HomeMy WebLinkAbout92-2096
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788.6611
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Date / -L '? / - 9::l
,
209&8
Permit
0UILD~ EL~ PL~ M~AL
::~:::,~.::?~fJ!!~ V/ ~
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Description of Work
Energy COde:j1 Radon Gas:
/i -+- . #- -+- ~
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~ .... -
NO OCCUPANCY BEFORE C,O,
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
City License Registration # J~
State Certified License# C&-.tJllJ 902.3
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pe'~;t:jt? ~
Slgnat 0 ~
Company
Address
Telephone#
/21& ~
:7
Valuation or
Contract Price ~ / .s- o. o-D
P~NG
...........
MEC~ICAL
"
Ftr.
Pre SLB Z~(p ~'1-L- {j;/j
Lintel
FRM,
Insul. CL
WL
Tp, Servo
Rough In
Meter Can
Const, Pole
Pool
Pre-Meter
Final
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 ($15.00) 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
OW:JER
...r",A?6J T~
,
APPLICANT
ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D .l~
WORK PROPOSED:_New Construction t.-~~~r~~~ ~c;taU
_Sign/Temp.
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
_M/F
_It of Units
_N/H
_Commercial
----:.Indus t.
_Swim. Pool
Other
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COMNERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS, & (1) SET ENERGY FORNS. ,'n':
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORi-IS.''n':
**COPY OF CONTRACT REQUIRED.
_BUILDING
$
$ PERMITS REOUESTED
/ r /';;0 c/O
CO Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp,
_\~.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLlJNBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame _Steel
Other
Builder
FLOOR ELEVATIONS: FT.
.................:::::::l~:~ e; ~
City License Registration IF tt'A!5tZO/tJt70t...3
****w******************************
FINISHED
Signatu
Company
Signature
City License Registration ~
******************************************
Plumber
Company
Signature
City License Registration U
******************************************
Hechanical
Company
Signature
City License Registration lj
******************************************
Other
Company
Signature
City License Registration #
******************************************
I Hereby certify that I have read and examined this application and know the same to be
true and correct. All provisions of law and ordinances governing tllis type of work will be
complied with ,,,hether specified herein or not, the granting of a permit. does not presume to
uthority t;o violate or cancel the provisions of a}rY) other state or local 1m"
sting cOryJr 1 ~io r per rmance of constructi~/o1J / ? .
W!/) ~ / _, ..~._,..
Signature
~-7
of Owner
....) r '. I
I, / _'\ Date
,... Wot~l'u~fi~.$faf~ ", rJl~d "'~'-
My Comrr;f ''OJ C :',': -,. "'i' "'('l . "~3
- . 'I- .}I..
non~!c'~ ~:..,;u-:
, "c.
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The undersigned understands that this perlit lay be subject to 'deed restrictiDns. which may be ~ore restr,ictive than City
regulations. The undersigned assuaes respons1bil1tv:;for,.colpliance with any applicable deed restrictions.
.~. . ~
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
II 'h. .,.., h., h".d . ,.",.",r ., "",.,I,r. " .,d.".t. ..,t, 'h.y "y h. r'o,I,.d ., h. 1I,.".d I, .c",d.'c, ,I"
state and local regulations, If the contractor 11 not licensed as required by law, both the owner and contractor ftay be
,il.d I., . .I'd....", vl,I.tl., .,d.' ,t.,. I." 11 Ih. ",.r ., "'.,d.d c"I,.,'" .,. "c.".I, ., " ,h" ilc."I'g
r'o,I,...'" "y .pply I" 'h. Int.,d.d ",t, 'h.y .,. .dv;,ed t, "".,1 'he Clly 'I Z.phy'hlll' ',ildl', D.p.,I.e,', 'Bll'
78B-6611.
F"the""" II Ihe ",e, h., hl,ed . "",.,1" " ",t,.,I,r" he I, .dvl,ed t, h.ve tho c"',.cl.",, 'I" p"II,., ,f Ih.
'c,.tr."" S.c'I,'" ,I 'hI, .ppll,.I;" I" ,h;ch 'h'y ,III be ,e,p",lble, II y", ., 'h. "..r 'I,. ., 'h. ,.,1,.,1",
y" ", i,dlc.tl', Ib.t y", ,.Ih., Ih., 'he ,.,t,."", ", ,.,p",lbl. I" 'h. "", If 'h. c,,'r."" ,i,h., y" t, 'I"
., ",'r'c'" Ih.1 "y b. ., i,dlc.tl" th.1 he " "t p"p"Iy Ilce"ed'.,d i, ,.t e,'ltl.d I. p."illl', "lvIIeg., i. Ih.
City Df Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D.
CONSTRUCTION LIEN LAW
(CHAPTER 713~ FLORIDA STATUTES, AS AMENDED)
I ,e,lify 'h.1 I, 'be .ppII"'I, h.ve bee, p"vlded ,I'b . "py 'I 'Fl"id." C"""cli., L;" L., - H'..",.," P"l.ctl"
G,id.' p,.p.,.d by Ih. FI"id. D.p."..,1 ,I ",ic.lt". .,d c"".e, '11.1", II 'he .ppl'c,,' i' ,..ed.. ,'h., 'h., lh.
