HomeMy WebLinkAbout95-5009
BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit N!
(813) 788.6611
:2b -' cJV :LIJ. Of)
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~~~ ~ECTRICD C:;IIIMBIN0 MECHANICAL
P<opertyOwne, jff5/'~ - ~"IA~r./> .
Job Address: L5__ _ /3__
Parcel LD. # //-:26 - ;;t/. CJ CJ/ tJ - ()tF-y,",o ,- 0 C) {, 0
"7-500Q 13
J7c; - ov
Date
b -/a-9~-
Sewer Conn
Water Conn:
Water Meter:
T,LF.'s:
Zoning: ~ Energy Code: Radon qas: _
Description of Work ~~~ /~ ~~~([
r4\...AO
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
)
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
City License Registration # 2 ()
State Certified License#
Inspector
Permit Fee .L.4..t2 ~ ?7'c..J
Sign'ature ~ rYl~
Company
Address
Telephone#
Valuation or
Contract Price / tJ J ,;)../..3. cr-v
Jk}uo~ ~ d~A\d~/
BUILDING ELECTRICAL 6
Ftr. ~ t:r13,t,j~ ~l\.L Tp. Servo
Pre SLB frr 1'1 - f) LL Rough In
Lintel Meter Can
FRM. Const. Pole
Insul. CL Pool
WL Pre-Metpr
Final ~..lJ:1, qc( ftb
Driveway ~ '6c.Ai)
to-(Ii' t} J 6lU-
,vt~7t~" ~
O1-D
MECHANICAL
PLUMBING
SLB M- b-/3..Lt' 6lLL
Tub Set
Water
Sewer
Final 1,"1'147 ttL0
Breakers
Ducts Insl.
Compressor
Final
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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APPLICATION FOR PDKIT
CITY OF ZEPIIYRIIILLS
BUILDING DEPAR'l'KENT
OWNER'S IWm fllM teVI:U:'i (JKJ./20IyN Krr.r /i~~S ~J.-C PHONE ') f3 - I r'J 3 S-
OWlIER'S ADDRESS .s '7 () 9 /3,..J, Sf
JOB ADDRESS C" II '1-1 'f-
,
LEGAL DESClUPlION: LOT(S)
BLOCL-SUBDIVISION
PARCEL I.D.' I,.). L .~ I
00/ (J
of\yoc) 0 (j & () (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction ----...Addition ----...Alteration --.Jlepair _Install
_Sign
---..Nove
--Peaolish
PROPOSED USE: ~ingle Faaily
_ec-ercial
----KIF _' of Units ----"'/H
_Indust. -X,Swia. Pool _Other
-----Restaurant & Health Departaent Approval
DESCRIPTIOII OP WORK: ~ 7J/l(J (J if ; 1 f,<:r.c J-
BUILDING SIZE: X Square Feet, Height
RESIDENTIAL:
COMMERCIAL :
ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOIJESTED
~UILDING
c-~
$ /O;;U3
Valuation of Total Construction
---..ELECrRICAL
----lIECIIAIIICAL
AMP Service
Florida Power Corp.
N.R.E.C.
$
Valuation of Hechanica1 Installation
.-PLUHBIIIG
GAS
ROOFING
SPECIALTY
TYPE 9F COIISTB.ucnOIl: _Block _Praae _Steel
Other
FIIIIISIIED FLOOll ELEVATIOIIS:
Fl.
IS PROJECT III FLOOD ZONE AREA?
YES NO
..........................................
BlffT.DD
CO~crORSEcrroN ,
COtIPAIIY 1I(yt1.\J~P~ ~~
State Cert. or Regist.' CI-'C..~~1"''''''~
City License Registration' ...L.O
..........................................
Signature
COMPANY 'I) CN ,....~.,. ),22,;,-" f'> .1..., I € l- ..,- <2 c .......+.
* /J State Cert. or Regist.' (,,/1
\ J/LH....ff,.P City License Registration ,
. ......................................
COtIPANY ~1ti'7{~ (]u.~~L-,
) State Cert. or Regist.' Cfl,--(),).~j-v ~
LL <:> City License Registration , r:f)-o
..........................................
PLUHBER
COMPANY
State Cert. or Regist. I
City License Registration f
..........................................
Signature
OTRRR
COMPANY
State Cert. or Regist. ,
City License Registration ,
......*.***.*...**.******.***.**......*...
}f ~ !J1 ~ d PBBHIT OFFICER.
Signature
APPLICATION APPllOVED BY
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this pemit laY be subject to 'deed restrictions' wbich lily be lOre restrictive than City
regulations. !be undersigned asSUle& responsibility for cmpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas hired a contractor or 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 .isdeJeanor violation under state law. If the olflU!r or intended contractor are uncertain as to wbat licensing
requiruents lily apply for the intended work, they are advised to CGI1.tact the City of Zepbyrbills Building DepartJent, (813)
788-6611.
