HomeMy WebLinkAbout95-4888
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BUILDING PERMple!~. .4888;2
CITY OF ZEPHYRHILLS .,'.. _ P
(813)788-6611 Oat€' /f-~b-9~
~.. P~
Pmp'rty Own" Y/H'/~ ';J{r-~'~~''J ~ .
Job Address: ~ C3i...t .
ME~ Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Parcel 1.0. #
Zoning:
Description of Work
() En"9Y Cod" _ ~ _ Radon Ga" _ ~
tb~\ - . ~41{1
NO OCCUPANCY BEFORE C.O.
FINA~~-~ -9~
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O. --"
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or 1- t.1 i)
Contract Price .::2/ ~ /0'-
Permit Fee
Signature ......---
Company
Address
Telephone# V '7?~ - 3-J/ t7,3
City License Registration # ~
State Certified License# ~
Z2 /'
l 1/ HJ.J.;'
BUILDING
ELE~-
-
PLU~
--"
MEC~
~
Ftr. 5....3...'15 ~
Pre SLB
Lintel
FRM,
Insul. CL
WL
Tp. Serv.
Rough In
Meter Can
Const. 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.
'1
JOB ADDRESS /)~~1 tJ5~ ~~d, ~l7/1 17, '1~~'-If
LEGAL DESCRIP'llON: LOT(S) 1 st T 3 -r I/, I.~ -{ SUBDIVISI: I~ ~~~.
PARCEL 1:.D.# (OBT N _ _~_ TICE)
APPLICATION FOR PElUlIT
CITY OP ZEPII!IUIllJ:.S
BUILDING DEPAR1'KBIiT
~~Wt;~"'];;;;'~ .
tft1 ~rL; 0 ;? &-rl1 fyez.,
If ~q' ~/(f
-18,~ -,,:p.~-1
-,--~"......,~~.....!".........-.,<~~.-..,...-
OWNER' S'
0WlIER' S ADDRESS
WORK PROPOSED:-Rew CoDstructioo. ----..Addition --...Alteration -.Jlepair _Install
-/--sign ---Kove ->>eaolish
PROPOSED USE: ----/iiDg].e P8IIi!y --1f./F _' of Units --1f./H
_ec-ercial _Indust. _Swill. Pool _Other
, ~estaurant Ii: Health Departaent Approval
DESCRIP'llOR OP WORK: In...7Jf;ujd/(on al uJtJOdPA ,-:1 ..dldM/ ':;;7/7.
BUILDING SIZE:
x
~uare Peet.
Height
RESIDEI1TIAL: ATTACH (2) PLOT PLARS Ii: (2) SETS OP BUILDING PLARS Ii: (1) SET EBERGY PORMS.
COMMERCIAL: ATrACH (3) SETS OP BUILDING PLARS Ii: (1) SET ENERGY PORKS.
PROPERTY SURVEY REQUIRED POR ALL NEW CORSTRUCTION.
PERMITS REOUESTED
~UILDING
$
Valuation of Total Construction
_ELEcrRICAL
A!IP Service
Florida Power Corp.
W.R.E.C.
----lIECIIAlIICAL
$
Valuation of llecbanica1 Installation
.-PLtllBDG
GAS ROOFDfG
SPECIALTY
TYPE OP mRSDUCTIOR:
R10cIt _Praae _Steel
Other
FDlISHED FLOOR ELEVATIORS:
Fr.
:IS PROJECT IR FLOOD ZOIiB ABEA'l
YES NO
..........................................
BlrrT.Dn
COliTRAcroR SECTION
Signature
mtlPAIIY
State Cert. or Regist. #
City License Registration ..
..........................................
RT .RCTRTCIAIIl
Sionature
COHPARY
State Cert. or Regist. .
City License Registration'
..........................................
PLUMBER
Signature
COMPARY
State Cert. or Regist. ..
City License Registration ..
..........................................
IlECllAliICAL
Signature
COMPANY
State Cert. or Regist. #
City License Registration .
.................*************.**..*******
Signature
~. COIlPAIIY ~l:C[-\ SIG.1J5
~ ;'~Q State Cert. or Regist. .
>' . D City License Registration' (2) ...3 .~
~ .........................................
flTIIIm
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Ibe undersigned understands that this perlit lilY be subject to Ideed restrictions I wbieb lily be lOre restrictive tban City
regulations. !heundersigned asBUJes responsibility for capliance witb any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tbe owner bas bired a contractor or contractors to undertake work, they lilY be required to be licensed in accordance witb
state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractor lilY be
cited for a lisdeJeanOr violation under state law. If tbe owner or intended contractor are uncertain as to wbat licensing
requireJents lilY apply for tbe intended work, tbey are advised to contact tbe City of Zepbyrbills Building Departllent, (813)
788-6611.
