HomeMy WebLinkAbout93-2961
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Property Owner:
Job Address:
Parcell.D. #
Zoning:
Description of Work
BUILDING PERMIT
2961;6
~_.~ Date /-~S7a
~NI~~ Sewer Conn
Water Conn:
CITY OF ZEPHYRHILLS
(813) 788-6611
;}S--_-___~ ~5"-
~ G.!-~~BIN~
';{{?'(jiA~~
4.... c:l~- c2/4.5' - 0
Permit
N<!
Water Meter:
T,I.F.'s:
FINAL
C.O.
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.
Valuation or
Contract Price
DATE
JifJ-
City License Registration #
State Certified License#
.25(, o/ue
Signature
Company
Address
Telephone#
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
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.
~,M~;'L:'~;ITOIlll FOk :?'.J:.'\iifrT
CII'Y: l;,..'" ZE 1I'0lJIiIl1\.;5:
BlIi::;[j,:.i)n"'l:~ DEP~i'
<<MiER'S lWIE $/!tX/ZI~C
OWIiER'S ADDRlrSS_ ~ tJ S I
"2LE
PIIOD k 7%'2.. 2- Z '7 &
....
P~~_5r /-.-C!./JL~.5ILJE /YJIJ .t7<., zC:~I-I'I/ttl/ur,. R-I1-
JOB ADDRlrSS
.;S~
LEGAL DESCRIPTIOIM: IDI'(S)
__~SUBDIVISION OA/<'SI.LJe /J1tJ, //c....
PARCEL I.D.'
WRK PROPOSED:~Jllev Construction .-J'ddition _Alteration _Repair _Install
_Sign
_lIove
_Deao1ish
PROPOSED USE: ~ Singl.e Fam.1y
_KIF
_, of Units
~K/H
_~rcia1
_Indost.
_Swill. P001
Ot:her
<.' ......
BUILDIlfG SIZE:
___estaurant 6: Hea1th ))eparment Approva1
'2.8 r xK, /:3 7;2.. ~e Feet,
N/R
Height
RESIDENTIAL :
cotmERCIAL :
AlTACO: (2) PIDJ' PI.AIlIIS 6: (2) SEI'S OF BUIIJ)IJIG PLUS &: (1) SET EllERGY FORtIS. **
ATI'ACB (3) SEn" OF BUIIJ)DIG PLUS 6: (1) SET ENERGY FORtIS. **
**oopy OF COtrrKACf KJJQUIRED.
'Mf.RKTTS REQuesTED
.'~"~~II~r'6lf"~sbr'1
VBUILDIliG
,./ ELECTRICAL
V KECllAlUCAL
/' PLUKBIWG
$ 025; ~tJo Va1uatiOl...!. of Total Construction
/SO AtIP Service _~ Florida Power Corp.
W.R.E.C.
$
/ ';;"0 D
.ya111'ation ;:I Kecbanica1 Installation
- KOOFDiG
-
SPECIALTY
GAS
TYPE OF roliSTRUCTIOII: _B1ock _ _~ _Stee1
/J/. ,J./
Ot:her
FTIiISHED FLOOR ELEVATImiS:
FT.
IS PRO.JEC1t' DI FLOOD ZONE AREA?
YES NO
**********************,,,*******"'***********
awrRACIOR SECl'IOR
BIJTT.DF.R ~ W!lPANY )./-/L ~
,AI ~ . St:ate Cert. or Regist. I
Signature -,;~ ~ City License Registration I 85f>
******************************************
ELECTRICIAN __ OO!IPAIlIY C7~' #-- ~/UJJ'11,J Z c.<:::::7C-r
~ Stare Cert:. or Regist.' f,
SiPIIAture City License Registration , 38
****************~*******************
~1goa-cure
~~
,
W!lPAIiY__ Jt/c/stt~ ~/h;n.J
State Cert. or Regist. ' I
Ci.q ...~~--~!:e ~eg!.f;1:~",.j~ t __."
/ tl t"
PLOItBER
*****~************~*********************** .
KECBAlIICAL h"'~' OO!IPAfi /8/1 /--I;12..r d-o'pr}Y~ ~ ~ - ~.
~ Stare Cert:. or Regist. f
Sigoature~.Lih "1w. ~ City License Registration , "7l?
/ *********ii'*'lH:.......L***..........:i'*******************.
O"I"IIKR CO!IPMIY
State Cert. or Regist. f
Signature City l.icense RegistratiOn ,
*.....***-lI:***,O~.'""**.......***... ..*******************
APPLICATION APPROVED BY PERIIIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait aay be subject to "deed restrictions" which lay be lore restrictive than City.
regulations. The undersigned assuaes responsibility for coapliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBiLITIES
If the owner has hired a contractor or contract~-s to undertake wOo'ks they aay be required to be licensed in accordance with
state and local regulations. If the contractor is Ji~! licensed as required by law, both the owner and contractor lay be
cited for a aisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requireaents aay apply for the intended work, they are advised ;0 contact the City of Zephyrhills Building Departlent, (8131
78B-6611.
Furtheraore, if the owner has hired a contractor or contractors, he is advised to have th~ 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 aay be an indication that he is not properly licensed and is not entitled to peraitting 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 - Hoaeowner's Protection
6uide" prepared by the Florida Departaent of Agriculture and Consuaer Affairs. If the applicant is sOleone other than the
.owner., I certify that I have obtained a copy of the above described docuaent and proaise in good faith to deliver it to the
.owner" prior to cOlaenceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developaent.
Application is hereby lade to obtain a perlit to'do work and installation as indicated. I certify that no work or
installation has cOlaenced prior to issuance of a perait 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 governaental agencies aay apply to the intended work, and that it is
ay responsibility to identify what actions I lust take to be in coapliance. Such agencies include but are not liaited to:
f Departaent of Environaental Requlation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treataent
I Southwest Florida Water "anaqeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Aray Corps of Enqineers - Seawalls, Docks, Navigable Waterways
, I Departlent of Health l Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US Environlental Protection Aqency - Asbestos abateaent
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 .colpensating voluae" will be subaitted which is prepared by a professional engineer registered in the State of
Florida prior to perait issuance.
A perait 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 per.it prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or viola~ions of any code. Every perlit issued shall becole invalid
unless the work authorized by such perlit is coa.enced within six lonths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six aonths after the tiae 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 aD nth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY 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
c..~ UNDE~UE DO NOT Nt,D TO RECURD AND p~ c~..
SI6NATURE: OWNER OR AGE SI6NATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
bef,:-~e me this ___, 19__ ~y
STATE OF FLORIDA
COUNTY OF
The foregoing
:;-,efc" ~ ,n~ th i s
instrument was acknowledged
, 19_ oy
who is pel-sona 11 y knclwn to me or who has
produced
as identification and who did/did not
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)
(SignatLrce)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
':;'SITE:::'i~PLft N'
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(RES1DENJ1AL: USE ONLY)
PR;'LY:L.iNurYi~E~ .'
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