HomeMy WebLinkAbout95-4917
BUILDING PERMIT
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Property Owner:
Job Address:
Parcell.D. #
CITY OF ZEPHYRHILLS
(813) 788.6611
Permit N!
_4917~
Date . S - >? - 9 ~ -
.
EL~'
ME~-Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
FINAl~L)--/5~ c;-
OATE
NO OCCUPANCY BEFORE C.O.
c.o,
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector 111
Valuation or
Contract Price
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P~rmit Fee, .~_
Signature --- :::---...,.
Company
Address
Telephone#
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
ME'CHANI\...AL
-----, .
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
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 ($15.00) 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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II Da t e-...-------.--------.--------------
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SCHAF"e:R
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RESIDENT l~~Z,#HERC I .:
Regi~ter.d Build(
F~e~d, stet'.d Roof j.
11250 South
- NEW WOOD ALLOWA~CE:
... INSTALL NEW .-~K L,gQ;'
:'j~:~:1;~ ' .,' ~~"';'~"
-- I N~3TALL NEW V~f.:!-Yd:ETArJJ.:.
.- II\I~~;TALL NEW /?/uwjJ
INSTALL NEW VENT BOOTS
-. II\lt:;T ALL .:?;[2 YEAR
BF~ANO
TRASH REMOVAL
YEAR CONr.~ACTOR'~:~
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APPLICAnON FOR PEBIIIT
CITY OF zEPIIDBILLS
BUILDING DEPARTHENT
JOB ADDRESS
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PHONE
SCc. f- <:0 S ~'-~
OWNER'S IIAHR
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OWREB.' S ADDBESS
......
LEGAL DESClUP'fiOR: LOT(S)
BI.OCK..--SUBDIVISIOR
PARCEL I.D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew construction ~ition ~teration ~pair _Install
_Sign ~ve ~lish
PROPOSED USE: _Single F8IIily ----31/F _' of Units ----31/H
_ec-ercial _Indust. _Swia. Pool ~o~er
DESCRIPTIOII OF WORK:
. .--Jlestaurant Ii: Health Departaent Approval
~~~~
BUILDDG SIZE:
x
square Feet,
Height
RESIDENTIAL:
COHKERCIAL :
ATTACH (2) PLOT PLAlIS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATtACH (3) SETS OF BUILDING pLANS Ii: (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION.
pF.RMITS REO~TED
~UILDING
$
valuation of Total Construction
RJ.RCTRI.CAL
AHP Service
Florida Power Corp.
W.R.E.C.
_PL1IIBING
GAS
Valuation of Hechanical Installation
y. ROOFING SPECIALTY
_Fraae _Steel Other
.___JIECllAllICAL
$
TYPE 9F OOlISTIlUCTIOIi: ~lock
FT.
IS PROJECT IN FLOOD ZOO AREA?
FIJDSBED FLOOIl BLEVAnOIlS:
YES NO
******************************************
coHTRACTOR SRCTION
,.,
PUJMBER. COMPAIfY
State Cert. or Regist. ,
Signature City License Registration ·
****.*************************************
BIlTl.DU COMPAIfY
State Cert. or Regist. .
Signature City License Registration ,
******************************************
RJ_RCTRTCIAII COHPAIfY
State Cert. or Regist. .
City License Registration .
******************************************
JlRCRAlfICAL COHPAIfY
State Cert. or Regist. .
Signature City License Registration f /
******************************************
IU"E" CCIIPAIIY &I-\~ ~~\...(,.
State Cert. or Regist.' [l <- cosec "llD3
Signature City License Registration' 42-
*********************************
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
\'lie underalgaed -s_ tbat this P....1t .., be 8Ubject to 'deed RBtricti.... IIlIiclJ .., be .... restrictive than City
regulations. rhe undersigned assutes responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the -. "'" hired a lXIDtractor or COIItractois to -tale _. they.., be required to be Ii_eel in _ 11th
state sed loc:al regulati.... If the COIItraclor Is DOt Ii_eel as required by Iao. hoth the -. sed COIItraclor .., be
cited for a IiadeIeaaor 'folatioo - state I... if the 0IIIJer or inteoclecl oootractor aro lllIC:eCtain as to ....t IiC8ll8iog
reqo1'-ta .., apply for the int_ ""'t. they are ad.ised to CQlltact the City of lep/Jyrhlils Ilu.IIdiog IIeIJortaeot. (813)
788-6611.
