HomeMy WebLinkAbout93-3206
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N~ _ 320&4
Date Jf -27-72
~
Property Owner:
Job Address:
Parcell.D. #
E~- p~_.. ~IANIe:AL
J:i~~1fg;~
;2 - d t:, - :2-/ - ,:) - 0
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
FINAL ..s- - /6-- Z5
DATE
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 ~ . I V 0
Contract Price .::2,000
Inspector
~f-~
Permit Fee ~ ,-- /
$;gnaMe n , AI 0 .J~lJd lJiI'
Company
Address
Telephone#
C;tY Ucense Reg;strat;on # >$I 1m ~
~u~ '
BUILDING
ELE~
~
Tp, Serv,
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Pll.1M811\Jc;/
MEC~...
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Ftr,
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
5-1./ ,q3 z.:tI
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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nu:n.nING DEPAR'rHENT
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JOB LOC:l\TION
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PARCEL I.D. 1?
SHOH hLL EXISTJDNG ,S: l~ROJPOSJE:llJJ STR1Ufe'['l":JRES GIVING DIHENSIONS & SETBACKS.
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
(NOTE EXAMPLES 1 & 2 ) STREET
1. SETBACKS FOR Rl, R2 ZONING
60'
la'
P E
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
FRONT PROPERTY LINE
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FRONT PROPERTY LINE
2.
SETBACKS FOR R3 ZONING
60'
1 A'
10'
-
10' EXISTING 10'
d_
PROPOSED
20'SGL FAM 30'DUPLEX
1 0'
FRONT PROPERTY LINE
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APPLICATION FOR. PIlmUT
GI'IY OF ~
BUII.DIBG DEP~
OWER'S IWtE_V85777 N€RSHMe&elG
OWNER'S ADDRESS to:2D~P}@q~ (\ t-
PIIOIiE
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
~~mBDIVISION O/}/(-'5J 6H"
PARCEL I. D. t
WORK PROPOSED:_5ew Construction _Addition _Alteration _Repair _Install
_Sign
~ve
_Deaolish
PROPOSED USE:
Single Fa.ily
_KIF
_' of Units
_K/H
_ec:-ercia1
_Indust.
_Swill. Pool
Other
---Restaurant &: Hea1t:h ~t Approva1
BUILDDlG SIZE:
x
~e Feet.
Height
, RESIDENTIAL:
COKKERCIAL :
A'lTACH (2) PLOI' PLA!iS &: (2) SEIS OF BUILDIIiG PLANS &: (1) SET KNERGY FORKS. **
ATTACH (3) SEIS OF BUILDIRG PLMlIS &: (1) SKI' ENERGY FORKS. **
**COPY OF CONTRACT RIlI1UIRiID.
PERKITS REQUESTED
~UILDING
$ ~/lXX) ,DO
Va1uatiOll; of Tota1 Construction
_ELECTRICAL
AtIP Service
Florida Power COrp.
W.R.E.C.
_KECllAlITCAL
$
Va1uation o:f Kechanica1 Installation
_PLUKBING GAS ROOFlliG
SPECIALTY
TYPE OF CONSTRUCTION: _Block ~ _Steel
Other
FllIISHED FLOOR ELEVATIONS:
FT.
IS PROJECT DI FLOOD ZONE AREA?
YES NO
******************************************
Signature
BUILDER
SiPn~ture
COIIPAIIW
State Cert. or Regist. ,
City License Registration I
******.~****~~*..*********...*************
ELECTRICIAN
Signature
COIIPMlY
Statt:: !;ert. or Regist:.. ,
City License Registration I
..**.....**~*~*.******~********.**********
PLOtBER
..~
OTHER
.
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ClI!IPJ.l1IY
State CeJ.. ,:. or Regist:. f:
City }k:~e Registration I
***.*..***;,:,**':'!-~."".**'Jlo.\\r**'i.\-*"".*..***.******
KECllANICAL
Signature
amPM!IY
State Gert:. or Regist. f
City License Registration ,
....**...**.**.*.***.~~*.****.**.*********
Signature
APPLICATION APPROVIID BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlitlay be subject to "deed restrictions" which lay be .ore 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 contract~r ~I;co~tractors to undertake work, they aay-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 .ay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, !813l
788-6611.
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor!sl 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 perlitting privileges in 'the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE2.
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 doculent and promise in good faith to deliver it to the
"owner. prior to cOI.encelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet 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 governaental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
Water/Wastewater Treatlent
f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environ.ental Protection AQency - Asbestos abatelent
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. will 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 8uilding Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code.. Every perlit issued shall beeo.e invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, Dr if work authorized by the perlit is
suspended Dr abandoned for a period of six lonths after the tile the work is coaienced. One 90 day extension of tile, .ay be
allowed for the perlit 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 lonth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT "AY 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
COH"ENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
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SIGNATURE: OWNER OR AGENT
.oeti &/JIJJ_
SIGNA E: CONTRACTOR
(SignatUl-e)
STATE OF FLORJ~ ,\
COUNTY OF Ht:JR).IlHV D 0
The fDregoing instrument was acknowledged
befol-e me this 5~9 , 1923. by
~ ~\\a
8Sm Jl8"'R.5~t!.o 00 i/~<t
whcI is pei),nallY ~~.n9':p-)."ff(l1\o hag
produced VlIoeP.:",4e" .0 'i
as identificati ~nd! wht,:;;uhi6,-Jdtd nit
1996 ::
take an oath. 5 =
;::
..
.,
ST ANDARD FORM OF AGREEMENT
BETWEEN CONTRACTOR AND OWNER
THIS AGREEMENT made the--ri".uenii - Nnv.-rrl ~~L r:+f>~L
Nineteen Hundred anrl NIN~/- fl:1tZC& by and be~eeJl ,ec(Be €..
hereinafter called the Contractor, anr! LlG'67'l7 I-IGJeSHJ!3G".e(S ~ ~
Owner, Witnesseth, that the Contractor and the Owner for the considerations named agree as follows:
in the year
hereinafter called the
ARTICLE 1. SCOPE OF THE WORK
and perform all of the work shown on the Drawings and described in the Specifications
ARTICLE 2. TIME OF COMPLETION ')
The work to be performed under this Contract shall be commencerl AS StDn C1..S t-eC'vn'l+ ;<;
substantially completed W rn+ IN ONe- li.::f-..F k.
'~~le~()eJ
and shall be
ARTICLE 3. THE CONTRAGr SUM
The Owner shall it" the Contractor for the performance of the Contraet, subject to additions and deductions provided therein, in current
funds as follows(.-1f 02000 ,00 ) /LUO 7'Jh:;u.s;;9/\/6
- (State here the lump lum amoWlt, unit prices, or both, as desired)
Authorized Change Orders will be submitted by the Contractor for all work nol specillcally included in this Contract.
ARTICLE 4. PROGRESS PAYMENTS
(Insert here any provision made for the aptount retalDed after the work reaches a certain Italle oE completion,)
ARTICLE 5. ACCEPTANCE AND FINAL PAYMENT
Final payment shall be due --r}+G'" day, ~ substantial completion of the work provided the work be then fully completed
and the Contract fully performed,
ARTICLE 6. THE CONTRACT DOCUMENTS
The General Conditions of the Contract] the Specifications and the Drawings together with this Agreement form the Co tract and th
f::fo~:~~~: a part of the Contract as it hereto attached or herein repeated,' The following is an itemizati~n of other es~entiai pertine~
Owner
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~~nt~~
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SEMINOLE FORM 410
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