HomeMy WebLinkAbout93-3569
BUILDING PERMIT
Permit N ~
CITY OF ZEPHYRHILLS
(813) 788.6611
35696
Date
/0 -/-5---- 7'3
9t7 . 0()
BUILDING
olCJ - c/C)
ELECTRICAL
o2o-~
PLUMBING
~tJ ~ d<.)
MECHANICAL
Sewer Conn
Water Conn:
P,"perty Owne' ft,' 0f. gJ;~
Job Address:.3 '-/3? - /
~,
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning: Energy Code:
Description of wor~ s- /,....h::7-r-7( ~
Jft~
./
Y-'>
J 0 /13 -
CL4....~. tl A ~Ld
- / -
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.
DATE
Inspector
P.,m;! Fe.~ J ~
Signature . t'{ ~
Company
Address
Valuation or
Contract Price
~--- tf7JC) . - cl7J
/
City License Registration #
State Certified License#
Telephone#
W'901/
/J.Lg-7L/J /~--
PLUMBING
BUILDING
ELECTRICAL
/J~;- ti~,e4Ul~A/c
MECHANICAL 7 r
I7'M fYf.PL-
'-Ill ~-z., 9/
~
FRM.
Insul. CL
WL
~~: ;e:':t~iV-TJ~
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Driveway I 0~\
3bd\ ~(~ 1 sf-a} I). -9-U~
Ftr.
Pre SLB
Lintel
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.
----
APPLICATION FOR PHRnIT
CITY OF Z,HPlfJRBILLS
BUTIWlliG DHPARntlr.1IIfT'
OWNER' S NAHE T. fi .
OWNER' S ADDRESS 3' f5 "'/- '3'7
3~~37
E/-1s~d/
/ of T/~ /9t/E
/3/.# /9t/E
.PHONE
3/.5 - ?r ;?-;z 7 II
.JOB ADDRESS
LEGAL DESCRIPl'I01M: LOf(S)
BLOCK
SUBDIVlSIOlNl
PARCEL 1. D.'
WORK PROI'OSED:_lNJew Construction ~ddiUon _Alteration _Repair _Install
_Sign _lPtove _De.-o.lish
PROPOSED USE: Single Fallil,. _"'F _' of Unit.s
_~rcial _Indust. _Swbl. Pool
_Restaurant 5- Health Depar~t Approval
/ //
BUILDING SIZE: 35 X Zr- . ?'~t9 Square Feet.? &
_KID
Other
Height
RESIDENTIAL:
cottKERCIAL :
AtTACH (2) PLOI' PUUls 5- (2) SEIS OF BUILDING PINiS 5- (1) SET ENERGY FORKS. U
AlTACB (3) SEIS OF BUllDING PI..Mis 5- (1) SKI' BEReT FORItS...
......COPT OF CONTRAct REQUllRED.
_BUILDING
$
dJd
.5; t:P Cj#r'
"
PEIUIlTS REOUESTED
Valuation of Total Construction
_EI.HCfRICAV/
_HEt."IIANICAL v' $
AKP Service
Florida Power Corp.
W.R.E.C.
Valuation of Kechanical Installation
_PLUKBING ./ GAS ROOFING
SPECIALTY
TYPE OP CONSTRUcnOlNl: _Block -"'ralle _SLeel
Other
FlllUSRED FLOOR ELEVATIONS:
FI' .
IS PROJECT IN FLOOD ZOIfE AREA?
YES NO
......................................................................................................
COJI'IKA.ClUR SECI'ION
BUTlDER W!fPANY #~~ ~A/~~---
-/ ~ ---- .....~ State Cert. or Regist. I
Signat.ure ~/v. ~ Cit.,. License RegisLration I
~ ................................................................................................................
WIlPARY ffol(o~LJ 61 ~ /i~-e
~ . d state Cert.. or Regist.. I
JJ.-U r' City License Regist.rat.ion I ??- /
~.........................................~..... ~~ '~
PLUllBER ~' / lDlPAIIY C~~~-C ~Ay ,
State Gert.. or Regl.s . I
Signature I CiLy License Regist.rat.ion t /' .;).5'
......................................................................................................................
flEatARICAL
Signature _~~
COlPIPMY ~ I/,e 5 /J! 0 "r-/ f:.. G)Il,S e...
