HomeMy WebLinkAbout02-1605
BUILDING PERMIT
CITY OF ZEPHYRHILLS Permit N!
BUilDING
1605
(813) 780-0020
Date
/117'" tl8-- (J ~
.
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
C f- ~.
(.~pf~;1J;~' ~
Property Owner:
Job Address:
Parcel I. D. ,
Zoning:
DescriDtion of Work
Water Meter:
T,I.F.'s:
Energy Code:
*Jf<I(l.' rt~
Radon Gas:
5f~
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
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
City license Registration #
State Certified license#
BUilDING
Ftr.
Pre SlB
lintel
DATE
\ ?SO' ~
I
Inspector
Permit Fee #0 II {YO
~ignature~ ~(j'A.~/A..n,^_-
/"- (f
Company
Address
)<relephone# ~)j-/N-~JY
S vY1 s~;;:L. LtJvv\."~ /lI'Ilf
PLUMBING
30Ll
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. P
Pool
Pr
inal
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) 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.
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C::O~J:-"~TJ.0?\!S r)~ ?SPMlT AFFlr:JAVI';
A. NOTICE OF DEED RESTRICTIONS
Th.e uncl.ersigned understands that L1:LS permit Inay b!~ suhject to "deed restrictions" '\.-Thid.
may be more restrictive than City r:eguletions. TI1'~ under:sLqned assumes responsibilit:y for
compliance with any applicable deed restrictions,
B. UNLICENSED CONTRACTORS AND CO'TTRACTUR Ri:<::SPr)NSIBILITI~S
If the owner has hired a contractor or sontractors to Ulldertake 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 tile owner and contractor may be cited for a misdemeanor
violation under state law, If the owner or intended contractor are uncertain as to \'That
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, ~s 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. TRANSPORTA'rJON 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 Const~uction
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 ced,fy 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 tllat 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 pe~mit and that
all work will be performed to meet standards of all laws regulating const.~uction, 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
kArmy Corps of Engineers-Seawalls, Docks, Navigable Waterways
kDepartment of Health & Rehabilitative Services, Environmental Healtll 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 "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, 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 become invalid unless the work authorized by such permit is commenced w.1.thin
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 perj,od, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT III YOUR
PAYING '!'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR I,ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,JOBS IHIDER
$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRACTOR
acknowledged
, 19_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this_____day of
by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _ day of
by
acknowledged
1.9
(name of person acknowledged)
Dwho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
o who has produced
(type
and whoD did Ddid not
of identification)
take an oath,
Dwho has produced
(type of identification)
and who Ddid DUd not take an oath
Signature of person taking acknowledgement
Signature of person taking acknowledgment
--
Name typed, printed or stamped
Name typed, printed or stamped