HomeMy WebLinkAbout92-2772
BUILDING PERMIT
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Permit
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CITY OF ZEPHYRHILLS
(813) 788-6611
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Date
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~-'Sewer Conn
Job Address:
Parcell.D. #
Water Conn:
Water Meter:
Zoning:
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.
Inspector
Valuation or .d _ '? d.L-O" lJ...!!-
Contract Price ;;t::... ~ ~
City License Registration # ff / &,/h"....
State Certified License#.,
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C~~ ~E~C
Pe,mit Fee #r~;;
SIgnature .....-: a.<1
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Company
Address
Telephone#
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Ftr,
Pre SLB
Lintel
FRM,
Insul. CL
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Tp, Servo
Rough In
Meter Can
Canst, Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
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 ($15,001 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,
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APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
ADDRESS
OWNER j ("J t--, : S
JOB LOCATION,f5~
PHONE
r .K()e'4/er
kU:JUl f> Ofl. 2e..f^yr~:I/ S / P'L..
LOT SIZE~X rfb
AREA SQ,FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D. 4F ! &-"(/..6_ J-I - b D::J..A - ^ }}.L)CO - CJ OOD
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~tall
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair
____Sign/Temp.
____Sign
_Move
____Demolish
PROPOSED USE: ____Single Family
____M/F
____4F of Units
.____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.
PERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_\\T,R,E,C,
____MECHANICAL
$
Valuation of Mechanical Installation
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
~ ~I ... CONTRACTOR SECTIO~ I.~ ( .
BUILDER - a J~ Company . -I. 0 ~R/t~ :;;;;;..~
. State Cert. or Reg1st, # 0 C)
Signatur /" City License Registration ifr Cj('" I
.-. - .......................................***
ELECTRICIAN
Company
State Cert. or Regist, ifr
City License Registration 4F
******************************************
Signature
PLUMBER
Company
State Cert. or Regist. #
City License Registration #
******************************************
Signature
MECHANICAL
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
OTHER
Company
State Cert. or Regist. #
City License Registration #
Signature
******************************************
APPLICATION APPROVED BY
PERMIT OFFICER,
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restricti~ns" which lay be m~re restrictive than City
regulations. The undersigned assumes responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
"
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 misde.eanor violation under state law. If the owner or intended contract~r are uncertain as to what licensing
requirements may apply f~r the intended w~rk, they are advised to c~ntact the City ~f Zephyrhills Building Department, (813J
788-bbll,
Furthermore, if the ~wner has hired a c~ntractor or contractors, he is advised to ha~e the contractor!s) sign portions of the
"Contractor Secti~ns" of this application for which they will be responsible. If you, as the ~wner 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 permitting privileges in the
City of Zephyrhills,
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 - Ho.eoNner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is sOle~ne other than the
"owner", I certify that I have obtained a copy of the above described doculent and pr~mise in good faith to deliver it to the
"owner" prior to cOlmencement.
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 cOlpliance with all
applicable laws regulating construction, zoning, and land development.
Application is hereby lade to obtain a permit to do work and installation as indicated. I certify that no work or
installation has co..enced prior to issuance of a permit and that all work will be performed to meet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies lay apply to the intended w~rk, and that it is
.y responsibility t~ identify what actions I lust take to be in c~lpliance. Such agencies include bllt ~le n~t lilited t~:
I Department of Environ.ental Reaulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Ldnds,
Water/Wastewater Treatlent
I Southwest Florida Water Manaaelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Army Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Department of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatment. Septic Tanks
I US Environmental Protection Aaency - Asbestos abatement
I also certify that, if fill material is to be used in Flctod Zcone "A" or "A,etc.", it is understc.od tlitlt. a drainage plan
addressIng d "colpensating ~01ule" will be'sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A permit issued shall be construed to be a license to proceed with the work and not as authority to vioj~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Ufficial from thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every permit issued ;hall becole invalid
unless the work authorized by such permit is cOI.enced within six lonths of issuance, or if work authorIzed by the per.it is
suspended or abandoned for a period of six lonths after the tile the work is commenced. One 90 day e~tf~sioii of tile, may 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 tooth period, or the project will be considered aballdoned.
