HomeMy WebLinkAbout95-4756
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit
N~ 4756f?
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GLECTRIC]~
Date
PLUMBING
MECHANICAL
Sewer Conn
P,"perty Owne' ~!:1:-/ At!
Job Address: /, 9"
Parcell.D. # ...3 -~, -a../ - t)/)OLO - CJ t.3 c; t9CJ - 0/7'0
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: E~Y Code:
Description of workU 4 61 ~ 1 AI,
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL-3_-~ ")
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O. --
Ail work shall be performed in accordance with City Codes and Ordinances.
City License Registration # J;;;L Y
State Certified License#
Permit Fee
Signat'IJre
Company
Address
Telephone#
Valuation or
Contract Price
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
P,e SL~ \.....
Lintel' 0,;-
FRM. 1'1~
Insul. CL 1:>- v
WL -----flY-V
Breakers
Ducts Insl.
Compressor
Final
Tp, Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
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 ($15.00) 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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1890 CHURCH STREET · WeST PALM BEACH, FLORIDA 33409
PALM BEACH (401) 686-0101 · BROWARO (305) 426-2333 · FAX (407) 686-9144
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PLA1JS REVI~O
DATE ~_~-9.~~
BUILDING DEPT APPROV~- \
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This sketch and design shaH remain the Pfoperty 01 Sign Craft,
k1(:, The design. as a whole or in pari may nol be used WIth-
out the eJpress wnl1en consent 01 Si9n Craft. Inc. this sketch
shan be returned upon or belore the completion of ne9Qtia-
lions. Herein, cuslomer a9lees to acct'pt liability lor a rea'
sonable lee levied by Sign Craft. Inc. 10' relentiOO of same,
This sketch may not be copied Of reproou<:ed in any way by
anyone other than a Sign Craft representative, This slate-
ment is a part 01 the ske1ch to which it is attached,
ACTUAL SIZE OF FINISHED SIGN MAY VARY SLIGHTLY DUE
to VARIATION IN SIZES OF MATERIALS AVAILABLE.
PLANTER OR LANDSCAPE SHOWN IN THIS DRAWING IS FOR
VISUAL EFFECT ONLY. IT IS NOT INTENDED TO BE PART OF
THE FINISHED SIGN.
THIS SIGN IS DESIGNED TO WITHSTAND
LBS, P.S.F. WINO LOAD
SQ. FT. ALLOWED SQ. FT, PROPOSED
eYe:,qt~~ IA.'CeL.O ~e;G~
cP44cG ~tA...- f3LA1t/.
~t;;-PH~~(~I FL.&eIDA
Accepted
By
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<'I A_ I g-r -loU II l'-\Ct1\~ ~ \ 1l\ \.\
APPLICAnON FOR PERKIT 0 J ,() .. '^ " .~. n
() rt I I f~::lJU-^A v :\.^{)Ul.
CITY OF ZEPIIYRIIILLS lU""\
BUILDING DEPARTHENT
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JOB ADDRESS l64L\tS Gn \ \ b \ \( cd
~ fI3-'72d-SS04?
7e .1 ~ IFl ~%41_
LEGAL DESCRIP'I'ION: LOT(S) BLOCIL--SUBDIVISION
PARCEL LD.' 3alo~\a~CXJ()OCbl0 \10 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew ~truction ~ition --...Alteration ~epair _Install
~Si~'k.a \ \ C*1{~ ---.JIove _Deaolish
PROPOSED USE: _Single Fsaily ---1I/F _' of Units ---1I/H
Vec-ercial _Indust. _Swia. Pool _Other
~estaurant &: Health Departaent Approval
DBSCIlIP'fi08 OF WOIlK: \~\\ ~\\.t~ed CI-'Y'J.J')ne.i \e-i\u's
BUILDING SIZE: 52.lo1x 2- .J Os.~~~quare Feet.J ~ Height
RESIDERTIAL: 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.
PERKITS REOUESTED
.',;UlU>JJJG C~I~~~~~~rnmar..-L~~~~ ~
~ELEcnuCAL ,. A!IP Service Flor~power Corp. W.R.E.C.
---"ECIIAlIICAL $ Valuation of lIechanical Installation
~UKBING
GAS
ROOFING
SPECIALTY
TYPE OF CORSTRUcnON: _Block _Fraae _Steel
Other
PI1IISBED FlOOR ELEVAnORS:
Fr.
IS PROJEcr IN FLOOD ZONE AREA?
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Bml.DRR I
Signaturj
YES NO ~
.......................................... fl' >
CO~cr~sEcrmN ~
COMPANY SC'.aJ CAl'oL-t-1 rY/ ~~
State Cert. orlRegist~SO(OO~W /
City License Registration . 7;;' X"
..........................................
