HomeMy WebLinkAbout95-4760
BUILDING PERMIT
Permit ~
CITY OF ZEPHYRHILLS
(813) 788-6611
4760A
Date J - /0 - 7 S-
8J ELECTRICAL PLUMBING MECHANICAL
k ~. "'1
P,"porty Owne, ~(f~~.. ~ ~
Job Address: d _----==-___ ~ _
Parcell.D. # 1/- [26 -d./- /) /)/0 - CJ3.S6G!J - t:J1..3 0
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning: Energy Code: R~dO/S:
Description of Work 7f A" t. ~ a....(j....IL- <)' ~'l.~
NO OCCUPANCY BEFORE C.O.
FINAl__3.--30.... <9S
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C,O. _.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
~-t1-. ~~
1-~ ZP ~
Valuation or
Contract Price , ? c/lJ ' t:J'7)
City License Registration # !7 7
State Certified License#
~d1~$/;--
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Canst. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
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 ($15,00) 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.
OWNER'S NAHE
APPLICAnON FOR PERMIT
CITY OF ZEPBYRHILLS
BUILDING DEPAImfENT
~ C~~J0
C~;If~6 ~..e/t!)C- lJ-i.y PHONE
I
~ <{ :;t ~s- a t-L- Ih/ 6-' .
Zd1f(,R1fr CLS / K.. :'3 35'1 (
OWNER'S ADDRESS
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
PARCEL !.D.' / I d-- ~ ..2... (
WORK PROPOSED:~ew Construction
BLOClL.--SUBDIVISION
0/30
OO/D O~30() (OBTAIN FROM PROPERTY TAX NOTICE)
---.Addition --..Al.teration ---..Jlepair _Install
_Sign
---1Iove
-Deaolish
PROPOSED USE: _Single Faaily
--.Jf./F _, of Units --.Jf./H
_ec-ercial
_Indust. _Swia. Pool _Other
---..Jlestaurant & Health Departaent Approval
DESCRIPTIOII OF WORK: 00 I,<)<?~C- tf-Y-ro S70~~ 5~
BUILDING SIZE:
x
Square Feet,
Height
RESIDERTIAL: ATTACH (2) PLOT PLARS & (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.
~UlLDING
$
}O() -nJ
PERMITS REOUESTED
Valuation of Total Construction
_ELECTRICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
--.JIEClWlICAL
$
Valuation of Kechanical Inst:allation
-PLUHBIIIG
GAS
ROOFING
SPECIALTY
TYPE OF COIISTRUCl'IOR: _Bloc1t _Fraae _Steel
Other
FIllISBED FLOOR ELEVAnORS:
Fl' .
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..........................................
RITU .DER
~7p~
/./~
~v
CORTRACTOR SECTION
COKPARY 5rJv~"/~ JIlC(jI(t'~1/
~ State Cert. or Ilqist. .
-" ;z.... City License Registration .
.........................................
77
Signature
RT.JO:CTRICIAII COMPANY
State Cert. or Regist. ,
Siooature City License Registration ,
..........................................
PLIDIBER COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
HECIIAliICAL COKPARY
State Cert. or Regist. ,
Signature City License Registration ,
..........................................
OTRRll COKPARY
State Cert. or Regist. ,
Signature City License Registration ,
..........................................
