HomeMy WebLinkAbout94-3798
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Property Owner:..e.tO ~
Job Add'." A ~ ~~.) )( i/ PJJ r
Parcell.D, #
BUILI:?!t:~9Hy~!RM!! N~ .37986
(813) 788-6611 Date /- ,;}~- 94
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: C. Code: ;;t Rado~.J'Gj: ,
De'C';~~t~~~ ~;;;I~~]Ja~~~~j,c>
~~_ Z- a
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
V I' ~ tlO
a uatlon o~ 4 .1/ SD' -
Contract Price , .
Permit Fee
Signature~
Company
Address
Telephone#/'
'7 :10 ~ tf?7;?
,
AL
PLU
MECH
L
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.
APPLICA.nOll FUR PERKlT
GI'IY OF ZEPIIYRIllLLS
BUII.DlliG DEPARlluulI
~o ])rYlJ/n~
IC~ ~ 1%
~C; /(0 /y , / /t2w
LEGAL D&<<iCRIPl'IOII: UJI'(S) ~SUBDIVI.SIOII
OWNER · S RAIlE
PROD
73tJ - /l if9
OWNER' S ADDRESS
JOB ADDRESS
7<V H;rL
J
PARCEL I.D.' /
WORK ~POSED:~ Construction
_Sign
_Addition ----Alteration ____..Repair _Install
_Move
_ne.ol.ish
PROPOSED USE: , .../ Single F_ily
_ft/F
_' of Units
-----1118
_~rcial
_Indust.
_Swbl. Pool.
Other
BUILDING SIZE:
____..Restaurant &- Hea1.th Deparment Approval
,5 (D f
J 0 x3 ( .
,
Square Feet.
/ '(0 '(
Height
RESIDENTIAL:
cotIIIERCIAL :
A1TAaI (2) PI.OI' PLAIIS &- (2) SKIS OF BUll.DIRG PLAIIS &- (I) SEt' ElIERGY FORIIS...
A1TAaI (3) SKIS OF BUII.DIIIG PLAIIS &- (1) SEt' ElIIIRGY fURIIS...
..mpy OF mll'J"KAGr 1UlQU1JUID.
,.
/
/
J"BUlLDING
t - 0::'--- PIlIIIIt]li IlIlIIIIJl.~J'llII
J !JU - Valuation of Total
(
Construction
$
_ELECTIUCAL
Aftp Service
Fl.orida Power Corp.
W.R.E.C.
----.J[ECIIARlCAL
$
Valuation of ftechanica1 Installation
-PLUllBIBG GAS ROOFIBG
SPECIALTY
TYPE OF mNSTRUC'I'IOB: ---..Bl.oclt -.Fo.e _Steel.
Other
FINISHED FLOOR ELEVATIOIIS:
FI' .
IS PROJEGr IN FLOOD :milE AREAT
YES NO
..........................................
BUTT.DER
WDRACIOR SECI'IOR
lDIPMY ~~Ar:~ ;jIJrnm rlfV/
State Cert. or Regist. . ~~) c.J3C-oc9~t' 717
City License Registration t c2 g' P
.............................
Signature
RI.RCTRTCIAB
aJIIPAIIY
State Cerl:. or Regist. f
City License Registration .
..........................................
SiDDAture
PIJIIIRItR
aJIIPMY
State Cert. or Regist. t
City License Registration t
..........................................
Signature
fIItaIAJIICAL
aJIIPMY
State Cert. or Regist. t
City License Registration .
..........................................
Signature
OTRIlR
CDlPABY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
APPLlCAnOB APPROVED BY
PElUllT OFFICER.
COND 1 'I tiNS UF PEnN I T (\FF I D/W I T
() . I"QII.~t;:-_QE.,._Q~~P__.B~t?IRAt:;.J..!..lJ.N.E3
The undersigned understands that this perlit lay be ~"bject to "deed restrictions" Khich lay be .ore restrictive thanCily
regulations. The undersigned assu.es responsibility for co~pliance Kith any applicable deed restrictions.
Fe. lJNL lJ';;J;.Nt?E-.ILJ~;mflf'lfl.t:;TJJB9u.ol.mu f;9NIHf)C_'QfL.Por:::f:lF:PHJ?I!Ul""ITtr;.9..
If the OHner has hired a contractor or contractors to uuderta~e work, they may be required to be licensed in accordance Kith
state and local regulations. If the contractor is not licensed as required by laM, both the owner and contractor .ay be
cited for a .isde,eanor violation under state laK. If the OKner Dr intended contractor are uncertain as to Khat licensing
require.ents lay apply for the intended "or~, they are ad~ised to contact the City of lephyrhills Building Depart.ent, lB13'
7BB-bblJ.
