HomeMy WebLinkAbout95-5013
BUILDING PERMIT 0
CITY OF ZEPHYRHILLS Permit If.
(813) 788-6611
~- 5013 };
DatE! 6 -I.. ~ - 7. \-
~ ELECTRICAL PLUMBING
""aperty Owne. ~ J~ : .# "-----n
Job Address: ~i: ~ /6:H~--.
Parcel I. D. #
Zoning: Energy Code:
Description of wor~ 12 ~~
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
- 2G-9S
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
f<:l-
Permit F~ ~)
Signatur~~~-
Company ::::::s-
Address
Telephone#
Valuation or
Contract Price
9-.SCJ - c-D
City License Registration #
State Certified License#
-~/rPA ~
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
-
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
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.
.AF~LICATIaN FaR PERMIT
.CITY .oF' ZEPHYRHILLS.. ,.
BUILJ)'ING DEPARTMENT '" " .,
APPLICANT. "~~ ~~~~~~/f'.:...;'-'-----
ADDRESS . 1 \ 2S:::> S. M~'~" :C:Wj'
OWNER .~ ?W\\~ "", ' , ....' ",'
JOB LOCATION ~A~ \\o~ .S~~ ,LOT SIZE
.-'.'r~:1 .,.-..,.-
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PH~~-,-,S~'"1-: ,B5ij:.) " ,':; " .,
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'f,"t _'.--":~;: ...-::.~':'
x
AREA SQ-:FT~-- "-.-- -'
~ ; - J i...: ;,' .
LEGAL DESCRIPTIO~: LOT(S)
BLQ{;l{
SUB.DI;VISION-'
....,,, -. '" '.. .... . .'"'\
PARCEL I.D.~t
:"-- '"-.,, ,'..
_Sign/Temp.
_Sign
_Move
~,nst~~l
-DelDolish
WORK PROPOSED:_New Construction ----Addition ----Alteration ~epair
PROPOSED USE: _Single Family
---KIP
_~t of Units
, .-Jl/H
_Commercial
~Indust..
_Swim.. Pool
Other
. ~;'
_Restaurant & Health Department Approval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PF.RMTTS RF.OlJF.STE.D
_BUILDING
$' ~ ,C;I:.>
Valuation of Total Construction
_ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
GAS
Valuation .of Mechanical
">< ~~OFING
/ ',.
____Frame ____Steel
Installation
----MECHANICAL $
.
_PLUMBING
.0#- .
SPEC<IALTY
TYPE OF CONSTRUCTION:
____Block
Other
:.
FINISHED FLOOR ELEVATIONS: FT.
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Regis~rati'
***************************************
Signature
::::~.::AH .'
/
/
/
Company
State Cert. or R~gist. #
City License Registrati
***************************************
Company
State Cert. or Regist.
City License Registra on ~~
******************************************
Signature
Company
State Cert. or Resist.
City License Registrat n
************************************** ***
Signat~re
OTHF.R ~~\~
Signature ~0---\.:- ~
Company S~~QR ,.~,~~~
State Cert. or Regist. tt_k C03G-.. ,(03
City License Registration # ~~
******************************************
~
PERMIT OFFICER.
APPLICATION APPROVED BY
CONDITIONS C~ PERMIT AffIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The und~rsigned understa~ds that this perlit lay bl subject to "deed restrictions. Nhich lay be lore restr,ictivl than City
reguhhonl. Thl llndlnlgnld ilS1ll11 ruponlibility""for cOlplhnn NUh any appliuble dttd restrictions.
. .
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the ONner has hired a contractor or contractorl to undertake Mork, they lay be reqllirldto b. lic.ns.d in accordanc. _ith
Itatl '~d locI 1 regulationl. If thl contractor il not liclftlld al required by laN, both thl ONner and contractor IIY be
cited for a lilde.elnor violation llnd.r state laM. If the OMn.r or intended contrlctor Ir. uneertlin IS to .hlt lic.nsing
reqllile.ents IIY apply for the intended Mort, thlY Irl Idvilld to contlct the City of z.phyrhilas Building D.part..nt, ISa31
788-661 1.
