HomeMy WebLinkAbout94-4266
BUILDING PERMIT
Permit N ~
CiTY OF ZEPHYRHILLS
(813) 788-6611
4266.&
Date
?-3o-1 Y
6~ ELECTRICAL PLUMBING MECHANICAL
PmpertyOwn", .jJ.,;ti- 'bL
Job Address: S E?-O;) - / lJ _ _ ~
Parcell.D. # / / - d.-b d.-/ - D () / tJ - 0 b;JLJ 0- '/r---'l-j 0
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
Description of Work / [) / X ~ 0" ..J~ ,f
Radon Gas:
FINAL '1- Z-
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordarr:-e with City Codes and Ordinances.
DATE
Inspector
Permit Fee ~,~~ /~
Signature 4-~1,F-A.,/~
Company
Address
Telephone#
Valuation or
Contract Price
/,~tJO. OV
~
City License Registration #
State Certified License#
c1J-.. fyL() /I
ELECTRICAL
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.
APPLICATION FOR PERKlT
CITY OF ZEPRYRHILLS
BUILDING DEPARTMENT
OWNER'S N~~ /l.7 ~ ~
OWNER'S ADDRESS 'lrtJA 7 I 0- ~
PHONE
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
~ 8-/'7-10
PARCEL I.D.' /1- ~ b-c2/ - 6 0/0 A-- 0 b :J...Oc:J ~ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:____New Construction ____Addition ----Alteration ____Repair ____Install
____Sign
----",ove
____Deaolish
PROPOSED USE: ____Single Faaily
----"'I F
____, of Units ----1l/H
____ec-ercial
____Indust.
____Swia. Pool _Other
____Restaurant & Health Departaent Approval
DESCRIPTION OF WORK:
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
v BUILDING
$
/,~OO~ CV
,
Valuation of Total Construction
____ELEC'fRlCAL
AMP Service
Florida Power Corp.
W.R.E.C.
____MEGBAIUCAL
$
Valuation of Mechanical Installation
____PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CORSTRUCTIOR: ____Block _Fraae ____Steel
Other
FIRISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA.,
YES NO
******************************************
CONTRACTOR SECTION
BUILDER COHPARY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
F.T .F.CTRICIAR COMPANY
State Cert. or Regist. ,
SiRnAture City License Registration ,
******************************************
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
MECHANICAL COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
omF.R COMPANY
State Cert. or Regist. ,
Signature City License Registration .
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this perlit laY be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
regulations. Tbe undersigned asSllleS responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe ~er bas bired a contractor or contractors to undertake work, they .ay 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 lilY be
cited for a .isdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
reguirelents .ay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if the ONner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tbe
"Contractor Sections' of this application for wbicb they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather tban tbe contractor, are responsible for the work. If the contractor lisbes you to sign
as contractor that lilY be an indication that be is not properly licensed and is not entitled to per.itting 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 witb a copy of 'Florida's Construction Lien Law - HoIeoIner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs. If the applicant is sOleODe other than the
'owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to COlleDCelBDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infor.ation in this application is accurate and that all work will be done in cOIpliance with all
applicable laws regulating construction, loning, and land developlent.
Application is bereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
installation bas c~ced prior to issuance of a perlit and that alllork will be perforted to .et standards of all lals
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify tbat I understand that the regulations of other goveIDJeDtal agencies laY apply to the intended work, and that it is
.y responsibility to identify wbat actions I 80st take to be in cOlpliance. Sucb agencies include but are not lilited to:
t Departlent of EnviroRleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Manag8leDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health i Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
t US EnvirODleDtal Protection Agency - Asbestos abatelent
I also certify that, if fill .aterial is to be used in Flood ZOne 'A' or 'A,etc.', it is understood that a drainage plan
addressing a 'cQlP9Dsating volllle' will be sublitted wbicb is prepared by a professional engineer registered in the State of
Florida prior to per.it issuance.
