HomeMy WebLinkAbout94-4136
BUILDING PERMIT
Permit N.~
CITY OF ZEPHYRHILLS
(813) 788.6611
4136/3
Date
6 -3tJ -p 'f
~
::~:::,~:'~s-~~^!b- ~~ff
Parcell.D. # / J - c9-b - d-I-. 0 CJ / /J..,. OSy,t; o. 00 h 0
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water M!!ter:
T,I.F.'s:
Zoning: Energy Code:
Description of Work /"0")( /;;J...; J JfZ /
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
?:.. /....
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordaf'ce witn City Codes and Ordinances.
DATE
Inspector
WI!
Permit Fee
Signature
Company
Address
Telephone#
~~p Crrrt: L"'
Valuation or
Contract Price ~ 0 ...'S ~:. C/O
City License Registration # 7 /"
State Certified License#
._ ~/A141<L;to~
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
Tp. Serv.
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
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. 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 ZEPBYRHILLS
BUILDING DEPARTMENT
JOB ADDRESS
If Ib(tC- '(A!
!Jtf d 'l
t:J II1f l
fl66Y
I t-ff<- '3 r
PHONE
Ir~'~ ~7(
OWNER'S NAME
OWNER'S ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
PARCEL I.D.' II 02-(p 02-( OC)IO (j 5100 0'(;00
WORK PROPOSED: ~ New Construction ____Addition _Alteration ____Repair ____Install
_Sign
Move
Demolish
PROPOSED USE:
Single Family
_M/F
_# of Units
~/H
Comercial
Indust. _Swim. Pool
Other
Restaurant &: Health Department Approval
BUILDING SIZE:lo X f~, k Flit> 5lfU Square Feet,
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.
lo5~ -bV
PERMITS REQUESTED
____BUILDING
ELECTRICAL
$
Valuation of Total Construction
AMP Service
Florida Power Corp.
_W.R.E.C.
____MECHANICAL
PLUMBING
$
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: Block Frame Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
BUILDER
CONTRACTOR SECTIO:N
~ ~ COMPANY Su/llS7Jf7c.
State Cert. or Regist. #
' ,/I' ~ Ci ty License Registration #
******************************************
/It. () if {/t/ d If
77
Signature
ELECTRICIAN COMPANY
State Cert. or Regist. #
Signature City License Registration #
******************************************
PLUMBER COMPANY
State Cert. or Regist. #
Signature City License Registration #
******************************************
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.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
rile undersigned understands that this perait laY be subject to .deed restrictions. wbich lay be lOre restrictive than City
regulations. !he undersigned assUJes responsibility for CCIIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas 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 0IIIll!I and contractor laY be
cited for a lisdeIeaDor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requiretents laY 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 laY 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 with a copy of .Florida's Construction Lien Law - lReowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and COnsUler Affairs. If the applicant is SOMOIle other than the
.owner", I certify that I bave obtained a copy of the above described docuIent and pn.ise in good faith to deliver it to the
"owner" prior to co.enCl!leDt.
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 developleDt.
Application is hereby tade to obtain a peIlit to do wort and insWlation as indicated. I certify that no wort or
installation bas CDIl!Jlced prior to issuance of a perlit and that all wort will be perfoIled to .et standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveI1llleDtal agencies IlaY apply to the intended work, and that it is
If responsibility to identify wbat actions I lUSt tale to be in cotpliance. Such agencies include but are not lilited to:
* Departlent of EnvirOJlleDtal Regulation - Cypress Baybeads, Wetland Areas and Invil'OllleDtally Sensitive Lands,
Water /lfastewater !reablent
* Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* AIIY Corps of Engineers - Seawalls, Docks, Navigable Watenays
* Deparblent of Health i Rehabilitative Services, InvirODl8Dtal Health Unit - Wells, Wastewater treatlent, Septic tants
* US InvirODlental Protection Agency - Asbestos abatl!lf!llt
I also certify that, if fill laterial is to be used in Flood ZOne .A. or IIA,etc.lI, it is understood that a drainage plan
addressing a .co.pensating volute. will be subllitted wbich 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 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 peIlit prevent the Building Official fl'Ol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall becoIe invalid
unless the work authorized by such peIlit is ~ced within s1llODths of issuance, or if work authorized by the perait is
suspended or abandoned for a period of sil IODtbs after the tile the work is ~ced. One 90 day utension of tile, IlaJ be
allowed for the petlit with fee charge of $15.00. rile utension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each s1llODth period, or the project will be considered abandoned.
