HomeMy WebLinkAbout93-3064
BUILDING PERMIT
5P-,59-
c-~~Ull~
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~ 3064g
%-$-9~
Date
~.
::~:::,~,:~e' ~~9 06f/fJr<t:f ~
ParceII.D.# //-,:2(, -.;1/-0010- 10900 - Ole;o
~.
ME~ Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
NO OCCUPANCY BEFORE C.O. DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
t9-D
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Permit Fee
Signature
Company
Address
Telephone#
City License Registration # ~ 7/ ~~~
State Certified License# t!Y( t7.0 3.3 ~~/
/I'_Th (!<dJ1~~~)
GUILD~ 5Ec=M
Ftr. '3-L!,. <i ~ flu Tp. Servo
Pre SLB Rough In
Lintel Meter Can
FRM.
Insul. CL
WL
PLUMBI~
~
MECH~
~
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Const. Pole
Pool
Pre-Meter
Final
Driveway 3'if4 3 ~
~.tlAM: J 3 ~I" _q"L 1>l1..J
ftov/. -- - - -,-: 0 ~
~~b- 3 -Cj-?3 ~LLL
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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170 '3,/.7
APPLICATION FOR PEImIT
CITY OF ZR'PHYRIIILLS
BlJTIIJHNG DEPAR'DIENT
OWNER · S NAKE
f<. 'C Ais: 1\ T
(?~ 2 9'
,
f- 13i:l..) L Q,/J K,f} k c
/97/1, -5/;
PHONE
')Fz-AZ99'
OWNER' S ADDRESS
JOB ADDRESS c. J..J / )_ 1- ,~ r:-j~ /7 r
LEGAL DESCRIPTION: WI'(S) Ie t / J BI...OCK SlJTBDIVISION
PARCEL I. D ., / J - z t;. -. "'2) - C c: / C " / C 9 1:' C -- C I t't)
WORK PROPOSED: 'OOe:til Construction /, / Addit:ion _Alt.eration
_Repair
_Install
_Sign
_Hove
_Deaolish
PROPOSED USE:
v{ingle Faaily
_KIF
_, of Units
_K/H
_~rcial
_Indust.
_SwI... Pool
Other
_Rest:aurant & Health Depar1:llent Approva1
BUILDING SIZE:
20 X IE,
(~-::?0 D
Square Feet,
"
f,'
Height
RESIDENTIAL :
COHKERCIAL :
ATTACH (2) PLOT PL.MiS &: (2) SEIS OF BlITLDING PLUS & (1) SET ENERGY FORKS. **
ATTACH (3) SETS OF BlITLDDlG P!.MS & (1) SET ENERGY FORKS. 'H-
**COFY OF COINITRACT REQUJJDU]J).
PEImITS REOlJESTED
_BUILDING
$ Z-). ;;-n
Va1uation of Tot:a1 ConstTuct.ion
_ELECTRICAL
AMP Service
Florida Power COrp.
W.R.E.C.
_MECHANICAL
$
Va1uation of Hechanica1 Installation
_PLUMBING GAS ROOFllIG
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fr3llle _Steel
Other
FlliISHED FLOOR ELEVATIOlNlS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
mJfll'W\.CIOR SECTION
BUILDER ~ ____ WltPMIlY >>J'.J (\ f'/L/ 5::/
/".,{ ~ ~ - /J./ State CerL or RegisL' C i<. C C' '35 --r z /
Signature l{ L.' ' (, 1 '~ ~ City License Registration' 2.S-:S-
******************************************
ELECTRICIAN CO'IfPANY
State Cert. or RegisL ,
SiRnature City License Registration I
******************************************
PWKBER COI!IPARY
State Cert. or RegisL ,
Signature City License Registration I
******************************************
HECHARICAL CO'!fPMW
State Cert. or Regist. I
Signature City License Registration I
******************************************
OTHER COlIPANY
State Gert. or Regist. ,
Signature City License Registration ,
******************************************
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlitlay ~e 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 Dr contractDrs t~ undertake work, they 12Y be required to be licensed in accordance with
state and local regulations. If the contraLtol is not licensed as required by lall, both the owner and contractor lay be
cited for a aisdeaeanor 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 advis~~ tG contact the City of Zephyrhills Building Departlent, (813)
788-b611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is} 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 per.itting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE2.
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 - He.eowner's Protection
Guide' prepared by the Florida Departaent 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 document and promise in good faith to deliver it to the
'owner" prior to cOlaencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIL
I certify that all the inforaation in this application is accurat~ and that all work will be done in co.pliance with all
applicable laws regulating construction, zoning, and land developeent.
Application is hereby aade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced 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 governlental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not lilited to:
I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatment
I Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways '
I Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
I US Environaental Protection AQency - Asbestos abate.ent
I also certify that, if fill laterial is to be used in Flood Zone "AE or "A,etc.", it is understood that a drainage plan
addressing a "coapensating volule" will be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A pertit 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 pertit prevent the Building Official frot 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 pertit is cOllenced within six lonths of issuance, or if work authorized by the pertit is
suspended or abandoned for a period of six tonths after the tile the worK is cOltenced. One 90 day extension of tile, lay be
allowed f~r the perlit Hith fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved 'inspection lust be logged during each Si~ ~onth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTILt CF COKMENCEMENT MAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN 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 "NOTICE OF COMMENCEMENT".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
STATE OF FLORIDA
COUNTY O{ PASCO
The foregoing inflt:ument was acknowledged
before me this ~~~, 19~3- by
ktJ hf!,l2fK, Pi i(e ~d {5ea..L~J.I- K /? fe .- (i/~v,-)
who is personal y kno'tm to ,me Clj- who ha&,b who is pel-sonally k~I~'tm to.me or ,lJhC' ~~?
produced (-l- tf> 0 - 77/-J-iJ- 30/ pn.duced Pt.- 01 )f:-rr.,-?()() -0</.1'-3 v---)j" ~
as identification and who did/did not as identification and who did/did nol;
tak~~~ takeLtrtL! :Jf)d~
(SW)e:.tur;:~') , y w'J '/ ;i-; (.?.?:gnatLrce) 1m -.- j, (I ,,-r-
ngu.-~4{ /"- (7;;t/~ Ft.-ilL (J;;'07J -0 7/-23 -~ ':,;J-j" ,1/1.. ~ J 1//1 {/ fl a.#~
(Name Typec.. Pr i nted or Stamped) ~me Typed. Pr 1 ntJd Cq- Stamped)
NOT ARY PUBL i c ~r _ - Y I! /) NOT ARY PUBL I C
---- / 1l....-6<.-<-Jl~c<-, / L~lf ~
MarJorie . Carifenter, Notary Marjorie S. Carpenter, Notary
NOTARY PUBLIC, STATE OF FLORIDA .",
MY CO;ii ,';1 I.>:';,ON EXP:RES: JULY 31 i993 NO::.';Y PUBLiC, STATE OF FLORIDA'.
SON.oEo TnHU NOTARY PU6L.,IC UNDERv.:RITfi:R;. MY COi'vi ,',ilSS:ON EXrlf\i:S: JULY 31, 1993".
aONI.:H:D THHU NOTAHY PUBl.IC. UNDERWRITERS.
STATE OF F\,.ORIDA ~ tJii. ~ ~
COUNTY OF (J/hS(! 0 . C' ,t'v2 ct '~
The foregoing instrument was acknowledged
before me th i s f1 J:U /b..2--. 19..i...3...- by
Yic:~