HomeMy WebLinkAbout94-4242
BUILDING PERMIT
Permit N'~
BUILDING
ELECTRICAL
PLUMBING
Jo .. o-v
~~Nlc~~sewer Conn
Water Conn:
4242/'1
5'-,;13--71
CITY OF ZEPHYRHILLS
(813) 788-6611
Date
Property Owner:
Job Address:
Parcell.D. #
Zoning: Energy Code:
Description of Work L""'- ~/ ~( -
Ak--W-4.AJ
:.s-;;2 6 k- -
1i~
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Water Meter:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
Cf-/6-({
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordart::'e with City Codes and Ordinances.
c.o.
DATE
Inspector
City License Registration # / ", 'j
State Certified License#
Pe'm;t Fee ~ - ~
S;gna,",e j ~4ti .
Company
Address I
Valuation or
Contract Price
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Telephone#
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BUILDING
ELECTRICAL
PLUMBING
Ftr.
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Brea ers
Ducts Insl.
Compressor
Final
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.
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APPLICATION FOR PERKlT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAKE /r./t. #CW4.-t./) c;,4! cA
OWNER'S ADDRESS 5"?() gig .:-"'; .u
5e:Jo8 /BSI-A,/
PHONE 78:J -;2 7 fLj
JOB ADDRESS
LEGAL DESCRIFl'ION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D.'
(OBTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction --.Addition ----Alteration ----..Repair _Install
_Sign
----.JIove
_D~olish
PROPOSED USE: _Single Faaily
_H/F _' of Units ---"'/H
_ec-ercial
_Indust. _Swill. Pool _Other
----..Restaurant &: Health Departaent Approval
DESCRIPTION OF WORK: /",.,J oS h'U/ A/ c'4/ Of T<l-v C~"..A4' A c: A E"" ~ ;' 4/ ~ t/ AI I r
BUILDING SIZE:
x
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.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELECTRICAL
AHP Service
Florida Power Corp.
W.R.E.C.
.
----1IECllARICAL
$
Valuation of Hecbanical Installation
-----PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CORSTRUC1'I.ON: .-Block _Fraae _Steel
Other
FIRlSHED FLOOR ELBVATIORS:
FT.
IS PROJECT IN FLOOD ZONE AREA.,
YES NO
..........................................
((OtfTR4C1OR SECTION"
;. I
BUILDER
cotIPAHY
State Cert..or Regist. ,
City License Registration .
..........................................
Signature
ELECTRlCIAH
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
SiOIlAture
PLUMBER
COMPARY
State Cert. or Regist. .
City License Registration ,
..........................................
Signature
tlECllAtUCAL /l COMPANY ~v /E~/~;' A EAhv~: tI C~Qt. ,,;" c;,
! All / I.;J State Cert.' or Regist. .
Signature ~44J.~4ilr-- City License Registration, /'-ILf
~ ..........................................
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
APPLICATION APPROVED BY
PBRHIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit laY be subject to "deed restrictions" wbieb laY be lOre restrictive than City
regulations. fhe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas hired a contractor or contractors to undertake work, tbey lay be required to be licensed in accordance witb
state and local regulations. If the contractor is not licensed as reQuired by law, both the owner and contractor laY be
cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertain as to what licensing
reguirelents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (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 a~plication for wbicb 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 wishes you to sign
as contractor that laY be an indication that he is not properly licensed and is not entitled to perJitting privileges in the
City of ZephyrhUls. .
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. ~ONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - RoIeoIner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant i8 sOl8ODe other than the
"owner", I certify that I have obtained a copy of the above described docUlBDt and prOlise in good faith to deliver it to the
.owner" prior to COIleDCeleDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas cOlleDced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other governaental agencies laY apply to the intended work, and that it is
IY responsibility to identify what actions I lust take to be in COIpliance. Such agencies include but are not luited to:
. Departlent of EnviroDlental Regulation - Cypress B8yheads, Wetland Areas and EnviroDJeDtally Sensitive Lands,
Water/Wastewater freatleRt .
. Southwest Florida Water ManageJeDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
. ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
. Departlent of Health , Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater freatlen~, Septic fanks
. US EnviroDlental Protection Agency - Asbestos abateleDt
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 "cOlpensating volOl8" will be sublitted whieb 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 ,iolate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery petlit issued shall becoIe in,alid
unless tbe work authoriled by such perlit is cOll8nced within sillOntbs of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sillOnths after the tile the work is cu.enced. One 90 day eatension of tile, laY be
allowed for the perlit with fee charge of $15.QO. Tbe eatension sball be requested in IdUng to the Builc1ing Official. An
approved inspection lUst be logged during each sil lOoth period, or the project will be considered abandoned.
WARNING TO OIINER: YOUR FAILURlTO RECORD A NOTiCE OF COIIMINCBIIINT MAY RlSULf IN YOUR PAYING flUCK FOR IMPROVIIIIIIS fO YOUR
PROPIRTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULf IUTH yOOft LINDIR OR AN An IFORl RICORDIJlG YOUR NO'UCK OF
COMHENCEHENf. JOBS UNDER $2,500 IN VALUI 00 101.' NEED TO RBCORD MD POST A 'NOT
lk-4jd~ Y UdE-t
.' SIGNATURE: OIINIR OR AGINI .
STATE OF FLORIDA
COUNTY OF Pasco
The foregoing instrument was acknowledged
before me this 8/23 , 19~ by
STATI OF LORIDA
COU F Pasco
The foregoing instrument was acknowledged
before me this 8/23 , 19 94 by
at
(Signature)
Sandra L.
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
to me or who has
c
Stamped)
r~ ,_:'-::'~J r::')~~:5 S~a~~ c1 r'~~!l~
~"'J . . . :1), 1995
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