HomeMy WebLinkAbout94-3965
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N9 3965/3
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Date
'/0. Cl?
<3 -s .~ c.JV
-3-f;" ~
PLUMBING
02-0. cf-i)
MECHANICAL
Sewer Conn / J- /' f': tJl!
,
Water Conn: , ? J"CJ. tJV
Water Meter: / b ..5': t!lV
T.I.F.'s: / ~-: tft>
.,
BUILDING
ELECTRICAL
Pmperty owne'dr ~Q f;~~
Job Address: '-- 7 J . ~
Parcell.D. # J - J6 ...2/ - 0/36- 000 cJ D. ZJ~ 0
Zoning: -;;i,:J!eV Code'
Description of Work 'Plt ~. .;z,,~
Radon Gas:
~/--r
NO OCCUPANCY BEFORE C.O.
FINAL ,,Ii'
c.o. ~'1-..;J.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
City License Registration #
JSb
Signature
Compa
Address
Telephone#
~r::lt;fi'!'l ~se# _
,~~.1Z-b rkn ~_
BUILDING ELECTRICAL
/U.;; ~::::;:
/OJ--
PLUMBING
~~;-;d1?~4VL-I-~
MECHANICAL J'y
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
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.
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.
7,/ a _ i./ -/ -.!)--.9 Y
fJ'/ Jf-;2. 6 - / 'I
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERKIT
GITY OF ZEPIIYRIIILLS
BUILDllIG DEPAR'IItENT
OWNER"S
lWtE ,:;tl,Se- ~N,)
ADDRESS 3773 yo AJ ~t.UA L
54-Ju.~
4v'i...
mONE ;?;3-ZR2-22.76
/ ;C~/HY-L/hZ4" /-~ 3=3~;;~1'
,
OWNER' S
JOB ADDRESS
LEGAL DESCRIPl'IOR: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1.0.'
t:J3 --2(;, - ).../- t:J/3.o -~o ,00 - eJz6. 0
WORK PROPOSED:~Nev Construction _Addition _Alteration _Repair _Install
_Sign
_Hove
_D~lish
PROPOSED USE:
Single F_ily
_H/F
_' of Units
~H/H
_eo..ercial
_Indust.
_Swia. Pool
Other
_Restaurant & Health Departaent Approval
BUILDING SIZE: t..S Xbb'g",
~re Feet,
/ 'f)m.~
Height
RESIDENTIAL:
COIVIERCIAL :
ATI'ACB (2) PLOT PLUS & (2) SEI'S OF BUILDING PLANS & (1) SET ENERGY FORKS.
ATI'ACB (J) SETS OF BUILDDiG PLANS & (1) SEI' ENERGY FORKS.
PROPERTY SURVEY REQtmIED FOR ALL ImW CONSTRUCTION.
~ BUILDING
~ELECIRICAL
~ ttECBARICAL
~ PLOIBING
$
PERKITS REOUESTED
.2~ ?.rv Valuation of Total Construction
,
IS'?}
AIIP Service Florida Power Corp.
~ W.R.E.C.
$
/~
Valuation of Hechanical Installation
GAS
ROOFIBG
SPECIALTY
TYPE OF CONSTRUCl'ION: _Block _Fr_e -==--.Steel
/J1#-
Other
FINISHED FLOOR ELEVATIONS:
Fr.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
BUILDEI\ ~
Signatureh ..-
CONTRACTOR SECTION
cotIPAliY #' ~ /Z- ~
# State Cert. or Regist. .
~~ City License Registration' 3<;:b
******************************************
F.I.F.CTRICIAR COMPANY C' -" N- ~a..a- ~C;-c;~
~/J~~ 24 / State Cert. or Reg{st. .
Sil:m~turw~~ ....~/~ ~City License Registration' 3\"
( .****************************************
PLUttBER ~ COMPANY fi,1-J~ 4-.-/
L State Cert. or Regist. I
Signature ~ City License Registration . /?J&-
/ v ******************************************
~
Signat-- ~
COttPANY~A.~ ~pP~ C:~ .~ A
~ ~ Sta<e Cer<. or llegis<. .
City License Registration .;;??"
****** ***********************************
OTIIF.R .
COtIPANY
State Cert. or Regist. I
City License Registration I
*.****************************************
Signature
APPLICAnOll APl'IllIVED BY 'i1 d1L.l'"(J ~~--u
PERIflT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this perlit laY be subject to 'deed restrictions" which laY be IOIe restrictive than City
regulations. 'lbe undersigned asSUle& responsibility for COIpliance lith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OIfIIer 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 OIfIIer and contractor Iilr be
cited for a lisd8leanor violation under state law. If the OIIl8r or intended contractor are uncertain as to IIbat licensing
reguiraents lilY apply for the intended IOrk, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
788-6611.
