HomeMy WebLinkAbout92-2086
BUILDING PERMIT
Permit
2086 15
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CITY OF ZEPHYRHILLS
(813) 788-6611
"'TO
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Date
G'J;2DINV ELE~
Pmperty Owne' FAA .f~~40-
Job Address: 5'~tO / __~
PLU~
MECH~
Sewer Conn
Water Conn:
L~
Water Meter:
T,I.F.'s:
Parcell.D. #
Zoning:
Description of Work
Energy Code:
/7-X2o p~.
Radon Gas:
~'w\r
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans. Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances,
DATE
Inspector
City License Registration #
State Certified License#
77
Permit Fee
Signature
Company
Address
Telephone#
~~
Valuation or
Contract Price
/116))
"(9
fS,~ ALu.vtl.
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
'J.-"~'
Fina(.'
PLUMBING
Breakers
Ducts Insl.
Compressor.
Final
BUILDING
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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.
APPLICATION FOR PEIDlIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTr-lENT
APPLICANT
hl?5rr-
6,510
Pk S;:t7;eX ;JW
I 'I s;rr:-
(Ifv~
ADDRESS
PHONE
,1 g :}"7 cf I:J-
.
OWNER
JOB LOCATION
LOT SIZE
x
AREA SQ.FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D. ~~
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____sign/Temp.
____Sign
_Hove
____Demolish
PROPOSED USE: ____Single Family
____M/F
____i~ of lIni ts
, ,____M / H
____Commercial
_Indust.
____Swim., Pool
Other
BUILDING SIZE:
____Restaurant & Health Department Approval
I). X t70 fUFf'O '&'~'fJ Square Fee t,
,
Height
RESIDENTIAL:
COM!-1ERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOIU1S. **
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.H:
**COPY OF CONTRACT REQUIRED.
:ff.RMTTS 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.
******************************************
,c' . ~ /1; "f( ~/d9;?WRACTOR SECTION
nUIT.UER 0d14 <> '''L~ ItUI /..", ,~tjompany
~ ~~. State Cert. or Regist. iI_
Signature :- Y-~ .<)-t<<~: City License Rer.istretion " -
** **************************************
77
~
Si!!nature
Company
State Cert. or Regist. !I
City License ReGistration !I
******************************************
f,T.ECTRTCTAN
Signature
Company
State Cert. or Regist. ~
City License Registration !I
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. !I
City License Registration ~~
******************************************
MECHANTCA1.
Signature
Company
State Cert. or Regist. 0
City License Registration ~
OTHER
*******Vl**J*~*;h:*~;*1:**J1::;:;'~;**********
APPLICATION APPROVED~Y __~i'~_tL,,- p-rJ~
PERl'lIT OFFICER.
CONDITIONS OF,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tht ,undtrsigned understands that this perDit lay bv subject to 'deed restrictions' which ~ay b~ oore restr,ictive than City
regulations. The undersigned assules responsibllitf;for, COlpllance with any app)icab)~ deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner 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 il not licensed as required by law, both the o>>ner and contractor ~ay be
cited for a lisdeneanor 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)
7Sa-6611.
Furtherlore, if the OHner 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 Hill be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are respe,nsible for the w(,rko If the c(,ntracteor wishes ye,u to sign
as contractor that aay be an indication that he is not properly licensed ~nd is not entitled to per~itting 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 - Ho~eowner's Protection
Guide' prepared by the Florida Depart_ent of Agriculture and Consuler Affairs. If the applicant is soeeone other than the
'owner', I cedify that I have e.btained a, copy of the above described document "nll prc,rrli"~ in g(,od faith to deliver it to the
'owner' prior to cOI~ence~ent.
:l....:.: "
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all wor~ Hill be done in coapliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby ~ade to obtain a perlit to'do work and install~tion as indicated. I certify that no work or
installation has cOlmenced prior to issuance of a perlit and that all work will be performed to ~eet standards of all laws
regulating construction, City codes, zoning regulations, anrl land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies ~ay apply' to th~ intended Hork, and that it is
IY responsibility tc. identify Hhat actions I lust take to be in compliance. Such ag~"cies include bllt ~l e not linited to:
...
