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Home My WebLink About03-1890 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N2 1890 (813) 780-0020 Date ,-1.... -i- tV 9"- BUILDING ELECTRICAL PLUMBING MECHANICAL Sewer Conn Water Conn: Property Owner: ~ r r <-it a.-, ~ ~K.Ic-c.-t1J Job Address: '5'745 -- .5'7'-11 (t+-<- ST~ Water Meter: T_I.F.'s: Parcel I. D. , Zoning: DescriDtion of Work Energy Code: Radon Gas: K--eplc..ce ~ ~ YiJerll~iJl {OK cl(.lj//~ , FINAL 3 -.1 C' - 03' DATE NO OCCUPANCY BEFORE C.O. Complete Plans. Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. c.o. City license Registration # State Certified license# /~0 Inspector pg,mit Fee 7' ~ ~ Aignature' 1//:/ ~ ~:::::y ~ )hlephone#7~7-6 ~t "7/1- c? DATE !?L (I Valuation or Contract Price Ftr. Pre SLB lintel FRM. Insul. CL WL Tp. Servo Rough In Meter Can Const. P e Pool Pre- Fina {'A/hi .:fty~5 PLUMBING SLB Tub Set Water ..1-Sewer/ 3-~O -03 Final Breakers Ducts Insl. Compressor Final Driveway I / I / .' , i I / ( I~'i 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. ~ l'J.'X BUII,IllNG OF ZEPHYRHILLB PERMIT APPLICATION DSPARTMBlN'f 6335 8th S'fREE'f ZBlPHYRHILI.S, FL 33540 PhoneI813-780-Q020 FaxI813-780-0021 DA'fBl RB(llllIVIID -,-,-~_,__ -"11"'-'------- PLANS RBlVIIlIW II'Jil,______,,_______ . (MHER' S HANE -~~-4rleila~-~AjJ1&,d__~n nnn___n_~ ~n_~~n_ PHOllE CON'l'A"T--:28..;1.3d~~ ,roB 8 I'U ADDRED88_5.7!t'2- -:----~.1 'I t------iLlbJt-----_~kL~il6----~:::.~---.-------..-------- LtilllAL Dlil8UR I P'rION I LOT (S) BIDC!K SUBJJIVISlON ------...---....- R__._.______ I?ARCElr~ ID # [J S WI1 o ATlDI'l'ION [J A I/l'E RAT 1011 [1 REPAIR o ].NSTAI.I, o MOVE 0 DEMOI,ISII DMtJI,1'I - FA""nN 0# OF lIN!'I'S [] MOBII.1ll UDt41l1 [J INDlIS'1'RTATJ OSWH1MING I?OOL [] orfHIllR _.._--_.~'-----,._._-_..---- ~------~~--_._-_.~._---,..........-..----- (OBTAUl F1ROM I?RPI?ER'l'V 'PAl< NU'J':fClE) WURK PROP8E1D I [J NB:W ('ONS'l'RUCT ION I?ROi:108EIl lJSE: [laGlJ FAMILY DWELLING fJ COMMEDRC TAl, --------------- o RESTAURANT & HEDArml DElPARTt11ilNT APPROVAL S e ~-L-.i:L1.f!.._f. ~ce ~ l''l f-----_____.___________.___._ HElHUl'f SQUARE FOOTAGE j)jj)8CRII?TION OF WORK BlJILIHNl3 SIZE ~.._.,~-.._.---- RESIDElN'l'IAIJ I C01'1MElRCIAIJ I A'I"l'ACH (:2) PI.Orr PTJAlIS .& (2) SElTB OF BUII,DING PI,AUS & (1) BElT IlINlilRCiV FORMS, A'I"rAr~H (3) SETS OF BUII,TlING PLANS & (1) SET ENBlR<JY FORMS. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. FE~IIS REQUESTID [] BIJILIJINf3 $-- VALUATION OF 'fO'1'AL CONSTRlJCrl'ION Ll BlLtilC'1'RWAI, -.-------- AMP ~ElRVWEJ [] FI,ORIDA I?OWER o W.R.EJ,n. J>l P!.UtIJBING. o I1EUHAlHUAL , $---- - VALUATION OF MEC'HANCIAI, INSTAIJI.A'I'ION [J GAS [J ROOFING [J Sl?lllOIAI.'l'Y [] 0'11HER 'llYPB) OF C01~8'l'RlJ(!'j.'ION I [J BLOCK o FRANE! [] STEETJ [] OTHER FINISHlllll FI,QOR IlIIJtilVATIONS -~---- T 8 I?ROdEC'I' IN FLOOD ZONE! AREA [] YES [] ND BUILDBlR *** ** I< ***** it ** it **** * ****'/r** ****** *** ****** ** *** ** ****** ** * it ** **** * (~otI\PANY __________.__.__________.__ ___.___ STA'I'Hl CEJR'I' OR REGIS'!' # __. _ ___m.__.__________.__.__ CITY PROCESS ING fL------..____________h_____~______ 8lGN'ATlJRB: -~---_._--._---_.-...-__._--------- IiII.aO'I'RIOIAN S I GNATlJREJ __ ...---------....---------------------,.-------- C0f\1PAl1Y ______________________._________.__ STATEl CElR'I' OR REG I S'I' # CITY PROCESSING # "---'-'---'-----.- - --~----- ------_..--- * * * * * * * * it it * it 1<. * it * * it it- * * * * * * * * * * * * it * * * * * * * * * * * * * * * * * it * * '" * '" , . * * I< I< * . . * . PI.UNBaR t4 -~ (!OMPANYnnn41&-J.fJlj/JeL_flv"1b17i /-1/ STA'l'E CElR'I.' OR REGrST # '.l!F--::-1JJJ-'~ 'II] SIGNATIJRE ___ .. e.~_ ________ CI'I'Y PROCESSING # ------1.6.6-_______.__.____ *** ***.***************************************************"**** : -----_..._-._.---.----.-..._--~.._--~----- MBlCHANICAI, ---_._---------~--_..__._- I!O'ViPANY___ ______________________ STATE ~~RT OR REGrST # . CITY PROCESSING # .-----------.--.--. SIGNA'I'URE *******************'**'**'********'***'******'**********""""* -~------,--..._--- OTHER -------.---.----, (~0l,1PANY STATE CERT OR REGrST # CITY PROCESSING # ----.--------------.--- S WI1A'I'URE '--~._._--_..~._~_._--,- ...... ,- ------ ~---_._~--~---..__..~ **'******'*'*'***'*******'**'*"'*'***'*************"'**'****"* -----._----..._-----~~--....---...-.---------- CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The u~dersigned understands that this permit may be subject to "deed restrictions" which may be more restrictive than City regulations. 1'h,= undersigned assumes responsibility for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIIBILITIES 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 I 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 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, 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 "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 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 NOT NEED TO 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 19 (name of person acknowledged) Dwho is personally known to me, or (name of person acknowledged) [1ho is personally known to me, or Dwho 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 acknowledgment Signature of person taking acknowledgement Name typed, printed or stamped Name typed, printed or stamped