HomeMy WebLinkAbout92-2725
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N<?
2725~
Date / f)- M -9~
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ME~~r Conn
Water Conn:
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P"c.II.O.' .:;~ _ ---=- ~ j
Water Meter:
T,I.F.'s:
Zoning, I En"g. Co,"., Redon ~e1
o.'c:::tW~WI ~~g):!~ ~
NO OCCUPANCY BEFORE C.O.
~?-L ~~~
FINAL -.L 1- -;~
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or ~ () 0
Contract Price ~ ~ 0 f) ,-
City License Registration # :251 ~~
~fi..d Licen:;; .
~L/ ~ /p/~
~ .-
~
~- "
P~rmit Fee . ~ r\'
Signature ~
Company
Address
Telephone#
G))~~
7gg -;;(gg
ELE~---
~
~-_.
~PL
ME~I(,AL
.-.-
--"
Breakers
Ducts Insl.
Compressor
Final
Tp, Servo
Rough In
Meter Can
Const, Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. 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 ($15.00) 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.
STATEMENT
FROM .111/ Ii e W //1//1 11/ ~ Cc/?/s7duc7~
37//6 Lvmo It.~ J1 vt~ Z - 1/,(/05
OA.W, d ,s 19~
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TO JJ1;( -f /J1;( ~
ADDRESS ~/,5 /
, I
CITY 2-f{ I' (/s
TERMS
OR~DER NO.
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HEAllTZ INC:GARLAND TX 75041
I ...Scribblet ex#- I
JOB LOCATION
CITY OF ZEPHYRBILLS BUILDING DBPARTMENT
t7l k' -{ /11 R S m i 1<'. C" f? iff nr ~dt J rI-J,
615/ t bJ1.)N<e-/
,-
OWNER
PARCEL 1. D, #
SHOW ALL EXISTING &: PROPOSED STRUCTURES GIVIHG DIMENSIONS &: SETBACKS.
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION,
/~
t
~
ALLEYWAY ACCESS FOR
, GARAGE OR CA~O RT -
15 FOOT~ET, K
RE, QU.I. R~E~ , ' , 1
,~~ .' l
lJ e/ ' 0
"I ~~~i\C , ,,~4:
~("i" ",
,/ ~ ' , . .A.1f1
i:J l'j.
(NOTE EXAMPLES 1 & 2)
STREET
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 1 0'
S I
E N
D G
20'
l"ROIr.r PROPERTY LINE
10'
I
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
APPI,;]rG..!\TIOJlilI FOR PER."iTT
crl'Y OF ZEPHYRlITLLS
llU1TILDIJIilIG DlE;PARJrKE'NT
OWER'S NAME !J1 tf y III f[ s' JJl//{ e I( fi /';no JVd /
OWNER'S ADDRESS ~ /S / J, e NlVef
, ,
5;:IJMt:
mOl!\'E ?X1-:-- --- :5 ( cf ,2
JOB ADDRESS
LEGAL DESCRIPTION: LOY(S)
B.LOCK
SUBDIVISION
f)&jL J~
PARCEL 1. D . #.
k~RK PROPOSED:____Xe~ Construct~on ~Addition ____Alteration ____Repair ____Install
____Sign
____nove
____Demolish
PROPOSED USE:
Single FallIlily
____KIF
_* of Units
_H/H
____ \.ommlercial
_fudUlSt.
_Swim. Pool
Other
____Res1t;:mrant 0& ! ',,",alth Departlll€'lllt Approval
BUILDING SIZE:
x
Square Fee t.
Height
RESIDENTIAL:
COKrliERCIAL :
A1TACII (2) PLOT Pf ,;UIIS 0& (2) SEI'S OF BillLDING PLANS 0& 0) SET ENERGY FORMS. **
ATTACH (3) SEIS G: RUUDlllG PI..MJJS 0& (1) SET ENERGY FOfu"lS. ~~'
-!.--!.-COP1!" OF ro~"TR."'C RIE:QID:mID.
PEltllfi.TS REQUESTED
ABUILDING
_ELECTRICAL
$ d @-OO
Valuation of Total Construction
AMP Service
Florida P<>>~er Corp.
