HomeMy WebLinkAbout92-2371
BUILDING PERMIT
Permit
2371L?
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CITY OF ZEPHYRHILLS
(813) 788-6611
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( BUILV ~ PLU~
Property Owner: ~A.#L1~ J7 &;.;
Job Address: ....;W-<f9 7 - ....5~y E
Parcel I.D. # .;l. - ;;l b -. d-I- 0 a I 0 - tJ 6 {1 c? - 0 rY / 0
Date
M~L
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code: Radon Gas:
Oe,e';ption of Wo,'',. ;;r A -', - 4~ L~"J ~ ,f~
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee~~ .
Sign'ature ~ . -1/l 0-
Company
Address
Telephone#
Valuation or
Contract Price
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City License Registration # 3 ry-
State Certified License#
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Pre SLB
Lintel
FRM.
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Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
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Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway
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REINSPECTION FEES: When extra inspection i '. /e 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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DATE.
4/6/92
DRA'..IN BY'
M,D.C.
CHECKED BY,
CAS.
JOB NO.1
D'..IG NO.1
SHEET
[I] OF [I]
SILCOX ENGINEERING, INC.
5409 N. Nebraska Avenue
TAMPA. FLORIDA 33604
(813) 238-9755
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SILCOX ENGINEERING, INC.
Post Office Box 8574
TAMPA, FLORIDA 33674-8574
(813) 238-9755
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'FLo~\DA l-lbHTIN& 2c 'S\&NS
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APPLICATION FUR PERKIT
GI'IY OF ZEPII1'RHILLS
BUILDDiG DEPARIlIIENT
OWNER · S NAKE
~ c.--f/.- +sZ 0/'/ (:, e-k.e w s;,J;! PRONE
OWNER' S ADDRESS
.JOB ADDRESS
c5 % ~7 ?
5YE
LEGAL DESCRIPl'Imi: LOT(S)
BJ...OCK
SlDBDIVISIO~
PARCEL I. D _ f
o 2 --.2-b~.2/ ~ 00/0
-OGOn
00 / ()
WRK PROPOSED:_Nev Construction _Addition _Alteration _Repair _Install
~Sign
_l!Iove
_Deaolish
PROPOSED USE:
Single Faaily
_"'F
_, of llInits
_K/H
_~rcial
_Indust.
_S,"-. Pool
Other
_Restaurant &: Health Depart:aent Approval
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL :
COftKERC'IAL :
ATTACH (2) PI..OI' PI...MiS &: (2) SEIS OF BUILDING PIAIlilS &: (1) SEf RNERGY FORKS. u
ATI'ACH (3) SEIS OF BUllDIBG PIAIlilS &: (1) SET mmRGY FORKS.-&--:l-
..COPV OF CON'l"KAcr ~.
PERKITS REQUESTED
~BUILDING
CC
$ ~~ Odic> ~
Valuation of Tot:al Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFDfG
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FInSHED FLOOR ELEVATIONS:
FT.
IS PRO.JEcr IN FlOOD ZONE AREA?
YES NO
...-&-.................................*..*.
BUILDER
<'i4~ ~~~c.
State Cert. or Regist. ,
City License Registration ,
....................-&-..............
aJMI'RACIOR SECTION
OOIIPBY Ho/C/4
Signature
rD.
...J'~fL
./&( t:Jt?~ S- ~f 7
~CTRICIAN
CU!lPMIY
State Cert:. or Regist:. ,
City License Registration I
**.**...**....**..................*.....**
I), S 12113 ture
PLOKBER
Signature
CO!IPAKY
State Cert. or Regist. ,
City License Registration #
.........................................-&-
KECllANICAL
Signature
CO!IPMiY
State Cert. or Regist. #
City License Registration I
..............**.~........*..........*..**
01'1IF.R
OOIIPAKY
Signature
;_~r-.~.I:e C'~rt:. or Regiz"!:.. '_...
City License Registration j
.**.******....*******.......*******.......
APPLICATION APPROVED BY
II "'-"h J' 0~.;2/1 -'~
PERKlT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it.ay be su~ject tD "deed restrictiDns" which lay be lore 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 ONner has hired a contractor o~ con\ractors to undertake Mork, they .ay be required to be licensed in accordance with
state and local regulations. If the contractor is net licensed as required by law, both the owner and contractor .ay be
cited for a .isde.eanor violation under state law. If the ONner 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, !8131
788-6611.
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the
"Contractor Sections" of this application for which they Mill 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 per.itting 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 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 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 inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land develop.ent.
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 perlit 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 govern.ental 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 Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Dorks, Navigable Waterways
f Departlent of Health! Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
f US Environtental 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 "colpensating volule" will be subtitted 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 ~ith 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 frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall berole invalid
unless the work authorized by such perlit is COI.enced within six lonths of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of six lonths after the tile the work is cOlienred. 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 tonth period, or the project will be considered abandoned.
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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
CllItIlENCEllENT. JOBS ONOER ",50' IN VALOE DO NOT HE" TO '''0'0 ANO PO~T ~ C"""'Nt,",NT'.
SIGNATURE: fiWNER OR AGENT SIGNATURE: CONTRACTOR
/7l1dJO...J S;;; 5~-,;:Q f-
STATE fiF FLORIDA
COUNTY OF
The fc,regoing instl-Umal.. .,.'~Jas acknowledged
befclj-flni'lc s~i~o' IDA> ' , 199.;;1 by
NOTARY P , ID'-'~""R' Dee 30 19
MY COMMi.%l~~ ;y.~:.:tlc UN;:;i:1.W7Ull'ERS.
Bm\DEDTHKU N'-"'\" ~"
who is personally known to me or who has
produced
._ 'de~tific~t~on and who did/did not
take an oath.
STATE OF FLO~~ 1Ll/ ~
COUNTY OF ~ ~
The foregoing instrument was acknowledged
before me thi!;;~~- /) ,19~ by
who is persc,nall y known to me rlj- W:l~: has
produced
as identificatloii and who did/dd n:ot
take an oath.
(qj'~71r~) L. tvnl /YJu.rL .
(Name Typed, ~r i 'nted CIj- S~ped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC