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Home My WebLink About03-2012 BUILDING PERMIT CITY OF ZEPHYRHILLS Permit N~ BUILDING 2012 (813) 780-0020 Date 7 -:<3..03 ELECTRICAL MECHANICAL Sewer Conn Water Conn: PLUMBING Property Owner: Job Address: Parcel I. D. II -=ro~N Mc,kA1.- .5f)'-fo I ~. 5' - Water Meter: T.I.F.'s: Zoning: Descriotion of Work Energy Code: Radon Gas: 'f~h .C) ~VIC-e.. FINAL NO OCCUPANCY BEFORE 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 c.o. DATE Inspector . ~,- , ".-0 Permit Fee ~ ~ignature -# % ~41. Company Address Velephone# 9'9 / ~ ~,.y 7,tJ City License Registration # State Certified license# Ftr. Pre SLB Lintel FRM. Insul. CL WL ;' Driveway C~4L)~ ~ ELECTRICAL Tp.Serv. SLB Rough In Tub Set Meter Can Water Const. Pole Sewer I Pool Final I Pre-Meter /1 Final f\'\~r(fL. lNc;rftU-1iJ fM ~ '10 (S.)a- lv~p~17W, ';125i1...~ 66, 17//) () /JuT -1tJ ~~{~ Breakers Ducts Ins!. Compress r Final / / REINSPECTlON FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of twenty-five and 00/100 Dollars ($25.00) shaH be made for each trip for each trade: a. Wrong Address b. Condemned work resulting from faulty construction. c. Repairs or corrections not made when inspection called. d. Work not ready for inspection when called. e. Permit not posted on job site. f. Plans not at job site. g. Work not accessible. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. CITY OF ZEPHYRHIIJLS PERMrr APPIJICATION BUIIlIJING I>BlI?ARTMEN'r 53315 8 th S'rREBI'r ZBlPHYRHII,I,S, Fl, 33540 Phohe.B13-780-n020 FaxI813-780-0021 !JA'n RBOJllIVJ!JIl ,_ _ ..,..c_ InANe RlllVIBlW rJllJ...._,~.~'u oWNeR'S HAM" ___ J~At1_J2tt'J:1/_ ____ ~______~______ ___ PHONm ('ON'I'Af'T3..i'Z-~d2t2.c [JOB SITEl ADDREl88 ,-.:2-:ff."u:L_..j!! s:t.___________________________ -..------------.-.-'_.H ___ ___,_ LElOAL THllSt!RTPTIOll: LOT(S) BfDC'K SUBDIVISION - .---_ _~._.R. ~ _.__~. u_. _"_"'___..""" ....__._._ PARC1flJIJ III 1t_.!L_::..2.&..~)--.L::.{/.t2/t? ~-:t2Li!(ltl '/J / -uf((._____~_~~~~~~~l___~'.~)M _!~,r~=~~~'.~_'l'~~..~~~~teE1_~__ WORK PROPSElD I []NEW CONSTRUCTION [) ADIJI'rIOt-T 0 AUI'ERATION II REPAIR LI INBTAf,I, [Jsrrm C) MOVE rJ DEMOr,rSII PROPOSEJIl USE I [JaGII, FAMIIJY DWELIJINr~ flt1tJI.'l'I. FAHII.Y [)# OF UNITS []SWH1tUNG POUL lJ MOB!I,El HOME LJ OTHElR [] Cm1MIlJR(!IAf, [J INDlJS'l'RIAJJ 11BJSCRIP'l'ImT OF 110RK o RB1STAtJRAN'r & HElALTII DBlPARTt1ElN'I' APPROVAL -L(I2~~~Lc:.~d.__1dtJJ2a$#___...._, -_._-_._-~--_..,._-_..~-_._-._- _.~.__. BtJILflINI] Ell ZEl --_.__.--------..~------ SQUARE FOOTAGE: "--- .----.------- fl EI !I1H'r ....:"'"--".__.w _....._ __~.........__ RBlElII1ElNTIAT'l (~OMMmRr.!IAIJ : A'!''f'ACH (2) PLo'r PI"A1l8 & (2) SElTS OF BUIT ,[)INC~ PLANS & (1) SElT ElNIllRnV FORMS, A'r1;A.CH (3) SElTS OF BUtLJJING PLANS & (1) SET ENER(~Y FORMS, PROPElRTY SURVEY REQUIRElD FOR ALL NEW CONSTRUCTION. FERMITS REQUESTED [] BtJn.IJINr~ $ VALUATION OF TOTAl, CONs'rRtJC'l'ION 1.1 BlIJElCTRWAI. ------__.__ AMP SElRVICEI o FInRIOA POWElR [J W,R,El.C!, [J PI.tJt18ING U HHiUHAN T(JATJ $,---- - VJ\I,UATION OF tIlElC'HANCIAI, INSTA.l,lJATTON [] m\8 LJ RooP'Hm LJ 8PECJtAI/l'Y [) OTHER 1'YPEJ OF COH8'I'Rt1C!TION I [J 8IJOCK [) FRAME! [J STEElIJ [) OTHER FINlSHElTl FI,OOR ElIJElVATIONS IS PRO,lECT IN FLOOD ZONE! AREAO YES 0 NO BUILOBlR , . -------.-----------..----- ------------ ---..--- CotllPANY ---.-.~___..,__._. .___., _'__"___n_.,_.._._~.___,... .__ STATE CElRT OR RElrJI S'!, # ~_____..__ ---_____c. ___'___ CITY PROCESSING #____, _._____. _.._.___.____,.__ '__,__,_ _.. E:llGN1\TtJREl ****************************************************************** B1r.JlIC'rRICtAH .. C()[1PANY~~~_.._____.______ 8]<3IJ '1' JR"" ~/ LJ. ~ ~T~TE C'8~T 0 ElC1#TS'l' # __________.__.._______..____,..___,___..... ,A I CJ ... .- .~..:._. _ ____ CI ry PROCESSING -------.--- ..,_._._~ _._.- -- . _._-_.__...__.~--_.. * I< ** *** * *' * **** * * *** *** *** * * * * * ** * * **** ***************** A********* PI,UMBBlR ...- ._~-_._._...-..._.~_._~-..-- -'-- ----------,---..~_._--- C~OM P ANY .----------_____n______._.._.._._____.. ._____.,... STATE CERT OR REGIST # ________~,~.._.._.__.... CITY PROCESSING # SIlmA'l'tJREl ..--~-..._._-._--_....--..-._----,_._-.._---~._--_._..- MBlOHANICAT. COMPANY _.___._._._._____.________..___.,..__.._,... STATEl (~ElRT OR REGrST # _____.____._.___,____._____.._, 8IGNATU~rn CITY PROCESSING # ********************************************************k********* --------.....----- -----._---_.-._.~..__._--._------_._- *****************'*********************************************** OTHER --------...-------------- (~or,1PANY STATE C'ElRT OR REGIST # CITY PROCElS8INO # ---------.-----..------. --..--... ,----- ,-.. ._-...-._._.:..._-~------_.~-_._._----------- 8 I <3NA'l'UREl ---"-.'- ---"_..~.._-_....-_.__._.--- - _.. ~ ***************************************************************** --------- -. ..-.-.-.-.-.-----...--.----- '~-_.'---._---- CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that 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 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 conunencement. 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 conunenced 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 rnust 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 conunenced 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 conunenced. 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 of identification) take an oath. Dwho has produced (type of identification) and who Ddid DUd not take an oath Dwho has produced (type and whoD did Ddid not Signature of person taking acknowledgement Signature of person taking acknowledgment Name typed, printed or stamped Name typed, printed or stamped