HomeMy WebLinkAbout95-5000
BUILDING PERMIT
Permit N ~
CITY OF ZEPHYRHILLS
(813) 788-6611
500nt
0- S--C;s
06/Id8/95 BTIL
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BUILDING
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Date
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Parcell.D, # / ~ - ;JIb - .;1 / - tJ / & D - 0000 () - () / '7 ()
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Zoning: Ene~: :;2:Radon Gas: _ . -2 ~
Description of Work (_~?Jf)~ C dL'r;-hJ
~D
ELECTRICAL
~D-
MECHANICAL
Sewer Conn
Water Conn:
Property Owner:
Water Meter:
T.I.F.'s:
Job Address:
NO OCCUPANCY BEFORE C.O.
FINAl__2- / '7 - q S
DATE
C.O, ~7-1 -9S-
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or -:I- ". " ,iJ-;)
Contract Price ' I D; S () i)
Permit Fee
Signature
Company
Address
Telephone#
City License Registration # ~ ~
Certified Li ense# t? 'BC! 0 3 .1;-'1 q 1
BUILDING
ELECTRICAL
06/08/95 BTIL
Ftr. Tp. Servo
Pre SLB 06/08/95 BTIL Rough In ~'-U-~J'- t:J:b
Lintel v1~-'Io~) a.u- Meter Can '
FRM. &2-b-7) hlU-- Const. Pole
Insul. CL (t:rZ7~q-) ittu- Pool
WL C:. - z 7 -'F, 1Jl t.l- Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl. {c::;-U-C;-; i~b
Compressor
Final
Driveway
~L
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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VAL.>JI\T'aCN: 10/500:'0 v
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CITY OF ZEPHYRHILLS BUILDING DEPARTMENT'
OWNER -BRC!NDA ~ \AI A.YN~ -t-\i C-t: s -
JOB LOCATION 4-lo~5 'Wjs..t-~a..jp,. A()e.. - Z-\--1\\\5
u I '0 - ~(o - ~ l- 0 l ~ 0 - 0 DO 0" - 0 I r-r D
PARCEL I. D. It -
SHOW ALL EXISTING & PROPOSED STRUCTURES 9IVING DIMENSIONS & SETBACKS.
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11.11
PROP
ADD. 20
J)(lSTJNG__________
1001
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7,5
UTILITY BUILDINGS
HUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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3S.7
(NOTE EXAMPLES 1 & 2)
FRONT PROPERTY LINE
STREET \N \ ~+~lZ.1 A...f..t;O We., VC-
1. SETBACKS FOR R1, R2 ZONING
60'-
10'
P E
R X
0 I
, 10' P S 10'
0 T 1 0'
S I
E N
D G
20'
FRONT PROPERTY LINE
2. SETBACKS FOP, R3 ZONING
60' -
10'
10' EXISTING 10'
PROPOSED
20'SGL FAH 30'DUPLEX
1 0'
FRONT PROPERTY LINE
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APPLICATION FOR PERl'IIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
A~~LICAN; & M. 1\-",) . COI\)S-\.c<:.u.e.~ ()tQ J ~ "'~
ADD~ESS3"l~~S ~. e. E,4 '\N - ?(7 phye.bd.L~__PIl0NI::" <e>z... o~s-
OWNER ""WA-YNe ~ ~~t)A ~t<:\c.s.. __
JOB LOCATION 4<o~ """Y'S-\-~I~ P(C\~ LOT SlZECcO~ AREA SQ,FT. G,6()t)
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D, ii~ 6 .~ <.o'~ \ - 6ltoD -a::x:>tY) - 0170
WORK PROPOSED:____NewConstruction ..2L.Addition X Alteration ____Repair ____Insta.Ll
_Sign/Temp. ____Sign _Move ____Demo I is 1:
PROPOSED, USE: ..J:J.-Single Family _M/F _II of Uni ts ,_M/H
,;~
~
_Commercial _Indust. _Swim, Pool Other '.
~ _Restaurant & Health Department Approval
'.
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BUILDING SIZE: \S X~O I .~OO Square Fee t, 8~ Heigllc
RESIDENTIAL: '. ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR.'1S,"'"
COMMERCIAL: ATTACH (3)5ET5 OF BUILDING PLANS & (1) SET ENERGY FOR~IS, ,',*
**COPY OF CONTRACT REQUIRED.
~LDING
~~, CTRICAL
v:~~
_MECHANICAL
PERMITS REOUESTED
$
",5\ DOt>
,.
Valuation of Total Construction
::1~
AMP Service
Florida Power Corp.
_\~,R,E.C,
$
Valuation of Mechanical Installation
__PLUMBING
GAS
-6loCk
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION:
_Frame _Steel
,Other
FliNI.SHED FLOOR ELEVATIONS: . FT,
J.." \
**********************************~*******
, CONTRACTOE SEC~ON
BUnnER; ," " , Company ljMA:t\J CbNS.~~c..-\-iOI\) ~f\)'
~~ State Cert. or Regist. !I CI!c-035\34
Signa.tu .",. '.' '0-.---- City License Registration;1 F35'
. " .. . HU......"*....*u..*.......**,,.,,,,,,,,,,,,
EI FeTRrer AN- . Company MoIL~,;:) G- \eci-e~~
't-1' State Cert. or Regist, II
Si"oature 'Lt9 ~~ City License Registration ;,1 _4l
~ * * * * * * * * " * * * * * * * * * * " "' * * * \1 * * " * ,I * "~I " ,', " ,'r " ,'r " " " "
PLUMBFR ~ J A- Company
rH' State Cert. or Regist. ;!
