HomeMy WebLinkAbout93-3115
BUILDING PERMIT
Permit
_ 3115$
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Property Owner:
Job Address:
Parcell.D. #
/'
;;'0
(!LEZ;~~
CITY OF ZEPHYRHILLS
(813) 788-6611
N~
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g),7
Date
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c&UII nll~~
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Sewer Conn
lit
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
NO OCCUPANCY BEFOR
FINAL
"3 --ct 3
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
City License Registration #
State Certified License#
6f:it -
-
15~
Permit Fee
Signature'
Company
Address
Telephone#
Valuation or t Z"'-- I ~
Contract Price . ~ 00
I
BUILDING
I ~~~-6fs 8&-[
f "...----~
~TRICAt# L?~
PLJ..1M'e1f\JG--
-
~."
Ft,_ ~/~~
Pre SLB
~:~~' ~'5ii1
InSUI.~~ 9
Tp. Serv. ~SLB
Rough In/1--7,q!, 6 Tub Set
Meter Can Water
Const. Pole Sewer
Pool Final
Pre-Meter
Final
Breakers
Ducts Ins!.
Compressor
Final
Driveway
@~~ 4-z-D-'l3 B~
,
(? '-\-d/l-93 B~
EINSPECTI 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.
APPLICA'ITON FOR PERKIT
CITY OF ZEPllYRHILLS
BUIl.DI.5G DEPAR'nIE'.5T
OWNER'S NAME IA.) )).. L ))'1- p'1 f3 tf( 19 0 k / ..vG
OWER'S ADDRESS .39/cJ 0 Y/,(/G L./>>G
JOB ADDRESS S/7 ~7 c
PHONE 'J {1 .3 -- 6 fj z/
2- -H/LLs 33-s9D
LEGAl. DESCRIPTION: LDT(S) BI.OCK SIJJBDIVISION
I ,'2 --Z,b -ZJ - OOZfl'-O/OOO.-{)8IT7D
PARCEL I. D . I' I
WORK PROPOSED :_OOew Construction / Addition _Alteration _Repair _Install
_Sign
_!!love
_Deaolish
PROPOSED USE:
t-"
Single Fallily
_KIF
_, of Units
_M/H
_~rcial
_Indust.
_SwI.. Pool
Ot:her
_Restaurant &: Beal.t:h Depar1:Dlen.t Approval
BUILDING SIZE:
IS X /S-:
,--;;> '"'7 .r--
c.~ ,-,__?
Square Feet,
P"
Height
RESIDENTIAL :
COHKERCIAL :
ATTACH (2) PLOT PLANS &: (2) SEIS OF BUILDING PLUS &: (1) SEI' ENERGY FORMS. **
ATTACH (3) SEIS OF BUII.DDlG PLANS &: (1) SEI' DRRGY FORMS.**
**COPY OF COln'RACT RIlll1HRllD.
PEKlIIITS REQUESTED
_BUIIJ)ING
$ '500
Valuation of Tot:a1 Construction
_ELECTRICAL
MIP Service
Florida Power COrp.
W.R.E.C.
_HECHAlUCAL
$
Valuation of Mechanical Installation
_PLlJMBING
GAS
/Block
ROOFDiG
SPECIALTY
TYPE OF CONSTRUCTIOl!if:
_Pralle _Steel
Ot:her
FI5ISHED FLOOR ELEVA'lTONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
~
YES NO
******************************************
BUILDER
COIJ'I'RACIOR SECTION
-.;
COlfPMIIY f1 V 5 CD /V..5 T:
r LL m.l / St:at:e Cert. or Regist:.' CI{ Co 3 3~Z /
l . (~ ~ City Lic....se Registration f ) 3.6'
******************************************
Signature
EUCrRICI'
. I,
Si ture j ,
COlfPANY
St:ate Cert. or Regist:. ,
City License Registration I
********************************
/'fT
PLmtBER CO'!fPANY
StaL~ ceLL. or Reg1st. *
Signature City License Registration ,
****************~*************************
HECHANICAL COlfPANY
St:ate Cert. or Regist. I
Signature City License Registration j
***************************.**************
O'IBER COlIPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
APPLICA'lTON APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS -
The undersigned understands that this perlit.ay be subject to .deed restrictions. which lay be .ore restrictive-than Ci:y
regulations. The undersigned assules responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be
cited for a lisdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirements may apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (8131
788-6611.
Furthermore, 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 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 permitting privileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~.
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 - Homeowner's Protection
Guide. prepared by the Florida Department 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 doculent and prolise in good faith to deliver it to the
.owner. prior to cOlaencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIr
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 development.
Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation has cOlmenced prior to issuance of a permit and that all work will be perfor.ed to .eet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies .ay apply to the intended work, and that it is
my responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not liaited to:
f Department of Environmental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Army Corps of EnQineers - Seawalls, Docks, Navigable Waterways '
f Departlent of Health ~ Rehabilitative Services, Environmental Health Unit -:~ells, Wastewater TreatDent, Septic Tanks
f US Environlental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flood Zone .A. or .A,etc.., it is understood that a drainage plan
addressing a .colpensating volule. Mill be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit 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 perlit prevent the Building Official froD thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becole invalid
unless the Mork authorized by such permit is cOllenced within six months of issuance, or if work authorized by the permit is
suspended or abandoned for a period of six .onths after the tile the Mork is comienced. One 90 day extension of time, lay be
allowed f~r the permit 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 month period, or the project will be considered abandoned.
WARNING TO OWNER: Y~UR FAILURE TO RECORD A NOTICE OF COHMENCEMENT 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
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COMMENCEMENT".
~,A -:1~
SIGNATUR~ OR AGENT
G'~~
SIGNATURE: CONTRACTOR
-
ST~TE O~ FLORIDn
COUihY OF' PF15C 0 _
The foregoing instrument was acknowledged
before me thist2-'1f{CJf-/e~ 1923 by
Co,' / ;, A-1tl t? roo~
who is personally kn~wn 0 me ~Ir.who has
- \ . I \ L-
produce +- OT \ <:" -II t" \ J4 rS \~C c:.-
as id tification and who did/did not
take an oath.
fjfr~
STATE OF FLORI~
COUNTY OF r' /9-s .G 0
The foregoing instrument was acknwwl~dged
befcq-e me this E}11tl.cfi' 18 , 19~ by
IL-Itur !taK
who is personally known to me or who has
produced 'F \ c. r:J p 'Dr \'J~ ('i L \' t1
as idel . ficatioil and who did/did not
take clath.
;:! " (. z.. f
or Stamped)
s~n~ture) ~ I
l.( !:..A ItJ A yJ-\ C IJ) I u.-
(Name Typed, Printed or
NOTARY PUBLIC
NOTARY PUBLIC, STATE OF FLO~IDA..
MY COMM.SSION EX,'U,ES: APRIL i 6, 1993
BON.oL;O Tdf<U l'l.OTAH.'f PUBLIC UNDEHWRiTIiiRS,.
..Jd bc;vIoZ./
Stamped)
NOTARY PUBLIC, STATE OF FLORIDA.
MY COMMISSION EXPIRES: APRIL 16, 1993-
BONDED THRU NOTARY PUBL.IC UNDERWRITERS.
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