HomeMy WebLinkAbout95-4981
BUILDING PERMIT
Permit N?
CITY OF ZEPHYRHILLS
(813) 788-6611
49818
Date
_Z;- - /)..S-- 9j-
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Property Owner: 11_ J- .....?>
Job Address: < j'9~ . . M ~ : ~+&~- /
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Water Me!er:
T.I.F.'s:
Parcell.D. #
Zoning: Energy Code:
Description of Work .1..~p ~~
j)' Radon Gas:
'j
.Ax!
NO OCCUPANCY BEFORE C.O,
FINAl___06/08/95
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 W.A. BURGESS
Valuation or
Contract Price
~ C>V. ct-?:J
Pe,mit Fee ~ d-O ~
Sign'ature . '-,.J ~~ -
_. - <~
Company
Address
/' (. -C?'
City License Registration # t? <l 0
State Certified License#
7150-1000
Telephone#
c.~~~71JUX1 xlJfh.:h--
BUILDING
Ftr. 5-&-'15" Bc.Q(J
Pre SLB
Lintel
FRM.
Insul. CL
WL
ELECTRICAL
PLUMBING
MECHANICAL
Tp. Servo
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 ($15.001 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.
APPLICAnON FOR PERIIIT
CITY OF ZEPBYRBILLS
BUILDING DEPARTKERT
OWNER'S lWIB Pe~: ~O
OWlIER'S ADDlIESS 3 9 .5" Lf .3
3cf543
c ~st.~\esL. (u ((cl ~ (\.
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fheQ~we,C).4 kocp
Mea.. J w (") r~ ~ '- L c r:> f Z f7 A Y}-h ~ (l ~
7'1 B~SUBDIVISION f1'lPa.J6wood Es~ps I
PHONE 7f?~- 7~76
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
PARCEL LD.'
(OBTAIN FROM. PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction --.-.Addition ---J\lteration --Repair _Install
_Sign
--.-JIove
_Deaolish
PROPOSED USE: _S~e F_ily
--.Jt/F _' of Units --.Jt/H
_ec-ercial
_Indust. _Swia. Pool _Other
---..Restaurant & Health Departaent Approval
DESCRIPTIOII OF WORK: ':t <\... 5 ~ \ l
SCL-\-e. \\ ~-\-P V ( ~ ~
BUILDING SIZE:
x
Square Feet,
Height
RlmIDEBTIAL:
COHMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
ATTAaI (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION.
PERMITS REQUESTED
-BUILDING
$ 5' 00
Valuation of Total Construction
RT.RcnuCAL
AIIP Service
Florida Power Corp.
W.R.E.C.
--'lECIWIlCAL
$
Valuation of tlechanica1 Installation
_PLUMBDG GAS ROOPIRG
TYPE QF CORSTRUcnOIl: ____...lock _F~ _Steel
SPECIALTY
Other
PDJISBED FLOOJl ELEVAnOIlS:
Fl.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
**..*....**..............*...*....*..*.*..
CONTRACTOR SECTION
RIITT.DER
aJHPAIIY
State Cert. or Regist. .
City License Registration .
...................*..............*..*....
Signature
RT.RCTRICIAR
COMPANY
State Cert. or Regist. .
City License Registration .
......*.*.......**..*.....*......*.**.....
Sianature
PLtDlBER
COKPANY
State Cert. or Regist. .
City License Registration .
....**...............*.................**.
Signature
HECBARICAL COMPANY
State Cert. or Regist. .
Signature City License Registration .
.................*..............*...*.....
OTRRR ~ L COMPANY Gc9c>J 0'-'15
c::::;;;;? State Cert. or Regist. .
Signatur . .Jeg,..,<( City License Registration .
~ .....*.............*.......*.......*..**..
APPLICAnON APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'Ibe undersigned understands that this penit IlaY be subject to 'deed restrictions' Ibich IlaY be lOre restrictive than City
regulations. lbe undersigned as8UIeB respcmsibility for COIpliance lith any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If tile owner bas hired a contractor or contractors ' to undertake IOrk, tIIey lay be required to be l1ceD8ed in accorclance Ii tII
state and local regulations. If tile contractor is not licensed as reguired by law, botll the 0I0ler and contractor IlaY be
cited for a .isdeJeallor violation under state law. If the OlDer or intended contractor are uncertain as to lbat licensing
requireJents llay apply for the intended IOrk, they are advised to CODt.act the City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtlleIlOre, if tile 0IIJIer bas lIired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tile
.Contractor Sectionsl of this application for Ibiell they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If tile contractor wishes you to sign
as contractor that IlaY be an Indication that be is not properly licensed and is not entitled to penittlng privileges in the
City of Zepbyrllills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN. LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that 1, the applicant, bave been provided lith a copy of 'Plorida's construction Lien Law - BoIeoImer's Protection
Guide' prepared by the Florida Departlent of Agriculture and Consl1ler Affairs. If the applicant is SOIl!OIIe other than the
lowner', I certify tIIat I bave obtained a copy of the above described docUIent and pnmse in good faith to deliver it to tile
1000er' prior to co.mCl!IeJlt.