Furtherlore, if the owner has hired I contractor Dr contractors, he is advised to have the contrictor(s) sign portions of the
"Contrlctor Seetions" of thil application for which they .ial be responsible. If you, as the o.ner sign as the contrletor.
you are indicating that you, rather than the contrlctor, are responsible for the Mork. If the contractor Nishes yOll to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to per.ittinq 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 Mith I copy of .Florida's Construction Lien LaM - HOleo.ner's Protection
611ide. pr.pared by the Floridl D.partllnt of Agriculturl and Consultr Affair.. If the applicant is sOltone oth.r than the
.o.ner", I certify that I have obtained I. copy of thl abov. d.scribed doeulent and prolise in good faith to d.liv.r it to the
.0Nner" prior to COllencelent.
E. CONTRACTOR'S/OWNER"S AFFIDAVIT
I certify that all the inforlation in this applicltion is accurate and that all Nort Mill be done in cOlplianee Nith all
applicable aaMs regulating constrllction, zoning, and land d.y,lDpaent. '
Application is hereby .ade to obtain I per.it to do Mort Ind instlll~tion as indicated. I certify that no Nort or
installation has cOI.enced prior to issuance of a per.it and that all Mork .ill be perforled to leet standards of all laNs
regulating construction, Ci ty codes, zoning nguhti6ns, and land develop.ent regulations in the jurisdiction. I also
certify tbat I understand that the regulations of other govern.ental igencies lay apply'to the intended Mort, and that it is
IY responsibility to identify Mhat actions I .ust tate to be in co.pliantl~. Such agencies include bllt iU e 1I0t Ii.ited to:
#'
I Deoart.e~t of Envir~nlental Reaulation - Cypress Bayheads, Yetland Areas and Environaentally Sensitive linds,
Water/Wastewater Treatlent
t SouthNest Florida Water "anaae.ent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
t Ar.v CorDS of Enaineers - SeaMalls, Docks, Navigable WaterMays
t DeDartlent of Health L Rehabilitative Services. Environ.ental Health Unit - Yells,' WasteMiter Treat.ent, Septic Tanks
t US Environlental Protection Aaency - Asbeitol abate.tnt
I also certify that, if fill laterial is to be used in Flood Zone "A" Dr "A,etc.., it is understood tt..t a drainage plan
addressing a .colpensating volule" Mill be sublitted which is prepared by a professional engineer regist~.ed in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed Mith the Mort and not as authority to viol~te, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Official fro. thereafter
requiring a correction of errors in plans; construction, or violations of any code. Every perlit issu~d iball becoa. invalid
unless the .ork authorized by such perlit is eOllenced Mithin six lonths of issuance, or if work authoi I%ed by the perlit is
suspended Of abandoned for a period of sil lonths after the tiae the Nork is cOllenced. One 90 day c~tE"sioll of tile, lay b~
alloNed for the perlit Nith fee charge of $15.00. The Ixtlnsion shall be requested in Mriting to the Building Dfficial. An
approved inspection lust be logged during each six lonth period, or the project Nill be considered ~b.lIdoned.
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 N~ ECORD AND POST A "NOTICE OF COM?2. ENT".
SIGNATURE' ~ SIGNATURE____ - -~-
~<Z-~ - --------------- ~L~ V':^- ~
OATE------~l~~----:-------?1l-- ------- OATE______~J~:------~-----------
NOTARY AS TO' . NOTARY AS TO
OWNER OR AGENT____ ")~ CONT~ACTOR---- "~
MY COMMISSIO
...~
: ijIU'fi
-'jUi5ifHL.SCHAPER-
Notav Pl.lbllc. State of Florida
My Comm, EKP. June 6. 1997
No, CC 292357
f:i" ""
4." ~
: fi
XPIRES__________________
JUDITH L. SCHAPER
Notorv PubliC. State of FIoIlda
t./ti Comm. Exp. June ().1997
No. CC m357
MY COMMISSIO
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RESIDENTIAL & COMMERCIAL
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8uildlng Contractor
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F\B 0032:j24
RC 005676:':.
F,: ~.:~ CJ 1 .:~ .:.:; t:.~ r" i.:.:.~ d
11250 South
Highway 98, Dade City,
Phone # (904)567-8580
Bonded and Insured
Flot'ida
33525
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ShINGLES, DRIP EDGE. AND DAMAGED WOOD
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U-'STALL NEW VALLEYlETAL AND FL(,SHWGS ~le
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