HomeMy WebLinkAbout95-4612
BUILDING PERMIT
N".'
Permit
CITY OF ZEPHYRHILLS
(813) 788-6611
4612 /1
Date
I - / 0 - 5?~-
~
~1tE
Property Owner:
Job Address: ~ fJ 7?J/jJ~-JI ~~O
Parcell.D, #
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I,F.'s:
Zoning:
Description of Work
Energy Code:
~ddA1 . ~
Radon Gas:
. ~:-~J ~Lf'vtA'A':'~'
NO OCCUPANCY BEFORE C.O.
FINALl-2tfr7)
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordal"ce with City Codes and Ordinances,
c.o.
Inspector
.., rJ....- Q
City License Registration # ~ ~L
State Certified License#
Permit Fee
Signature
Company
Address
Telephone#
~&ti''uJ
Valuation or
Contract Price ~ ~ "t/()
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr,
Pre SLB
~~~I -~~.r
Insul. C~
WL Bl tY
Driveway
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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M ENClNEERlNG PRov.oEO YillH MSE ~YilNCS IIEElS M
STAI<<lARO BUIlOlNG COOt: REOOREIlEMlS fOR M nPES ~
SlRUC lURES SHO'Ml
AU. 1Mf0000"nON AND llET.....S CONTAIIED ON lHIS DR"WlNG ARE
PR~RTY ~ v.'lIllE/lC1 E, BENNE" AND .....Y MOT BE REPRO-
OUCEO/COPIEIl OR USEO 1M ANY IIAHNER .THOOT HIS 'MlITTEN
PERIII~SIOl. IMfORllATlON IS MOT VNJ) YilTlIOOT HIS SlCN"TIJ/lE
NlO E111lOSSED SEAl ON II"STER ru: CCl'Y BELONQHG TO
THE PERSON U~C " copy ~ 1ltS.
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ESTIMJ~TE & AGREEMENT
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H'/ (t:) ry /y,. ,1/ /c/e--
DATE:
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1021
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BID: We hereby propose to furnish material and labor
to complete the work outlined herein for the sum of:
/h/2 -D\i~aDJ1/:~4i,f lL<<4\/ct;~l~ '. ~o~~~~
($ / ?) [~-:; ~~ ) Payment to be made :s follows:
To
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We hereby submit specifications and bid for:
FOlD HERE
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CONTRACTOR'S GUARANTEE
ACCEPTANCE OF BID
We guarantee all material used in this contract to be as specified above and the
entire job to be done in a neat, workmanlike manner, Any variations from plan or
alterations requiring extra labor or material will be performed only upon written
order and billed in addition to the sum covered by this contract. Agreements made
with our ,Work!llen are not recognizec}'!
DATE i{/ //"[c SIGNED, /'/
"//./J 71
The above specifications, terms and contract are satisfactory, and
(I) (we) hereby authorize the pE~rformance of this work,
DATE
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SIG""ED ../
V'"
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1289
THIS CONmACT fS VOID:30 DAYS FROM DATE;: UNLESS PINK COpy IS SIGNED AND RETUf3~E;D TO BiDDER
. "iWpColW'/tvwn'HALL WORKMAN'S.COMPEt-lS,ATION & PROPERTY DAMAGE LIABILITY INsrJAANdI:'~~, ,
r.
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,
APPLICAnON FOR PERKlT
CITY OF ZEPIIY1UII.LI.S
BUILDING DEPARTHENT
OWNER'S
ONE
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
(OBTAllI FROM PROPERTY TAX NOTICE)
tdition -..Alteration --Repair _Install
PARCEL I.D.' /
WORK PROPOSED: ~ et--
6u0
Z~
PROPOSED
f96~
re ----P~lish
_' of Units ---.Jt/B
t. _Swia. Pool _Other
DESCRIPTIOII
,t ApprovalC:: II G -LL \
jf)YVJ ~/~ 71Y}J cnC~e~~
t, B I Height
BUILDING SIZ!
RESIDEIITIAL:
COMMERCIAL :
1
BUILDIIIG PLANS &: (1) SET EIIERGY FORMS.
.-sitS &: (1) SET ENERGY FORKS.
-- "OR ALL NEW CONSTRUCTION.
~LDING
$.
. (!fD
r?aJO '--"
PERKITS REOUESTED
Valuation of Total Construction
RI_RCTRICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
---1IECBAlIICAL
$.
Valuation of Mechanical Installation
-PLUHBDG
GAS ROOFIIIG
SPECIALTY .
TYPE OF COIISD.UcnOIl:
Bloclt -Yraae _Steel
Other
FDlISBED PJ.OOR ELEVAnONS:
FT.
IS PlWJECI' IN FLOOD ZONE AREAt
YES NO
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BIITI.DRR
~~... 1.17.. '~~. or~t. .
.. ',f)({j/kt1.a{ City License Registration .
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Signature
RT_RCTRICIAR
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
SilmAture
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
tlECHANIGAL
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
APPLICAnOIl APPROVED BY
PERKlT OFFICER,
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'l'be undersigneel understands that this pel1lit IIaY be subject to -deed restrictiOll8- .bich lilY be lOre restrictive than City
regulations. !be undersigneel asSOles responsibility for co.pliance .ith anJ applicable deeel restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they lilY be reguireel to be licensed in accordance .ith
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lilY be
cited for a lisdeJeallor violation under state la., If the owner or intended contractor are uncertain as to wbat licensing
requirBlents IilJ apply for the intended work, they are advised to contact the City of ZepbJrhUls Building Departlent, (813)
788-6611,
FurtherlOre, if the OIner bas bired a contractor or contractors, be is adviseel to bave the contractor(s) sign portions of the
-Contractor Sections- of this application for .bich they will be responsible. If Jou, as the OlDer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wishes you to sign
as contractor that lilY be an indication that be is not properly licenseel and is not entitleel to perlitting privileges in the
City of ZepbJrbills,
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided .ith a cOPJ of -Plorida's construction Lien Law - lIoIeowner's Protection
Guide- prepared by the Plorida Departlent of Agriculture and COnsUlBr Affairs. If the applicant is 8OIBOD8 other than the
-owner-, I certify that I have obtained a cOPJ of the above described docuIent and prOlise in good faith to deliver it to the
"owner- prior to COII8IlCl!lBJ1t,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all .ort will be done in cOlpliance .ith all
applicable laws regulating construction, loning, and land developlBllt.