Further~ore, if the OHner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the
"Contractor Sections" of this application for Hhich 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 Kor~. If the contractor wishes you to sign
as contractor that .ay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the
City of lephyrhilIs.
l:. JJ3ANSPO~TAT I OIJ J t.IPt4~LEI;.t;:JJ_l:!IJl!.,_IJIJ'=-tD'~j':;lJHtlJ~_~LtQtt"..FEE,9.,
D. (:~,UI\ISTRUGnQN_l.::JEtL1--'}H (C"nPIEn '7 j ~=l. FLUn I IH) STATUTES. ()S I)NHWED)
I certify that I, the applicant, have been provided Kith a copy of "Florida's Construction Lien La" - 1I0leo"ner's Protection
Guide" prepared by the Florida Depart~ent of Agriculture and [onsuler Affairs. If the applicant is sOleone other than the
"oKner"~ I certify that I have obtained a copy of the above described docu~ent and pro~ise in good faith to deliver it to the
"oKnpr" prior to cO'lence.ent.
F . t;lli_iTnr~.rQR_'-B.LPt'Jt!~B.-'-_~_.,DE_F_!..R()\l).I.
I certify that all the infor.ation in this applicatiun is accurate and that all Murk Kill be done in cOlpliance with all
applicable laKs regulating cunstruction, zoning, and land develop.ent.
Application is hereby lade to obtain a per.it to do "or. and installatiun as indicated. I certify that no "ork ur
installatiun has co.,enced prior to issuance of a per.it and that all "ork "ill be perfor.ed to leet standards of all la"s
regulating construction, City cudes, loning re~lIlatiuns, and land develop.ent regulations in the jurisdiction, I also
cprtify that I understand that the regulations of other goyprn~ental agencies .ay apply to the intended work, and that it is
.y responsibility to identify "hat actions I IlIst take to be in cOlpliance. Such agencies include but are not li.ited to:
· Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Hetland Areas and Environlentally Sensitive Lands,
Uater/WasteKater TreatMent
, Southwest Florida Water nanaqelent District - Hells, Cypress Bayheads, Hetland Areas, Altering Watercourses
, ~r.v Corps of Enqineers - Sea"alls, Docks~ Navigable Waterways
, ~epart.ent of Health & Rehabilitative Services, Environlental "ealth Unit - Wells, HasteKater Treat,ent, Septic Tanks
, US Environ.ental Protection Aqency - Asbestos abate.ent
I also certify that, if fill .aterial is to be used in Flood lone "A" Dr "A,etc.", it is understood that a drainage plan
addressing a "co.pensating volule' "ill be sub.itted "hich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A per.it issued shall be construed to be a license to proceed Kith the Hork and not as authority to violate, cancel alter, Dr
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, Dr violations of any code. Every per.it issued shall beco.e invalid
unless the "or. authorized by such per.it is co..enced within six lonths of issuance, Dr if "or. authorized by the perlit is
suspended Dr abandoned for a period of six .onths after the tile the "ork is co..enced. One 90 day extension of tile, lay be
alloNed for the per.it "ith fee charge of '15.00. The extension shall be requested in writing to the Building Official. An
approved inspection .ust be logged during each sin lonth period, or the project "ill be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
PRUPERTY. IF YOU INTEND TO OBlAI" FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. 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
COIJNTY OF
The foregoing instnlment
before me this
If/as ackmmledged
, 19_ by
STATE OF FLORIDA
[DUPlTY OF
The foregoing instrument
befcore me this
was acknowledged
~ 19_ by
IIlho is persoTl.:llly kno...m to me or Nho h.:ls
pl'oduced
as identification .:lnd who did/did ,mt
t.:lke .:In o.:lth.
who is personally known to me or who has
pl-oduced
as identification .:lnd who did/did not
telke .:In o.:lth.
(Signahwe)
(SignatUl-p)
(Name Typed~ Printed Dr Stamped)
tl.QLllliY PUBLJ C
(Name Typed~ Printed or Stamped)
NQ.IAR'LfJJJlL I C
'. CI~F ZEPlfYRBILLS BUILDING. DBPARftCElft"
OWNER L;:' (7 ''fJfl~ Vi:) ,^
JOB LOCATION /_ -;; L'///?'(ff!!-o !JcrA) f?)) L
PARC;;EL I. D. #
SHOW ALL EIIS"1"IIIG Ii PROPOSED S'!'RUCftJRBS GIVDIG DDlBHSIOIIS Ii SB'l'BACKS.
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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PROP*TY
--.....
UTILITY BUILDINGS
HUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT
LINE
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
~1L'" f .i;,.!,
e'~ ):. '
20'
:,I,!:::
10'
10' EXISTING 10'
PROPOSED
1 'J I
" '20 ' SGL FAM 30 'DUPLEX
','.
1 0'
10'
P E
R X
o I
10 IPS
o T
S I
E N
D G
10'
1 0'
FROIlr PROPBR"rY LIIiB
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