HomeMy WebLinkAbout92-2830
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~
2830 {5
Date I,;J.. -3,- P:L
~ E~ p~.. MECH~werConn
Water Conn:
Pmperty Owne' ~ ~ ~~.
Job Address:~J.57 - ~ .:~ ~. .. ...e~ 4 2i _ r
Parcel LD. # 3-;2.6'- ~/ e 0/ D'- / J 2-00- CJ 030
Water Meter:
T.I.F.'s:
Zoning: ~
Description of Work ~,J2 .,
_ Radon Ga'~ I~.
-4J~ /" _
FINAL 8'''- Id- -8
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
Valuation or
Contract Price
Y'A
Pe,m;t F.~" - ~
Slgnature_ L:U _".
Company
Address
Telephone#
City License Registration #
State Certified License#
t. t)..3
:2.4T:~~~
C BUILD~~ ELE~t.1
~
~_...
~NICAL
~
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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 ($15.001 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 FO~ PERMIT
CJ:TY OF ZEPif'tKHI.LLS
BUILDING DEPARTMENT
APPLICANT IfL4'~~ 5 if ~
ADDRESS ? g t,/- 55"- ,~ d~ '- 5 ~~~ PHONE 7 %0<- S' 5""'/ P
OWNER /!~~~ ,,' .(f~.L<..c
JOB LOCATION
LOT SIZE_____~ A~A SQ. FT.
& (!~ trrl 3. "7 {vv/I}; tv\() Jt ?x/fJC, <<lA~ ;LI ~~~ /-1-'"/ / to (tJ1-tf. '";Y"
LEGAL DESCRIPTION: LOT(S)l PI./4;11,utdt'7f.. J/"Z-' BLOCKX . SUBDIVIg'IONk ~ k&~2h1?) u5 .
PARCEL I.D.#)( ()~!J -r?-b-;ll-' OO~O .-1 \?()O --nD3o
WORK PROPOSED:____New Construction _Addition _Alteration _Repair _Install
_Sign/Temp. _Sign _Move ~lish
PROPOSED USE: _Single Family _M/F _# of Units. ._M/H
_Commercial _Indust. _Swim. Pool Other
_Restaurant & Health Department Approval
BUILDING SIZE: /!f X 3'b .
(r;f/l?'
Square Feet,
/t:-J r
.
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.
_W.R.E.C.
I
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Registration #
******************************************
BUILDER
ELECTRTCTAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
Sit:mature
PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
*********************~********************
~,
MECHANICAL
Signature
Company
State Cere. or Regist. #
City License Registration #
******************************************
OTHER
Signature
Company
State Cert. or Regist. #
City License Registration #
~u
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toIltrs. -, ~ ~ ,.r.,. ""'.
,,~.iV-, .. J. .;.,.;.,.,
PERMIT OFFICER.
A
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit .t~Y be subject to .deed restrictions. which lay be lore restrictive than City
regulations. The undersigned assutes responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OMner has hired a contractor or contractors to undertake Mork, they lay 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 .isde.eanor violation under state law. If the OMner or intended contractor are uncertain as to what licensing
requirelents .ay apply for the intended work, they are advised to contact the City of ZephyrhillsBuilding Depart.ent, (813)
78B-6611.
Further.ore, if the owner has hired a contractor Dr 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 per.itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN L.AW (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.eowner's Protection
Guide. prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the
.owner., I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the
.owner. prior to co..ence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation 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 .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has co..enced prior to issuance of a per.it and that all work will be perfor.ed to leet 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 govern.ental agencies .ay apply to the intended work, and that it is
.y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to:
I Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Metland Areas and Environ.entally Sensitive Lands,
Water/Wastewater Treat.ent
I Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I Ar.y Corps of EnQineers - Seawalls, Do~ks: Mavigable Materways
I Depart.ent of Health & Rehabilitative Services. Environaental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
I US Environ.ental Protection AQency - Asbestos abate.ent
I also certify that, if fill .aterial 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.itled which is prepared by a professional engineer registered in the state of
Florida prior to per.it issuance.
A per.it issued shall be construed to be a license to proceed with the work and not as authority to violatel 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..enced within six .onths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six .onths after the ti.e the work is co..enced. One 90 day extension of tile, .ay be
allowed for the per.it 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 .onth period, or the project will be considered abandoned.
WARNING TO OWNER: VOUR ~AILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AV RESULT IN YOUR PAVING TWICE FOR IHPROYE"ENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMKENCfHENT. JOBS UNDER $2.500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEHENT..
X ~('~J) k~/.~A:v
SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR '
STATE OF FLORIDA
COUNTY OF P A < C.: /:)
Th~,foregoing ins~rument
before me this l.:l - ?
.
was acknowledged
, 19 ~ by
STATE OF FLORIDA
COUNTY OF PA f c. 0
. The foregoing instrument
before me this I ~ - ~
.
lo'Jas ac knolo'J I edged
, 19.2.Z- by
ffHo,P/.//d~ /( .5 RE(J..r
who is personally known to me or who has
produced
as identification and who did/did not
take an (a~f". i. /J ~ ./
(Signatur~
lJe? A/ w/lie-eL. c A(
who is personally known to me Dr who has
produced
as identification and who did/did not
take an oath.
,
(Name Typed, Prin
NOTARY PUBLI C
(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC
~ -l!m- ,
R. .. Hay.,....
State of FIliIIlIa
My Comm. EllD..-
Comm. tce
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