HomeMy WebLinkAbout94-4122
BUILDING PERMIT
N,o
Permit '.
C:TY OF ZEPHYRHILLS
(813) 788-6611
_41228
& - d. :1-Cf!
~De-
C~~
Date
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Property Owner:
Job Address:
Parcell.D. #
(].J700~ ~ <r 6JA/ikA '7Y/e.. p;;-t-
c~9 :3 /l f) "~ II OA-e-.
Water Conn:
Water Mejer:
T,I.F.'s:
Zoning:
FINAL ?-- d-
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordar~e with City Codes and Ordinances.
c.o. _
DATE
Valuation or ~02 2... ,!-!-
Contract Price I ()
Inspector
Pe,m;t Fee 'I ?i · ~
S;gnat",e"""'-- ~ I f.k.t ~
Company
Address
TelePhone#~l tf'Z.- / J ~ /
EL
PLUMBING
MEC
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Fiinal
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. 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 PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKEJ].l@nlQu~ euJ1~ moOJ
OWNER' S ADDRESS .s q <1 ao 13 f1.. oe . Ce ~!L
PHONE
'1 jJ,
33s-yd
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL LD.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:____New Construction -XAddition ____Alteration ____Repair. _Install
____Sign _Hove ____Deaolish
PROPOSED USE: _Single Faaily _H/F _' of Units _H/H
_C~ercia1 _Indust. ____SwiRl. Pool _Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK:
SL(LfW ~,~V '-
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.
PERMITS REOUESTED
A-BUILDING
_ELECTRICAL
$ d I t-D. 6U
Valuation of Total Construction
AMP Service
Florida Power Corp.
W.R.E.C.
_MECBAlfICAL
$.
Valuation of Hechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: ____Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..........................................
ELECTRICIAN COMPANY
State Cert. or Regist. t
Si2Dature City License Registration t
....................**.*..*...***....****.
PLUKBER COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
.*........*.**....*..**...**........*.*...
MECHANICAL COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
....*................*..........*.*.......
OTHRR COMPANY
State Cert. or Regist. ,
Signature City License Registration f
.............*....................*.......
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 JaY be lOre restrictive than City
regulations. !be undersigned asSUles responsibility for allpliance 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 lil1f, both the owner and contractor JaY be
cited for a lisdl!leilllOr violation under state law. If the mmer or intended contractor are uncertain as to wbat licensing
requireleJlts JaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtheIlOre, 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 IIOrk. 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 peraitting 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 ,ith a copy of 'Florida's Construction Lien La, - lkIIeolmer's Protection
GuideN prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOIeOJle other than the
'owner", I certify that I have obtained a copy of the above described dOCUJeDt and pImlise in good faith to deliver it to the
'OIfIler' prior to co.encelellt.
E. CONTRACTOR'S/OWER'S AFFIDAVIT
I certify that all the infoIlition in this application is accurate and that all work ,ill be done in COIpliance with all
applicable lil1fS regulating construction, loning, and land developll!Jlt.
Application is hereby Jade to obtain a perlit to do wort and installation as indicated. I certify that no IOrk or
installation bas ~ced prior to issuance of a perlit and that all work will be perfoIJed to _t standards of all laws
regulating construction, City codes, loning regulations, and land developleJlt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveI1lllelltal agencies JaY apply to the intended work, and that it is
Ii responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
I Departlent of EnviIODlelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllentally Sensitive Lands,
Ilater /Vastewater 'I'reatlent
I Southwest Florida Water ManageleJlt District - Wells, Cypress Bayheads, lIetland Areas, Altering Watercourses
t ArIy Corps of Engineers - Seawalls, Docks, Ifavigable lIatenays
I Departlent of Health i Rehabilitative Senites, EnvirODlelltal Health Unit - lIells, Wastewater !reatlent, Septic !ants
I US Envil'ODll!lltal Protection Agency - Asbestos abateleJlt
I also certify that, if fill Eterial is to be used in Flood ZOne 'A' or 'A, etc. " it is understood that a drainage plan
addressing a 'CQlpeDBating volute' will be sublitted wbich 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
Bet 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. Ivery perlit issued shall becoIe invalid
unless the work authorized by sucb perlit is ~ced within sillODtbs of issuance, or if lort 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 utension of tile, 18y be
allowed for tbe perlit with fee charge of $15.00. !be I!ltension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sillODth period, or the profect ,ill be considered abandoned.
