HomeMy WebLinkAbout93-3029
BUILDING PERMIT
Permit
_ 3029$
~-17-93
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CITY OF ZEPHYRHILLS
(813) 788-6611
N~
Date
Property Owner:
Job Address:
Parcell.D. #
Zoning: Energy co~ ~adon Gas:
:c~~~:z:W1~~
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Valuation or
Contract Price
Permit Fee
Signature
Company
Address
Telephone#
City License Registration #
State Certified License#
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.
-
APPLTCKfIOIN! r'Ok l'E1UnT
c:rr:lt OF ZE:PllIiU:rnI.LS
BllfIlllIlIilG mr,PAR:>m'l'.iNT
OWNER'S NAME
C" #>'~ ,'Orl
8u9
,
PlIOi1fll:
OWNER'S ADDRESS
JOB ADDRESS
;/U/Y
r
50/
N
d--
~A.pff'/
I
PO/Y/ ;eel
LEGAL DESCRIPTION: LOT(S)
BTnc:K
SlffiDIVISIONl
PARCEL 1. D . ~
WORK PROPOSED:_lNJe'W' Construction _Addition _Alteration _Repair _Install
~gn
_Move
_Demolish
PROPOSED USE:
Sing1e FatDily
_KIF
__, of Units
_H/H
_Cosmlercial
_Indost.
_SwiD. P<x;l
ather
_Resmurani:: Ii: IIealt:h Deparbilllent: Approval
BUILDING SIZE:
, r
70 X~J~_,_
_______Square Feet,_
He;ight
RESIDENTIAL:
COHHERCIAL :
ATTACH (2) PLOT PLANS &: (2) SE.TS OF BlJTIUHINiG PLAOOS & (1) SET ENERGY FaRMS. u-
ATTACH (3) SETS OF BlITIJ)Di1G PlANS .& (1) SET .ENE:RGY FOIatS. H
**copy OF COIlITRAG1" RE'Qlf.JJ3ffil,l])"
'p_E:itt."fiTS RF;QlIlESTEQ
_BUILDING
$
?~cJ
Va]ua1:ion of Total ("..onstluction
_ELECTRICAL
AMP Service
Florida Pm>i'er c.:-"i~.
W.R.E.C.
_HECHANICAL
$
Valuatiou of Hechanic3~ Il1sta11ation
_PLUMBING
GAS
_____ROOFI~G
,.:3PECl'ALTY
TYPE OF CONSTRUCTION!: _Blodi.:
,___Frallil"-.: ___Steel
Other
\..
FII!fiSHED FLOOR ELEVATImi!S:
IF:'~
IS PFD:fECT IN FLOOD ZQ?lf:E .'IRE..>\?
YES NO.
~~~~*~~~~~~~~t~~*~~~t~*~*~*~.**~*~~~~*~~**
BUILDER
~u
Oll~~J\C.'VQF_ 'sRCT'fOiN'
OOiMI'JkI,{..J2Pf4//~ ~r9Af'>' /;""'0
State (.:,,;rL or Regis\.:.!# i(XOOS? ~~-::?-
O\A.--J Cit:y '.License lRegist:ration #
*-A clI:'II:JIr "".:1: 'II: 1Hk -I.\.il'1ll;1ll:il:il:i\-'.e, 1\1:-Al:iI: Fd"-!i: '10\-1\1: ~ 'I: il: 1l:* 'II: il:1l: il:.Jl: flc'& ""* i!o ~
Signature
SiRTlature
r)t1\jiP1~J~
Stat.:.' ',;,:~:'t. :>r Reg:~st iF
City :L,ice~~se Regisi'':r:~'cJi_O[\ 4ffi
EI.ECTRI CIA.~
~~~~~~ ~*~~~~.~~*~~~~-~~*~~~~i7~~~~~~~i.~*~~~
PLUKBER
0!.llliPA~1Y__
Sta't.c CerL or Regist. j#
..,____ City L':. 'c:..iSIC RegiS1:.T2.::ion #
~****"d~-j!,*i!:xi!:-j!,*****..\b:ib.,"'",**:c'-,,*1l:****-5.:,~ . .Od,"~**
Signature
HEClLL\.NICAL
OD:lfP)'1I1"y
----
Stat'2: Ce'c~_ or Regist:. #
Cit:.)" J"icense Regist:cat.ion ;.~
Signature
*~~~~~*~~~~***~**~xi~~~'***~*~~~.~**~~*~~~~~**
OTlJER C1Dfi'fi' J'J.k(
St;,jt~:..~ Cere. or Regis~:'. #_
Signature _~_.' ___.____.. Ci1t'Ji' License Registration 1#
"'clI:*~..., _',,,,~***-.II-***,,,.*'..a--l>~"'.*1~"'***il:*******ool!:**~,1ll;*\I>
APPLICATION APPROVED BY PElUnT aFFICER.
CONDITIONS OF PERMIT AFF~DAV~T
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit ~ay be subject to 'deed restrictions' which may be ~ore restrictive than City
regulations. The undersigned, assuees responsibility for compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS ~IND CONTRACTOR ~~ESF'P~'IS.L~U::..LLIE~
If the OHner has hired a contractor or contr~~tcrs to undertake Hork, they may be required to be licensed in accordance Hith
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor oay be
cited for a .isdeDeanor violation under state law. If the OHner or intended contractor are uncertain as to what licensing
requirements lay apply for the intended worK, they are advised to contact the City of Zephyrhills Building Depart0ent, [8131
788-66 II.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sl 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 Hishes you to sign
as contractor that Day be an indication that he is not properly licensed and is not entitled to permitting privileges in the
City of ZephyrhilIs.
