HomeMy WebLinkAbout92-2088
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
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Date
~ E~ C;:UMBINV
P,"perty Owne" ~ _~ ~
Job Address:J ___ ___ _
Parcell.D, #
ME~L
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: ---r;--, Energy Code:
Description of Wor~ ~-: i If' ~_
~ ~ ?~~;"I''' _4'/A.~ ~
NO OCCUPANCY BEFORE C.O.
Radon G~:
2 AY7 "J.. ...~_
r~';;4~a
FINAL
..;, 3...4fZ-
DATE
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
Contract Price
:~;:::,:e ~~~
Company
Address
Telephone#
~A-
City License Registration # 3 Y" I
State Certified License#
~z k ~.~ (~"
- _ P~UMBI~ .. M~NICAL
"""
SLB Breakers
Tub Set Ducts Insl.
Water Compressor
Sewer Final
Final
C'
BUILLJINti
E~AL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. 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 PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT $) L 50 1'1
ADDRESS 3 73.5' 2
OWNER S 17 fr1 E
JOB LOCATION SUNSET E'S 7 4TE~
LEGAL DESCRIPTION: LOT (S) :# g L/-
IJ, HE'!
"3 &.- ,J}- V E 2. E "flY J? H J}.LOS ') F L , PHONE
7~Z -- 7f5~b
LOT SIZE X
AREA SQ. FT.
BLOCK
SUBDIVISION
PARCEL 1. D . #
WORK PROPOSED:____New Construction ----Addition ----Alteration ----Repair ____Install
____Sign/Temp.
____S ign
____Move
____Demolish
PROPOSED USE: ____Single Family
~/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.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
~ECHANICAL
$
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 #
******************************************
BUILDER
Signature
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
company~hJ~ 'J'/ ~-,/y, c&d<--,
State Cert. or Regist #
City License Registration 4~ '3 <-/ /
******************************************
F.LF.CTRICTAN
Silffiature
PLUMBER
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Cpmpany
State Cert. or Regist. #
City License Registration #
OTHER
Signature
APPLICATION APPROVED BY
~*********~:*********************
<1 ALl' q- ..........Jl-.. r
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 assules 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 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 lisdeleanor violation under state law. If the owner Dr 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.
Furtherlore, 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 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 Departlent 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 developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOltenced 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 governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
, Departlent of Environlental ReQulation - Cypress Bayheads, Yetland Areas and Environlentally Sensitive Lands,
Yater/Yastewater Treatlent
, Southwest Florida Yater KanaQelent District - Yells, Cypress Bayheads, Yetland Areas, Altering Yatercourses
, ArlY Corps of EnQineers - Seawalls, Docks, Navigable YaterMays
, Departlent of Health & Rehabilitative Services. Environlental Health Unit - Yells, Wastewater Treatlent, Septic Tanks
, US Environlental Protection AQency - Asbestos abatelent
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 subtitted 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 becole invalid
unless the work authorized by such per.it 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 tile the work is cOllenced. 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 .ust be logged during each six lonth period, or the project will be considered abandoned.
YARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT KAY 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
COMKENCEKENT. JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT'.
s~#--~----- ~~~~~~~~;~S
~~~~~D~FF~~_____________________
The foregoing i~trument was acknowledged
before me thiS/f~~~_' 19q_~_ by
~J~jQ~__~~_1ii1L____________________
who is pe~OnallY-khOWn to me or who has
produced ~JJir.tJu.m::,agfJ.::JlL.:~~--
as ident ication and who did/did not
take an oatt)~+j I [}ti;1L,{)~
~pt~=~~~!tM~~SLi
(Na~yped, Printed or Stamped) ,
NOTARY PUBLIC NOTA'RY PUSUC.STATE OF FLORIDA,
MY COMMISSION EXPiRES: NO\/', .:,;. 1993.
aQW;l&Q IJi&l1i!U'AIU eUli,"l.Q Ulig&RWRll'&Rll.
STATE OF FLORI!lA.
COUNTY OF ___~~~~~~~_______________________
The foregoing instrument was acknowledged
befclre me th i s ~T&rl <.lAJJ. 19 q,Z by
-----------. -----
__~___~,_~~_Q._!!9~f:!_~______
who is personally known to me or who has
produced ~_~~___~J~______~--
as identification and who didtC:lid n~
t~~"PtY'1. . _ ,_
~~,---------------------
(Signature) .T ......,\ .. \
Dc NI>t '-l' "::;>U 1T D I'-J
----------------------------------------
(Name Typed, Printed or Stamped)
NOTARY PUBLI C
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