HomeMy WebLinkAbout95-4696
BUILDING PERMIT
Permit
4696 J3
.J-J'f-9.s-
CITY OF ZEPHYRHILLS
(813) 788.6611
N,~
-!:. ~-: l'7J
@
P<ap,rty OW"", 1t,~!;;J ~~ ~
Job Address: 6;2...5 .
Parcell.D. #
Zoning: Energy Code: Radon Gas: i
D,,,,iptio" of Wo'k ~ ~-< ~.,;.~ -/J.,...:J7 J - 0-/ /' (D \.
~-(.\)'
nJ }JIj'
33,J..'i)
~.i
Date
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Me.ter:
T.LF.'s: J>~ ~ (j
FINAL _3,.1) -~ ')
DATE
C.O. ~/-c2Y./7.!:>-
DATE
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances,
City License Registration # .y 7
State Certified License#
:~:~~?'
Company
Address
Telephone#
Valuation or
Contract Price
r L-J-zrz:J . c:rv
./
rj;/L/{~
/J1 ~~ 'II
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
h~L. :1- tJ ~,-) $,,,-
Driveway
Tp. Servo
Rough In 3- "1-q.5 PM,...
Meter Can,,)..f y-9J>
Const. Pole
Pool
Pre-Meter 3 -1-'1 I) Eft:
Finalj- ~., c,{'" &b
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 ($15.001 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.
--~'C'~~.,",
' ~ ,'~fJI1I'"
r
APPLICATION FOR PERKIT
CITY OF ZEPIIYIUIILLS
BUILDING DBPARTllBNT
'.a.
OWNER'S NAIIIL..l)) \ ~),~, \?-
OWNER'S ADDIlBSS ~I S2~
JOB ADDRESS
~~-)\:1"
C'~(\
$\ ~~\J
3,
.
PHON! ~\~) (~~ -:t:.so ~
~ ~~'V~\'\~' \=1
0:L~b ~V /~~~J7i,
~
LEGAL DESCIUP'lION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D.' (OBTAIN FROH PROPERTY TAX NOTICE)
WORK PROPOSED:---.Jiew Goostruction ---^ddition ~teration --Repair' _Install
---1Jigo
--.JIove
---Peaolish
BUILDING SIZB:
x
.
Square Feet,
RESIDENTIAL: AtTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SIT BaG!' FORKS.
COtlKERCIAL: ArlACII (3) SETS OF BUILDING PLANS &: (1) SBT BNERGY FOlUlS.,
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERH.I.TS REQUESTED
--BUILDING
$. Valuation of Total Construction
;"
RI.RC1'RlCAL
AIIP Service Florida Power Corp.
W.R.I.C.
---llEQWIlCAL
$.
Valuation of llecbao.ical lDstall.ation
---JJLUHBIRG
GAS ROOFlBG
SPICIALU .
TYPB ~F COBSDUenOB:
FIRISIIED FLOO1l ELEVAUOBS:
lUocIt --.Jr_e --.-Steel
Other
FI'.
IS PlWJBCI' IN FLOOD ZONB AREA., ,
..........................................
YES NO
, "
co~ SIlCTIOB .. ~.:. .
" WltPAllrJ- E, me
. '
State Cert. or Reaist. . .
City License Reai~tratiOD . Ll7
..........................................
. "
BIITI.QRR.
,'.
Sisnature
~ :~~' COtIPANY~~
. $ State Cert. or Regist.' 1=-/1'1-
~ . O~.ff'a City Licease Realstrstlon' '11
I ... .....................................
,f!T .
PLIIl8IlIl ~. COIIPAIIr Loe.~ l)o~
. . .' State Cert. or Reaist. .
s.......turec- ~J) -~ City Lie...... Jlea,lstrstlon .
... . .................................. .
I~b
IlECllANIGAt COMPANY
State Cert. or Reaist. ,
Si80ature City License Registration .
..........................................
j' ~";
OTHRR GOHPANY
State Cert. or Regist. ,
Signature City License Registration ,
..........................................
