HomeMy WebLinkAbout93-3544
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
35448
Date / ~ - 6' Y3
c~
BUILDING ,
Pmpe"Y Owne, ~ ~
Job Add,",,, h / . ~ . ~ 4
Parcell.D. # ....3-~b -;)../ .. cJ% .:. I/;;J.... 0-
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
00.30
Zoning: Energy ~
De,c';pt;on of wo,,,,j;/".d&L -d .- L~
Radon Gas:
#Ji~ ~/U 1l_Z;M .<<J# ~~
NO OCCUPANCY BEFORE C.O,
FINAL
C,O,r1\ i'! - /~
- ,~I
Inspector
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances,
DATE
City License Registration # -Yh
State Certified License#
Permit Fee~. ~
Signature ~~
Company
Address
Telephone# l?" /3 ~ 7'33 r- I P 7 /
Valuation or
Contract Price
~Sf7ZJ~/!J'Z)
-
ELECTRICAL
PLUMBING
MECHANICAL
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
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.
J & ,} SIGN CO"
. BEI&V'UO f'LOnlb^'!l WEST CO^RT
~09". o"F'b~'~ox. '7'Si\7'
T^,,,pA. FLOntO^ 33002
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EnECTION
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TUE UNDERSIGNED "EREBY
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PROPBRTY OWNBR
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J.A. FALSONE II P.E.
STRUCTURAL ENGINEER
5201 Seminole Ave" Tampa, FL 33603
Date 1 /z:z../ c" 3 Design
Check
J.F. DESIGN SHEET
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PROPERTY OWNBR
ADDRESS
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PROPBRTY OKNBR
ADDRBSS
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APPLICATIOIi J10R PERllIT
CIn OF ~IKHIT.I_c;
BUIIJlIlIG DEPAImIEIIT
OWIIER' S RAIlE
PIIOIIE
0WlIER' S ADDRESS f)7. ~cf, ~
JOB ADDRESS 'IS I 9-"J- ~ ~ 4~-4
LEGAL DESCRIPl'IOIII: IDI'(S)
~SOBDIVISIOlI
PARCEL I.D.' C) S ~ 1-' ~ j../. Co I a ~ If 2tOf"'J ~ ~ n31J
IiOU PROPOSED:__ev Construction -l'ddit.ion _Alteration _.Repair _Install
~ign
_lIIove
_De.o1ish
PROPOSED USE:
Sing1e F-u.y
_"IF
_, of Units
_"/H
_~rcia1
_Indust.. _Swm. P001
Ot:her
R_t:aarant &- HeaJ.t:h ~t Approva1
BUILDING SIZE:
x
~e Feet.
Height
RESIDENTIAL:
aJItIIERCIAL :
A1TAaI (2) PIDI' PLAIIS &- (2) SEIS OF BUII.DDIG PIAIIS &- (1) SKI' ElIERGY FORItS. **
ATI'AaI (3) SEIS OF BUIlDDIG PIAIfS &- (1) SKI' ElIIERGY FOKIIS.**
**mpy OF mNTKACf lUlQUIIUlD.
PERIfI'IS REQUESTED
_BUILDING
$.
Va1.uat.ion of Tota1 Construction
_ELEC'l'RICAL
AIf.p Service
F10rida PoIiIer Corp.
W.R.E.C.
---..JIEQIANICAL
s.
Va1.uation of 1f.echanica1 Inst:allation
_PUJlf.BING GAS KOOFIIIG
SPECIALTY
TYPE OF mNSTRUCl'IOII: _B1ock _Fra.e _Stee1
Ot:her
FINISHED FLOOR ELEVATIOIIIS:
FT.
IS PRO.JECI' Di FLOOD ZONE AREA?
YES NO
******************************************
QJII'IRACIOR. SECl'IOR
RmIJlF.R
aJIIPANY
State Cert. or Regist.. I
City License Registration .
******************************************
Signature
RI.F.CTRTCIAII
aJIIPAIIIY
State Cert.. or Regist. .
City License Registration .
******************************************
Si mUIt.ure
PI.DIRF.R
aJIIPAIIIY
State Cert.. or Regist.. .
City License RegiSI:rat.ion .
******************************************
Si.goature
IIEaL\lIIICAL
aJ!IPAIIIY
State Cert. or Regist. .
City License Registration .
******************************************
Signature
OIRIIR
~ aJIIPAIIIY j ~ S S' I GN 00
C:Ztlt. ~ Q State Cert. or _to .
~~ IA~ . City License Registration' :SP'// I
* ***. ********************************
Signature
APPLICATION APFBOVIl'.D BY
PERIf.IT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NQI.H::E OF _DEED.--f:ESJRI j:T.l..Q.!:m,
The undersigned understands that this per.it lay be subject to -deed restrictions- which .ay be .ore restrictive than City
regulations, The undersigned assu.es responsibility for co~pliance with any applicable deed restrictions,
B. !Jt~L I CENSED CONTRACTORS __8NP__t;_Q!jJJ3...8J;_LQR ....BE:9.E:m~!:iI.~_I L!.I I Eq
If the owner has hired a contractor or cDntractors to undertake work, they m~y 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 .isde.eanor 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 Depart.ent, (8131
788-6611.
Furthermore, if the owner 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 Mill 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 TRANSPORTA T I ON I MPACT F_E~!:L {)NQ... UT IJ.. I TY ..J.:,;.QNNECTJ OJ::L.EEE~.
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 - Ho.eowner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is so.eone other than the
"owner", I certify that I have obtained a copy of the above described docu~ent and pro.ise in good faith to deliver it to the
'oMner. prior to cO'lence.ent,
E. ~ONTRACTOR'S/OHNER'S AFFIDB.YXI.
I certify that all the infor.ation in this application is accurate and that all work will be done in co.pliance with all
applicable laws regulating construction, 20ning, and land develop.ent,
Application is hereby aade to obtain a perlit to do work and installation as indicated, I certify that no work or
installation has co..enced prior to issuance of a per.it and that all work will be perforled to .eet standards of all laws
regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction, I also
certify that I understand that the regulations of other govern.ental agencies lay apply to the intended work, and that it is
'Y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to:
, Depart.ent of Environ.ental Requlation -- Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
Water/Wastewater Treat.ent
I Southwest Florida Water "anaqe.e"t District - Wells, Cypress Fayheads, Wetland Areas, Altering Watercourses
f Ar.y Corps of Enqineers - Seawalls, Docks, Navigable Waterways
, Depart.ent of Health & Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
, US Environ.ental Protection Aqency - Asbestos abate.ent
I also certify that, if fill .aterial is to be used in Flood lone .A" or "A,etc,., it is understood that a drainage plan
addressing a -co.pensating volu.e- Mill be subtitted which is prepared by a professional engineer registered in the State of
Florida prior to per.it issuance,
A per.it 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 perait prevent the Building Official fro. 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 perlit is co..enced within six .onths of issuance, Dr if work authorized by the per.it is
suspended Dr abandoned for a period of six .onths after the ti.e the work is co..enced, One 90 day extension of ti,e, .ay be
allowed for the pertit "ith 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 .onth period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"MENCEMENT nAY RESULT IN YOUR PAYING TWICE FOP. 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: OWNER OR AGENT
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
before me this
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument1was acknowledged
befell-e me this , 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 Dr who has
pl-oduced
as identification and who did/did not
take an oath.
(SignatLll-e)
(Signature)
(Name Typed, Printed Dr Stamped)
r~OTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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