FurtherJOre, if the 0lfDer has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
.llJotractor SectJoos. of this applicatioo for IIlIiclJ they ullbe Cl!8jlOOsihIe. if,.... as the lI8Ier up as the COIItractor,
you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wishes you to sign
as contractor that lily be an indication that he is not properly licensed and is not entitled to pemjtting priVileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, tbe applicant, have been provided with a copy of IFlorida's Construction Lien Law _ BoIeowner's Protection
Guide- prepared by the Florida DepartJent of Agriculture and COD8Uler Affairs. If the applicant is so.eone other than the
lownerD, I certify tbat I have obtained a copy of the above described docuJent and prcmse in good faitb to deliver it to the
Downer- prior to co.enCBlellt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infOrlation in this application is accurate and that all wort will be done in COIpliance witb all
applicable laws regulating construction, loning, and land develDplent.
Application is hereby lade to obtain a perJit to do wort and installation as indicated. I certify that no wort or
installation has CDlenced prior to issuance of a PeIJi t and that all wort will be perforJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land develoPIIBDt regulations in tbe jurisdiction. I also
certify tbat I understand that tbe regulations of other goveIDlental agencies lily apply to the intended ut, and that it is
If responsibility to identify what actions I lUSt tate to be in co.pliance. Such agencies include but are not luited to:
t DepartJent of BnvilDlllelltal Regulation - Cypress BaYh8ads, Wetland Areas and Bnvirolllentally Sensitive Lands,
Water/Wastewater rreatJent
t Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
t AI'IJ Corps of Engineers - Seawalls, Docks, lavigable Waterways
t De t of Healtb & Rebabilitative Services BnvirOJ1leJ1tal Health Unit - Wells, Wastewater freatlent, Septic rants
t US Bnvil'ODleDtal Protection Agency - Asbestos abatBlent
I also certify that, if fill aaterial is to be used in Flood Zone -A- or -A,etc. I, it is understood that a drainage plan _
addressing a lCOQensating vol.- will be sublitted "hich is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance.
A p,mit issued shall be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or
set aside any proviSions of the technical codes, nor shall issuance of a peIlit prevent the Building Official fIlII thereafter.
requiring a correction of errors in plans, construction, or violations of any code. Every pemjt issued sball beCCIIe invalid
unless the wort authoriled by such peIlit is co.enced within sillOllths of issuance, or if wort authoriled by the PeIJit is
suspended or abandoned for a period of sillOlltbs after the tHe the uk is ~ced. One 90 day Bltension of tHe, lily be
allowed for tbe perJit with fee charge of $15.00. rhe Bltension shall be requested in writing to tbe Building Official. .An
approved inspection lUSt be logged during each sillODtb period, or the project will be considered abandoned.
WARNING TO lMfIR: YOUR FAILURB fO RlCORD A DICK OF aJIIIDCIIlIft HlY RESULr II YOUR PIYDlG !lIICK FOR DfPROVBIrS TO YOUR
~F YOU IIfIID TO OBtAII FWlCIIG, COBSULr WU'H YOUR LODER OR II AftORRIY BlFORI RICORDIIG YOUR DleI OF
~.. -Ll1 JlIIS - fl.500 II VILllII 00 IIlr 181/)10 - lID · lit ClBICIIIar'.
SIGlAr .
...-------
srArI OF FLORIDA
coum OF
The foregOing instrument was acknowledged
before me this , 19_ by
srArl OF FLORIDA
coum OF
The foregOing instrument 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 1M! 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, Printed or Stuped)
NOTARY PUBLIC