HomeMy WebLinkAbout95-4995
BUILDING PERMIT
CITY OF ZEPHYRHILLS
(813) 788-6611
Permit N-<<?
4995A
Date 0--- --3 / ---9~-
e ELECTRICAL PLUMBING
PcoP'~Y OW"" ~r! ~~A b
Job Address:~"30:J... 20_ ""~ ~
MECHANICAL
Sewer Conn
Water Conn:
Parcell.D. #
/
/
I
Water Meter:
T.I.F.'s:
Radon Ga~ '"/
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,
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Zoning:
Description of Work
R Ene~gy Code:
AlA~.J ,-c~
FINAl__
NO OCCUPANCY BEFORE C.O.
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
~L' -
Permit F .;:> - t;;)-p
S~gnature c:~
Company
Address
Telephone#
Valuation or
Contract Price
~Y'70. t7V
City License Registration # ? '7
State Certified License#
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
(Xj/08/95 HIlL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Driveway
6-R.9~ B::.iP
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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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,''''''"'''" ACCEPT AI\ICE OF PROPOSAL
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AUTHORIZED ,
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E; I GNP-i TUF:E ~ _____.u._____u._____.._u._____.___.____________.________'_U__ .
11250 3D. HWY 98, DADE CITY, FL. 33525 (904) 567-8580 =0::.==;::;;":";''--
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APPLICANT
ADDRESS
OWNER .
JOB LOCATION
APPLICATION FOR PERMIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
PHONE
~i=)tJl-~~0
'.
LOT SIZE_X
AREA SQ. FT.
BLOCK
SUBDIVISION
LEGAL DESCRIPTION: LOT(S)
PARCEL 1. D. if
WORK PROPOSED:____New Construction ____Addition~Alteration ____Repair ____Install
_Sign/Temp.
PROPOSED USE: ~Single Family
_Commercial
BUILDING SIZE:
RESIDENTIAL:
'COM1iitRCIAL
,!. .
____BV,ILDING ..
~ELECTRICAL
__MECHAN".l:yAL
_PLUMBING
_Sign
_Move
_Demolish
_M/F
_t~ of Uni ts
._M/H
~Indust~.~Swim. Pool
Other
_Restaurant & Health Department approval
x
Square Feet,
Height
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
..ATTACH (3) SETS. OF BUILDING PLANS. &.(1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PERMITS REOUESTED
$ ,:.~ 1+46 .~s
Valuation of Total Construction
AMP Service
Florida Power Corp.
_W.R.E.C.
$
Valuation of Mechanical Installation
GAS
ROOFING
SPEQIALTY
.lXf~9f CONSTRUCTION:
_Block
'. ..; I,"
_F~ame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
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, i C6NrR~~~:n~ECTTO~",*V_ c9<",~,,,:,
. StateCert: or Regist. !F {l.: .:;ZS"2A-
City ~icense R~gj.sr-r-ation t~ ~l
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~ig'fw.t~re
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::::::::AN
Sigp.~tl.r!:'~ .
Signature
OTHER
SiFnature
/
/
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Company
Stat~Cert. or Regist. 4~
City License Registration
* ***** ********* * ** ******* ** *'" ** *-1,*-1, * *-1:* * * *
Company
State Cert. or Regist. #
City License Registrati
***************************************
. Company
State Cert. or Regist. #
City License Registrati
************************************** **
/
/
/
Company
State Cert. or Regist. #
City 't,'icense Registrat. n
**********************~************~~*****
PERMITOFFIGER.
'APPLICATION APPROVED BY
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
-
The undersigned understands that this pertit lay be subject to "deed restrictions" which lay be more restr.ictive than City
regulations. The undersigned assules re&pDnsibility~'for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor Dr contractors to undertake work, they lay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be
cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the
'Contractor Sections' of this application for which 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 the contractor wishes you to sign
as contractor that aay be an indication that he is not properly licensed and is not entitled to perlitting 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, the applicant, have been provided with a copy of "Florida's Constfuction Lien Law - HOleowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOle6ne other than the
'o"ner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the
'owner" prior to COI.ence.ent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work "ill be done in compliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby .ade to obtain a pertit to do work and install~tion as indicated. I certify that no work or
installation has co.aenced prior to issuance of a pertit and that all work will be performed to leet standards of all laws
regula.ting construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies lay apply'to the intended work, and that it is
IY responsibility to identify what actions I must take to be in cOllpliance. Such agencies include bllt ~Ie not lilHed to:
. ,
f Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive lands,
Water/Wastewater Treatlent
f Southwest Florida Water "anaQetent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
f Departlent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treat~ent. Septic Tanks
f US Environtental Protection AQency - Asbestos abate.ent
I also certify that, if fill taterial is to be used in Flood Zone "A" Dr "A,etc.', it is understood tli~t a drainage plan
addressing a 'colpensating volule" will be subtitted which is prepared by a professional engineer regi5t~ied in the State of
Florida prior to pertit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, Dr
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official frol thereafter
requiring a correction of errors in plans; construction, Dr violations of any code. Every permit issued =hall becole invalid
unless the work authorized by such perlit is cOlmenced within six lonths of issuance, Dr if work authol Ized by the perlit is
suspended or abandoned for a period of six lonths after the tise the work is commenced. One 90 day e~t~nsioli of tile, lay be
allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lust be logged during each six tonth period, Dr the project will be considered dballdoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NY) . CORD AND POST A "NOTICE OF C(!M NT". .
SIGNATURE~__~_ SIGNATUR~__~- -~---
DATE________SSJ1J.lp<:;---------m------- DATE_______.5j2.l %----------------
NOTARY AS TO . NOTARY AS TO
OWNER OR AGENT_____________~_____________~- CONTRACTOR_____________________________
..
MY COMMISSION EXPIRES______________________
MY COMMISSION EXPIRES
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