HomeMy WebLinkAbout95-4920
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BUIL~~~~HY~L~RM!,! ~ _49204
(813) 788-6611 DatE~ S - 9-9 b
Property Owner:
Job Address:
Parcell.D. #
~I ~..~
0/11< .~~ C! d~a;;6
S-/~'7- 9~ (~.
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
/q~
NO OCCUPANCY BEFORE C.O. I\) ./ \ 0
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
FINAl__
C.O. _
DATE
DATE
Inspector
Valuation or ~ c>.vC)
Contract Price ~ (300
C;ty License Regis".tion _~ % f2)~
State Certified License# c;!.. '7
Q~"- ~~G ~Q
~~ ~-.
Permit Fee
Signature
Company
Address
Telephone#~ 3 Y.5- ~;}?/ / (::?/ 3 )
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
~.~
Breakers
Ducts Insl.
Compressor
Final
~l~
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 ($15.001 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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APPLICAnOIf FOR PElUlIT
CITY OF ZEPBYRBILLs
BUILDING DEPAR'DIENT
OIIIIBIl'S IWlIl It p ~ E?:.
0WlIER' S ADDUSS _<: / ~ J
~~V
G/jt/~ T
7/?~
PHOIfE ~yy S/?c2
JOB ADDRESS
'-
LEGAL DESCRIPTIOIf: LOT(S)
BLOCIL.-.-SUBDIVISION
PARCEL LD.' Jt/ 4 (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:-"ew Construction ----Addition --Alteration ---.Jlepair~Atall
_Sign
--Jove
_Deaolish
PROPOSED USE: ~iog1e Faaily
---.Jf./F _' of Units ---.Jf./H
_eo..ercial
_Indust. _Swia. Pool _Other
-At ~t Awrova1
DESCRIPTIOII OF WORK: .
BUILDING SIZE:
x
, / g C/O Square Feet,
,
Height
RESIDENTIAL: ATTACH (2) PLOT PLAIIS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL IfEW COIISTRUCTION.
-BUILDING
oV
$ (2~OV
PERMITS REQUESTED
Valuation of Total Construction
_ELEcrJlICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
__lIEClWlICAL
$
Valuation of Hecbanical Installation
_PLUMBIIIG
GAS
~ooFING
SPECIALTY
TYPE 9F COIIST.RDCTIOII: _Block _Fraae _Steel
Other
FDIISIIED PLOO1l ELEVAnOIlS:
Fl.
IS PROJECT III FLOOD ZOO AREA?
******************************************
YES NO
. mRrRACmR ~~
RlIDJ>RR ~ lXIIPARY ~tMO ~ l>.e/(J~~s
State Cert. or Regist.' CC 6 CJ S- / ~ ~ /
Signature . . City License Registration .
~ **** ************************************
RJ.RCTRl;CIO COMPANY
State Cert. or Regist. .
SiDnAture City License Registration'
******************************************
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration ,
******************************************
IlECllMlICAL COHPARY
State Cert. or Regist. .
Signature City License Registration f
******************************************
OTRRR COMPANY
State Cert. or Regist. .
Signature City License Registration ,
******************************************
APPLICAnON APPROVED BY PElUlIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
fbe undersigned understands that tbis perlit lilY be subject to Ideed restrictions I wbich lily be lOre restrictive than City
regulations. !be undersigned assUJeS responsibility for ~liance witb any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OlDer bas bired a contractor or contractors to undertake work, tbey lilY be required to be licensed in accordance lith
state and local regulations. If the contractor is not licensed as required by law, botb the owner and contractor lilY be
cited for a lisdeEanOr violation under state lal. If the mmBr or intended contractor are uncertain as to lbat licensing
requirl!ll!Dts lilY apply for tbe intended IOrk, tbey are advised to contact the City of Zepbyrbil1s Building Departlent, (813)
788-6611.
FurtheIlOre, if the OlDer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of tbe
'Contractor Sections I of tbis application for wbich they lill be responsible. If you, as the OlDer sign as the contractor,
you are indicating that you, ratber than the contractor, are responsible for the IOrt. If the contractor wishes you to sign
as contractor that lilY be an indication that be is not properly licensed and is not entitled to pertitting pdvileges 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, the applicant, bave been provided witb a copy of IFlorida's construction Lien Law - lkIIeoImer's Protection
Guide' prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is 8OIIeOI1e otber than the
'OIDerl, I certify that I have obtained a copy of the above described dOCUlf!llt and prcmse in good faith to deliver it to the
-OlDer I prior to co.enceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all tbe infOrlation in tbis application is accurate and that alllOrt will be done in COIPliance with all
applicable laws regulating construction, zoning, and land developent.