./ ~ State Cert.. or Regist.. t ~Co yJ'Y
~ Cit.,. License Registration t 75 ~
..........................................................................................................................
~ .:1>v c.
OTHER
COPIPAIiY
Stat.e Gert. or Regist.. I
City License Regist.rat.ion ,
......................................................................................................................
Signature
APPLICATION APPROVED BY
7'taM"'(J. ~~J-
PERtlIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. t:!QI.IJ;:E ~E_DEED_REJ~rrp~IJ~.T I ot~iI .
The undersigned understands that this perlit May be ~ubject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assules responsibility for COMpliance with any applicable deed restrictions.
B. ~NLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ollner has hired a contractor or contract~~~t~-~~de~t;k;-;or~ih;y-;;y-b-;-;:~Qtti~edt;;-b;i-i.censed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the ollner and contractor tay be
cited for a .isde.eanor violation under state lall. If the owner or intended contractor are uncertain as to what licensing
require.ents lay apply for the intended lIor~, they are advised to contact the City of Zephyrhills Building Depart.ent, (9131
799-6611.
Further.ore, 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 ollner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the lIork. If the contractor Nishes 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 ZephyrhilIs.
C. TRANSPORT AT I atl HJPACT FE~!2._ ANP_l:!.Lt!::- 1)'{.J.:;ot'l/Nf:CTLQN FEE~.
n. ~ON9.JRUCTtm~L_I",LE::tL_LJ~H (CII(WTFR 7 J 3 ~ FLOn.1 Df) STfHUTES ~ AS ()"JENDE}))
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien LaN - HOMeowner's Protection
Guide" prepared by the Florida Depart.ent of Agriculture and Consuaer Affairs. If the applicant is so.eone other than the
"ollner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
"owner" prior to co.aencelent.
E. t::;ONTRACTOR ' SImmER'S AFF I PI:!Y IT.
I certify that all the inforlation in this application is accurate and that all work lIill be done in cOlpliance with all
applicable lalls regulating construction, zoning, and land develop.ent.
Application is hereby lade to obtain a perlit to do 1I0rk and installation as indicated. I certify that no lIork Qr
installation has cOI,enced prior to issuance of a per.it and that all 1I0rk will be perfor.ed to .eet standards of all lalls
regulating construction, City cQdes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
certify that I understand that the regulations Qf other govern,ental agencies aay apply to the intended work, and that it is
'Y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not li.ited to:
f Departaent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive lands,
Water/Wastellater Treat~ent
f Southllest Florida Water ManaQelent District - Wells, Cypress Bayheads, Hetland Areas, Altering Watercourses
f ArlV Corps of EnQineers - Seawalls, DQcls, Navigable Waterways
· Departtent of Health & Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US. EnvirDnlental Protection Aqencv - Asbestos abateaent
( also certify that, if fill .aterial is to be used in Flood Zone "AR or "A,etc.', it is understood that a drainage plan
addressing a "cQapensating volule" "ill be subaitted IIhich is prepared by a professional engineer registered in the State of
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 Qf the technical codes, nor shall issuance of a per.it prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, Dr violations of any code. Every perlit issued shall becole invalid
unless the work authorized by such perlit is co..enced within six .onths of issuance, Qr if lIork authorized by the perlit is
suspended or abandoned for a period of six ,onths after the tile the work is co.,enced. One 90 day extensiQn of tile, lay be
allowed for the per.it with fee charge of tI5.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be IQgged during each six lonth period, or the prQject will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCE"ENT 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
COM"ENCEMENT. 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
befor"e me this
II'las acknol-dedged
~ 19_ hy
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
befcq-e me th i s
II'las ac knell-II edged
~ 19_ by
who is pers6nally known to ~e Dr 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.
(Signature)
(Signahn-e)
(Name Typed, Printed Dr Stamped)
r~OT ARY PUBLI C
(Name Typed, Printed Dr Stamped)
NOTARY PUBLIC
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