HomeMy WebLinkAbout93-3149
BUILDING PERMIT
Permit N C?
CITY OF ZEPHYRHILLS
(813) 788-6611
_3149#
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Zoning:
Description of Work
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAL
C.O.
DATE
NO OCCUPANCY BEFORE C.O.
DATE
Valuadon 0' ~.2, . t23!
Contract Pric ' 000
Permit Fee
Signature
Company
Address
lephone#
City License Registration #
State Certified Lic e#
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Breakers
Ducts Insl.
Compressor
Final
Tp. Servo ~LB
Rough In 5.... Pl-q 3 Tub Set
Meter Can Water
Const. Pole Sewer
Pool Final
Pre-Meter
Final
Ftr.
Pre SLB
Lintel ~
FRM. 5/}-q?J
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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CITY OF ZEPHYRHILLS
COMMERCIAL CHECK APPLICATION
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APPLICANT:
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NAME :)F OWNER: OF mnLDIW;:
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ADDRESS:
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ZONING CATEGORY & CONFIRMATION:
PRESENT USE:
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IF VACANT, HOW LONG?
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PROPOSED USE IN DETAIL:
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ARE THERE ANY FLOOR PLAN CHANGES?/ il,/'" 1/'"
IMPORTANT:
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SOMEONE MUST BE PRESENT AT TIME OF COMMERCIAL CHECK~
THIS SECTION FOR CITY USE ONLY.
DATE:
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COMMENTS AND/OR REQUIREMENTS: Building, Electrical, plumbing & Mech.
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INSPECTOR
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SIGNED
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ZEPHYRHILLS FIRE DEPT
Zephyrhills Florida 33540
FIRE CODE INSPECTION
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Classification
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Address ~ () /) ,'-;,'-' 5 I
Owner/Manager --r, / .,-" ')-;" /;,-// d ':
Business Phone '-,:- ,,;---/).. / :2;7(".-
Emergency Contact, Phone
Occupancy Load
TYPE OF INSPECTION CONDUCTED
o QUARTERLY
ORE-INSPECTION
o APPROVED
o FINAL 0 ANNUAL
o OTHER
o NOT APPROVED
OBI-ANNUAL
'0) COMMERCIAL CHECK
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Listed below are items which must be complied with before this occupancy can be approved by the Fire
Department.
o CODE VIOLATIONS
This inspection report specifies code violation(s) which if not corrected could cause a fire, contribute to the
spread of fire, or prevent safe egress during a fire. Your immediate attention to the correction of these
violations shall be required, as failure to do so is a violation of the city of Zephyrhills Fire Prevention Code.
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Inspect. Date
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Inspect. Time /'
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Fire Dept. 10 #
Re-Inspect. Date
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Owner/Manager Signature.
Title
This building has been checked by the Zephyrhills Fire Dept. under the codes & regulations of the NFPA minimum
standards, the State Fire Marshall's Uniform Fire Safety rules and other local fire safety codes.
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APPLICATIOlNl FOR PERHIT
GI'IY OF ZEPlIYRlIILLS
BUILDIlNlG DEPAR'IHE'Br
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OWNER'S NAME l (' ,,;-' ,.
OWNER'S ADDRESS
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JOB ADDRESS
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LEGAL DESCRIPTION: wr(S) 1'2., 'i 1,0
RLOCK \ \.p 0 SUBDIVISION
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PARCEL LD.I
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lroRK PROPOSED :_Nfew Const:ruction
_Addition
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2-Alt.eration
_Repair
_Install
_Sign
--"ove
_Deaolish
PROPOSED USE:
Single F3Ilily
_KIF
_, of Units
_H/H
-,--ec-ercial
_Indust.
_Swia. Pool
Other,
_Restaurant & Health Deparblent Approval
BUILDING SIZE: B ~ X I> 'Z> J
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Square Feet,
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Height.
