HomeMy WebLinkAbout93-3141
BUILDING PERMIT
Permit
_31416
'1-s-73
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CITY OF ZEPHYRHILLS
(813) 788-6611
NC?
Date
~sewerConn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning:
Description of Work
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
/;S-oo' f2.E-
-:z;::(
C;ty Ucense Reg;s',.';on' -811[ ~~
State Certified License# F5 oat) I/O
Telephone#
g;~~ ~C~~~Y~~
Ftr. )/-p-tf3 C~ Tp. Servo SLB
Pre SLB Rough In Tub Set
Lintel Meter Can Water
FRM. Const. Pole Sewer
Insul. CL Pool Final
WL Pre-Meter
Final
MECHA~-
------
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
-
APPLICATION FOR PHrnnT
CI'lY OF ZEP.IIYRIULI..s
BUILDING DEPARTt'fE',itl1T
OWNER'S NAME R ~ Bl::XT '~'''.' 'R~ ~]-s:
OWNER'S ADDRESS 332 33 ~ =To E ;C'Of7!:J
JOB ADDRESS .5';2 3:2 6-~.f: 6Lt/,?J. 2-C::7>/T-Y/2/-r((. L$ / F< '
,
!. // 7- 587-5
MIONlE (;)(P
LJ/fCle- c/r-ct'~ ~, 335:2~
(
LEGAL DESCRIPTION: WT(S)
RLOc:K
StmDH"ISIONl
PARCEL LD.#
,,"'URK PROPOSED: !!ire", Construction
~gn
----...Addi tion
_Alteration
_Repair
_Install
_Hove
_Demolish
PROPOSED USE:
Single F3Ilily
V CoImIercial
_KIF
__, of Units
_M/H
_Indust.
_Swim. roo 1
Other
Restaurant & Health Departaent Approval
- 1 I
BUILDING SIZE: 7.5 X I? ,
Itr2,5.
Square Fee t ,
55'
Height
RESIDENTIAL:
COtfHERCIAL :
ATTACII (2) PLOT PLANs & (2) SETS OF RUJIDING rlANS & (1) SET ENEHGY FORMS. **
AITACII (3) SETS OF BUILDDilG PLMilS & (1) SET ENERGY FORJ!'IS .~~
~~COPY OF CONTRACT RIl'.Q1HRED.
~/(rr,U
V BUILDING
/' ELECTRICAL
PEmlITS REQUESTED
$
r 500.00
7
Valuation of-Total ConstnJction
MfP Service
Florida Pmi'er COrp.
W.R.E.C.
_HEClIANICAL
$
Valuation of Hechanic~l Installation
_PLUMBING
GAS
ROOFING
_Fraae V Steel
SPECL\ i.TY
TYPE OF CONSTRUCTION: _Block
(Jl. 1H nc-'
Other
ITNISlIED FLOOR RL.EVATIOJ!~S:
FT.
IS PROJECT IN FLOOD ZO~F. ARR~?
YES NO
~~~~~~~~~~~~~~~*******~~~~~~*****~*~~~*~~~
roNJ'TR.l\CTOR SRCT'ION
n UIl,DF:R
Signature
d~ ;Y~
CUl'!fPAlNIY
St:ate Cert:. or Regist. lit
CiLy License Registration #
******************************************
&:5ooCJO fro
RI.RCTRICIAN
Si1!J1ature
dlo-vk- #~J
ampANY
State Cert:. or negist. iF t:?'-S c?ooO / 10
City License Registrat:ion #
********************~************~********
PUmRER
COMPANY
State Cert. or Regist. lit
City License Registrat:ion i
*************************~************~~**
Signature
MP..ClJANTCAL
c:::oHPANY
State Cert:. or Regist:. #:
City License Registration ~
**************************************~***
Signature
0TlTY.R.
CO.HPANY
State Cert. or Regist. 4ft
City License Registration lit
******************************************
Signature
APPLICATION APPRO\~D BY
PERmT OFFICER.
i}
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait ~ay be subject to "deed restrictions' which may be aore 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 contracto~ or contracto~s to undetta~e work, they ~ay b;-;~quired ~icensed in accordance with
state and local regulations. If tlie"COnt'rador is not"licensed as required by law, both the owner and contractor lay be
cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (B131
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 work. If the contractor wishes you to sign
as contractor that eay be an indication that he is not properly licensed and is not entitled to per~itting 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 - 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 promise in good faith to deliver it to the
.owner' prior to cOllencement~
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all wurk will be done in cOlpliance with all
applicable laws regulating construction, zoning, ~nd land developlent.
Application is hereby lade to obtain a perlit tD do work and installation as indicated. I certify that no w~rk or
installation has cOllenced prior to issuance of. a perlit and that all work will be perfor~ed to seet 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 may apply to the intended work, and that it is
IY responsibility to identify what actions I must take to be in cOlpliance. Such agencies include but are not li.ited to:
f Departlent of Environmental ReQulation - Cypress Bayheads, Hetland Areas and Environ~entally Sensitive Lands,
Water/Wastewater Treatment
t Southwest Florida Water NanaQesent District - Wells, Cypress Bayheads, Hetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways '
t Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treataent, Septic Tanks
t US Environmental 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 'compensating volume' will be submitted whic~_is pr~~ared 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 froa thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall_becote invalid
unless the Hork authorized by such perlit is commenced within six months of issuance, or if wc,rk authorized by the permit is
suspended or abandoned for a period of six sonths after the tise the work is com~enced. One 90 day extension of ti~e, lay be
allowed for the perait with fee charge of $15.00~ The extension shall be requested in writing t[, the 8uilding Official. An
approved inspection must be logged during each six month period, or the project will be considered abandoned.
HARKING TO OHNER: YUUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR rAYING TWICE FOR IMPROYEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COM NCENEN. JOBS ur R $2, 0 IN VAL DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMHEr~CEMENT'.
~? a!~ 7!42~7
S'IGNATURC--CWACTO~~
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF
The forege. i ng
befcore me th i 5
STATE OF FLORIDA
~
COUNTY OF
The foregoing instrument
before me this
instrument was acknowledged
~ 19 by
who is personally known to me Dr who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
pl-oduced
as identification and who did/did not
take an oath.
(Signatul-e)
(Signature)
(Name Typed, Printed or Stamped)
t:tOTARY PLlm.~L~
(Name Typed~ Printed or Stamped)
NOTARY PUBLIC
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SILCOX ENGINEERING, INC.
5409 Nebraska Avenue
TAMPA, FLORIDA 33604
Phone(813)238~755
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