HomeMy WebLinkAbout92-2722
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N<! 2722 fJ
/O-02b-?~
Date
G=DI~ ~ ELE~'~ M~L
::"::::,~:~:?d1/~~:J!:.. ~~
P"ceII.D.' I $1- ;;LiP . ;2./ - C)/ 60 - ::~0 - 001.60
Sewer Conn
Water Conn:
Water Meter:
T_I.F.'s:
Zoning: EnelY Code: ~on Gas:
Description of Work -Jlo(, - C~- . ~.:o
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signa.ture
Company
Address
Telephone#
It" g~<
''j
X
-
Valuation or
Contract Price
6 3?.s., a-v
/
City License Registration # / (0 0
State Certified License#
EL
ICAL
LU
MEC
L
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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 ZEmYRBILLS
BUTI.DDiG DEPARlKElIilT
.OWHER'S lWtE Q1LC K#5.YS
OWHER'S ADDRESS .:l*itJ STlti ~ ~. ~1
JOB ADDRRSSL.()-r:d,b 38~/')' ~1Jf()hPIJA J.tx;p
t"I/ J-HJ M 6. 5' A i..u S'
,
ZE.fJlI '1',e IfiLL $
W!J y W/l~/J W/AI.ttS
PIIONE
7ftJ' -7f'9o
r//J. J-sS'/1
PI //1' jJ./J-;I<K
/
LEGAL DESCRIPTION: 1..01'(5)
BT...oc:K
SlllBDIVISION
PARCEL 1. D. f
J 1. - :21:? ~ .:2 I - 0/ btJ .. CJ/)t/pp... tJ tJ./..o
RORK PROPOSED: v'Xew Construction _Addition _Alteration
_Repair
_Install
_Sign
_Kove
_DeJIOHsh
//
PROPOSED USE: v Single Faaily
_"-IF
_* of Units
_H/H
_COIIIIIercia1
_Indust.
_SwI... Pool
Ot:her
_Restaurant &: Healt:h Depart:lM!nt Approval
BUILDING SIZE: /.2.. X ?
,
'7btf PA/()ER.KotJ~ Square Feet.
P:7t!) 9'
Height
RESIDENTIAL:
COKKERCIAL :
A'ITACII (2) PLOI' PI.MilS &: (2) SEIS OF BlITLDIMG PU\MS &: (1) SET RHERGY FORKS. **
A'ITACH (3) SETS OF BUTI.DDG PU\MS &: (1) SET ErrmRGY FORMS. U'
*-4-COPY OF COIlITRACT Rlr.Qm:RED.
PEmlITS REOUESTED
("BUILDING
$
hJ J.7 ,.00
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_HECHANICAI.
s
Valuation of Mechanical Ins'tallation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block ,...., Pralle _Steel
/1 J,/A p"/ -
Other
FINISHED FLOOR EI.EVATIONS:
FI' .
IS PROJECT IN FLOOD ZONE .AREA?
YES NO
-4-***-4-*-4-******************-4-*-4-****-4-*-4--4-**-4--4-t-4-
BUIIDER
COllD'RACTOR SECT'ION
COfPMY /lcE/lL U/J? '
/) #/ ...J- /J . State CerL or RegisL .C/2C t::) Jy'~t)
~ City License Registration :J / 60
**************************-4--4-***-4--4--4-*-4-*-4--4-***
Signature
Sismature
COItPANY
State Cert. or Regist., :J
City License Registratjon I
********************************-4--4-*-4-**-4-*-4-*
ELECl'RICIAN
COMPANY
State Cert. or Regist. :J
City License Registration I
*************************-4-****-4-*-4--4-*-4-***-4--4--4-
PLOKBER
Signature
CO'IIPANY
State Cert. or Regist. :J
City License Registration I
*************************-4-******-I:-I:-I:*-I:***-4--:!:
MECHANICAL
Signature
7l,l4A~-J
COMPANY
State Cert. or Regist. :J
City License Registration M
***********.**~.**********~****-I:**-4--I:**~*-:!:-I:
r~~~
~J"/l ..dl-t}-I
L"-_...-
0T1IER
Signature
APPLICAUON APPROVED BY
.> '"'1
PERKIT OFFICER.
",:,,;,..,"""":"-
~
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this pertit lay be subject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assules responsibility for co.pliance with any applicable deed restrictions.
B. UNL I CENSED CONTRACTORS AND CONTRACTOR F:S:,:?I:_\J!':ISJJ:~-l...lh.I 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 contractor(sl 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 Day 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 FEE2.
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 so.eone,o~her than the
"oHner", I certify that I have obtained a copy of the above described document and promise' in good faith to deliver it to the
"oHner" prior to cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all wvrk will be done in compliance with all
applicable laws regulating construction, zoning, and land developlent.
,
Application is hereby lade to obtain a per.it to do work and installation as indicated,. I certify that no work or
installation has cOllenced prior to issuance of a per.it and that all work will be perforled to leet standards of all laws
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 governmental 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:
f Department of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Enviro'naentally Sensitive lands,
Water/Wastewater Treatment
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - SeaHalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
f US Environmental Protection HQency - 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 volume" Kill be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to pertit issuance.
