HomeMy WebLinkAbout93-3626
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N <<?
_ 3626 /J
Date / I - / ?J'- 7. ?
~
Pmpertv Owne' ~ 7fT
Job Address: - ~ '-6.0"3 - .//-
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning: ---D E~,
Description of Work ./1.".1? ~
Radon Gas:
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NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee c: "5...5-' o-D
Sigr'lature ~ ~'::>
Company
Address
T~lephone# q 0'1 - s-3:?- ~J' ~
Valuation or
Contract Price ..:~ 0...5:.--0 I Liv
City License Registration # \.. {')f
State Certified License#
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
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.
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APPLlCAnOIil FOR PERKIT
CIlY OF ZEPBYRIIILLS
BUllDUG DEPAImIEIn"
OWNER'S RAKE
IJ7 If.. &oOd~ 0 n
-It, J
1/ 5 Tr~e..j
PROD <pI 3 ,-,t:?J>- :2 S' I ~
"'Z.. - \-\~ \ \s PL. 3 3 ~-'-f 0
OWlIER'S ADDRESS S-603
JOB ADDRESS .s~ ~c.
LEGAL DESCRIPl'IOII: wr(S)
B.LOCK:'
SUBDIVlSIOII
PARCEL I.D.' /1-.26- 2/-0010--/0300- 0030
'-
WRIt PKOPOSED:_rlew Coost:ruct:ioo ~t:ioo _Alt:erat:ioo --.Jlepair ~Install
S.
- 19J1
_tIove
..lL.ne.olish
PROPOSED USE: X SiDgle Faaily
_"'F _' of Unit:s
_K/B
_ec-ercia1
_Indust:. _Std.. Pool
Other
llestaurant: &: Hea1th De~t: Approval
BUILDDIG SIZE:
x
61.'300
~ Feet:.
Height
KESIDEIITIAL: A1TAaI (2) PIDr PlAIIS &: (2) SETS OF BUIIJ)DIG PIAIIS &: (1) SET EllERGY FORKS. **
COItKERCIAL: A1TAaI (3) SETS OF BUIIJ)DIC PLUS &: (1) SEJ' EIIERGY FORKS. **
**mpy OF mNTRACf REQUIRED.
PEBKITS REQUESTED
XJUD.DDIG
$ 3oS-O.. 00
Valaat:ioo of Tot:al CcxIstruct:ioo
-ELECTRICAL
~CAL
AKP Service
Florida Power Corp.
V.R.E.C.
$
Valuat:ioo of KeclIanica1 Inst:al1at:ioo
~IBG GAS ROOFDIG
SPECIALTY
TYPE OF mIlSTRUCrIOII: ----...Block _~ _St:ee1
Other
FIIIISBED FLOOR ELEVAUOIIS:
fT.
IS PKOJECT III FlOOD ZOIIE AREA!
YES 110
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aD'I'RACIOR SECrIOIi
BIJTTDnl
S ignata.re
~
CO!IPAIIY
St:at:e Cert:. or Regist:. f t( (oJ q SSe
(J.I~ City License Regist:rat:ioo . LC (o~q5S-J #6,'(
******************************************
ELECTRICIAN COIIPOY
St:at:e Cert:. or Regist:. .
SitmAt:ure City License Regist:rat:ion .
******************************************
PUllBER aJIIPAIIY
St:at:e Cert:. or Regist:. I
Sigoat:ure City License Regist:rat:ion .
******************************************
KEalAIlICAL COIIPOY
St:at:e Cert:. or Regist:. .
Sigoat:ure City License Regist:rat:ioo .
******************************************
OT'IIF.R COIIPANY
Stat:e Cert:. or Regist:. .
Signat:ure City License Regist:rat:ioo .
******************************************
APPLICAnOIl AP.nmv1W BY PEIIIIIT OFFICER.
,<'
.
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CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The und~rsigned understa~s that this perlit lay be subject to "deed restrictions" which lay be lore restrictive than City
regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESpdNSIBILITIES
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 owner and contractor lay be
cited for a .isdeleanor 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 advised to contact the City of Zephyrhills Building Departlent (8131
798-6611. '
Further.ore, if the owner has bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for which they will 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 FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien law - HOleOwner's Protection
6uide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is soltone other than the
"owner", 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 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 Dr
installation has cOI.enced 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 develop.ent 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 lilited to:
f DeDartlent of Environlental Requlation - Cypress Bayheads, Wetland Areas and EnviroRlentally Sensitive lands,
Water/Wastewater Treat.ent
t Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t ArlY CorDS of EnQineers - Seawalls, Docks, Navigable Waterways
f DeDartlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US Environlental Protection Aqency - Asbestos abatelent
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 volule" will be sublitted which 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, tr
set aside any provisions of the technical codes, nor shall issuante of a perlit prevent the Building Dfficial fro I thereafter
requiring a correction Df errors in plans, construction, Dr violations of any code. Every perlit issued shall becoae invalid
unless the work authorized by such perlit is cOllented within six lonths of issuance, or if work authorized by the perlit is
suspended Dr abandoned for a period of six lonths after the tile the work is cOllenced. Dne 90 day extension of tile, lay be
allowed for the perlit Mith fee charge of $15.00. The extension shall be requested in .riting to the Building Dfficial. An
approved inspection lUSt be logged during each six lonth period, or the project will be considered abandoned.
WARNIH6 TD OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENCEKENT KAY RESULT IN YOUR PAYIN6 TWICE FOR IMPROYEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COK~MENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF C~NCEKENT".
SIGNATURE: OWNER OR AGENT
slw~f
)
was acknowledged
, 19_ by
STATE OF FLg~
COUNTY OF ~O
The foregoing instrument was acknowledged
before me this (\(\\1 \0 , 19.9.3..... by
\
who did} id not.~~
. ',' ~G}
I<::U" G-- C\. C\. \~)\'
(Name Typed, Printed or Stamped)
NOTARV P~~LIC
..<:i\Xl~
Oil"
o .
. .
cI'~ ~...
'l't OF f\.O'f'
TARA N ALFORD
My Commission CC263392
Expires Mar 09,1997
Huckleberry Associates Ino
800-422-1555
STATE OF FlDRIDA
COUNTY OF
The foregoing instrument
before me this
known to me or who has
who is personally
produced
as identification
take an oath.
and who did/did not
/
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLI C