HomeMy WebLinkAbout93-3139
BUILDING PERMIT
Permit N~ 3139
Date /-5-93
CITY OF ZEPHYRHILLS
(813) 788-6611
C:-~
:..r..4t811~. --&ewer Conn
Water Conn:
Property Owner:
- l:Lt:CTRICAL "fllUM iii If J13
E; 1 D, t{,r 10
.K93fO 8"(. ~vP--c
Water Meter:
T.I.F.'s:
~ qf
Job Address:
Parcell.D. #
Zoning:
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
Valuation or
Contract Price
~aJ- -
City License Registration # ~r
State Certified License#
it;f GrtU .
PM .5 r;:)~ER(!{JiSt,
BUILDING
f.kE;CTFlIE!AL
PL~
-MttHANIeA1.
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
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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APPLlCATIOX FOR PE!{~HT
CIlY OF ZEPIIYRJII LL'i
BUILDI~G DEPARHliEXT
JB ADDRESS
PHO\F
? r Z --:rt:1 z- 3
Z ~ P flY-t( II I . ~l:LS ..r-E~
I
3 ..(,; U{!
_____~____.::. __----L_..'--~ (
...n!Il'S IWIE t'+-~4-if
.iNER · S ADDRESS ==3 9 3 / .
.
~GAL DESCRIPTION: LDI(S)
'1/
BLOCK
SUTBDIVISIOX
'S (I IV '5 t=:. T 2 ') T.li_I.E c)
\RCEL 1. D . # } <~ - ;?, 0 - /:l.! - (, ~ / (; - [,~ c 0 (;
t;22IC'
JRK PROPOSED:_Xe1I<' Construction _Addition 1..:\lleral u:m
l(ep:l i r-
] 1: ~.. ( : 11 l
_Sign
_~ove
_Dc,,",ol isll
,OPOSE>> USE:
Single Fauily
_HfF
* of t-nils
-j!/I!
i
_ CoIiIIIJle rc ia 1
_Indust.
_S'..is. Pool
Other
_Re~itaurant [. lIealth DepartJlll("nl Approval
JILDING SIZE:
X__,
Square fleeL,
He i f',h t
e:SIDENTIAL :
JHKERCIAL :
ATTACH (2) purr PLANS &: (2) SETS Of BurlI.I>I~G I'LAXS [,. (I) sn E?\r:RGY FtH(MS.H
ATTACH (3) SETS OF BUILDING PIA~S [. (1) SET E:!\ERGY FOR~{S. ~ ~
uCOI'Y OF CONTRACT REQUlfllRED.
Pf.:RJ.'lfITS Rt:om:.<;TEO
_BUILDING
$
~()(),{;(j
Valuation of Tota 1 ConstnlCl ion
_ELECTRICAL
i\.."iP Service
Florida I'O\<.('!- O),l'p.
___\,r. l( . E . C.
..-..MECHANICAL
s
Valuation of Mechanical InstaIJalion
_PUJKBING
GAS
ROOFH':G SPEC I :\I.TY
YFE OF CONSTRUCTION: _Block
_FraDe ____SLeel
OIlIer
INISHED FLQOR f;LEVATlOl!iS:
FI'.
IS PROJECT IN FLOOD ZO:\t AiUX:
----.roo
YES SO
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CONfR.ACYOR SFGnO~
ignature
a>>i1'A."'iiY
State Cert. or Regist.. *_________
City' License Registl-3tioil =F _____
UILDER
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i!!Il.3ture
aJiii P A1." Y
State Cert. or Reglsf..
City License Registration
*~~~~..~.***.~..~~~t~t~*~~~~~*~*~~~~~~~~~~
r..ECTRICIAN
ignature
a~lPANY
St:ate Cel-t. or Ref' i 51 _ :f:
I ,,------~----.----.
City License Regi~;u';tf. ion
*t~~*.t**~*.~~**~A~~~~~~~~~~~~t~~~~~~~~~~~
LUKBER
cmtPA_XY
St--ate C('rf.. or Reg i5;(. ;,'._______
City Li cellse Registr<lt iOll '.' ______
******************.~a.**~*.*****~***~~~~~~
t:CHAliI CAt.
igna Lure
~.
ignature
C{)llPA.XY _________.______________
State Cerl. or Regis!. ________________
CiL}" I..icen!;e l{egistl.a~..if.l~~
*..~*.*~t~**~~~t~*~~**~~~~~~~~~~~~~~~~~~~~
I.I.J!.ER
.PPLICATIOH APPROVF~ BY
jll i:~_~': i i- OFF I C~<!,~.
C[i!.JD I T I m,E; ("e- F[
A. NOT I CE OF DEED F:ESTi~:.I CT U;;n~Li
The undersigned understands that this perlit lay be subject tD 'd~ed re5tricti~ns'
regulations. The undersigned assutes responsibility for cOlpliance ~ith any appli
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B. UNL I CENSED CONTR~~CTORS AND Cm-nRr,C~Hm___J~~[~5F'(JII~ r: U- T I I'
If the ollner has hired a contractur or contractors to undertake ue,rl, they "'0)' be rc';',i,d te, [Ii ljli.n~(.ii il. <c;,cc,CP 'It',
state and local regulations. If the contractor is not licensed a:; required by 12rl, be t the ;"i'.?r 2i,j Onll-":.,;, ,ji be
cited for a lisdeleanor ,'iolation under state law. If thp owner or lntenc:Ed [~n,.]ct,r e J -i'rte. 0, ti' ,,' t ::,(:;"1',1"
requirelents lay apply for the intended ilorl, they are ad,'ised :c, centact th~ C:'.. :;', ,;i:, i', f-_. '~'.: >; .;c; >, .