RESIDENTIAL:
COKHRRCIAL :
ATTACII (2) PLOT PLAliS &: (2) SETS OF BUILDING PIJ\NS &: (1) SET ENERGY FORMS..,u-
ATTACH (3) SETS OF BUILDDilG PI.ANS &: (1) SF:I' ENERGY FORMS.-f<*
**COPY OF CONTRACT REQlU.RIlD.
PHmtITS REOlW_'iTED
_BUILDING
$
Valuation of Total Construct.ion
_ELECTRICAL
AKP Service
Florida Power COrp.
W.R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFllfG
SPECIALTY
TYPE OF CONSTRUCTION: _Block
_F'nmIe _Steel
Other
FINISHED FLOOR EI.EVATIO~S:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
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COJrilTRACY'OR SECTION
BUILDER .
Signature~~ ~
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CUKPMfi-1M~/t 'Sldd,
State Cert.. or Regist.. I
City License Registration
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ET.ECTRICIAN
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PLUKBER COllfPAIiY
Stat.e Cert. or Regist:. I
Signature City L,icense Registration I
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MECHANICAL CO!jpA!NY
State Cert:. or Regist. ,
Signature City License Registration I
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01'1JER cmfPAHY
St.ate Cert. or Regist.. I
Signature Ci~ License Regist.ration ,
******************************************
APPLICATION APPROVED BY PER.J,.>tfIT OFFICER.
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CONDITIONS OF p~nMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it 'IaY be subject- h "-dl'ed restrictions" which Ilav. b~ IDr~ restrictive than City
regulations. The undersigned assules responsibility for cOlpliance Kith any applicable dl!~d restrictiDns.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contracto~ or contractors to undertake work, they may be required to be licensed in accordance with
state and local regulations. If tli!r'~bilt'ractor isnot"!icensf'd as required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state IaN" If the 0Wne, or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advis~G to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired ~ contractor or contractors, he is advised tD have the contractor(s~ ~ignportions of the
'Contractor Sections" of this appliLation 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 r2sponsible 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 perlitting privileges in the
City of ZephyrhilIs.
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 - 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 cOllencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this applir.ation is accurate and that all work will be done in cOlpliance with all
applicable laws regulating const'ruction, j:nningf :cittd land developlent" "
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work Dr
installation has coalenced prior to issuance of a per.it and that all work will be perfor.ed to teet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other govern.ental agencies may apply to the intende~ work, and~that it is
IY responsibility to identify what actions I lust take to be in coapliance. Such agencies include but are not ]iaited to:
f Departaent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive LandsJ~_ __
Water/Wastewater Treatment
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Aray Corps of EnQineers - Seawalls, Docks, Navigable Waterways _..
f Departeent of Health 1. Rehabilitative Services, Environlllental Health Unit - Wells, Wastewater Treahent, Septic Tanks
f US Environlental Protection AQency - Asbestos abate.ent
I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.', it is understood that a drainage plan
addressing a 'colpensating volule" will be sub.itted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issua~ce.
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 frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
unless the work authorized by such perlit is cOI~enced within six lonths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the tiee the work is com~enced. One 90 day extension of tile, lay be
allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved ~nspection lust be logged during each s!x lonth period, or the project will' be considered abandoned.
\/AHNING TO OWNER: YtlUR FAILURE TO RECORD ,~ l'iCTILi:. Or- COH~ENCEilENT I1AY RESULT IN YOUR Pr\Y1NG THICE FOR IMPROVEI1ENTS TO YOUR
PROPERTY. IF YOU IN,END TO OBTAIN FlNANCING~ CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COI1"E~E~ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
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SIGNATURE: CWNER OR A SIGNATURE: CONTRACT
STATE OF FLORIDA
COUNTY O( PAS CO
The foregoing instrument was acknowledgp.d
before me this March 31, , 19-21- by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
befcl}-e me th i 5
"Ias ackno"J1 edged
19_ by
Leo A. Klodzinski
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who is personally known to me or who has
produced Personally known
as identification and who . /did not
take
who is personally known to me or who has
prDduced
as identification and who did/did not
take an oath.
(Signature)
Dl- Stamped)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(i) MARYH. RAY
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