HomeMy WebLinkAbout92-2723
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N? 2723/j
Date
/0 -~t --72-
c9 ELE~ PLU~ ME~
p<op'rtYOwn"J:!J j(,~ _~~'~A2-
Job Address: <~__::J ~~ \:a
Parcell.D. # / '/ -~.2 h - d.-/ - ~/6 0 - CJ CJ CJ - C) 0 rO
Zoning: ~ne;fJY Code: Radon Gas:
Description of Work ~ JL - ~ A /14 -~...:t!;-~.;
I
Sewer Conn
Water Conn:
Water Meter:
T_I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
~-.s-:
~)-JAA 7:J~ -
~
Valuation or
Contract Price 07 9" 7 {; , 07J
City License Registration # / h ()
State Certified License#
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.
APPLICA'l'IOl!il FOR PERKIT
CITY OF ZEPllYRHILLS
BUJIll)I5G DEPARnIE'.NT
Go L D Kft. '('~ tIJ / HIJ M &.-
OWNER'S ADDRESS .f'lJ~/) SmrE -{(n. S'y
JOB ADDRIiS~.t=3 J>J>~S'41. MWA"vO/) Ll:JotIJ
OWNER'S NAME
S/lLtf S PHONE 1 RO. 7.f9o
ZjfP)JyjeJlIJ.,L~ ~~. J:l ~r,I/
/AlIJ-YIAI/J,eLJ IV/,up:s ~/;f-.I11A' k
LEGAL DESCRIPTION: LOI'(S)
BLOCK
SUBDIVISIOI!i
PARCEL LD.I
/'1- :26-J /~ CJ/6o- t)CJc70~ - t'/tPt?O
WORK PROPOSED: ""--lSlew Construction ~ition _Alteration _Repair _Install
_Sign
_Move
_Deaolish
PROPOSED USE: ;..../' Single Faaily
_H/F
_' ot: t'Units
_K/H
_~rcial
_Indust.
_Swill. Pool
Other
~estaurant &: Healt:h Depart:aent Approval
BUILDING SIZE: J / X ~
.
hSO HN.oe~ ttotJp;. Square Feet.
p , 7"'t'J 9' '
Height
RESIDENTIAL :
COHHERCIAL :
ATTACH (2) PLOI' :PI.A.NS &: (2) SETS OF BUILDII!iG PLiUilS &:' (1) SlIT ENERGY FORKS. U
ATTACH (3) SETS OF BUIIJ)ING :PI.A.NS &: (1) SET IOOJRGY FURHS.**
**COPY OF COI!iTRAC'I" REQrnrRED.
PERl!lITS RROOE."iTED
~UILDING
$
~9qb.t90
Valuation ot: Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_MECHANICAL
s
Valuation ot: Mechanical Installation
_PLlJKBING
GAS
ROOFDiG
SPECIALTY
TYPE OF CONSTRUCTIOI!i: _Block ~Fr3lle _Steel
/9Lt/ /I? .
Other
FINISHED FLOOR ELEVA'l'IOl!ilS:
Fr.
IS PROJECT IN FLOOD ZOI!iE ARE..\?
YES NO
***************.**.***.******************.
COfl'RAC'IOR SECTION
BUILDER
CO!tPANY /I c.E /7 LU I?"J
/J J? / -? /J _ State Cert. or Regist. 4# ~CO r3 YbPO
~~ City License Registration 4# ./.t.b
**************...*************************
Signature
ELECTRICIAH
CUlIPANY
State Cert. or Regist. ~
City License Registration 4#
*.**********.*...****..*******************
Sismature
Signature
CO!IPANY
State Cert:. or Regist:. 4#
City License Registration ,
******.*..**********.*********************
PLDtBER
Signature
CO!IPMY
State Cert. or Regist. ,
City License Registration ,
.*...*.********.**************************
KECHAlUCAL
CO!IPMY
State Cert:. or Regist. 4#
City License Registration I
**.*****.*.....*..*..*********************
OTHER
Signature
APPLIF~;;~;;r/1d4u'A
L_'""__"H_'''''"'''''_'''~'' .,', _', _ d
>4cflA J'L..I~
J..,
, " ,"'-"'7 P~'"".'.'.
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OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to 'deed restrictions. which may be lore restrictive than City
regulations. The undersigned assules responsibility for cOf;pliance with any applicable deed restrictions.
B. UNL I CENSED CONTRACTORS ANI:) CONTRACTOR F~sSF::(J~l9JL,--11J T ls.~~
If the owner has hired a contractor or contractors to undertake work, they ~ay 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 lisde.eanor 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, (BI3)
7BB-bb 11.
Furtherlore, 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 FEE~,
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.eon~ other than the
'owner', I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the
'owner' prior to cOlmencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVII
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 cOI.enced prior to issuance of a perlit and that all work will be performed to meet 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 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 limited to:
t Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ;entally Sensitive lands,
Water/Wastewater Treatment
t Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health t Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US Environ.ental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flood Zone 'AH or HA,etc.., it is understood that a drainage plan
addressing a 'compensating volule' will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to permit 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 permit prevent the Building Official froe thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every periit issued shall becole invalid
unless the work authorized by such permit is comlenced within six months 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 comlenced. One 90 day extension of tiDe, lay be
allowed for the permit with fee of $15. " The extension shall be requested in writing to the Building Official. An
approved inspection lust ogg d duri~g each ~ix lonth period, or the project will be considered abandoned.
