HomeMy WebLinkAbout92-2713
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611 Date /t) -c2J - 9 :L
1/ tJ" c;D 3-.5'"'; t:J7) 3-5": oviJ-tJ r tJ1)
~~. LECTRlaL) ~UMBI~0~A~ sewe,co,,:z==/ ,
~ /J I / Water Conn:
Property Owner: jAa.A~ ~-p~L ~ ~/l- Water Meter:
Job Address: t/,;2 3 t:,-A-. b2J T_I.F.'s:
Parcell.D. # d.- -;;Lt, -:J-/ - -.S'- 0
Permit
N~
2713.A
Zoning: ~~r~y Code: Radon Gas:
Description of Work !Jl4.dL ~ ~.;r ~~
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
,~/f
City License Registration #
State Certified License# / D fI t)tJ 0 '1
Signatur - ~11:o
Company ~ 7,/)/ Q'Y;( If?, \"
Addres~ (" i/2/ Mu y tf& AJ i/1J<eltv"Xi; pt
~~~~.8'/.'3 - ~ 77-/8'9-<1
~~~A~9
. -~DING ~ ELECTRICAL:
Ftr. Tp. Servo
Pre SLB Rough In
Lintel Meter Can
FRM. Const. Pole
Insul. CL Pool
WL Pre-Meter
Final
E~
. PLUMBING .
SLB
Tub Set
Water
Sewer
Final
~
N';'--'
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.
APPLICATION FOR PERKIT
CITY OF ZEPBYRllILLS
BUILDllIG DEPAR'IKENT
OWNER'S
MAKE /5:; r/{} r() - 0/- ;r(v,'fJ rrI \. 717a;e I"
ADDRESS (,/27 (!(J/})fO &.7f'{Jhyrhrl/s I rt-
(P/23 &nlf'O &JrT'{'f 7e/)/"yrA///\ )
f '
PHONE
+-;?;2- '2~ 7?-9
OWNER'S
JOB ADDRESS
TL 33S'/{)
LEGAL DESCRIPTION: LOI'(S)
BLOCK
SllJBDIVISION
PARCEL I. D.I
WORK PROPOSED:_lNlev Construction _Addition _Alteration' _Repair ~stall
/lJot5/{ E f)J/Y/t:-
_Sign
_I!tove
_DeJI01ish
PROPOSED USE:
Single Faai1y
_KIF
_, of Units
~H
_~rcia1
_Indust.
_Swia. Poo1
Other
_Restaurant &: Hea1t:h Depart:Dlent Approva1
BUILDIMG SIZE: 2 Lj i X i../ ()' ,
Square Feet,
Height
RESIDENTIAL:
COHrtf.ERCIAL :
AtTACH (2) PLOI' PLWS &: (2) SEIS OF BIITLDUl!G PIJ\lNlS &: (I) SET ENERGY FORMS. u
ATTACH (3) SETS OF B1llIJ)DilG PLWS &: (1) SET EINIERGY FORKS. -f:':!,
-f:*COFY OF CONTRACT REQm:RED.
PmmITS REQUESTED
_BUILDING
$
Va1uation of Tot:a1 Construction
_ELECTRICAL
Artf.P Service
Florida Power Corp.
W.R.E.C.
_KEGllAlfiCAL
s
Va1uation of Hechanica.1 Insta11ation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION!: _Block _F"r;me _Stee1
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
-f:****-f:********************-f:***-f:*****-f:***-f:*
COIlTKACIOR SECTION
BUILDER CQ!IPMl!Y
S~tureLf), I all ;, tl jJ,-c.~ ~~\~:';e O;e:~:;~~i:" ,
*-f:*-f: *-f:**-f:*-f:-f:**********-f:**-f:**-f:************
ELECTRICIAN COIIPMiY
..~ ~- 'f: State CerL or Regist. 4#
SiPl1atur~ . ~.J Cit::y License Registration' I
***** ************-f:-f:**********************
PUllKBER ~ CQ!IPMiY
~ 'State <:erL or RegisL 4#,
Signaturif'~L~ ~(1 J.-fi ,) City License Registration I
****** **********************************
KECHAlUCAL~ ~/--: " CQ!IPMiY
/ State CerL or RegisL 41
Signature '.<..A.A~ ..; j Cit::y License Registration I
**** * *******************************~*-f:
0'T1IF.R
S~~~!{
f ~-~,,~
z; AP~ 1ft(-H~'PPROVED
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""".,,~#70 ......,.........~~. ' ,.,,"
"'fl ~=t '=10.,. .
