HomeMy WebLinkAbout92-2820
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N<1
2820A
Date
/1-d.~-7';L
~IlDIN0 ~ PlU~
p<op,ny Own" ~?~~
Job Add".s ~.e'~ - _ " :- &A .e '1l~
Parcell.D. # ,;2...;;J..{, -;;../ - 0 () / 0 ~ I) u CJ c:J ~ .~ <:) I Y 0
Radon Gas:
~~ _.-,.I~dft -~~
ME~
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning; ~ Code:
Description of Work .. . ~
FINAL
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
p~rmit Fee ~~ ~ ~
Signature ~~ CJ2/l;,
Company
Address
Telephone#
Valuation or
Contract Price f.~ -~ - ~-V
City License Registration # ~ Y
State Certified License#
ELE
CAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
FRM.
Insul. CL
WL
J / 'to ~~al
Driveway 1/<' -
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.
APPLlCATION FOR PiOOilT
CITY OF ZEPlffKlLtTUS
BUIIJlDIG DEPAKI!ff1m
OWNER'S RAKE 6eC>lZfY-~tU<
OWNER'S ADDRESS~/I ~=??f)~
JOB ADDRESS S;:;me:
PIlOn
(filM/'! 6e,
LEGAL DESCRIPTION: LOT(S)
B~SUBDIVISION
PARCEL LD.f d- d& -;1/- OO/(J - 60r)r'J() - D /~
KORK PROPOSED:_5ev Construction .--.Addition _Alteration _Repair _Install
_Sign
_l!Iove
_Deaolish
PROPOSED USE:
Single Faaily
_"IF
_' of Units
_K/H
_~rcial
_Indust.
_S,"-. Pool
other
_Restaurant &: Health Depart:aent: Approval
BUILDING SIZE:
x
Square Feet,
Height
. RESIDENTIAL:
cottKERCIAL :
ATTACH (2) PLOt' PI.MlS &: (2) SEIS OF BUILDING PI..!U1S &: (1) SET RNERGY FORKS. **
ATTACH (3) SEIS OF BUTI.DlliG PLMS ~ (1) SKI' ENERGY FORKS. **
**COFY OF CONTKACT BIlQUIRIlD.
PERKITS REQUESTED
_BUILDING
$
I. S7)() _ iX)
,
Valuation of Tota1 Construction
_ELECI'RICAL
AKP Service
Florida Power Corp.
W.R.E.C.
_KEGllAHICAL
$
Valuation vf Hechanica1 Installation
_PLUKBING GAS KOOFTIIiG
SPECIALTY
TYPE OF CONSTRUCTIOIiI: _Block _FraIIe _Steel
Other
FlliISBED FLOOR ELEVATIONS:
FI' .
IS PItU.JECI' IN FLOOD ZONE AREA?
YES NO
***********~******************************
CDftiI'I'RACIOR SECTION
Signature
~" ~o~ ~
CO!IPBY Bi--.
State Cert:. or Regi .,
City License Registration
******************************************
BUILDER
,>...~ '"'- i ,. "".
,
CO!IPMIY__
State Cert. or Regist. ,
City License Beg~~Qtion I
******************************************
ELECI'RICI.AN
SiPn;tture
". ;
PUltBER
: t'''-'. "l' "'~ ...
.
~., ".,.1,,'"
'.
CO!IPOY
State Cert. or Regist. ,
City License Registration f
******************************************
Signature",
<; \, "\ ,,>0,
r . .. ..~ ';U _6'" ". "
. ".,~,.. . ~ ,
.', .-}
KEClJAliICAL CO!IPMY
State Cert. or Regist. I
Signature City License Registration I
******************************************
011IER CO!IPANY
State Cert. or Regist. :/It
Signature City License Registration I
******************************************
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRIC1IONS
The undersigned understands that this perait ..ay be subject to "deed restrictions' which lay be lore restrictive than City
regulations. The undersigned aS5uaes responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired ~ contractor ~~.,c,~tracto~s to un~ertake work, they .ay be required to be licensed in accordance with
state and local regulatIons. If the contractor 15 ~t~lcensed as required by law, both the owner and contractor lay be
cited for a aisde.eanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing
requireaents lay apply for the intended work, they are advised ':c contact the City of 2ephyrhills Building Departlent, (8131
788-6611.
Further.ore, 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 FEES
D. CONSTRUCTION LIEN LA~ (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of '~lorida's Construction Lien Law - Ho.eowner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and Consumer Affairs. If the applicant is sOleone other than the
'owner', I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
'owner' prior to coaaenceaent. '
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work will be done in co.pliance with all
applicable laws regulating construction, zoning, and land develop.ent.
Application is hereby tade to obtain a perait to do work and installation as indicated. I certify that no work or
installation has coaaenced prior to issuance of a pertit and that all work will be perforted to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of vther governlental agencies may apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be ill co.pliance. Such agencies include but are not lilited to:
f Departtent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Trfatlent
f Southwest Florida Water KanaQetent District .- Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departaent of Health ~ Rehabilitative Servirgs, Envirorlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environtental Protection AQency - Asbestos abateaent
I also certify that, if fill aaterial is to be used in Flood ',ne .~. or 'A,ete.', it is understood that a drainage plan
addressing a 'colpensating volute" will be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to pertit issuance.