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 A1TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE
SIGNATURE
------------------------------
----------------------------------
OWNER OR AGENT
CONTRACTOR
DATE_______________________________________
DATE
-----------------------------------
NOTARY AS TO
OWNER OR AGENT
NOTARY AS TO
CONTRACTOR
-----------------------------
-----------------------------
MY COMMISSION EXPIRES
MY COMMISSION EXPIRES__________________
----------------------
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER Lou; 5 T J(f"YeA )fr
JOB LOCATION S5:iC:; ~43p "'~ 'DR 2r/j,y rJ..: lIS FL J,?Syc>
PARCEL I. D. # J,;( ~ d. /...-;t.../ - 0-0 ~t'> -1'5T'1SDD ~ Oc> DO
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
J:u~~ ne nR
2. SETBACKS FOR R3 ZONING
60'
1. SETBACKS FOR R1, R2 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 ' DUPLEX
1 0'
FRONT PROPERTY LINE
'FRONT PROPERTY LINE
LAKELAND
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PLANT CI1Y
A.1 Quality Aluminum Improvements, Inc.
5050 Gall Boulevard
Zephyrhills, Florida 33543
roa.SlaleLICeIlMNo.RXOO5iOl5 (813) 782-5946
CASH SALES CONTRACT
/' /.1Jl"n U a ~ b nd
THIS AGREEMENT iI made and er8f8d no Ihi& (c-.. Giya l-L-~ ,19 7 . Y a between
OVEMENTS Inc. 50 0 Gall Blvd., Zephyrhills, FL 33541
.' L , (hereinafter called
Phone: 7~~-~;::/O.b
WHEREAS, Own.r wiahtla '0 retain the services of Conlraclor to provide Ihe malerials and workmanship more speClflcollly
.scrlbed below, and
WHEREAS, the partie. wish 10 reduce 10 wflling the lerms of their agreemenl.
NOW, THEREFORE. in consideration of the promises and mutual covenants conlcllned heftlln, the p..rI,,,,;, ....iUtI ..:.
Jllow$;
(List speclllc Improvements here)
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56,00
SO,OO
2. Work Will begin Within approximately aller credll is approved if any amount oflhls eonlr"ct
I~ to be financed, Otherwise, worK will-begin Within approximately of signinQ this contract. Work. Will be
completed wllhin approximat.ly working d.,s. Conlractor will nol Utt iiaOle lor delays beyon<J tIlS control.
J. II I. agreed 1n.1 Ih.s conlrOlc;t shall nol become banding upon the Contractor unlll it is approved by an olllcer of the
company,
4. Any rlpr...nlallons or agreements not contained herein shall not be binding on either party. All oflhe agre.ments ilnd
unaer$landlngs 0' .ach party ar. conlalntel her'ln.
S, In the event it become. necessary for the Contractor to employ an attorney to riiicover monies due under this agreement. or to
enforce any of the terms and provisions hereof, Owner(s) will be liable for, and agretl(s) to pay, all costs and IUpenSQs, including
reasonable attorney', ,.... necessarily incurred by Contractor as a result. regardless of whether suit is filed or not.
6 All unused male".'s shall. unaer any conditions. r6malO Iha property of .ne Conrraclor.
7. The underSigned waHanl(') Ihal he is (they are, the owner(s) ollhe above menlloned premises and Ihe legallllle therelo
slilnds of record In hiS (Ihelf) name(sl.
8. "BUYER'S RIGHT TO CANCEL": This is a home solicitation sale, and if you dO not want the gOOdS or serVices, you TndY
cancel thiS agr.emenl by providing wrillen nOllce 10 Ihe seller in person, by telegram. or by mail. ThiS notice muSI indiCate tn.at
;ou do nol wanllhe goods or services and must be delivered or poslmarked belore midnight ollhe third bUSiness day alter you
,IUn IhlS agreemenl, If you canc'l thiS agreemenl, the seller may nol keep all or part of any cash down payment.
9. In the event Owner attempts to cancel this agreement after the date and time allowed for cancellation under paragraph 8 of thiS
dgr8111ment, Owner(.) will be liable for, and agree(.) to pay Contractor, all damages which Contractor sustains as a result of such
cancellation, inctuding loa. of profit, Contractor's coat of any material. specially fabricated, and a 15% re-stocking charge for all
matenals required tor the work specified ai)ove,
HE OWNER(8) H EaV CKNOWLEDGE(8) RECEIPT OF It. COMPLETEL V EXECUTED COpy OF THIS CONTRACT.
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OWNfR (/ .
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() J TOTAL CASH PRICE: ~
31P3 YY3 /
J 08 7Jj.:JO /8 LESS DOWN PAY MENT: $
BALANCE DUE ON COMPLETION: S
d-~jO__OV-
JOO,
~35(i).. "0
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