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Home My WebLink About92-2216 BUILDING PERMIT Permit 2216A DatE~ .5 - ) F- f;L CITY OF ZEPHYRHILLS (813) 788.6611 N<! C:~'LDID ~ ~ ME~L P,"pert'{ Owne, _~.!.~~~ Job Address: Q ~ / I _____ _ ~_ Parcell.D. # . ~ /7~ I? Sewer Conn Water Conn: Water Meter: T.I.F.'s: Zoning: Description of Work Energy Code: /) // /J Jd-X/D'~~ Radon Gas: NO OCCUPANCY BEFORE C.O. FINAL 5~2-?- epoL 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 Company Address Telephone# ~ '1, c:rtJ ~E ~ Valuation or /' Contract Price {I .3 tl 00 trV City License Registration # State Certified License# -------- SLB Tub Set Water Sewer Final ~G ----- ~ ~ Breakers Ducts Insl. Compressor lFinal Tp. Servo Rough In Meter Can 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. OWNER CITY OF ZEPHYRHILLS BUILDING DEPARTMENT IV ~) R, M ,Y /) ~ N' c;... JOB LOCATION 5~:So II rH 5/"". IE pH Y'Kf./ J )/ r F/ PARCEL I.D. # SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS. ~ ~ .... i 0- , IO~ ~~ " X b I, PI? E $~ L." E 1 f.([ Ar[~ ;'J L,/g 'Jef ~.r( to )Ij I ~,II C. E AI If'!? ~ FJ J.; Y \f'" 'P it' f SS I.->!( t. rREI?J.t:.i;; p " ()" ,< ,[) E (, k oS ~ 101 1--'--- k-IO ':'-.:jt f r-'-T-l, /2' ~/ I. ' . ~ ~ I ..ff.....&.2.?"i!~_,__.. . j."I --- .... r.- ~ '--iI -T H~U5~ i UTILITY BUILDINGS MUST SHOW SIZE & FOUNDATION INFOR- MATION. ---. FRONT PROPERTY LINE (NOTE EXAMPLES 1 & 2) STREET 1. SETBACKS FOR R1, R2 ZONING 60' 10' P E R X 0 I 10' P S 10' 0 T 1 0' S I E N D G 20' FRONT PROPERTY LINE 2. SETBACKS FOR R3 ZONING 60' 10' 10' EXISTING 10' PROPOSED 20'SGL FAM 30'DUPLEX 1 0' FRONT PROPERTY LINE APPLICATION FOR PERMIT CITY OF ZEPHYRHILLS BUILDING DEPARTMENT APPLICANT D A l~ I b .sZ~D J/ 1~fJ p- '- Yo (./ /1/ G- OWNER f-,/ l; / r\ '"""')' s:r Z E PH VI? H / / ! f, f/ PHONE 1 'l ~ - <6 () () ''j '. , / C> V rl cr ADDRESS )>Ii JOB LOCATION 'S: g' "3 0 If {.~ C:,'} I \to ,~ . LOT SIZE_X BLOCK ~ 7 SUBDIVISION AREA SQ. FT. LEGAL DESCRIPTION: LOT(S) 17-/g PARCEL I. D. ;F P/R r Bt'~' It ), 'P....bl! <:. RE<:DRJ>!: p r;.. S Jf ' C,i ,&. P ~ S ~ 0 ,',. .'::'''' ^i rl/" WORK PROPOSED:~New Construction _Addition _Alteration _Repair _Install _Sign/Temp. _Sign _Move _Demolish PROPOSED USE: _Single Family _M/F _# of Units ,_M/H url I rrY .. ; ,,:t;;w. _Commercial _Indust. _Swim. Pool t3vILl.), "Other ! _Restaurant & Health Department Approval BuiLDING SIZE: I (). x-1...L , I , ~ ~ Square Feet, 91 Height RESIDENTIAL: COMMERCIAL : ATTACH (2) PLOT PLANS & (~) SE1'S OF BUILDING PLANS & (1) SET ENERGY FOR..'1S.'''' ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** **COPY OF CONTRACT REQUIRED. PERMITS REOUESTED ~BUILDING $ LJ J~, 6 <6 Valuation of Total Construction _ELECTRICAL "f _MECHANICAL AMP Service Florida Power Corp. _\\.R.E.C. $ Valuation of Mec11?nical Installation _PLUMBING GAS ROOFING SPECIALTY TYPE OF CONSTRUCTION: _Block ~Frame _Steel Other FINISHED FLOOR ELEVATIONS: FT. ****************************************** CONTRACTOR SECTION Company State Cert. or Regist. # City License Registration # ****************************************** BUILDER Signature ELECTRTCTAN Company State Cert. or Regist. # City License Registration # ****************************************** Signature Company State Cert. or Regist. # City License Registration # **********************ft******************* PLUMBER Signature Company State Cert. or Regist. iF 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 The undersigned understands that this per.it ..ay be subject to .deed restrictions. which .ay be .ore restrictive than City regulations. The undersigned assu.es responsibility for co.pliance 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 .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (813) 788-6611. Further.ore, if the owner has hired a contractor Dr 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 .ay be an indication that he is not properly licensed and 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 - Ho.eowner's Protection Guide' prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is sOleone other than the 'owner', I certify that I have obtained a copy of the above described docu.ent and promise in good faith to deliver it to the 'owner' prior to co..ence.ent. Y E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infor.ation in this ~ppIication is accurate and that all work will be done in co.pliance with all I applicable laws regulating construction, zoning, and land develop.ent. Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or installation has co..enced prior to issuance of a per.it and that all work will be perfor.ed to .eet standards of all laws regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended work, and that it is .y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not limited to: f Departtent of Environ.ental Requlation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treat.ent f Southwest Florida Water "anaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways f De art.ent of Health & Rehabilitative Services Environ.ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks f Environmental Protection AQency - Asbestos abate.ent I also certify that, if fill .aterial is to be used in Flood Zone 'A' or 'A,etc.', it is understood that a drainage plan addressing a 'co.pensating volute' will be sub.itted which is prepared by a professional engineer registered in the State of Florida prior to per.it issuance. A per.it 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 per.it prevent the Building Official fro. thereafter requiring a correction of errors in plans, construction, Dr violations of any code.. Every pertit issued shall beco.e invalid unless the work authorized by such per.it is co..enced within six .onths of issuance, or if work authorized by the per.it is suspended or abandoned for a period of six .onths after the tite the work is cotmenced. One 90 day extension of tile, .ay be allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection .ust be logged during each six month period, or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT "AV RESULT IN YOUR PAVING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR 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'. SIGNATURE: CONTRACTOR SIGNATURE: OWNER OR AGENT was acknowledged , 19____ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me Dr who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC