HomeMy WebLinkAbout93-3130
BUILDING PERMIT
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~ _ 31308
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Date
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Water Conn:
Property Owner:
Job Address:
Parcell.D. #
Water Meter:
TI.F.'s:
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Zoning:
D.""iption ~1f
FINAL
C.O.'
, f\/
Inspector
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
Valuation or
Contract Price
. <;?v
~~D' .-
Permit Fee
Signature
Company
Address
Telephone#
City License Registration # --2 {l.t<..t?
State Certified License#
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ELE AL PL M
Ftr. Tp. Servo SLB Breakers
Pre SLB Rough In Tub Set Ducts Insl.
Lintel Meter Can Water Compressor
FRM. Const. Pole Sewer Final
Insul. CL Pool Final
WL Pre-Meter
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.
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. nGAEEMENT WI"rHI Jie.--..C:t .,<f.J.f n II" .' ~:Lr1...n.O..~f.~,.IHlIl~! .J /...3 /) ?3 ,
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TELEPHONE. 3-8.: 7-- 31 7 Jr......
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THIS tlGnEEMENT MAllE:: "Un 9 ---bt\V bt=-'~..--._,.._........ ....--.. 19. .IJt:.I WE.EN HE.R[I'S MUD 1 LL HUML
AND ALUMINUM SERVICE ANO ------ -.------..--.........flUsunEs Hun THE nBUVE NnMED
COMPANY IS RES"ONSleLE to ASb!MILI "HI) tNSlALL COMJ-"U:"E: THE: FOLLOWING 1 TEMS
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ALL MAl'E:JHALS R~MnIN ,.,fE t.'ftmtR"\tt" tHE CUNrr~nCltlU UNr IL I'flll) lOR IN rULL.
nLL JUf:t'S MINIMUM or 5flt,c, btl\JN UM..~OA AfthAN13~D WUH CUNrnnt:tOrl FlrHIHF ~;tnNIN';'
ALL MATERIALS REMOVEU FnOM J[)II~ttlM~a "tmPERTY OF CUNTnnCHln.
" nCCIDENlS OR bTHER CRUSES ~l::vtiNb HUt REnSoNtmLE CONTIU.IL.THIS SHOLL
CONSTITUTE THE ENTIRE CONtRI!tt. ANV WbRK OtHtn nfntJ m'FCIFIED nnOVE Sllf1Ll FW
.. EXTRn ABOVE THE: CONTRAct "'Ucl,
"'.WE: PROPOSE HEREev TO FUANUIH ,..t\tltftUiL ANt> LRBOR COM"LE. , E IN nCCORlmNCF
WITH THE neOVE st'ECU=-tCAttt1NS. ~t1" t.~~ SUM OF . ~. . 40
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PAVMENT TO BE: MADE: AS f:t1LLI3W11 ,,, . ~, ,.'
. 'ot {:.- --,.
lTH BALANCE TO bE p~tb UPON ~dM~LCtElbN OF WORK .
i1~I!flll; 'I [
~CCEPTANCE OF' CONTRACT- tHt: t\lJbvt "htt:~~, E:;PE:CIFICrnIUNS AND CONDIT I(JN~:;
.; . ARE SAT Jar-AC TORV ANt> An-=: HEhl::.V ACCEPtED. YOU nRE nu rHOR I ZEn TO n IF wnm~ n~';
J~::..~"ECIFIED. PAVMENT WILL 1.'1:: Ml:\bl:: AS CJU'TLIN':D (WOVE.
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CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER
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JOB LOCATION L~ / ..:,~. .;.:" ~ Ct//)(;';/
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PARCEL 1. D. #
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
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UT[LITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION. FRONT
(NOTE EXAMPLES 1 & 2) STREET
l. SETBACKS FOR R1, R2 ZONING
60'
10'
p E
R X
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10' p S 10'
0 T 1 0'
S I
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D G
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~~y LINE
2. SETBACKS FOR R3 ZONING
60'
20'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
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APPLICATION FOR PEmlIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTt-lENT
LIC #2-
APPLICANT /< t!!-j'1 /./ 4- rz...J2 C;; I 13 <t} ;'.ftI~( ,
ADDRESS ;.. ft(,7.-'2.- '/J-vV'1 S'l-f.. 'E:.
f(--e IV N A (Z.. ~ ., (} I (3 f1, 0 1-1 {.
JOB LOCATION J s("~7-. 7- /J,-,,-, 1 L{ L( i-
LEGAL DESCRIPTION: LOT(S)
F~ @L (;
IZAn
7 ~2- - 3 ( q g- ,
PHONE
OWNER
LOT SIZE X
AREA SQ. FT.
