HomeMy WebLinkAbout95-4926
'BUILDING PERMIT
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Parcell.D. #
Zoning: ~n"gl;Code:
Description of Work 13../.J , &F ~
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N!
49218
;26.., c.TV
GECTR~)
Date
,~- ~ /0 - 7!;-
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Radon Gas:
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
NO OCCUPANCY BEFORE C.O.
Pre-meter FPC (Mary) Nancy 05/16/95 09:45 A.Me
City License Registration #
State Certified License#
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P..m;, Fee~~--o
Signature . / -^- . -y -Gr ~\:'"
Company
Address
Telephone#
Valuation or
Contract Price ~ o--z;-zJ. (/7)
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
F.inal
5--ltJ1') Bob
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.
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APPLICAnOB FOR PElllIT
CITY OF ZEPIIYIUIlLLS
BUILDING DBPAR'I'IIBI1T
JOB ADDRESS
111 crl /lEt.-
37S"'>B 6rt'{b
~ ;l'lLl Fa ,,-,
.p . r;;pJ!A//t:
5Cf U
Kr,d () R)
PROBE 7~~- 730&
.
2CPJlYA? /ftas .
.2F/NY,e~uo .
OWIIBR'S II.AtIE
OWI1EIl'S ADDRESS
LEGAL DESClUP'l'lOIl: LOT(S)
BLDClL.-.SUBD:tVISIOII
PARCEL I.D.'
(OBTAIII PROM PImPRIlTY TAX IIOTICE)
WORK PROPOSED:--.J1ew Ccmstruction ----..Addition --..Alteration
Ilepair _lDatall
--1Jip
---IIove
~lish
.
PROPOSED USE: --1JiD&1e Faaily
---1I/F _, of Units ---1I/H
_ec-ercial
_IDduat. --1Jwia. Pool _Other
Restaurant &: Health Departaent Approval
DESCIUPTl:OB OF WOlUt: 7() ~JU d 6
c)fJ 7tJ ufz>c
FtJ~ L"7-
BUILDING SIZE:
x
Square Feet,
Height
RESIDEI1TIAL: ATTACH (2) PLOT PLAIIS &: (2) SETS OF BUlLDDlG PLAIIS & (1) SBT BIIERGY FORMS.
cottMERCIAL: ArrACH (3) SETS OF BUlLDDlG PLAIIS & (1) SBT DERGY FORMS.
PROPERTY SURVEY REQUIRED FOIl ALL IIBW COIISTlWC'fiON.
PERMITS VRnllR.c;'I"RJ)
-BUILDING
$ J.o6()
Va1uatiOll of Total Construction
RJ.RCTIlICAL
AIIP Service
Florida Power Corp.
W.R.E.C. .
.-JIBCIWI:lCAL
--.J'L1IIBDIG
$.
Val.uatioo of llecbanica1 lDatallation
GAS
IlOOPDIG
SPBCIALTY
Other
TYPE OP 00EDUCn0ll: -Bloclt _pnae _Steel
PIIIISIIBD PJ.OOR ELBYAnOBS:
FT.
IS PBOJBC'I' DI FLOOD ZOIIE AREA'
YBS 110
*******************.*****.****************
RJ.R~Tr.r A.
COII'I'RAC'l'nR SRC'I'TOR
. . . CDlPAft L-.6'1f ~
. ~ ~ m?~ State Cert. or JleaUt. .
cY 'I~' /' City License Ilegistration .
, *"**** *********************.***********.
rid b'Q,J
,
State Cert. or Beaiat. ,
City Liceo.se Relistratioa .
***********...**..****.**.**..**.*****.*.*
LbuS7VJC7?M
BUTI.DRR
Signature
yV(Jt~
COHPAft
E--L~c.ntJc.
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PI.DIRRR
OOIIPAIIY
State Cert. or Reaist. .
City Lic:eD8e Begistration ,
******************************************
Signature
IlECllAllICAL
Signature
COIIPANY
State Cert. or Begist. .
City License Registration .
*****************************.************
O'I'IIRR
COIIPAIIY
State Cert. or Relist. .
City Lic... Reaistratioa. .
*************.***********************.***.
Sigoature
APPL:tCAfiOJl APPJtOVED BY
PEJUaT OPnCER.
..........
"-~
. CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that tbis pmit lily be subject to Ideed restricti0l81 tdJiclllilY he lOre restrictlYe tbaa Cit;
regulatiOllS. !lie undersigued aasUIeB responsibility for Clllpliance 11th aDy applicable deed rutrlctiOllS. .,.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPOKSIBILITIES
If the OlDer lias hired a contractor or contractors to undertake IOrt, tiler .y he ngu!red to lie licenaed ia ac:cordaace lith
state and local regulatiOllS. If tbe contractor is not liceD8ed as required by In, both the 0IIIIer aod contractor .., he
cited for a .i~r violation under state lal. If the OlDer or inteaded contractor ve uncertain as to lllat llClD&Iag
requlrllellts ., apply for the intended IOrt, they are advised to coatact the City of Ie1iarrIaUls BuilcUDg IlepartBt, (813)
788-6611.
