HomeMy WebLinkAbout92-2087
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BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
)f~ 2087
/ - OJ... 9-7~
B.
I
I
Date
ca;;;LD:V ElEc~L p~
P,"perty Owne, b 1J1~
Job Address:L ?~ b.-
Parcell.D, # d.s- - ~-B-I - a O~1--A--
MEC~CAL
Sewer Conn
Water Conn:
Zoning:
Description of Work
Water Meter:
T,I.I=.'5:
-
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
City License Registration #
State Certified License#
77
.
Permit Fee
Sig7ature
Company
Address
Telephone#
Inspector
Valuation or
Contract Price rQ /) I> [) .. oi)
j
ELECT~L
---........
SLB
Tub Set
Water
Sewer
Final
P~NG
"'-...
Mrc.~NICAL
~
Tp. Serv.
Rough In
Meter Can
Breakers
Ducts Insl.
Compressor
Final
FRM.
Insul. CL
WL
Canst. Pole
Pool
Pre-Meter
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 ($15.00) 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.
APPLICATION FOR PERl'lIT
CITY OF ZEPHYRHILLS
BUILDING DEPARniENT
JOB LOCATION
70 t, ;1 rJt..1J 13 I T7) ..,
3 <3'~ q ~ LA-M :~ IbIl/ 1hi';Z'
'5' 11-7't r
S',1T1t,
PHONE
"7!5;;L- 9~11
APPLICANT
ADDRESS
OWNER
LOT SIZE~'{/(/!) AREA SQ. FT.
V SUBDIVISION It-LPtHf /;LLfit.)E,
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL 1. D. i~
3';- ,).-5 21
fl3 sA-
dVa~o
1~0?
WORK PROPOSED:____New Construction ~ddition ____Alteration ____Repair ____Install
____sign/Temp. _Sign _~love ____Demolish
PROPOSED USE: ~ngle Family _M/F ____i~ of Units ,_____tilH
_Commercial
_Indust.
____Swim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COM1'lERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~~S.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.**
**COPY OF CONTRACT REQUIRED.
PERMTTS REOUESTED
____BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
_H.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
*********~********************************
Signature
~ .. co~rRACTOR SECTION
d ~1("'(!If~fcompanY
. State Cert. or Regist. 0
. .' e 4 , ' ' City License Regi~tration ii
******************************************
BUILDER
77
Si!?nature
Company
State Cert. or Regist. n
City License Registration 0
******************************************
El.ECTRTCTAN
Signature
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. 0
City License Registration i"
******************************************
MECHANICAl.
Signature
Company
State Cert. or Regist. 0
City License Registration 0
QTHER
APPLICATION APPROVED
~**********~************************
BY _ _ 4.....(.% ' /ZA.....I) A} , '
PERHIT OFFICER.
CONDITIONS OF,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The ,undersigned understands that this perllt lay be subject io "deed restrlcti~ns" whirh ~ay be ~~re restr.irtive than City
regulations. The undersigned assules responslbll1tf;for, COlpliance with any applirable deed restrictions.
8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITI~S
If the ONner has hired a c~ntractor,or contractors to undertake work, 'they lay be required t~ be lirensed in arcordance with
state and local regulations. If the contractor 1s not licensed as required by law, both the ~"ner and r~ntractor nay be
cited for a .isdemeanor 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)
788-66 II.
Furthermore, if the owner 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 will be responsible. If you, as the owner sign as the contrartor,
you are indicating that you, rather than the contractor, are responsible for the work. If the cc,ntractor wishes you to sign
as contractor that lay 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 Cc'nstruction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agricu1ture and Consuler Affairs. If the applicant is so~eDne other than the
"owner", I certify that I have obtained l c~py of the above described document and promise in good faith to deliver it to th~
'oMner' prior to cOI~encement.
:1.,,'7 '
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all wor~ will be dene in coapliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby made to obtain a perlit to'do work and install~tion as indicated. I certify that no Mork or
installation has cOllenced prior to issuance of a perlit and that all work will be performed to roeet 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 governmental agencies ~ay apply'to the intended work, and that it is
"Y responsilJility tel identify what actions I lust take to be in compliance. Such agencies include bllt ~'e Iie,t liaited to:
.0-
f Deparhe~,t elf Envir~nllenial ReQul;tion - Cypress Bayheads, lI~tland Areas and EnvirclnITientally Sensi \j,'e L3nds,
Hater/Wastewater Treatment
I Southwest Florida lIater'ManaQe~ent District - Wells; Cypress Bayheads, Hetland ~reas, Altering Watercourses
f Ar., Corps ~f EnQineers - Seawalls, DOCKS, Navigable Haterways
f Depart.ent of Health ~ Rehabilitative Services, Environmental Health Unit - Uells, HasteHater Tre"t~en~. Septic Tanks
f US Environaental Protection AQency - Asbestos abatement
I also certify that, if fill material is to be used in He,od ZClne "A" elr "A,etc.' f it is undHstc,od tho! a drainage plan
addre,ssing a 'coJ!lpensating volullie" will be sublitted which is prepared by a prc,fessic,nal engineer registeied in the State of
Florida prior to permit issuance.