W.R.E.C.
_HECHMIi"ICAL
$
ValWl',ltion of Mechanical Installation
____PLUMBING
GAS
ROOFDI'G
SPECIALTY
TYPE OF coNsTRucnm1i: ____Bloc!
_Fr3lllle _Steel
Other
FIlnSHED FLOOR ELEVATIONS:
,!PT.
IS PROJECT IN FLOOD ZONE: AREA?
YES NO
x~~~~~ ~~~*~~~~~~~~~~~*~~~~~~****~:~~~~*~~
OI)1NJ'][Rf\c:roR SECT'IOiN
BUILDER
OOOfPMW 4? I (/{ (:" G~ (( 1(; /? //1 S C,-";) M ?,,-c'u 1'6J'l.
(~~ ",,011 /) '" d.7 4 0 S~ate ~ert. or R~gist. _ #!
//2/ "..-r4cc Ct!.-/ d....f:~-...<J C1ty L1cense Regl.stxatwn #I
~~~~~~ ,~~~~~~~~~*~:~~~~~~~~~~*~~~~~~:~~~~*
Signature
ELECTRICIAN OGMPANY
State Cert. or Regist. #I
Si~tllre City I.icense RegistratIon :I
~'i:~"f;~-::;' ':t::,!::{i:1i;:'fl:1l:11:'!!i:'f/:-!1:,!:~':f;~'ik'R:~11',!:.g;'f::'ir'f:'*'!:''f::it:*-e:'~~~-i:x~
Signature
COI!fPANY
State Cert:. or RegisL #f.
City !.i'C:~e RegistTation !IF
~*~~~~ ~~~~~~~~.~~~~~~~~~~~~~*~~*~~~~~~**~~
PLlJlKBER
Signature
OI:mPANY
State Cert. or Regist. #I
City License Registration ~
~-!.-~~~;~-!.-~~~~-!.-~-!.--!.-~~-!.-~-!.-~-!.--!.--!.-*~~-!.--!.--!.-~-!.-~~~~~~~~
MECHAlnCAL
0'TlJE'R OOHPAID?
State Cert. or Regist. #I
Signature City License Registration #I
~~*~t~~~*~*~*~~~~~~t*~~~~~*~~~*~~~*~~~~~~~
APPLICATION APPROVED BY
PERi/HT OFFICER,
Ci .>ID I T IONS OF Pi F~:M I T ('.FF I D('.') I T
A. NOTICE OF DEED RES1RICTIONS
The undersigned understands'th-;t-t-~;js; ;I:-~itllay be ~lIbjed to "deed restrictions" ~Ihi[h lIlay be Itore restridive th?n City'
regulations, The undersigned aSSU2es ,csponsibility for compliance with any applicable deed restrictions.
B. UNL I CENSED CONTR~~C_l :~~B.? P,ND CONTRACTOR RESF'Cil\IS I B I LIT IE:=';
If the owner has hired a contractlJr or :{,ntradors to undertake t/lJrk, the'1-;~y"b;--;:-;;q;:;-i-;;d't~:-b~-1'i-censed in accordance wi th
state and local regulations. If the (rntractor is not licensed as required by law, both the owner and contractor may be
cited for a lisdeleanor violation unde, state law. If the owner or intended contractor are uncertain as to what licensino
requirements lay apply for the intende work, they are advised to contact th~ City of Zephyrhills Building Departlllent, (813)
788-6611.
Furthermore, if the owner has hired a Qntractor or contractors, he is advised to have the contractor(sJ sign portions of the
"Contractor Sections" of this application for which they will be responsible. If youl as the owner sign as the contractor,
you are indicating that you, rather th n the contractor, are responsible for the work. If the cDntractor wishes you to sign
as contractor that may be an indicatiol that he is not properly licensed and is not entitled to permitting privileges in the
City of Zephyrhills.