Furthenore, if the owner bas bired a contractor or contractors, be 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 indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that laY be an indication that be is not properly licensed and is not entitled to pemitting privileges in the
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, have been provided ,ith a copy of 'Plorida's Construction Lien Law - BoIeoImer's Protection
Guide' prepared by the Florida Departlent of Agriculture and CoIl8Ull!l' Affairs. If the applicant is 8OIl!OIle other than the
'owner', I certify that I have obtained a copy of the above described docUIent and pI'Olise in good faith to deliver it to the
Immer' prior to COIIeDcuent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infomtion in this application is accurate and that all work ,ill be done in co.pliance ,ith all
applicable laws regulating construction, loning, and land develo(IIeDt.
Application is hereby Jade to obtain a perlit to do IOrk and installation as indicated. I certify that no work or
installation bas CDleDCed prior to issuance of a pemit and that all work ,ill be perfoIJecl to leet standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveI1lll!lltal agencies laY apply to the intended work, and that it is
If responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to:
. DepartJent of EnvirOllll!Jltal Regulation - Cypress Baybeads, IIetland Areas and EnvirollleDWly Sensitive Lands,
IIater/llastewater !reablent .
. Southwest Florida IIater Managuent District - IIells, Cypress Baybeads, IIetland Areas, Altering IIatercourses
. ArIy Corps of Enqineers - Seawalls, Docks, Navigable IIatenays
. Departlent of Health i Rehabilitative Services, InvirOllleDtal Health Unit - IIe11s, IIastewater !reablent, Septic !ants
. US EnviIOJllelltal Protection Agency - Asbestos abatuent
I also certify that, if fill Iilterial is to be used in Flood Zone 'A' or 'A,etc.', it is understood that a drainage plan -
addressing a 'COIpeDSating volUle' ,ill be sw.itted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A I*Iit issued shall be construed to be a license to proceed with the IIOrk and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a pemit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery penit issued shall becme invalid
unless the IIOrk authoriled by such pemit is ~ced within sillODtbs of issuance, or if IIOrk authoriled by the peIlit is
suspended or abandoned for a period of sillODtbs after the tiIIe the work is coaenced. One 90 day 81tension of tile, laY be
allowed for the pemit with fee charge of $15.00. !be 81tension 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.
VARKIIG 'fO (MID: YOUR FAILURE !O RECORD A NO!ICE OF CCIIIIBKCBMm' MAY RESUL! IN YOUR PAYIKG !IIICE FOR IIIPROVBIID!S 'fO YOUR
PROPBR'rY. IP YOU IIft'BIiD 'fO OBt'IIK PIWCIIG, COISUL! III!H YOUR LBlDIR OR III A'l"fORRIY BEFORE RlCORDIIG YOUR DICE OP
ClIOIDCEMIK!. JOBS UlmER"2, 500 IN VALUE DO NO! lIED 'fO RECORD IIID POS! A ',NO!ICE OF C(lfllDCBIIEK!'.
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SI~"': 111III1111 AGm . rr-. - - -. I!:II_i: ClIIIIIC!III
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
",~-:;"~Ir;:--'_, SHARON L. BARBER
rrX~~ ~ COMMISSION' CC443613 EXPIRES
~.~:~.. March i, 1999
'~iif.:r..~" BONDED lNRU TROY FAIN INSIJRANCC,INC,
S!AR OF FLORJDJ '
ccum OF itQ seD
The foregoing inst~t was ac)p~ledged
before me this 0L ' 19~ by
..ho i~~~ll~f1~~ Dr who bas
produced __~
as identification and who did/did not
takyr~~~
(Sf'gnature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
$~-:;"~r~ SHARON L, !iAR8fh
E*{~~ MY COM\fISSION # CC443~13 E:fi~
~~~ M8/tll!ii, lS'b':
-1II:.l:i" BONDED THRU mo'! rA!N '!<,.:"AlK .';1,:
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NAME: M'IRot.J )(.oPP5(.8~~
ADDRESS: S7 of) /3 THS
,CITY: ~HYIt/-IJUS .;::l;,
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, '
~HE POOL PROPOSED FOR CONSTRUCTION AT THE ABOVE ADDRESS
DOES NOT CONFLICT WITH ANY UNDERGROUND OR OVERHEAD FACILITIES OF
FLORIDA POVlER CORPORATION, PROVIDED THAT THE POOL IS INSTALLED IN
THE LOCATro~ SHOWN ON THE ATTACHED SITE PLAN PROVIDED TO US BY
THE POOL CONTRACTOR.
-- THE POOL PROPOSED FOR CONSTRUCTION AT THE ABOVE ADDRESS
DOES CONFLICT WITH OIH UIG FACILITIES OF FLORIDA POWER
CORPORA TION.
ARRANGEMENTS HA VE BEEN MADE WITH US FOR RELOCATION OF THE
FACILITIES SO AS TO CLEAR THE POOL AREA SHOWN ON THE ATTACHED SITE
PLAN.
FLOFJDA POWER CORPORA nON
~ 7 ~ o/'s-h's-
STEPHEN F. BUNNER
DISTRIBUTION ENGINEERING
ZEPHYRHILLS OPERATION CENTER: 36453 Geiger Road. Zephyrhills. Florida 33541. (813) 783-6944
A Roriela ProQress Company
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