;:.'.Signature City License Registration 'I
,t,1 , " '" * * * * * '* * * *' '* * '* * '" * * * -1:-1: '* ,*;/r * -It -I< .... -I, * * '* it -It ,'t " ,', ,', * ,I " ,'t ,',
~ MECijANTCAL~ ~~:~:n~er ~~~~:~iS~~ 4 e,A~~4,3<'\'t8
: Slgnature>~m"w""..;~~~,~:~;~~;;.~;,~::~::~;:~~ '1- !i;i(') '-l&j 'IF;-
~.:
~i:;::O,T H F R
:\~:::Signa ture
~i\- '
Company
State Cert. or Regist, 0
City License Registration #
~ APPLICATION APPROVED BY
****'***'****'***'*****'***********************
,(.',
PER~lIT OFFICER.
-=-:--~7A-. NOTICE OF DEED RESTRICTIONS v~
The undersigned understands that this penH lay be subject to "deed restrictions" which lay be IIOre restrictive than City
regulations. the undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
~~.,;..u'J,.J.. J.. ill.: J..: .)..J..)Ci, v ..t.)..
B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they lay be required to he licensed inaccordanceillith (1;\
state and local regulations. If the contractor is not licensed as required by law, bOth the 'ollIler and contractor lay be
cited for a lisd8leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing'!c',
requireJents lay apply for the intended work, they are advised to contact tbe City of Zephyrhills Building DepartJent, (813)
788-6611.:;:;.\
Furtherlore, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
"Contractor Sections" of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
you are indicatingtbat you, rather than the contractor, are responsible for the work. If the contractor wishes'you to sign,:C
as contractor that lay be an' indication that be is not properly licensed and is not entitled to perlitting privileges in the
City of Zephyrhills. .
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
,: :~J
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - Hoaeowcer's Protection"
Guide" p~epared by the Florida Departlent of Agriculture and ConsUler Affairs. If the appIicantis sOlieo.ne other than': theJ'6?l((
"ollIler", I certify that I have obtained a copy of the above described docUAent and prolise in good faith to deliver it to.,tbe;L' '.
"owner" prior to couenceJent. '(.;,if;"';:
'fY\ ',.'.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in compliance with all
applicable laws regulating construction, zoning, and land developlent.
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Application is hereby lade to obtain a peuit to do work and installation as indicated. I certify that no work or ,,1
installation bas couenced prior to issuance of a penH and that all work will be perforJed to leet standards of alllillls;,:,.:
regulating construction, City codes, zoning regulations, and land development regulations in' the jurisdiction. I also
certify that I understand that the regulations of other governJental agencies lay apply to the intended work, and that
11' responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are notlilited to:
A Department of Environmental Regulation - Cypress Baybeads, Wetland Areas and Environmentally Sensitive Lands,
Water/Wastewater TreatJent
A Southwest Florida Water Manageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
A ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
A DepartJent of Health & Rebabilitative Services, Environmental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
A US EnvirODlental Protection Agency - Asbestos abatement
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A, etc. ", it is understood tbat a drainage plan
addressing a "cOlpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or
set aside any provisions of tbe technical codes, nor shall issuance of a peIlit prevent the Building Official frOJ thereafter;; 1:
requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued sball becOle invalid,
unless the work authorized by such perlit is commenced within Sil lonths of issuance, or if work authorized by the peIlit is
suspended or abandoned for a period of six IOnths after the tile the work is cOIIenced. One 90 day extension of tile, JaY be
allowed for the perJit with fee charge of $15.00. The extension shall be requested in writing to the BuildingOfficial.':l,,An,,i!:
approved inspection lust be l09ged during each six IOnth period, or the project will be considered abandoned. ," ".,
WARNING TO OWllER: YOUR FAILURE TO RECORD A NOTICE OF COHMEHCmNT KAY RESULT IN YOUR PAYING rwlCE FOR IMPROVEHmS TOYOUR:4.~<~r::;~[.
PROPERTY. IF YOU mEND fO OBTADl FIHAHCIHG, CONSULT WITH YOUR LENDER OR AHArTORHEY BEFORE RECORDING YOUR )lO'flCE OF!';iCi'}!
COIIIlEIICElIIlIII. JOBS OHniR \2,500 IN VALOH DO NO'! NEIlO 10 RK::; p.a~ A '~~CElIIlIII"
~~ ---- - ~::~
SIGNATU~ SIGNATURE: COIl~
--
STATE OF FLORIDA LJi1
COUNTY OF ui 5 c 0
The foregoing instrument was acknowledged
before me this "1Y1'7J ~:L-, 19.:t..r.- by
~o is personally known t~r who has
produced
as identification and who did/did not
take an'oath~::1n1 ~
(Signature)
STATE OF FLORIDA ~
COUlITY OF ,19.5 CO", , "
The foregoing instrument was acknowledged
before me thiS~1 d--~ , 19~ by
~ho is personally ~~~ to ~ or who has
pro uced ---~
as identification and who did/did not
take an ~ vrn ~~. "
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Nam~ Typed, Printed or Stamped)
NOTARY PUBLIC
#'.' ~
ti t- DONNA M SINCLAIR
* ~ * MyC0mmi8sionCC38261Q
~_ Expires Jun, 14,1998
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#'.' ~
.^ DONNA M SINCLAIR
* * My Commission CC38261!;
Expires Jun. 14, 1998
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