BLOCK
SUBDIVISION
PARCEL I.D.l~
v{ns tall
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair
____Sign/Temp.
____Sign
____~love
____Demolish
PROPOSED USE: ~Single Family
~M/F
____1~ of Uni ts
.__M/H
____Commercial
____Indust.
_Swim.. Poo 1
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Fee t,
Height
RESIDENTIAL:
COH1'IERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY fORHS.**
**COPY OF CONTRACT REQUIRED.
EERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
_\-l.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
.'
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ~Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
DlI11.llF.R ~~
Signatur -- ~ 1.1.
CONTRACTOR SECTION .
J.3 ~ 7' . Company tip n 1< ( -4 L " ,..-.. .
State Cert. or Regist. Ii 1\)( on~1 ~ It!
':5<{ tf] r ~, City License Ecr~is tra t i.nn II 2..-.
******************************************
Signature
Company
State Cert. or Regist. 0
City License Ecgistration #
******************************************
f,LECTRTCTAN
Signature
Company
State Cert. or Regist. Ii
City License Registration 1
******************************************
PLUMBER
Signature
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
MECHANICAL
OTHER
Signature
Company
State Cert. or Regist. 0
City License Registration 0
******************************************
PERHIT OFFICER.
APPLICATION APPROVED BY
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The,undtrsigned understands that this per.it .ay bl subSecf ~o "doed re5tricti~ns' which ~ay b~ D~re restr1ctive than City
regulations. The undersigned assu.es respon5ibility~for"co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RES~ONSIBILITIES
If the owner has hired a c~ntractor .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 ~lfner and contractor ~.y be
cited for a Disdeaeanor violation under state law., If the owner or intende~ contract~r are uncertain as to what licensing
requirelents lay apply f~r the intended Hork, they are advised to contact the City of Zephyrhills ~uilding Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the c~ntract~r(s} sign portions of the
'Contractor Sections' of this application for which they will be responsible. If YDU, as the ~wner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the H~rk. If the contractor wishes y~u to sign
as contractor that ~ay be an indication that h~ is not properly licensed ~nd is not entitled to per~itting 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 - Ho~eoHner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is sote6ne other than the
.0Hner", I certify that I have obtained l c~py of the above described document and promise in good faith to deliver it to the
"owner' prior to cOI~encement.
~ 1, .: '.: 7. '-. ' ; :'
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all Hork will be done in coapliance with all
applicable laHS regulating construction, zoning, and land development.
Application is hereby made to obtain a perlit to'do Mork and install~tion as indicated. I certify that no work or
installation has COlmenced prior to issuance of a perlit and that all work will be performed to meet standards of all laws
regulating construction, City cDdes, zoning regulations, and land development 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
IY responsibility tc. identify Hhat actions I Illust take to be in compliance. Such agencies include bllt ~l e !\C.t liaited to:
I Departle~t of Envir~nmental ReQul;tion - Cypress Bayheads, Hetland Areas and EnvirDnmentally Sensi tjy~ L~nds,
Water/Wastewater Treatment
. SouthNest Florida \later ManaQement District - Wells; Cypress Bayheads, Wetland ~reas, ~ltering Watercourses
I Aray CDrps ~f EnQineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health L Rehabilitative Services. Environmental Health Unit - Wells, Wasto"ater Treit~en~, Septic Tanks
I US EnvirDnnental Protection AQency - Asbestos abatement
I also certify that, if fill material is to be used in Fltood Zc.ne "A" r.r "I\,et[.', it is undHstr,e,d 1I,~t a drainage plan
addressing a 'conpensating volume" Hill be sublitted Hhich is prepared by a professional engineer fegist~led in the State of
Florida prior to perlli t issuance.
A permit issued shall be construed to be a license to proceed with the work and not as authority to yiol~te, cancel alter, or
set aside any provisi~ns of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a cc,rrection c.f errors in plans; consiructit,n, [of violiltions of any code. Every per~it issu,!j ::hall beec,1E invalid
unless the wc.rk authori2ed by such permit is cr.uenced Hithin six 1II0nths Df issuance, c,r if IIC,I f. a\lthe" ).ed by the perlit is
suspended or abandc,ned fc.r a period of six months after the ti:ae the 110rk is c~Menced. Dile 90 day e~\~i,5ioll of tiae, lIay be
allowed for the per~it ~ith fee charge of $15.00. The extension shall be requested in "riling to the Building Official. An
approved inspectic,n oust be logged during each six lIlonth period, c.r the prc,ject Iii 11 be cc,nsidered dbdlld('i1~d.
WARNING TO OWNER: YOUR 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 Al-TORNEY
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
DATE
-----------------------------------
DATE
--------------------------------.-------
NOTARY AS TO .
OWNER OR AGENT_____________~_____________~_
MY COMMISSION EXPIRES
NOTARY AS TO
CONTRACTOR_____________________________
MY COMMISSION EXPIRES__________________
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