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HomeMy WebLinkAbout02-1416 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N! (813) 780-0020 uJd~ Date ~ -~ ~... 02- C'''~ 1416 Sewer Conn Water Conn: Property Owner: Job Address: Parcel 1.0. , Zoning: OescriDtion of Work Water Meter: T,I.F.'s: Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. FINAL C.O. DATE NO OCCUPANCY BEFORE C.O. DATE City License Registration # State Certified License# gDIV Inspector Valuation or Contract Price BUIL~ ~ ELE~- ,......- 9/7-S77t Q~~~ PlU~/ MECHANIC~~ . - Breakers Ducts Insl. Compressor Final SLB Tub Set Water Sewer Final Tp. Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Final Ftr. Pre SLB Lintel FRM. Insul. CL Wl 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. APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT . DATE RECEIVED PLANS REVIEW FEE OWNER'S NAME C>tL\ t)~ 2e ph\.\Rh\ \ \~ \='Itte be-pi JOB ADDRESS foCfD1 DQ\ R \1 R.d. \ PHONE ~ ~D "' D04} LEGAL DESCRIPTION: LOT(SI BLOCK SUBDIVISION PARCEL ID # (OBTAIN FROM PROPERTY TAX NOTICE) o SIGN o ADDITION ~TERATION o REPAIR o INSTALL o MOVE 0 DEMOLISH OMULTI-FAMILY 0# OF UNITS o MOBILE HOME o INDUSTRIAL o SWIMMING POOL o OTHER WORK PROPSED: ONEW CONS'l'RUCTION PROPOSED USE: OSGL FAMILY DWELLING ~MMERCIAL DESCRIPTION OF WORK D Dof'\vllt1- CArp I~OI\(" ~~ ~fLom RESTAURANT & HEALTH DEPARTMENT APPROVAL lP to ~Q-\U{l.a I 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. PERMITS REQUESTED o BUILDING $ VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL o PLUMBING o MECHANICAL $ ~ 0 ROOFING 0 SPECIALTY AMP SERVICE o FLORIDA POWER o W.R.E.C. 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 o NO BUI:LDER SIGNATURE COMPANY STATE CERT OR REGIST # CITY PROCESSING # ****************************************************************** ELECTRI:CI:AN COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** PLUMBER COI1PANy..------'---. STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE **********~******************************************************* MECHANICAL COMPA1"lY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** OTHER ~ COMPANY //1...-v,i. "-:ru / ...--- STATE CERT OR REGIST # :+rf?<t' SIGNATURE)/7cP( (/.t ~~ CITY PROCESSING ~~ t) *********************************************~*****~~***** " . CONDIT lUNS OF PEHtHT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Th~ und~signed understands that this permit may be may be more restrictive than City regulations. The 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 STATUTES, 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 tllis 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 perIni"\: 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 certi~y,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 addressing a "compersating volumeH 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 becorne 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~O RECORD AND pos'r A "NOTICE OF COMMENCEMENT", P~OR=~~ SI~C'ffj~ STATE OF FLORIDA./J STATE OF FLORIDA ~ COUNTY OF ,~ COUNTY OF .A ~ The foregoing instrument was acknowledged The foregoing instrument wa~ck~edge~7 Bef~e me this .;:l.c2--/f:J.ay _Qf ~'tA"-r(_, 1999 Before )~ this fi2=-da'hOf..~J~~, 19 ~ by (")~.I ~k-->~:;J _ 5;e/'/f t1~J'lA"" by ~~ ~ ~ -.JOS_5~//I ~ ~A/}4I(J (na e of person acknowledged) (nam of person acknowledged) ,. ~ho is personally known to me, 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. and who Odid mid not take an oath , L2--~ taking acknowledgment subject to "deed restrictions" whiCh undersigned assumes responsibility for Name pe , l~ IIlfJtU rinMMtY... pARIIImped Notary Public. Slat. 01 Florida My comm. .xpIres Sept. 28, 2002 No. CC789981 Signatur of pers/tn aking acknowledgement I.. J ,/ j'1A~'IIlN/U /l-;e,s, Name ty~d, prin~~~ -r ~~~m~8. awiv ANN PARISI ..$11\ Notary PublIc, State 01 FJorlda f My eomm. .xpIres Sept. 28. 2002 No. CC789981 ..