HomeMy WebLinkAbout92-2051
BUILDING PERMIT
Permit
2051,6 ;
/-15-<f~
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CITY OF ZEPHYRHILLS
(813) 788-6611
No
, .
Date
Property Owner:
Job Address:
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M~AC-"" Sewer Conn
Water Conn:
(-=--Eill.'~gl~)
Water Meter:
T.I.F.'s:
Parcell.D. # /4-~(,,-J.::z.I- i)oOlJ'- [)C)/2 iJo - 0/;2.3
Zoning: , E~ergy Code:.- , ((2 "' Radon Gas: iJ"
Description of Work 1-;2}t 5..::> __ i ?re..,~ t.p/vI!-
tR~ #Jj2M*,l tIM I y;~.
NO d~PA~CY BEFORE C,Q, tv<- ~L~~ '} XF/Jt
Complete Plans, Specifications and Fee M~~~nv'~~.
All work shall be performed in accordance&,1th City Codes and Ordinances.
FINAL 1- 15-- .?-
DATE
C,Q.
DATE
Permit Fee
Signature
Company
Address
Telephone#
Inspector
/' ~
City License Registration #
State Certified License#
/0 n? 1L-(/JyJ.~
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Valuation or -1/:..' . - ~
Contract Price . ~ ,2 <? ~' -
7<(??l0 {j m(J~./1i:7
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t" <: BUILDI~ -E-I::E'CIRICAL
----,~".. .,..."
PL\.lM8+NG
-----
MECHANlr....l
Driveway
k-JS'~ 8U1
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB I-/~.q J-. 4r11
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
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.
c
,"
Customer's
Order No.
SOLD TO
ADDRESS
SALESMAN
CASH
QUAN.
SIGNATURE
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f ~ 16701P
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7f2 - C'&:':?o
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TERMS
RECD. ON ACCT.
AMOUNT
V!1?tJ /2 ~
By This Bill
CITY OF ZEPHYRHILLS BUILDING ?,PARTMENT
OWNER fl14 P... V / AI ~\ IT f/
JOB LOCATION tjf? 2.. (; o:'d Y'J S T tel f- /:2 1
PARCEL I.D. It
SHOW ALL EXISTING & PROPOSED STRUCTURES ~IVING DIMENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2) STREET
1. SETBACKS FOR R1, R2 ZONING
60'
10'
P E
R X
0 I
; 10' P S 10'
0 T 1 0'
S I
E N
D G
20'
FRONT PROPERTY LINE
LINE
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
ADDRESS
i,etll/l! <;7111 / /JI.
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rt p? ~cJlZ()tfN S'p.
;y3
~;V: tNCAP-
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pHONE / 0- C/ ..:s
APPLICANT
'.
t tm J,lf
Ik~r
/
BLOCK
, ", uj~ ;
Lo'T S!.ZE~X 7~"'" AREA SQ,FT.
tJIA1/?,LJ
SUBDIVISION
OWNER
JOB LOCATION
LEGAL DESCRIPTION: LOT(S)
PARCEL 1. D. 4~
WORK PROPOSED:~New Construction ____Addition ____Alteration
_Repair
____Install
____Sign/Temp,
____Sign
_Hove
____Demolish
PROPOSED USE: ~Single Family
~/F
____t~ of Uni ts
, .____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,
~ERMITS REQUESTED
LBUILDING
_ELECTRICAL
$
Valuation of Total Construction
AMP Service
_Florida Power Corp.
_W,R,E.C,
_MECHANICAL
$
_Valuation of Mechanical Installation
_PLUMBING
GAS
RUOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block ____Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT,
( ;1 ..................................***....,
Let IV~ CONTRACTOR SECTION nA1..uL
. Company /~'Iv~
State Cert, or Regist. Q
Signature City License Registration j~
********************************
1/'7"
I~
ET,ECTRICT AN Company
State Cert, or Regist. Q
Signature City License Registration U
******************************************
PLUMBER Company
State Cert, or Regist. n
Signature City License Registration j~
******************************************
MECHANICAl. Company
State Cert. or Regist. #
Signature City License Registration iF
******************************************
OTHER Company
State Cert, or Regist. 0
Signature City Li.~ense Registration iF
APPLICATION APPROVED BY PERMIT OFFICER.
