HomeMy WebLinkAbout94-4472
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N;~
4472/1
Date / / - J;, -9' 'I
, ,
BUILDING
;to - trD
ELECTRICAL
PLUMBING
~6.lnJ
MECHANICAL
Sewer Conn
Water Conn:
Pmp,rty own",~, A~--,--
Job Address:l5 _~I ~
Parcell.D. #
Zoning: Energy Code:
Description of Work -.A-/ c ( -/.A..-#1. (J' /
~
Water Me;er:
T.I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
1/" Z
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordarce with City Codes and Ordinances.
c.o,
DATE
Inspector
Permit Fee J~ ;O'Vti
s;gna,",~ ( :d...
Compan __
Address
Telephone#
Valuation or
Contract Price ~ V 7...s-... c/7)
City License Registration # ?l
State Certified License#
BUILDING
ELECTRICAL
PLUMBING
~' ~
M ::::JlAL
/.4 ~~ /~--9
,
Tp, Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
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 ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAHE . VI - J41 '8 r r 1./
OWRER'S ADDIlBSS .3 7 '2 a/ / 4-/; s s ~
JOB ADDRESS 5 ~ .S2
PHONE ;? ~O - b->;t:r9
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1.D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSBD:---.Jiew Construction ---..Addition ----Alteration ---..Jlepair -_Install
_Sign
----Hove
->>eaolish
pmPOSWWE: _S~eF_ily
---Yt/F _, of Units ---Yt/H
_ec-ercia1
_Indust. _Swia. Pool _Other
DESCRIPTION OF WORK:
---..Jlestaurant Ie Hea1th Departaent Approval
oZ (O?U tI c- ,p...
BUILDING SIZE:
x
Square Feet,
Height
RESIDBIITIAL :
COttHERCIAL :
A'lTACB (2) PLOT PLANS Ie (2) SETS OF BUILDING PLANS Ie (1) SET ENERGY FORMS.
A'lTACB (3) SETS OF BUILDING PLANS Ie (1) SET BHERGY FOlUlS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTW
~UILDING
$
Va1uation of Total Construction
Rl,RC'l'RICAL
AIIP se~Ytt . Florida Power Corp.
$ ;;( <I ,/ s: ~tion of Kecbanica1 Installation
W.R.E.C.
~ClWJICAL
--PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF OOISmUCrION: ~loclt _Fralle _Steel
Other
FDlISBBD PLOOll BLBVAnONS:
Fl.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRACTOR SECTION
RIJTlJlER
COMPANY
State Cert. or Regist. .
City License Registration ,
..........................................
Signature
~ ' COIIPAllYf'l'trg4.",,, O",<:ii: 'C
- . . ~ State Cert. or Regist. . ' 6j~f ~/ 7
ur . City License Registration t ~~
. ',/ ..........................................
'--""
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration t
..........................................
COKPAHY /(;-;J S$1-,;..- C.9~{,J
State Cert. or Regfst. t d/e~/..2.
City License Registration . ~ /
..........................................
Signature
HECIIAHlCAL
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration t
..........................................
Signature
APPLlCAnON APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
fbe undersigned understands that this perlit lily be subject to -deed restrictions- wbieb lily be lOre restrictive than City
regulations. !be undersigned assU1e8 responsibility for COIpliance with any applicable deed restrictiODS.
B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they lilY be required to be lIcl!ll8ed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the 0IIIIer and contractor .y be
cited for a lisc1eJea1lor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requireaents lilY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
-Contractor Sections- of this applicatim for which they will be responsible. If you, as the owner sign as the cootractor,
you are indicating that JOu, rather than the contractor, are responsible for the worl. If the contractor .ishes you to sign
as contractor that lilY be an indication that be is not properly licl!ll8ed and is not entitled to perJit.ting privileges in the
City of Zephyrhills. --
C. TRANSPORTATION IMPACT FEES AND UTILITY COHHECTION 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 Consuter Affairs. If the applicant is 8oteone 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 co.enceaent.
E. COHTRACTOR'S/OWHER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all wort will be done in coapliance with all
applicable laws regulating construction, loning, and land developlent.
Application is hereby tade to obtain a perlit to do wort and installation as indicated. I certify that no wort or
installation has co.encecI prior to issuence of a perlit and that all wort will be perfoIJed to Ieet standards of all laws
regulating construction, City codes, loning regulations, and land developlll!llt regulations in the iurisc1icUm. I also
certify that I understand that the regulatioos of other gOYBIDlleDtal agencies lilY apply to the intended wort, and that it is
IY responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
I Departlent of BnvirOlllel1tal Regulation - Cypress Bayheads, Wetland Areas and BnviroDleDtally Sl!II8itive LaIIds,
Water/lfastewater freatlent
I Southwest Plorida Water Hanageaent District - lIells, Cypress Baybeads, Wetland Areas, Altering Watercourses
I ArIY Corps of Bngineers - Seawalls, Dods, lavigable Watenays
I Departlent of Health i Rehabilitative Smices, BnvirODleJ1tal Health Unit - Wells, Wastewater freatlent, Septic fanks
I US EnviIOlllelltal Protection Agency - Asbestos abateaent
I also certify that, if fill taterial is to be used in Flood ZOne -I- or -A,etc.-, it is understood that a drainage plan
addreSBing a -COIpl!II8ating volute- will be subtitted wbieb is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perait issued shall be construed to be a licl!ll8e 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 perait prevent the Building Official fICII thereafter
requiring a correctim of errors in plans, construction, or violations of any code. Jverr perJit issued shall beaIIe invalid .
unless the work authoriJed by sueb perlit is COM8Jlced within sillOnths of iSBuance, or if IOrt authoriJed by the perlit is
suspended or abandoned for a period of sillOntbs after the tile the work is co.encecI. One 90 day utension of tile, lily be
allowed for the perlit with fee charge of $15.00. Tbe utl!ll8iOD shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
WARNING ro milD: YOUR FAILURB fO RlCORD A IOI'ICI OF O>>IIIBICBIIBI! MAY RESULT II YOUR PAYING !IIICI POll IIIPROVIIIIIl'S fO YOUR
PROPBRIY. IF YOU IIJ'DD ro OBflIl FIWCIIG, COISULT WIfH YOUR LDDIR OR 11 AnoRDY BEPORI RlCORDIIG YOOB MOI'ICI OF
CfJIMBICBHDI'. JOBS UBDIR $2,500 II VALUE DO 101' !DD ro RBCORD AID POSf A 'IOI'ICI OF aJllllllCIIID'f'.
"
"-...
~
~/
SfAfE OF ~
ccum OF
The foregoing inst1'Ulllent was acknowledged
before me this!~ -zl::--k ' 19~ by
,. '
Kinsey Central
Heat & Air-Conditioning
7718 Fort King Highway . P.O. Box 2209
Zephyrhills, Aorida 33539-2209
(813) 782-2300
FtK1M7Ro- .s-
IlMlE
APARTMENT
DATE PROMISED
ADllIlUS
em
IIIMlE
IIOIlEL
8EIUM. NO.
o ESTIMATE
o CASH
o CHARGE
NATURE Of ~
SERVICE ......,
REQUEST
QUAN. PART NO.
DESCRIPTION
PRICE
AMOUNT
TECHNICIAN
~ PERFORMEO . ? -
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