788-6bll.
Furtherlore, if the Oriner has hired a contractor or contractors, he is ad
'Contractor Sections' of this application for which they riil] be fisponsit ~,
you are indicating that you, rather than the contractDr, are r~sp: Sible
as contractor that eay be an indication that he is nc,t pfeperl! li,ensed d
City of Zephyrhi]ls.
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TRANSF'ORTATlm'J H1F'ACT j'_EES rIND UTU",.lJ.Y~_
D. CONSTRUCT I ON L I EN LAW (CHAF'TEF\ '71 3, F-'L ': C::i1'I' :'1", t "1 "j nt'l[.' ~_ L' ,
I certify that I, the applicant, have been pr':vidl.'d with a copy e,f '~i:,:-i.i, 's l'-:'1i5'.iUCtIC( i_ n ,- :i:'!ee'~IPr'5 Ii(,ti:;t;:::
Guide" prepared by the Florida Dl.'partlent of 19riculture and Consumer Iffdl'S. If tre arpllc.nt SD~e0ne cIne: than the
'OllOer" , I certify that I have obtained a cop of thp above described jc~'~ nt ,,":. '1([,::;(" 1(: ,'. ,t tel dell'E.' ;t t: '.'c'
"ollner" prior to cOllenCl.'Il.'nt.
E. CONTRr~CTOR ' S/OvJt~ER I S PI F I DA\)l T
I certify that all the inforlatio:1 in this ,',plication is accurate and lh,' all ~I,rk hjl;
applicable lalls regulating constn:ction, zo!:ing, and land de'/elJpment.
'liJnCf ,~:t all
Application is hereby lade to obta n a perlit to do lIork and installat on dS incic3ted. [[Pi~,' ii
installation has cOllenced prior tr issuanre of a perlit and that all ark "II! be perf:rmpJ [0 ~e~
regulating construction, City coder" zonir~ regulations, and land deve,optent rl:, 'L;t10r,s ",;-.(:,U::5
certify that I understand that thl.' regulations of other govl.'~n~ental agencies ~ y lDI; to '~e Int'
.Y responsibility to identify what c.ctions I lust take to br in c(i(:pliafice. Sl,:t' oL :jl::~:f.j:: inc~u,jo <'
f Departlent of Environ.ental Rl.'Qulil_'lon - Cypress Bayhl.'ads, ~e\Jarrd Areas ar,d:,...irorif:',',:, :,.
Watl.'r/Wastl.'lIater Treat~ent
I Southwest Florida Water /'lanaQelent _listrict - ~ells, Cypress 8ayheads, ~etlan' lr"jS, i):tpc",::2' i[{,
f ArlY Corps of EnQinel.'rs - Seallalls, ~!cks, Navigabll.' Watl.'f~ays
f Departaent of Health ~ Rehabilitati\e Sl.'fvicEs. Environllll.'ntal Health U"'( - ~,,: I; j<;tOri::'
f US Environlental Protection AQl.'p~- Asbestos abatl.'lIl.'nt
I also certify that, if fill latl.' ial is to bE uSl.'d in Flood Zone 'A' or 'A,e!,,',
addressing a 'compensating yolul" lIiil be sublitted ~hich is prepared by a pfof[ssj~
Florida prior to perli t i ssuanc, .
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A perlit issued shall bl.' cons';.ued to b.' .3 lic.'nse to prc'cel.'d with the He'll a,-,d .:c,t
set aside any provisions of l,re technica codes, .or shall issuance of a per~i t ~ri 1, \:,e ~ lel- e,f!
requiring a correction of e'l!)rS in plar. 0, constr 1(tion, Cor vi(,jatioDs of an)' C11d
unless the lIork authorized J, such pl.'rlit is cOlel~(ed within six ~Dnths Df is.~ .(', f' f.
suspended or abandoned for a Jeriod of six tonths Her the tifle the worK is [(,f ' ,,[f
allolled f,or the pl.'rlit with 1,?~ chargl.' of $15.00. '"I' l.'xtension shall be feqllE' f',11
approved inspectiDn Ilust be hjgl.'d during each six tonth period, Cor the I'fo.;e,' ,;iIIl [['I-,:i.':':i., "::,,ne, ,.,
WARNING TO OWNER: YllUR AlLUm: TO RECORD A NOTICE II COMMENCEMENT MAY RESULT' i YOUR .~,'i!,.,,:; ':<1CC Ole n'
PROPERTY. IF YOU INTEND TO Of:TAlN FINANCIt/S, CONSUL \lITH YOUR LENDER OR f\N ' [ORriEiFC~.C: c.c':C':['! .,::
COKKENCEKENT. JOBS UNr:ER $2,5('0 IN VALUE DO NOT NEL' ~O RECORD AND POST t, . W. ICE Of" C'I:t'::C,i,,':r',
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SIGNATURE: OWNER OR AGENT
_...........1...... J ...........""'::;.~~...!"'.........."~'Ill__ur~:~1II..~
SI:;N~IUR~: CCh'R~[l:.
STATE OF FLORIDA
COUNTY OF
The fDregoing instrument was acknowledqed
befc.re me this____, 19 by
c , ~ OF Fe OR I
0:, 'Y OF
t-..~ f [I '1- E g ~: i i : -'. C)
h ,f. I" e rn (:' t r-';
:. ,- t. tl ,,1-,
.;:-1
who is personally
produced
as identification
take an oath.
known to me or who has
It'-( IS. pf?r-I.::ciJ:~ll ~
~ J I
r '(
LlCf?cJ
and who did/did not
E\ d f.? J-j t i r
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(Signatun,,)
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(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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