HomeMy WebLinkAbout93-3507
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N~ 3507/3
Date 9 -d../ - 9-3
~LD~ ELECTRICAL PLUMBING MECHANICAL
PcopO'ty owoO''1< 1;;tp~~
Job Address: ..3 r.!>'72. " r
Parcell.D. # 3.s----;;;..s- -,;)...j" L) ~---z; ~ /) 0" 0 C/ ~ I'J Ii' S/ 0
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:___, Energy Code:
:;J~o~w~d1/~P/h
Radon Gas:
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FINAL
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
C.O.
DATE
Inspector
p~'m;t Fe~
Slgnature_ _ ~~
Company
Address
Telephone#
Valuation or
Contract Price
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City License Registration #
State Certified License#
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ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr. 11-30-93 RTT.T.
Pre SLB
Lintel
FRM.
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.
OWNER
IJ. '..r..'/:"" C. IT:~OF }EPHY.R.HI~.. BUILDING DEPARTMENT
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'Jda LOCA1'IOM
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'PARC!t., I. D. #
SHOW ALL EXISTINGt& PROPOSED STRUCTURES-GIVING DIMENSIONS & SETBACKS.
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,UTILITY BUILDINGS
r~UST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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FRON PROPERTY LINE
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EXAMPLES 1 & 2)
STREET
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,<,'(!~k~R CARPORTS OR LIKE STRUCTURES PLEASE COMPLETE THE FOLLOWING:
;"':~!V!(~~1+" .
,,:.~;;,t 1 ) DESCRIge WHAT TYPE: FREE STANDING OR ATTACHED (CIRCLE ONt).
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(2) IF ATTACHED', HOW IS IT TO BE FASTENED TO STRUCTURE?
SETBACKS FOR R1, R2 ZONING 2 . SETBACKS FOR R3 ZONING
60' 60' "
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"
J 10' 10'
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10' P S' 10' 10' EXISTING 10' "~ .
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0 G PROPOSED
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20' 20'SGL FAM 30'DUPLEX
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FRONT PROPERTY LINE FRONT PROPERTY LINE
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APPLICANT
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
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PHONE
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OWNER
JOB LOCATION
LOT SIZE_X
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL I.D.~~ tf - j2,j -), / - C> Cf' .;/0 "de? () U 0 0 7 i c)
-
WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install
____sign/Temp.
____Sign
_Move
____Demolish
PROPOSED USE: ____Single Family
_M/F
____~~ of Uni ts
.____M I H
____Commercial
_Indust.
____Swim. Pool
Other
____Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED,
pRRMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp..
_W,R,E.C.
____MECHANICAL
$
Valuation of Mechanical Installation
.#0 .
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block
____Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
Signature
CONTRACTOR SECTION
Company
State Cert. or Regist. D
City License Registration #
******************************************
BUILDER
Sillnature
Company
State Cert. or Regist. #
City License Registration #
******************************************
F.LRCTRTCTAN
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
PLlJMBRR
Signature
Company
State Cert. or Regist. #
City License Registration #
******************************************
MRCHANICAT,
OTHRR
Signature
Company
State Cert. or Regist. #
City License Registration #
APPLICATION APPROVED BY
~*******~***************************
t1 .M f1.A ~ ,..flAAfvtcy-- .
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
.
The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lore restr.ictive 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 contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor il not licensed as required by law, both the owner and contractor aay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to IIhat licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (813)
788-6611.
Furtherlore, if the ollner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the
.Contractor Sections. of this application for which they lIill 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 per~itting privileges in the
City of Zephyrhills.
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 lIith a copy of "Florida's Construction Lien Lall - Hoaeollner's Protection
Suide" prepared by the Florida Departlent of Agriculture and Consuler Affairs, If the applicant is soae6ne other than the
"ollner", 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 application is accurate and that all work will be done in compliance with all
applicable lalls regulating construction, zoning, and land develop.ent.
Application is hereby .ade to obtain a perait to do 1I0rk and install~tion as indicated. .1 certify that no 1I0rk or
installation has cO.lenced prior to issuance of a perlit and that all work lIill be performed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction, 1 also
certify that I understand that the regulations of other govern.ental agencies lay apply'to the intended work, and that it is
IY responsibility to identify IIhat actions I lust take to be in COlpliance. Such agencies include but ~le lIot liaited to:
. J.fII.-
I Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive ldnds,
Water/Wastellater Treat.ent
I Southllest Florida Water "anaQelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of EnQineers - Seallalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatment. Septic Tanks
I US Environlental Protection AQency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.., it is understood tli~t a drainage plan
addressing a "colpensating volule" lIill be sublitted which is prepared by a professional engineer regist2ied in the State of
Florida prior to permit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to viol~te, 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 permit issued :hall becole invalid
unless the 1I0rk authorized by such perlitis co..enced within six months of issuance, or if wOI'k authofJ1ed by the perlit is
suspended or abandoned for a period of six lonths after the tiJe the work is commenced, One 90 day e~ttnSioli 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 lonth period, or the project will be considered dbalidoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
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 COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE__________________________________
m.JNER OR AGENT
SIGNATURE______________________________
CONTRACTOR
DATE_______________________________________
DATE
-----------------------------------
NOTARY AS TO
OWNER OR AGENT___________________________~-
MY COMMISSION EXPIRES
NOTARY AS TO
CONTRACTOR_____________________________
..
MY COMMISSION EXPIRES
----------------------
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