HomeMy WebLinkAbout94-4100
BUILDING PERMIT
Permit N'~
PLUMBING
J-s-; JV
~HA~'I~
_ 410011
b -/b -YY
CiTY OF ZEPHYRHILLS
(813) 788-6611
Date
BUILDING
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G~RIC~
Pmperty Owne' (~j i!. ~
Job Address: ...s J'7J '/ c ai/-€-
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcell.D. #
Zoning: ~E~Y ~~e:
Description of Work ~~ ~ N. ^
cf
.A-lc~on Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O,
b - Z. 9- q '-I
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordar'~e with CIty Codes and Ordinances.
DATE
Inspector
City License Registration #
State Certified License#
/7"
.
p~r~it Fee~; t7l)~
Signature ~ ~ fi_.
,
Company
Address
Telephone#
Valuation or
Contract Price :l / tTZJ?J ~ crv
BUILDING
1AL/~4<f !A.tfL~
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PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
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.
Pasc:o 842-7400 .
Bowman Mechanical Service, Inc.
7841A C1arlc Moody Boulevard · Port Richey, FL 34668
Stotf! Certifif!d Air Conditioning Contractors IICAC0-42674
PlnenBs 446-4675
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l~ ~.... OFFICIAL SEAL
i ~ \ COLLEEN STROTT
t : My Commission Expires
.0 r.4: Jan. 20, 1996
."~Ol'f~... C.)mm. No. CC 174750
........
APPLICATION FOR PERKlT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S ADDRESS
( 1--1 t< l-c rt C~ F
.c7A fYl. E
c)-{ /11 . Gj r
PHONE
7~7- ;() L;o
OWNER'S NAKE
JOB ADDRESS "ll 7 ~'l
A.v c
Z p,of/~? It!. L S
fiA )).)~O
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1.0.' (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction ~ddition ~lteration _Repair ~nstall
_Sign
_Move
_Deaolish
PROPOSED USE: _Single Family
..&ec-ercial
~/F
_, of Units _M/H
_Indust.
_Swia. Pool ___Other
DESCRIPTION OF WORK:
A~()
& Health Department Approval
) 5".0 (T t]V-fTF/vl
I
_Restaurant
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.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKlTS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
~GHAIIICAL
AMP Service
Florida Power Corp.
_W.R.E.C.
s=::2ooa ,60
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUcnON: _Block _FrUle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
COMPANY
State Cert. or Regist. ,
City License Registration .
*************************************
RUTI.DER
Signature
OMPANY
tate Cert. or Regist. ,
ty License Registration .
*****************************
/~
PLUHB~
Signature
COMPANY
State Cert. or Regist. .
City License Registration .
*************************************.***.
MECHANICAL
Signature
COMPANY
State Cert. or Regist. *
City License Registration .
***.**..****.*......*............*.*.*.*..
~
~
COMPANY Ebv.../f"V\4/\/ /1 r= c 1+4-#1 -'-I( L 7-E;tu, 'CF FIL-C.
State Cert. or Regist. , C A G c) (/;). (".0 I Y
~ity License Registration ,
*******.**...*****.**.*******..**.*..*.*..
OTRRR
APPLICATION APPROVED BY
PERKlT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this pertit lily be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
regulations. !be undersigned assUleS responsibility for cmpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired 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 liar be
cited for a lisdeEanor violation under state law. If the owner or intended contractor are uncertain as to "bat lic8D8ing
requirl!l8Du lilY apply for the intended work, they are advised to contact the City of Zepbyrbills BuildiDg Departlent, (813)
788-6611.
FurtberJore, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
IContractor Sections I of this application for which they will be responsible. If you, as the OlDer sign as the contractor,
you are indicating that fOU, rather than the contractor, are responsible for the work. If the contractor wiabes fOU to sign
as contractor that lilY be an indication that be is not properly licensed and is not entitled to pemitting 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 - lkIIeoImer's Protection
Guide' prepared by the Florida Departlent of Agriculture and ConsWler Affairs. If the applicant is 8OIeOIle other than the
lowner", I certify that I have obtained a copy of the above described dOCUJellt and prOlise in good faith to deliver it to the
lowner' prior to co.enCl!l8Dt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlation in this application is accurate and that all work will be done in COIpliance with all
applicable laws regulating construction, loning, and land developlellt.
