HomeMy WebLinkAbout93-2931
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~
29316>
Date 1- /S--9~
~~ E~ PLU~
Pmperty owne/--:R~'!f~V:u: 4
Job Address: ,yg--~ - :;:;-..
Parcell.D. # /y-:Ji, - - C) 0/ L? - 0 ~t/LJ - Oil / 0
MECHA~. Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
~
Zoning:
FINAL
NO OCCUPANCY BEFORE C.O,
Complete Plans, Specifications and Fee Must Accompany Application, C,Q.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration #
State Certified License#
Inspector
Pe,m;t Fee ~ e
S;gnature ~~- /6~g~~
Company - c7"
Address
Telephone#
Valuation or
Contract Price ~ S~.. o-D
7?.e :JY~~E
PI..:
Breakers
Ducts Ins\.
Compressor
Final
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
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 FOR PERKIT
CITY OF ZEPIIYRIIILLS
BlJfILDUJG DEPAR'I1IIENT
OWER'S NAKEJ (~Y\t-D ~ . ~6NN5J) ~
OWER'S ADDRESS LI4}Z}' ,....16' .If." y---
t..f1z ~ 14 f.k ";>--+.
tf73Z-S""
mmm
/1~ ~.
JOB ADDRESS
LEGAL DESCRIPl'ION: WI'(S)
BI...OCK
SllBDIVISIOJil
PARCEL I. D. #
14-2-G,..-21 -ooto --02'500- 0070
/
~epair
_Install
t<<lRK PROPOSED:_Mrew Construction _Addition _Alteration
_Sign
_!!love
_Deaolish
PROPOSED USE:
~ingle
Faaily
_KIF
_, of Units
_H/H
_~rcial
_Indust.
_Swia. Pool
Other
_Rest:aurant &: Health Depart:aent Approval
BUILDING SIZE:
x
Square Feet.
Height
RESIDENTIAL:
COHHERCIAL :
ATTACH (2) PLOI' l'LARS &: (2) SEI'S OF BlITLDIJilG PLUlS &: (1) SET ElffiRGY FORHS.**
ATTACH (J) SE'I"S OF BllJILDDilG l'LARS &: (1) SET ENERGY FORKS. .u.
......COpy OF CONTRACT REQUfRED.
~LDIRG
PERKITS REQUESTED
$
IS;o , 00
1
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
_HECHMfiCAL
s
Valuation of Mechanical. Installation
_PUJHBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION!: _Block
_FraBle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FI' .
IS PROJECT Hi FLOOD ZONE AREA?
YES NO
..............................*****...****............*... *...*................................. * *
CONlTRACTOR SECTION
BUILDER COI!fPAHY 0 Wf\J E~ .
State Cert. or Regist. I
Signature City License Registration I
**.........*...****...*...*************************...**
ELECTRICIAJi COIIPANY
State CerL or RegisL I
Si~ture City License Registration ,
**...**.........***********************...*...**...*****
PLmtBER COI!tPAln
State Cert. or Regist. ,
Signature City License Registration I
**************************************......**
HECHAlfiCAL COI!tPABY
State Cert. or Regist. I
Signature City License Registration I
*****...************...*****...**************...**
0'l'BER. COI!fPANY
State Cert. or Regist. I
Signature City License Registration ,
***...***...****.*******......****..........************
APPLICATION APPROVED BY PERKIT OFFICER.
r
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit ..ay 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 reQui~ed 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 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 Depart.ent, 18131
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 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
6uide' 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 cOI.encelent.
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 cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cottenced prior to issuance of a pertit 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 governmental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
f Departlent of Environtental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water KanaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable WaterwdYs '
f Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental Protection AQencv - Asbestos abat~lent
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 volule" Mill be sublitted 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 frol 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 cOI.ented within six Bonths of issuance, or if work authorized by the pertit is
suspended Dr abandoned for a period of six lonths after the tile the work is coslenced. 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 lonth period, or the project Hill be considered abandoned.
WARNIN6 TO OWNER: YOUR FAILURE TO RECORD A NGTICE OF COHKENCEHENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCIN6, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COKHENCEHENT, JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT',
~~ 2/kR~/V><tt
SIGNATUR: CONTRACTOR .
Ov-JAJ ~-t-
SIGNATURE: OWNER OR AGENT
was acknc.wledgeo
19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19 by
STATE OF,FLORIDA
COUNTY OF
The foregoing instrument
before me this
who is personally known to me Dr who has
pl-oduced
as identification and who did/did not
take an oath.
who is personally known to me or who has
pl-oduced
as identification and who did/did not
take an oath.
(SignatLll-e)
(Signahn-e)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC