HomeMy WebLinkAbout94-3775
BUILDING PERMIT
Permit N~
CITY OF ZEPHYRHILLS
(813) 788-6611
3775g
J-J)-9Y
Date
~~ ELECTRICAL PLUMBING MECHANICAL
Pmpe"v Own..~ g ~:o~
Job Address: ,~7_ __ ~
Parcell.D. # /J- ;J..6-c!)j- C) O//J - oS 3' 00 - CJ /3 (J
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: ~nergy Code:
Description of Work ~ 4. U A if R
Radon Gas:
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.
Inspector
Permit Fee
Signature
Company
Address
Telephone#
I; 7. ,s-v
~ . =z.
..... - --... -
---
Valuation or
Contract Price
:2 .y tJ7J ~ t/D
./
City License Registration #
State Certified License#
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB 01/20/94 BlB
Lintel 1-~IJ'1lf ~
FRM. - -qi LL
Insul. CL
WL
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
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.
/-/o-?y
APPLlCAnOll fOR PERllIT
CITY OF ZEPIIYRIlILLS
BUII.DllIG DEPARIIIIlXI'
OWRER'S IWtE ~a.. V\ J .~() N\4-0
OWRER'S ADDRESS SIO b q tS S-\~
78"> a I S u
PIIOIIE - '(., . I .,..
7 h"\l,
L_ "......
JOB ADDRESS
,S 1-\ rl\ e.....
LEGAL DESCRIPl'IOII: I.OI'(S) \"~, \4, ~ (~ AUla( 5-5'"- SUBDIVISIOR (:1' 'lOP 2-k.1I s:
PARCEL LD.' f ( 2 ~ 2 'OC f ooSSOOo ; '3 t)
-
WRIt. PROPOSED:+-.lIew Consl:rucl:ion ~I:ion _All:eral:ion _____epair _Install
S'
- 19I1
_Move
_Oe.olish
PROPOSED USE:
Single F_ily
_"'F
_' of Ifnit::s
_"/B
f.?A fZ.A <0 f=- Other
_~rcial
_Indusl:.
_Swi..-. Pool
RpStauranl: & Hea1th Deparment Approval
( /
Z 'z -TJ
X I' ,-. ,
484
~e Feet,
8'
Height
BUILDING SIZE:
RESIDENTIAL: ATrAaI (2) PLOT PLAIIS & (2) SEI'S OF BUIIJ)IlfG PLAIIS & (1) SEI' ERERCY fORKS...
cotItIERCIAL: ATrAaI (3) SEI'S OF AUD.D.IIIG PLAIIS & (1) SKI' ERERGY fORIIS...
..COPr OF COllIKAcr RllQUI.RIlD.
PJr.RJIITS REQUESTED
bUILDING
$
'240
I 0
Valual:ion of Total Construcl:ion
F.1.F.Cl1UCAL
NIP Service
Florida Power Corp.
W.R.E.C.
--1tECllANICAL
s
Valual:ion of lIechanica1 Installation
_PLuttBING GAS ROOFING
TYPE OF OONSmUC'l'IOII: -block. ~~ _Steel
SPECIALTY
Other
FINISHED FLOOR ELEVAnOllS:
FI'.
IS PROJEcr IN FLOOD :milE AREA'! K
YES NO
..........................................
BUII.Dn
aJJIDIACIUR SECl'I.OII
CDlPAIIIY Ow tJ -Q., r
State Cert. or Regist. ,
City License Registratioo. t
..........................................
()~
Signature (::r),A~ ct::.--------
F.I.RCTRT 1:1 AN CUlPAIIY
State Cerl:. or Regisl:. ,
Si....Al:ure City License Registration ,
..........................................
PIDlBER. aJIIPAIIY
Stal:e Cerl:. or Regist. ,
Signature City License Registration ,
..........................................
IlEalAllICAL aJIIPAIIIY
State Cert. or Regist. t
Signature City License Registration t
..........................................
O'T1IRR aJIIPAIIY
Stat.e Cert.. or Regist.. .
Signature City License Registral:ion ,
..........................................
APPLICAnOIl APPIlOVED BY PERllIT OFFICER.
COND 1 'J uns UF F'EHI'II T (~FF I D(W IT
(). NlJIt~_E;:__QE._._pg~!LB~~'rE~.JJ':JJJJ.I\I!::; ,
Ihe undersigned understands that this per.it lay be ~ubject to "deed restrictions" Hhich lay be lore restrictive than City
fegulations. Ihe undersigned as~u.es responsibility fDr (o~pliance Hith any applicable deed restrictions.