C. TRANSF'ORT A T I ON H1F'( C:::T FEES AND UT I 1_ I T''r' cm~ltECT lQJ::LFEE:~,
D. CONSTRUCT I ON L I EN I m~ (CHAF'TER 713, FLOR I Dr'. ST?'1 'lUTES, f:iS At'-1ENDED)
I certify that I, the applicant, have fen provided with a copy of "Florida's Construction Lien Law - Homeowner's Protection
Guide" prepared by the Florida Depart[. nt of Agriculture and Consumer Affairs. If the applicant is sOleone other than the
"oNner", I certify that 1 have obtain0 a copy of the above described document and promise in good faith to deliver it to the
'owner' prior to cOlmencement.
E. CONTRACTOR'S/OWNER'~ AFFIDAVII
I certify that all the information in his application is accurate and that all Nork will be done in co~pliance with all
applicable laws regulating constructi[' ~ zoning, and land development.
Application is hereby lade to obtain 2 perlit to do work and installation as indicated. I certify t~at no work or
installation has cOlmenced prior to is uance of a permit and that all work will be performed to meet standards of all laws
regulating construction, City codes, Z' Ding regulations, and lard development regulations in the jurisdiction. I also
certify that I understand that the reg 'lations of other governmental agencies may apply to the intended work, and that it is
IY responsibility to identify what act ons I must take to be in compliance. Such agencies include but are not limited to:
I Department of Environ.ental Requlati,.~ - Cypress Bayheads, Wetland Areas and EnvirDnmentally SensitiVE Lands,
Water/Wastewater Treatment
I Southwest Florida Water Manaqement D,strict - Wells, Cypress Bayheads, Hetland Areas, Altering WatercourSES
I ArlY Corps of Enqineers - Seawalls, 'Dcks, Navigable Waterways
. Department of Health L Rehabilitati\ _ Services. Environmental Health Unit - Wel]sl Wastewater Treatment, Septic Tanks
. US Environmental Protection Aoency - Asbestos abatement
I also certify that, if fill material 5 to be used in Flood Zone "A" or "A,etc,', it is understood that a drainage plan
addressing a 'compensating volume' Xli he submitted which is prepared by a professional engineer registered in the State of
Florida prior to per~it issuance.
A perait issued shall be construed to Je a license to proceed with the work and nDt as authority to violate, cancel alter, Dr
set aside any provisions of the techni.:al codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in pl1ns, construction, or violations of any code, Every per~it issued shall be[o~e invalid
unless the work authorized by such per1it is com~enced within six months of issuance, or if Hork authorized by the permit is
suspended or abandoned for a period of six months after the time the work is cDru~enced. One 90 day extension of ti~e, lay be
allowed for the permit with fee charge of $15.00, The extension shall be requested in writing to the Building Official, An
approved inspection must be logged during each six ~onth period, Dr the project Hill be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RElJRD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAVING THICE FOR IMPROVEMENTS TO VOUR
PROPERTY. IF YOU INTEND TO OBTAIN Fit: ',HeINS, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOF:DIHB YOUR NOTlCE OF
COMMENCEMENT. JOBS UNDER $2,500 IN vr ,UE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEHENT".
!Jt;~lqJ.dt~
SIGNATURE: OWNER OR AGENT
~e' ~ ~, _
,. / . ,r",
~ ,~<:.A h'__:" /' dL.,---..o
SIGNA.TURE: CONTRACTOR
STATE OF FLOR~
COUNTY OF rI $ 0
The foregoing instrument
before me this &C~ ~
STATE OF FLORI~
COUNTY OF t11s'c D
The foreQoinq instrument was acknowledged
befc<l-e m~ th i 5 11:T. ;Z6 , 19 ~ by
w~s acknowledged
I ''1!l1::- by
or \<)ho has
IRe w/I ;;/l~S
who is ersonallv known to m or who has
produced
as identification and who lid/did not
tak an oath.
Q,
\.,)ho did/did ne.t
(Name Typed, Printed Dr St mped)
NOTAF:Y PUBLIC
(Name Typed, Printed or Stamped)
r~QJ ARLfJ!f:~U C
JAMES A, STONE
M Notary Public, State of Florida
y comm, expires May 16 1 ,,,,L"
CC 11 0274 ' ;7~v
JAMES A. STONE
Notary Public, State of Florida
My comm. expires May 16, 1995
CC110274