HomeMy WebLinkAbout94-3854
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
_385~
Date ,.;).- / 'Y ~9 Y
,
GILDIN0
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner: ~ aL
Job Address: 7......8'Sf - /;;t.. ...f'/-
Parcell.D. # I--.......l/ - A 0';;l - .f /~-+/ b
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: ~ Energy Code: .4 Radon Gas:
Description of Wor~ . d"JI ~ ~ ..J- _ ~I
NO OCCUPANCY BEFORE C.O.
FINAL ~~ .-
C.O.
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Permit Fee ~t>, t7f) ~
Signature ~f~~<YI'/p-.c: . k
Company
Address
Telephone# 7 ~ .- c; ? a. b
Valuation or
Contract Price
~ ~.;l y. (}{)
City License Registration #
State Certified License#
~
ELECTRICAL
PLUMBING
MECHANICAL
Ftr. 02/24/94 BILL
Pre SLB 02/24/94 BILL
Lintel ~
FRM. 6-4-q tL-l
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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 ($15.00) 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.
APPLICATION FOR PERMIT
CITY OF ZEPBYRBILLS
BUILDING DEPARTMENT
OWNER'S NAME
,..........
/
. ~
PHONE
;; f-~" &.S-'H d
1::-_.
...)
OWNER'S ADDRESS
JOB ADDRESS
I' j / ~ (
LEGAL DESCRIPTION: LOT(S)
/ !/' :'If : \ /t.- BLOCK '\
SUBDIVISION
PARCEL loD.' / / - ~ Co -J-I
I< ~-;) -.f / J - / h
WORK PROPOSED:~New Construction ____Addition Alteration _Repair _Install
_Sign
Move
Demolish
PROPOSED USE:
Single Family
____M/F
_, of Units
_M/H
Co_ercial
_Indust. ____Swim. Pool
;/-. j .~.f < . Other
.---..
____Restaurant & Health Department Approval
BUILDING SIZE:
1,/" X' ~ / 1.) /
I':;:> ~,
; '?'-; Ii Square Feet,
;' "r,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. **
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. **
**COPY OF CONTRACT REQUIRED.
PERMITS REQUESTED
LBUILDING
ELECTRICAL
$
Valuation of Total Construction
AMP Service
Florida Power Corp.
_W.R.E.C.
MECHANICAL
$
Valuation of Mechanical Installation
PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: Block Frame _Steel
Other
FINISHED FLOOR ELEVATIONS:
F'l' .
IS PROJECT IN FLOOD ZONE AREA?
******************************************
YES NO
CONTRACTOR SECTION
BUILDER
Signature
COMPANY
State Cert. or Regist. ,
:1:2<"" / City License Registration,
******************************************
ELECTRICIAN
COMPANY
State Cert. or Regist. ,
City License Registration'
******************************************
Signature
PLUMBER
COMPANY
State Cert. or Regist. ,
City License Registration ,
******************************************
Signature
MECHANICAL COMPANY
State Cert. or Regist. ,
Signature City License Registration #
******************************************
OTHER fIIt:1.4;(f}V'~) COMPANY (\ -I- f)
./.5!- / V State ceil. or Regist. ,
Signat,ure ~.;?V~.p~~~ City License Registration'
******************************************
APPLICATION APPROVED BY .~!~~ ~~ PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this perlit JaY be subject to 'deed restrictions' wbich lilY be lOre restrictive than City-
regulations. !be undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they JaY 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 lilY be
cited for a lisdl!leallor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirl!lents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Deparblent, (813)
788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections' of this application for wbich 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 wisbes you to sign
as contractor that JaY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of 'Plorida's Construction Lien Law - lReowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is soeone other than the
'owner", I certify that I bave obtained a copy of the above described docUleDt and pro.ise in good faith to deliver it to the
"owner" prior to COlleDCl!ll!llt.
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 COIpliance with all
applicable laws regulating construction, zoning, and land developllent.
Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas CDleDced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developleRt regulations in the jurisdiction. I also
certify that I understand that the regulations of other governJelltal agencies lilY apply to the intended work, and that it is
If responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not luited to:
· Departlent of EnvirollJelltal Regulation - Cypress Baybeads, Wetland Areas and Envirouentally Sensitive Lands,
Water/Wastewater lreablent
* Southwest Plorida Water Managl!l8llt District - Wells, Cypress Baybeacls, Wetland Areas, Altering Watercourses
* ArQ Corps of Engineers - Seawalls, Docks, lavigable Waterways
* Departlent of Health i Rehabilitative Services, Envirouental Health Unit - Wells, Wastewater Ireablent, Septic lanks
* US BnviroDleDtal Protection Agency - Asbestos abatl!lent
I also certify that, if fill Iilterial is to be used in Plood Zone "A" or "A,etc.', it is understood that a drainage plan
addressing a 'cOlpeDsating vol.' will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball 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 authoriled by such perlit is COIIeDced within sillOntbs of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sil IODtbs after the tile the work is co.enced. One 90 day I!Itension of tile, lilY be
allowed for the perlit with fee charge of $15.00. lbe I!Itension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
WARMIIfG TO owm: YOUR FAILURE 10 RECORD A NOIICE OF COIDIDCBIIIN! MAY RESULI IN YOUR PAYING ftlCE FOR DIPROVBMElITS 10 YOUR
PROPERlY. IF YOU IIIEND TO OBlIII PlMAKCIIIG, COIISULI WIIH YOUR LBKDER OR All AnomY BIFORE RECORDIIG YOUR DICE OF
COOIEIICEMEII. JOBS OlDER '2,500 II VALUE 00 NOI IfIED TO RECORD DD POSI A -NOIICE OF COOIDCEIIEMfI.
SIGXAfURB: 0IflIER OR AGm
SIGlIAfURE: COlI!IIACfOR
STAlE OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
SIAfE OF FLORIDA
coum OP
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
I
r
CITY OF ZEPHYRBILLS BUILDING DEPARTMENT
.
OWNER
JOB LOCATION
PARCEL I. D. #
SHOW ALL EXIS".l"IRG & PROPOSED S'l'RUC"I'URES GIVDIG DDlERSIORS & SE"1"BACKS.
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ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAH 30 'DUPLEX
1 0'
FROII'I' PROPERTY LINE
FRONT PROPERTY LINE
I
MUNICIPAL.
COM MIt"RC IAL.
JOHN J. HEDRICK, JR. AND ASSOCIATES
CIVIL ENGINEERS. SURVEYORS
.
P. O. BOX 101515 PHONE 87-2911
TAMPA. FLORIDA
August 27,19.56
Hr. William V. Womack,
P. O. Box 181,
Zephyrhl11s, 11a.
CERTIFICATE OF SURVEY
INoun RIA.L..;.:,...._;;
,; -.: .'--":~ \,~
,1'1,::, .
"
1.
AU(0lst 24--I._195i.., we snrveye<.l the following
CERTIFICA TION is made that on__
described property:
Lots 1.5 and 16 Blade Ro..52, Map of Zephyrh111s, Florida
according to the plat thereof as filed W'irch J.8..-~__jn Plat Book No. 1
on Page No. SS Public Record8-_'_~A1l..C.O._ County, Florida.
There are no encroachments upon this property except as shown hereon.
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