A per.it 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 pertit prevent the Building Official froD 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 cOllenced 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 com~enced. One 90 day extension of ti~e, lay be
allowed for the pertit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be, 0 Ing each 'x lonth period, or the project will be considered abandoned.
WARNING TO OWNER: Y A E R CORD A NOT E OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF Y NTEN DB AIM INANCING, ONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT JOBS R $2,5 VALUE D ~OT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
51
dUJ.
SIGNATURE: CONTRACTOR
STATE OF FLORIDA ~
COUNTY OF ~r OxJ. (' /)
The foregoing instrument was acknowledged
befol-e me thisl1d~23, 19.!1l:::... by
~ ~
who ~personall y known to me ~r tIME' F\.:\:3
pl-'- QUi:tiOl<j
.=l"'- lrlpnt.;f:'b:iilti~'n and who ~did not
take an oath.~ . ~
(Signature) j.<.lfrHl-EE:.AJ 7ir. BRoc..JW
STATE OF FLORIDA
COUNTY OF vf (:iAJ~
The foregoing instrument was acknowledged
befcq-e me th i s {1e/~ 23, 19 ? 2- by
~v.~
\l'Jho is pel-==-onally kno\'m to me 4;1'" tJI--,e:, Mas
~Odl..ll...d
;:\5:; iglin+ifir-~t;.-,n and who eh-d-/did not
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
take an oath. ~f~.L-1') . ~
(Signature) Jt
J.< A TJ-I LEE.. j./ J: E/2duJ JJ
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~ KATHLEEN J. BROWN
i 1, State of Florida
My Comm. Exp. April 2, 1995
~ Comrn.#CC095617
#'J(:~
ia'f.
KATHLEEN J. BROWN
State of Florida
My Comm. Exp. April 2, 1995
Comm. , CC 095617
,.;.It
38545 ~81m Grove Drive
Zephyrh!l'8, Florida 33540
'ACE
ALUMINUM
Job No.
Phone: (813) 782-2616
.~
SOLD TO GlJLiJ J(( y ~ ML
ADDRESS J 1/ 'I/o Sl7J'fL ~/). ~
SHIPTO~f.'''u' J!IlI~ A.lJW/I.!IJOA ~4':JP
DATE ,_....LV - :JIJ- q:J-
PHONE
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The unde(Sisned aeIY, '!S to pay
INSTAlLERS IN FUU. O~ COMPLETIO
PERMIT
PRICE
TAX
TOTAL PRICE
DEPOSIT
BALANCE C.O.D.
:~L-~
bp~ ..
~- f
C~TY OF ZEPHYltBILLS BUILDING DEPARTMENT
OWNER GOLD)(~ Ys TY\08JL~ J-iIJM;;' sALES
JOB LOCATIon Lor ~. 3R'f)/.:J.. A~W/1tV.t)~ AO~P
PARCEL I, D, # j if-.2" - ~ 1- ~/6{). t't:Jt:1pCJ- ~..Jb()
IVlJivt.l1-et> All tJ/J',5 fh/IIfJt4""
f168,1rr
SHOW ALL iCXISTING 6: PROPOsEn S'l'RUC'!'URBs GIVDIG DDlENsIONS 6: SETBACKS,
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ALLEYWAY ACCESS FOR
GARAGE OR G1\RPORT -
15 FOOT SE'fBACK
REQUIRED.
~~. 1 Cj
LY
.UTILITY BU [!..O:ING,S
MUST SHOW 'bIZE &
FOUNDATION INFOR-
MATION.
FRON~ROPERTY LINE
$'3 "
STREE~l,.ibr-.,1b .3RP~.J LAVAICl/)/J
L. PC) ,t:'
(NOTE EXANPLES 1 & 2)
2. SETBACKS,FOR R3 ZONING
60'
10'
,
10' EXISTING 10'
PROPOSED
I
,
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
..
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.. : C~TY OF ZEPHYP}ULLS BUILDING DEPARTMENT
OWNER'" (;.{)l.:J)'L )(~ y~ mO/JJ/..}:;...._ ).10M F;, 5AlfS
JOB LOCATION' Lor.2b.. 3R't>/~ ~,tJ1W/1.tV.l)A ~o//p
PARCEL I. D. # / if'. ..2~ - J 1- ~/b[). t:J/Pt70&- tP.:u,()
WIliAJteJ:, IJlpJj'j f1)Itlf],Lr
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SHOW . ALL ~'r..J:S"1':rHG it: PROPOSEO 8I'1lUC'l'URES G:tVXHG DntBNSIONS " SETBACKS.
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STREI~;;Jn'..;?h JPo/.J. LAVAJ4Jf)/J LOt) f'3
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ALLEYWAY ACCESS,FOR
GARAGE OR Cl\RPORT -
15 FOOT SETBACK
FEQUIRED.
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.UTILITY BU !:!..#xNd,s
MUST SHOW 'GIZE &
FOUNDATION INFOR-
MATION.
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(NOTE EXANPLES 1 & 2)
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2. SETBACKS,FOR R3 ZONING
60'
10'
,
10' EXISTING 10'
PROPOSED
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20'SGLFAM 30'DUPLEX
1 0'
FRONT PROPERTY LINK
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