NS OF PERMIT AFFIDAVIT A. NOTIC~ OF DEED RESTRICTIONS The und~rsigned understands t~at this permit may be subject:,to "deed restrictions" which may 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 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, they are advised to contact the City of Zephyrhills Building Department, 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 contractor, 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 permitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTEa, 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 information in this application is accurate and that all work will be done in compliance with all ap.plicable laws regulating construction, zoning, and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certity 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 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 addressin~ a "compensating volume" will be submdtted 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 ~nd 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. Everypermit issued shall become invalid unless the work authorized by Buch 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 HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOfU; RECORDING YOUR NOTICE 01' COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". .~I/.~ SIGN URE: OwNER OR AGENT ' SIGNATURE: CONTRACTOR STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _ day of by acknowledged , 1!L- STATE OF FLORIDA COUNTY OF , The foregoing instrument Was Before me this ~day of by acknOWledged , 19-=- (name of person acknowledged) o who is personally known to me, or Dwho has produced (type and whoD did Ddid not of identification) take an oath. (name of person acknowledged) [1ho is personally known to me, or o who has produced (type of identification) and who Ddid OUd not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped