HomeMy WebLinkAbout92-2212
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N<!
2212/j
Date J-17-7~
c~~ EL~ ~
Pmperty Owne" ~L1;
Job Address: ,-~6 ./3 J?a.l'~< ~
Parcell.D. #
Zoning: Energy Code:
Description of wo;;-'i-( 0 '- ..J)~
~CAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINA
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
City License Registration #
State Certified License#
77
Permit F9Y
S;gnatu, _~~ t;pv<
Compan ___
Address
Telephone#
Valuation or
Contract Price
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/
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ELE~L
...............
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~CAL
-------
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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.
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ADDRESS
-l::\{> 1'\11~ r\ :SD h~
6 (0, J. 'J)..Q. H~ h
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~D U:. \
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
Co I1J!,.UC Ira< C~.
, ,<? .) - Ol.P8(;
PHONE
APPLICANT
OWNER
';\.~
JOB LOCATION
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.#
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____Sign/Temp.
_Sign
_Move
_Demolish
PROPOSED USE: _Single Family
~/F
_4~ of Uni ts
__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.
__MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
.X' ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
.. CONTRACTOR SECTION C C
'. Company \..jJ~ I' ~(YUJ Ytl1.t!/-iuu. ~ II j/
~ : . ',/ State Cert. or R gist. !~
'---'t-< 1"" J(!I'!fif.c City License Registration il 77
/ * * * *** * * * * ***** *** * * *~, *;,*;, * * * * * ,', 'I, 'I,;,;, ,': -!:,~ *
BUILDER
Si2:nature
Company
State Cert. or Regist. #
City License Registration #
******************************************
ELECTRICTAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
Th~ und~rsign~d und~rstands that this perlit lay b~ subject to "deed restrictions" which lay be lore restr.ictive 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 stat~ law. If the owner or intended contractor are uncertain as to what licensing
requir~lents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, !8l3}
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 S~ctions" 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 th~ 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 Const~uction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is SOle6ne 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 information in this application is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and install~tion as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be performed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other governaental agencies fiay apply' to the intended work, and that it is
IY responsibility tel identify what actions I lust take to be in cOlpliance. Such agencies include but ~le not lilited to:
.#'
I also certify that, if fill laterial is to be used in Fl~od Zone "A" or "A,etc.", it is understood th~t a drainage plan
addressing a "colpensating volute" will be sublitted which is prepared by a profes~ional engineer fegist~iQd in the state of
Florida prior to perlit issuance.
A perlit issued shall be con~trued to be a license to proceed Kith the work and not as authority to yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter
requiring a correction of errors in plans; consiruction, or violations of any code. Every perlit issued ;hall becOle invalid
unless the Nork authorized by such pertit is cOllenced within six months of issuance, or if ~ork authol lzed by the perlit is
suspended or abandoned for a period of six lonths after the tiJe the work is commenced. One 90 day e:tension of tile, lay be
allowed for the permit 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 tonth period, or the project will be considered dbalidoned.
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 R AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. J U ER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COM M T"
SIGNATURE__~~----------- SIGNATURE / ~~---------
DATE __________..JfiL7b.5?:-------------------- DATE______0jolf~------------------
NOTARY AS TO -to \'.. \
OWNER OR AGENT___j~~~~---~-~-
MY COMMISSION EXPIRES____~Q~_~:~~--------
~g~~~~C~~R~~__--~~~----
MY COMMISSION EXPIRES____~Q:l~~~~-----