HomeMy WebLinkAbout94-3846
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
_ 3846S
Date ~-/O- py
1(0.07/
BUILDING
~tro
ELECTRICAL
~-:&7"D
PLUMBING
0U1- crv
MECHANICAL
Sewer Conn
PmpertyQwne, ~~
Job Address: .3 r t:J G- . ~
Parcell.D. # /~-fJ.-6 -~/ - 0/ b 0 ~ 0 c:J Q 0'-
Water Meter:
1/cJ"lJ. ~.
~~~trD
/6-.5--' tJi)
- J _ 9YoJ.tJlJ
,
Water Conn:
T.I.F.'s:
o =>...3 D
Zoning:
Description of Work
Energy COd~
>1l d~
e.
Radon Gas:
~r-~
NO OCCUPANCY BEFORE C.O.
c.o.
Complete Plans, Specifications and Fee Must Accompany Application.
C?'. S~~':;3;~~;:~::~es and Q,d;nances. Inspector
~)u~ I or p~rmit~,e'3 O. trU/
Con ct Price Slgnatu ~_
Compa
City License Registration # ~6 Address
State Certified License# Telephone#
DATE
/S
Ji.; !?~(2$,~
YML..- sr
ELECTRICAL
I!J4-Arp?r-~
PLUMBING / o~
/?,J-A,d 7d~v *;(:
MECHANICAL 7~
BUILDING
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 ($15.001 shall be made for each trip for each trade:
a.
b.
c.
d.
e.
f.
g.
Wrong Address
Condemned work resulting from faulty construction.
Repairs or corrections not made when inspection called.
Work not ready for inspection when called.
Permit not posted on job site.
Plans not at job site.
Work not accessible.
7J..fl" ~ -/o~9'1
p j ;L -c7Y- 9,/
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERKIT
CITY OF ZEPIIY.RIIII.LS
BUlLDTIiG DEPAR'IIfENT
OWNER' S MAKE
CL /h L7L
38018
3801 B
;:a OUJf:/t. mrJ1..J
LAWAIJIJA LCJt:) p.
LAwJ'W1J14 ~oP.
PIlOSE % 782~2-Z-7{'
OWNER' S ADDRESS
JOB ADDRESS
" U,.(J/ff'"4. #t a5/ rU4-
,
LEGAL DESCRIPl'IOlM: LOT(S)
BI..OCK
SUBDIVISION
PARCEL LD.' I~-;z.~ -.:2/ - 6 I~ (') -0000 0 ~ Cl2-~.O
WORK PROPOSED:~5ew Construction _Addition _Alteration _Repair _Install
_Sign
_I!fove
_Deaolish
PROPOSED USE:
Single Faaily
_KIF
_, of Units
*-K/H
_~rcial
_Indost.
_S~. Pool
Other
_Restaurant &: Hea1th >>epan:.ent Approval
BUILDING SIZE: S.:f X ZB .
Square Feet.
Height
RESIDEIiTIAL :
COItftERCIAL :
AtTACH (2) PLOI' PLAWS &: (2) SEI'S OF BUll.DIMG PLANS &: (1) SET ENERGY FORKS. u
ATI'AaJ (3) SEI'S OF BUII.DTIiG PLANS &: (1) SET ENERGY FORKS."''''
......COpy OF CONTRACT KIlQ1lJIRED.
PEHI!IITS REOUESTED
V'" BUILDING
r ELECTRICAL
~ MECHANICAL
i/ PLUHBING
$
~ ,J , eJO
7;
Valuation of Tot:a1 Construction
/6tJ
AtIP Serwice
_ .~ _~Florida Power Corp.
W.R.E.C.
$
I~o
Valuation of Mechanical Installation
GAS
KOOFDlG
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Pralle _Steel
j)1tJ. #o~
Other
FINISHED FLOOR ELEVATIOBS:
FI' .
IS PROJECT DI FLOOD ZONE AREA? ~
YES NO
..................................******..................................................................
aJlIil'I'RACI'OR SECTION
BIJTUlER
~-~
.