""f/IUIU"I\\!" '
CQ!IPMfi
S~te'"'cert. or Re~t:.= f
61:-..:1' L1.cen::.e Registration j
**** ***********************~*******-f:~*
...-_-.c....".......___........
BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit '.ay be subject t~ 'deed restrictions' which .ay be lore restrictive than City
regulations. The undersigned assules responsibility for co.pliance with any applicable deed restrictions.
B. UNL I CENSED CONTRACTORS AN[) CONTR ACTOS-U.;s.?Y_QJ\1 f>JJ3 I L ~ T I E~i
If the owner has hired a contractor or contractors to undertake work, they may be required 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 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 Department, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorls} 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. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~.
D. CONSTRUCTION LIEN LA~ (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 Protecti~n
Guide' prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone ~ther than the
'owner', I certify that I have obtained a copy of the above described document and pr~mise 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 will 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 cOllenced prior to issuance of a peTlit and that all work will be perforl~d 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 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 compliance. Such agencies include but are not liaited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
f Southwest Florida Water Kanaoelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental Protection AQency - Asbestos abate.ent
I also certify that, if fill material is to be used in Flood Zone 'A" or 'A,etc.', it is understood that a drainage plan
addressing a 'co.pensating volule' Mill be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A pertit issued shall be construed to be a license to proceed Mith the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fro. 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 pertit is cOI.enced 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 Mork 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 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".
,/
L/] ,jall(~;;) ~
SIGNATURE: CONTRACTOR
STATE OF FL~DA
COUNTY OF ~~~Q?t?
The foregoing inst~um~~t~~as acknowledged
befcl)-e me this ~/~ 19~ by
. ~'e 11 ~J- d ;5, SA I9-r e 10 ;:ht (i
'bLiib NY 14.T. SA tr-f.e-r-
who is personally known to me or who has
produced
as identification and who did/did not
a oat .
STATE OF FLORIDA
COUNTY OF OA, S (' co
The foregoing instrument was acknowledged
befcl)-e me th i s OC.i, d- \ ,19 '1 d---. by
tit eLArJlE A, PHO-lPS
who is personally known to me or who has
pl-oduced F~ P41:l-S'+/-er" -Co<;!G-() r:'fP f:;/C;e-.
as identification and 10 did/did not '
take al oat
~
)C1'2)
lName Typed, Printed
NOTARY PUBLIC
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tWTARY Pl'BlIC. STATE I~;; Fl,
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,-.,HuED THhU NUTARY' PlJWl-k. '...!Ni ..
CI'TY OF ZEPHYRIIILLS BUILDING DEPAR"tMEHT
OWNER
JOB LOCATION ~
PARCEL I. D. # c2 - ;;:2 b -;;L / - -5~ - 0
SHOW ALL EXISTING Ii: PROPOSED STRUCTURES GIVING DIMENSIONS Ii: SETBACKS.
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
fj.~ <- \'3 I ~
J9'
FRONT PROPERTY LINE ~ql__~
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60 "
la'
P E-
R X
0 I
la' P S 10'
0 T
S I
E N
D G
20'
1 A'
la'
la' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
1
FROMT PROPERTY LIKE
,~
FRONT PROPER'TY LINE
, I
'2..4 I~' I
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