HomeMy WebLinkAbout93-3069
BUILDING PERMIT
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BUILDI~ J
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~ _ 3069,6
~ -'1-9~
Date
ELE~~
PL~
MEC~~ Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. # 0 .- bJO
Zoning: Energy Code: ~n Gas:
De,e';p';on of Wmk ~' >< I,~ I Itii 6? @t-
J{)/ ~e, Le<)~ ~-
NO OCCUPANCY BEFORE C.O.
Water Meter:
T,I.F.'s:
=t ~aAJgLA,) ~JJ&...
FINAL
DATE
City License Registration #
State Certified License#
77 ak~
c.o. ' ~\
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Inspector
:~;~~::,::!--~ ~
Company
Address
Telephone#
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation o~ ~g J./ s:: -. lJ-i)..-
Contract Price J Q).
,
ELECT
PLUMBI
MECHA
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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 ($15,00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site,
f. Plans not at job site,
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same,
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SUN STr~TE l\lUM!~PJM. ,~~C,
37528 Hwy, 54 We~
ZE.PHYRHILLS, HCR!D.t\ 33<;: 1
(813) 788.7308
PHONE
STREET
JOB NAME
CITY, STATE
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AND ZIP CODE
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JOB LOCtTI~
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ARCHITECT
DATE OF PLANS
JOB PHONE
We hereby submit specifications and estimates for:
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lIr Jrnpnlil' hereby to furnish material and labor - complete In accordance with above specificatIOns. for the s~ of:
,~ ~~---;"~\~~\f__i~ ~ - <::>~,~~~ ~. ~ ',~'" \,-=s.-'~ ~llars ($ "~~)L~SS "Q~ ).
Payment to be made as follows:
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All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifica.
tions involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance.
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Authorized ~~' _,=.cc..'---
Signature ./' ",/ ---"~=---
(/___ e, his proposal may be
withdrawn by us if not accepted within
1\tttptuntt nf 'rnpn.aul- The above prices. specifications
and conditions are satisiactory and are hereby accepted, You are authorized
to do the work as specified. Payment will be made as outlined above,
I
,
Signature .....
fl.-Cv
days,
Date of Acceptance:
Signature
PRODUCT 118-3 LNE:iiS/8Inc" Groton, Mass_ 01471, To Order PHONE TOll FREE I +800-225.6380
APPLICATION FOR PERKIT
CIlT OF ZEPIIYRHILLS
BUIIJlINlG DEPAR'I1!'IFJ'Nf
JOB ADDRESS
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OWNER' S NAME c....uD~
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OWNER · S ADDRESS .....J l~ =:::;)
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SUBDIVISION ~S\<;QA "('()-~ .)) "
LEGAL DESCRIPTION: LOT(S)
BLOCK
PARCEL I. D."
)4- ' /.lo - :2-)
cY::0\:J - en 1...C:>o - ~t)
..-uRK PROPOSED:-X-New Construction _Addition _Alteration _Repair _Install
_Sign
_!!love
_Deaolish
PROPOSED USE: !<J-Single Faaily
_~rcial
_KIF
_, of Units
_M/H
_Indust.
_Swlli. Pool
Other
[:2-, Rest:aurant &:, ~th Depart:.ent Approval
,~ \"2-')( \'5 ~ \ \0 )
BUILDING SIZ . X . Square Feet.
~1C\ '*?
Height
RESIDEIITIAL:
cmtKERCIAL :
A'ITACH (2) PLOI' PI.ANS &: (2) SEIS OF BUILDING PIJUilS &: (1) SET ENERGY FORMS. **
ATTACH (3) SETS OF BUII.DDilG PLMlS &: (1) SET ElfflRGY FORKS.*:!'
**COPY OF CONTRACT REQrnBED.
_BUILDING
$
~ PERKlTS REQtmSTED
34')5 Valuation of Total Construction
_ELECTRICAL
MfP Service
Florida Power COrp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Inst:allation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fr:me _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD zmre .AREA?
YES NO
***************************:I-*:I-*********:!-*:I-
co~croR SECTION
BUILDER cmtPANY
St:ate Cert. or Regist. I
Signatnre City License Registration I
****:I-****:l-*********:I-******:I-*:I-*:I-******:I-****
ELECTRICIAN OOIIIPANY
St2te Cert. or Regist. I
Si~tnre City License Registration I
:I-*:l-*:l-**:I-:l-:l-**:I-**:I-*:I-************:l-**:I-*:I-:l-****:!-
PLmtBER CO'ItPAlft
SI;:ate f'.ert. or Regist. I
Signature City License Registration f
**:!-*:I-**:I-:l-:l-***:I-*:I-:l-*:!-:l-:l-:l-:!-:!-:l-:!-:l-:!-:l-****:l-*:l-:l-*:l-:l-*:l-
MEC'HAlUCAL COMP,AHY
St:ate Cert. or Regist. f
Signature City License Registration I
*:l-*:l-*:l-****:l-*:l-*:l-:l-*:l-:!-:!-***:l-:l-***:l-:l-:l-:!-:l-:l-:l-:l-:l-*:l-:l-**
0'I1IER CO'!IPANY
State Cert. or Regist. I
Signature City License Registration I
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APPLICATION APPROVED BY PERKIT OFFICER.