COI!tPANY Hill. J~~ ~ ~
State Cert:. or Regist:. #
Cit::y License Registration ,
........................*....**............~........................................................................
Signat::ure
a~~
ELECTRICIAB .~.. .~ COI!tPARY ~,; j.../. JOILAXh--J e:z.e01lf./'t.-
. '. :J<<~~tate Cert:. or Regist. ,
Si.....<ure!".i"1UUl&- ~h~ ~City License Registration I 3s'
~ .. .......***...........***.*.........................................................
COI!tPARY AI /2$ BtJ ~ /k-,.,J
St:ate Cert. or Regist:. ,
~ii:::1" Licem;;e Registl.'3Lion I /08
.................................*........**........................................................*.........
1IEaWII~~~4~4-
PlHlBER ~
Signature ';()i - # J .
,
Signature ~l}l-illS 1'~/)/t1-l' 4',4.:>.14<.-.
mlItPANY ~ I}lf M ~ ILl ~ /h..I';.. G;-/) ~
State Cert. or Regist. I
Cit::y License Registration I
............................**..**....*...................................................
-- A-<-
7~
O'T'IIRR COI!tPMY
State Cert. or Regist. ,
Signature City License Registration ,
........................*.*........*..................................*..............*............
APPLICATION APPROVED 'BY PERKIT OFFICER.
;;>-.
,
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands 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 RESPONSIBILITIES
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 i~, not licensed as required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state law. If the owner Dr intended contract9r are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised'to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired 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
Guide. prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone 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 ~one 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 cOllenced 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 developlent 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 Departlent of Environlental ReQulation - Cypress Bayheads, Metland Areas and Environlentally Sensitive Lands,
Water/Wastewater Treatlent
f Southwest Florida Water "anaQelent District - Wells, Cypress,Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
f US Environlental Protection AQency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone .A. Dr .A,etc,., it is understood that a drainage plan
addressing a .colpensating voluae. 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, 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, or violations of any code, Every perlit issued shall becole invalid
unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the per.it is
suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of tile, lay be
allowed for the perlit 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 .onth period, Dr the project will be considered abandoned.
IIARNIN1i TO'OIlNER: YOUR FAILURE TO RECORD A NOTICE OF (oHHENCEHENT HAY RESULT IN YOUR PAYING TI/ICE FOR IHPRoVEHENTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT \11TH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COHHENCEHENT. JOBS 'UNDER $2,50 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICt OF COMHENctHENT..
CV < '-oJ /? --
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
, ......\:.
Ah~LS r;JJ K Y ~ /1-,.)
who is p'ersc.nall y known to 'mel<lr Hi,L' I,a!r"
p,odu.:::ect
a~ ieentifiE3ti~n-and who ~did not
ta~~~ . ~1-H-J
(S;cnaturel Jf
A 77-1 LFEJJ ..;;r. l3 f< Izt )JJ
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
STATE OF FLORIDA
COUNTY OF P-1l.$C' 0
The foregoing instrument was acknowledged
before me th i 5 ~1JIUILIH2Y ..2)', 19--:J.!L by
AI C=:-L. So A.J 7? Y M A Ai
who is pel-sonally known to me Eo-!'" ~,h~ Rd3
fir educed
.. i~Qr~;.;-~~;~~ and who-e+e/did n~t
STATE OF FLORIDA
COUNTY OF /Jab e tJ
The foregoing instrument was acknowledged
before me th i s J}l1-Ju.A-et/ rti, 19.!l.!L by
take~ath- fJ ~
1: .IL~A,J . ~ ~
(Signature)
k JJ.Tl-II Fe A) J. f$~l..j
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
KATHLEEN J. BROWN
State of Fl/)'
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A::lcrw'\"ledgeme.!H he luw ;j()e~ n(.( Imp!y ac..\:pLili(e uf coacurrence, but simpiy receipt of a copy of thIS form, pl.'Ulg the buildmg permit
. I;;: ,,"pll,," 0, I.:' ,,:';.",1...;';,",;' ,u;J ~t . r" , >C~, of payment for sam~,
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