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Home My WebLink About05-3820 CITY OF ZEPHYRHILLS 5335 - 8TH STREIT (813)780-0020 PLUMBING PERMIT 3820 Permit Number: 3820 Permit Type: PLUMBING Class of Work: PLUMBING/NEW Proposed Use: NOT APPLICABLE Square Feet: Est. Value: Improv. Cost: Date Issued: 2/08/2005 Total Fees: 390.00 Amount Paid: 390.00 Date Paid: 2/08/2005 Work Desc: PLUMB TO METER Address: 37404 LAUR L HAMM ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: OAK RUN Parcel Number: Name: TOWNVIEW MEDICAL ARTS CENTER Address: 37404 LAUREL HAMMOCK DR ZEPHYRHILLS, FL. 33542 Phone: PLUMBING FEE WATER METER RES 3/4" IRRIGATION CONNECTION REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a charge of Thirty-five dollars ($35.00) 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 "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." Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances ALL PLUMBING SHALL REMAIN EXPOSED PRIOR TO INSPECTION ~~ CONTRACTOR PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER (""', (1 ~ ('1 r, (", n ('l 103110 n n fQ3 (1 PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919 5-D3'1-4 CITY OF ZEPHYRHILLS ZEPHYRHILLS, FLORIDA WATER ACCT. NO. DATE ,z/J";:S- I / OWNER/ RENTER f?y~ (l~ ,/UU ~- MAILING SERVICE ADDRESS 31Lf~Y ~ !kn~dr, kt~ @....wATER o SHUT OFF SERVICE TURN ON SERVICE ~ ~ o SEWER o GARBAGE INSTALL METER READ METER o m-"1N CITY CHECK METER o o OUT CITY ~ No. OF UNITS OTHER o _ DEPOSIT AMOUNT _ AMOUNT LAST Bill 3/. (( /<-f - tJ~~ _ DATE _ MISC. CHARGE WORK COMPLETED BY & DATE COMPLETED ORDER TAKEN BY Retain white form in office at all times. Send pink & yellow forms to Water Service Depl. Water Service Depl. to sign yellow form & return to office, ___ c2 --tf--ZJ 5 4r ~'1f~DERL CITY OF ZEPHYRHILLS PERMIT APPLICATION BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542 ~~ . ~ 813-780-0020 FAX: 813-780-0021 t~ DATE RECEIVED PHONE CONTACT FOR PERMITTING OWNER'S NAMa ~'~&/7:" ~~NE R 13~)cF~ -€) ?d-.-S JOB ADDRESS' 3? t..f Of ~~~. . LEGAL DESCRIPTION: LOT(S) !)~ BLOCK ~ SUBDIVISION l?/~ PARCEL ID # ~f-:<.s -:;;; - 0/:50 - VO~...O ~AIN FROM PROPERTY TAX NOTICEl WORK PROPS ED: 0 NEW CONSTRUCTION o ADDITION DALTERATION o REPAIR o INSTALL o SIGN o MOVE o DEMOLISH o COMMERCIAL DMULTI-FAMILY o INDUSTRIAL 0# OF UNITS o SWIMMING POOL o MOBILE HOME o OTHER PROPOSED USE: DSGL FAMILY DWELLING DESCRIPTION OF WORK ~RESTAURANT & HEALTH DEPARTMENT APPROVAL ~~~~- BUILDING SIZE SQUARE FOOTAGE HEIGHT RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. PERMITS REQUESTED o BUILDING $ VALUATION OF TOTAL CONSTRUCTION o ELECTRICAL ~NG o MECHANICAL AMP SERVICE o Progress Energy 0 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 0 NO h~:_;~~::~1~t~';~Tiif57 _~~,;~~J~~~~:rd~r:~ ~\~rJJ~~i~~0~1-:~-i - - ~ - - t t. '~' "~;.:- :,- ~~ ~ ~-~_.)~ 7.~:- ~~~~~~~~lr~;\~f{~~~i:ij:I~f{~', ~~~~.ti:.:~~L______ ______~~ .__~_._____..!~~~:iJ.i.:1~lt' jll' ""1, Y." r'v:::~,j4 ~if. 'l~-in: ) ;~~ld,'\f.'j,w~~ l;(ti BUILDER COMPANY STATE CERT OR REGIST # SIGNATURE ****************************************************************** ELECTRICIAN COMPANY SIGNATURE STATE CERT OR REGIST # PLUMBER ..................................:::::::~~~~~~ STATE CERT OR REGIST # ~/~ l:,O,:)",,/ SIGNATURE **************************************************** MECHANICAL COMPANY SIGNATURE STATE CERT OR REGIST # ***************************************************************** OTHER COMPANY SIGNATURE STATE CERT OR REGIST # A. NOTIc;E 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, 813-780-0020. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign po~tions 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 indica~ion 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 this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land development. Appli~ation 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 *Departm~nt 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 understodd 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 correctiqn 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 on six months after the time the work is commenced. One 90 day extension of time may be a~lowed 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 per,iod, 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 $2,50.'lN VALUE DO NOT NE TO RECORD AND POST A "NO.7 OF COMMENCEMENT". --:'D, - . c..b~" # /1;. ~,<'~ SIGNATURE: SIGNATUR~O~ . STATE OF FLORIDA P~. -=-. STATE OF FLORIDA ~_~___-;:::, COUNTY OF COUNTY OF ~ The foregoing ins~t wa~dge~ The foregoing i~~llent wa~nowledged ..s :;~D~~~~ . .' 2CE: :;for~~s~~~~:,f.~ 20~ ~erson acknowledged) ~me of person acknowledged) ~o is personally known to me, or ~ho is personally known to me, or owho has produced ~f identification) an who odid ~d not take an oath of identification) take an oath. gna ~~~~n taking acknowledgement . . My COmmission 00127425 ~Off\ol Expires June 20. 2006 Name typed, printed or stamped acknowledgment Name typed, printed or stamped