HomeMy WebLinkAbout93-3087
BUILDING PERMIT
~~
Pmp'rty Own", ~ dth-~..,.. f'....t
Job Address: ~ ~
CITY OF ZEPHYRHILLS
(813) 788-6611 ",-
~~
~~)
Permit
ilL
_308~
~ - /a-Cj-S
.
N~
Date
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
1/
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
0-;;
Valuation or LL j / c-". -
Contract Price '4-~~
SIe a. 6PpUA~rt.
City License Registration # S ~ I ..::5 P&II4L q
State Certified License#
Permit Fee
Signature
Company
Address
Telephone#
PL
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERl'IIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
ADDRESS
/1/l;T2;/L~ .>F?/l1114
;-;;-; f (}-/l? L- /?? L/ t>
OWNER .>'IIA1~
JOB LOCATION .$ 11 )Y(;?
PHONE
"/ ,f'j~-6b71
APPLICANT
'.
LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I.D.~~
WORK ~ROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install
____sign/Temp.
_Sign
_Nove
____Demolish
PROPOSED USE: ____Single Family
-Lcommercial
~/F)
_t~ of Uni ts
.._M/H
_Indust.
_Swim.. Pool
Other
_Restaurant << Health Department Approval
BUILDING SIZE:
x
Square Fee t,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS << (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS << (1) SET E~ERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMtTS REOUESTED
_BUILDING
,.
$~~/S'<9. .YO
Valuation of Total Construction
_ELECTRICAL
~MECHANICAL
____PLUMBING
AMP Service
Florida Power Corp.
_W.R.E.C.
$ .L~ //S-01,?rV
-
Valuation of Mechanical Installation
.""'.. .
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
Signature
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. ff
City License Registration ff
******************************************
BlJTLDER
Signature
Company
State Cert. or Regist. ff
_ _ .. . City License Registration ff
****** *,\-'if********* ***.** * * ** ** * * * i: * i: * ** * ** *
ET .ECTRT ClAN
Signature
Company
State Cert. or Regist. 4~
qity License Registration ff
'. ***.***.**,*********************************i,
PLUMBER
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The undersigned understands that this penH uy be subject to "deed restrictitlns. which lllay be IItJre 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 or contractors to ~ndertake Mork, 'they lay b~ required to be licensed in accordance with
state and local regulations. If the contractor il not licensed as required by law, both the tJliner and ctJntractor ~ay be
cited for a eisdeleanor violation ~der state laM. If the owner or intended contractor are uncertain as ttJ what licensing
requiruents uy apply felr the intended work, they are advised to tontad the City of Zephyrhills Building Depadlent, IBl'3}
7B8-6611. '
Furtherlore, if theDMner has hired a contractor Dr contractors, h~ is ~dvised to have thetontractorlsJ sign portions of the
'Contractor SectioAs" of this application for 'Milich they Min lie responsible. If YClu, as the e,wner sign as the contractor,
you are indicating that you,nther t\\an t~" contrac\!lr,are re$ponsible ,for the work. If the contracte.r wishes yelu to sign
a,S contractar that lilY be an indication that he is notpropedy'1icensed"and is not entitled tc. perlitting privileges in the
City of Zephyrhil1s.
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 pTCIvfded Mith atopy of "Florida's Construdieln lien Lall - Hel.eowner's Protection
. Guide" prepared by the Fhrida. Deparhent of Aqriculture and Consuler AiJairs. If the applicant is sCl.ee~ne other than the
"oMner", I certify that I hav~(lbhineda,copy of the above describeddotulent and pttl~,ise in gClod faith tCl deliver it to the
'owner' prior to cOllence.ent. '
:\-...;:
E. CONTRACTOR'S/OWNER'5 AFFIDAVIT
I certify that all the infor.ation in \~\5 ,~p~lication is ilccurate and that all work lIill be dClne in coapliance with all
, applicable lallS rel}ulating construction, zoninq, and landdevelllplent.'
Application is hereby tade to obtain a penit h'do work and install~tion' as indicated. I certify that no 1I0rk or
installation bas couenced prior to issuance of a peraH and that all wo.rk will be perf o fill ed to .eetstandards of all laws
regulating construction, City COd~51 20ning regulathns, and land developaent regulations in the jurisdiction. I also
certify that I understand that the r~gulatiD~s of ~ther governaental agencies lay apply'to the intended lIork, and that it is
IY responsibility to idlmtify Mhat actiOns I lust take to b~ inc{\lplianc~. Such agencies include but ~Ie not lillited to:
. J.;
I Depart,ent of Environ.ental ReQulation - Cypress Bayheads, Wetland 'Ar~s and Environmentally Sensitive L~nds,
Water/Wastellater Treatlent
I Se.uthllest Florida lIater l1analleaent District- Wells; Cypress Bayheads,lIetlandAreas, Altering lIatercourses
* Anv Ce,rps -of EnQineers - Seawalls, Docks, Navigable lIaterllays
* Departlent of Health ~ Rehabilitative Services. Environ.ental Health Unit - \lells, Wastellater Treilt~en~. Septic Tanks
* US Environaental Protection AQency - Asbestos abatennt
I also certify that, if fill laterial is to ,be u!l!IIin FloodZo. "A" "or "A,etc.', it is understcleld tt.~t il drainage plan
addressing a 'colpensating volule" will be sublitled which 'is prepared by a professional engineer reqisl~ied in the State of
Florida prior to per.it issuance.
. '
A penit issued shall be construed to be a license to proceed llith the tlorkand neot as auttlCoTi,ty tel \'ie,J~te, cancel aHer, or
set aside any provisions of the t~chn.ical cod,1s,' nor shall issuance Df a per III it prevent the Bui lding Offici.1 fn,. thereafter
requiring a correction elf errors inplansj cf1lls1ruc~tion, or viDlations of any code. Every per.it iss\ll!d =hall becc.1e invalid
unless the "Drk authorized by suchperliti" f~.~nc;,ed within silt tlonths flf iS5uanc~, or if wel\k authM l1ed by the perlit is
suspended or abandoned fH a periDd clf six,_onths af1;er the tin t~e. 1I0r,kis CCI'lmenced. One 90 day (I~\;;r,siDII of tile, lay be
allowed for the permit lIith fee,charge of $15.00. The e1(~ension shall be'requested in IIriting to thl' Building Official. An
approved inspection lust be logged during each six eonth period, or the prcljllct tiill be ceonsidert'd dbcilldoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A ,NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE.E'OR I MPRO,VEMENTS ,TO YOUR PROPERTY. IF YOU
INTEND TO OBTAI~: FI.NANCl,NG., C.ONSUL.i~ITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORD7N& YOUR NOTICE OF CO~MENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COM~~~'Y'~~
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SIGNATURE____~~OR~-~-~ rGNATUR~~~:-
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U'HYRHILIA FL W41
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