Furtberlore, if the OlDer lias Jaired a contractor or contractors, lie is advised to ltave the COIItractor(s) sign portiOlll of the
ICOIItractor Secti0ll81 of this application for lhicll they lill he responsible. If JOU, as the .. sign u the CIIltnctor,
you are iDlUcatillg tbat fOU, rather titan the contractor, are responsible for the IOn. If the contractor wiJlla JOU to sign
as CIIltractor tbat lily he aD iDc1ication tbat Iae is not properly licensed and Is not eatiUed to penittiDg privU.... ia tM
City of lepbyrJailla.
C. TRAKSPORTATION IMPACT FEES AND UTILITY COJINBCTION FDS
D. COKSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AIIB19DED)
I certif, tbat I, the applicant, ltave been provided ,itb a copy of I,lorlda's COastructlon Liea Law _ .......r'. ProtIctlon
Guidel prepared by the Florida DepartleDt of Agriculture and COas.-r Iffairs. If the applicant is .... other tbaD the
10IID8l'1, I certify that I ltave obtained a copy of the above described c10cuIeDt and prGIiae in good faith to dellVII' it to the
lOImerl prior to ~t.
E. CONTRACTOR' S/OWNER' S AFFIDAVIT
I certify that all the infODliltiOll in tbis application i. accurate and tbat all IOrt ,ill he doae in Clllpllance ,itb all
applicable 1_ regulating construction, loniDg, and land deve1.....t.
Application. is laerellr Iilde to obtain a pmit to do wort and installation as indicated. I certify that no 10ft or
installation lias ~ced prior to issuauce of a pmit and tbat all wort ,ill be perfOllld to _t .tIDduda of all _
regulating construction, City codes, lOlling regulatiODS, and I_ devel..t regulatiOll8 ia tile jurildicUlII. I also
certify that I under.tand that tbe regu1atiOll8 of otber PlIDBtal agenciu lilY apply to the inteDl1ed at, and tbat it is
If responsibility to identify ,ltat actiOll8 I lUSt tate to be in allpliance. Such agencies Include bat are not lUlted to:
t DeparUent of IDYil'OllleJltal Regulation - Cypress "yheads, IIeUand lIeu and IDvilOllllDtally 8eDsitive LaDds,
IIater/lfas_ter lnatBt
t Southleat Florida Water ~t DI.trict - llells, Cyprus ..,.., IleUaod lIeas, Iltering lfaterc:oursea
t IrIy CorDI of lDgineers - Senall., Docb, lavigable Watenars
t ~t of Bea1tb , Relaabilitative Services, Invi~tal B8a1tb lJDit - ileUs, IIIstelater !reItBt, Septic laob. '
t US InYIlOIIIII1tal Protection Agency - .l8bestoa abat_t
I also certify tbat, if filllilterial is to he _ in Fload lODe III or II, etc. I, it i. lIIdentood tbat a drainage plaD
addressing a l~satiDg vol..1 ,Ill he soblitted lhich Is prepared by a prof.iODal engiDeer registered in the State of
Florida prior to penit lasuauce.
I penit issued shall he construed to be a liCeDSe to proceed ,itb the IOrt and DOt as autboritr to violate, ~ alter, or
set aide aDy provi.iOll8 of the technical codes, DOr sJaall i88U1DC1 of a pmit prevent tile lIuUdiDg OfflcW fa tlllnafter
requiring a correct1oa of errors in pl., CCIII8tructiCll, or vlolaUIIII of aDl code. Iverr pea1t 1'" IMll .... IBalld
unl. the _t autboriled by such pmit is ,.,..ed ,itbin .il _the of 181UaDC8, or If IOrt autIIoriaed Jar tile pea1t 1.
IIIIp8Dded or ahlJ_ed for a perioc1 of sUlODtba after tile tile tile at Is -=--ed. b 90 dar atallll of tile, .., be
allCMld for the pe.nit ,itb fee claarge of '15.00. !be at_lOll aball be rlQUlted in lritiDg to the BuiWDg Offic1l1. In
approved iDlpectiCll at he logged during each sil _th perioc1, or tile project ,Ill be ...iderld ....... '
UllIIG !O (lID: YOOI mLIJII !O RICOID llO!ICI 0' ~ MY aLl U YOOI PIYIICi !ltlCK . ~ !O YOOI
PlOPlIft'. IF YCXJ IIIIID !O OIIDU. 'IIIICIIG, awsm.I UD mil.'" ClllIlftCBIY .. BalDIIG YOOI alCl 01
~. JOBS UIDIII'2,SOO U VlLUI 00 IIO! 1aD!O IIDID _ f08! I IDlCE OF ~I.
81.!IJII: CIIIR CIIlGIJI'I
81.!IJII: CCII!IICmI
SliD 0' MIDI
coom 01
The foregoing instI'WleJlt was acknowledged
before _ this , 19_ by
SliD 01 PLCIIIIM
coum OF
The foregoing instI'UMDt was acknowledged
before _ this , 19 by
who is personally known to _ or who has
produced
as identification and who did/did Dot
take an oath.
who is personally known to .. or who has
produced
as identification and who did/did not
take an oeth.
(Signature)
(Hue. '1'yped, Printed or Stuped)
HO'1'ARY PUBLIC
(Signature)
(M_ 'lyped, Printed or StMped)
McnARY PUBLIC
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