WARNING TO OWNE . R AllURE 0 REC RD A NO - CE OF COHMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. YO TO OBTAI ANCING CONSULT WITH YOUR lENDER OR AN ATTORNEY, BEFORE RECORDING YOUR NOTICE OF
CO,",HCE OS UHOER ",'00 0 NOT NEEO TO RECORO AHO POST A 'HO~~
SIGNATURE: vCONTRACTOR
--_/
STATE OF FLORIDA
COUNTY OF --P 11..5 <:!.-('") __
The foregoing instrument was acknowledged
befcl\-e me this tJe/~.1..J, 19~ by
who i ~~ y~o"I~::;:;': \IF,/:. r.-:,~
pn: ELtECB-
a:s idl,.;..,L:..r~\-L:\l~\..'I' and who~did not
STATE OF FLOR
COUNTY OF
The foreg ,in instrument was acknowledged
before me - is tJdL,,; ;2J" 19!b:::.. by
~ ~])~~_~Lv
who' is pel-sonally known to me €ti \li'1[ hiil"
f*'~ddced
~~ iaeAtif;,~tion and who ~/did not
take an oath'.~~d-.~
(Signature) 0
~ATI-/ t..-G:&JJ J. 13t<ro.JN
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
take an oath. c:A/ ~A # '"'Y.Z. J
~~~J.-J _' ~~
(Signature)
I< ArJ../ L E./2.AI J-J3R DWP
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~
KATHLEEN -..1, ,Ii
State of Floc J.
My Comm. Exp. April 2, 1935
Comm. II CC 095617
~
KATHLEEN J. BROWN
State of Florida
My Comm. Exp. April 2, 1995
Comm.' CC 095617
! )
38545 Palm Grove Drive
Zephyrhl\ls, Ftorida33540
'ACE
A.LUMINUM
~
Job No.
Phone: (813) 782-2616
SOLD TO _ GOLf:> K ~~~ _ (Yt J }1 tJ fVJ €.- S ~) fl~
ADDRESS. 3f'lt} SrltrJ2 /(./J. t 5''1' Z&-f>#YRJlI~ ~/A, ,JJS~I
SHIP TOjpr: JfCJ D~ )....IJlVlflfV/J/t.L4J~ ZE-,PIIf/~/r'IL.i.-.J h,+, 3:;>o~ /
DATE__ '7RtJ-7Rtjo
PHONE __ / tJ - o? tJ - 9..?t-
.
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CIJNCf.6' rE .___
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7;;). )< dt{ rAb~ -n r/O
o
PERMIT
PRICE
TAX
TOTAL PRICE _
DEPOSIT
BALANCE C.O.D.
The undersigned agn 1ft to pay
INSTALLERS IN FUI.r. ~)N COMPLETI
$uL~
Rep.
CUStomers Slanature
',00
CITY OF ZBPIIYRHILLS BUILDING DEPARTMENT
OWNER btJLf:LY.ffY~ fl1DBJl-t... ~O~€-( ,
JOB LOCATION J..tJi-: 8' .J !/Jb~ )./9141 A/lJOA I./JI),D YAf/w/JAL>
PARCEL I.D. # Ii/A 26 '~/. tI/M- tJOdCJO- /JtJJ~l
J//JV~'5' /0/11 !1JRK
,
h3tJ~
SHOW ALL BXISTIHG & PROPOSED S'l'RUC"J."tJ'RES GIVING DIHBHSIONS & SETBACKS.
5'1' I
i
,., ,
..'0
.,
t
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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at "V I J '
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(NOTE EXAMPLES 1 & 2)
p,rIO
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t
dO
FRONT PROPERTYJtINE
" ---
ST~EET '-"rol' .~iO~ .i..19,1,I/lIIIIJ14
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
, ,(.ODP
1. SETBACKS FOR R1, R2 ZONING
60'
..
2. SETBACKS FOR R3 ZONING
60'
10'
P E_
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
10'
10'
EXISTING
1 .0'
1 0'
PROPOSED
. 20'SGL FAM
30 ' DUF.':'EX
FRONT PROPBRTY LIRE
FRONT PROPERTY LINE
CITY OF ZEPHYRHILLS BUILDING nBPARTMBNT
OWNER btJL b K ~ y.s [r)D13J LL ~Ofl1 i: S
JOB LOCATION I.J)T-: If J !tJb".J. ,L.l9w I4nJOA 1../)1J'p jA!A'Iw/JA.f)
PARCEL LD. # /'I--.2~ -oJ./. #//;0- tJt:JdCJO- t:)ttJ,fj'
JalJ/II-^,'S 1~III11R~
I'
h30~
SHOW ALL BXISTIHG &: PROPOSED STRUCTURES GIVJlfG DIMENSIONS &: SBTBACKS.
5'1' I
'f
,
30
I
'\),
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
JI/ )
V'
~}'S{ l.v ~ '
ty'\Ooltr
(NOTE EXAMPLES 1 & 2)
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L ~:;,~],
'"-
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t
FRONT PROPERT./J,LINE
, , ,
ST~EET LtJr.J' .?RO~ kl'llVAN/JA
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..60 t-'7~4
lOb'
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
. A.ODP
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E----,
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
10'
10'
EXISTING
1 (I'
1 0'
1 .0'
PROPOSED
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FRONT PROPERTY LINE
FRONT PROPERTY LINE
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