HomeMy WebLinkAbout92-2040
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
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2040g
Date j-/O-(lL
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Sewer Conn
Property Owner:
Job Address:
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Water Conn:
Water Meter:
T,I.F.'s:
Parcel I. D. # ..2.-
Zoning:
Description of Work
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,
Energy Code: Radon Gas:
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NO OCCUPANCY BEFORE C,O,
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C,Q.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration # e-;<
State Certified License#
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Permit Fee
Signature A-
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Company''-: /,/2/ j
Address ~//)-'/t-/Jc-d C/ rc &
TelePhone#./ 7F2 - _S-~ Z 5'
Inspector
Valuation or ~ j/ ~ J.
Contract Price ~) rt I
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BUILDING
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PL u!l481'Kf G
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Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 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.
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BUILDING DEPARTMENT
PARCEL I.D, It
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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MUpT SHOW SIZE &
FOUNDATION INFOR-
MAlI'ION.
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FRONT PROPERTY LINE
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(NPTE EXAMPLES 1 & 2)
STREET
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1. SETBACKS FOR Rl, R2 ZONING
60'
10'
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10' P S 10'
0 T 1 0'
S I
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D G
20'
2. SETBACKS FOR R3 ZONING
60'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
ADDRESS, ?%7/7 ~;7~
OWNER Ct ./'i-/~//L H~a;.
JOB LOCATION ~;?;-
PHONE
7/,(- 53? c:-dLd~.
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LOT SIZE_X
AREA SQ, FT. 3-05/
LEGAL DESCRIPTION: LOT(S) /rJ r /(J/
PARCEL I. D, # Z -;70 ~ 021 - JiJ - r:J -
BLOCK
SUBDIVISION
WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install
_Sign/Temp,
_Sign
____Move
_Demolish
PROPOSED USE: _Single Family
_M/F
____# of Units
._M/H
_Commercial
_Indust,
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
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.H
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_W.R,E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT,
******************************************
CONTRACTOR SECTION
Company
State Cert, or Regist. # ' ,
City License Registration # /;l...(~~
******************************************
Signature
ELECTRICiAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
Signature
Company
State Cert, or Regist. #
City License Registration #
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
APPLICATION APPROVED BY
Company
State Cert. or Regist. #
City LJcense Registration #
.' )
* * * * "'^t- * * ~.{~ *"'-
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OTHER
Signature
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit .ay be subject to .deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assuaes responsibility for cOlpliance with any applicable deed restrictions. '
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they .ay 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 lay be
cited for a lisde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) sign portions of the
.Contractor Sections. of this application for which they will be responsible. If you, as the owner 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 Construction lien law - HOleowner's Protection
Guide. prepared by the Florida Departaent 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 doculent and prolise in good faith to deliver it to the
.owner. prior to cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land develop.ent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies lay apply to the intended work, and that it is
.y responsibility to identify what actions 1 lust take to be in cOlpliance. Such agencies include but are not liaited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
Water/Wastewater Treat.ent
. Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
. ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health & Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental Protection AQency - Asbestos abate.ent
I also certify that, if fill laterial is to be used in Flood Zone .A" or .A,etc.", it is understood that a drainage plan
addressing a "colpensating volule. will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, Dr
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall bee ole invalid
unless the work authorized by such perlit is cOI.enced within six lonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the ti.e the work is cOlaenced. One 90 day extension of tile, lay be
allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six lonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO~NCE"ENT ~Y RESULT IN YOUR PAYING TWICE FOR IKPROYEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSUlT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CDK"ENC~ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COKKENCEKENT".
~---f~)^,~, . ~ 13, ~ -
SIGNATURE: OWNER OR AGENT SIG ATURE: CO~T~A~OR
was acknowledged
, 19_ by
who is personatly
produced -
as identification and who did/did t
take an oat~4 :;f? ~
(Signature) /)L, /....,' '7 "'-
J4 [)~ 4 . J.::; t{..5
(Name Typed, Print d or Stamped)
NOTARY PUBLIC __ .----"
'N6t!iY POti11e. .,...... v, rlOJlua
My Commission Expires Sept. 23. 199Z;
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
STATE OF FLORIDA
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
ISignature)
(Name Typed, Printed or Stamped)
NOTARY PUBLI C