Fl. U!-JL I G.p.JSE,!>.. CQN.IHm:~'U:m.!:;.,J)IJl)H t;PI:-JTBDGJ[)ll.I3E::E:;e(JH~.!JUbITtE;,S;.
If the o"ner has hired a contractor or contractors to underta~p Mork, they may be required to be licensed in accordance Mith
state and local regulations. If the contractor is not licensed as required by la", both the o"ner and contractor lay be
cited for a lisdeleanor violation under state laM. If the owner or intended contractor are uncertain as to "hat licensing
reQuire.ents lay apply for the intended "ork, they are ad~ised to contact the City of Zephyrhills Building Depart.ent, 18131
788-6611.
FUfther~ore, if the o"ner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
.Contractor Sections" of this application for "hich they Hill be responsible. If you, as the o"ner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the "ork. If the contractor "ishes 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 tephyrhills.
\; . rDAN!?PORTAT I DILl nPA~L.f_E;J~.~_l:ltjQ,JJ.I..tl.-I.ILn..I.::91~.t'-~~IJQtL...fEE,!2,
n. ~ON!?rRUGTION_1",..u::IL1--'.tH (CllflF'n::,n 7j~=J~ FLIJF<UH'. ST(nUTES~ ()S (WIENDEUI
I certify that I, the applicant, have been provided "ith a copy of "Florida's Construction Lien La" - HOleo"ner's Protection
Guide" prepared by the Florida Departlent of Agriculture and [onsu.er Affairs. If the applicant is sOleone other than the
"oHuef". I cprtify that I have obtained a copy of the ahove described docu~ent aud promise in good faith to deliver it to thp
"oMner" prior to cOllencelent.
F . ~(JtH:.R()CTQR I s/m'J!jf:;B_~J:;L.EEE!..PH'v'J.I.
J certify that all the inforlation in this application is accurate and that. all "ork will be done in cOlpliance with all
applicable la"s regulating construction, loning, and land develop.ent.
Application is hereby lade to obtain a perlit to do Murk and installation a~ indicated. I certify that no "ork or
installation has cOI.enced prior to issuance of a per~it and that all work "ill be perforled to leet standards of all la"s
regulating construction, City codes, loning regulations, and land development regulations in the jurisdiction. I also
cprtify that I understand that the regulations of other govern,ental agencies lay apply to the intended "ork, and that it is
"Y responsibility to identify Hhat actions I .ust take to be in co.pliance. Such agencies include but are not Ii.ited to:
· Departlent of Environlental Requlation - Cypress Bayheads, Wetland Areas and Environ,entally Sensitive Lands,
Water/Wastewater Treat~ent
, South"est Florida Nater nanaqe,ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
, flr.y Corps of Enqineers - Sea"alls, Docks, Navigable Water"ays
· ~~p'~~ent of Health & Rehabilitative Servi~~~vir~~ental lIe~~.~t - Wells, Wastewater Treatlent, Septic lanks
· US Environ.ental Protection Aqency - Asbestos abatelent
I also certify that, if fill lIlaterial is to be used in Flood lone "A" or "A,etc.", it is understood that a drainage plan
addressing a "co"pensating volule. "ill be sublitted "hich is prepared by a professional engineer registered in the State of
FIDrida prior to per.it issuance.
A per.it issued shall be construed to be a license to proceed "ith the "ork 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 fro. thereafter
requiring a correction of errors in plans, construction, Dr violations of any code. Every perlit issued shall becollle invalid
unless the "ork authorized by such per-it is co",enced "ithin si~ lIlonths of issuance, Dr if work authorized by the perlit is
suspended or abandoned for a period of six lonths after the tile the "ork is co..enced. One 90 day extension of ti.e, lay be
allowed for the perlit "ith fee charge of tI5.00. The extension shall be requested in "riting to the Building Official. An
approved inspection lust be logged during each six lonth period, or the project "ill be considered abandoned.
WARNINS TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PRUPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATIORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEnENT".
~l3~~~~
SIGNATURE: OWNER OR AGENT
-_._._--
SIGNATURE: CONTRACTOR
STATE OF FLORIDA
WUN JY OF
Tile foregoing instrument
hefof'e me this
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument
befDre me this
\o'las acknc'\o'lledged
, 19_ by
"IIID is per SDna 11 y l:no,,"1ll to me Ctl- whD has
pl-oduced
as identification and who did/did not
take an oath.
who is persDnally known to me or whD has
pt-odLlced
as identification and I-'Iho did/did not
take an oath.
(SignatLn-e)
(SignatLll-p)
(Name Typed, Printed Dr Stamped)
NUl ARY PUBLIC
(Name Typed, Printed Dr Stamped)
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