HomeMy WebLinkAbout92-2455
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~
2455 t3
< )I 0, ~ J-.S'.. d?J
CBUIL~ELECTRlcV
~~~
Property Owner: d
Job Address: C I () b A 9 ~~
P.".II.D. # ,1' - _ 6 - 2C 0/ . - ~ . ~ 0 '" - 0 'Z. I 0
Date 7 -;2 -7;L
.5 ..J -: cr-D
GUMBIN0
.:L-Q," cro
Sewer Conn /.;L 7 y. cro
,
Water Conn: 3..s"";:J . crv
Water Meter: I b.5~ c.r-D
T,I,F.'s: l..s~ ;l~-flJ
,
Zoning:
~,o,
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL r"l_ ~ t;
DATE
C.O. 1-~ ~
DATE
NO OCCUPANCY BEFORE C.O.
Inspector
p~'m;~~
Signature . ~
'-'
Comp y
Address
Telephone#
Valuation or
Contract Price
~A
City License Registration # J-Sb
State Certified License#
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final f\....~v...Cf~,~k
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.
....
~
~ 1
40'
5~' t
D~
~
0 oQ)
U"l 25' lO - Existing
("') x:O
- shed
<1) . 0
"0 NE
.Vi
~
Sf'
, 15'
7
- c=J ,7.5', ....
0 -
0 7.5' 8
.-
.....
<1) .....
:2 <1)'
VI :Q
t VI
20'
}
....
-
7.5'
-
~
8
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<ll
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APPLICATIOIIiI FOR PERKIT
GI'JY OF ZEPHYRllILLS
BllfILDIRG DEPARIIIEIIiIT
OWNER'S
;7J~~-133 3
---y -", - c//
-/4. J.:)J / I
./ ~S V'/
SUBDIVISIOB ~;:/P/-/:d. g~~..."....-
OWNER'S MAKE /~~
JOB ADDRESS
LEGAL DESCRIPTION: LOI'(S)
PARCEL I. D. f
:.{ ,;; {.. r/ / - /1 / /. ,"" /2 ,
</ l'r ./. (' .-- /'{'?:1, L\0.. ~ ''/ .~, (
WORK PROPOSED :~lIiIetil Construction -.JWdition _Alteration _Repair _Install
_Sign
---1Iove
_D~lish
PROPOSED USE:
Single Faaily
_KIF
_, of Units
. dS....-K/H
_<=<-ercial
_Indust.
_Swia. Pool
Other
_Restaurant &- Hea1th >>epan:.ent Approval
BUILDING SIZE:
L/t/ X :-;( J
,
xdd
~e Feet.
4,~
/
&- (1) SET
FORKS. **
Height
RESIDENTIAL :
cottKERCIAL :
ATTACH (2) PLOt' PLAliS &- (2) SEI'S OF BUILDING PIJUilS
ATTACH (3) SEI'S OF BUII.DlllG PIJUilS &- (1) SET ENERGY
**COPY OF COIfTRACT IUlQlIlTRIlD.
ENERGY FORKS.**
PERl!nTS REOUESTED
,~ BUILDING
~ELECTRICAL
,.jLHEGHAlUCAL
~PLUKBING
$
zj
),(/ tIt' i.'
Valuation of Total Construction
1.71.1 AMP Service Florida Power Corp. ~ W. R. E. C .
$ r2t Jt'z' Valuation of Kechanica1 Installation
GAS
KOOFDlG
SPECIALTY
TYPE OF CONSTRUCTIOR: _Block _~ _Steel
/) ;, /', xlt'J~' i .
Other
FIIfISHED FLOOR ELEVATIOIIiIS:
FT.
IS PKOJECT IN FLOOD ZOIiE AREA?
'*
YES NO
******............**.................*....
COIlTKACIOR SECTION
BUIIJ)ER l,/J // COl!IPANY,#-A //c/I 02JJd/L /)/c) ,
,;0I~tuj (jPd<< State Cert. or Regist. .
