HomeMy WebLinkAbout92-2198
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~
219815
Date 3' - J / - r d....
C:9~ ~ ~L
Pmp,"y Own"~ l~~~' ~
Job Address: ,,,5 ~__ / _ _ ~
Parcell.D. # 1/-;;16 -cJ./ - t:J 0/ 0 -.: /7? 00 - CJ /,;)... 0
Zoning: Energy Code: Radon Gas: 3.3-6
Description of Work J .v; ..x ;l.. y" ~ ~ ~
/
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL .:f-J J.;
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances,
c.o.
DATE
Inspector
City License Registration #3/ s-
State Certified License#
P~"m;t F~ (T7) k oL5: PiJ~
Slgnetur ~__ ~ -< _ j)
17'"
Company
Address
Telephone#
Valuation or
Contract Price ~ ~ (TV. o-v
~&a~
~UIL~ING - .'
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
~NG
..............
M~CAL
.......
Tp. Servo
Rough In
Meter Can
Breakers
Ducts Insl.
Compressor
F:inal
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
CITY OF ZEFHYF)-,:I1LS FJI1DIhC DEFhRTKEJ':1
OWNER ~a"r ;f;.;/;.!/~rJ
JOB LOCATION j~J't' /1i"IJ 5f
:LEGAL DESCRIPTION/SUB DIV.) J-.l ~ .) 1- 00 10
.
BLK ./7t ()O LOT 01 :J..()
Show all existing and proposed structures giving dimensions & setbacks.
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PROPOSAL SUBMITTED TO
STREET
CITY, STATE AND ZIP CODE
ARCHITECT
DATE OF PLANS
We hereby submit specifications and estimates for:
Page No,
...
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PHONE
DA TIc
of
~ges .
JOB NAME
JOB LOCATION
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JOB PHON E
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Dr 'rnpn.nr hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
Payment to be made as follows:
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifica-
tions involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance.
Attrptuutr uf Jrupu.aul- The above prices, specifications
and conditions are satisfactory and are hereby accepted, You are authorized
to do the work as specified, Payment will be made as outlined above,
Date of Acceptance:
dollars ($.,/
Authorized
Signatur~
"
Note: This proposal may be
withdrawn by us if not accepted within
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Signature" ..
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APPLICATION FOR PERI-lIT
CITY OF ZEPHYRHILLS
BUILDING DEPARnmNT
APPLICANT aAl7e
ADDRESS 5:2.3 ~
- &h//k~~
/7 "4 Sf
.
PHONE
OWNER '
JOB LOCATION 51/ ~e. LOT SIZEttJ x/'/O AREA SQ. FT. g,/&,pfP
LEGAL DESCRIPTION: LOT(S) 0/)..0 BLOCK/1'lfoosunrnVISION / /~:z.~-';?'J -()Ol 0
PARCEL I.D.~~ //-1.6-.1./ ....110/0 - /7?Oo... 0;;20
WORK PROPOSED: ~New Construction ____Addition ____Alteration ____Repair ____Install
____Commercial
____Indust.
____~Iove ____Demolish
____t~ of Units , _____1'1 I H
____Swim. , Pool Other
Approval
Square Feet, Y'~ Height
BUILDING PLANS & (1) SET ENERGY FORtIS. **
(1) SET ENERGY fORHS. *-1:
____Sign/Temp.
PROPOSED USE: t/' Single Family
____Sign
...:...-M/F
BUILDING SIZE:
____Restaurant & Health Department
/:1 v..-i, :J 36 ~
RESIDENTIAL:
'COM1'1ERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF
ATTACH (3) SETS OF BUILDING PLANS &
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
____BUILDING
$
/ A~()
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_W.R.E,C.
____MECHANICAL
$
Valuation of Mechanical Installation
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
/lLI././I-1.
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
/VJ (/ 4/ CONTRACTOR SECTION
ntnLDER /'lfJ 5 /7/V111.1 Company
,
~L ' J /J State Cert. or Regis t. il
Signature /'(F.t. ~ (4/4.e:'1,j;J 11 ' ' City License Rcr.L~traUnn il
*****3*****************",",1, * 1,***~' i, ,', ,', ,', ,',i, ,', 1, ,', *
"3/~
Si9nature
Company
State Cert. or Rcgist. 0
City License Registration 0
******************************************
ET.ECTRT CT AN
Company
State Cert. or Regist. #
City License Registration 0
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. 0
City License Registration #
******************************************
MECHANICAl.
