HomeMy WebLinkAbout94-4196
BUILDING PERMIT
Permllt N~
CITY OF ZEPHYRHILLS
(813) 788-6611
4196 -,(3
.. ~ 0..9
~
Date
~-d-9Jf
ELE~L
PLU~
MEC~
Sewer Conn
Water Conn:
Description of Work
~~~..,
lo03<g' ~~ ..u...
\o~ - \~ - 0>33~gCj~- d 3
Energy Code:
C("l~, .y 9~
Water Meter:
Property Owner:
Job Address:
Parcell.D. #
(b~)
.
T.I.F.'s:
Zoning:
Radon Gas:
NO OCCUPANCY BEFORE C,O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordarr:-e with City Codes and Ordinances.
c.o,
DATE
Inspector
Valuation or
Contract Price
$$999 ~
~oo
it Fee l) lJtVtLl. ~
~~
City License Registration # J b<:!>
State Certified License#
Telephone#
<tt- J bO
&~
BUILDING
ELECnicAL
(
PLUM~G
/
MECH~CAL
,
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
~~J/ 1-,;2$;'1'1 '.
OWNER'S NAME. CI1A RLti-S Rsr~/2.. PHONE 7tfJ-;;~?~
OWNER'S ADDRESS fpl))~ PSI1I< L (\T
JOB ADDRESS SA Yt1 E f)/fKSIIJ/i /fJ1 H /J1tR.-k::'
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D. , (;;, /-/0 ;-P3s PtJ'R ...;)3 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~W Construction _Addition ---1-lteration _Repair _Install
_Sign
-----'love
_Deaolish
PROPOSED USE: s/Single Faaily
,
-----'l/F _, of Units _"/H
_Coi..Mercial
_Indust. _Swia. Pool _Other
____Restaurant & Health Department Approval
DESCRIPTION OF WORK:
C4~ P-1p..T -d- P^'T/O
Square Feet,'
Height
BUILDING SIZE :- X
RESIDENTIAL:
COMMERCIAL
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTAClI (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUTRED FOR ALL NEW CONSTRUCTION.
~UILDING
_ELECTRICAL
PERHITS REQUESTED
$
CJ?9.() 0
Valuation of Total Construction
AMP Service
Florida Power Corp.
W,R.E.C.
_MECHANICAL
$
Valuation of Mechanical Installation
_PLUKBING
GAS
ROOFING
SPECIALTY
TYPE OF C<lNSTRUCTION: ____Block ____Fraae ____S teel
I)LJ/fYJ"
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA't
YES NO
..........*...............**........*..*..
BUILDER
Signature
t~l.ECTRI ClAN
COMPANY
State Cert. or Regist. ~
City License Registration i
.*....***...._.*****_.*....*...*....**.***
Sh:nature
COMPANY
State Cert. or Regist. ,
City License Registration .
*.****.******.**.****************.._******
PLUMBER
Signature
MECHANICAL
COMPANY
State Cert. or Regist. I
/ City License Registration .
***..******.********.**..******.*****.*.** .
Signature
OTHER COMPANY
State Cert. or Regist. ,
Signature City License Registration'
.******..*_.******************************
APPLICATION AP~.~:_~ ~~~~=~
,v- '.....h;.. :._... '.;
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this perlit lay be subject to Ideed restrictions I wbich JaY be lOre restrictive than City
regulations. Tbe undersigned assUles responsibility for COJp1iance with any app1icab1e'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.law, both the owner and contractor JaY be
cited for a .isdeJeallor violation under state law. If the owner or intended confractor are uncertain as to wbat licensing
requireJents JaY apply for the intended work, they are advised to contact the City ofZepbyrbills Building DepartJent, (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 wbich they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are resporisible for the work. If the contractor wishes you to sign
as contractor that JaY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrbil1s.
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 IFlorida's Construction Lien Law - HOJeOWner's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is sOleone otber than the
"owner., I certify that I have obtained a copy of the above described docUJeDt and prOJise in good faith to deliver it. to the
"owner" prior to COll9JlCeJent. -
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developleDt.
Application is bereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas COIIeDced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developll!Dt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveruental agencies JaY apply to the intended work, and that it is
.Y responsibility to identify wbat actions I lust take to be in COIpliance. Sucb agencies include but are not liJited to:
t DepartJent of invirolllental Regulation - Cypress Baybeads, Wetland Areas and inviroDJentaUy Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Hanagl!leDt District - WeUs, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Arl' Corps of ingineers - Seawalls, Docks, Mavigable Waterways
t DepartJent of Health , Rehabilitative Services, invirODJeDtal Health Unit - Wells, Wastewater rreatJent, Septic ranks
t US EnvirODJental Protection Agency - Asbestos abatl!leDt
I also certify that, if fill laterial is to be used in Flood Zone "AI or "A,etc.", it is understood that a drainage plan
addressing a "cOlpensating VOlUIBI 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
set aside any provisions of the technical codes, nor sball issuance of a perlit prevent ~e Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code.,ivery perlit issued sball beCOll! invalid
unless the work authoriled by such perlit is COIIenced within sil IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sil IODtbs after the tile the work is COIII!!nced. One 90 day extension of tile, JaY be
allowed for the perlit with fee charge of $15.00. Tbe extension shaU be requested in writing to the Building Official. An
approved inspection lUst be logged during eaeb sillOnth period, or the project wiU be considered abandoned.
