HomeMy WebLinkAbout92-2552
'awes
6U!UMO uosJad a4:l O:l panss! aq II!M s:l!wJad Ja4un~ Aue aJo~aq apew aq lIe4s saa~ uO!:l::>adsu! ~o :luawAed a4.L
'alq!Ssa::>::>e :lOU >IJOM '6
'S:l!S qof:le :lOU sueld .~
'a:l!s qof uo pa:lsod :lOU :l!wJed 'a
'pelle::> ue4M uO!:l::>edsu! JO~ ApeaJ :lOU >IJOM 'p
'palle::> uO!:l::>edsu! ue4M apew :lOU suo!:l::>aJJo::> JO sJ!edel:l .::>
'uo!:l::>nJ:lSuo::> A:llne~ WOJ~ 6u!:llnSeJ >IJOM pauwapuo::> 'q
ssaJpP'V 6uOJM 'e
:apeJ:l 4::>ea JO~ d!J:l 4::>ea JO~ apew aq lIe4s (00'9L $) sJellOa 00 LiOO pue uaa:l~!:f ~o a6Je4::>
e 'SUoseaJ 6u!MOIIO~ a4:l ~o auo Aue O:l anp AJessa::>au aJe sd!J:l uO!:l::>adsu! eJ:lxa ue4M :S33:f NOI.L::>3dSNI3l:1
AeMa^!Ja
leU!:f
Ja:lall\l-aJd
lood
alod ":lsuo::>
ue::> Ja:lall\l
UI 46nol:l
'^Jas'd.L
1M
1::> 'Insul
'lI\Il:I:f
la:lu!l
SlS aJd
, Jl:f
leU!:f
JaMas
Ja:leM
:las qn.L
SlS
leU!:f
JossaJdwo::>
'lsul s:l::>na
sJa>leaJS
DNla11ns
uau04dala.L
ssaJpP'V
Auedwo::>
}
~ >>~& ~~, 4l amleu6!S
c:!---O /~~'r aa:f l!wJad
JOloadsul
uasua::>!l pa!~!:lJa::> a:le:lS
U uoqeJlS!6al:l asua::>!l A:l!::>
9-(J '~ ''1/
a::>!Jd :l::>eJ:luo::>
JO uO!:lenle^
3,HfO
'sa::>ueu!pJO pue sapo::> A:l!::> 4:l!M a::>uepJo::>::>e U! pawJopad aq lIe4s >IJOM II'V
'0':) 'UO!le::>!ldd'V Auedwo::>::>'V :lsnV\l aa:f pue SUO!le::>!Jpads 'sueld alaldwo]
l"NI~
'0':) 3HO~38^:)N"dn:):)o ON
-,l\d~
:S1?8 uOPI?H
h /X --c'lf >fJOM 10 UO!ld!J:>sao
:apoJ A6JaU3 :6u!uoZ
:S,'::IT1
~" :r-'i'Fl'
//-.z:E" ~-e- CJ{.o- -el # 'O'llaaJl?d
y[! - ~~~ .~/~'S".,ppvqor
~ :JaUMO A1JadoJd
~ ~3 C~NIOlV
:JalaV\l Jall?M
:UUOJ Jall?M
UUOJ JaMas
~V\1
c: 6- / -~
t,
fl GSSC:
all?a
oN
L L99-SSL ([ LS)
SllIHHAHd~Z :10 All::>
llWH~d !)NIOllflO
l!WJad
CONDITIONS OF PERMIT AFFIDAVIt
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait .ay be subject to .deed restrictions' which lay be lore restrictive than City
regulations. The undersigned assuaes responsibility for coapliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or t~ptractors to u~dertake work. they lay be ~equirEd 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 aay be
cited for a aisde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requireaents aay apply for the intended work, they are advised to contact the City of Zep~yrhills Building Departaent, 18131
788-6611.
Furtheraore, 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 aay be an indication that he is not properly licensed and is not entitled to perlitting privileges in'the
City of Zephyrhills.