Application is bereby lade to obtain a perlit to do wort and installation as indicated. I certifJ that no work or
installation bas CDlBDceel prior to issuance of a pel1lit and that all wort will be perfol1ll!d to Jeet standarc1s of all laws
regulating construction, City codes,. loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveIDleDtal agencies IilJ apply to the intended work, and that it is
IY responsibilitJ to identify what actions I lUSt tate to be in COIpliance, Such agencies include but are not lilited to:
t Departlent of EnvirODlental Regulation - Cypress Bayheads, lIetland Areas and EnviroDleDtally Sensitive Lands,
lIater/llastewater !reatJent
t Southwest Florida lIater HanagBlBDt District - Wells, Cypress Baybeads, lIetland Areas, Altering lIatercourses
t ArlY COIPS of Engineers - Seawalls, Docb, Navigable Waterways
t Deparblent of Health' Rehabilitative Services, BnvirODleDtal Health Unit - Wells, Wastewater !reablent, Septic !ants
t US BnvirODleDtal Protection Agency - Asbestos abatl!lBllt
I also certify that, if fill laterial is to be used in Flood Zone -A- or -A,etc,-, it is understood that a drainage plan
addressing a -COIpensating vol.- will be subJlitted which is prepareel by a professional engineer registereel in the State of
Florida prior to pel1lit issuance. '
A pertit issued sball be construed to be a license to proceed "ith the vork and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official fa thereafter
requiring a correction of errors in plans, construction, or violations of anJ code. BvetJ perlit issueel shall beCCE invalid
unless the .ort authorized by such perlit is COll8llCeel within sillODths of issuance, or if wort authorized by the pel1Iit is
suspendeel or abandoneel for a period of sil IODtbs after the tile the vort is co.enced. One 90 day utension of tille, lily be
allo.eel for the pel1Iit with fee charge of $15.00, Ibe utension sball be requested in writing to the Building Official. An
approveel inspection lUSt be logged during each sillOllth period, or the project will be considereel abandoned.
IIARIlING 10 omR: YOOR FAlLURlIO RlCORD A NOt'ICE OF alfMBNCDIBIft' HlY RlSULI IN YOOR PAYING !VICE FOR IIIPROVIHD!S '1'0 YOUR
PROPERft. IP YOU lJDIO) 10 OBtAIN FIlWICIIG, COJfSULI WI'I'H YOOR LINDER OR AI A'l'IOIIUY BEFORI RlCOHDIIiG YOUR IIOfICE OP
-~~-6~~
SIGIII!. - 01 - - 'JJfL - - S 11IOI: CIuDt1Ul -
S'I'A'I'B OF FLOR~
COUNTY OF 6t!.O
The foregoing instrument was acknowledged
before me this GAN, frJ,-, 19~by.
(Y/Aterv /Jfo,v'j,IP'<<-e#
~ho'is petsonally known to m~ or who has
produced
as identification and who did/did not
~~.~..
(S. ature)
. (RiIIIIe Typed, Printed or Stamped)
NOTARY PUBLIC
S'l'IIE OF FLORI9&. . '
coum OF 1:11 SC 0
The foregoing instrument was aCknowledged
before me this;7A~ 9fA; , 191:C" by
,ho ~~t~~t!~t:~~hO has
produced .
as identification and 0 did/did not
take oath.
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
,,'
JAMES A, STONE
Notary Pubiic, State of Florida
My comm. expires May 16, 1995
CC110274
JAMES A, STONE
Notary Public, State of Florida
My (;omm. expires May 16, 1995
CC110274
,/; .CIT~/~,Z'PHYRHILLS ~ILDING DBPARTKENT
OWNER ;to ( h (tQ
:::C::C;~:~N# 3}~~fI'iHo;aJ ;4i /cn~f-:Jr
- . . ..
SHON ALL EXISTING &
St.:.R-I?# )?a-" ~ ~>u w~
Lcl'?,L' ~~rL..-fi<t,;;>r
/?:?~.J!.f C'/,~ ()' tZ+/'?...frL
PP/~C;lMj l:;'" -- j
. ~r... .fjf-~~-'-
. q..- v.
c~
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED,
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION,
SBTBACKS.
~r:''3~
~J1\
~Y\~r
jo if
~~
~
~p
!')
G ,..::>5 lrLu:..r, wJ
'> L~v:;K..t.- '~I~
of t'frlL
(!),.-. ~ f€rl ~>
f tL-~'i
~1.J1t-0
~
"" '
tJ
t)r0l{
~~V\~
'1
t'xurKR'f'Y "J:r/2 I
J!' RUNT
(NOTE EXAMPLES 1 & 2)
1, SETBACKS FOR Rl, R2 ZONING
60'
2, SETBACKS FOR RJ ZONING
60'
10'
pop E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM JO'DUPLEX
1 0'
1 0'
FRO1ft' PROPERTY LINE
FRONT PROPERTY LINE