HomeMy WebLinkAbout95-5038
BUILDING PERMIT ,,-
CITY OF ZEPHYRHILLS Permit N ·
(813) 788-6611
~~"503~~
Date
~ - a.-!-7'~
~ ELECTRICAL PLUMBING
Property Owner: a~ m
Job Address: S ~/ d- - ;l 0 ~r
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T_I.F.'s:
Parcel I. D. #
Zoning: _E~gy ~d.~
Description of Work ,..d"v-f ~
j)~
Radon Gas:
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
Inspector
Valuation or r/
Contract Price j 6 ?...s -:- cTi)
City License Registration # b~~ -~
State Certified License#
Permit Fee
Signature
Company
Address
Telephone#
zs-. cru
~,~ tl.. OAA~~
--)
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BUILDING
ELECTRICAL
PLUMBING
-
MECHANICAL
Ftr. b~~d.-q~ 6. lot..
Pre SLB
Lintel
FRM.
Insul. CL
WL
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 PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTHENT
JOB ADDRESS
.~ \ Le~~
FJ ;;< I d.
S- J- / d.-
.
LEGAL DBSCRIP'llON: LOT(S)
I~ ~ r y Le
;Z 0 '"\- \" b l'
2-0 \~ S+
B~SUBDIVISION r\ I\e C. \-eS-\-.
PHONE
7~:s;{oS-o
OWNER' S NAHB
OWNER · S ADDJlESS
PARCEL LD.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction ----!addition --Alteration ~epair .x.Install
_Sign
~ve
_Deaolish
PROPOSED USE: _Single Feaily
---1t/F _' of Units ---1t/H
_ec:-ercial
_Indust. _Swia. Pool _Other
~estaurant It Health Departaent Approval
DESCRIPTIOR OF WORK: I ~ S ~ \ \
7L
s c~ -1-e \ \ ~ te
\) ~: S '"
BUILDIRG SIZE:
x
Square Feet,
Height
RFSIDEIITIAL: ATTACH (2) PLOT PLANS It (2) SETS OF BUILDING PLANS It (1) SET ENERGY FORKS.
COKKERCIAL: ATTACH (3) SETS OF BUILDING PLANS It (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION.
PERMITS REQUESTED
_BUILDING S--! <7? C(, C;. ~) Valuation of Total Construction
_ELEcrRICAL
AIIP Service
Florida Power Corp.
H.R.E.C.
-'lECllAllICAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CORSTRUCTIOR: _Block _Fraae _Steel
Other
FIIIISIIBD PI.OOll ELEVAnORS:
Fl.
IS PROJEct IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRACTOR SECTION
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
RIITI.DRR
Signature
RT .RCTRTCIAII
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
SiDnAture
COMPANY
State Cert. or Regist. .
City License Registration t
..........................................
PLUMBER
Signature
IlECllANICAL
Signature
COMPANY
State Cert. or Regist. t
City License Registration .
.........................
Signat
OTRRR
COMPANY
State Cert. or Regist. . ~X 0cJ 5b~~
City License Registration' __ ___
..............................
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'l'he undersigned understands that this pel'lit tay be subject to 'deed restrictions" which lilY be lOre restrictive than City
regulations. !he undersigned asS\IHS responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake wort, they .ay 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 .isdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
requireaents tay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartElt, (813)
788-6611.
Furthel'lOre, if the owner has bired 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 indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
as contractor that lilY be an indication that be is not properly licensed and Is not entitled to peraitting 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 with a copy of 'Florida's Construction Lien Law - Hoteowner's Protection
Guide" prepared by the Florida DepartJent of Agriculture and Consuaer Affairs. If the applicant is SOJeOne other than the
'owner', I certify that I bave obtained a copy of the above described dOCUleDt and prOllise in good faith to deliver it to the
"owner' prior to COIIeDceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developleDt.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas COIIeDCed prior to issuance of a perait and that all work will be perfoIJed to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other governaental agenCies lilY apply to the intended work, and that it is
IY responsibility to identify what actions I lUst take to be in cOlpliance. Such agencies include but are not lilited to:
* DepartJent of Environaental Regulation - Cypress Baybeads, Netland Areas and EnviroDleDtally Sensitive Lands,
Nater/Wastewater 'l'reatlent
* Southwest Florida lIater Hanageaent District - lIells, Cypress Baybeads, Wetland Areas, Altering lIatercourses
* AIIY Corps of Engineers - Seawalls, Docks, Havigable lIatenays
* DepartJent of Health' Rebabilitative Services, Environaental Health Unit - Wells, Wastewater 'l'reatJent, Septic 'l'anks
t US Environaental Protection Agency - Asbestos abateaent
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 'c0tpeD8ating voluteR will be sublitted wbich is prepared by a professional engineer registered in the State of
Florida prior to pel'lit issuance. .