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this pertit.ay be subject to "deed restrictions" which lay be .ore restrictive than City
regulations. The undersigned assutes responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contract9r,or,,~~ntractors to undertake worK, they say be fcequired to be licensed in accordance with
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state and local regulations. If therontractnr jc ~b~'licensed as required by law, both the owner and contractor lay be
cited for a tisdeteanor violation under state IaN. If the owner Dr 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 Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or~ontractors, he is advised to have the 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 lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of 2ephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE2,
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 - Hoteowner's Protection
Guide" prepared by the Florida Departtent of Agriculture and Consuler Affairs. If the applicant is sOleone other ;~han the
"owner", I certify that I have obtained a copy of the above described document and promise in good faith to delj"er it to the
"owner" prior to cOI.encelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all worK will' be done in compliance with'all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby made to obtain a perlit to do work and installation as indicated. I certify that no work Dr
installation has cOllenced prior to issuance of a perlit and that all worK will be perf Dried 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 ~& applY to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agenci.eie,inc1u~e but aLe n,ot lilit~,d,Jo:
f Dellarhent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and tnviron.enta}ly Sensitive Lands'~:' "".
Water/Wastewater Treatment
~ ... <'a: ~I.l
f Southwest Florida Water ManaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - SeaMalls, Docks, Navigable WaterMays ' . ..
f Departeent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environ_ental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc,., it is understaod that a drainage plan
addressing a "collpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to per_it issuance. ~;
A per.it issued shall be construed to be a license to proceed with the work and not as authority to violate, ca~:el 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, Dr violations of any code. Every pertit iS5U~d shall ~~cole invalid
unless the work authorized by such perlit is coe.enced within six tonths of issuance, Dr if work au.horized by the perlit is
suspended or abandoned for a period of six tonths after the tile the worK is comienced. One 90 day ~~tension of tile, lay be
allowed f~r the pertit 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 tonth period, or the project will be considered abandoned.
WARNING TO OWNER: Y~UR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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
coo:;';' ';' UNDER '2,500 I~ V~UE ~ U NEED TO RECD~RD AND POST A "NOTICE OF COMI'\E~~NT~
C/'~ C Va:r - - ~/
)( SIGNATURE: OWNER OR AGENT RE:'~~~TRACTOR
...
, i\
STATE OF fLORIDA~
COUNTY OF ~ ~
The foregoing i~trument was acknowledged
befc,,-e me this//J~"'; ~ 19 93 by
_~.SJAT~.OF FLORIDA ~
COUNTY OF ~
The foregoing in trument
befol-e me th i s d/lA._PL
was acknowledged
19 p.:3 bv
~ - ~
~e
t/ CLv{,
l/~
l~
who is personally known to me or who has
produced V,OL 63:J.. 7 '10 1/;03 D;7 t
as identification and who did/did not
take a~th. ~ .. ,
/ ~ '#Oif-7tJYj;.
(Signature) ,
#11- N t. t{ ~ r ~ '2.--
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
who IS personally known to me or who has
produced Fi- {/L- a. (;" (90 fS...r {, 0(;'.5- 0
as identification and who did/did not
take an~~ ~ ~()Cf7CJ9h
(Signature) ,
,/V1J,Il.;(L y A.eJr~-z--
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
f'
"/I, 0 CITY OF ZE, PHY~~S?UILDING DEPARTH~NT '
~ hLJ.~:' C. 1Ll1-.'.! '
:::E:OC~TI:N f-t 003 to~t //;;..; /~
PARCEL 1.0. #
SHOW ALL EXISTING & PROPOSED STRUCTURES-GIVING DIMENSIONS & SETBACKS.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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\' FRONT PROPERTY LINE \
(N~E ~~ 1 n1;8!~BT ~~
1. ~TBACK~ FOR Rl, R2 ZONING 2. SETBACKS FOR R3 ZONING
60' 60'
10'
P E
R X
0 I
10'. P S 10'
0 T 1 0'
S I
E N
D G
20'
, F.RONT PROPERTY LINE
. 10'
10' EXISTING' 10'
PROPOSED
. '
20.' SGt FAM 30'DUPLEX
1 O'
FRONT PROPERTY LINE
FOR CARPORTS OR LIKE STRUCTURES PL~ASE COMPLETE THE FO~~QWING:
(1) DESCRIBE WHAT TYPE: FREE' STANDING OR~CH~CIRCLE ONE).
(2) IF ATTACHED, HOW IS IT TO BE FASTENED TO STRUCTURE?
(3) DESCRIBE POST SPACING' FASTENING (IF TO CONCRETE, IN WHAT HANNER?)
(4) GIVE DIMENSIONS OF CARPORT LENGTH, WIDTH, & HEIGHT:
(5) GIVE AMOUNT OF OVERHANG FROM STRUCTURAL SUPPORT:
(6) COMPLY WITH REQUIRED SETBACKS AS GIVEN IN ABOVE REFERENCED PLOT
PLAN.