APPLICAnOR APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Ibe undersigned understands tbat tbis penit laY be subject to Ideed restrictions I wbieb laY be lOre restrictive than City
regulations. !be undersigned assU1e8 responsibility for cmpliance witb any applicable deed restrictions. '
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe OIlIer bas bired a contractor or contractors to undertake IIOrt, tbey laY be required to be licensed in accordance witb
state and local regulations. If tbe contractor is not licensed as required by law, botb tbe mmer and contractor laY be
cited for a lisdeJeallOr violation under state law. If tbe mmer or intended contractor are uncertain as to wbat licensing
reguireJeDts laY apply for tbe intended IIOrt, tbey are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if tbe OIlIer bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe
.Contractor Sectionsl of tbis application for wbieb tbey will be responsible. If JOU, as tbe OIIIler sign as tbe contractor,
you are indicating that you, ratber than tbe contractor, are responsible for tbe IIOrk. If tbe contractor wiabes you to sign
as contractor tbat laY be an indication that be is not properly licensed and is not entitled to peIJitting privileges in tbe
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, tbe applicant, bave been provided witb a copy of IFlorida's construction Lien Law - lkIIeoImer's Protection
Guidel prepared by tbe Florida Departlent of Agriculture and ConsUlel' Affairs. If tbe applicant is SOJeODe otber than tbe
lOIIIlerl, I certify tbat I bave obtained a copy of tbe above described dOCUleDt and pr~ise in good faitb to deliver it to tbe
Rovnerl prior to co.enCeJ8J\t.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all tbe infoIJation in tbis application is accurate and that allllOrt will be done in COJpliance witb all
applicable la1l8 regulating construction, loning, and land developaent.
Application is bereby Jade to obtain a petlit to do IIOrk and installation as indicated. I certify tbat no IIOrk or
installation bas ~ced prior to issuance of a petlit and that allllOrk will be perfoIlecl to leet standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in tbe jurisdiction. I also
certify tbat I understand tbat tbe regulations of other goveruental agencies laY apply to tbe intendeclllOrt, and tbat it is
IY responsibility to identify wbat actions I lUSt take to be in COJpliance. Sueb agencies include but are not lilited to:
t Departlent of EnvirOlll8lltal Regulation - Cypress Baybeads, Wetland Areas' and InnroDleDtally Sensitive Lands,
Water /IIaste1later Ireatlent
t Soutbwest Florida Water Managl!leDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArJy Corps of Engineers - Seawalls, Docks, lavigable Waterways
t Departlent of Healtb i Rebabilitative Services, EnvirODleDtal Healtb Unit - Wells, Wastewater Ireatlent, Septic !ants
t US EnvirODleDtal Protection Agency - Asbestos abateJeDt
I also certify tbat, if fill laterial is to be used in Flood Zone IAI or IA,etc.", it is understood that a drainage plan
addressing a lC0JPeD8ating VOlUleR will be sublitted wbieb is prepared by a professional engineer registered in tbe State of
Florida prior to peIlit issuance.
'7
SIAIE OF FLORIDA j,
CoomOF /45~
The foregoing inst~t was a~kooWledged
before me this 3~ ,19' ~{ by
. .
SIAIE OF FLORIDA 0
coum OF 1 /tS Cd
The foregoing inst~ent was aC~~edged
before me this g -;5K- , 19 ~ by
who is personally known to me or who has
produced
as identifi~ '~., 0 did/did n.ot
take an o~th __ /. . 67 (/J _
c..--/ _ ~(2..J
-'
(Signature) /1 ~ .//.L' .
~ I tlf L€)~;f
(Hame Typed, Printed or Stamped)
HOTARY PUBLIC N Publ' P C Ft
otary Ie alCO 0,
My Commission Expires May 13. 1995
who is personally known to me or who has
produced
as identification ~~hO
take an oath. . k/
(Signature) !K6i77f G~/rr_
(Hame. Typed, Printed or Stamped)
NOTARY PUBLIC
Normy Public Pasco Co, FL
My Commission Expires May 13. 1995
.MelL J.D.
.
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e.BUSt~~ SUN STATE ALUMINUM, INC.
: r-olvl: 37528 State Road 54 West
\~ ZEPHYRHILLS, FL 33541
....lltC,.G (813) 788.7308
\\- ~~-~\- OO\~ -C~- Ol2>Q
CUSTOMER'S ORDER NO.
L~~,€..
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ADDRESS .-~~(). "%''''---'''-'''''' .---......__.._..'.
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PHONE
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NAME
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TOTAL
RECEIVED
All claims and returned goods
MUST be accompanIed by thIs bill.
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