APPLlCAnOB APPBOVID BY PBBHIT OFFICII.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
file undersigned WIl1erltaods tJaat this penlt llal be subject to 'deed restricUooa' Ibich llal be lOre restricU,e tbaD City
regulaU0D8. lbe lIIII1ersiga,d assU188 responsibility for cmpliance lith any applicable deed restrictioos.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OlDer .... bired a CODtractor or contractors to undertake IIOrk, thel III be reQuired to lie licensed in acc:orc1uce 11th
state and local regu1aUoos. If the contractor is Dot licensed as required by lal, both the cnmer and contractor 8' be
cited for a U8d8eIDOl' violatioo under state lal. If the cnmer or Intended contractor are uaeutaln as to lllat llC8D1lng ,
requirl!ll!Du IlaY apply for the intended IIOrk, thel are addsed to contact the City of Zepbrrbi1l8 Building Depar~~~ ,(813)
788-6611. . " ,.., . .
, "
, ,
FurtberlOre, if the 0IIl8l' has bired a contractor or contractors, be is advised to have the c:ootractor(s) sign portioos of the
'Contractor SecUoos' of Ws'appllcaUoo for which theYlill be responsible. If fOIl, as the OlDer sign u the ~tractor,
rou are in4icating that JOU, rather than the contractor, are responsible for the IOrk. If the cootractor liaIIu you to 81gB
as contractor tJaat ., be an iDlUcaUon tJaat be is not properl, licensed and Is not enUUed to perJ1tUng pd'1:l~,~ the
Citr of Zepbrrb1l1s., ,"" '.
C. TRANSPORTATION IMPACT FEES AND UTILI'l'Y CONNECTION FEES
D. CONSTRUCTiON LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AKBNDED)
I certify that I, the applicaat, have beID provilled lith a copy of 'Floriila's COostrucUon LiID Law - .....r'8 'rot8cUoo
Guille' prepared by the floriila Departlent of Agriculture and COll8l118l' Affairs. If the appllcaat i8 .... ok than the
'owner', I certify tJaat I have obtained a copr of the above described c10cUIIeDt and promo in gooiI faitla to de1i1er it to the
'OlDer' prior to co.eDCMeDt.
f1' ~
E. CONTRACTOR' S/OWNER 'S AFFIDAVIT
I certify that all till infonaUon in Ws application is accurate and that all IOrk lill be 40ae in cmpl1ance ,ltII all
applicable lava regulatiDg construction, 10000g, and land developllDt. \ \. ,
Application II herebr Jade to obtain a perlit to do lork and installation as indicated. . I cerUfr that 110 IOrl or
installation baa ~ prior to i88uance of a perlit and that alllOrl ,111 be perforMll to _t ataDl1ard8 of a111aa
regulating COD8truCUon, Citr coc1es" 10ning regulatioos, and land deve!opIIDt regu1aU_ in tile jurl84lcUCIl. I also
certify that I understand that the regulati_ of other gOYerDl8Dtal agencies .r appl, to the lDtenl1el111Orl, aDIl tllat it II
IY rupoosibllitr to ldentifr lllat actioos I IUIt tale to be in COIPl1ance. Such agencies include but Ire DOt l111te4 to:
· Departlent of lovin_tal Regulation .. Cypress Bayhead8, Wetland Areas and InYirODllDtallr Sensitive Laal18,
later/lastewater Ireal:lent ,
I South.est Florida later lIanagl!l8llt District .. le11s, Cypress Baybeac1s, leUanclAreas, Iltering lfatercoursu" , '
