HomeMy WebLinkAbout94-4315
BUILDING PERMIT
Permit N.~
CITY OF ZEPHYRHILLS
(813) 788-6611
_ 4315g
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Date
M~IL.AL
Sewer Conn
Water Conn:
Water Meter:
T.I.F '5:
Parcell.D. #
Zoning:
Description of Work
Energy Code:
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NO OCCUPANCY BEFORE C.O.
,crt
. D ,,13
I
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordar'2'e with City Codes and Ordinances.
DATE
City License Registration #
State Cerf ied License#
~S~ fl~t!7
Inspector
Permit Fee +- .,5$rJ' ~,
Signature ~~S~
Company
Address
Telephone#~ 7.R D -:JQ9 0
Valuation or ~ 1- ~:J:!!!--
Contract Price C::<, /P
ELECT
PLU
MECHANICAL
Ftr. q -'1-2 ~c;c.J
Pre SLB
Lintel
FRM.
Insul. CL
WL
gLL
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
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 ($15.001 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 PBRKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTKENT
0IlIIER' S IWIIl Do -->j-\ u. s Gc '.u <j P ):-
OWNER'S ADDBm)S 4 7 4 3 I ' 7 r~ ~-t,
JOB ADDRESS 4 7 4 S J 7 r-t.. Si- ' Z t> (J k y ~ ~'"\ ~ \ \ S
LEGAL DESCRIPTION: LOT(S) 5 IV i'J.:~ ~B~SUBDIVISION r1'\C)O)-eS ~'...~t
PBONE
7<Dd-.. ) 7 5R
PARCEL I.D.' (OBTAIN FROM PROPERTY TAX. NOTICE)
WORK PROPOSED:_New Construction ___,Addition ----.AJ,teration ---.Jlepair +Install
_Sign
--lfove
_Deaolish
P~POSED~E: ~s~eF_ilY
_ec-ercial
~/F _' of Units _M/B
_Indust. _Swia. Pool _Other
DESCRIPTIOR OF WORK:
---..Restaurant Ii: Health Departaent Approval
\ () ( M.e ~ SeA... ~ \ \ \ ~ \) ~ ~
.
~c;kt\
BU1LDIliG SIZE:
x
Square Feet,
Height
RESIDEIiTIAL: ATTACH (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET EliERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BU1LDIliG PLANS Ii: (1) SET EIiERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION.
~UlLDIliG
PERMITS REQUESTED
$~Valuation of Total Construction
AKP Service Florida Power Corp.
W.R.E.C.
_ELECl"R1CAL
-"ECllAllICAL
$
Valuation of Mechanical Installation
_PLUKBIliG GAS ROOFIRG
SPECIALTY
TYPE OF CORSTRUcnOR: _Bloclt _Fraae _Steel
Other
PIlIISHED FLOOR ELBVAnORS:
Fr.
IS PROJEct IN FLOOD ZORE AREA?
YES NO
..........................................
CONTRACTOR SECTION'
BITTTJ1RR
COHPAIiY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
RT .RCTRTCIAII
COHPAIiY
State Cert. or Regist. .
City License Registration .
..........................................
SionAture
PLUllBER
COKPAIiY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
IlECllAllICAL
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
~
It
Signature
COMPANY 'v...J
State Cert. or Regist. .
City License Registration .
..........................................
OTHRR
APPLICAnOIl APPROVED BY
PERHIT OFFICER.
~
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Ibe undersigned understands that this perait aay be subject to 'deed restrictions' wbieb lilY be lOre restrictive than City
regulations. !be undersigned assUJeS respousibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake wort, they lilY 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requiretents lilY apply for the intended wort, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
788-6611. '
FurtberJOre, 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 wbieb they will be responsible. If JOU, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wisbes you to sign
as contractor that lilY 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 'Plorida's Construction Lien Law - lkIIeoImer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUll!I' Affairs. If the applicant is IKII80De other than the
"ownern, I certify that I have obtained a copy of the above described docUIent and prOlise in good faith to deliver it to the
lowner' prior to COIIeIlCl!lellt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforution 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 Iilde to obtain a perlit to do work and insWlation as indicated. I certify that no wort or
installation bas COIIenCed prior to issuence of a perait and that all wort will be perfoIled to leet standards of all Ian
regulating construction, City codes, loning regulations, and laud developlll!Dt regulations in the jurisdiction. I also
certify that I understand that the regulations of other gDVerDIl!Dtal agencies lilY apply to the intended wort, and that it is
IY responsibility to identify what actions I lUSt take to be in COIpliance. Sueb agencies include but are not lillited to:
I Departlent of EnviIOlllental Regulation - Cypress Baybeada, Wetland Ireas and Invirolllentally Sensitive Lands,
Water /IIastewater Ireablent
I Southwest Florida Water Hanagetent District - Vells, Cypress Baybeads, Wetland Areas, Altering Watercourses
I AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
I Departlent of Health i Rebabilitative Services, EnviIODlental Health Unit - Wells, Wastewater Ireatlent, Septic lants
I US EnviIODlll!lltal ProtectiOn Agency - Asbestos abatetent
I also certify that, if fill I8terial is to be used in Flood ZOne III or lA, etc. I, it is understood that a drainage plan
addressing a 'COIpenSBting volUle' will be subllitted wbich is prepared by a professional engineer registered in the State of
Florida prior to petlit issuance.
A pertit 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 the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any coc1e. Ivery perait issued shall beCCIIe invalid
unless the work authoriled by such perait is COIIenced within sillODtbs of issuance, or if work authorized by the perait is
suspended or abandoned for a period of sillODtbs after the tile the work is ~ced. One 90 day atension of tile, lily be
allowed for the perait with fee charge of $15.00. !he atension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb sil IODth period, or the project will be considered abandoned.
IIARMING YO OIlIER: YOUR FAILURI YO RECORD A lfOtICE OF CC>>lMIICIIIDl' MAY RESULI II YOUR PAYING DICE FOR IMPROVIIIDI'S 10 YOUR
PROPmY. IF YOU Inmm YO OUlIlf FIIIAlfCING, COISULI WIfB YOUR LIIIDIR OR AI AnoRIIY BEFORE RECORDING YOUR DICE OP
. JOBS UJm $2,500 I VA DO lOt tIIID 10 RECORD AID POSI A 'IOtICE F C(JOIIlfCEllllfl".
SfArl OF FLORIDA
CDUm' OF
The foregoing instrument was acknowledged
before me this , 19____ by
SIAfE 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 kn01lll to me or who has
produced
as identification and who did/did not
take an o~th.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Sta.ped)
NOTARY PUBLIC
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SILCOX ENGINEERING, INC.
5409 N. Nebraska Avenue
TAMPA. FLORIDA 33604
(813) 238.9755
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5409 N. Nebraska Avenue
TAMPA. FLORIDA 33604
(813) 238-9755
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SILCOX ENGINEERING, INC.
5409 N. Nebraska Avenue
TAMPA, FLORIDA 33604
(813) 238-9755
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