:~ ~ Jr COMPANY
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/ State Cert. or Regist. ,
e crv' (I\.,. City License Registration ,
.................*.....................***
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
....*..*...*....*.....***.....*..........*
Signature
IlECllARICAL
COIIPANY
State Cert. or Regist. .
City License Registration f
**.*****.**********.**************.*.****.
Signature
OTRRR
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COIIPANY
State Cert. or Regist. ,
City License Registration ,
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Signature
APPLICATION :APPROVID BY
PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this penit lilY be subject to 'deed restrictions I wbich lilY be lOre restrictive than City
regulations. !be undersigned assU11e8 responsibility for co.pliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they lilY be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the 0IIIleI and contractor lilY be
cited for a lisdf!ll8aDor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireents JaY apply for the intenc1ed work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
788-6611.
FurtheIlOre, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
IContractor Sectionsl of this application for wbich, 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 JaY be an indication that be is not properly licensed and is not entitled to perJitting 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, have been provided with a copy of 'Plorida's construction Lien Law - BoIemmer's Protection
Guidell prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If the applicant is SOElle. other than the
lowner', I certify that I have obtained a copy of the above described dOCUlent and pnmse in good faith to deliver it to the
lIownerl prior to cOllenceent.
E. CONTRACTOR I S/OWHER I S AFFIDAVIT L-,
I certify that all the infonation in this application is accurate and that all work will be done in cOJpliance with all A C[ )
applicable laws regulating construction, loning, and land developlellt. ~lv~ ~ Vj vI A
Application is hereby Jade to obtain a perlit to do work and insWlation as indicated. I certify that nO work of:k. ~ f:;~'
installation bas CDlenced prior to issuance of a penit and that all work will be perfoIJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other gOYeIDIIl!Iltal agencies lilY apply to the intended work, and that it is
If responsibility to identify what actions I lUst take to be in co.pliance. Such agencies include but are not lillited to:
t Departlent of InvirOlllelltal Regulation - Cypress Bayheads, Wetland Areas and Invirollll!lltally Sensitive Lands,
Water /IIastewater !reatlent
I Southwest Florida Water Hanagel8llt District - VeIls, Cypress Baybeads, Wetland Areas, Altering Watercourses
I AIly Corps of Engineers - Seawalls, Docks, Havigable Watenays
I Departlent of Health i Rehabilitative Services, InvirOJllental Health Unit - Wells, Wastewater !reatlent, Septic !anks
I US InviIOlllental Protection Agency - Asbestos abatuent
I also certify that, if fill laterial is to be used in Flood Zone 'A' or IIA,etc.l, it is understood that a drainage plan
addressing a lCOIpen8ating VOIUle' will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to penit issuance.
A ~it issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perJit issued shall beCOle invalid
unless the wort authorized by such peait is COII8Ilced within sillODtbs of issuance, or if wort authorized by the penit is
suspended or abandoned for a period of sil IODtbs after the tille the work is co.encec1. One 90 day eltension of tile, lilY be
allowed for the peait with fee charge of $15.00. !be eltension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
VARIIIMG 'fa OIIHBR: YOUR FAILURE 'fa RECORD A NOt'ICE OF aJtMBICBHBlft' MAY RlBUL! IN YOUR PAYIHG filCE FOR IIIPROVBIImS !O YOUR
PROP . IF YOU IJft'BHD 'fa DUlIN PINUCIMG, COHSUL! WID YOOR II OR 11 IftORRIY UPOD RICORDIJIG YOUR IIO'fICE OP
. JflIIlIIlIJIIR 12,500 II muJl 00 IIIr IIIlD 10 lID j~~~
SIGJIA!URIl: COHIRAC'fOR
~~O~FFLORI~(b :O~FJ(?
The foregoing ins.!f;WDent was acknowledged The foregoing ins~~t was aCknowledged
before me this ~, 1~ by before lie this , 19_ by
w is persooally 1m0llD 0... or who ha~perlljlDil~~'" or who has
oduced. 4
as identification and who id/did not as identification and who did/d"d not
take an oath. take an oath
(Sign
~
(Name. Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~~*,~'rit... JACK A. WHITE
f*:"A'f*i MY COMMISSION' CC 194125
~'. .';f~ EXPIRES' ......, 15 1996
..:.*'.....;f:~~ . "t'" .
"Rf.,fti.'" IlondecI Thru NolIry PuIIIIo lInd8Iwrtl8nI
"'~~"""" JACK A. WHITE
!~l:" l'Ii.t~ MY COMMISSION' CC 194125
-.- ....
~~" .~J EXPIRES: AplIl15. 11186
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