HomeMy WebLinkAbout92-2851
BUILDING PERMIT
Permit
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CITY OF ZEPHYRHILLS
(813) 788-6611
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Sewer Conn
Water Conn:
Water Meter:
Description of Work
lergy Code:
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Parcel LD. #
Zoning:
NO OCCUPANCY BEFORE C.O.
FINAL -LI-
e.o.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
1-r/2, .-q ~ 0
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Inspector
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Permit Fee cf):l) '-
Signature ~ ~ f)~
Company
Address
City License Registration # .:z qq /' ~
State Certified License# t!A eO tl btJ/{'T
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Ftr. Tp. Servo ~ SLB
PreSLB Roughln j-'fS.-43 :riJB,J.I3TUbSet
Lintel Meter Can Water
FRM. 1-'8-'1 3 ~iS. Const. Pole Sewer
Insul. CL Pool Final
WL _ Pre-Meter
Final
Telephone#
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MECHA~W"'L.
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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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ADDRESS
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
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APPLICANT
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JOB LOCATION
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OWNER
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D .1F
30
WORK PROPOSED:____New Construction ____Addition
____Repair ____Install
_~gn/Temp.
PROPOSED USE: ~Single Family
____Sign
_Move
____Demolish
____M/F
____IF of Uni ts
.____M I H
____Commercial
____Indust.
____Swim. Pool
Othel'
____Restaurant & Health Department Approval
BUILDING SIZE: ft~,s,Ct-eeV) ~M. IO'f./d-square Feet,
,
l'do4)
Height
RESIDENTIAL:
COM..I1ERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~I1S.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FO~I1S. ,~*
**COPY OF CONT~~CT REQUIRED.
vfuILDING
~CTRICAL
PERMITS REOUESTED
$
~i9.50J>'
Valuation of Total Construction
AMP Service
Florida Power Corp.
_W.R.E.C.
____MECHANICAL
$
Valuation of Mechanical Installation
____PLlTMBI~G
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GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
BUJ LDER 'fA ~ ~'rJ./UUt" AJ U IV]
Signature ~'av~?3~a0\
CONTRACTOR
Company
State Cert. or Regist, #
City License Registration #
******************************************
Company -:{ ~1 () l!.../L-o.-1
State Cert. or Regist. lF EI2' 00 I / -~/ 7
City License Registration # /59
******************************************
Company
State Cert. or Regist. #
City License Registration ~
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. 0
City License Registration ~
******************************************
MECHANICAL
Signature
Company
State Cert. or Regist. #
City License Registration #
OTHER
Signature
******************************************
APPLICATION APPROVED BY
PERMIT 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 restr.ictive 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 contractor is not licensed as required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state law. 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 Zephyrhi11s Building Departtent, 1813}
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 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 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 - Homeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
"owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the
"owner" prior to cOllencelent.
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 developtent.
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 perlit and that all work will be performed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies lay 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 ife not lilited to:
I Departlent of E~vironleni;l ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
Water/Wastewater Treatlent
I Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas,'Altering Watercourses
f Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treatlen.t. Septic Tanks
f US Environtental Protection AQency - Asbestos abatement
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 "colpensating volume" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to permit issuance.
A per.it 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 pertit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issu~d ~hall becole invalid
unless the work authorized by such pertit is cOllenced within six tonths of issuance, or if work authorIzed by the pertit is
suspended or abandoned for a period of six lonths after the tile the work is co..enced. One 90 day e~t€nsioli of tile, lay 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 must be logged during each six lonth period, or the project will be considered abalidoned.
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 ~~~r.f!'~6', ~'~"!:}Jol} OF COMMENCEMENT".
S~~ER-OR-AG~----- SIGNATUR~_~R______________
DATE_____________j~~!_~~_~~______________ DATE______L~~~~~~::~-;;;-~-
4~_~_~______ ~g~~:~C~~ ~~_ _______~~-~-----
JAMES A. STONE
N EXPIRES~a~~~~~r~a
My comm. expires May 16, 1995
CC110274
XPIRES JAMES A. STONE
-1IDfaryPubIIC,'SfateofFlcrlli:i
My comm. expires May 16, ~ 995
CC110274
MY
MY COMMISS
PARCEL I.D. #
CITY OF ZEPHYRH~IS BUILDING DEPARTMENT
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OWNER
JOB LOCATION
SHOW ALL EXISTING, & PROPOSED STRUCTURES-GIVING DIMENSIONS & SETBACKS.
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90'
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
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1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
R X
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10' P S 10'
0 T
S I
E N
D G
20'
1 A'
10'
la' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
FOR CARPORTS OR LIKE STRUCTURES PLEASE COMPLETE THE FOLLOWING:
(1) DESCRIBE WHAT TYPE: FREE STANDING OR ATTACHED (CIRCLE ONE).
(2) IF ATTACHED, HOW IS IT TO BE FASTENED TO STRUCTURE?
(3) DESCRIBE POST SPACING & FASTENING (IF TO CONCRETE, IN WHAT MANNER?)
(4) GIVE DIMENSIONS OF CARPORT LENGTH, WIDTH, & HEIGHT: -
(5) GIVE AMOUNT OF OVERHANG FROM STRUCTURAL SUPPORT:
(6) COMPLY WITH REQUIRED SETBACKS AS GIVEN IN ABOVE REFERENCED PLOT
PLAN.
...
OWNER
CITY OF ZEPHYRH~LS BUILDING DEPARTMENT
frf}6t K-e Vi!JiJ _
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(J J - ). Co - J.- \ - () I ~ 0 /" () 0 () 0 tJ - Olo {)O
JOB LOCATION
PARCEL I. D. #
SHOW ALL EXISTINGj& PROPOSED STRUCTURES-GIVING DIMENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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(NOTE EXAMPLES 1 & 2)
STREET
FRONT PROPERTY LINE
I t# (if
l. SETBACKS FOR R1, R2 ZONING
60'
10'
P E
R X
0 I
10' P S 10'
0 T 1 0'
S I
E N
D G
20'
FRONT PROPERTY LINE
2. SETBACKS FOR R3 ZONING
60'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
FOR CARPORTS OR LIKE STRUCTURES PLEASE COMPLETE THE FOLLOWING:
(1) DESCRIBE WHAT TYPE: FREE STANDING OR ATTACHED (CIRCLE ONE).
(2) IF ATTACHED, HOW IS IT TO BE FASTENED TO STRUCTURE?
(3) DESCRIBE POST SPACING & FASTENING (IF TO CONCRETE, IN WHAT MANNER?)
(4) GIVE DIMENSIONS OF CARPORT LENGTH, WIDTH, & HEIGHT:
(5) GIVE AMOUNT OF OVERHANG FROM STRUCTURAL SUPPORT:
(6) COMPLY WITH REQUIRED SETBACKS AS GIVEN IN ABOVE REFERENCED PLOT
PLAN.