C. TF:ANSPORTATION IMF'ACT FEES. AND UTILITY CONNECT I oY,j 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 - Ho~eowner's Protection
Guide' prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is so~eone other than the
'owner', I certify that I have obtained a copy of the above described document and promise i~ good faith to deliver it to the
'owner' prior to co~~encement.
E. CONTRACTOR'S/OWNER'S AFFIDAVI~
I certify that all the information in this application is accurate and that all work will be done in coepliance with .all
applicable laws regulating construction, zoning, .and land development.
Application is hereby made to obtain a perDit (0 do work and inst~llation as indicated. I certify that no work or
installation has commenced prior to issuance of. a permit and that all work will be perfor~ed to ~eet standards of all laHs
regulating construction, City codes, zoning requlations, and land develop~ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to the intended ~ork, and that it is
.y responsibility to identify what actions I must take to be in co~pliance. Such agencies include but are not li~ited to:
f Deoartment of Environ~ental ReQulatio~ - Cypress Bayheads, Hetland Areas and Environ~entally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida ~ater ManaQement District - Hells, Cypress Bayheads, Hetland Areas, Altering Hatercourses
f ArlY Corps of EnQineers - Seawalls, Dor.ks, Navigable Waterways
f Depart.ent of Health ~ Rehabilitative Services, Environmental Health Unit - ~ells; Haste~ater Treatlent, Septic Tanks
f US Environmental Protection Aqency - Asbestos abatement
I also certify that, if fill material is to be L~ed in Flood ?one 'A' or "A,etc.", it is understood that a drainage plan
addressing a 'compensating volu~e' will be sub~itted ~hich is prepared by a professional engineer registered in the State of
Florida prior to perait issuance.
A ~erlit issued shall be construed to b,: a license to proceed with the Hork and nc,\ as' authority to violate, cancel alter, (of
set aside any provisions of the technical codes, nor shall issuance of a per~it prevent the Building Official froQ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per~it issued shall becole invalid
unless the Hork authorized by such permit is com~enced within six ~onths of issuance, or if Hork authorized by the permit is
suspended or abandoned for a period of six Donths after the time the HorK .is com~enced. One 90 day extension of ti~e, ~ay be
allowed for the permit with fee charge of tI5.00. The extension shall be requested in writing to the Building Official. An
appruved' {nspeclion ~usl be logged during each six month period, or the project Hill be considered abandoned.
WARNING TO OHHER: 1UUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAV RESULT IN VOIIR rAVING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU lNTEND TO OBTAIN FINftNCIHG, CONSULT WITH YOlm LENDER OR AN ATTORNEY DEFORE RECORDING YOUR NOTICE OF
COMKENCEMENT. JOBS UNDER 12,500 IN VALUE DO NOt NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT'.
- .....-""'--_..,--...-"""........
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA
COUNTY OF
~
The foregoing instrument was acknowleJged
befc,re me this 19_ by
STATE OF FLORIDA
COUHTY OF
The foregoing instrument
befo\-e me thi,>
v)c..5 dckno\,Jl edged
19_ by
who is personally known to me or who has
pl-oduced
as identification and who did/did not
take an oatil.
who is personally knO\'lll tel I1le Cq- who has
pl-oduced
as identification dnd who did/did n~t
take an oath.
(Signatun:e)
(Signature)
(Name Typed, Printed or stamped)
~jQI. A R Y --E1!f:lJ=-.I C
(Name Typed, Printed or Stamped)
NOT AF:Y PUBLI C
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Contact:
Location:
Od~IS Sign
lept)fHVil!e ~ l
~,or~I("i:lI.' ')'..}I '.' ,t' ~1'-'Ih.H thl~. contract ()~I!V If bub.'o'llraclor pro-'\Oes
prr.,' ,.lr",nl,'UI f; (:ompell~aOon InsurtwGe and "'eoero! 10 #1 witTlHl
r~\J "'-' , , ')f (18t(-, of purchaSE> Order Send .~ coPies 01 Y0ur InvolC'.e
Work Description
In~~. ;!I Of,,> ~.,\ r "lC{fWHv ieitr+rs. as per specs SUbrTlitted
S t1t'IAt> ~'.
NO! l. I'le 11, J. J V, ~ HI HNAl INS fAl.LA liON MUS I HE
SUBM! II~' U wn H YCXJH INvOICl
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Sales Tax
Total Cost
.~
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Purchase
Order
No: 3927-C
'..a ;'>urCh8.- ()rd&. l'I.U('lbe' "'..1)' appear on
a;' InVOIces. adoJlOW'8dgElI11&~ts. billa 01
jading. correspondence &nd ahlppmg cartone.
Date: , /6.1'93
Date RequIted 2-15.93
Please notJ~ uEI In Wi1ltlng If you artJ unable to
\ ~'T1p.81tt ~'i(h" tly OtHto';Q.J'r.....i
T e "118: Nt'! 30 #93 01.
Cost
$7?C ()<;
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$0 00 j
$720~~____._.
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Authorized SIgnature