WARRING ro (JIIBR: YOUR FAILURE to RlCORD A NOtICE OF CCJtMDCEIIItI! MlY RESULt 1M YOUR PAYING !VICE FOR IIIPROVIIImS to YOUR
PROPERTY. IF YOU IIft'BID ro OB'lAIN FWlCIIG, CORSULt WItH YOUR LBlDBR OR AI AnomY BEFORE RECORDING YOUR JIOtICl OF
COMMDCEMEIl!. JOBS UNDER U,500 IN VALUE DO lOt IBED to RECORD AID POS! A "NOtICI OF aJIIEICBIID!-.
SIGII'fURIl: (MIllR OR AGIIft'
SIGIA'fURIl: COIft'RAC!OR
SfArE OF FLORIDA
CDUm OF
The foregoing instrument was acknowledged
before me this , 19____ by
StAtE OF FLORIDA
CDUm OF
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)
(Rame Typed, Printed or Stamped)
ROTARY PUBLIC
(Signature)
(Rame Typed, Printed or Stamped)
ROTARY PUBLIC
S IT E PLAN .' ...
, .
P~MIT #
( RESIDENTIAL USE ONLY )
I ( ;2b ~( 0lJ (v o3~(Jn OD 0C)
LEGAL DESCRIPTION: . .
SECT,ION TOWNSHIP
.
SUBDIVISION OR OTHER LOCATION DESCRIPTION:
,
r 0
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5161
( .
RANGE
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FRONT (
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Show all ~xisting and proposed structures giving dimensions and setbacks. Also. indicate
any adjacent bOdies of water and roadways adjacent to the property. Indicate size of
mobile homes such as: 12' x 60' J 24' X 36'.
EXAMPLES
HOU~.~_Q~~TB_~f.nON
PROPOSED AD~ITrON
MOR T' F HnMf ~ rTI 10
, .
~
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L-7 1/" (~. /,4) ,
~....... SUN STATE ALtl~I(llJM:r{~
"go \-
.. 37528 Hwy. 54 West , ~
\...." l ZEPHYRHILLS, FL 33541 129. N
."" (813) 788.7308 p:r yP ;. ~)
i
.
CUSTOMER'S ORDER NO.
N"'ME
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Interest of 1112% per month' after 30 days, In'
,the-event it '--becomesnecessary.to-Pta~e' is n-..,--
account wIth an attorney or agency, f '~
"cotlectlon;---t/Weagree'-'(opar-'lln--C" "Of !k=
collection, including reasonable attorney lees.
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ISOMETRIC (f BUILDING
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MOn'lIS IlItAllHG SHOtN Fat ClARfICA1ION AIf,) S1A1C>AI!O <XWSlRUClION
" NOTES au. TrPlCAL ~ AU MO-I),,~
,
~~ IS falllAXlUl'*>TH ~ 12'-0"
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END ELEVATION *TH DOOR (SITE SPECIFIC)
'/4! - ,'..0-
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DESIQI Lo.ADS
I. flOOtlA( LOAD -------------------12~ .../~ It.
2, ROOf' 1M LOAD ---------------------~ "-/"1 ft,
1. fl~ ,OSTS ANI) SEAUS SHAU If PR(SSUR[ 11IU JEll SWllOH PH
GEHERAI. NOlES
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, "214 2.4 2.4 214
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