HomeMy WebLinkAbout93-2958
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N<! 2958(51
/-;;;S'-1'3
Date
~~
EL~
PL~
ME~ Sewer Conn
Water Conn:
Property Owner: # ..P..A.L~
Job Add".., 51 7:,'7':'-';;; '1'/
.
Water Meter:
,927 A-
T,I.F.'s:
Parcell.D. #
Zoning: f1 En:.rgy Code:
Description of Work _~'~
J - -c-.~adon Gas:
,-[ --01/4
FINAL
DATE
NO OCCUPANCY BEFORE C.O.
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 dJ-.s-. OV
. ?
Signature ~~~~ 7~~~
Company
Address
Telephone#
Valuation or
Contract Price
;(. 0 CJ ---0. c:ro
./
City License Registration # I
State Certified License#
8:-t (:~G
~QjLDIN~
ELE~
PLU~
ME~AL
---
Breakers
Ducts Insl.
Compressor
Final
Ftr. Tp. Servo
Pre SLB 1-:J'1-Q3 fJUI Rough In
Lintel Meter Can
SLB
Tub Set
Water
Sewer
Final
Driveway
l-d1.'i~ &:LI
Const. Pole
Pool
Pre-Meter
Final
FRM.
Insul. CL
WL
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.
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
,#/ . Ae~ f/ A/
JOB LOCATION -7?::?:; r:? 5// 9';/z{ ~ lY rJ:
OWNER
PARCEL I. D. #
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
}J,C,
,clc-l J'/de vJlof K
~,
;t"X 1-
L}u~/(,e 6(
I /trc.
-/~ - ,
/lJJ . .
. jJ IC / u e wry f
. )-'1' -
FR NT PROPERTY LINE
/lb
.5~
(NOTE EXAMPLES 1 & 2) STREET
l. SETBACKS FOR R1, R2 ZONING
60'
10'
P E
R X
0 I
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
APPLICATION FOR PERNIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
, ~~ () ? rT /('/ AA:f t;.. it!);J.
,?yp Jr,?:3
J y U CdA/C L /7+(;, $/ldcJ/v/l y
7~:.ff.',r--~?~/ 9 ~'~'-rE
~~/ ,/~/Z. ,f).:J
JOB LOCATION ,r:?? 9 j/,? 9'" /
A,PLICANT
ADDRESS
PHONE
OWNER
".
~Yz(rf"S: LOT SIZE~Y V~~ AREA SQ.FT.
LEGAL DESCRIPTION:, LOT (s)
BLOCK
SUBDIVISION
PARCEL I.D.ff
WORK PROPOSED:~New Construction ----Addition
_Alteration
_Repair
_Install
_Sign/Temp.
_Sign
_Hove
_Demolish
PROPOSED USE: ~Single Family
~/F
_ttof Units
.._M/H
_Commercial
_Indust.
_Swim., Pool
Other
_Restaurant & Health, Department Approval
BUILDING SIZE:
x
Square Feet,
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 FORl-iS. **
**COPY OF CONTRACT REQUIRED.
CdNc/2 ele
~/2/t;e
_BUILDING
PERMITS RF.OUESTED
$ ~,{J 0 () , tJ6
Valuation of Total Construction
_ELECTRICAL
AHP Service'
Florida Power Corp.
_W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
.... .
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
.1,
_Frame _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT. . .
******************************************.
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City Licens~ Registration ff
******************************************
BUILDER
Signature
ELECTRTCTAN
Company
State Cert. or Regist. ff
City Licens~ Registration 0
******************************************
Signature
Company .
State Cert. lor Regist. 4!
City License Registration #
******************************************
.PLUMBER
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MECHANICAL
Signature
OTHER J:; r:? c C1."I"'J<:: /L- e Ie ~J' ()/lJ.,L Y Company ,
__ / .:- State Cert. or Regist. tF /
Signature ~~~ ~//~f7" City License Registration iF
******************************************
APPLICATION APPROVED BY
PEfu'HT OFFICER.
CONDITIONS OF,PERMIT AFFIDAVIT
A. NOTIC~ OF DEED RESTRICTIONS
Th. ,und,ralgn.d undnat.n.ds thlt this penH uy bl subject io "lI11ed restrldleons" which /'lay bQ o~rl.' rfstr,idiv, thin City
rllgulltlons. The undersigned ..SUIUS relpon.lb~lltyM:for;,co.pllanco with any .pplicabll.' deed restrictions.