C. TRANSPORTATIQN IMPACT F~ES_~ND 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 - Hoaeowner's Protection
Guide. prepared by the Florida Departaent of Agriculture and Consuaer Affairs. If the applicant is soaeone other than the
.owner', I certify that I have ob~~ined a copr of the above described doculent and proaise in good faith to deliver it to the
.owner. prior to coaaenceaent.
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 coapliance with all
applicable laws regulating construction, zoning, and land developBent.
Application is hereby aadeto obtain a perait to do work and installation as indicated. I certify that no work or
installation has coaaenced prior to issuance of a perait and that all work will be per10rled to aeet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies aay apply to the intended work, and that it is
ay responsibility to identify what actions I aust take to be in coapliance. Such agencies include but are not liaited to:
. Departaent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and' Environlentally Sensitive Lands,
Water/Wastewater Treataent
. Southwest FIDrida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
. ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departaent of Health & Rehabilitative Services, Envir~Eaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
. US Environaental Protectiull Hqem:y - ksilt1stos c!Jilteaent '
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 voluae. will be sub.itted 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 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 perait prevent',the Building Official froa 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 perlit is cO'lenced within six lonths of issuance, or if work authorized by the perait is
suspended or abandoned for a period of six aonths after the tiae the work is cOllenced. One 90 day extension of tile, aay be
allowed for the perait with fee charge of tI5.00. The extension shall be requ~sted in writing to the Building Official. An
approved inspection aust be logged during each six aonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUA PAYI~S TWICE FOR IKPROVE"ENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDiNG YOUR NOTICE OF
COK"ENCEMENT. J08S UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COMMENCEMENT'.
SIGNATURE: OWNER OR AGENT
SIGNATURE: CONTRA~TOR
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
, 19_ by
who is r~rsonally
produced
as identification
take an oath.
kno~:n to ::~= t:l'i ","', h..'
1. _._
~ fa:;:)
..i"lL> is personally
p:-oduced
as identification
take an oath.
known to me or who has
and who did/did not
and who did/did not
.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed Dr Stamped)
NOT ARY PUBLI C
JOB LOCATION
CITY OF ZEPIIYRBILLS BUILDING DEPARTMENT
hi, E. NEt. s: 1.-"1 /,,'
..~J 2 > i3 c L T- I( A-/V1 j)~
L () T JI g L. 3
2 t PH'i" I< tll(, ~ 51 F L. :J:: s-If 0
I
'2.. ~ If 7~.J
OWNER
PARCEL I.D. #
SHOW ALL EXISTING &: PROPOSED STRUC'J."O'RES-GIVING DIMENSIONS & SETBACKS.
70'
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
, I
,,:
"'1
J ,
~ So -> I
. :-i
--
_~~~i; \
,,' ~': I
~ " ~ ;,
-.', '~ 1 I
(', , :
.---LO ~___. _____\_~ _~~~1 _----------!
1:2: \ ~
- '-'l \ "':>
~I
"
"
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
71
1"3
C)
.........
...........
FROll'r PROPERTY LINE
/01
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1f R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10' -
...P ~I
R
0 I
10' P S 10'
0 T
S I
E N
D G
20'
T
1io'
\ 10'
I
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
(1)
( 2 )
CARPORTS OR LIKE STRUC'I'URI!;S PLm:.\:~;;~ _(::Q:KPLETE THE FOLLOWING:
DESCRIBE WHAT TYPE: FREE STPJ:IDT,,>1'G 06"M"A~ (CIRCLE ONE).
IF ATTACHED, HOW IS IT 'r0 BE FA~ ISNED TO STRUCTURE? .31' Err I? /J pE/)
lie II Och....
FOR
(3) DESCRIBE POS"I' SF;..c~ f. FA::"i'i"'ThjD~iG (IF TO CONCRETE, IN WHAT MANNER?)
.:? // C lis 7/ If' 4- '1 H (I JI ') S /l.. J! 0 L 1- S
GIVE
J )
DIMENC!IONS '"\1:" .....'!'p....',r:-" .......n....",.. T.'T'....~H ".~..IG...n.I.'( }~
_ . __ '-"'....... ......1..... _...~..1I-...;)........., Wl.J.J.J. , oc: .lJ.J::A nJ..
/~ #
(/
9'1
( 4 )
( 5 )
GIVE AMOUNT OF OVERHANL:, ??lWfol s'rkJC7ul'.AL GUPP0?T:
(6) COMPLY WITH REQUIRED SETBACKS AS GIVEN IN ABOvE REFERENCED PLOT
PLAN.
(7) SUBMIT DETAILED DRAWIliG-
( 8) FIBERMESH CONCRETE IN iolRIVEWAYS PNLY - EXCLUDING R. O. W. · S.
APPLICATIOIl FUR PERHIT
CI'IY OF Z.El'IUKH II.T.S
BUlLDIliG DEPAKnIRNT
OWHER'S RAKE
~tl, E, NEL
OWHER'S ADDRESS b-J d~
~tJ AI
!5 e L- T I~ Jtfr1 J)/l.
JOB ADDRESS .5;4 /V; e .4 s 4- Ii? t:) 1/ 12,
LEGAL DESCRIPl'I01II: LOT(S) II ~SUBDIVISIOR
"7 c..) r
PIIOe '" 6 - L/ ,;'
2- e P f-'/;" .~.L: /!..- LI ,t'" L
.
..,/
/" \.it
J J J-"'" 0
,2-
HIS
PARCEL I. D.'
WORK PROPOSED:_lIew Construction ~tion _Alteration _Repair, _Install
S'
__ 19J1
_Mo\Je
_ne.tolish
PROPOSED USE:
./ Single Faaily
_tf/F
_, of Units
_K/H
_ec-ercial
_Indust.
_Swill. Pool
Other
_Restaurant &: Health Depar1:aeIlt Approval
BUILDnG SIZE: 1:<
x/t.J
/7b I
Square Feet,
9'1 )/
Height
RESIDENTIAL :
, cottKERCIAL :
ATTACH (2) PL01' PI.AliS &: (2) SEI'S OF BUlLDDiG PLAJ!iS &: (1) SET ENERGY FORKS. **
ATTACH (3) SEI'S OF BUllDDG PIAIlS &: (1) SET DRRGY FORKS. **
**COPY OF COIilTRACT REQUIRED.
PI!:ImITS REQUESTED
~BUILDIlIG
$
J. fc, f/O ,O-V
/
Va1uation of Total. Construction
_ELECTRICAL
AKP service
Florida Power Corp.
W.R.E.C.
~CAL
$
"alaai:ion ~.t ~eehani(,,:::Il Installation
_PLUKBIBG GAS HOOFING
SPECIALTY
TYPE OF COllSTRUCTIOI!i: _Block _Fraae _Steel
Other
FIIIISIIED FLOOR ELEVATIONS:
FT.
IS PROJECT Df FLOOD ZONE AREA?
YES NO
*********k********************************
COII'I'RACIOR SECTION
Signature
)f;, [-
CO!IPAiM:l
~ ____ State eer<. or Regis<- ' t,
, ~ City License Registration ,
*****..****.............***************************'
RmT .DF.R
Sipiili#crore
CO!IPAft'
State Cert. or Regist. I
City License Registration ,
********~***.............************************* .
KI.F..cTRICI.AlI
CO!IPMY
State Cert. or Regist. t
City License Registration'
******************************************
PLDIBER
Signature
~~lWIY._"
State Cert. or Regist. I
City License Registration I
******************************************
MEalARICAL
Signature
.
CO!IPARY
State Cert. or Regist. 'f
City License Registration ,
**********..**********~*******************
BY ~ M "'~ _.$-" A.:ffi-J-
0T'IfF.R
Signature
APPLICATIOll APPROVED
PERKIT OFFICER.