HomeMy WebLinkAbout93-3436
BUILDING PERMIT
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~
~DIN~~
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N~ 3436 13
Date ~- J 7-73
ELECTRICAL
MECHANICAL
Sewer Conn
Parcell.D. #
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Radon Ga" .:2SS-'~
n-u'l~-?-,:~J ~rY
Water Conn:
Property Owner:
Job Address:
.1. F.'s:
Zoning: ~code:
Description of Wort. ". ../ ~
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Pe.mit Fee ~ 2/- : 0
Signatur~... ~. ~~
Company
Address
Telephone# 7&-3-6 I ?,7
,
Valuation or
Contract Price I~ ~ 0-0.1 gr..IZJ.
City License Registration # ..33 'I'
State Certified License#
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
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
?~{"'-l 5lA-J3 01\t1-WA"
q-{t} -Ce3 I1tJ 'it; q1 M
REINSPECTION FEES: Wlien extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
<;ame.
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APPLICATION FOR PEmIIT
GI'IY OF ZEPJIYRlIIU..5
BUILDIBG DEPARTHfl'.1fn'
OW'NER'S NAKE /!LJre.v/i6r #E/I~$SY57~h1.r / SaA/PE27 PlIONE
/ ,/
OWNER' S ADDRESS 1fA h57 ~5t 0 '?/EP/C/U ec;r/TE-2
JOB ADDRESS 7'/J.:f'D fj.ALt ~A.P / ZEP..AfY.eN/~ ~ Y.7.fj1o
?tW-N//
LEGAL DESCRIPTION: LOT(S)
RIncK
SUBDIVISIOINl
PARCEL LD.'
.sEt AJ7A<!..J1€f)
'lURK PROPOSED:--X-!Mev Construction ----'p\ddition _Alteration _Repair ._Install
_Sign
_Hove
_De.-olish
PROPOSED USE:
Single Faaily
_"IF
_, of Units
_H/H
_Coaaercial
_IOOO5t.
_Swi_. Pool
Other
~estaurant &: Health Deparl:Dent Approval
BUILDING SIZE:
x
Square Fee t.
Heisht
RESIDENTIAL:
COHHERCIAL :
ATTACJI (2) PLOT PlANS &: (2) SEIS OF BUILDING PJ,AOOS &: (1) SET ENERGY FORHS.u
ATTACJI (3) SlITS OF BUILDING PI.ANS &: (1) SET EINlE:RGY FORtiS. U
"''''COPY OF CONTRACT RlfQUIRIlD.
PElMITS REOUP.5TED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AKP Service
Plorida Power COrp.
W.R.E.C.
_HECIIANlCA.L
$
Valuation of Mechanical InstaLlation
_PLUMBING
GAS
..ROOFI~i\;
~l'r.t;.lAL.Tl
TYPE OF CONSTRUCTION: _Block _Praae _Steel
Other
FlNISIIED FLOOR ELEVAnmDS:
FT.
IS PROJReTIN FLOOD ZONE AREA?
YES NO
"''''~'''*'''''''''*'''*''''''***'''*'''**'''*''''''*'''''''''*.'''**''''''''''''*'''''''''
nUII.DY.R
CO~CTOR SECTION
~ WHPANY :jf,u d..ff.€ti<7/..... C., -#c
~/ State Cert. or Regist.' CQ f!...OJl1 ~~
c; -nru City License Registration # - '3
~-- . ..........................................
Signature
PLUMBER
RI.ECIRICIAN ~ WHPMOY ~--/'.a. ~ ~~. .~
Stat.e Cert. or Regist. i# ~ <taco,,"& ~ 3
SiRllature _ City License Registration f b/.."!:'-3
~.. _ ..........................................