Signature
Company
State Cert. or Regist. 0
City License Registration 0
OTHER
Signature
APPLICATION APPROVED BY
~~*******~**************************
'hL.At...< 1 -LA/("" A 9- , ' ' '
PERHIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
-
lh~,undersigned understands that this perlit lay be subject to 'd~~d restricti~ns' which ~ay b~ o~re restr,ictive than City
regulations. The undersigned assules responslbl1itf;for,colpliance with any applicable de~d restrictions.
..' '
"
E. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they lay b~ r~quired to b~'licensed in accordance with
stlte and local regulations. ' If the contractor is not licensed as requir~d by law, both the o~ner and contractor nay be
cited for a misdeleanor violation under state law., If the owner Dr intended contract~r are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City ~f Zephyrhills Building Departaent, (813)
7BB-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the c~ntract~r(s) sign portions of the
'Contractor Sections' of this application for which they will be responsible. If y~u, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the w~rk. If the cc,ntract~r wishes y~u 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 Construction Lien Law - H~~eowner's Protection
Guide' prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is sOle6ne other than the
'owner', I certify that I have obtained a, CDPY of the above described d~cument and promise in good faith to deliver it to the
'owner' prior to cOllencelent.
: 1, "; .:~. ". ' , .'
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inf~r~ation in this application is accurate and that all work will be don~ in coftpliance with all
applicable la~s regulating construction, 20ning, and land development.
Application is hereby lade t~ Dbtain a perait to'do worK and install~tiDn as indicated. I certify that no work or
installation has cOllenced prior tD issuance of a perlit and that all work will be performed to meet standards of all laws
regulating construction, City codes, 20ning regulati~ns, anrl land devel~pment regulations in the iurisdicti~n. I also
certify that I understand that the regulations of other governmental agencies ~ay apply to the intended w~rk, and that it is
my responsibility tCI identify lihat actions I IIIUSt take to be in compliance. Such agc-f1cic-s include bill ~le IiC,t liftited to:
. J.<I>'_...
I Department of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensi tive L~nd5J
Water/Wastewater Treatlllent
f SDuthwest Florida Water ManaQelent District - Wells; Cypress Bayheads, Wetland ~reas, ~Itering Haterc0Ufses
f ArlY Corps of EnQineers - Seawalls, DOCKS, Navigable Waterways
I Department of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastc-liater Treat~€n~, Septic Tanks
I US Environcental ProtectiDn AQency - Asbestos abatement
I also certify that, if fill material is to be used in Hc,od ZClne 'A' clr '~fetc"f it is undr:rstc,(,d thot a drainage plan
addressing a 'co~pensating volule' will be sublitted which is prepared by a pr~fc-ssi~nal engineer registered 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 vio13te, cancel alter, Dr
set aside any pr~visions of the technical codes, nor shall issuance of a permit prevent the Building Official fro~ thereafter
requiring a cc,rrE':ction (,f errors in plans; cc,nstructic,n, clr violations of any cc.de. Every per~it isslll!d ohall bece'le invalid
unless the lj(lrk authorized by such permit is cCllllllenced within six 1lI0nths of issuance, e,r if He,d; a\1I1,(O\ I,ed bi the p~rlit is
suspended or abandoned f(,r a perioll elf six lonths after the ti:ae the IlCirk is ce'Memed. One 90 day C-~lfilsioll of tile, say be
allowed for the per~it with fee charge of $15.00. The extension shall be requested in ~riting t~ the Building Official. An
approved inspectic,n r..ust be logged during each six month period, Dr the project Iii 11 be considered ilbdl,Ge,";-,d.
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 DETAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al'TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT",
SIGNATURE~~_~-------- SIGNATURE -,,-//.-..L_U-- c.~.
OWNER OR AGENT ~TRACTOR~-
DATE 3 r / I... 1 ;2...
-----------------------------------
NOTARY AS TO I. _' /l \ r 1.. I-..J J
CONTRACTOR__~-1Y-4~--
.. Nota", Public, Stat. of Florida
MY COMMISSION EXPIRE"~~~~1993
Ionded thN TrOJ fuiA - In4wr"nce In..
DA TE __2 ~!.!_"7..L2:.-.::-- --------'------,-------
NOTARY AS TO La,..- t1 ,r P... . J .~.J
OWNER OR AGENT _)lJ.LUL-!1.......:~--.-
Notary Public, Stat. of FIoritf<<
MY COMMI SS ION EXP IRES-Jly.ComIniJslen b';les'llJ!f.'3t,11193
Ionded Thru Troy F"in. In4Wr"nc, In,_
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