HomeMy WebLinkAbout95-4686
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit NC?
468&8
~-Jtl -9~-
Date
c,~~~.;:) ELECTRICAL PLUMBING MECHANICAL
Pmperty Own", ~I1:i Ji~.
Job Address: ,?~~ s _ a..r-f?....
Parcell.D. # II -616-:l/ - t:>~/ tJ - /~'Y~O - 0 CJ 6 CJ
Zoning: Energy Code: Radon Gas
De,e';ptlonofWock ~ A!jr q -~ ·
Sewer Conn
Water Conn:
Water M!lter:
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL
;;J- J b-
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Inspector
P~rmit Fee ~.~ ~
Signature ~
Company
Address
Telephone#
p~
Valuation or
Contract Price
r:2 {TzJ. crV
City License Registration #
State Certified License#
~A.
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
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 PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
i -3 - lr
OWNER' S N~ ~C.H A l'--D
OWNER'S ADDRESS 3 ~ 0.3 q
JOB ADDRESS S.A-M e-
LEGAL DESCRIPTION: LOT(S) ~) 7} 7 g BLOCK/~q SUBDIVISION C JTy
PARCEL LD.' / J - :l-~ -.1./- OOJO <~ lS-qoo....OO~tJ(OBTAIN FROM PROPERTY TAX NOTICE)
.
'I kl'nt'l I-!';N.ydbQ/ fill> PAeK~' 1@8--7(.74
S'rH Au e- Z6PH-'tJ<.H lLLS, ~ 33.('
WORK PROPOSED:____New Construction ---Addition ---Alteration ----Repair -A-Install
____Sign --Kove ____Deaolish
PROPOSED USE: _Single Feaily --KIF ____' of Units --K/H
____eo..ercial _Indust. _Swim. Pool ~Other
_Restaurant & Health Department Approval
DESCRIPTION OF WORK: CA 1< PO g,',
BUILDING SIZE: J 0 X W, ::L 00
','1 p E:.
ROOF
,
Square Feet, f3.- Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
bUILDING
$ 200.-
Valuation of Total Construction
---..ELECTRICAL
AKP Service
Florida Power Corp.
_W.R.E.C.
-1lECllANICAL
$
Valuation of Mechanical Installation
--YLUHBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block ____Freae ____Steel A Lv IV) ''''I) tv') Other
FIRISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRACTOR SECTION
BUILDER COMPANY
State Cert. or Regist. t
Signature City License Registration ,
..........................................
ELECTRICIAN COMPANY
State Cert. or Regist. I
SiRnAture City License Registration ,
..........................................
PLUMBER COMPANY
State Cert. or Regist. t
Signature City License Registration ,
..........................................
MECHANICAL COMPANY
State Cert. or Regist. ,
Signature City License Registration .
..........................................
.Q.'ID.BR COMPANY
State Cert. or Regist. t
Signature City License Registration ,
..........................................
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this perlit .ay be subject to "deed restrictions" which .ay be lOre restrictive than City
regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordance with
state aDd local regulations. If the contractor is Jlot licensed as required by law, both the O1IIler and contractor aay be
cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requireaents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner bas hired.a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
"Contractor SectioDs" of this application for which they will be responsible. If you, as the O1IIler sign as tbe contractor,
you are indicating tbat you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that aay be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills.
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 witb a copy of 'Florida's Construction Lien Law - HOIeOWDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOIeone other tban the
"owner", I certify that I bave obtained a copy of the above described dOCUlent and pro.ise in good faith to deliver it to the
"owner" prior to cOll8Dceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify tbat all the inforlation in this application is accurate and that all work will be done in coapliance witb all
applicable laws regulating construction, loning, and land developaent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas cOllenced prior to issuance of a per.it and tbat all work will be perforled to leet standards of all laws
regulating construction, City codes, loning regulations, and land develop.ent regulations in the jurisdiction. I also
certify tbat I understand that the regulations of other goverDlental agencies .ay apply to the intended work, and that it is
IY responsibility to identify wbat actions I .ust take to be in co.pliance. Sucb agencies include but are not 11lited to:
t Departlent of EnviroDlental Regulation .. Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
Nater/Nastewater Treatlent
t Soutbwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t Ar.y Corps of Engineers - Seawalls, Docks, Ravigable Waterways
t Departaent of Health & Rehabilitative Services, Bnvironaental Health Unit - Wells, Wastewater Treattent, Septic Tanks
t US Environaental Protection Agency - Asbestos abateaent
I also certify that, if fill .aterial is to be used in Flood Zone "A' or 'A,etc.', it is understood that a drainage plan
addressing a 'cOlpensating volUle' will be sub.itted which 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 work and not as autbority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Official frOl,thereafter
requiring a correction of errors in plans, construction, or violations of any code. Bvery peIlit issued shall becOIe invalid
unless the work authorized by such per.it is cOlIBnced within Sil IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of Sil IOnths after tbe tile the work is cOllenced. One 90 day 81tension of tile, laY be
allowed for the perlit with fee charge of $15.00. The extension sball be requested in writing to the Building Official. An
approved inspection .ust be logged during each six tOnth period, or the project will be considered abandoned.
WARRING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKERCEKBNr HAY RESULT IN YOUR PAYING IVICE FOR IHPROVBHBNTS TO YOUR
PROPERTY. IF YOU INTERD TO OBTAIN FINANCIRG, CONSULT NITH YOUR LBRDER OR AM ATTORNEY BEFORE RBCORDIRG YOUR NOrICI OF
COKHENCEHBNT. JOBS UNDER $2,500 IN VALUR DQ. NOr RBED TO RBCORD ARD POST A nROTICE OF COHHERCKKBRr".
~~"v -d..h
SIGRATURE: OWNER OR AGERT SIGRA1URB: CONTRACTOR
STATE OF FLORIDA
COURn OF PASCO
The foregoing instrument was acknowledged
before me this January; 19~ by
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this , 19 by
Kathleen Henk
who is personally known to me or who has
produced Personally known
as iden . 'cation and who did/did not
take
Q
(Signature)
Mary H. Ray
(Name 1yped, Printed or Stamped)
NOTARY PUBLIC
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
!tc"""l~f. MARY H. RAY
=*: ~,d ItlCOIoIIlIIS&ION' co 1e8412 EXPIRES
~. :..} December 14,1995
'~;':;!i\. BONDED THRU TAOY FAIN INSURANCE, !NC,
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LAWRENCE E. BENNETT
CIVIL ENGINEER & DEVEWPMENT CONSULTANT
P.O, BOX 4368
SOUTH DAYTONA, FL 32121-4368
TELEPHONE 904/767-4774
9 January, 1995
jQ ALL BUILDING DEPARTMENTS
1995 Master File Enqineerinq
Dear Sirs,
This is to certify that the following Contractor or AAF Chapter is
authorized to use my Master File Engineering for the year 1995.
Please add them to my January 2, 1995 Master file list.
Name: Sunstate Aluminum
Address: 37528 SR 54
Zephyrhills Fl 33541
Should you have any questions please contact me at your convenience.
~n~~6~~~
Lawrence E. BenneLt, P. E.
# 16644
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Civil Engineering, Land Planning, Environmental Engineering, Feasibility Studies
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