HomeMy WebLinkAbout92-2728
BUILDING PERMIT
Permit
2728/fll
/o,-;L6 ---7:1-
CITY OF ZEPHYRHILLS
(813) 788-6611
d..b. trD .3 CJ ~_ ~ate
~'NG ~,~ PLU~~'CAL '; Aew" Cone
~~'-~ '--'-=~' .~~ Water Conn:
Pmperty owne:;R" <l ~~?1 ~
Job Address: ~_ - - ---
NC!
Water Meter:
T,I.F.'s:
Parcell.D. #
Zoning: Energy Code: 4, ~ _ ::'d_: ~s:
Description of Work /~'"7J rf.// ~!:::.
<3 ~./,--"frY
NO OCCUPANCY BEFORE C.O.
FINAL
L
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
c23 0-0. on
'"
Pe_mitFee ~- '''~J~
5;9"0'"'0(: __ N ^<,. /~
Company
Address
Telephone#
,~~f"
IV
Valuation or
Contract Price
City License Registration #
State Certified License#
ING
Breakers
Ducts Insl.
Compressor
Final
SLB
ub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM,
Insul. CL
WL
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 ($15.001 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.
APPLICATION FOR PER}lIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
Preston Townsley
ADDRESS 6218 Cameo st.
OWNER Same as above
PHONE 813-788-7439
"
JOB LOCATION same as above
LOT SIZE_X
AREA SQ,FT.
LEGAL DESCRIPTION: LOT(S)
PARCEL I.D.n 00317-00019-00022-00000
BLOCK
SUBDIVISION
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install
____sign/Temp.
____Sign
_Nove
____Demolish
PROPOSED USE: ~Single Family
~/F
____i~ of Uni ts
. .____M / H
____Commercial
_Indust.
____Swim" Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED,
PF.RMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
2QQLELECTRICAL
1sn
AMP Service
Florida Power Corp,
_W.R.E.C,
X"-MECHANICAL
$ ?~nn nn
Valuation of Mechanical Installation
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
BUIT.DF.R Company
State Cert. or Regist. #
Signature City License Registration a
******************************************
F.T.F.CTRICT AN Richard Crandall Company Richard Crandall
State Cert. or Regist. ii ER 0012910
Si2nature City License Registration a 240
******************************************
'PLUMRF.R Company
State Cert. or Regist, a
Signature City License Registration 1~
******************************************
MF.CHANICAT. Clayton Craddock Company Craddock's Air Conditioning
ar ~ State Cert. or Regist. II RM 0019937
Signature r '_ . /' ?"../ ~ ,./ City License Registration 11 18
***;****~*********************************
Signature
Company
State Cert. or Regist, #
City License Registration a
PTHF.R
APPLICATION APPROVED BY
~:;~~**;:gl'*;~ -;;:,:;... "*,.. **....,..
-- .
PERMIT OFFICER.
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'.......,-~_.. .,..
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,;rf
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. .... .'
CONDITIONS, OF,PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The ,undersigned understands that this perlit lay be subject to "deed restrictions' which ~ay be more restr.ictive than City
regulations, The undersigned alSUles responsibility;for, co.pliance with any applicable deed restrictions,
, ' ,
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ollner has hired a cc.n,tractoror contractors to undertake Kork, they lay be required h 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 [.wner [.r intended contractClr are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of 2ephyrhills Building Departaent, 1813)
788-6611,
Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is) 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. Jf the contractor wishes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to permitting privileges in the
City of 2ephyrhills.
C. TRANSPORTATION IMPACT FEES AND 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 - HOleowner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and ConsuDer Affairs. Jf the applicant is SOlec.ne 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 cOlmenceDent,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all worK will be done in compliance with all
applicable laws regulating construction, zoning, and land developlent,
Application is hereby lade to obtain a perlit to'do work and install~tion 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 leet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. 1 also
certify that I understand that the regulations of other govern~ental agencies fiay apply' to the intended work, and that it is
IY responsibility t[, identify what actions I lust take to be in cOlllpliance. Such agencies include bill ~1 e nc,l lil!ited to:
. J _.,..
I Departlent of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive lands,
Water/Wastewater Treatlent
f Southwest Florida Water ManaQement District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps ,of EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treat~En~, Septic Tan~s
I US Environaental Protection AQenc~ - Asbestos abatement
I also certify that, if fill laterial is to be used in Flbod Zone "A" Dr "A,etc,", it is understood th~l a drainage plan
addressing a "colpensating volute" Hill be sublitted which is prepared by a professional engineer fegist211?d in the State of
Florida prior to per.it issuance,
A perlit issued shall be construed to be a license to proceed with the work and not as authority to yiol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fro. thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every permit iS511~d ;hall becoae invalid
unless the work authorized by such permit is coamenced within six months of issuance, Of if Hol'k authDllzed by the pertit is
suspended or abandoned for a period of six lonths after the tiJe the Hor~ is commenced. One 90 day 1?~IEosioll of tite, aay 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 ~ust be logged during each six lonth period, or the project will be considered abdlldoned.
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 $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE ~Jt.~{1L/'-;_____ SIGNATUa ~C~
r~----O~ER OR AGENT .~VC: ONTRACTOR
DATE ___-Oc.~.26..r--~------------'------- DATE ___Q.G..t..Q..b-eL-2.9-,-JJJ2- ------ - ---------
NOTARY AS TO /}' ._J~" NOTARY AS TO /7' ,J~ d 1
OWNER OR AGENT ~~~Q._,s . _~ONTRACTOR_~~~Qd2l~S ~aj(--/
Diana L. Judah ' ~ Dlana L, Judah
MY COMMISSION EXPIRES__~_3D~-j 2~___---_ MY COMMISSION EXPIRES_~-3D~_j995_---
~
DIANA L, JUDAH
State of Aorida
My ('.omm, Exp. July 30, 1995
Comm,' co 1~978
fJ(:.....
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DIANA L. JUDAH
State of Florida
My Comm. Exp. July., 1995
Comm. , co 1tt978
CRADDOCk'$"NR CONDITIONIH,G
3I43t CoR. 54 Eat .: .
ZE&tVIHIUS. . Fl 33540
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TAX
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OFFICE COPY I hereby aooe. pi above performed ..tVlOe, .nd oh",ge.. .a being eallll-
. .' . laG lory .IId ae; knowledg. "'a'.ql/lpmenl II.. an lea iii good ooilcIltIon..
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