HomeMy WebLinkAbout93-2921
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
d-o.- .JfJ :20.' J1J ;J 0 . cFiJ
C~ ~T~ ~UM~ ME~AL
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Parcell.D. # / C> - ;;l /; ... ;J..-/ - /
Permit
N~ 29218
j-/.s-??
Date
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of W~ R",..-..LI)~ ~~ -4
J!~s: ~
_L~-<-' -.I-
DATE
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector ~
Permit Fee b~-~ t
Signature ~ '( r _'-
f
Company
Address
Telephone#
Valuation or
Contract Price
9~ .- CTiJ
City License Registration #
State Certified License#
Tp. Servo &!r-
Rough In /-llI4l5
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set I-J,IJ...fi.g tJtf.Jl
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM. ).,I""I-~.:i l3iU
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 ($15.00) 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.
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APPLICATIOI!IJ POT< PEmtIT
CITY OF ZEPlffRHILLS
BlITLDUIG DEPARlKENT
OWER' S
MAKE .111 J)/l;" Cl L ~ r
ADDRESS .sTs~.3 c)Gi-cL
.,
o (?W/V{ .5
OWNER. · S
LI4 w C-
2~/~~f /;;/0-,
~..L~~ y.e ii/A
PIIONE [j1.J '7?D-~7ql
3->sYf
, F~ .130"'1 {
I
A
JOB ADDRESS .s S" S' ..3
o u.. (L /.... t:JN ~
LEGAL DESCRIPTION: WT(S)
PARCEL LD.I / CJ - :;;'6 -d.-/- I
BI..OCK
SUBDIVISION
WRK PROPOSED:_lN/ev Construction _Addition _Alteration _Repair ~Install
_Sign
_Hove
_Deaolish
PROPOSED USE:
Single Faaily
_H/F
_, of Units
_K/H
!3a-rh 2DD~ Other
_~rcial
_T..w.idust.
_SWI... Pool
_Restaurant &: Health Departaent Approval
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COHKERCIAI. :
ATTACH (2) PLOI' PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET E'NERGY FORKS. u
ATTACH (3) SETS OF BUILDING PUNS &: (1) SET ENERGY FORKS. **
**COPY OF CONTRACT REQIJJ1'RED.
PElmITS REQUESTED
_BUILDING
$
Valuation of Tot:al Construct.ion
_ELECTRICAL
AKP Service
Florida Power COrp.
W.R.E.C.
_MECHANICAL
$
Valuatiofi of Mechanical Installation
_PLUKBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTIOlN/: _Block. _Fraae _Steel
Other
FINISHED FLOOR ELEVATIOlNlS:
FI' .
IS PRO..JECT IN FLOOD ZONE AREA?
YES NO
******************************************
COl!il'i'RACYOR SECTION
BUILD~
Signature .Jf./i.
COKPMY
Q Q. f. State Cert. or Regist. 4#
'--'II ~ City License Registration 4#
***** **********~*************************
ELECTRICIAN
S i1m3 ture.J-f Z.
Q CO!IPMY
.--- . ri L State Cert. or Regist. 4#
( rYe City License Registration'
*****~***********************************
PLUKBER
~ ~ COKPDY me(4 ee. (5 PL ~.......t i~
. , , State Cert. o~Regist. 4#
/-..ftt2..12./e. vu. ~etL City License Registration I '9,(.!1~
***~*************************************
~
Signature
13b
MECHANICAL cmtPMif'
State Cert. or Regist. I
Signature City License Registration I
******************************************
01'HER CO'!IPMH
State Vert. or Regist. J
Signature Ci~ ~icense Registration ,
******************************************
APPLICATION' APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICT\ONS
The undersigned understands that this perlit .ay be subject to .deed restrictions" which may be .ore restrictive tha~ C~ty
regulations. The undersigned assules responsibility for cospliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or ~,ntractors to undertake ~ork, they may be required to be iicensed in accordance with
state and local regulations. If the contractor is not licensed as r~Quired by law, both the owner and contractor say be
cited for a lisdeleanor violation under state law. If the ownei' or intended contractor are uncertain as to what licensing
reQuiresents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (B131
7BB-bbll.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor(sJ 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 FEE~
D. CONSTRUCTION LIEN LA~ (CHAPTER 713, FLORIDA STATUTES~ AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Hoseowner's Protection
Guide. prepared by the Florida Departlent of Agriculture and Consuler 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 promise in good faith to deliver it to the
.owner. prior to cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVI~
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 Jevelop.ent.
Application is hereby .ade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOI.enced prior to issuance of. a perlit and that all work will be perforled 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 governlental agencies .ay apply to the intended work, and that it is
IY responsibility to identify what actions I .ust take to be in cOlpliance. Such agencies include but are not lisited to:
I Departtent of Environtental ReQulatiun - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastew~ter Treatment
I Southwest Florida Water "anaar~~"t District - :~1 -; CJ~r~~: 3;)~eid;f WEtland Areas, Alteriny Wa~ejCOUrSE5
I Arty Corps of EnQineers - S~aMalls, Docks, Navigable Waterways .
t Oepartlent of Health iz n~hdhili~dti'lt: :;L;'-i:t.;_~~, :1.'ii.~.(I;E'lj~:'. }:-.:~l~~. Uiii~ - W:l!~, ~J:tr:~;3te; T~'c~t!K.ent~ Se-pt:i: T?~~~
I US Environsental Protection AQency - Asbestos abatelent
I also certify that, if fill aaterial is to be used in Flood Zone "A. or "A,etc.., it is understood that a drainage plan
addressing a "coJpensating volule" will be subtitted 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 Hork and not as authority to violate, cancel alter, or
set aside any provisions of the technical cudes, nor shall i5suance of a perlit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or -'1012tions of any code. Every perlit issued shall becole invalid
unless the work authorized by such perlit is cOleenced within six Bonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six I01ths after the tile the work is cOlienced. One 90 day extension of tiDe, lay be
allowed _for the persit 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 ~ix month per~od, or the project will be considered abandoned.
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 FIN~KCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COIIIIENCEMENT. JOBS UNDER $2,500 IN VALlJE DO NOT NEED TO RECORD AND POST A .NOTICE OF COM/'IENCEIIENT".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER DR AGENT
was acknowledged
f 19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
befcq-e me th is
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
befcq-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 no~
take an oath.
who is personally known to me Dr who has
produced
as identification and who did/did not
take an oath.
(SignatUl-e)
(Signature)
(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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