HomeMy WebLinkAbout93-3224
BUILDING PERMIT
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~HA~CA.0 Sewer Conn
Water Conn:
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Radon Gas:
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CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N~ _ 3224 n1
Date ~-'I- 9 -::j , , \
B~~;/
~AL
~G
Property Owner:
Job Address:
Parcell.D. #
Zoning:
Description of Work
Energy Code:
~-e.(.1 )
NO OCCUPANCY BEFORE C.O.
FINAL
,j!.-
-u3
DATE
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#
~S'.
/'7 I~~L..
Valuation or \. 4t --::::< I t.2. 0
Contract Price 7f' cY) 700
City License Registration # 5' b ,/lIe!..-.
State Certified License#
PLUM
Breakers
Ducts Insl.
Compressor
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
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 ($15.001 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.
-
APPLICATIOlNl FOR PERlln'T
CITY OF ZE.'PJIYRlUI.I_<;
B1lIIIJ)IlNlG DEPA'RT1HRl'IT
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LEGAL DESCRIPTION: LOT(S)
RT.ocK
SUBDIVISION
~.~_. ('-);'::)-8lo.~8\ .rn~-.c):)Scr)-CD~()
"'URK PROPOSED:_!/Lfev Construction --.J\ddition _.lUteration _Repair _Install
_Sign
_Hove
_Demolish
PROPOSED USE:
Single Falllily
_H/F
_, of Units
_li/H
_Coaaercial
_Indust.
_Swim. Pool
Other
_Restaurant & Health Departaent Approval
BUILDING SIZE:
x
Square Fee t,
Height
RESIDENTIAL:
COHHERCIAL :
ATTACJI (2) PLOT PLANS & (2) SEI'S OF llu;IIJ>ING PLANS & (1) SET ENERGY FORMS. **
ATTACH (3) SETS OF BUILDING PIJ\Ns & (1) SET EiNEr.RGY FOR~IS.~!:
HCOPY OF CONTRACT REQUITRED.
PERmTS REQUP:STED
_BUILDING
$
Valuation of-Total Constnlction
_ELECTRICAL
.MJ1r'n A 1LTT rAT
s
AMP Service
3,COQS)
Florida PO\oI'Cr COrp.
W.R.E.C.
Valuation of Mechanical Installation
_PLlJMBTNG
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION!: _Block
_Fr3IIIC _Steel
Other
FIHISlIED FLOOR E'L.EV A TIOJI~S :
FT.
IS PROJECT IN FLOOD ZONE ARR~?
***********************************~~~**~~
YES, NO
CO/XITRACTOR SRCT'ION
nun.DF.'R
CUlHPAINY
State Cert:. or Rcgist:. #!
CiLy I..icensc !{egistration #:
******************************************
Signature
RT.P.CTRICTAN
a>>IPANY
State Cert:. or Regist. fIi: C,.
'.''''eity I.icense Registration f
*~*~***~*******.*~*******~***~*~**********
SiRTlatl1re
t
PUmRER
COHPAlNIY
State Cert. or Regist. m
City License Registration ~
~**~*****~******************~*****~*******
Signa ture
N"'~.'--'''',
Signature [.~, L~ _
~' ~'
,," COJIPANY rC('~ e.. b{:r: \ ". '-.-
~~/VJ " State Cere. or Regise. # ~R.~"'LJ:711'
, / I L-{ I City License Registration ~
* ********~*~***~**~******~***~**~*******~
0l'lTY.R
rouPANY'
State Cert. or Regist. ~
City License Registration *
******************************************
Signature
APPLICATION APPRO~TD BY
PF.Rffi.T OFFICER.
'!!----------.-~--_._---~-----------
--~..-_.-. -""'_.-.-..---.-----------..------'~.~--'--~..._.. --------"-.---
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this per.it ~ay be subject to 'deed restrictiDns' which may be more restrictive than tity
regulations. The undersigned assu.es responsibility for compliance with any applicable deed restrictiDns.