, .
8.
,
. .
UNLICENSED CONTRAC~ORS A~D CONTRACTOR RESPONSIRILITI~S
If the owner has hired a contractor ,~r contractor~ t~ undorta~o work, 'they lay be rl.'quired to hI.' licensed In accordance with
s!at' and local regulations. ' If the contractor i. not licensed as required by law, b~th the o"ner and contractor nay be
clted for a misdeaeanor violation u~~er state law., If the owner Dr Intended contractor arc uncertain as to what licensing
requirelents ~ay apply for the intended work, they are advised to contact the City of Zephyrhills ~uilding Departlent, (813)
7BB-bbll.
Furtheraore, if the owner has hired a contractor or contractors, he is advised to have the ccontractorls) 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. lf the contractor wishes you to sign
as contractor that aay be an indication that he is not properly licensed ~nd is not entitled to per~ilting 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 - HOleowner's Protection
Guide' prepared by the Florida Departaent of Agriculture and Consumer Affairs. If the ~pplicant is sO&I.'~ne other than the
'owner', I cedify that I have c,btained a. crjpy of the above described dc,cuJlont and prcI~,ise in qcood hith to deliver it to the
'6wner' pri6r to C6lmencement. I
.. . " '~',:~:. ". ' ; : .
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inf6rmation in this application is accurate and that all work will be done in coapliance with all
applicable laws regulating construction, 10ning, and land developeent.
Application is hereby lade tc. obtain a penlt to'do Kork and installi!tic,n as indicated. I cedify lhat no work or
installation has COlmenced prior to issuance of a pertit and that all wDrk will be perfor~ed to ~ect standards of all laws
regulating construction, City codes, zoning regulatieons, anrl land development regulatio~s in the iurisdiction. I also
certify that I understand that the regulations of other governmental agencies flay apply to the intended work, and that it is
my responsibility tc. identify what actions I lust take to be in cOlllpliar.ce. Such agencies include tollt "1 e I\c,t lillited to:
...
I Deparhe~,t c.f Envir~nlenial RI!Qul;tion -'Cypr~ss Bayheads, lIl!tland Areas and Envif{,nmentally Sensi li\'~ l~nds,
Water/Wastewater Treatment
I Sc,uthllest FI6rida \later' ManaQellent District - WellS; Cypress Bayheads, Hetland Arl'as, rd lering Halerc(Jurses
t Army CC1TPsof EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health L Rehabilitative Services, Environmental Health Unit - lIells, Haslewater Treot~€n~. Seplic Tanks
I US Environaental Protection AQency - Asbestos abatement
I als6 certify that, if fill aaterial is to be used in Hood Zc.ne 'A' or 'A,etc.', it is undrrstcocod \1,,,\ a drainage plan
addressing a 'compensating volule" will be subtitted which is prepared by a professional engineer reqist~led in the State of
Florida prior to permit issuance.
A perait issued shall be construed to be a license to procl!ed with the work and not as authority to viol~te, cancel alter, Dr
set aside any provisions of the technical codes, nor shall issuance of a per~it prevent the Building Of(ici~l fro~ thereafter
requiring a ccorrEctiDn c.f l'!rrors in plans; cc,nstructicln, c.r violations of any CCodc,. Every prr~it isstll~d ohall becc.I!.' invalid
unless the wc.rk authc.rized by such penit is cc.uenced within six JIIonths [If issuance, cor if li[,d: aull,c.\ ),ed bi the per.it is
suspended or abandoned for a pl'!riod of six lonths after the tiJe the "ork is (o~men(ed. One 90 day e:te~5iol\ of tile, aay be
allowed for the per~it Hith fee charge of $15.00. The ext~nsion shall be requested in writing to the Building Official. An
approved inspectic.n oust bl:' lClgged during each six Ilonth period, or the prc.jed Ilill he (c.nsider~d ilb~"dc.ned.
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 OBTAI~ FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOT I CE OF COMMENCEt1ENT".
SIGNATURE__________________________________
OWNER OR AGENT
SIGNATURE
------------------------------
CONTRACTOR
DATE____~___________________~______________
DATE
-----------------------------------
NOTARY AS TO .
OWNER OR AGENT_____________~_____________~-
NOTARY AS TO
CONTRACTOR
-----------------------------
'\
MY COMMISSION EXPIRES______________________
MY COMMISSION EXPIRES
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