HomeMy WebLinkAbout94-3785
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
378513
I-If-flY
Date
~
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
P<aperty Own.. f4 ?bi:ti/~
JObAddress:_~ ~ ,_ __ ~
Parcell.D. #
Zoning: . Energy Code: Radon Gas:
Deec,;",;on of Wo" %<' ~ ~ ~ t:?A<M < ..;.~
9'0
Water Meter:
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL
1
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
City License Registration # ~
State Certified License#
Signatur
Company
Address
Telephone#
Valuation or
Contract Price ?/9 d), t:T7J
)/;Al~ t2f;/A-YJ
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Ins!.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
InsuJ. 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 ($15.001 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 fUR PERllIT
CI1Y OF ZEPHIICIlI.LI..S
BUllDllIG DEPARllulIlI
OWNER I S IIAItE
C '7--
i..-:- 1/ C',I2.. e "A/'{
I I, '\. "
l (J 'r 0/ tJ
S' A/Y\ e,
1'1
III ;' fire!?):; ~ L j/ ftIOIIE
'n
N (!Ii. L,n i.A/
OWNER I S ADDRESS
S '1.. ~ 'c-. JC?i-f
r (
/
JOB ADDRBSS
LEGAL DESCRIPl'IOJI: I.OI'(S)
~SUBDIVISIOII
PARCEL LD.'
-
WORK PROPOSED:_1Iev Construction ----...Add.ition _Alteration _.Repair _lnst:all
S.
- J.gIl
_lIove
~e.olish
PROPOSED USE:
Single Fam].y
_n/F
_' of Ifnil:s
_niB
_ec-ercial
_Indust.
_Swbl. Pool
Ot:her
-.Jlesl:aur8nt & Rea1t:h Deparment Approva1
BUILDING SIZE:
x
~e Feet.
Height
RESIDENTIAL:
aJItIIERCIAL :
ATrAm (2) PI.OI' PLAIIS & (2) SEIS OF BUlIJJIIIG PUUlS & (1) SKI' ElIERGY fORtIS...
ATrAm (3) SEIS OF BUlIJJIIIG PLANS & (1) SKI' ElIERGY fORKS...
..ropy OF OOlI'IKACI 1UlQU1JUII).
PJI:RIIllS R.EOUESTED
_BUILDING
$
Va1uaUon of Tot:aJ. Construction
--ELECl'RIGAL
AIIP Service
Florida PoIIer Corp.
W.R.E.C.
--1IECllAlUCAL
s
Valuation of nechanica1 lnst:allation
_PLUllBIRG GAS ROOFllIG
SPECIALTY
TYPE OF roNSTRUC'I'IOII: --..Block -Tu.e _Steel
Other
FIIIISBED FLOOR KLEVATlOllS:
FI' .
IS PROJECI' IN FLOOD ZOIlE AREA!
YES NO
..........................................
Blnl.DRR -f/~' / .. _ _
. '~
S1gnature:::-...::l:-..:,. '..' .
aJII'IRACIUIl SECI'IOR
(DIpAllY ,fI--<.f2{';;,~' ,//'/ {, 151 .I ~ /J^-./' .J l-l L (/ /L-t
J.r? I Sl:ate Cert. or Regist.' 1\.J. d o..s .Lf.~ I '-/
{ .-:::- ~_--i &q City License Registration , 7..J
..........................................
1t1.F.:CT'RTCIAR
alllPAIIY
State Cerl:. or Regist. ,
City License Registration ,
..........................................
SiPIIAture
PUllBER
lDIPAlIY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
~IGAL
aJIIPAlIY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
01'IIItR
CUlPAlIY
Sl:ate Cert. or Regist. ,
City License Registration ,
..........................................
Signature
APPLICAnOR APPROVED BY
PERIIIT OFFICER.
COND 1 , J Ut'lr~ UF FEFI'I IT (\FF I LHW I T
() . NQTI.~_~_QE....J)gI:;JLB~J1IJltGJJJJJ,I_rJ
Ih~ "nd~rsigned understands that this p~r.it '~y b~ ~"bject to "d~~d r~strictions" Mhich tay b~ ,ore restrictive than City
regulations. Th~ und~rsigned assutes responsibility for (o~rlian(e "ith any applicable deed restrictions.
Fe . P!>JL I CENSE D ~Qt!IfiO~Jlt!3p.__0ImuCJJUT BDJ~IQn._p.E::F:ir:(Jr~J2I!UbIT:Ll;_9.,
If th~ o"ner has hired a contractor or contractors to underta~e Mork, the, may b~ required to be licensed in accordance "ith
state and local regulations. If the contractor is not lic~nsed as required by la", both the owner and contractor lay be
cited for a .isdeleanor violation under state IaN. If the owner or intended contractor are uncertain as to "hat licensing
require.ents lay apply for the intended work, they are advis~d to contact th~ City of Zephyrhills 8uilding Departtent, 19131
7BB-bb I I.