Application is hereby lade to obtain a perIIit to do IOrt and installation as indicated. I certify that no IOrk or
installation bas cmlenced prior to issuance of a perlit and that alllOrt will be perfoIJed to Jeet standards of all laws
regulating construction, City codes, loning regulations, and land developll!Jlt regulations in the jurisdiction. I also
certify that I understand that the regulations of other QOVeI1IIeDtal agencies lilY apply to the intended wort, and that it is
If responsibility to identify lbat actions I lUst tate to be in COIpliance. Such agencies include but are not lilited to:
I Departler1t of BnviroDlelltal Regulation - Cypress Baybeads, Wetland Areas and !nviroDleDtally sensitive Lands,
Water /Wastewater freatlent
I Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
I AI'lY Corps of Engineers - Seawalls, Docks, Xavigable Waterways
I Depart:lent of Healtb i Rehabilitative Services, EnvirODleDtal Healtb Unit - Vells, Vastewater freatlent, Septic !ants
I US BnviIODlental Protection Agency - Asbestos abateaent I
I also certify that, if fill Jaterial is to be used in Flood ZOne HAl or 'A,etc.l, it is understood that a drainage plan
addressing a lCOIpeD8ilting volutel will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to peI'lit issuance.
A ~it issued shall be construed to be a license to proceed witb the work and not as authority to violate, cancel alter, or .
set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official fl'Ol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becDe invalid
unless the IIOrt authoriled by such peIlit is co.enced witbin sillOntbs of issuance, or if IIOrt authoriled by the perlit is
suspended or abandoned for a period of sillODtbs after the tile tbe work is co.enced. One 90 day atension of tile, IilJ be
allowed for tbe pertit litb fee charge of $15.00. fbe atension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sillODtb period, or the project will be considered abandoned.
WAIUUXG fO 0VlfD: YOUR FAILURE to RECORD A XO'I'ICE OF CCIlMEICEIIBR! MAY RESULf IX YOUR PAYIIG fllICE FOR IIIPROVEIIBftS fO YOUR
PROPIRft. IF YOU II'IIIID 'fO OBtAIX FIIIlXCIIG, COISULf VIm YOUR LllDER OR IIAftORIIY BIFORI RICORDIKG YOUR JIO'IICE OF
llIlIIDCIIIIIII. JOIllI - 12,500 II VILIlIl 00 lOr IIID III lIECOIlIl ~4
SIGIA!URI: omR OR AGm
Sf!!! OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
SUfi 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 wbo did/did not
take an oath.
wbo is personally known to me or wbo has
produced
as identification and wbo did/did not
take an oath.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
85/08/1995 13:53
"
81328'37787
DIAMOND TAMPA
PAGE 81
120 E, Calhoun Street
Woodetock,'L GOoge
1-800- 4-3861
ROOFING SYSTEMS
SOLO, FURNISHED & INSTALLED
BY Diamond Exterlora, Inc.
A S.srs Authorized Conrr.ete"
( '. 'I.... ..
~J "''',Il/",. (J I
l ~ h ~,., ~.,., ~ ( ~ 'tJ
Date:
Job Number: ;;;tJt~fK5Y
Ot-flCt: I'HONt:
CllY
SrA.TE
Q SHEET METAL CJ SOFFIT & FASCIA LEAN.UP
ClINSUlATION (ATTIC) CJ VENTILATION 0 GUTTER WORK
-:":.~.""':---:-~~-T":--. .....r...~ -. ......~.~l-:. , ~q: '.". :._~_.
......'.'.......;.....T..
:Q:::::J:~:::::::I::;::::::
. .. . ................,~.
, '" . . . " . . . .. ,......1:).
. ... S4:~..,.. ..........
y~ ...~o- ~_:.. ::. .~+t~..'-. .... ..:, :...:....:...:. ~i: :.
I Ofler: . . I . . ~~., ,. ,.,... ,.
I NOTE: BI Mow I... ~rl.t/cl In "'. due to ""'erIOn tflMJ .001tl eOlO,.. BlaCk I
=;:u:::n':(1fV.i~~ryhoUM. RJ...2-<{ '/n12'. ~ ~ 110:0" I .....: I::
vlltached Garage 0 FI'8..~ncling G~' a Low-Slope Room AddItion
O " ....::t::::::-' ~: :
ther; _ _ . .. ,.,... '" ~_. .
TYPE tl Shingle. 0 Plain Q Cut-up B1i"lbIe a Hip . .- ~-:-:-: ""'D'" l----.-.~ :1.' .
:OF, '~::'.. g=~' OM...._OW.... ~ ::: : : : : : , : : : . . I :: :
Other: .
