HomeMy WebLinkAbout93-3075
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~ _ 307s.1
.;$ -s -, '?5
Date
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~~ BUIL~ ,)
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Parcell.D. # I'/-~ -c:;.I- LJpZ;l}- ;:;O:2...Z>V- O/J~U
M~;;~onn
Watl~r Conn:
Water Meter:
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T,LF.'s:
Zoning:
FINAL _
c.o. _
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.
DATE
Inspector
Valuation or ,4 . ~ . ~
Contract price-J /; :; D 0
Permit Fee
Signature~
Company
Address
Telephone#
PLUM
M~Il.-AL
Breakers
Ducts Ins!.
Compressor
Final
Driveway
j-9.ct_~ KIL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
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.
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APPLICA'fifJlLD FOR P -:RKlT
CITY OF ZIlPJIYFHH.LS
BUILDlliG DEPAR:I;1fEMT
OWNER'S NAKE~06 to / f'\ fe (- s
mmm
OWNER'S ADDRESS
LUt~+e~cs hr .
JOB ADDRESS 321 1 17
LEGAL DESCRIPl'ION: LOT(S)
B.LOCl{
SUBDIVISION
PARCEL I. D. f
WORK PROPOSED:_lMev Construction ----.JWdit.iOlt ___Alteration _Repair _Install
_Sign
_lIIove
_Deaolish
PROPOSED USE:
Single Faaily
_"IF
__, of Units
_K/H
_<=<-ercial
~_Indust.
_Swia. Pool
Other
_Rest:aurant &- Health ~t Approval
BUILDING SIZE:
x
Square Feet,
Height
. RESIDENTIAL:
~CIAL
ATTACH (2) PLOI' PLARS &- (2) SEIS OF BUILDING PI..AIiS &- (1) SRT ENERGY FORKS. **
ATI'ACH (3) SETS OF BUII.DDK: PLARS &: (1) SET ENERGY FORMS. **
**COPY OF CORTRAGr RIlQUIlUlD.
PEmlITS REqY1JE5rED
_BUILDING
$ 1P2lJO ,ov
Valuati(j;u. of Tot:a1 Construction
_ELECTRICAL
A!IP Service
__Florida Power Corp.
W.R.E.C.
_KEaJAlUCAL
$
\-cl.luat101l ot: dechanical 1n.st:allation
_PLUMBING
GAS
ROOFlliG
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fra.e _St"eel
"
('oNe kCr&' Other
FlIISHED FLOOR ELEVATIOBS:
FI' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
**************%*******x*******************
aHilTRACIOR SECTION
BUTT .oF.R
J8
i3~J/~ oJ
+
St:ate Cert:. or Regist:. ,
City License Registration
**********************~~******************
Signature
ELECTRICIAN
CO!IPMiY
St:ate Cert. or Regist. I
City 'license Registration f
*************...........*.**.*************
SiPn::l1:ure
PLDtBER
'" '. CO!IPDY
, > ~,' ~ .J~'" '... St:ate Cert. or Regist:. ,
. ~~.~,~. Ii. i9"'1~". ". ' City License Registration ,
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"Y.... ~ ;,,~. St:ate Cert. or Regist:. I
~~.~,~ l ,,' ___ City License Registration I
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CD!l2ANY
St:ate Cer"::. or Regist:. I
CiL~ License Registration ,
**.********.-t******************************
Signature
KEClIAlUCAI.
Signature
OTHER
Signature
APPLICATION APPROVED BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlitlay be subject to "deed restrictions" "hi~h lay be lore restrictive than City
regulations. The undersigned assules responsibil!ty for co~pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RES~ONSIBILITIES
If the owner has hired a contractor ~~ c~~~ractors to undertake work, they lay be r~quired to be licensed in accordance with
state and local regulations. If the'contractor is '~t'licensed JS required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state iaw. If the owner or intended contractor 'are uncertain as to what licensing
requirelents lay apply for the intended work, they are advis~d to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, 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 ~ork. If the contractor wishes you to sign
as contractor that lay be an indication that he i~ not properly licensed and is not entitled to perlitting 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 Departlent 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 prolise in good faith to deliver 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 cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade 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 perlit and that all work will be perforled to .eet 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 .ay apply to the intended work, and that it is
.y responsibility to identify what actions I lust take to be in cUipliance. Such agencies include but are not lilited to:
f Departsent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treat.ent
I Southwest Florida Water ManaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
I Departaent Df Health '. Rehabilitative Sen!n>'L Envirol'lunta! !jpa)th Unit - iJellsl Wastewater Treahent, Septic Tanks
I US Environlental Protection AQency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zjne "A" or "A,etc.", it is understood that a drainage plan
addressing a "colpensating volume" Ilill be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to pertit issuance.
A persit issued shall be construed to be a license to proceed with the Mork and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fro. thereafter
requiring a correction of errors in plans, construction, Dr violati~ns of any code. Every perlit issued shall becole invalid
unless the work authorized by such perlit is co..enced within six tonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the tile the work is co..enced. One 90 day extension of tile, tay be
allowed for the per.it with fee charge of $15.00. The extension shall be requested in Mriting to the Building Official. An
approved inspection lust be logged during each six lonth periud, Oi the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAVING TWICE FOR IHPROVEHENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT IIITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECO~D AND POST A "NOTICE OF COHKENCEKENT".
SIGNATURE: OWNER OR AGENT
~ 11pLe-
S GNA UR: CONTRACTOR
was acknowledged
10 h\l
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br
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
befol-e me th is
who is personally known to me Dr who has
produced
as identification and who did/did not
take an oath.
who Ie:;
produced
as identificati
take an oath.
(Sign'i)~~~e 17/t#'
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signatul-e)
(Name Typed, Printed or StampEd)
NOTARY PUBLIC
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STANDARD FORM OF AGREEMENT
BETWEEN CONTRACTOR AND OWNER
TillS AGREEMENT made the -m//t.~
Nineteen Hundred ane! Nt N 72:1'1- mICE €:..
hereinafter called the Contractor, ane!
Owner, Witnesseth. that the Contractor and the Owner for the considerations named agree as follows:
(~ of r(kl?-ell-
by and between re.q ( eeA e..
;n the year
--hereinafter called the
on the Drawings and described in the Specifications
ARTICLE 2. TIME OF COMPLETION
The work to be performed under this Contract shall be commencerl AS St:()/1 0...<; f~bVY\'I+ j<, re.~le~0e(~
substantially completed W rnt IN 6NtT l..Lf-j! k.
and shall be
ARTICLE 3. THE CONTRACf SUM
The Owner shall
Iunds as follows.
Authorized Change Orders will be submitted by the Contractor for all work nol specifically included in this Contract.
ARTICLE 4. PROGRESS PAYMENTS
(In..rt he... any provision made Cor lhe "!,,ount rellilil.d uter lhe work reachel a certain Ilalll of completion.)
ARTICLE 5. ACCEPTANCE AND FINAL PAYMENT
Final payment shall be due ::I1l.H'" rlay, PF' b t ti I I ti f th k
d th C tr I 11 I d ... su s an a comp e on 0 e wor provided the worle be then fullv completed
an e on act u y per orme . ,
ARTICLE 6. THE CONTRACf DOCUMENTS
The General Conditions of the Contract the Specifications and the Drawin s to eth .th th
are as f~lly a part of the Contract as iI hereto attached or herein repeateg 'Theg Iocllr w"'? Is Agreement, form the Contract and they
Information: d. 0 Ing is an Itemization of other essenlia\ pertinent
Owner
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BE.MINOL.E FOAM ""IS