E. CONTRACTOR' S/OWNER' S AFFIDAVIT
I certify that all the infoIlliltion in this application is accurate and that all work lill -be done in CCJlpliance lith all
applicable laws regulating construction, zoning, and land developlellt.
Application is hereby Be to obtain a peIlit to do lork and installation as indicated. I certify that no work or
installation bas CDlenced prior to issuance of a penit and that alllOrk lill be perfoned to .8t standards of all laws
regulating construction, City codes, zoning regulations, and land developlellt regulations in the jurisdiction. I also
certify that I understand that the regulations of other gOYernllental agenCies IlaY apply to the Intended work, and that it is
If respcmsibility to identify lbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
t Departlent of EnvlrOlllelltal Regulation - Cypress Baybeads, Wetland Areas and EnvirODlentally Sensitive Lands,
Vater /IIastelater 'Ireatlent
t Southwest Florida Water NanageleDt District - Veils, Cypress Bayllea4s, Wetland Areas, Altering Watercourses
t Any Corps of Engineers - Sealalls, Docks, lavigable Waterways
t Departlent of Health i Rebabilitative Services, lnvirOJllental Health Unit - Wells, Wastewater 'IreatBt, Septic lanD
t US EnviI'Olllental Protection Agency - Asbestos abatellellt
I also certify that, if fillllaterial is to be used in Flood Zone 'A' or "A, etc. " it is understood that a clrainage plan
addressing a 'COIpeJl8ilting volUll!' lill be sw.itted lhiell is prepared by a professional engineer registered in the State of
Florida prior to peIlit issuance.
A ~it issued sball be construed to be a license to proceed lith the work and not as autbority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official fa thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery penit iasued aball becoIe Invalid
unless tile IOrk autborized by suell penit is COIIllIlced litllin sillODths of issuance, or if IOrk authoriled by the penit is
suspended or abandoned for a period of sil IODths after the tile the work is CDlenced. One 90 day atension of tile, IIilf be
allowed for tile penit lith fee cllarge of $15.00. 'II1e atension shall be requested In writing to the Building Official. An
approved inspection lUSt be logged during each sillODth period, or the project lill be considered abandoned.
VARlfIIfG fa MIR: YOOR FAILURE fa RICORD A IIO!ICH OP COIIIIICIIIIft MlY RESUL'I 11 YOOR PAYING !IIICH FOR DIPROVIIIII!S fa YOUR
PROPER!Y. IF YOU IIIIIID fa OB!1IJf PIIIDCIIfG, COIf SOLI VI'IH YOOR LBIDIR OR 1II1'1fOBDY BIPORI RICOIIDIIG YOOR IfO'IICH 0'
WlHBlCIMBH'l. JOBS UlfDm $2,500 11 VALUI DO IIO! IIDD 10 RICORD AID POS'I A WI F aJIIBJICBMIIl'Il.
~~ b. (yD&~
SIGII : (MIIR OR AGBlIt
SfA'R OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
STAR OF FLORIDA
coom OP
The foregoing instrument was acknowledged
before me this , 19_ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Name Typed, Printed or St~d)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
"'''f'I"'.';;:''':''" ..".
CrrY OF ZBPIIYIUIl:LLS BUILDING DBPAR"IIIBIft"
OWNER C ~'Jl""lrl €s L. ~p ~ ; cJ n ,ct.^- R 0 l-, II\.. G.
JOB LOCATION 395'43 rhea ~r<)L"'DC~ Loo~~
PARCEL I.D. # h.ot- 7tt. (Y\et:\.~LV00~ EC;-\-ct!ps. elCAH- (Sock IS
fqje k$
SHOW ALL BUS'I"IRG & PROPOSED S'l'RUC'l"URBS GIVDIG DDlBHSIORS & SB"l'BACKS.
~
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
.. ~.A
30
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4. ....---.,-..... .".... _. ""H. ."
UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
FRONT PROPERTY LINE
(NOTE EXAMPLES 1 & 2)
STREET
1. SETBACKS FOR R1, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
1 0'
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30 'DUPLEX
1 0'
10'
P E
R X
o I
10' P S
o T
S --I
E N
D G
10'
20'
F.-.r PROPBIl"I'Y LDIB
FROJft' PROPBIl'I'Y LDIB
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BUILDING DEPT APPROVED
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GOOD NEWS
SATELLITE & TV
SALES, SERVICE & SUPPLIES
948-3474 . 780-1000
INVOICE
OAT! ~~---
PROMI~(D :i....;;l..8
(OMPlITlD
MOOll .___
QUANTITY
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PAYMENT OF THIS INVOICE, INS.
CLAIM #
ASSIGNED TO GOOD NEWS SATELLITE
~".ICE
CA~H DUWN
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TAX
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