HomeMy WebLinkAbout94-4401
BUILDING PERMIT
Permit N~
CaTY OF ZEPHYRHILLS
(813) 788-6611 ~~""
JY---
r ~ECHANIC~
~il C~,~~ ~ {)J.:;L
. 440W(
./O-dl/-ry
Date
B~-
E~
Sewer Conn
Water Conn:
Property Owner:
Job Address:
Parcell.D. #
Water M~Jer:
T.I.F's:
Zoning:
J
a-.:5
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. e.o.
All work shall be performed in accordarce with City Codes and Ordinances.
Valuation or ~ ~
Contract Price ~ / () 0 .,
City License Registration # /41 ~ /~
State Certified License# t:!/1 C!O-.!:J /..~ J I
w
Inspector
~~~' 0 ;
Permit Fee -
Signa'"," -,- -:-- j3;,,~-: ~
Company
Address
Telephone#
Cn~~'
PLU~- fL <..- M HANIC~
--
BUI~'
~
EL~-.
/'
Breakers
Ducts Insl.
Comprepsor
Final 11-/1>4'1
SLB
Tub Set
Water
Sewer
Final
fJ~
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.
CALL 'Jove '-J'i'i'
, (SOO) 633-2950
i'1tj !'<lOAtH MFt'f'tOHlAI. PAi~K~v"'r
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IN ALABAMA (205) 534-8038
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APPLICATION FOR PERKIT
CITY OF ZEPBYRBILLS
BUILDING DEPARTHENT
OWNER'S NAME
72'~j/1
&:, /OL/
,
U/OL/
/r ,~"6;{/E l-
f k E/.?~v sl- -
/
CAM~c/ 51
I
PHONE 7 JlP( ~ 3)1/ i
OWER'S ADDRESS
JOB ADDRESS
LEGAL DESCRIPlION: LOT(S)
BLOCK
SUBDIVISION 0-' f' SI-C1{ ~~
(OBTAIN FROM PROPERTY TAX NOTICE)
PARCEL I.D.'
WORK PROPOSED:~ew Construction _Addition ---..Alteration _Repair _Install
_Sign
---..JIove
_Deaolish
PROPOSED USE: _Single Faaily
---3'l/F _' of Units ---3'l/H
_~ercial
_Indust. _Swia. Pool _Other
.-Restaurant Ii: Health Departaent Approval
DESCRIPlIOIi OF WORK:
GA44~c C'J{/r
BUILDING SIZE:
x
Square Feet,
Height
RESIDEIiTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUlLDIIiG PLAIIS Ii: (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLAIIS Ii: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW COIiSTRUCTION.
PEBKITS REOUESTED
-BUILDING
$
Valuation of Total Construction
_ELECTRICAL
t//HECllAlllCAL
AMP Service
Florida Power Corp.
W.R.E.C.
$
:?/~C)
Valuation of Mechanical Insta11ation
_PLUHBIliG GAS ROOFING
SPECIALTY
TYPE OF CORSTRUCTIOIi: _Bloclt _Fraae _Steel
Other
FIlUSBED FLOOR ELEVAnORS:
Fl.
IS PROJEct IN FLOOD ZONE AREA?
YES NO
..........................................
COrfrRAC'rOR SECTION
,.,
mHPARY
State Cert. or Regist. .
City License Registration .
..........................................
BIJTIJ)RR
Signature
RI.R.CTRTCIAR
COMPAIiY
State Cert. or Regist. .
City License Registration .
..........................................
SionJlture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration f
..........................................
Signature
HECBAlUCAL
COMPANY ~~/? /b~ AEA?-~',c/b /. (~t:'/N 6
State Cer . or Regist.' C,4:~ "7/5//
City License Registration .
..........................................
Sigoature
OTIIRR
COMPANY
Sate Cert. or Regist. .
City License Registration t
..........................................
Signature
APPLICATIOR APPROVED BY
PEBKIT OFFICER,
. ..
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Ibe undersigned understands that this pemit JaY be subject to 'deed restrictions' wbich lay be lOre restrictive than City
regulations. !be undersigned asSOles responsibility for cmpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired 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 owner and contractor laY be
cited for a .isdeleallor 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 Departlent, (813)
788-6611.
Furthe1'lOre, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
.Contractor Sectionsl of this application for wbieb 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 be is not properly licensed and is not entitled to perlitting 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 - lDeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is SOlf!Olle other than the
'owner", I certify that I bave obtained a copy of the above described docuaent and pralise in good faith to deliver it to the
"owner" prior to COIIenCetent.
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 pemit to do work and installation as indicated. I certify that no work or
installation bas ~ced prior to issuance of a perlit and that all work will be perforted to teet standards of all laws
regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDlental agenCies laY apply to the intended wort, and that it is
If responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
t Depart:lent of Bnvirol1llelltal Regulation - Cypress Baybeads, Wetland Areas and InvirolllM!Jltally Sensitive Lands,
Water /Wastewater Ireatlent
t Southwest Florida Water Hanagetent District - Wells, Cypress.8aybeads, Wetland Areas, Altering Watercourses
t AI'IJ Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Depart:lent of Health i Rebabilitative Services, BnvirOlllelltal Health Unit - Wells, Wastewater Ireat:lent, Septic lants
t US EnvirODlelltal Protection Agency - Asbestos abatetent
I also certify that, if fill Jaterial is to be used in Flood ZOne "AI or "A,etc. I, it is understood that a drainage plan
addressing a 'COIpensating volUte' will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued sball 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 shall issuance of a perlit prevent the Building Official frOt thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid
unless the work authoriled by such pemit is cOllellced within six IOnths of issuance, or if work authorized by the pemit is
suspended or abandoned for a period of sil IODtbs after the tile the work is co.enced. One 90 day 81tension of tile, laY be
allowed for the pemit with fee charge of $15.00. fbe 81tension sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sillODtb period, or the project will be considered abandoned.
WARMING TO omR: YOUR FAILURE 10 .~COJ.D A. NOfICH OF <XIlMII!CEIlIMf HAY RESULI IN YOUR PAYIKG nICH FOR IIlPROVEHBIl'S 10 YOUR
PROPBRfY. IF YOU IJlfEMD 10 OsrAIlf FWHeING, CONSULI lID YOUR LBIIDER OR AM A!'IORDY BIFORE RECORDING YOUR NOIICH OF
COMHEJicmmlft'. JOBS UlDER $2,500 IN VALUE 00 NOf RDD TO RECORD AID POST A 'NOfICE OF C(JIHDCEMm'.
, .
SIGlA'lURB: OWIIIR OR AGE1ft'
SIGlAIURI: comACfOR
SIAfE OF FLORIDA
COUlffY OF
The foregoing instrument was acknowledged
before me this , 19____ by
SIAfE 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 oath.
(Signature)
(Rame. Typed, Printed or Stamped)
ROTARY PUBLIC
(Signature)
(Rame Typed, Printed or Stamped)
ROTARY PUBLIC