Application is bereby Iilde to obtain a perlit to do wort and installation as indicated. I certify that no work or
installation has cmlenced prior to iss~ce of a pemit and that all work will be perfoIJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveruental agencies laY apply to the intended work, and that it is
III responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to:
t Departlent of EnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllelltally Sensitive Lands,
Water/Vastewater !real:lent
t Southwest Florida Water Jlanagl!l8Dt District - Wells, Cypress Baybead8, Wetland Areas, Altering Watercourses
t Ally Corps of Engineers - Seawalls, Docks, lIavigable Watenays
t Departlent of Health' Rehabilitative Services, EnvilODlelltal Health Unit - Wells, Wastewater !reatlent, Septic !ws
t US BnvirOllleDtal Protection Agency - Asbestos abatl!l8Dt
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 'CalpenSating vol_I will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A pemit issued shall be construed to be a license to proceed with the wort 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 fl'Ol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pemit issued shall becoIe invalid
unless the work authoriled by such perlit is COIIeJIced within sil IODthS of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sil IODtbs after the tile the work is IDIeDced. One 90 day eltension of tile, lilY be
allowed for the perlit with fee charge of $15.00. !be eztension shall be requested in writiDg to the Building Official. An
approved inspection lUSt be logged during each six IODth period, or the profect will be considered abandoned.
WARlfIIIG !O 0WIfER: YOUR FAILURI !O RlCORD A IIOtIC! OF aJlMDCIIIIJft' NAY RlSULI III YOUR PAYIIfG DIC! FOR DIPROVIIIIIft'S !O YOUR
PROPEm. IF YOU IJIDIiD !O 0B!111l PlIlAlfCIIIG, COISUL! WIR YOUR LlllDIR OJ! AllftOJlllY BIFORI RICOJIDIIG YOUR JIO'fICI OF
crJIIEllCEHKIf!. JOBS UllDIR $2,500 III VALUE DO IfO! IfUD !O RICOJID AIfD POS! A IIIOtIC! OF C(llMBJfCllllll!I.
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SIGlAmO: (MIIR OJ! AGIII1' SIGIf1!URI: COJ!RlC!OJI
SIAII OF ~
coum OF Sf. n
The foregoing i~trument was acknowledged
before me this .....qP \t; ~, 19 q\..~ by
\-t" ~'('\ p\.z' \-\\~->0
who is personally kDown to me or who has
produced \-'Q (:"'CiYO \\ q \/~(\'''''l'''~\,
as identification and who did/did not
ta~ an oath.
~ " ~\^- ~!LA, ~ f'. _" \,('
(Signature)
( .f'. t \p P V.I ',> \ -( ~t+-
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
SIAR OF FLORIDA
coom OF \-=t... '\( 0
The foregoin~ i~trument was ac~r-ledged
before me thl.s INIO I C, , 19q - by
_ \01. (' ~l e r~) W (Y'(.. n
who is pers~ll~ kn~ to me or who has
produced 'fl.. \).{ ,\k'( S. LtC,
as identification and who did/did not
takeC: ~~~ ,- ~~~-~~
(Signature)
('0) \\ Q <:l .",-. ~ \ ,,\.::.) \--\-
(Name Typed, Printed or Stallped)
NOTARY PUBLIC
............,
..~y~..
/# t>\. OFFICIAL SEAL
: ~ i COLLEEN STROTT
\ ! My Commission Expires
...:'>.;, ., ~.. .Jan. 20. 1996
t. ~ OF flP':.' Co N
......... mm. cr. CC 174750
...........
....~ PI./lI;:..;..... OFFICIAL SEAL
i _: COLLEEN STROTT
i .: My Commission Expires
......... - A/ Jan. 20. 1996
......~ di"":'.
..~Off~.* C'.'mm. N'J.. CC 174750
........