HomeMy WebLinkAbout92-2526
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N~ 2526
Date 7-2 L(- 'Iv
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Property Owner:
Job Address:
Parcell.D. #
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Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning:
Description of Work
Energy Code:
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NO OCCUPANCY BEFORE C.O.
FINAL ;l -d-l.j- 92
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
Permit Fee
Signature.
Compan
Address
Telephone#
Valuation or
Contract Price
idoL ~
City License Registration #
State Certified License#
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Breakers
Ducts Ins!.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM,
Insu!. 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,
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER ;rAQk'1~ )/ O//I---/U t?~C.~~
JOB LOCATION ,51n~P /JhY77A e-,- ;Z~1!{')/r/I,) FI.-
PARCEL I.D. #
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
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7'
FRONT PROPERTY
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT
15 FOOT SETBACK
REQUIRED.
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(NOTE EXAMPLES 1 & 2)
STREET
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1. SETBACKS FOR R1 R2 ZONING
60
2. SETBACKS FOR R3 ZONING
60'
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10'
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10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT
FRONT PROPERTY LINE
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APPLICATIOllil FOR PERMIT
CI'IY OF ZEPIIY.RIIILLS
BUILDllIG DEPAImPIEN'T
OWNER'S
NAKEI fl-(l, k I ,;-
ADDRESS~cr; 9'
SfJ/1'1 E
/./oLL~1tJ Bt:e)c
I< 1112 tv1J It C!.. T
molfE~3- 7~-3ajr
::2 cTlflylLflt /lr I r .L
OWNER'S
JOB ADDRESS
LEGAL DESCRIPTION: UJI'(S)
BLOCIt'
SUBDIVISIOllil
PARCEL I. D. t
WORK PROPOSED: /l8!ev Construction ~tion _Alteration _Repair _Install
_Sign
_Move
_ne.olish
PROPOSED USE: '
Single Faaily
_KIF
_, of Ufnits
_K/H
_~rcial
_Indust.
_Stria. Pool
Other
_Rest:aurant &- Healt:h ~t Approval
BUILDING SIZE:
/0 X 8" ,
<go
Square Feet,
~
~J
Height
_ RESIDEIfTIAL:
COHKERCIAL :
ATTACH (2) PLOI' PLAIIS &- (2) SEIS OF BUILDING PLAJlS &- (1) SEf ENERGY FORKS. **
ATTACH (3) SEI'S OF BUll.DDiIG PLAJlS &- (l) SEf mmRGY FORKS. **
**COPI' OF COllilTKACT RIlQ1lJIRIlD.
PERI/IITS REQUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
MIP Service
Florida Power Corp.
W.R.E.C.
_KECHAlUCAL
$
Valuation of Kecbanical Installation
_PLUMBING
GAS
lIDOFDiG
SPECIALTY
TYPE OF CONSTRUCTION: _Block _FraIIe _Steel
Other
FINISHED FLOOR ELEVATIOllilS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
***~*************************.************
COJn'RACI'OR SECTION
BUILDER CO!tPANY
St:ate Cert. or Regist. I
Signat.ure City License Registration I
************************~***************** .
ELECTRICIAN CO!tPAIMY
St:at.e Cert.. or Regist. ,
Si~at.ure City License Registration I
******************************************
PLUKBER CO!tPMY
State Cert. or Regist. ,
Signature City License Regist.ra~ion .
******************************************
KECllANICAL CO!tPMiY
St:ate Cert. or Regist. ,I
Signature City License Registrat.ion I
******************************************
O"I"IIF.R aJ!IPMY
State Cert. or Regist. I
Signature City License Registration I
******************************************
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT,
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait 'lay bE subject to "deed restrictions. which lay be .ore restrictive than City
regulations. The undersigned aS5uaes responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OMner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulation~. If thf cGfftfactor is,not"Jicensed as required by law,' ~oth the owner and contractor aay be
cited for a aisdeleanor violation under state laM. If the owner or intended contractor are uncertain as to what licensing
requirelents aay apply for the intended work, they are advised to contact the City of2ephyrhills Building Departlent, (813)
788-6611.
Furtheraore, 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 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 Mith a copy of .Florida's Construction Lien Law - Hoaeowner's Protection
Guide" prepared by the Florida Departaent 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 to the
"owner" prior to COllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforla~iDn in this application is accurate and that all worK will be done in coapliance with all
applicable laws regulating construction, zoning, and land developaent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no MorK or
installation has cOllenced prior to issuance of a perlit and that all MorK will be perforled to leet standards of all laMS
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 cOlpliance. Such agencies include but are not li.ited to:
f Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treat.ent
f Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, WasteNater Treatlent, Septic TanKS
f US Environaental 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 'co.pensating volule" will be subaitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perait issued shall be construed to be a license to proceed with the work and not a~authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit preven~ the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becole invalid
unless the work authorized by such perait is cOllenced within six lonths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six aonths after the tiae the work is cOI.enced. 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 will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCE"ENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCE"ENT. 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
beTDre me this
STATE OF FLORIDA
COUNTY OF
The foregoinq instrument
before me this
was acknowledged
, 19_____ by
who is personally known to me Dr who has
produced
as identification and who did/dld 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