Signature 1I!k.::~:/ItIic-l6") City License Registration ,
..........................................
//'1.1itfT //.. ~'-~
.?~,
COl!IPAlIiY (7' II JUf/ <fl"', ;41.,.U'/'U '
_ / St:ate Gert. 0 egist.' ~
r(-, City License Registration f ~
) .......** .......**......................
.PLOKBER U /} COl!IPARY /ij:/~!'i-/~$A/
S. (/ ! (I>e h) J'1XO ^ . (k S~te <<:ert. or R~gist. _, ~
19naturY. 0/1 -&.. C1ty L1cense Reg1sLrat.1OD ...
..................................*.......
Si
/{lg
/
COl!IP.MJY74j;i'~ .ftJ//J~ &/J I~! C
St:ate Gert. or Regist.. 1 f
City License Registrati,on f ;7,'{"
....... .........................*........
,. fl. ? :=:n ee1"~r 1e~=~~/c
,~~~'b, ~j fr~UCUI City License Registration' ~F
.........~........*.................*....*
APPLICATIOR APPROVEO BY '71~~~A~
Signature
0'I'1IF.R
Signature, A(}
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay 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 RESPQNSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they aay be required to be licensed in accordance with
state and local regulations. If the~entr,ctor is not licensed as required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state law. If 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 Departlent, (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 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 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 - HOleowner'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 docusent and prolise 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 Mill be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has [Ollenced 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 governlen,al 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:
, Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
, Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
, ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
, Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
, US Environlental Protection AQency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone "A" Dr "A,etc,', it is understood that a drainage plan
addressing a "colpensating volule" will be sublitted which is prepared by a professiona~ 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 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 becole invalid
unless the work authorized by such per.it is cO.lenced within six lonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the tile the work is cOllenced. 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 lonth period, or the project Mill be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IHPROVE"ENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COHHENCE"ENT. JOBS UNDER $2,500 IN VAL DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEHENT".
.~~.~~~~
Ptf4j<W-? l~ ~r;-vod
nt was acknowledoed
/, 19-1L. by .
J
/
STATE OF FW!!~.!~,~_..{./'
COUNTY OF 1/;7:/ " ')
Tt,p fDreg~,in1 inst.ru""J
before me this~ ~
STATE OF FLORIDA ' .~
COUNTY OF ~(t),
The foregoing instrum
before me this I '
was acknowledged
c'
~ 1 9...22..- by
who is personally known to me Dr who has
produced Zt- t'Y.,L.-S:SU'-632 -35-' --/0;5
as identification and W 0 did/did
take an 0
who is persDnally known to me Dr who has
pl-oduced /1/ ~t' L ')<;6 .;; 32. ;17- //; ~,
as identification and ho did/did not
ke a It.
<:
(Signa.ure) ,
t/J>;J; )/( J ~}))f)) /1/ ~
(Name Typed~ Printed Dr
NOTARY PUBLIC
'L:>AV fi,,-tIV('cvrJ'Zl!/
Stamped)
"r?;' DAN FARNSWORTH
(l);--'f~~ t.f'( COMMISSION /I CC 186067 EXPIRES
'~":~!!~?/!: AplII21, 1996
~~:qr:~'" toNDED THllU TROY fAIN INSURANCf, INC.
;$..~~r~... DAN FAANSWOftTH
€"; "JJ;."l:*1 t.f'( COMMISSION (J CC 1160&1' EXPlIlES
ri"~;$: AplII21, 1996
"'~iff.,i~,."" IONDED THAU TROY fAIN 1NSlMAHCE. INC.
JUL 08' 93 08: 57Rt'1 H&R H1TERSTRTE
7 ~~..it ~"
I\~ ~
\Y I /'}Sf '
~~h
, P. 1/'2 -
~ASCO COUNTY, FLORIDA
l'MDlI' .a ~ <",s A
!)Me ';7-,6 -1'_ '?
