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Home My WebLink About03-1778 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N! (813) 780-0020 1778 Date l-I'l~ 03 BUILDING ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Property Owner: Job Address; Parcel 1.0. , J ~s J-ovI'Yh ~'5 (it to ~ ~ flv'( .. Water Meter; T.I.F.'s: Zoning: oescriDtion of Work ~rgy Code: . ~V~ c...)/ Radon Gas: 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 Permit Fee >'5ignature Company Address )(Telephone# Valuation or Contract Price ~ L(~ " e-:o City License Registration # State Certified License# I/a fll {j ~ J- t.Yl(A';-;!i. Ftr. Pre SLB Lintel FRM. Insul. CL WL SLB Tub Set Water Sewer Final MECHANICAL BUILDING ELECTRICAL Tp. Serv. Rough In Meter Can Const. Pole Pool Pre-Meter Breakers Ducts Insl. Compressor Final Final Driveway /1 r 11- () J I./'[f 0 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 /.- /7 - fJ 3 PLANS REVIEW FEE OWNER'S NAME / JOB ADDRESS /.3 PHONE ~' ;?1i- .;r /0:< '7' \ , LEGAL DESCR!PT,ioN: LOT(S) PARCEL ID # :/~ /.2 c: Ie,; I , /' WORK PROPSED: DNEW CONSTRUCTION BLOCK SUBDIVISION c:JOJ d -cJd~ ~O~~c;ROM PROPERTY TAX NOTICE} o ADDITION DALTERATION o REPAIR o INSTALL DSIGN o MOVE o DEMOLISH PROPOSED USE: DSGL FAMILY DWELLING o COMMERCIAL DMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER DESCRIPTION OF WORK D RESTAURANT & HEALTH DEPARTMENT APPROVAL Dfll tk~ 4J~' 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. o BUILDING $ ,~~~ a):-- PERMITS REQUESTED VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL o PLUMBING o MECHANICAL AMP SERVICE o FLORIDA POWER o W.R.E.C. $ VALUATION OF MECHANCIAL INSTALLATION o GAS o ROOFING o SPECIALTY o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES o NO SIGNATURE COMPANY Aec-- ~ ~ ~fl C' (I STATE CERT OR REGIST # CI'L <-0 .~ <./ t5~ CITY PROCESSING # BUILDER ****************************************************************** ELECTRXCIAN COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ****************************************************************** PLUMBER SIGNATURE COMPANY STATE cERT OR REGIST # CITY PROCESSING # * * ***** * ** *.** ** * ***** * ** ***** * * * ** * ** * *** * *** * * *** * * ** * * ** * * * *** * * MECRANXCAL COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** OTHER COMPANY STATE CERT OR REGIST # CITY PROCESSING # SIGNATURE ***************************************************************** CONDITION::; (),~' P,~,~lT A.~'~'~:;)AV"','~.' . A. ljOTIcE OF DEED RESTRICTIONS The undersigned understands that this permi': may be sub:iec:t t:o "deed restrictions" which may be more restrictive than City regulations. The unde.r;siqned assumes responsibility for compliance with any applicable deed restric1:ion;:;. B. UNLICENSED CONTRACTORS AND CONTRACTOR R]~SPONSIBILrrIES If the owner has hired a contractor or contrac1:ors to undertake work, they may be required to be licensed in accordance with stat:e 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 in1:encled contractor are uncertain as to what licensing requirements may apply for the in1:ended work, they are advised to contact the City of Zephyrhills Building Department, 813-7138-6611. 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 A~fairs. 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 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 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, Wet~and 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 "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 cons~d to be a license to proceed with the work and not as authority to violate, cancel,'~lter, 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 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 PAYING TWICE FO PROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB WITH YOUR R ATTORNEY BEFORE RECORDING YOUR~, C 0 $2,500 N T NE~rL ECORD AND POST A "NOTICE OF OMMENC STATE OF FLORIQA COUNTY OF {lAS<." 0 The foregoing instrument was acknowledged Before me this r 7ft,... day of JAN u.AR..y , W~3 by .pAIft.-t~i Pr' I>bL-AR.H (name of person acknowledged) O,who is personally known to me, or ~ho has produced FL- JJt/ ';e~S L-Jl"'aJSE (type of identification) and whoD did ffdid not take an oath. ~~~,&,~ Signature of person ak1ng acknowledgement IE t~~~0~~1~~ J. ~W~ RESULT IN YOUR cING, CONSULT JOBS UNDER ~-_., i ,./ ,r ~,_____-,e , SIGNA: RE: CONTRACTOR STATE OF FLORIDA /) COUNTY OF r'ASC 0 The foregoing instrument was acknowledged Before me this .J.:C::....day of ~/..lkP.Y , l;j:;20z)3 byt<, p..y y AJ 1iZL...~ (name of person acknowledged) cwho is personally known to me, or o who has produced (type of identification) and who Odid [}:lid not take an oath ~j~ Qg~ Signature of pe son tak1ng acknowledgment Nat:~~ntd ~.~~ I ".~o., ',.' 'J';ROWN ' { 38525 2nd Ave. Zephyrhills, FL 33540 ACE ALUMINUM & CONCRETE, INC. :7lJ:v?~-> 4. ' ~ !)~ /'~ -:-?~ s' /if a....- zc. /. - ~(~ /,q Job No. Phone: (813) 782-2616 SOLD TO ADDRESS SHIP TO DATE PHONE //0 )C// // ~ /~7 PERMIT PRICE TAX o \.l ~ undersigned -- to pay TOTAL PRICE ,/ .. \ I it ALLERS IN FULL ON COMP DD\ DEPOSIT ....... .4 J / I, I I BALANCE C.O.D. y- Y' CAJ Rep. Customers ~;;;;;:.~-c~ ~ 81TR I'I..lJ1 . (,llESlDEHflAL usa nHLY ~ ,. l'A\lCEI> I': lJ I : ~; I:, \ ; i/lh ""'TIii' ~/ lUlU tJ03J t/OvuU tkJ~~ /,2... - ~Ull\l lILUC~ t.\,' I '/11) 1'1-: II'r)' , /110\ S 1l1l/.:J\ I:ll'r /cRS>C7-3 :?!/d f ~-#~, 1>^TI:: /~1h , . l: II i'i i il:.II;ri'. 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