A pertit issued shall be construed to be a license to proceed with the Mork and not as,authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuanC0 of a pertit prevent the Building Official frot 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 pertit is cOitenced within six months of issuance, or if work authorized by the permit is
susp~nded or abandoned for a period of six aonths after the tile ti,e work is COltenced. One 90 day extension of tile, lay be
allowed for the perait with fee charge of $15.00. The extensior. s;iaIl be requested in writing to the Building Official. An
approved inspection lust be logged during eaet. six to nth periud, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOT1CE OF COH"ENCEhENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CUNSULT WITH YOUR lEHDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COHKENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT ~EED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT'.
- JjRlc ~ Ib k , Ul...........
SIGNATURE:. ONTRACTOR l\~"~~ ELLI'O""'~
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S I ~
STATE OF FLOR~ ~ I'" C..... _III ,
COUNTY OF //Is =. IIII'ClI .. ,. =
The foregoing instr~JCt I .n IflljOged
befcq-e me th i s /1- '~""CJ fJ. ~~y
L J:> "f 'OF"~O ,.~:~
C? -e..'!le ~ I?Z!'J'!, II 'IllllIlIlllll"\\\\'"
Iflhe. is pel- _ona 11 y known to me or who has
produced ----
as identification and who did/did not
take an o~a. r} /J //
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,
(Signat'-!.!.-e) I //
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(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC
. OR AGENT ~,,\\\\t; Ellf""",~
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STATE OF FlORIDn ~ I \ 'a
COUNTY OF rP&t!D E :.., comm. expire.: E
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The foregoing instrQmeAt M~1~ndWljOged
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before me th j s JJ- cJ ~'" ~_19 ,"~Ji
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c?o.oRf'lB'" 7?i!!lIk ;"'I'I'I'III'",~,~ I~\\\\\\'"
who is personally known to m~ Dr who has
produced 19 ~.e.-I'A97?_ l)(~.~
as identifi~a~n and W. ho did/did ~ot
take an oat~.JfZl;;~
(Signat~~e) 1/ ' J~
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(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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THIS AGREEMENT mado the
Nineteen Hundred an
herelnaCter called tho Contractor. an
Owner, Witnesseth, that tho Contractor
S'fANDA1{l) fUKM OF AGREEMENT
BETWEEN CONTRACTOR AND OWNER
<lJl oC N()~L ~
y and between q req 'BeeA e..
I" the Y"
,
-
and the Owner for the conslderaUoru named aireo a.s foUows:
erelnafter calJ,.d t!
entitled
prepared by
Contract Docwnents entitled the Architec ,
Specifications and tho Drawings,
e Drawings and described In the Specificatior
e...,. . acting a$ and in th,.s
and shall do everything required by this agreement, the general conditions of the Contract, th
ARTICLE 2. TL\fE OF COMPLETION
The worlc to be pcrfonned under this Controlct sh.~1l be cornmcllcctl AS ~;["'.()n 0.") I'JrmJ: l~
substantially completed LA:) (nf IN 0 N 6'" lJ::f-.f k
,
\ -" 0 I e'(; t'D-"nd shJI! s,
ARTICLE 3. THE CONTRACf SUM
The Owner shale.! the Contractor for tho pcrfomlance of tlle Contract, subject 0 additions nn~ ~cjuc'-i~r:s r:'l,,;ded th':rein, in CUI1'C:l~
Iunw as Iollo.....s. 15ZC;PO J t)~ ~~^!.}J. hv. ;::'" ~O()
(Slale he", the lump rum &mollnl. ""it rr1'cel. or l.uth, OJ O'lir<<1)
Authorized Change Orders \\;11 be submitted by the ContTolclor Ior all work not spccwcally included in e,is Contract.
ARTICLE 4. PROGRESS PAYMENTS
(Irucrt hc:-e any provuJon tnace for th~ CLmoun~ rC'taiucd alter the WOlle re~chc. a C'C'ruin .tage- c.;{ Cf)~;:~:i~n..l
- ARTICLE 5. ACCEPTANCE AND FINAL PAnfENT
Final payment shall be due -=rJtr::: d J:>F b I I' I '
and the Contract Cully performed, ay, .... su stanUa comp etion 0 the worle provided the won:: be Ull'n Iully completed
.'
ARTICLE 6. THE CONTRACf DOCUMENTS
The ~ncral Conditions oI the Contrac.t the Spccilications ane! the Dra....;n s to 'etl1l'r \VI' I
~rIe as f~lIy a part uf the Contract os d hereto attached or here;n rC""'Jte~ 'Tile!; f II .' t.1 tllis ^gre~ment, Co= the ContTolct and tt.~'"
Ul ormation: . v-. 0 OV>lnj;\ is ~1l itcmiz.ar.:o;; c; other CSSt'nlial pcrtir.~~:
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