FurtbeIlOre, if tbe owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tbe
IContractor Sectionsl of this application for 1Ibieb tbey will be responsible. If you, as tbe OIIIler sign as the contractor,
you are indicating that you, rather tban the contractor, are responsible for tbe work. If tbe contractor wisbes you to sign
as contractor that lilY be an indication that be is not properly licensed and is not entitled to pertitting 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 tbat I, the applicant, bave been provided witb a copy of IPlorida's construction Lien Law - lbIeoImer's Protection
Guidel prepared by tbe Florida Departlent of Agriculture and ConsUIeI Affairs. If tbe applicant i8 ~ other than the
lOIIIlerl, I certify that I bave obtained a copy of the above described c10cUIent and pIOlise in good faith to deliver it to tbe
lownerl prior to co.enCl!l8l1t.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIliltion in tbis application is accurate and that all work will be done in COIIpliance witb all
applicable laws regulating construction, loning, and land developleDt.
Application is hereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas cmlenced prior to issuance of a pertit and that all work will be perfoIJed to Jeet standards of all 1_
regulating construction, City codes, loning regulations, and land develO(ll8llt regulations in the jurisdiction. I also
certify tbat I understand tbat tbe regulations of otber goveIDllental agencies lilY apply to the intended work, and that it is
If responsibility to identify what actions I lUSt take to be in COIpliance. Sueb agencies include but are not lilited to:
I DepartJent of EnvirOllJelltal Regulation - Cypress Baybeads, Wetland Areas and bvirolllH!lltally Sensitive Lands,
Water/Vastewater !reatlent
t Soutbwest Florida Water Hanagl!lent District - Wells, Cypress Daybeac1s, Wetland Areas, Altering Watercourses
t AIIY Corps of Engineers - Seawalls, Docks, Kavigable Waterways
I Departlent of Health i Rehabilitative Services, bvirODlelltal Healtb Unit - Wells, Wastewater !reatJeDt, Septic lanks
I US bvirODJeJltal Protection Agency - l8bestos abatl!l8l1t
I also certify that, if fill Iilterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
addressing a lCOJP8DSBting volael will be snblitted 1Ibieb is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance.
A perlit issued sball be construed to be a license to proceed with tbe 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 tbe Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery pemit issued shall beCCIIe invalid
unless tbe work authoriled by sueb peIlit is COII8IlCed witbin sillOntbs of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sillODtbs after tbe tile tbe work is co.enced. One 90 day 81tension of tile, lilY be
allowed for tbe peIlit witb fee charge of $15.00. !be 81tension sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during eaeb sillODth period, or tbe project will be considered abandoned.
WWING ro 0IRfER: YOOR FAILURE ro RECORD A KO'IICK OF C<IIHDCEIIIKl' HlY RESULI IN YOOR PIYIKG fIIICK FOR IIIl'ROVIIID'IS ro YOUR
PROPERlY. IF YOU IIUIID ro OB'I'W FIIIIKCING, COKSUL! WID YOOB LIKDIB OR II IftORRIY BBFORB RECORDING YOUR HO'IICK OP
cmomKCIHBIiI'. JOBS DIlDO $2,500 IK VALUE 00 HO'I KIID ro RECORD IKD POS! A INO'IICK OF C(JOlDCEIIIK'II.
SIGlllfURI: comAC'fOR
SIGlAfURI: (MIBR OR AGm
SfA'll OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_ by
SIAD OF FLORIDA
coum OF
The foregoing instI'Wlellt was aCknowledged
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)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Print;ed or Stuped)
NOTARY PUBLIC
FREE STANDING CARVED SIGN
I~
CONCRETE
FOOTING
30..W. X 40..D.
.1
OWNERlllti:;;n ;J
JOB LOCATIO~ - {! .
ZEPHYRBILLS BUILDING DEPARTMENT
.2Iu~~
PARCEL I. D. #
"
SHOW ALL EXISTING & PROPOSED STRUCTURES GIVING DIMENSIONS & SETBACKS.
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
0----
;
~ ~I f ...
( 5~
FRONT PROPERTY LINE {st
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
3ql
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1f R2 ZONING
60'
~
2. SETBACKS FOR R3 ZONING
60'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 'DUPLEX
10'
,..P E-
R X
0 I
10' P S 10'
0 T
S . I
E N
D G
20'
1 0'
FROII"I' PROPER"l"Y LIRE
P'ROIft" PROPER"I'Y LDIB
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RONALD P. ANDERSON, P.E.
Consulting Engineer
P.O. Box 270633 Tampa, FL 33688
Fla. Reg. No. 19381 (813) 961-3742
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