NAIUIIMG TO OIIMER: YOUR FAILURE 1'0 RECORD A MOTICE OF COHHBMCBHm' MAY RESULT 1M Y IHPROVBHm'S TO YOUR
PROPERTY. IF Y T T WITH YOUR LBRDER OR Y ICB OF
COHHEMC . JOBS 1'0 RECORD ARD PO
/(JJbc.JN
J<NnJN
STATE OF FLORIDA
COUNTY OF y? .4....') e-o
The foregoing instrument was acknowledged
before me this Jt.-u"",/ 2~, 19~ by
KAY' DAAJI ~I 5-
who is personally known to me or who has
produced
as identification and who did/did not
~~~L.~
(S19 ature) fJ-B
K A TH I F'EA.J J :if'dW AI
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
STATE OF FLORIDA t?
coum OF T2l- -S e.D
The foregoing instrument was acknowledged
before me this Jt.t..J.. y ;22, 19 9 t/ by
~y :J)J};J/ E?-S
who is personally known to me or who has
produced
as identification and who did/did not
ta~e",JD _o~t9,. LO
~J9' ~A'7L~
(Signature)
(Name'~~/pd~ ;,fSt~~^J
NOTARY PUBLIC
I{i;"
KAT~I_F"!I. P,ROWN
MyG;, ..." , ,,1995
Cc,',rn. ii .~'~ '" ,,)~~ 7
.~."
f .I!',,~^..,
J>:2>
KATHLEEN J. B!'OWN
f;'i.;:~e c,f F'Orj.ja
My C~m,~.. Exp. April 2. 1995
Comm. # CC 095617
L
~.
L,
38545 Palm Grove Drive
ZephyrhiUs, Florida 33540
ACE
ALUMINUM
Job No,
Phone: (813)782-2616
SOLD TO -1-1- ~ R- .I
ADDRESS 6,0 :s f! P $Jft L- s:r. t) I} If $/ ~Je. fJj) /I P 1fL. It
SHIPTO 'ZEP# 'l'1!-1/'-L..-S rIb Yc1,rz/L?
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,
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,
PEIVv\IT
PRICE
TAX
The undersigned agrees to pay TOTAL PRICE _ q tf"f, tJ ()
INSTALLERS IN FULL ON CO ION ') DEPOSIT
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kql.
BALANCE C.O.D.
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HOST
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________ [XTRUQm OR 8REAKI,l[T,It
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r ASTENER DETERMiNED
BASED ON CONS TRtlcnON
Cf HOST STRVCTVR(
CONNECilON TO HOST STRU,CilJRE
SH A DING 1Yr'E II DENO TE 5
INTERIOR POST !.lAX. R<X;f AREA
SEE TABLE.
. #10 l Ct.+l l/n \11TH
____ 1 1/.. 'IIASliER 0 .. D.C. !.IiN.
3 I' Oxl 1/2. 'J,lS PER PAIl PANEL
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STRAP Sl1AlL BE o. EACH SlOE AND
CON nNUQlS O~R THE S TVO
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NOTE: ~ERE 1/2. CDX Plrt.<<X> IS US(O FRA},IiNG Sl1ALL BE 0 24' OC. !.IN.
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IIRAPP(O '(1/ FELT PAPER
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SO LB. 2500 PSI
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PORCH POST CONNECTION
-L ~ / POOR(O CONCRETE
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1 W REFER TO TABU: 5
ISOlATED roOilNG
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NOrf:: M HOST Sl1l\JC11JRE II1JST BE CAPABlE !$ ~Tl~C ]liE iIl.L'l./If.t'U Sffi\JC11JRE TO BE ATHQj(1) TO ]liE HOST S1R\JC11JRE. GEM:RiIl.t'f ]liE
CONQtTlC<< ~ T);E EXlsn~c STRVCTURE l\lIJ. INQiCArf: ]liE STR1JC11JRES CAPABlUT'f. ]liE FCUC'l1l~;; CONOtT1a.S/HO$T S1R\JC11JRrS ARE CAPABlE
!$ SlJPPal TlNC 1}j( iIl.l:MIN\lU SffiUC TURE 10 BE A TTAQj(D;
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4. ALL ffi\JSS SmEllS SiAU HA'.t A lIAx.'lJ\:!,j SHCNC !$ 24. O.c.
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