I Departme~t of Envir~n~enial ReQul:tion - Cypress Bayheads, Hetland Areas and Environmentally Sensi live Lands,
Water/Wastewater Treatment
. Southwest Florida Hater ManaQe~ent District - Wells; Cypress Bayheads, Wetland Areas, Altering Hatercourses
f Arty Corps ~f EnQineers - Seawalls, Docks, Navigable Haterways
f Departlent of Health L Rehabilitative Services, Environmental Health Unit - W~lls, Wastewater Treat~en~. Septic Tanks
f US Environ~ental Protection AQency - Asbestos abate~ent
I also certify that, if fill material is to be used in He.od Ze,ne 'A" c.r 'A,etc.', it is undHst(,(,j tl.~t a drainage plan
addressing a 'cospensating volule' Hill be sublitted Hhich is prepared by a professi(,nal engineer regist2icd in the State of
Florida prior to permit issuance.
A perlit issued shall be construed to be a license to proceed with the Hork and not as authority to yiol~te, 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 c(,rrection e.f errors in plans; constructie.n, (,r violations of any c(,de. [very perlllit iSSIlI~j ohall beec,I(' invalid
unless the wc,rk authorized by such perlit is ce"llIIenced wi thin six 1II0nths of issuance, c,r if lie,) \; alltl".. I ,ed by the perli t is
suspended or abandoned for a period of six _onths after the tiJe the >>ork is commenced. One 90 day e:IEnsiDII of tile, say be
allowed for the per~it with f~e charge of $15.00. The extension shall be reque5t~d in >>riling to the Building Official. An
approved inspecti{,n /:lust be logged during each six month period, or the prc,ject Iii II be cl,nsiderr,d db,;l,de.;,ed.
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 $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A II NOT I CE OF COMMENCE!1ENT".
,/-:::::
SIGNA TURE _________________________________..
OWNER OR AGENT
''''~:?':, ;p""""
--/
- .;;;::---------------
CTOR
~
DATE________L~~-/~2~--------------
~~~~~~C~~R:~____~~~--
MY COMMISSION.. sx~ Public Pasco Co. FL
My tommlsS1onExpiieS May 13.-1995-
DATE_______________________________________
NOTARY AS TO
OWNER OR AGENT "
-----------------------~---~-
MY COMMISSION EXPIRES______________________
-
S IT E
PLAN
PERr1IT #
(RESIDENTIAL USE ONLY
LEGAL DESCRIPTION:
SECTION
TOWNSHIP
RANGE
SUBDIVISION OR OTHER LOCATION DESCRIPTION:
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REAR (
11 re- sr
FT. )
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Show all existing and proposed structures giving~ensions and setbacks. Also, indicate
any adjacent bodies of water and roadways adjacent to the property. Indicate size of
mobile homes such as: 121 x 60., 24' X 361.
FRONT
EXAMPLES
S IT E
PLAN
PERI'lIT ..
( RES IDE N TI A L U 5 EON L Y
LEGAL DESCRIPTION:
SECTION
TOWNSHIP
KhiJGf
SUBDIVISION OR OTHER LOCATION DESCRIPTION:
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5 S- 10 / 9 sr;
REAR (
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FT. )
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Show all existing and proposed structures giving~~enSions and setbacks. Also, indicate
any a~acent bodies of water and roadways adjacent to the property. Indicate size of
mobile homes such as: 12' x 60', 24' X 36'.
EXAMPLES
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SUN STATE ALUMINUM, INC.
37528 Hwy, 54 West
ZEPHYRHILLS, FL 33541
(813) 788-7308
i
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CUSTOMER'S ORDER NO PHONE
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N~:~~ ?fVt;$~~~)~,~
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SOlD BY
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Interest of llf296 per month" after 30 days
TAX
"~I-- ,
TOTAL
All claims and returned goods
MUST be accompanied by this bill.
PROOOC'T 610
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