FurtheIlOre, if the OlDer has bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
IContractor Sections' of this application for wbich they ,ill be responsible. If you, as the OlDer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the IIOrt. If the contractor ,ishes you to sign
as contractor that lilY be an indication that he 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, have been provided ,ith a copy of 'Florida's construction Lien La, - lbIeoImer's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is 8OI8ODe other than the
1I0000er", I certify that I have obtained a copy of the above described docuIent and pro.ise in good faith to deliver it to the
HOlDer" prior to co.mCl!leDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlation in this application is accurate and that all IOrk IIi 11 be done in cOlpliance ,ith all
applicable la'8 regulating construction, loning, and land developlent.
Application is bereby lade to obtain a perlit to do wort and installation as indicated. I certify that no work or
installation bas co.IeDced prior to issuance of a perlit and that all IOrk ,ill be perfoIled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land develOpll!llt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveruental agencies lilY apply to the intended IOlk, and that it is
If responsibility to identify ,hat actions I lUSt take to be in COIpliance. Such agencies include but are not liaited to:
t DepartJent of EnviIODIeDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
Water /Wast8later !reatJent
t Southwest Florida Water Hanagel8Dt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t AIIJ Corps of Engineers - Seawalls, Docks, lavigable Waterways
t DepartJent of Health i Rebabilitative Services, BnviIODleDtal Health Unit - Wells, Wastewater !reablent, Septic ranks
t US BnvirODleDtal Protection Agency - Asbestos abat8leDt
I also certify that, if fllllilterial is to be used in Flood Zone lA' or IA,etc. I, it is understood that a drainage plan
addressing a '~ating volue' ,ill be sublitted Ibich is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance.
A perlit issued shall be construed to be a license to proceed lith the IOrt 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 peIlit issued shall beco.e invalid
unless the IOrt authorized by Bueb perlit is COIIeDCed within sillOnths of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sil IODths after the tile the IOlk is co.encecl. One 90 day extension of tile, lilY be
allowed for the penit lith fee charge of $15.00. !be extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during each sil IODth period, or the project ,ill be considered abandoned.
WAIUlIIG 'fO OIlER: YOUR FAILURI !O RICORD A IOIICE OF aJlHBRCBHm HAY RESUL! II YOUR PAYIIG DICE FOR IHPROVIIIIIIJ'S !O YOUR
PROPER'fY. IF YOU ImID 'fO OMAIM FIIAICIIG, COISUL! WIft YOUR LBlDER OR AI AnORDY 8BPORI RECORDIIG YOUR DICE OF
COHHBICEHBIfI. JOBS OlDER $2,500 1M VALUE 00 100IfBID 'fO RECORD AID POS! A HIOIICE OF COHHBICEIIBIfI'.
~~ s~~
S!ArB OF FLOR% S!A!B OF FLO)1DA
COUI'fY OF c () coum OF 5'(. 0
The foregoing instrument was ac~owledged The foregoing instrument was aCkn. owledged
before me this 1.':,-rA."d~' 19~ by before me this 1Sd- ~ ' 19~ by
tic LSD..} K'f ",,...! ~So.1 f..r rn~
~is personally known to--lDeOf who has ~ ~e.Ll:juIlCllly known t~ Dtej>r who has
produced _ prOduced ._
as identification and who didfdid n.oD as identification and who 4id1dl~~
take ~~;J-~ take:~ ~
(Signa":' ,.----, (Signature) I' :-\ 2 I
L oj DAD, r;; {) rJ;J I-- / /.,/ !) t7 0. A-f\../
(Name Typed, Printed or Stamped) (Name Typed, Printed or 'Stamped)
NOTARY PUBLIC NOTARY PUBLIC
,,'"U,~ luna 0 SOAN
'~~"'"'' UND'" 0 SOAN ~"~iI\'.t~~.. L_ .
~:&"l~"' ~~~~~
:~1' ':;~ Mi C<M.1lSSKlN , CC 209693 EXPIRES N ;*E Mi COMMISSION * CC 208593 EXPIRES
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"'~ ''':;'': .' BONDED THRU........ FAIN tNSllIWlCE IHe ''Jf.nr. !l\.' IONIJEI) TIIlll mqv FAIN 1NSUIlAHCE, INC.
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(RESdJE'NTIAL':'LisE' ONLY)
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