WARNING fa OIlIER: YOUR FAILURE !O RECORD A NO'I'lCE OF CCIIMBRCINIIft' MAY RESUL! IIf YOUR PAYING !IIICE FOR IJIPROVBIIEUS !O YOUR
PROPER'lY. IF YOU IIft'BMD !O OB'lUIf. FIIWICING, COif SOL! IUft YOUR LODER OR 1If InoRREY BEFORE RICORDIKG YOUR MOriCE OF
COMMEMCEMEIft'. JOBS UlmER $2,500 1M VALUE DO If 0'1' IfEED !O RECORD 1IfD POS! A '.O'I'ICE OF COMMEMCINIIft'-.
~,IS:l-'1Y- l./O?'-G ~ ~. '
C --"--- 1iJJ~
SIGKA!URE: ODER OR AGD'I' . ~ COIft'IIACf4)R'
S'I'A'fE OF FLORID~
coum OF
The foregoing instrument was acknowledged
before me this :J'lJ rve cJ.../ , 19_~ by
C. ~~~/t '.e fV1 eJ 0;-
who is ersonally known 1;.0 me or@o hao
Oduce bRt veo ).../~('>A/S c
1 entification and who did/did not
take oath.
S!AfE OF FLORIDA /J
coom OF U..---- aa.-c.....o
The foregoing instrument was acknowledged
before me this ~~ ~I , 19~ by
~"I ~e/((..t-
~ is ersonall to me~r who has
produced
as identification and who di
take an th.
Typed, Printed or Stuped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
JAMES A. STONE
Notary Public, State of Florida
My comm expires May 16, 1995
CC110274
JAMES A. STONE
Notary Public, State of Florida
My comm. expires May 16, 1995
CC110274
;I CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER" 0~ ~ B~ fhj) D~
- ".'
JOB LOCATION ~9 3~() 13 Aue Ze~ pI.-
LEGAL DESCRIPTION/SUB DIV. BLK. LOT
Show all existing and proposed structures giving dimensions & setbacks.
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~ lOA" s... FT. LONG CARPORT ROOF CEILING GUrTDt
lOANS _ FT LONG OVERHANG CEILING GUT'n:lt
"T" BARS CARPORT PATIO ROOF -
FT. AWNING RAIL (STD. OR GUTTER TYPE) ....
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FLASH FRONT
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GABLE AND BEAM WORK ON "'LUSH FRONT
FT. GUTTER ON SIDE OF COACH
Z X Z "'A8CIA BACKUf' BAR
I~ x3a.x I ~SCREEN ENCL.05URE (DOORS INCLUDE CLOSER. THltlEllHOLD.. KEY LOac)
SPL~IOLATE i/ IlUGSHI ELD SCltEEN /{l X 4 ....
CANTED WALL ;J. DOOR(SI__ BELL GltlLL(S1
X _ UTILITY R()()N _ WINDOW SHELVES (TO ROCW.. STD)
X'_X - CABANA WALLS (Z" EXTRUDED Olt J" WOOO WITH TRAILER.uN_
. INTERIOR PANELING OU'TSJDI: LlGHI' __~
OUTLETS
AWNING WINDOWs SINGLE HUNG W1NDOWII DOOltfSl,
IOANEL TRAILER WALL BUILD 4TH WALL, cur ARCHwAY
X_ RAIRD WOOD "'LOaR (ZXe.lOln,PLYWOOO "'LOaR. /lUTAL "'~NG
LIN. FT. (ALUMINUM OR BLOCKI FILL JrROM GROUND TO...L...OOII
HEAT DUCTS OR El.€CTRIC BASl:80ARD HEATERS
RAISE ROO,. AIIOVE TRAILER
X _1N8ULATED CEILING (SPECIFYI
WINDOW AWNINGS: SIZES
PERMIT
The undersigned agrees 10 pay PRICE ~ J x:-n -
INSTALLERS IN FUll ON COMPLETION - ---
TAX
TOTAL PRICE ~ I S? () -
DEPOSIT
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\ BALANCE: C.O.D.
CAN-AM Aluminum
38937 B Ave.
Zephyrhills, Florida 34248
ooLD TO Ct\lW\..\ 'C. a ?J~120f\"T\ v'\..\ ""-Lo[
ADDRna 31~:;;(flk)f-_ I 7.9 Pd~l2tt/l'L~.) I Fi 3~l/ ()
782.1151
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fiLL ,&IU.
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CAN-AM Aluminum
fu~rr Q!O'lf'~ I n
CUSTOMER TURE
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