Further.ore, if the ONner has hired a contractor or contractors, he is advi5~d to have the contractorlsl sign portions of the
"Contractor Sections' of this application for "hich 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 Mishes you to sign
as contractor that tay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
C. Jf3BNr;lPOGTAT I fJ1LI t-1Pfl~LEJ~_I;:_~_ {.)tJl)__J=''':U_bl_L'L_.J;Qt~t!~t;,:...I1JJN.__ FEE9..
O. ~ON~JRUc.;T '!"Q!'!_bLr::::!',L1J.\H (CII()PTER '7 J ~=J. FLOR I D() SlAIUTES ~ ns (WIENDED)
I certify that I, the applicant, have been provided "ith a copy of "Florida's Construction Lien La" ... "oleo"n~r's Protection
Suid~" prepared by the Florida Departlent of Agriculture and C"nSUler Affairs. If the applicant is sOleone other than th~
"o"ner", I c~rtify that I hav~ obtained a copy of the above d~5(ribed do(u~~nt and prolis~ in good faith to d~liver it to thp
"owner" prior to cot.encelent.
F. ~IJNT.RACTQR' Slm'J~E;:B~J:L})fJ=:J..RHYJI.
I certify that all the infor.ation in this applicati~n is accurate and that all "~rk "ill be done in COMpliance with all
applicable la"s regulating construction, loning, and land developMent.
Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no Mork or
installation has co.tenced prior to issuance of a perlit and that all "ork "ill be perforled to .eet standards of all laMs
regulating construction, City c~des, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other governlental agencies lay apply to the intended "ork, and that it is
.y responsibility to identify "hat actions I lust take to be in co'pliance. Such agencies include but are not li.ited to:
I Depart.ent of Environ.ental Requlation - Cypress Bayheads, Wetland Areas and Environtentally Sensitive Lands,
Water/Wast~"at~r TreatMent
, Southwest Florida Water nanaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
, ~r.v Corps of Enqineers - SeaHalls, Docks, Navigable Water"ays
I D.~'p'art,.ent of lIealth L Rehabilitative Services,_EnvironlPntal lIe~lliJ!!I11 - Wells, lIaste"ater Treatlent, Septic Tanks
, ~S Environ_ental Protection Aqenty - Asbestos abateMent
I also certify that, if fill Material is to be used in Fl~od Z~ne "n" or "A,etc.", it is understood that a drainage plan
addressing a .colpensating volu.e' "ill be subMitted "hich is rr~pared by a professional engineer registered in the State ~f
Florida prior to per.it issuance.
A perlit issued shall be construed to be a license to proceed "ith the "ork and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the 8uilding Official frot 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 cOI,enced "ithin six .onths of issuance, or if Mork authorized by the p~r.it is
suspended or abandoned for a period of six .onths after the ti,~ the work is cOI,enced. One 90 day extension of tiMe, lay be
allo"ed for the perlit "ith fee charge of fI5.00. The extension shall be requested in writing to the 8uilding Official. An
approved inspection .ust be logged during each six tonth period, or the project Mill be considered abandoned.
WARNING TO ONNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
PROPERTY. IF YOU INTEND TO 08lAIN FINANCING, CONSULT WIlli YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. J08S UNDER f2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMnENCEMENT'.
~~j~ f?1.d. ~~b"'t f}~L
SISNAJURE: OMNER OR AGENT SIGNATURE: CONTRACTOR
STATE OF flORIDA LtJl
COUNTY OF w.2Co
Ihe fc'rego i ng i trument ",as acknNIl edged
befol'e m this . 19!i.J1- by
~ /~J!
"'I~C. i~ personally knD":;ato me c.r who has
pI oduLed ~..eA o-,.,..,~"f;'$J' ~~ -tJ ~
as ident fication a wlm -d:i:d'/dirJ not
:o',e on 00411-+ ~ ~~
(Stgnatur-e) /tJJ /7 /
<.i t- 4- 0 if:. 'i L, 1..2iA- 5..&__
(Name Typed, Printed Dr Stamped)
NO! ARY p~
-.---- ..... OFFICIAL SEAL
~~, GLADYS L. BUSH
_ \ My Commission Expires
.. : Oct. 7. 1996
""..~' -.bl Comm. No. CC 234022
...~ OF f\.~v..,.
.............
