HomeMy WebLinkAbout93-3427
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N~ _ 34276'
Date ~-/ b -:R:s
~
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcel 1.0. #
Zoning: , Energy Code:
De::t:r' Woe', ~ -u>......1 . A.,t-r~
~Q~{&~~
Water Meter:
4:
Rado~} U ~
~ / ~-~L
r - 0
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O. C
r\./~I
Inspector
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
City License Registration #
State Certified License#
7,7
Permit Fee
Si~nature
Company
Address
T~lephone#
~ ~ <7iJ
'~/{? ~~
Valuation or
Contract Price 6l, ~. CV
?Sf} - 7~ 0 <l
ELECTRICAL
PLUMBING
MECHANICAL
:;~ SLB 4J- / )-- t2J fE
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
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.
APPLICATIOOO FOR PERMIT
CITY OF ZEPHYRHILLS
BmLDIRG DEPAR'I'KEOO'T
OWNER · S NAME
Vofb{
6 /50>..
5'1W( ~ .
(j I/-FF,y (!. f
/0 K S?-
mONE
7t~~ 73~!
OWNER · S ADDRESS
JOB ADDRESS
LEGAL DESCRIPl'Imi: LDT(S)
BLOCK
SUBDIVISIOlNJ
PARCEL 1. D . f:
WORK PROPOSED :~lSlew Construction _Addition _Alteration _Rep..~ir _Install
_Sign
_Hove
_DeJIOlish
PROPOSED USE: V'Single Faaily
_KIF
_, of Ufnits
_K/H
_~rcial
_Indust.
_Swia. Pool
Other
BUILDING SIZE:
_Restaurant & Healt:h Depar~t Approval
91/2 X leg .
Square Feet,
Height:
RESIDENTIAL:
COttKERCIAL :
ATTACH (2) PLOT PI.AIlS & (2) SEIS OF BmLDING PIJUilS & (1) SET ENERGY FORKS. U
ATTACH (3) SEtS OF BUllDDilG PIJUilS & (1) SEI' DERGY FORKS. il:il:
il:il:COPY OF COlSlTRACT REQm:RIID.
PERKIlS REOUJESTED
_BUILDING
$
P--/6"O
Valuation of Tot:.al Construction
_ELECTRICAL
AMP Service
Florida Power COrp.
W.R.E.C.
_KECHMUCAI.
$
Valuation of Mechanical. Installation
_PLUMBING
GAS
ROOFIlSlG
SPECIALTY
TYPE OF CONSTRUCTION!: _Block
_Fr3llle _Steel
Ot:her
FINISHED FLOOR ELEVATIONS:
FI' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
il:*il:il:il:il:il:il:il:il:il:il:il:il:il:il:il:*il:il:****il:******il:***il:******
CDNTRACT'OR SECTION
BUILDER
eLK ~~ JV
S Uo/S71f--r1f._
State Cert. or Regist. 1#
City License Registration 1#
***************************il:**************
COIfPANY
I+LJlfr4d'1 ~c.
77.
Signature
ELECTRICIAN COIIPANY
State Cert. or Regist. 1#
SiRn3t:ure City License Registration ,
******************************************
PUllKBER CQIIPAHY
State Cert. or Regist. 1#
Signature City License Registration ,
******************************************
KEC'HANIGAL COIIPANY
State Cert. or Regist. I
Signature City License Registration I
******************************************
OIlIER COIfPANY
State Cert. or Regist. ,
Signature City License Registration j
******************************************
APPLICATION' APPROVED 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 lore restrictive thpn City
regulations. The undersigned assules responsibility for co.pliance with any applicable deed restrictions. '
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake worK, they may 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 lay be
cited for a lisdeleanor violation under state IaN. 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 Depart.ent, !8131
7BB-6611.
Further.ore, if the owner has hired a contractor or 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
Suide' prepared by the Florida Departlent of Agriculture and Consu.er 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 cOleencelent.
E. CONTRACTOR'S/DWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance 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 cO'lenced prior to issuance of a per.it 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 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 limited to:
f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater Treatment
f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways '
f Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environaental Protection AQency - Asbestos abateeent
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 volute' will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to pertit issuance.
A pertit 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 cOllenced within six tonths of issuance, or if work authorized by the permit is
suspended or abandoned for a period of six lonths after the tiee the work is cOIBenced. One 90 day extension of tile, lay 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 tonth period, or the project will be considered abandoned.
WARNINS TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCINS, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT..
SIGNATURE: CONTRACTOR
SISNATURE: OWNER OR AGENT
was acknowledged
19____ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
S 11' l~ 1 i LAN
(Hl'SIDl::'lo\T 1.\1. lJSg C)/.jLY)
,'ARCEL I. D.
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PROPOSAL SUBMITTED TO
\
STREET
CITY, STATE AND ZIP CODE
ARCHITECT
We hereby submit specifications and estimates for:
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_:,-t
Jrnpnnul
SUN STtrr~ AlUM'NU~!1
37528 SR 54 W~st
ZEPH/RH1LLS "-:-L 33:..)41
(813j 788-7308
DATE OF PLANS
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PHONE
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JOB NAME
JOB LOCATION
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Page No,
!NC
DATE
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of
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JOB PHONE
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Dr 'rnpnlir hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
Payment to be made,;1 follows:
,-
x ~()
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifica-
tions involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance.
Atttptuutt of 'ropo.aul- The above prices, specifications
and conditions are satisfactory and are hereby accepted, You are authorized
to do the work as specified. Payment will be made as outlined above.
Date of Acceptance:
"
Authorized',
Signature
dollars ($
Note: This proposal may be
wilhdrawn by us if not accepted within
Signature
Signature
1'7.:-
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PRODUCT 118-3 fNClis/fJlnc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1 + 800.225.6380
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