/3 /L. CONDITIONS OF. PERMIT AFFIDAVIT
(l" . '--
> A. NOTICE OF DEED RESTRICTIONS
. ,
/2.. k 5""""Z'
12- )('l.-r.
/
-
The undl!TSignl!d understands that this penit uy be subject to "deed restrictic.ns" which /Ilay be more restr.ictivl! than City
regulations. The undersigned assules responsibiHtf;for,.colpHance with an.y applicable deed restrictions.
. ,
8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor ~r c~ntractors to undertake wor~, 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 lay be
cited for a .isde.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 Depart.ent, (813)
788-6611.
Furthenore, if the owner has hired a contractor or contractors, he is advised to have the ccontractor!s) 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 wor~, If the contractor wishes you to sign
as contractor that say 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.
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 Departlent of Agriculture and Consuler Affairs. If the applicant is SOle~ne other than the
"owner", I certify t.hat I have cobtained a. copy of the above described dc,culllent ilnd pre,rr.ise in good faith to deliver it to the
"owner' prior to cOllencelent,
'I .:'
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 coapliance 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 CO.lenced,prior to issuance of a perlit and that all work will be performed to lIleet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other govermaental agencies liay apply to the intended work, and that it is
IY responsibility to identify what actions I tiust take to be in compliance. Such agencies include bill ~I e He,t lillited to:
. ".r <
I Depart.ent of EnvironlentalReQtllati~n - Cypress BaYltead~> hrtlaoG ~reas and Envirvnmentally Sensitive,lands,
Water/Wastewater Treatl~nt
I South~est Florida Water ManaQement District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
I Arty CClrps .of EnQineers - Seawalls, !locks, Navigable Waterways
I !lepartlent of Health ~ Rehabilitative Services, Environmental Health Unit - W~lls, Hastewater Treat~ent. Septic Tanks
I US Environaental Protection AQency - Asbestos abatement
I also certify that, if fillaaterial is to be used in Flc.od Zcone "A" or "A,etc,', it is understc,c.d that a drainage plan
addressing a 'coapensating volute" will be sublitted which is prepared by a professional engineer reqist2,cd 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 authorily tv vivlate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fro~ thereafter
requiring a correction of errors in plans; construction, or violations of any code, Every permit issll~d :hall beco.e invalid
unless the work authorized by such permit is r:c'lIl\enced within six months [of issuance, or if wc.rk autl,ollZed by the perlit is
suspended or abandoned for a period of six lonths after the tiJe the "ork is co~menced. One 90 day c~tro5iOIl of tile, lay be
allowed for the per~it with fee charge of $15.00. The extension shall be requested in "riling to the Building Official, An
approved inspecticon i!lust be logged during each six Ilonth period, or the pre.ject wi II be cc,nsidered tlbdlldconed.
WARNING TO OWNE~: 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 ,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOT I CE OF COMM~. NC ENT".
SIGNATURE________________________---------- SIGNATURE ~
OWNER OR AGENT kJ, F l<fV~ LCONT. ACTOR :.'.
FC 1)1< -it Flc3S- SIO - 32-4(,,0 (E: -93)
DATE12L:L~~_~?_______________________
-,
DATE
------------------------------~_._------
NOTARY AS TO
OWNER OR AGENT______~--------------------~-
MY COMMISSION EXPIRES
----------------------
NOTARY AS TO~ -. ~ J~ 1.
CONTRACTOR c.!:JUW-.
-----------PO~~~-su1fD~---
MY COMMISSION EXPIRES
NOTARY PUBLIC
My commis . . STATE OF FLORIDA
Bonded thr~JO;a~XDlres Jan. 28, 19~j
. erson - Becht Agen~y
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