Cl>>IPANY ~.fUr1 J1t tJ /}
~ . S<ate Ce~t. o,fRegist. ,
City License Registration ,
",,,,,,,,,,,,,,,,,,,i*,,,,,,*,,- .it.~.'il"I!,"'."'''''''**'''.''''''*''''''*'''**-!:'''''''''-!:
QJ/IPMOY J/o /tj,IH }1t(fl~ (MfL
State Cerl:. or egist. I
City License Registration' / 0 ~
******"'*."'.~+~*."''''''''''**'''''''''''''''**.''''''*-!:'''**~**'''* f
Signature
-~~
/sr
HP.:CllAHICAL
jJ!'
Signature
OTlIER
CO:tIPANI'
State Cert. or Regist. I
Ci~ License Registration M
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Signa ture
APPUCATION APPROVED BY ~ ,4//'lAJ'l-) .
PERHIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Th~ undersigned understands that this perlit 'Iay b~ su~ject tb 'rieed restrictions" which lay be lore restrictive than City
regulations. The undersigned assules responsibilitr for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONT~ACTOR RESPONqIBILITIE~
If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If lhrcbnfractor i: 1l0t';licel1s~d as required by law, both the owner and contractor laY be
cited for a lisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are acvised to contact the City of Zephyrhills Building Departlent, IBI31
7B8-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl sign portions of the
'Contractor Sections' of this application for which they Hill 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 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 - H~.eowneT'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 COllencelent.
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 coalenced 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 governlental 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 liaited to:
, Departlent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
Water/Wastewater Treat.ent
, Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
, ArlY Corps of EnQine~rs - Seawalls, Docks, Navigable Waterways .
, Departaent of Health ~ Rehabilitative Servires. Environ.ental Health Unit -Uells, Wastewater Treat.ent, Septic Tanks
, US Environ.ental Protection AQency - Asbestos abate.ent
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
addr!s!:!!'g ~ .!:!'~p~~!:~t!~g '!!'!!!'!~. ~~!! h!! ~t!~.!.""~'''.: ~h.!rh !!: ~r~~~!"~~ hy ~ r-r~f~!E~!~'!~1 ~~g!n~~!'" !"~~r~-t!r!~ !nth.~ st:!~~ I)f
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, Dr
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beeo.e invalid
unless the work authorized by such perlit is rOllenced within six Bonths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six lonths after the tile the work is cOl6enced. One 90 day extension of tile, lay be
allowed f~r the per.it Hith fee charge of $15.00. The extension shall be requested in Hriting to the Building Official. An
approved inspection lust be logged during each six month period, or the project Hill be considered abandoned.
WARNING TO OUNER: YOUR FAILURE TO RECORD A NUT'~E OF COMMENCEMENT MAY RESULT IN YOUR PAYIIIG TUICE FOR IMPROVEMEIITS TO YOUR
PROPERTY. IF YOU INTEND TQ OBTAIN FINANCING, CONSULT UITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COM"ENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COM EMEIIT".
STATE OF FLORIDA
COUNTY O( Pas<co
The foregoing instrument
before me this 4/26
was acknowledged
19~ by
STATE OF FLORIDA
COUNTY OF Pasco
The foregoing instrument
befctl-e me this 4/26
I-laS ac kne'l-l! edged
, 19-2L by
David Hi1uq~m ______._ ..,_ _
who is persc.nally Imo\'Jn tD me Cof'-Wi+c"'-F>a05
~~~---------------------------
..Ii-i.de.tI.t.1.:t:.i.c.aU.i.CLC. and ",ho .s+e\./ did nt. t
~~~"'.\:\.o~~~
~tUl-e)
June M. Herndon
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
.Notary Public, Stat~ "tIf FlorId.
JUNE M. HERNDON
My-commiSSion Exp. Feb. 1, 1991
,Comm. No. 252632
Charles D. Poole
-.---.---.-----....- -~--_._. --- ._,-~
\'Iho is pel-!:.ona 11 y knol'lIl to me t:'r"'>'l'ht:'-"'l!I"lr
~~~~-------------------------
~-i~el't1ri-f..;.ef'rt_i_f:ot~and who c;J.i-EJ.,ld id neft
(Si latLll-e)
Ju e M. Herndon
(Name Typed, Printed 0
NOTARY PUDUC
rlda
.1997,
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