NOTE: "it Is derBm1lnad Ihstth. existing $/Iingleurusbn"'s the CUlfomer must.""nge \ . . . , .. (!!..,.., l I;' ~ .
for tsar-ofT, "SIJHlW'Y W1rJ dumping accorr1ing to exilting 1octJ/, .,.,..nd F".II.w. . :-:--. . . . I . : . . . : : : . I . . :: :..,
o Low Slope (2. ri.. up to 4.): I 'If: Rl_ .In 12.. . , , . , " ....,.... ... .," . . , .
o Built-Up (must be u~ 2'): Ri....1 ~...:!.!l.12'. VENT/LA TION: Proper ventilation I, a requir.m.nt fqr all
.0 Val19y type ~ ~. . Fl. ~ .lCtt~ ",arran.-.. It help. prw.nt superheating of t"'Pped
MAIN ROOF has _Iaye,.. of L .ir dUring the eumm.r and harmf,,' concMn.atlon during the
SECOND ROOF has -~ layers of winter. P~r Yerltilaaon eonli_ of OM ~".,. loot f..e open
NOTE: " more {IIY.rs .,. found during instJJl/lttion, thE!re wil bftllll edcJifonsJ chatp9 of a...a for .v.ry 150 squ.... fMt Of atllc ftoor lpact.
$-- per 4tyer per f1QVa,.. (tOO Iq. It.). CUSTOMER INITIAL.: _____ CJ Ridge Ventt a StaCie Vtnlt 0 E.v. Venti
NOTE:. II a/.c'rlc~I.. .wlltflr, gu or aIr conC1ltJoning /in., are found imbedded during 0 Tultll". Vent. 0 PoMr Venti (J Gable End Vents
In,/anation, ~ ~f.t1~f!.r::J,.F.h". will b. !Jilido In wrtllng under II ~"'to form. lJ Oth,r Ventilation
TEAA"()FF exfstfno &.Ll/UN .u roofing .
to the deok. oover with a superior approved FEt. T Md thtn apply Wlingl... 8TACK COYERIIROOF "~CK8. RopIac:e . .
DECK: Plywood _" Thlcknt.. T & G _' x _' Oth.r: DRIP EDGE: Help. provlda .ffici.nt .water sh.ddlng al :he
ROTTEN OR DETERIORATED WOOD: We will install approved eltterior-grad. Ptrimaler edge. and proteQt. underlYing wood f~m rotllng.
.h.athing wile.. needed. Unll" .pecifi~1y .tartcl uncltt special instruction a, no In.tall al at ..'i' 8nd rUt ..... I~"" IIn. It.
charge or estimate h.. be,n mad..for replacing such rotten WOOd. If such condition' 0 GUTTERING (Color a~ o.~nption); .
.... found during in'tallation, an additional Ch.~~'~.:' !~f~ini ~~r a (WI! be ,n.liI/Itd e. tho'!" on dllg/1lm)
..parer. lonn. '.~~r.tI~!"~ ~ Q OVERHANG AND TRIM (Color and o.lCriptlon):
NAIL OVER EXISTING SHINGLES (Go Over). Con ..' . (win be instaJled a. shown on diagl1lm)
Q Apply over existing shingles. CAUTION: New ~W1n ''''''''3 unevenne.. Q INSULA TION: (~enough inlUletion to meet o.partment of
ol.xieting deck and/or shingles. TOMER INITIALI; Energy r-.commendation.) Sq. Ft.
OR PERMITS; Un.... olherwi_ indicated. Diamond Exteriors will
a Cut off lIfId haul away tabs of existing asphalt shingles to provide a smoother, obtain lhe ~'''ry '9OJ..f!tnl/ta.
mo,. ev." ~Qk lIfId apply shing19s. Charge for Pe""its: ~-!'
INSTALL: CLEAN.UP AND REMOVAL: Your horn. Will hew a n..t, clean
IJ lee.Water UndeJ1ayment (helps to protect against damage ceused by loe end/or appea/1ltlee after t~ job Is completed.
water build-up). Sq. Ft. SPECIAL INSTRUCTIONS: d r b'e
Q Premium Fell Underlayment.t all .ave. and VaJ"YI for superior Mather t~~ ~..~!:~c:tor Wlil De llel 18,1i.'
protection. -- Sq. Ft. ~eal:' nor d:'" .&lay,>> lAwn. or Sldewa $.
FLASHING: Instell or Aeplac;e; a Dormer~ FI.shing for damaij~!~ n..o.. .
CJ Chimney Flashing a Step Fleshing t9'V.nt Aathing
II Other Flaehif19
INSPECTION REVEALS THE FOLLOWING PROBLEM AREAS:
o Sj)IIIgle. a Decking a Chlm~y F1athinV CJ Shake., Tile., Metal
~en'-Pipe Fleehillg 9 Dormer Aa.hlng Cl V.ntRation 0 Guttering
Q 11lsulaliun hi Overhang & Trim 0 E}(posed c.iling.
QOther.
ROOF u: K8; Existing leak. a Ihown on SkefCh witll an .X..
DIAMOND EXTERIORS, INC., . Sea,. authorized cont/1lCtor ("Contractot"). ag.....
19a i Mati&. fthe . 9 of i ::
SKETCH: Show rool meB&Uremsnts including ris..
Shade out any pan of roof(&) not to be cov.,.d.
l"".11<:tnmAr inItialS _