HomeMy WebLinkAbout93-3570
BUILDING PERMIT
Permit N ~
CITY OF ZEPHYRHILLS
(813) 788.6611
3570 /3
Date
/0 - /~--7 3
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Pmperty Owne, 7ff,J ~ 6'A~
Job Address: 6/. - / / ~- ,.
Parcell.D. # ;2- ;;20 -.;)j - 6 c) lio- 0 () ,~ 0- () 0:;; 2)
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
Energy Code: _ ~~ /
J.+..X /r- __
,
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAl,,-
c.o.l
1/
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 # 7,/
State Certified License#
Permit Fee ~~ d(:.)
-Signature v( . . (;;~ ~"
Company
Address
Telephone#
Valuation or
Contract Price
~b 3/. t/7)
jL~~
BUILDING
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
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.
APPLlCAl'IOWi FOR 1"100I11'
CITY o.f' ZEPII1KIII US
BtHtDHiG DEPARJtlENT
OWNER "S NAltE
fj~~~
9r
moNE .?t;2 - ~S r 6'
OWNER"S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: 1Ol(S)
RW(..'1{
SUBDIVISION
PARCEL 1. D . ,
O;;L
dl-- G ~
67>8(5
tfJ ;Lr:;{j
c7{)(O
WORK PRo.I'OSED:_lNIev Construction ---^ddition _Alteration _Repair _Install
_Sign
_lPIove
_DeIIOIish
PRo.POSED USE:
Single Fa.iIy
_"'f'
_' of lIfnits
--"IH
_~rciaI
_Indust.
_Swu.. 1"001
0. the r
BUILDING SIZE:
_Restaurant 5- BeaIth DepartlleO.t Approval
Ir2x IlS , f RL Hf-B ;;711tj
Square Feet.
Height
RESIDENTIAL:
c:otVtERClAL :
ATTACH (2) .PLOI' PLAIIS 5- (2) SEIS Of' BUllDING PI..A!lS 6: (1) SEI' ENERGY Fo.RtIS. u
ATTACH (3) SEIS OF BUII.DllIG PLANS 6: (1) SEI' miERGY FORKS. **
**roPY OF rollfl'RACT RII:QlIflRllD.
_BUILDING
$
(~3(,(lJ
PERKlTS REOUESTED
Valuation of Total Construction
_EI.ECTRlCAL
MIP Service
f'lorida Power Gorp.
W.R.E.C.
_HEt.'1IANICAL
$
Valuation of Hechanical Installation
_PLmtBING
GAS
ROOFING
SPECIALTY
TYPE o.F CONSTRUCl'IOIli: _Block _Fr3lle _SteeI
0. the r
f'INISRED FLOOR ELEVATIONS:
FI' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO.
******************************************
BUllDER
wrnKACIOR SECTION
~ fDtPANY SOJ../~ Jlc-r;f(c~dlf
4r~ State Cert. or Regist. ,
l_ ~ I City License Registration , 7 T
***************************************** '
Signature
ELECTRICIAN
CUIPIPANY
State Cert:. or Regist. I
City License Registration I
******************************************
SiPnatU1e
PLUllBER
fDtPAIU
State Cert. or Regist. t
City License Registration ,
******************************************
Signature
KEClWUCAL
Wl!IPAn
State Cert. or Regist. f
City License Registration t
******************************************
Signature
011IF.R
cortPMiY
State Cert. or Regist:. ,
City License Registration ,
***************************************~**
Signature
APPLICATION APPROVIfD BY
PERKlT o.FFICER.
CONDJfIONS OF PERMIT AFFIDAVIT
A. NOT l~E DE-DEED RE_STR IJ~.J I ot~l3.
The undersigned understands that this periit lay be subject to "deed restricti~ns" which lay be lore restrictive than City
regulations. The undersigned assules responsibility f~r COMpliance with any applicable deed restrictions.
B. !,JNL I CENSED CONTRACTORS A.tlI;Lt;JJtLLRAc.__rQR .BsSEPNSi.I B I LII.!J~.9..
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 is not licensed as required by law, both the ONner and contractor lay be
cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
reQuire.ents lay apply for the intended work, they are advised to contact the City ~f Zephyrhills Building Depart.ent, 19131
798-6611.
Furtherlore, if the owner has hired a contractor or c~ntract~rs, he is advised to have the contractor 15) sign portions of the
"Contractor Sections" of this application for which they "ill 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. TRANSPORTAT ION H1PACT FEES ?)tH~ UT I!,.-I Tl_.~ONI':LECTJ OI't.EEES!.
D. h(JNSTRUCT I ON I",J E;LL1.,..f\_H ([~J'I(,)PTER '7 j :3 ~ F LUn J D() STATUTES ~ (IS ()I"lENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien Law - HOleowner's Protection
Guide" prepared by the Florida Departlent 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 prolise in good faith to deliver it to the
"owner" prior to COllencelent.
