The URL can be used to link to this page

Home My WebLink About92-2110 BUILDING PERMIT CITY OF ZEPHYRHILLS (813) 788-6611 Permit N~ 21101:5 -2 -s-7;Z Date Cq EL~ p~ P<o~rtyowne' ~ ~~ Job Address: 7 ~ :2. ~ . Parcell.D. # s.s- - d-I: - / - 0 0 ..s-V - 0 D 0 0 D Zoning: / Ene~y J:pde:. _ Description of Work 9' L.~ ~ ~ L~d.z.. - M~L Sewer Conn Water Conn: Water Meter: T.I.F.'s: - 6/'- 0 ~n;; Q NO OCCUPANCY BEFORE C,O, FINAL Complete Plans, Specifications and Fee Must Accompany Application. C,O, All work shall be performed in accordance with City Codes and Ordinances. DATE Inspect City License Registration # State Certified License# Permit Fee Signature Company Address Telephone# -jO ~ crv , ;;a;; rJ-d) Valuation or Contract Price ~(). d1) ~ JV"l ~A CBU'LD'~ Ftr. Pre SLB Lintel FRM. Insul. CL WL EL~L .......... PLl~G ~ ME~CAL " 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 APPLICANT ADDRESS i1 d \:J ~?9\ec~~r~~E' h \\l ct. OWNER ~\~ \~~ r\C\.~\. JOB LOCATION~d\;J ~~\~\~ ~\\\.l~_ LEGAL DESCRIPTION: LOT(S) \,~ BLOCK PARCEL I.D,# 55 - 1.~ -1\- a.~:Jb 1\(')C\~-(')\bt\ ,/<, WORK PROPOSED:_New Construction ____Addition PHONE (& t3) IY~3 - 11 J..{') LOT SIZE_X AREA SQ. FT. SUBDIVISION_f\\ \>'n,~&-~~ \$\\~" ____Alteration _Repair ____Install ____Sign/Temp. ____Sign i. tenc:.e _Move ____Demolish PROPOSED USE: ____Single Family ____M/F _~F of Uni ts _____M I 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. L-BUILDlNG f(::)f ~~ ____ELECTRICAL $ PERMITS REQUESTED 4~CJ Valuation of Total Construction 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, ****************************************** CONTRACTOR SECTION BUILDER Company State Cert. or Regist. # Signature City License Registration iF ****************************************** ELECTRICIAN Company State Cert. or Regist. # Signature City License Registration # ****************************************** PLUMBER Company State Cert. or Regist. # Signature City License Registration ifr ****************************************** MECHANICAL Company State Cert. or Regist. iF Signature City License Registration 1F ****************************************** OTHER Company State Cert. or Regist. # Signature City License Registration IF APPLICATION APPROVED BY PERMIT OFFICER. CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit.ay be subject to "deed restricticns" which lay be lore restrictive than City regulations. The undersigned assutes responsibility fOf cotpliance with any applicable deed restrictions, B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ownef 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 tay be cited for a tisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requiretents tay 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 contractorls) 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 Departaent 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 developtent 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: f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally 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 t 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 Flood Z~ne "A" or "A,etc.", it is understood that a drainage plan addressing a "colpensating voluae" will be sub.itted 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 fro. 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 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 cosienced, 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 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 CO""ENCE"ENT "AY 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 CO""ENCE"ENT, JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT", ~~~'0- ,"~\Cl,-l SIGNATU E: OWNER OR AGENT SIGNATURE: CONTRACTOR was ~~knowledged , 19 _ by STATE OF FLORIDA COUNTY OF The foregoing instrument befc'l-e me th i s STATE OF FLORIDA COUNTY OF Pasco The foregoing instrU!ent before me this Fe vias acknoviledged 19 by Kathleen Flack who is oersDnallv known to m~ Dr who has - produced as identification and who did/did not t.a}~ an oath~ /J _ ;, -L.I-~ r.~ -4"(.;' {J/(iAAJ (Signature) Norma Jean Cecil (Name Typed, Printed Dr Stamped) NOTARY PUBLIC .,... ""NIr~S'af..fflorJlr. II, Commission Expires Fe&. 7, I'" hoded Tbru r"'l' fala '1llsu1'llllC8'" who is personally known to me or who has prc,duced as identification and who did/did not take an clath. (Signature) (Name Typed, Printed Dr Stamped) NOTARY PUBLIC . , CITY OF ZEPHYRHILLS BUILDING DEPARTMEN'1: OWNER ~\~ \~~'(\ f\Cl~ \ .' . . JOB LOCATION '1,~ \.1 1\\>~E(f~e t\\ 'lJE... LEGAL DESCRIPTION/SUB DIV. ~\~ $\~~O.[~~~\~.'\ Show all existing and proposed structures giving K Street I 1 & 2) 1<- too' >t @ ~ &0'- , I !5' 10 0\\ \he W~ \ ..s\~ 6' \~ \\\:)~~ \'{\~\o\\ C:,yW(\ \\ '\\ \.. \f \\~...... J 0.. -3~\ 8a"\~ ~ \\Q...\..Q. \0 ~,\\ <,\.\,,'n<) f\\\:L 0\ -\ ~ \\M~\\ .::\~ (J,\'\;6..-\~ E(}S~ -.'S\fu.. lY:.\ -\ t~ E ~\ oS \~ I \~.s\~ iD ~\ '(f-\C -\o~~~\... ~~\\. -t'\\e t: ;\\~\\(C- tc:\\U . c1\\e e X-\:;:\\<r; .'.\~ ". ~ ~ \~~ .. 1'G 'fir' 1(\S.\':fDC,{;;::' (',\\\~ ':\~ \1 . \~ (} (J ''''_I - . 1M" \"'".,. \\(1\:i'i:;. ~\\R\\ \l~\ l)\.)..S. ~\'I\\:.~ v." ~C) ~\e $'{\. NO TE EXAMPLES (j) 8efback5 fOf 'R" J Ii,;?, f/ 1?-3 , A0111ng Nofe ~ . \0 Q~r"CJ1e. c;' 12urpQ;.t fl"'O~ at/eLf mU:3f h~o/e us' s~f~<!..k:. 'U!i(,1i bcJ~b{.hr.:s ~sf .:5~~ s;t.e < lot:.r,o.d- <!3 f IOVI . Ell:'; ....:s.t; J.1<j I ~O sf~e:f- ___.__~ ."_.____Etr=>',1.t~, BLK. LOT \ \0 dimensions & setbacks. t< >1 S~\0\\ Ilfl J S\:\e""ecI. Pt>(~ r I "1 0') )< CA /' .of'") I"b -::> r i 11- _ G Q\e.. ~ 8n p ~ ()l\.S.SL, \ ').. H- ~I >i 8e.+ ba.<!ks fot ~-:4 ~ Cllll H~ \0 110' EX is -r r't/I 'j -' /0' , 10' \D<P 1 1 Pro p.":, sol I1dd if(o" 30' /0 If, sf 5'1 reV- _ _...__ .._...","_. _.EY"9-!1...___ 10 rf, st '