HomeMy WebLinkAbout94-3913
BUILDING PERMIT
,
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N ~
39138
Date J - /b -'?Y
~ ELECTRICAL PLUMBING MECHANICAL
::~::,~s:~ ~1~j;-;/i~~'l~~
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning: Energy Code:
Description of wor~
Radon Gas:
~--'-~//
~/
~~
y/
h /1
FINAL
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration #
State Certified License#
/r
.
Inspector
Valuation or
Contract Price
Permit Fee
pert} - ~
~
Telephone#
ELECTRICAL
PLUMBING
MECHANICAL
p. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
FRM.
Insul. CL
WL
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 ZEPHYRHILLS
BUILDING DEPARTMENT
APPLICANT
t.)\\\ \0 ~ \ Q.c...\.. \\r\-
ADDRESS ~~~ (jc...\.\... ~\~d:tt~ 2~\\\~ PHON
OWNER 't-6~ N~" t.\.U 'fv0't.d\ ~G\. '(\,\~ 'Q<:tl' \- W 't i S~~ V
JOB LOCATION :s'\~~ -::{\8D1.. ~..~\ "V\tT tt,LOT SIZE
x
AREA SQ. FT.
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL I.D.t~ ~~-~S-~I-O(JOD -DOJO() -oOot)
WORK PROPOSED:~New Construction ----Addition ----Alteration ----Repair ____Install
____Sign/Temp. ____Sign ----Hove ____Demolish
PROPOSED USE: ____Single Family
...)L.commercial
--.M/F
____t~ of Units
.--.M/H
____Indust.
____Swim. Pool
Other
~estaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUlRED.
PERMITS REOUESTED
____BUILDING
$
Valuation of Total Construction
____ELECTRICAL
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: FT.
******************************************
CONTRACTOR SECTION 0 d ~ ('1 C+ 10 V\
Company ~~ ~ ~u , \.....0 ' - ,"",,'
State Cert. or Regist~ C Ci lOct:U
ty License Registration #
******************************************
Signatu
ELECTRTCTAN
Company
State Cert. or Regist. #
City License Registration #
******************************************
Sillnature
*******
MECHANICAL Company
State Cert. or Regist. #
Signature City License Registration #
******************************************
OTHER . Company
State Cert. or Regist. #
Signature City License Registration #
APPLICATION APPROVED BY PERMIT OFFICER.
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A. NOTICE OF DEED RESTRICTIONS .
T~e undersigned understands that this perlit lay b~ subSect to 'deed restrictions' which lay be lor. restrictive than Citr ,-
regulations. The undersigned assules responsibility for cOlpliance with any applicable d~ed 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 is not licensed as required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelenb lay apply fDr the intended work, they are advised to contact the City of 2ephyrhil1s Building Departlent, (8m
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(~) 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 wish~s 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.
I'
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 la. ~ HOleowner's Protection
Guide' prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
'olner', I certify that I have obtained a copy of the above described doculent and prolis~ 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 done 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 lork or
installation has cOltenced 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:
I Departlent of Environlental Requlation - Cypress Bayheads, Wetland Areas and Environlentally Sensitiv~ lands,
Water/Wastewater Treatlent
I Southwest Florida Nater "anaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
I ArlY Corps of Enqineers - Seawalls, Docks, Navigable Naterways '
I Departlent of Health & Rehabilitative Services. Environlental Health Unit - Neils, Wastewater Treatl~nt, Septic Tanks
I US Environlental Protection Aqency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood Zone 'A' or 'A,etc,', it is understood that a drainage plan
addressing a 'colpensating volule' 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, or
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 perlit is
suspended Dr abandoned. for a period of six lonths after the tite the Mork is cOllenced. One 90 day extension of tile, lay be
allowed for the perlit with fee charge of tI5.00. The extension shall be requested in writing to the Building Official, An
approved inspection lust be logged during each six lonth period, or the project will be considered abandoned.
WARNING TO OWNER: . YOUR FAILURE TO RECORD A NOTICE OF COK~NC8KENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROYE~NTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT NITH YOUR LENDER OR AN ATTORNEY BEFORE IN YOUR NOTICE OF
COK NCE"ENT. JOBS UNDER $2,50 E DO NOT NEED TO RECORD A D POST A 'NOTICE OF COK"E CE"ENT'.
SIGNATURE: CONTRACTOR
STATE OF FLORIDA ~
COUNTY OF \-'a..~~ D
The foregoing instrument was acknowledged
before me this ~~ \ ,19.:11. by
tr,-,
who is pe e or who has
produced
as identification and who . Idid n
take a~~"\F~~ _
(Signat~~ '-S~ \-'\ i\-c~
(Name Typed, ~nted or stampe~
NOTARY PUBLIC' .
STATE OF FLORIDA (\
CDUHTY OF V c.....5. ~ ~
The foregoing i~t!ument was ac~.npwledged
before me this ~ \ , 19~ by
who i. ~~~~ ~;}~';'~ha.
produced
as identification and who ld not
take an th
-s
(Signatur~~\:\:. 'SEo..~ <\-~ fO~ \
(Name Typed, pri~ed or Stamped)
NOTARY PUBLIC
.........., BETTY JEAN TIPTON
~.~
(.!rA}.:i MY COMMIS8ION' CC 23lI547
~ . EXPIAE8: 0aIDber 8. 1.
"" IIandId 11lIu NaIIry PuIlIc IblIlWIIn
BETTY JEAN TIPTON
MY COMMIS8ION , CC 23lI547
EXPIIB: 0ctaIIIr 8. 1.
80ndId 11lIlI NlIllIY PuIlIc tbIIIWI\IIII
'!'
ENGINEERING DESIGN
JOB NUMBER
610
DATE
2/15/94
JOB NAME
"FENCE" WALL DESIGN FOR
TOWNVIEW MEDICAL ARTS
DESCRIPTION
LOT 2 - PHASE 2
ZEPHYRHILLS, FL
CONTRACTOR
TOWSON-ROGERS ENGINEERING, INC.
DESIGNED BY
RICHARD L. KIDDEY, P.E.
4
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7 '
ABKAY ENGINEERING, INc.
structural engineers
5514 7th Street Zephyrhills, FL 33540
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