HomeMy WebLinkAbout94-4488
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BUILDING PERM!!N.~ _4488 {}
CiTY OF ZEPHYRHILLS . P
(813) 788-6611 Date //- :;]:5 -7~~
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Sewer Conn
Water Conn:
Zoning:
Water Meter:
Property Owner:
Job Address:
Parcel \. D. #
T.I.F's:
..:
FINAL
DATE
Complete Plans. Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordarce with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signature /"
Company
Address
Telephone# -J,./ 1~'~ 5 f., ..\-7
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Valuation o~ -4 /. /7/2 . Q..!.
Contract Price CC1 I <:51
ELECT
PLUMBI
ME
AL
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
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.
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BOUNDARY SURVEY
MERIDIAN PER RECORDED PLAT
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LEGEND
F. - Found
S. - Set
'-P. _ Iron Pipe
'-R. - Iron Rod
C,M. - Concrete Monument
C. - Cap
N, & D. - Nail & disk
P.K.N. = P,K. Nail
R.R.S. = Railroad Spike
(I') - Plat DImension ,
(F) - Field M_rement .
(D) = Deed Inlormation
(C) - Computed Dimension
P.P. = power Pole
L. P. = Light Pole
W.M. - Water Meter
...... ~ _ I"'h.ift I ink: Fence
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~7.tt) ,M.l>rd'/'IB ,Dr.'
Copeland and Sons. Inc. and or certifying sur~exor accept no
responsibility for right of way, easement restnctlons or other
matters effecting title to land surveyed other than those recited
in current deed and or instruments of record furnished by
client and or their agents.
"This is to certify that I have consulled the federal Insurance
Administration Flood Hazard bOundary map,
Community NO./..~"-~-~' Panel No. J?:!l.:I!ff?!?
elleetive date //_:..~:~and found thai the a_daSCrlbed
property Is in Zone.::._.!<.....::...' w,th a balle alevation
of~_MSL. This zone ,s notloculecl .n a sp..:iat 1I00d
. .". . . .' .... 0" ...,... - .
NOTE:
" UNDERGROUND ENCROACHMENTS IF ANY NOT LOCATED.
2. OCCUPATiON OTHER THAN SHOWN NOT MEASURED
3. ELEVATIONS BASED ON M.S.L. N.G.V.D BENCH
MARK REFERENCE - -
BENCH MARK NO. ~ €LEV.-
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Propola' No.
Proposal
Sheet No.
CbM.(J
~ '# ~ 388411 HWY. 54 E.
"CJ ~4! g Zephyrhills, FL 34248
~ iI 0 (813) 782-5657
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4tasot\~ -
Date
J () ,- 3/ -- 9 Y
Work To Be Performed At
Propola' Submitted To
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Street (I ).; () .0-<./; (./IA- f,.;'-"
City ! 'f:;' /.... (L, _State .? ..-,
Date of Plans
Architect
=
Name
Street L
City
State' ,~,. ,
Telephone Numbe
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All material is guaranteed to be
and specifications submitted for
as specified. and the above work to be performed in accordance with the drawings
above work and completed in a substantial workmanlike manner for the sum of
Dollars ($ ~. '7 3 .~ ).
with payments to be made as follows:
A.y olt.,o,;on 0' d.v;o';O' 1'0'" obov. .p.dfico';o", ;..olv;," ."'0 co.,. w;U b. .x.cu'ed only upo' w,;n.. o,d.". o.d wUl
beco"'. o. .x,'o cho'O. ov., o.d obov. ,h. ."''''.'.' AIt 00'.."'.'" cO";'O." upo. ..,;.... ocdd..,. 0' d.10y. b.yond 0"'
co.,,,,1. Ow..' '0 co"Y fi,.. 'o,"odo o.d otb., ..ce"O'Y ;."'ooc. upo' obov. wo". Wo""'.'" CO"'p."'o,;o, ..d Publ;c
liability Insurance on above work to be taken out by
Respectfully submitted
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Note _ This proposal may be withdrawn by us if not accepted within days
ACCEPTANCE OF PROPOSAL
Th. .b~. .';c... .pedfi,o';on. ..d ,o.d;';o", .,. ~,;docto'Y o.d .,. he,.by occ.p'.d. You .,. ou'ho,;,.d '0 do the wo" ..
specified. Payment will be made as outlined above.
Signature
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Accepted
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Signature
Date
W~ PrinIinll. InC. ,-
-------------
APPLICATION FOR PERKlT
CITY OF zEPBYlUllLLS
BUILDIRG DEPAR11tERT
OWNER · S IIAHB (}J C~- PHONE PJ3- 7 ff - ;3 *'J-2-()
OWNER' S ADDBESS 47~O W~ DA 2 ~f'~1 A~Jfz. :tt7~ .
JOB ADDRESS 47rcJ Iv I ",.:I-i;~ a
LEGAL DESClUFllON: LOT(S) &' rOO
B~SUBDIVlSION () / h ()
PARCEL I.D.'