B. UNL I CENSED CONTRACTORS AND CONTRACTOR RESF'QNSi.1.8 I L LI.l.S.8.
If the OMner has hired a contracto~ or contracto~s to unde~take _ork, they ~ay be required to be licensed in accordance with
state and local regulations. If the" cO\lt'ractor is not;,'licensecl as required by law, both the Clwner and contractor may' be
cited for a lisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as, to what licensing
requireaents lay apply for the intended work, they are advised to contact the City of Zephyrhills Buildi~g Departlent, (813)
788-bbll.
.
..
Furtherlore, if the owner has hired a contractor Dr contractors, he is advised to have the contractor(sJ sign portions of the
'Contractor ,Sections' of this application for which ~hey "ill 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 "ish~
as contractor that lay be an indication that he is not properly licensed and is not entitled to penitting pri~in"\n~
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~
D. CONSTRUCTION LIEN LA~ (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 Consumer Affairs. If the applicant is someone other than the
'oMner', I certify that I have obtained a copy of the abov~ described document and promise in good faith to deliver it to the
~owner' prior to cOlmencelent~
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work Hill be done in compliance with ,all
applicable laMS regulating construction, zoning, ~nd land development.
Application is hereby lade to obtain a permit to do Nork and installation as indicated. I certify that no wor~ or
installation has cOlmenced prior to issuance of, a permit and that all work will be performed to seet standards of all laws
regulating construction, Ci ty codes, zoning reg'ulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies lay apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in co~pliance. Such agencies include but are not li.ited to:
* Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
'Water/Wastewater Treatment
* Southwest Florida Water NanaQelent District - Hells, Cypress Bayheads, Hetland Areas, Altering Hatercourses
+ ArlY Corps of EnQin~ers - Seawalls, Docks, Navigable Waterways .'
f Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells: WasteHater Treataent, Septic Tanks
* US Environlental Protection AQency - Asbestos abatement ~-'
I also certify that, if fill aaterial is to be used in Flood Zone 'A' or 'A,etc,', it is understood that a drainage plan
addressing a 'co~pensating volume" will be submitted which is pr~~ared by a professional engineer registered in the State of
Florida prior to per~it issuance.
A perlit issued shall be construed to be a license to proceed with the Hork and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official froD thereafter
requiring a correction of errOrs in plans, construction, or violations of any code. Every per~it issued shall becole invalid
unless the work authorized by'such permit is comDenced within six months of issuance, or if HorK authorized by the permit is
suspended or abandoned for a period of six tonths after the tile the Hork is coo~enced. One 90 day extension of ti~e, lay be
allowed f~r the perait with fee charge of $15.00; The extension shall be requested in writing to the Building Official. An
approved 'inspection must be logged during each six month period, or the project will be considered abandoned.
WARNING TO OWNER: ytiUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROYEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY DEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 1M VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT'.
J1i~ iJ,,:c~'.'Va
\~~ ~~~
TUiiC~~ 1\
STATE OF FLORIDA r-.=>
COUMTY OF \,LJl4A!-/J
The foregoing instrument was acknowledged
befcl}-e, me this ~7? 19-ZL by
-- 7J e bra "5f?l H /?
I'lho i s~~WT~> knD\.m tc. me Dr \$10 has
produce
as identification and who did/did not
take al~t~. /J" // ~
~(/~~._G /To -<:.~/
(Signature) /
j")au / en ~ l/o//-ey
(Name Typed, Printed or StampedJ
t:.tOTARY pv..mJ._~ ~-)q"''''$ b -J -;9.5 -
STATE OF ~LORID~
COUNTY OF, lL.-. ~
The foregoing instrument was acknowledged
before me this ~.. '3 , 1913by
norD/At J. J~/(',tYl.s___-
who is perso ally known-~o ~eor who has
produced j) /lAA~/vO 01 AA'~~
as identification and who did/did not
takv~~~ ff~
(Signatu\-e)
___ (law. Lt.,!:} ~ /1-0 / I ~ ItL "
:. r~affi2 Typed, Pl- i nted 0\- St.(mped)
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