E. CONTRACTOR I S/Ot.JNER I ~..BFQQIiY-I.I.
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 Dr
installation has cOI.~nced prior to issuance of a per,it and that all work will be perfor.ed 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
IY responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not lilited to:
I Departlent of Environ.ental Requlation - Cypress Barheads, Wetland Areas and Environ.entally Sensitive Lands,
Water/Wastewater Treat.ent
I SouthNest Florida Water nanaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlV Corps of EnQine~rs - Seawalls, Docks, Navigable Waterways
I Departl~nt of Health L Rehabilitative Services, Environtental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
I US Environlental Protection Aqencv - Asbestos abate.ent
I also certify that, if fill .aterial 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 Nhich 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 wDrk and not as authority to violate, cancel alter, Dr
set aside any provisions of the technical codes, nor shall issuance of a per.it 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 per.it is co..enced within six tonths of issuance, or if work authorized by the per,it is
suspended or abandoned for a period of six lonths after the tite the work is cO'lenced. One 90 day extension of ti,e, lay be
alloNed for the per.it 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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY 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
C,""EMCE"EMT. 10'S ..OER $2,50' 1M V~!'-~T NEED TO 'ECOBO AND POST . 'NOTICE~
~- ~ J)
".. -~ -~,. - --~
SIGNATURE: __-- .:c= . Q}6NATURE:.-DlU .-/->--- .
STATE OF FLORIDA
COUNTY OF
The for ego i ng ins t?m'!lllt
before me this /6 I')
I
jJ 45-c(J
"Ias ackno\flledged
, 19 n by
STATE OF FLORIDA
COUNTY OF
The foregoing instn. ent "Ji:\S a~S{)\flledged
befl)l-e me th i 5 /() 15:" ~ 19 by
who is personally known to me or who has
produced
as .identifica~iCln::pd h~CI d'd/did not
take an oath.
~
-e-
( S i g na tLw e) Notary Public Pasco Co, FL
(Name Ty~~o,,"i:lN~~5~~----
NOTARY PUBLIC
who is personally known to me Dr who has
pt-oduced
as identification and who did/did not
take an oat~~ ~
(Signature) P bl' Pasco Co. FL
Notary u lC . ' 995
(Name Typ_CoIl_~8 fJplr~~t
riQT AR'LE_UBL I C
S 1T1~ "LAN
(Hl'SIJ)l:1\TL\1. USg (ittLY)
..,;..
;''\RCEL I. D.
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$lX
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tJ?J75)
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~'ROrEHTY t-IEASUHEl1ENT
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\11 drl1wings shall b~! druvlI to ucnl(~ for lIlI l'a~'cel:, ur tuLII 11vll I..'lll!; :Jr ll:~i!l.
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~1I0'W ALL EXISTING ANI.> PhJI'USED STHUCTUHES Gl'/:lh' DJJiI'J"'lllf" '1") 'T".. .',
....Ny BOUIES OF \oIATl::R At,D HOAU',,'A'i:i (I1~cLuDrllC -" .'I'IE'(O \ ...~~... (~'I~' II~ I'., ..1.6 ...'i..f,.l ,-, ""
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_7.E, YEfJ{, ".N!') Nl'.!'IE OF :.\IJ:31LE; :';UCll J\~ 1::' ;; (1)'. !',U.. d.L.,j", I.
,\11 "EASENENTS", II
KIGIIT-OF-\IAY" anJ "JLJHI~;l>lCT:t<il\~. 1.11:, .," :: .( .... .j<, ...,
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.:J:.~ BUS/.t(r,r
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~tRIC'" ...~<i>
SUN STATE ALUMINUM, INC.
37528 Hwy. 54 West
ZEPHYRHILLS, FL 33541
(813) 788-7308
CUSTOMER"S ORDER NO.
PHONE
NAME~ ~ .
~\ ')[l( \f\-
M e-(
~D~~.s
~\.
SOLD BY
PAID OUT
- a\ . CXj
CASH
QTY.
ll-.
DESCRIPTION
/ ~ ckJ \'J~~
~ ~~,~
PRICE
~
~ ~ ~.bO~
~";'1~
--
:"1-. '\~...
Interest of 1 "2% per month after 30 days. In
the event It becomes neceSSJry to place th:s
account with an attorney or agency for
collection, I/We agree to pay all costs of
collection, mcludln . easona~le attorney fees
TOTAL
claims and returned goods
T be accompanied by this bill.
PROOUCT 610
~ ~~ CCl1\}
-
AMOUNT
I
I
113:-
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I
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l~\-:I~
I
'17i<[) )
ll~i .\)3
<II-.f
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TAX
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