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HomeMy WebLinkAbout92-2101 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788.6611 Permit :Nt! 2101;8 ~ -s -/;~ Date C::~ EL~ ~ ::::::,~':~d~;~ ~~~,. 0 Parcell.D. # ,? -.;Lb - ,;2/ - 13 -- 0 M~L Sewer Conn Water Conn: Water Meter: T.I.I=.'s: Zoning: Energy COd:!) Description of Work /S---X /---5,- fJ-e:...~ Radon Gas: NO OCCUPANCY BEFORE C,O, FINAL . 1.... 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 Permit Fee~~ Signature_ ~ /11. Compa~ Address Telephone# ~ Valuation or Contract Price .~ ~ -UZ;;. 0-0 City License Registration # State Certified License# 0)/1 /Yl....P ../'\...- CBU'LD~ Ftr. Pre SLB Lintel FRM, Insul. CL WL ~AL ---- 'PWMBING -------- M~ICAL ~ Breakers Ducts Insl. Tp. Servo Rough In Meter Can Const. Pole Pool Pre-Meter Final SLB Tub Set Water Sewer Final 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 t:d tf:A . A J'- rB. a:: OWNER ~,..A J/J ~A.A. R--<4 JOB LOCA~ 3'7?' (J S- ~~) ~ APPLICANT PHONE 7 %~ -- 79/:1 ADDRESS LOT SIZE~X /~ AREA SQ.FT, LEGAL DESCRIPTION: LOT(S) BLOCK PARCEL I.D.# .5 - ~ 6 - eJ-/ - /:5 - 0 SUBDIVISION WORK PROPOSED:____New Construction ~Addition ____Alteration ____Repair ____Install ____Sign/Temp, PROPOSED USE: ~Single Family ____Sign _Move _Demolish _M/F ____~~ of Uni ts __M/H _Commercial _Indust. _Swim. Pool Other ____Restaurant & Health Department Approval BUILDING SIZE: /-r X IS- , L9~ Square Feet.4~ ~ ~ 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 i//BUILDING $ $ 0'h.h Valuation of Total Construction ____ELECTRICAL AMP Se:rvice Florida Power Corp. _\-l.R.E.C. ____MECHANICAL $ Valuation of Mechanical Installation ____PLlJMBING GAS /Block ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Frame _Steel J<..~ Other I FINISHED FLOOR ELEVATIONS:.3 FT. ****************************************** .d _ J j,., _ /l . CONTRACTOR SECTION BUILD~ ~ ~ Company I /; d. State Cert. or Regist. iF Signature ... ~ /1J ~.J City License Registration # ~ ****************************************** ELECTRTCTAN Company State Cert. or Regist. # City License Registration # ****************************************** Signature Company State Cert. or Regist. iF City License Registration # ****************************************** PLUMBER Signature MECHANICAL Signature Company State Cert. or Regist. # City License Registration # ****************************************** OTHER Company State Cert. or Regist. # City License Registration # Signature APPLICATION APPROVED BY ~;:::~.~~~***********.*.* 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 laM, both the owner and contractor lay be cited for a lisdeleanor 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, (8131 788-6611, Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sl 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 FEE2. 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 promise 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 cOllenced 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 govern.ental 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: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and EnvironaentaIly Sensitive Lands, Water/Wastewater Treat.ent f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways I Departlent of Health L Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks f US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill laterial is to be used in Flo~d Zone "A" or "A,etc,", it is understood that a drainage plan addressing a "colpensating volule" will be sublitted 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, or set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frot thereafter requiring a correction of errors in plans, construction, or violations of any code, Every perlit issued shall beco.e invalid unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the per.it 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 tI5.00. The extension shall be requested in writing to the Building Official, An approved inspection lust be logged during each six lonth period, or the project will be considered abandoned, 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 COMMENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT", L~.~ fit &/5 /J_A ~URE: 0 ER OR AGENT SIGNATURE: CONTRACTOR was acknowledged , 19_ by STATE OF FLORIDA COUNTY OF The foregoing instrument befc.}-e me this STATE OF FLORIDA COUNTY OF The foregoing instrument befc.re me this Iflas acknc,wledged , 19_ by who is personally known to me or who has produced as identification and who did/did not take y oath " ~ hi ~,;?--4 ~nature) who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC . , CITY OF ZEPHYRHILLS BUILDING DEPARTl\'IENT OWNER / LyL h'~lt.i! . JOB LOCA~ 3'7 yo s- 1'Jr<..~d 0 D r~ \'V e. , . LEGAL DESCRIPTION/SUB DIV. BLK, LOT Show all existing and proposed structures giving dimensions & setbacks. 1S' rJ~ l \J ~:.. ~ J , Qt (') ~J / I~~ , ~ --::7 l~t..~, ~\oc,~9 j/ ~ 't I$'" t :'<"' -- - - J: -/ ' 11.. ' ~ P90~:/"- 1s1. ~ ) J~ ~ I ~ ~ -~" ~ ..- - - K is' ~ I Wt'L F.s: . \ . . ~ l O~ \\$ f~' '-0 6(/.sft~1 - ~ -...... >1 \..',.., ,FRON K S tre e t I ~I NO TE EXAMPLES 1 & 2) (j) I, too' >t @ ~ &0'- >i 8ef back5 fOf 10' I !5' 8efba.<!ks fot 'R,', Ii,;?, f/ 1?- 3 ~-,4 , "proJio:::.ed ~ Clift J.i~ A 0 11 I ng fk/; i1/011 EX i.:s -r(~ 'j Nofe ~ -' /0' . \0 10' \0 I Q~r"CJ1e. en. \?urp,,;.t EK;~t-i "'CJ 110' \pp Pro p.":, eol irot-fA, at/elf mU:$f 1 1 /ldd i+(o" h~Ve us' ,,,'\!.fbeek:. "U!i(,1i bu~b?hcr." Me/sf I -:sO' ~O ~r~ s;~e. < !oc",i. .?:J 1C>'1. sf~e:l- '__~ .~...____Et9".t~" /0 If, sf slre,/ _ _..__............ _Er~n..___ 10 tj, st .