HomeMy WebLinkAbout92-2385
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N<! 23851'1
b - /- ?:J...
Date
~.
~L
PL~
~CHANIC~ Sewer Conn
p,.pertyowne'};:;~~;: y~ji A~
Job Address: 3 CJ ~ .A..-
Parcell.D. #
Water Conn:
Water Meter:
T.I.F.'s:
Radon Gas: ~
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Zoning: Energy Code:
Description of Work ~~ R LJ (')
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r
/61 CJ ~ IJtJT
FINAL
DATE
NO OCCUPANCY BEFORE C.O,
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
C,O,
DATE
Permit Fee
Sighature
Company
Address
Telephone#
77;7J->>-
/
Valuation or
Contract Price
~/0/ If
City License Registration # tf/ /1
State Certified License#
E~~
Breakers
Ducts Insl.
Compressor
Final
~ING
, :=L~
Tp. Servo
Rough In
Meter Can
Const, Pole
Pool
Pre-Meter
Final
~NG
~
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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CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER ::J A /1..-11- \ .J: IV c... d It / "- h ;'11'L / iJ J lJ A j<f-L"/1<. v
., I /
JOB LOCATION "?l'O) (,. m~tlLlC-1::J S') V'/.!,,_c 1.7,,--,
PARCEL 1.0. #
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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I
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I
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I
I
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT
15 FOOT SETBACK
REQUIRED,
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
,
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E
R X
0 I
10' P S 10'
0 T
S I
E N
D G
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 ' DUPLEX
1 0'
20'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
APPLICATIOlNl FOR PERKIT
CIlY OF ZEPIIYRIIILLS
BUllDDIc DRPARnIElNIT
OIlIlER'S IIAIIE SIIRIL):L<<<-. dfif fJ.1!1: li!s dAKKl1(
OWNER'S ADDRESS
PHONE
7/1'- .J 7 '-- I
JOB ADDRESS
3go 3' /I/}AIl_kCl S ()'A.~/LC' ~I
LEGAL DESCRIPI'ION: LOT(S)
BLOCK
SlDBDIVISIOlNl
PARCEL I. D.I
WORK PROPOSED:_Jlev Construction _Addition __Alteration _Repair
Gnstall
_Sign
_Hove
_Deao1ish
PROPOSED USE: Single Faai1y
/ ec-ercia1
_KIF
_' of lllnits
_K/H
_Indust.
_Swia. Poo1
Ot:her
_Restaurant &: Hea1t:h Depart:aent Approva1
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COHKERCIAL :
ATTACH (2) PLOI' PLANS &: (2) SEI'S OF BUILDIlNIG PLUS &: 0) SET ENERGY FORKS. '**
ATTACH (3) SEI'S OF BUILDDG PLANS &: 0) SET EHRRGY FORMS. **
**COPY OF CONTRACT REQm:RED.
PERlllITS REOU&<iTED
_BffiLDUIG
$
Va1uation of Tot:a1 Construction
_ELECTRICAL
AKP Service
F10rida Power Corp.
W.R.E.C.
_KEClWUCAL
s
Va1uation of Hechanica1 Installation
_PLUMBING
,/
GAS
ROOFDiG
SPECIALTY
TYPE OF CONSTRUCTION: _B1ock _Pralle _Stee1
Ot:her
FINISHED FLOOR ELEVATIONS:
FI' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************~*~********************
COJn'KACIOR SECTION
BffiLDER
COIItPDY
State Cert. or Regist. I
City License Registration ,
******************************************
Signature
ELECTRICIAH
COIIPMiY
State Cert. or Regist. ,
City License Registration I
******************************************
Siln1::1ture
PLOKBER
COIItPMW
State Cert:. or Regist:. ,
City L1cense Registration I
**************....*...**.***..*.***..**.**
S ignatuie
KEmANICAL
CO!IPMilY
State Cert. or Regist. I
City License Registration I
...***....*..***.....*....*........**..**.
Signature
OTHER
lDfPANY S~ d.h~ G'~
State Cer.t:. r Regist. I //e'r;
City License Registration I
.......*...*.*..**.*....2****.....*..*****
c;;~.
Signature (/ . ~ ~ '-~
,?/ ./'
APPLICAnOIl APPIlOVED BY )( C14:~4Q ~ <V1~'-
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this pereiteay be subject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assuees responsibility for coepliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ONner has hired a contractor or c..tractors to undertake work, th';y lay be re~;ired'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 eisdeeeanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing
requirelents eay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departeent, (8131
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 Sections" of this application for which they will be responsible. If you, as the ONner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the Nork. If the contractor wishes you to sign
as contractor that eay 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 LaN - Hoeeowner's Protection
Guide" prepared by the Florida Departeent of Agriculture and Consuler 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 AFFIDAVII
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laNS regulati~~ construction, zoning, and land developeent.
Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work Dr
installation has cOleenced prior to issuance of a pereit and that all work will be perforeed 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 Mork, and that it is
IY responsibility to identify what actions I aust take to be in coepliance. Such agencies include but are not lilited to:
f Departaent of Environmental Requlation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
f Southwest Florida Water Kanaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of Enqineers - Seawalls, Docks, Navigable WaterMays
f Department of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environmental Protection Aqency - Asbestos abateaent
I also certify that, if fill eaterial is to be used in Flood Zone "A" or "A,ete.", it is understood that a drainage plan
addressing a "colpensating volume" Mill be submitted which is prepared by a professional engineer registered in the State of
Florida prior to pereit issuance.
A permit issued shall be construed to be a license to proceed with the Mork and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frot thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle invalid
unless the Mork authorized by such per.it is coemenced within six lonths of issuance, Dr if work authorized by the perlit is
suspended or abandoned for a period of six aonths after the tiee the worK is cOI.enced. One 90 day extension of tile, lay be
alloMed 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 eonth 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
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
(j~ lP7 /.'J -;j~
SIGNATUR~WNER OR AGENT
E- CJ. G/lCI-ANJ
SIGNATURE: CONTRACTOR
STATE OF FLORID~
COIJNTY OF o.SCC-:>
The forego in instrument
before me thi
STATE OF FLORIDA
COUNTY OF
T!It:~ fon?9oin9 instrument
befol-e me th i s
was acknowledged
19_ by
who is personally known to me Dr who has
prc.duced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
N()T/,R\' P',fDUC
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