I kif Corps of bineers - Sealalls, Docb, litigable latenays
I Depart:lent of Bea1th , Rehabilitative Senicea. BnvlrODl8lltal Bea1th Uoit .. lfells, lastuater IreatMDt, Septic I_
I US BnviroDlll!llta1 Protection AgIDCY - I8beat08 abatl!l8Dt
I also certify that, if fill laterial is to be used in flood Zone 'I' or 'I, etc. ., it is WIl1erstoocl that a dralDage plan
addressing a 'CCJIP8II8ilting yol..' 1111 be sDitted Ibich Is prepared by a professional engineer regilterec1 in tile State of
Florilla prior to perlit issuance. ' ; ,
A per.it i8~ued sball be COJIItrued to be a license to proceed litll tile IOrk and DOt as authority to ,iolate, CIIlC81 alter, or
Bet asIde any provill_ of till tecbnlcal codes, nor shall i88uance of a penit prevent tile, BullcllDg Official fa tllereafter
rBCJUiring a correcUOD of erIOI:I lD plans" coostrucUoo, or violaUODI of anr code. IVIQ pmlt 1I8l18l1 8IIa11'.... maUd
unless the IOrl authorlle4 br luch penit II m.ncec1l1iWn IU IODtbs of i88I1a11C8, or if vorlautllori1e4 bJ tile pmlt is
IU8penc1ed or abaDIlone4 for a period of IU IODtbs after tile tile tile IOrl il ~cec1. ODe 90 clar uteuiCll of tile, 8r be
allowed for the penit ,ith fee charge of $15.00. lbe eatensloo sball be IllJueated in ,rlUng to tile BulWng Official. An
approved inspeCUoo lUSt be logged during each Iii IODtII period, or tile project ,111 be COII8itJered abanI1cIIed.
DIIIJIG 10 OUIII: rwa FlILURlIO R;lCORp, I IOIICI OF ~ 11I1 IllSULI II YOOR PIIIIG DICI fOIlIIPIIJV&IS 10 fOOl
PROPIIIY. IF YOU IIIIID 10 0BI1II 'FWICIIG; COISULI IUI8 YOUR LIIDIR 01 AI II1OR11Y IIIfOIB IImOIIG IWI DICI OF
alNllCIIIIHf. JOBS UIDIIl '2,500 II VILUIIIO lor IBID 10 BICORD lID POSII -IIOIICI OF CDElCIIIIII'. '
~
-".-
-</~-----
-itf-.~,/
I lUll: '
0.. f. j' .
. ",
srlrB OF FLORIDA
coun! OF
Tbe foregoing instru.ent was ackQowledged
before .e this , 19_ by, ' .
srlD OF PLORIDI
coom OF
Tbe foregoing instl'UlleDt was acknowledged'
before .e this ' , 19 by
'0'
wbo is persona~ly known to _ or who has
produced \ .., I ,
as identification and who did/did not .
take an 04th.
(Signature)
(Rue Typed, Printed or Stuped)
ROTARY PUBLIC
wbo is personally known to .e or wbo bas
produced
8S identification and who did/did not
take an oath. .
(Signature)
(RUB Typed, Printed or Stamped)
NOTARY PUBLIC
,"
_..L.
BuIU')IN&
~n\(..,
~
rn~AN1U\t..-
&JB1O Ti+ l-
Ci{ Ji.i) t T
701A-L-
SIUJ~
WA-T{i~
1V\6:l1A
lbr" L
; ,.~ ,........-,.-...,.,.
Md'~LL (o~yr.
- (PlS~ Ft: ~~\::r ~\).-
VAL.>JI\T'U:\N: ~t eoo
55: ~ \)
/ I~ vO X 72.0
(!cpA1fL )
33.50
N/It-
tJ/A
f<t. So
/'itA
<69J.. 5""0
LQ\.)N&.nW ,F~ ,
NIA
~A-~W 6\s
~l JJ!f1
&/
1~6PDa.rm7t>t\l tmma fiif-s
({fi;i^"- " tsq l. Oc. ~.: 72-D ::::. J t 2..1 7. S 2-
L-l(,-rtT
',.J~IJ <; 'fLy
43~c~o I~'# 7'l.D :: '.3.l ~ J 12 (Jt...lJ)(T
. 'I '.
"
_.. -riFS DulL.. = q tJ3. ~o
L_
-11
qq2..'O
-
UN IT #-.3
:>
~~1Z.U '~~"" II -
/,)"1 J /} <!) 1-
NEvJ 35,~:' ~;:"'Ci4i"- """""
6t' f1: ~l\/W6-
~. f~ OTItlUL