J 6- - ;}.Gt - :;L I
,
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED: I/'""Bew Construction .-Jddition ~teration ~pair _Install
_Sign. ---Hove ---peaolish
PROPOSED USE: vSingle Faaily ---Yt/F _' of Units ---Yt/H
_ec-ercial _Indust. _Swia. Pool _Other
DESCRIPTION OF WORK:
.--Jlestaurant &: Health Departaent Approval
JO~O" )I a-r-'-v" ~~ doL ~ fJ~b
,
BUILDING SIZB:
x
Square Feet,
Height
RBSlDERTIAL: ATTACH (2) PLOT PLARS &: (2) SETS OF BUILDING PLANS &: (1) SET DERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SBT DERGY FOIUlS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS RROUESTED
.---BUILDING
$
~
tJ713
Valuation of Total Construction
RT.RCTRICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
~CIWIlCAL
.-PLUHBING
$
Valuation of lIecbanical Installation
GAS
ROOfiNG
SPECIALTY .
~ Other
TYPE OF OOISTRUcnON: ~loclt _Fraae _Steel
Fl.
IS PROJBC1' II FLOOD ZONE AREA?
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FllI1SBBD FI.OOIl BLBVATIONS:
YES NO
..........................................
BIJIIJ)ER
Signature l/;$..dI
coNTRACTOR SECTION
I~ . ':~^_ . '=L.:.r~~~/:~
I ~LIf/'- City License Registration .
..........................................
t:J 'I,C)77 'L
RT.RCTRICIAII COMPANY
State Cert. or Regist. .
SigftAture City License Registration .
..........................................
PLmtBER COMPANY
State Cert. or Regist. .
Signature City License Registration'
..........................................
MECIIAIUCAL COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
vrmm COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
APPLICATION APPROVED BY PBBtIlT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perait lay be subject to 'deed restrictions' wbich lay be lOre restrictive than City
regulations. rbe undersigned a&8D1e8 responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertate wort, they uy be required to be licensed in accordance with
state and local reguIatiOJl8. If the contractor is not licensed as rl!CJUired by law, both the OIIDer and contractor .y be
cited for a .isdeaeanor violation under state law. If the orner or intended contractor are uncertain as to wflat licensing
requiraents .y apply for the intended wort, they are advised to contact the City of Zepbyrbills Building Departant, (813)
788-6611. .
Furtheraore, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
'Contractor Sections' of this application for which they will be responsible. If fOu, as the owner sign as the contractor,
you are indicating that fOU, rather than the contractor, are responsible for the wort. If the contractor lIisbes IOU to sign
as contractor that .y be an indication that he 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 _ lbIeolmer's Protection
Guide' prepared by the Florida Departlent of Agriculture and ConsDller Affairs. If the applicant is mIeODe other than the
'OIfDer", I certify that I f1ave obtained a copy of the above described c1oc:aent and pro.ise in good faith to deliver it to the
"owner' prior to CoaeDCeleJlt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlation in this application is.accurate and that all wort will be done in COIpliance with all
applicable Ian regulating construction, loning, and land develo.-ent.
Application is bereby .ade to obtain a perait to do wort and installation as indicated. I certify that no wort or
installation has ~ced prior to i88uance of a perait and that all wort will be perfOl'l8d to _t staDdarda of aUlbs
regulating construction, City codes, loning regulations, and land developllellt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveruental agencies .y apply to the intended lIOet, and that it is
.y responsibility to identify wbat actions I lUst tate to be in co.pliance. Such agencies include but are not luited to:
t Departlent of EnvirODlel1tal Requlation- Cypress Baybeads, Wetland Areas and Enviroaentally Sensitive Lands,
lIater/Wastewater freatJent
t Southwest Florida Nater Hanag8l8llt District - NeIls, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Aray Corps of Engineers - Seawalls, Docks, Navigable Waterways
t DepartJent of Health' Rebabilitative Senites, EnvilODlental Health Unit - lIells, Wastewater freatlent, Septic fants
t US BnvirODleDtal Protection Agency - Asbestos abataent
I also certify that, if fill .terial is to be used in Flood Zone 'A' or 'A, etc. " it is understood that a drainage plan
addressing a 'COIpensating volUle' will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to per.it issuance. . .
A per.it issued shall be construed to be a license to proceed with the IIOrt and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a perldt prevent the Building Official flOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perait i88ued shall hecaIe invalid
unless the Ifort authoriled by such perait is COMenced within sillODtbs of issuance, or if wort autIIoriJed by the perait is
suspended or abandoned for a period of sil IODtbs after the tiIIe the IIOrt is ~ced. One 90 day atension of tille, .y be
allowed for the perait with fee charge of $15.00. fbe utension shall be requested in writing to the Building Official. An
approved inspection at be logged during each sil IODth PeriOd, or the project will be considered abandoned.
WARJfING fO (MER: YOUR FAILURE fO RICORD A. HorlCK OF C<IIMDCIIIBIIf MAY RBSULf IN YOUI PAYING fllICK FOR IIlPIOVIIIIIrS fa YOUI
PROPBJIfY. IF YOU IJIDIiD fa OBfJDliIDlCIIG,.COBSULf WIrB YOOJi LBIfDIR OR 11 AffORDY BIFORB RBCORDDlG YOUR JfO!ICK OF
aJIHBIiCIHBHf. . JOBS UNDER $2,500 IN VALUlIJO Nor IiUD fa RICOJm AID POSf A 'lfOflCl OF OIIIDCIJIDf'.
-;;t-
SIGliAfURI: (IftfJR OR AGIIif
SIGllAfURI: COJIRACTOR
SfAfB OF FLORIDA
coum OF
The foregOing instI'Ullent was acknowledged
before me this , 19_ by
SfAR OF FLORIDA
coum OF
The foregoing instI'Ullent 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)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Na.e Typed, Printed or Stamped)
NOTARY PUBLIC