A perlit issued shall be construed to be a licenSE! to proceed with the work and not as authority to violjte, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frolli thereafter
requiring a cCorrection e.f errors in plans; constructic,n, e'r violations of any code. Every perill! t iSSIII!d "hall becc,le inval id
unless the llclrk authelrized by such permit is ce'luleneed within six months c,f issuance, clr if 1iC'I~ authc<I ILed bi the perlit is
suspended or abandoned for a period of six lonths after the tiJe the work is commenced. One 90 day e:le~5joll of tile, say be
allowed for the per~it with fee charge of ~15.00. The extension shall be requested in "riting to the Building Official. An
approved inspectie,n r.oust be logged during each six month peri(\d, or the prc,ject Iii II be cc.nsidered db';l,Gc.ned.
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. JOGS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE__________________________________
m,lNER OR AGENT
TRACTOR
DATE_______L_,~~L-~, ----------------
NOTARY AS nt"'\:'1:i!t::~W
CONTRACTOR_~_'t:..-----0r---------------
MY COMMISSION Ex~~~~~J~~~-~~FL- -
My Commission Expires May 11 m5"
DATE
--------------------------------.-------
NOTARY AS TO
OWNER OR AGENT_____________~_____________~_
MY COMMISSION EXPIRES______________________-
S IT E
PLAN
PERMIT #
If"
(RESIDENTIAL USE ONLY
:3 5';25 ,;2f 6Q 5 It 0::>00 () /55ZJ
. LEGAL DESCRIPTION:
SECTION TOWNSHIP
SUBDIVISION OR OTHER LOCATION DESCRIPTION:
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REAR (
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Show all existing and proposed structures giving dimensions and setbacks. Also, indicate
any a~jacent bodies of water and roadways adjacent to the property. Indicate size of
mobile homes such as: 12' x 60', 24' X 36'.
EXAMPLES
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PERMIT #
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(RESIDENTIAL USE ONLY
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LEGAL DESCRIPTION:
SECTION TOWNSHIP
SUBDIVI$ION OR OTHER LOCATION DESCRIPTION:
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mobile homes such as: 12' x 60', 24' X 36'.
EXAMPLES
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.~\NJsI"'v. SUN STATE ALUMINUM, INC.
\C2Z1 37528 Hwy. 54 West
1.trnnc"V ZEPHYRHILLS, FLORIDA 33541
(813) 788.7308
3 ~ - L';, - "'2.1-' 06 S~ -, C-::(~b - ) S-S-o
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Page No,
of
Pages
"
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STREET
PHONE
M'~~V~ ~~~r
PROPOSAL SUBMITTED TO
JOB NAME
-~ c,~ "-0
CITY, STATE AND ZIP CODE
-?_-~\~S
, ARCHlTrCT
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We hereby subm,t spec,f,eat,ons and eslimates for:
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l .",_m~ Jroposl' hereby to furnish material and labor - complete in accordance with above specifications. fort~:!lum~ of:
I~ ,,_\J: r.. J' r-,> \ \l~ (\ 't~-c.; ~ ~ .'-- - ' ' dollars ($ ~~ . ~ ),
, Payment to be made as follows ~
if- ,.. - ~ ------. -:.. ::::_..')~,~~...'::::-..__s..~~,~,."o. ~~>
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!~-- AI' mate,lal Is gua,anteed to be a~ :P~'C.~':"AII work to be completed In a workmanlike
ii manner according to standard practIces. Any alteration or devIation from above speciflca-
:1 tlOns Involving extra costs wdl be executed only upon written orders. and will become an
Ilextra charge over and above the estImate. All agreements, contingent u,pon strikes,. accidents
I or delays beyond our control. Owner to carry fIre, tornado and other rlecessary insUrance.
~ Our workers are fully covered by Workmen's Compensation Insurance
rAttrptuutr nf Jrnpn.aul- The above prices, specifications
I and conditions are satisfactory and are hereby accepted, You are authorized Slgnatur
to do the work as specified, Payment will be made as outlined above,
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( -~-'4'iIoi~:ThiS proposal may be
withdrawn by us if not accepted within
days.
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