A per.it issued sball be construed to be a license to proceed witb the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a per.it prevent the Building Official frOl.thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every par.it issued shall becoIe invalid
unless tbe work authorized by such per.it is cu.enced within sillOnths of issuance, or if work authoriled by the per.it is
suspended or abandoned for a period of sillOnths after the ti.e the work is co.enced. One 90 day I!Itension of tile, IliY be
allowed for the perlit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection 80St be logged during each six IOnth period, or the project will be considered abandoned.
WARKING TO 0IfN1R: YOUR FAILURE TO RECORD A ROT ICE OF COMMIRCEMBM1' MAY RESULT IN YOUR PAYING nICE FOR IMPROVIMDl'S TO YOUR
PROPERTY. IF YOU INTEND fO OBTAIN FlflARCING, CONSULT WITH YOUR LBlDER OR All AnORNlY BEFORE RECORDING YOUR NOTICE OF
COMMENCBHm. JOBS URDER $2,500 IN VALUE 00 NO! NIED TO RECORD AID POST A IINOTICE OF COMMINCIMDl'II.
SIGNATURE: OIfIfIR OR AGEIII
SIGRATURK: COIllRACTOR
STATE OF FLORIDA
COUIIIY OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19_ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oQ.th.
(Signature)
(Name ~yped, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
OWNER
JOB LOCATION
PARCEL 1. D. #
SHOW ALL EXISTIRG 6: PROPOSED STRUC"l"URES GIVIHG DIMENSIONS 6: SE'l'BACKS.
'-Ie
r
YO/
/ {
i___
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
/ ()
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
lj
1. SETBACKS FOR R1, R2 ZONING
60'
10'
P E
R X
0 I
10' P S 10'
0 T 1 0'
S I
E N
D G
20'
FROIft" PROPERTY LIME
2. SETBACKS FOR R3 ZONING
60'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 'DUPLEX
1 0'
FRONT PROPERTY LINE
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~ll ~at~rial~ & labor ~eI" 811 applic.~le loc~l codoa
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for, habl t...11on.
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nd~t5 th~ folloving design cr1t~r1A:
. ~uth jilorid~ Building Codo ct St~n(ja:d 3ull.Hng C,)d.,
, L'1t.,~t. 3drt.) ..lnd loads of 120 11.1'1'1.
Tbe buildln$ ....Ul -..1 t.o" tMd tbl> ~bo"l> l').1d8 .,,1 th pl~~...,r.
onol1or1ng. t At) an ~lhn14~ t.j r.,t"l1 CD on "J'iohodo$
t.'x 2'x 3' d.-tp, YXO p~l ooncr.)to foot<1r; (no. of (~ot~r5
~~., .. no. of anohora) can bo ua~d. e4., CQ~t1fl~, g~lY-
<1,,1t~d a t.,.,l ~ tr.t.p (i1in. t"l1a111) lJ trongth . ~. 15 , :ltn.
e~,b.,dA.,nt · 2'- 6" in COI1Cl"fltO).
1\'0 t<t A :
l'Setal atrAJ."' 1~ fiJ."3t tb:'I).'lcod thl"U the slit in bolt c\ 0'\3
the nut 13 tl(lh ~onod, tbe G trl\p ,,,1 nd3 aN\md thlJ bol t.
Sh~~. r:etal stJ."~p: certifiod ~~lv~n1z~d stoel 9\rap,
'H~n.ttJn:c"llo 3tron~th .1750 8., confor:1l1ntr to .3..NSI
119.1 . Tie !;..)....n N1cnor: 6 't....ln '4" helix .!\nehor,
t-odel A 22, as l!'~ar.lJf"lcturod y 1'1:-: X'i('1iJ::NGl~B~..:!~n.JGt
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CCNSUI. T,t~G ENGNHR
8136&02120
61' PARS0N AVENUE
LAi< ELAND FlOR'DA 3::'801
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