HomeMy WebLinkAbout92-2446
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~
24468
Date
~ -,2 9-7(;L
~~ p~
Pmperty Owne" ~ ~~
Job Address: ...3 J!- 7' Y () /-a.r- t:LJ-f?
M~L
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Parcell.D. #
Zoning: Energy Code:
Description of work-X e ~ _/)-<~
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL .2.... - 2-
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
C.O.
DATE
Inspector
City License Registration # ij' ::J...
State Certified License#
Signature
Company
Address
Telephone#
r
Valuation or
Contract Price ~ D 7~-" U"'u
EL
~ICAL
~
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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.
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APPLICATION FOR PERJIlIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT ~cw.\ ~,- Gx.~~~
ADDRESS 8~d-. .s. IJuJ?; 'T6 ~ US PHON~} - fSSSO
OWNER L Lh~ tV m ,,!JJC.cJ t:::... hi ;;?JI B ECTH w' · V\J I AI s 1-.0 J;
JOB LOCATION ~ tfO I S+AIH - L I..J~ ,LOT'SIZE_X AREA SQ.FT,
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I, D. ~F
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____Sign/Temp. ~Sign _Move ____Demolish
PROPOSED USE: _Single Family _M/F _iF of Units ._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 FOR.'1S. ''''
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
>-4'
_MECHANICAL
AMP Service
Florida Power Corp.
_H.R.E,C,
$
_PLUMBING
GAS
Valuation of Mechanical Installation
~ROOFING SPECIALTY
TYPE OF CONSTRUCTION: ____Block
_Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
L/-q ~
Signature
******************************************
CONTRACTOR SECTIO~~ /J J J.
Company r L8VzJ7'rUC~
State Cert. or Regi t. iF KC, OOSlP'?fo.."1
City License Registration if q.;;...
***********************************
ElECTRICIAN
Company
State Cert. or Regist. iF
City License Registration #
******************************************
Signature
PLUMRER Company
Sta~e Cer~. or Regis~. #
Signature City License Registration ~F
**********************ft*******************
MECHANICAL Company
State Cert. or Regist, #
Signature City License Registration ;f
******************************************
OTHER Company
State Cert. or Regist. iF
Signature City License Registration #
APPLICATION APPROVED BY PERMIT OFFICER,
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit .Iay 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 with
state and local regulations. If the contractor i~"licensed as required by law, both the owner and contractor .ay be
cited for a lisdeleanor violation under state IaN. '.rf~the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of'Zephyrhills Building Depart.ent, (8131
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 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 - Ho.eowner's Protection
Guide" prepared by the Florida Departlent 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 prolise in good faith to deliver it t" 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 co.pliance with all
applicable 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 Dr
installation has cO.lenced prior to issuance of a perlit and that all work will be perforled to leet standards of all la#s
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 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 liaited to:
I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
I Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Water~ays
I De art.ent of Health & Rehabilitative Services Environ.ental Health Unit - Wells, ~astewater Treatlent, Septic Tanks
I Environ.ental 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 plan
addressing a "colpensating volule" Mill be sublitted 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 alte'! or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol there2fter
requiring a correction of errors in plans, construction, or violations of any code.. Every perlit issued shall becole i0valid
unless the work authorized by such perlit is cOI.enced 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 cOllenced. One 90 day extension of ti~e, gay 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 lust be logged during each six .onth period, or the project will be considered abandoned.
IIARNING TO OIlNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT KAY RESULT IN YOUR PAYING JIIICE FOR IHPROVEI'1EIHS 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 COM" CEKENT".
td.J~
<---
SIGNAT E: OWNER OR AGENT I I' IN'.s J...t1JuJ
IE 1--1 ;;Z 4~(H W. VLJ
was acknowledged
, 19.,R by
STATE OF. FLORIDA ~ ~
COUNTY OF S,C U
The foregoing instrument
before me th i s 1I (a.~
STATE OF FLORIDA
COUNTY OF Pasco
The foregoing instrument
before me this June 29
~'jas acknovdedged
, 199d- by
Elizabeth W. WinslOW
who is personally known to me or who has
produced Personally known
as identification and w~~did not
tak~~n~~ )~~
(SignatUl-e)
D. Katherine Martin
(Name Typed, Printed or Stamped)
NOTARY PUBLIC NOTARY PUBLIC, STATE OF FLORIDA.
MY COMMISSION EXPIRES: August 26, 1995.
BONDED THRU NOTARY PUBLIC UNDERWRrlERS.
t:FCC t31)..g-J
who is~e~~~I*~\~~JL~, me Erl wh(. h:r:
1'1 eoduLed
as identification and who ~tdid not
take an oath . "
RV-'>R ,flo.. I.....:::i'~ lJ..ik
(SignatLrce) .... r-
~,f\}(.t.<'.c... tg~\,,-\-
(Name Typed, Printed or Stamped)
NOTARY PUBLIC