HomeMy WebLinkAbout92-2823
. BUILDING PERMIT
Job Address;
Parcell.D. #
Permit
S";; ..>7)
~ILD~)
..3?: ()7J
Sewer Conn ,
Water Conn: ~
Water Meter:~
T.I.F.'s:
Zoning;
.4L~-4?
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NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Valuation or
Contract Price
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
/ 0 - /3 -:; ~ Inspector
Permit Fee J I ~r cti)
Signature~.Q."" ~adr
Company
Address
c.o.
DATE
fttnJ,t7t)
City License Registration #
State Certified License#
Telephone#
CJ1--... f"vw .A
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SLB ~
Tub Set
Water
Sewer 'J-J5-f1tf 6 il!/
Final
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
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 ($15.00) 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.
'DEf\rJ ?E~S.
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ALL ,LUO~~i'~ ~~ -bc- d~N~ i ~y !l?.s;~~
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SYmBOLS FoR.. DeAWIN& ON PA<oE: f! Y
AND GE.NEtAL ~ i";Y) Bbc..~ f::oR t>A6ES 34-4
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APPLICATIOJl FOR PERItIT
CI'JY OF ZEPIIY.RIIILLS
BUII.DIIiG DRPARnIE1iT
7)c.41J E: ~ VoNck IV. nGGS PHONE 8t3 - (~;L.-8CJS8
OWNER'S ADDRESS S 7YS q'/-h <5J, Ze ph ,/~{, /Js / -;://1.
s~m~
LEGAl, DESCRIPTIOII, I.IJT(S) ~ &..J 7 BLIlI% "34 SOBDIVISIOII C,-kt o.p4?L'j~L')1s
PARCEL LD.I II-~~- :)..\-00\0 -03~OO - OOSD
WORK PROPOSED:_lNIev Construction V Addition ~teration ~epair _Install
OWNER'S MAKE
33<;; YO
JOB ADDRESS
_Sign
_Hove
_Deao1ish
PROPOSED USE: ~i.ng1e Faai1y
_KIF
_, of Units
_K/H
_~rcia1
_Indust.
_Swia. Pool
Other
Restaurant &: Hea1t:h ~t Approva1
~1; 11..' r
BUILDIIiG SIZE: q' to. II X ~ t ,,~' "37(, , ;;L~ Square Feet.
1/ '
Height
RESIDEIiTIAL :
cottKERCIAL :
AtTACH (2) PLOt' PLUS &: (2) SEIS OF BUILDDfG PLUS &: (1) SEI' ENERGY FORMS. **
AtTACH (3) SEIS OF BUllDDiG PLUS &: (1) SEI' ENERGY FORKS. **
**COPT OF COIn"RACT RIlQIDIRIlD.
PERl!lITS REOOESTED
vBUILDING
V"'" ELEC'rRICAL
4 rxJD c~
Va1uation of Total Construct.ion
AKP Service
v . Florida Power Corp.
W.R.E.C.
---1tECIfAIUCAL
$
Va1uation of Hecbanica1 Inst:allation
~PLlJK8ING GAS ~ HOOFDiG
TYPE OF COIiSTRUCTION: _Block /'~ _Steel
SPECIALTY
Other
FI' .
IS PKOJECT IN FLOOD ZOIiE AREA?
1/""
FllIISHED FLOOR ELEVATIOIiS:
YES NO
******************************************
C05'I'RAcroR SECTION
CO!IPMiY
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
Signatnre
ELEcnuCIAlf
CO!IPA1'iY
State Cert. or Regist. I
City License Registration f
******************************************
SilPn;lture
CO!IPARY
State Cert. or Regist. ,
City License Registration 1
******************************************
PLOIBER
Signat:ure
_i:'
CO!IPANY
State Cert. or Regist. 1
City License Registration I
******************************************
KEafAl[[CAL
Signature
OTHER CO!IPAIWY
State Cert. or Regist. 41
Signat:ure City License Registration ,
*********************~~****x**************
APPLICATIDN APl'IlOVED BY ~~^A~C___ PERIIIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assules 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 lay be required to be licensed in accordance with
state and local regulations. If the t&ntractor is not licensed as required by law, both the owner ~nd contractor lay be
cited for a lisdeleanor violation under state IaN. 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, (813)
788-6611.
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 Mork. 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 ZephyrhilIs.
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 Departlent of Agriculture and Consu.er Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described docu.ent and prolise in good faith to deliver it to the
"owner' prior to cOI.ence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
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 develop.ent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a per.it and that all work will be perforled to .eet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies .ay apply to the intended work, and that it is
'y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
I Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treat.ent
I Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health & Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US Environ.ental Protection AQency - Asbestos abate.ent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
addressing a 'co.pensating volu.e' will be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to perlit 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 perlit prevent the Building Official fro. 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 per.it is cO'lenced within six lonths of issuance, or if work authorized by the perlit is
,suspended or abandoned for a period of six lonths after the ti.e the work is cOllenced. One 90 day extension of tile, lay be
allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six .onth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"MENCE"ENT "AY 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
COM"ENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT'.
SIGNATURE: CONTRACTOR
STATE OF FLORIDA [)_
COUNTY OF ~~
The foregoing if.strument was ackno~ledged
before me thiM(_~3P<1 ,19 q:l by
'-(l~~ E. Q e.-~S
who is personally k 0 n to me or who has
produced ~ d; 0Jl0A- 'b~ 'IIQ..(' U t-Qns, 'E'
as identification and who .../~d not
take ~~AU\-
(Signat~~. L~QJL
(Name Typed, Pr i nted clr Stamped)
NOTARY PUBLIC
STATE OF FLORIDA
rIJUNTY OF
The foregoing instrument
befc,,-e me th i s
was acknowledged
, 19_ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
Notnry Public. State {'f Fb~HII
My CO:T.m1!.dcn Ex~ires Feb. =n 1995
Bonded Thru Troy Foin ..lmurance Ine..