STATE OF FLORIDA ~ ~
l:OUNTY OF (/ t:.L.<:tt50
The foregoing i R.'~trumentwo. acl:nowledged
before me th i s .l /1____ /',/ ~ 19 -U- by
7iu.~LI- /gt~{LL
"Iho is pel:.;ona 11 y kno,,", to me Dr \..,ho has
produced d.. P
as identification d ,,~h~did not
take an oath~/l /1 ~) ./If
. {' t?kJ-o . , /:.i<.~
(Signature) (/1 -
;, u4 Otl <; A. /3 V-...5- "-
(Name Typed~ Pdnted Dr Stamped)
NOTARY PUBLIC
......-.---------- OFFICIAL SEAL
t~ GLAO'lfS L. BUsH
_illy Co. m.mission ExpIres
~ : Oct. 1. 1996
'\~, "...11 Comm. No. CC 234022
~ClF~"
........
THIS AGREEMENT MADE
HERB'S MOBILE HOME
ASSURES THAT THE AI
AND INSTALL cOMPt!f
.0",*,,", ',,'.... ,,'c'
HER B IS... .Mb....'. .' '~.. '~.:'tlOMk AND ALUMINUM SERVICE
3~21\ti~~beth Circle
ZEPHyrf't~, Fl.01UDA 33540
TELEPHO/4~7199 OR (904) ~;y,; d<v~/
}iL'::.~
ALL MATERIALS REM
PAID FOR IN FULL. ..A. '. ..
WITH CONTRACTOR I3Etmtl!'f ". .'
JOB BECOMES PROPER. f.f:J!.,~. J........tm..........'...."
BE RESPONSIBLE FOR An:x-;J!'>i
ACCIDENTS OR O'1'HI l' 'ff HIS REASONABLE CONTROL.
THIS SHALL CONSTt1'U f'!!tbNTRACT. ANY WORK OTHER THAN
SPECIFIED ABOVE SHAfi< . ...fAAOVI!l 'rH~ CONTRACT PRICE.
WE PROPOSE HEREDY.;"';. !If't MAI1'Ettl:AL AND LABOR COMPLETE
ACCORDANCE WITH Tltlr:.'~IOVi!1r'~E'Ctt!CATIONS, FOR THE SUM OF
. ..:.! c'. . ,~, k,t.: . ". ..' JJ~ OLLARS $ f 92. 90
THE HOMEOWNER AS . '.;.11I BUILDING PERMI; $ fUtt<<:__
PAYMENT TO BE MAD~ J"~1!I.bow>>f'..z4',16-
WITH BALANCE TO t3! ~~M~ttT:tON OF WORK $ 246, 4.5---
ACCEPTANCE OF CON' . :tl!~Vi: PRICES, SPECIFICATIONS'
:~~ ~~~~~~i~:~ ~~~. "Jf1i'('!I~gCt:~E~~R~:~M~~iE~i~~. BE YOU
MADE AS OUTLINED A 'tIAStREAD THIS CONTRACT OVER
CAREFULLY. . .','
I.'
<....
... <>
~t':-,..: ' .
SIGNATURE
'~)...."
';~:;;11
SIGNATURE
SITE PLAN
(RESIDENTIAL USE ONLY)
PARCEL J.D.
SEe
T'WP
RNG
SUBD
BLOCK
LOT
"
...--
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,/
,-t-- .,."
~ /'
PROPEHTY MEASUREMENT
/,~~_."('-, '
.,
/.
CURRENT OWNEHS
All drawings sball be drawn to scale for all parcels or lots five acres or less.
DATE
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SHOW ALL EXISTING AND PROPOSED STRUCTURES GIVING DIMENSIONS AND SETBACKS. ALSO, INDICATE
ANY BODIES Of WATER AND ROADWAYS (INCLUDING NAMES) ADJACENT TO THE PHOPEHTY. INDICATE
THE SIZE1 YEAR, ~~D N~~E OF MOBILE; SUCH AS 12' x 60". 1981. FLEETwOOD.
All IlEASEMENTSIl, IlRIGHT-Of-WAYIl and IlJURISDICTIONAL LINESIl must be shown on all site plans.
DO NOT ENCROACH INTO ANY EASEMENT WITH A STRUCTURE
HOUSE CONSTRUCTION
SCALf:: 1-. eo'
PROPOSED ADDITION
'GALC: .-. .0'
MOBILE HOME SETUP
'tAL[: .-. 10'
roor 160rl.1
loJ
::I
..
z
~ 7,~'
o
II:
-
oJ
I~ .
20' . 10'
32.0' odd,
~ -
0 0
Q E.,.llnv 7.ll' ~
. Hou.. .
... ...,
;:; -
20'
P/L
ROAD NAME
!l0' 40'
o
'"
..,
.
!
E.o<I.,,"V
Shod
Hc.u..
7,.5' ~
.
..,
.
20'
~O'
ROAD NAME
ROAD NAME
silepl:lll:ce