HomeMy WebLinkAbout91-1705
STATE OF FLORIDA
City of Zephyrhills
B~HtCr
PASCO COUNTY Permit:N'~ 1705::1)
BUILDING DEPARTMENT ,- r
~~13-788-6611 Date ~..- ?? ~ 9/
~~I~ M~ ;-dLP<~;~j~7~
Property Owners Name: ~~ j ~ 0;;:4/116-1-./
Job Address: ._; e. s ' .
Legal Description: Sub.Div, Lot Blk.
Type of Permit
E~'
Zoning CI:
Description of Work
(y~,-~-:; 1~ "-,>J~tI~.;J ';W~
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Energy Code Readout:
) I
41t,~
Complete Plans, Specifications and Fee Must Accompany Application
Estimated Cost:
vii
Fee:
(f t-
ADDRESS
OCCUPATIONAL LICENSE t1,(~-ui, . TfLEPHONE II
~{,/ 't<,<<<ft
L-, "?t<9.Jk?%, j/ AO/-jj!
C~-~-~.~~) , ~E~L
SLB Tp.Serv,
Tub Set Rough In
Water Meter Can
Sewer Const. Pole
Final Pool
Pre-Meter
Final
All work shal! be performed in accordance
with the above and all City Codes
and Ordinances,
~
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Ftr.
Pre SLB
Lintel
FRM.
Insul.CL
WL
M~AL
,,~
Breakers
Ducts Insl.
Compressor
Final
Driveway
Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons. a charge of l~.. iSI8.80)
dollars shall be made for each~. /r,*- de (/~'"": tJ7) )
(a) Wrong Address
(b) Condemned work resulting from faulty construction
(c) Repairs or corrections not made when inspection called for
(d) Work not ready for inspection when called.
The payment of reinspection fees shall be made before any further permits will be issued to the person owning same.
~ C~TY OF ZEPHYRH~LLS BU~LD~NG DEPARTMENT
OWNER (ZP~ '-~~A~~
JOB LOCATION ~ - 6 3 t, ~ A;I,
PA.RCEL I.D. #
SHOW ALL EX~ST~NG & PROPOSED STRUCTURES G~V~NG D~HENSIONS & SETBA.CKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR Rl, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E~
R X
0 I
\ 10' P S 10'
0 T
S I
E N
D G
20'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAH 30'DUPLEX
1 O'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
APPLICATION FOR PERl"lIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT () V I LA
ADDRESS ....!?-fo:J "-
OWNER 0 V I L A
f'. L ESP 'Cf( A A/ c r '
c y Ire E S S Sf
,
/. L6.5' f/t=-R A IV C E
PHONE
7ff;Z
<7..j-(}" DL
JOB LOCATION S{, J '"
c y ~tfc:;5
r
ST
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D. ~~
WORK PROPOSED:_New Construction _Addition _Alteration ____Repair ____Install
_Sign/Temp,
PROPOSED USE: ~. Single Family
_Sign
_Hove
____Demolish
_Commercial
_Indust.
_Swim.. poo 1
,._M/H
~t.-~:' Other
f/
_M/F
_t~ of Uni ts
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t ,
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 FOIlilS. H
**COPY OF CONTRACT REQUIRED.
pERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida power Corp.
_W.R.E.C.
_MECHANICAL
LL:..PLUMBING
$
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
.#- .
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
~ONTRACTOR SECTION
Company
State Cert, or Regist. iF_
City License Registration if
******************************************
BPTLDER
Signature
Company
State Cert. or Regist. iF
City License Registration if
******************************************
f,T.Er:TRTCT AN
Signature
Company
State Cert. or Regist. 11
City License Registration ji ;?j -S & y
*******************************
Signature
Company
State Cert. or Regist. if
Cicy License Registration ~
******************************************
Company
State Cert. or Regist. if
City ~cense Registration !~
OTHER () Y L LA ^ ( Z I'" E A. A ,v c F
Signature d..:d ~4,;;wr/~
*~'it:r-~*
~:.
APPLICATION APPROVED BY {"f
/"
PERMIT OFFICER.
'.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The ,undersigned understands that this perlit lay be subject to "deed restrictions" which may be more restr.ictive than City
regulations. The undersigned assules responsibillty":for, co_pliance with any applicable deed restrictions,
'. . ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owntr has hired a contractor or contractors to undertake work, they lay 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 ~ay be
cited for a .isdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended Hork, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorts) sign portions of the
'Contractor Sections' of this application for which they Hill be responsible. If you, as the OHner sign 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 lay be an indication that he is not properly licensed'and is not entitled to perlitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION 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 - HOleowner's Protection
Guide' prepared by the Florida Depart_ent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
'owner', I certify that I have obtained a, copy of the above described document and promise in good faith to deliver it to the
'owner' prior to cOIDenceDent.
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 lade to obtain a perlit to do work and install~tion as indicated. I certify that no work or
installation has COllenced prior to issuance of a per_it and that all work Hill be performed to leet standards of all laMS
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies ~ay apply'to the intended worK, and that it is
IY responsibility to identify what actions I lust taKe to be in compliance. Such agencies include but ~l e m.t liaited to:
...
I Departle~t of Envir~nmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water ManaQeDent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
I Arty Corps Gf EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treat~ent. Septic TanKS
I US Environaental Protection AQency - Asbestos abatement
I also certify that, if filllaterial is to be used in Flood Zone 'A" or "A,etc.", it is underste.od th,t a drainage plan
addressing a "colpensating volute' will be sublitted which is prepared by a professional engineer regist~(ed in the State of
Florida prior to permit issuance.
A pertit issued shall be construed to be a license to proceed with the HorK 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 Offici~l frol thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every permit issll~d ;hall becote invalid
unless the work authorized by such permit is cOIDenced within six months of issuance, or if H01'k authDI lied by the pertit is
suspended or abandoned for a period of six lonths after the tiJe the work is commenced. One 90 day e:tE~siD" of tile, lay 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 ~ust be logged during each six Donth period, or the project will be considered dbdlldoned.
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 A~NT
DATE !1u fl.t, S:t ~ Lee; / ,.
-- _:1-:) }tL_______j-_ ..LA------~-.- ----
NOTARY AS TO l '~I - ) //
OW\\IER OR AGENTva~' - -1;2iLr-tlLf!f"
~J,. ..'. -,'.,.. ','.:''.'-, ",;t :tlqo-,.iJa
MY COMMISSION EXPI~ff~~;~~,',;;~;J7~~9~--
.. t,;;.,,:':?G ''-il;.:; Tp/ fain, ..ll):>ur(,.1nc.~ 10<;.. ..~
SIGNATURE______________________________
CONTRACTOR
DATE
-----------------------------------
NOTARY AS TO
CONTRACTOR_____________________________
"
MY COMMISSION EXPIRES
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