"",,', 1 ,e,lily 'h., I h.v, ,bt.i"d . "py ,I the .b,v. d.",ib.d d,c...,l .,d ",.1" i' ",d I,i'h I, delive' 'I " 'he
'owner' prior to co..ence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I ,e.'ily 'h.1 .11 'he l.f,...'I" I' Ihl, .ppl;,.li" I, .c"..'e .,d Ih.t .11 "" ,III be d,ne I,,'.pli..,e ,i'h .11
applicable laws regulating cDnstructiDn, zoning, and land developlent.
'ppli,.ti,' I, h.reby ..de I, ,bt.I, . per.;' I,d' "., .,d i"I.II,lio, '5 i.di"led. f ,er1ify Ih.1 ,0 "r' or
i.,I.II.li,' h., "..e.,ed prl,r '0 ;5,....e ,I . per.il .,d 'h.1 .11 ",k ,ill h. p.'f,..'d I, .e,1 ,1..d.rd' ,f .11 1."
re"I.li,g [,.,lr.[li", Cily [,d", ",i', reg.I.li"s, .,d I.,d d,veI'p.e.1 r",I,li,,' i, lhe i,rI5dlcli'.. 1 .1"
[,,\Ify Ih.1 I ,.d"5,.,d lh.1 Ih, re"I.li'" ,I ,Iher "ver,.e".1 .ge,[i'5 .,y ,pply'l' Ihe in,e,d.d "'I, .,d Ih.1 il is
'y ",pon5ibll lIy I' Idenll f: ,h.1 "II,,, I ",I loke to b, I' ,,,p1\ "", s~h, .,enc ins i,,' ,d' h,,' '" '" I 1\.I\.d I"
, .' '
. Den.r,.e,1 .1 E.vi.".enl.1 Reo.I.lio, - Cypre" B.yhe.d', ~,II.,d "e., .nd Envi.,n...i.Ily S.n5il;" L"d5,
Water/Wastewater Treatl~nt
t SDuth~est Florida Water Manane.ent District - Wells; Cypress Bayheads, Wetldnd ~reasl Altering Hdtercourses
t Army CDrps ~f EnQineers - Seawalls, Docks, Navigable Waterways
. D'D.rl.ent ,f H,.lih , R,h.'III,.live S,rvi[e" E,vir,..ent.1 He.Ilh U.lt - ~,115, u'5t,..I., lr,.I.'.,. Sepli, I.."
t US EnvirDnDentdl PrDtectiDn AQenc~ - Asbestos abatement
I .1" ,erllfy Ih.l, if fill ..t..i.1 ;5 \, be .5ed in FI.,d Zo,e .,' .. "',elc.', il i, ,.d,r,I..d lb.. · d,.i..,e pl.,
.ddre"I., . "".,..,.11', v,I,." .111 he "b.illed ,hich ;5 p,ep.r,d by . pr.f'55",.1 ,'gin"r r";",,.d I' ih. SI.le ,I
Florida prior to permit issudnC~.
, per.il i",ed ,h.II b. c"5Ir,ed I, be . Ii,e"e I' pr"eed ,llh Ihe ,'r' ,.d ,.' ., .,l.,rll, I, ,i,I;I', c."el .II.r, ,.
"I '5Id, ..y p.";,i.,, ,f Ib' te,b,I,.1 ,.de" "r ,b.11 I"..", ,f . p,r.il pr,v,.' 'b, B,lldin, Uffi,;.1 fr" lh.,e.fle.
reo,lri., . c,.,.cl;'. ,f e.r,r' i, pl.,,; ,.,,'r.,'i,', ,. vl.I,'I'" .f ,'y c.d.. Ev,'y p".ll I",.d ,h.11 h."., i.v.lld
"Ie" 'h' "" .,lh.,i"d hy "ch p,..11 i' "..e.,ed ,ilhl, ,I, ..,Ih, .f i",.n,', .r ;f .,,\ ,,"M ,.,d hy 'he "r.i. is
5"p.,d,d " .h.,d",d f., . per I,d ,f ,i. ."Ih, .fl.r Ihe ,;" 'he "" i' ,...",.d. On. II d., ..1...;." ,f \;", "y h.
.Il",d f.r 'he "r,I' ,ilh fee ,h.r,' ,I I'S.DD, The e.I,.,I" ,h.II b' r'o".,.d I' ,'i'l.g " I" ,.~dl., Dffici.l. "
.pp"vod i "P" II" ",, h, I,,,ed dor I', oath ,I. m'h p" i ,d, or th' p" lor' · ill ., ,on, Id" ,d ,t ...dor"d.
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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 DR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATU~~~~"~~"------ SIGNATURE DNTRA~~
DATE________-_________j-l-?:-'1L'l.~----- DATE_______-L:-?Q--C---------------
~~~~~v Q~5 A~~NT ------/~~1~~::,~:-~----
MY COMMISSiON EXPIRES ,'.' . . . d <<,..,~~,~~~~A
~~~-~-~---~-------~--
!,.. 'c-,_._<~,_:~ :_'." -:',. : r:.:v..
~OTARY AS TO'. /'1/, " .. " ,---
CONTRACTOR _ ___ _.j,-.!.l_~ _~.::_-- _~.i&~l~~:'---
MY COMMISSION EXPIRES
"
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My ("Om' ;,,:::'"" ." ;." .ilr;_il
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lronde'd 1hru 0,"1.
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