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CITY OF ZEPHYRHILLS
(813) ~-6611
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Parcell.D, # /1- ~- f)OID~__ -Olk'()
Zoning: Energy Code: Radon Gas: ..~
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lO /1> FINAl__
BUILDING PERMIT
Permit N.~
_4715,6
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Date
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M~ewer Conn
Water Conn:
Water MeJer:
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
DATE
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances,
DATE
BUILDING
(2);"'7<<4
ELECTRICAL
Inspector
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Company _ ~ _
Address
Telephone# ~7' fit) - lc:l- /.b
Q.J7I"1
Valuation or ..d.. ail..
Contract Pricerr- ~ 000'
City License Registration # _
State Certified License# _-------
UW71V?
PLUMBING
SLB r~~ t./-'I~(~q,l"""
Tub Set
Water
Sewer
Final
Tp. Servo
ell Rough In
Meter Can
Const. Pole
Pool
Pre-Meter iA-/f~> i3~~
.I Final
5"-q..1?~ U.u~~J\\ ~trn-L
5"'~/7.~} "&b
reakers
Ducts Ins!.
Compressor
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.001 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.
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OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMEIft"
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...?d;;;~ 9t~ ;S'{-
JOB LOCATION
PARCEL I.D. # II-d6 -.xj- OO/d - /Yd<n) - cJlRtJu
SHOW ALL EUSTDIG &: PROPOSED STRUC"I."URES GIVDIG DIMENSIONS &: SETBACKS.
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FRONT PROPERTY LINE
/c.fLJ
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
STREET
~J+
'/5
(NOTE EXAMPLES 1 & 2)
1. SETBACKS FOR R1, R2 ZONING
60'
10'
P E-
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
2. SETBACKS FOR R3 ZONING
60'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 'DUPLEX
1 0'
FROIft" PROPERTY LINE
FRO1ft' PROPERTY LINE
APPLICATION FOR PERHIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER' S NAKE 'uE~,.u C? o,;{.'/J
OWNER' S ADDRESS .dFc?~ ,t tire $..., ~T
PHONE 1 gcJ - '7.;/ / .(,
JOB ADDRESS
~/YJE
LEGAL DESCRIP'l'ION: LOT(S)/rq..OlO Ci-~i IS BLOCK
SUBDIVISION
PARCEL I.D.# 11-,;<t-oIl-~OIO-/%dOO - () 1% 0 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~New Construction ~ddition --Alteration _Repair _Install
_Sign
---1Iove
_DeJlolish
PROPOSED USE: _Single Faaily
---1I/F _, of Units ---"/H
_ec-ercial
_Indust. _Swi.. Pool LOther
~estaurant & Health Depar~ent Approval
DESCRIPTION OF WORK: rfJ./l'/~Lf~- i.lJ-CcI_ k<A-~ f~ - <;<- ~~
BUILDING SIZE: c? P X 3t:?, X q C:, Square Feet, ,~d f Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
LBUILDING
lELEC'l'RICAL
----"ECllANICAL
-LPLUHB~NG
rz~
PERKITS REOUESTED
$ Ie
,;{ r?J
AItP Service
Valuation of Total Construction
'-/.... Florida Power Corp.
W.R.E.C.
$
Valuation of Mechanical Installation
GAS
ROOFING
SPECIALTY
TYPE OF CORSTRUCTION: -LBlock _Fraae _Steel
Other
F1RISHED FLOOR ELEVATIONS:
******************************************
YES
'I--.
.....0.-
NO
Y1' .
IS PROJECT IR FLOOD ZONE AREA?
BUILDER
CONTRACTOR SECTION
COKPANY ~1.-
State Cert. or Regist. #
City License Registration #
***************************************
Signature
:=~
PLUMBER
. ~ OOHPARY ~~
~ " State Cert. or Regist. #
~ ' ~City License Registration'
~ ............................................
COMPANY tGr7t.1~
State Cert. or Regist. #
City License Registration #
* ****************************************
Signature
KECHANlCAL
COMPANY
State Cert. or Regist. #
City License Registration .
******************************************
Signature
OTRRR
COMPANY
State Cert. or Regist. ,
City License Registration #
******************************************
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this perJit laY be subject to "deed restrictions. wbicb laY be lOre restrictive than City
regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
cited for a lisdeIeaDor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents laY apply for the intended work, they are advised to contact tbe City of Zepbyrhills Building Departlent, (813)
788-6611.
FurtherlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that laY be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
City of Zepbyrhills.
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 "Florida's COnstruction Lien Law - HoIeowner's Protection
Guide" prepared by the Florida DepartJent of Agriculture and Consuaer Affairs. If the applicant is SOI8OIle other than the
"owner", I certify that I have obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the
.owner" prior to cOlleficeaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation has COIIeDced prior to issuance of a perlit and that all work will be perforted to leet standards of all laws
regulating construction, City codes, loning regulations, and land developaent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goverDlental agencies laY apply to the intended wort, and that it is
IY responsibility to identify wbat actions I lust take to be in coapliance. Such agencies include but are not lllited to:
t DepartJent of EnviroDlental Regulation - Cypress Bayheads, Vetland Areas and EnviroDlentally Sensitive Lands,
Vater/Vastewater Treatlent
t Southwest Florida Vater Hanageaent District - VeIls, Cypress Baybeads, Vetland Areas, Altering Vatercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Vaterways
t DepartJent of Health i Rebabilitative Services, EnvirODleDtal Health Unit - VeIls, Vastewater Treattent, Septic Tants
t US Environaental Protection Agency - Asbestos abatelent
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 "cOIpeRsating voluaen will be subtitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed ,witb the work and not as authority to violate, cancel alter, or
Bet aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official frOl,thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery pelIit issued shall becoIe invalid
unless the work authoriled by such perlit is cOlll!nced within sillOnths of issuance, or if work authoriled by tbe perJit is
suspended or abandoned for a period of sillOntbs after the tite the work is COMenCed. One 90 day stension of tite, laY be
allowed for the perJit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
approved inspection lUst be logged during each sillOnth period, or the project will be considered abandoned.
WARNING TO OIfRER: YOUR FAILURE to RECORD A NOTICE OF COMHINCBllBIII HAY RESULT IN YOUR PAYING TWICE FOR IHPItOVIHBIft'S TO YOUR
PROPERTY. IF YOU IIIIBND TO OBTAIN FlIlAHCING, CONSULT VITH YOUR LBNDER OR AN ATTORRBY BEFORE RECORDING YOUR MOTICH OF
COMMENCBllBIII. JOBS UMDBR $2,500 IN VALUE 00 NOT NEED TO RECORD AND POS'l' A "NOTICH OF CQtlHBNCBHBIII".
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUIIIYOF
The foregoing instrument was acknowledged The foregoing instrument was acknowledged
before me this , 19____ by 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)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARy'PUBLIC