HomeMy WebLinkAbout92-2228
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
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2228/1
Date J - ;;;l3 - ;?;;L.
~-:CTV
~HAN3Y
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
Description of Work ~JJJ A- / ("-
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL 3-2'=>~ 2-
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
5
City License Registration #
State Certified License#
7~
Permit Fee -$I -s -"'c O"'j)
Signature ~..d'-L----
Company
Address
Telephone#
Valuation or
Contract Price
;l. .3 73 - cru
,
BUILDING~
PLUMBING
~1/c
Breakers
Ducts Insl.
Compressor
Final
Tp. Serv.
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 ($15.001 shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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PR00UCT81.3{~___n!iJ"rnc,Groton.Mass.01471.ToOrderPHON[TOllFREEI+800.Z25.6380 - he~t U,).4eJ< --
-- --- -..------ -' -- -,--_._._--~_._- - - --- --- ,- -, -, - --.- -'-- - ~'--1
BAHR'S PROPANE GAS & Ale INC.
Sales, Service & Installations
4441 Allen Road
ZEPHYRHILLS, FL 33541
(813) 782-5013
<"'it -# 2/... 'Z€-/:2.-00IO()-- ()oo~-OO$C>
SOLD BY DATE
V r:;
~ \ . 1.1 .
NAME
Ralph Ball
ADDRESS
)025 Manner Dr.
CITY
3-16
19;/2
PHONE
7$'.7- -; I S- k;
>Hills
o CASH
o c,o,o.
o CHARGE:.
o PAID OUT .
o MDSE. RET'O
o PD. ON ACCT.
QUAN.
DESCRIPTION
PRICE
AMOUNT
1 2 ']'on Jjuxaire Heat Pump
2
5 Kw. Aux. Heat
3
Installed
2210.00
'J'a x . 11") .' 0
Po t~l 2,6. ~(()
5
6
7
8 A C Permi t
-30 . 00
q
MODEL FAAH-F024RA
SERIAL EBAS043065
13
14
15
16
TOTAL --
2 J" 3. ',()
~9J&w
APPLICATION FOR PER~IT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
ADDRESS 3 9' 0 '2. S
/J'JA;v o~
,()~
PHONE
OWNER
JOB LOCATION
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.lF
WORK PROPOSED:____New Construction _Addition _Alteration ____Repair ____Insta L l
_Sign/Temp. ____Sign _Nove _Demolish
PROPOSED USE: _Single Family _M/F _# of Units ._rt/H
_Commercial _Indust. ____Swim. Pool Other
I,
,'.
____Restaurant & Health Department Approval
BU1LD:LNG SIZE:
x_,
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S.*~
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
"HCOPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
_ELECTRICAL
;~
_MEt::HANICAL
AMP Service
Florida Power Corp.
_H.R.E.C.
$
Valuation of Mechanical 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
d Company Fl~ ,7 ~ /4.s .s
State Cert. or Regist.' If IS7
City License Registration #
*******************************~*********
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
PER!'IIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlitlay 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 Nith
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 state IaN. If the owner or intended contractor are uncertain as to what licensino
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Further_ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions {if the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contracto,-,
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 FEE~,
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 tDe
"owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it t" the
"owner" prior to cOllencelent.
~
!
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor_ation in this application is accurate and that all Nork will be done in co.pliance with all
a~plicable laws regulating construction, zoning, and land developlent.
I
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 per_it 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 governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpIiance. Such agencies include but are not lilited te.:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treat.ent
f Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f De artlent of Health L Rehabilitative Services Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f Environlental Protection AQency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.', it is understood that a drainage pla'i
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 ~erlit prevent the Building Official froD thereafter
requiring a correction of errors in plans, construction, or violations of any code.. Every perlit issued shall becoie i0ialid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the permit is
suspended or abandoned for a period of six lonths after the tile the work is cOlienced. One 90 day extension of ti~e, ~2, be
allowed for the pertit 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 COMMENCEMENT MAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO ',OUR
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: OWNER OR AGENT
SIGNATURE: CONTRACTOR
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 or 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