N../OMHr }./ .tR ..j... ~~.tr
=-~~~-~nr-:;~
aa.ua&lonfTJP8ll1U t. ~ . .4 Q
Til..'NSI'CATATJON JM1IACT P.IDI CALa,lLATION
\tale S
Sq, Ft. fUn!
IlIIpIIll JW AmoIlnI
:l.ant.
'IlIe I~Y' ImpiI:c r.e hu bcm
Counly CantlllglOMft.
!tnX1IR
pumIU1llo 1M 11 ~ LnJ*l ~ II ldeplad by tIlf IOItd at
lInIla peyabIo PIlIOR m!be IIIIIIllee of OceuplllCy m mthoctlY 10 udIIM 1M jMIlIIiaed
J1!S1DJ!N'W.l.
~asotJI.CB UCOVBU ASSBSSMIm'
NONRBIfDIlHtW.
ClIlIu Sq. PI. (OSP)
. Unill
J
be I 2IlU ..
~O.OO 1 O.!W I Yea
er$O.U1"c.y
(. VJlIllI) II (SO. 1315)
x (f o.YI)
au AlllJII ,
Aueumm...
~l.
aim a (mtU) 1I (0. 13 15).. (1I CIIyt)
100
TOTAL FBJ{ S
TOTAL FEE ,
oDileouDlId [II ~l
~ '/. ~5
1llUbMc lI.IAP'lIe.lllw beoaolll~lWIodplftll&ll'IIIh1PMloCDllllIy~ N4.I9.07I1111KMDJudOllNo. .9-197,u~
nil! A!SI!$SMmI' WIU.I! CALCULATiO ^ T'1'HB'llME Of ISSUANCB 011 THi CUT1PlCATB OP OCCUPANCY,
NO CBR1'IF'CA 1''& OF OCCIJPANCY OR FIl'IAL POWO Ul.BASB WILL II!: ISSlJIl) UNTJI. THE AMOl1N111J11'1D
ItA Vi: f1U!oj p.un A."W RECEIPTED POR BY A CItNTRAL raMlTI'INO OFFlCZ or PASCO COUNTY,
~Q.....lldpm~nl billow dDu nol imply Itclp1UC;Oof callellmllet. bll'.m.p1y recelpCot I ~ ofdlll rmn. plKi/l1 thebuil_ pcnnI.
owner ~ nDlh of thia UKAmMlIIId lhe condlliOlll 0{ pa)'lllcuC fIlt Ml\llI,
~By
DIle
..____......_.........-__..._......___........_____---.lH......1 -.........--_.....___..........
~
Ii. BY
DA~ - - IV
CnIy PIDk Grlu
D/~~ O~ B~/~p
omCB US! ONLy
Whitt
Appl1Ca/ll
, Cwry
TIpa I J'lDmgf
t '!UL~ ~H Hi
"'LZ'1zs,oe
80;8 l t8-8 -L I O~OL Jtldo~'I'l XOJ'~:AB IN~S
.JUL 08 ' 93 08: S8Ar'1 H&P- IrjTfp~;TATE
-- - ... .------- '0' __ ~_ ,_
.
F' . 2./2 "':
CONTRACTOR ...
NAME = H ~ R INTERSTATE
ADDR: 35247 HWY 54W
C/ST2 !HILL FL ~3541
C E N T R ALP E R M r T TIN a DATEI 07/07/93
PASCO COUNTY, FLORIDA PAGEl 1 O~ 1
ISSUE OFFICE. D
RECEIPT NUMBR= 00190e44
OFFICEI DADE CITY
FORr RESOURCE 24S~ B
CHECK .. 9441
03-26.21-0130-00000-0430
TOTAL AMOUNT;
AceNT COMPNV ACCOUNT CENTER
114 8430 - 363000 - 1
:24.25
AMOUNT DESCRIPTION/PERMT DATA DRIeR
24.2e ****** 60
~ECEIVEO flY
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