A perait issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sball issuance of a pel'lit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becoae invalid
unless the wort authorized by such pel'lit is COIIeIlced within six IOnths of issuance, or if work authorized by the pel'lit is
suspended or abandoned for a period of sil IOnths after the tile the wort is co.enced. One 90 day extension of tile, lilY be
allowed for the pel'lit with fee charge of $15.00. 'fbe extension sball be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
NARIIIHG '1'0 omR: YOUR FAILURE '1'0 RECORD A HorlCE OF COIHDCBIIBIft' HAY RESUL'I' lH YOUR PAYlHG twICE FOR IHPROVEHEIft'S '1'0 YOUR
PROPER'I'Y. IF YOU IIft'BHD '1'0 OB'l'IIH FIIWICIHG, COHSUL'I' WItH YOUR LllDER OR D A'I"I'OHDY BEFORE RBCORDIHG YOUR HO'I'ICB OF
COMMEHCBHRIft' . JOBS OlDER $2, SOD IH VALUE 00 Hor HEED '1'0 RECORD AND POS'I' A lIHorlCE OF COHHDCEHEM'I".
SIGHAfURI: 0IfIIBR OR AGBIft'
SIGlfA'I'URE: COIft'RAC'l'OR
STA'I'E OF FLORIDA
COllH'l'Y OF
The foregoing instrument was acknowledged
before me this , 19____ by
STA'I'E OF FLORIDA
COlJIf'I'Y OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is personally known to me or who has
produced
as identification and who did/did not
take an o~th.
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
.f
/
JOB ( 0 Pc /2EQ-'?/"-- "1 E:: 0
SILCOX ENGINEERING, INC.
5409 N. Nebraska Avenue
TAMPA, FLORIDA 33604
(813) 238-9755
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SilCOX ENGINEERING, INC.
5409 N. Nebraska Avenue
TAMPA. FLORIDA 33604
(813) 238.9755
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G't-o<-f'\.l '\ Eve l
~tW\::'i- -t<xbC,
OWNER
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
~ L D(_f\.~-\ \- ~ Q 'I L e
5" ~\ a {~() ~ <S'\-.
(O-\-' ~ \OC_K \ ~\ .'\.C'~ ~,
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JOB LOCATION
PARCEL 1. D. 1#
SHON ALL EIISTIHG 6: PROPOSED STRUCTURES GIVI.IfGDIHElfSIOHS &: SETBACKS.
SETBACKS PER ZONING
DISTRICTS:
RI, R2 & R3
FRONT 20'
SIDES 10'
REAR 10'
(UNDER R3 IF DUPLEX:
FRONT 30')
ESTATE RESIDENTIAL
FRONT 25'
SIDES IS'
REAR IS'
M-I
FRONT 20'
SIDES 7.5' (INTERIOR)
SIDES 10' (ABUTTING ST.
REAR 10'
*NOTE: ANY CORNER LOT
SIDES MUST COMPLY WITH
REQUIRED FRONT SETBACK
FOR SAID ZONING DISTRICT
FOR OTHER ZONING DISTRIC S
REFER TO LANDDEV. CODE
FOR APPLICABLE SET-BACKS
J. '{..J XLf . Cor\C~-\e
Lj:J- ) -j-D ~<' \'0,-""))'
30 3-~
-tJ..4-'
;- <
) '( ---=;r
S \ (\.~\e ~(l'\.~\ 'i ~(he
FRONT PROPERTY LINE
STREET :5'~ l ~
J 0 fk ~ + 'n:'J~'-\- .
~o-r.1 \6\OCK 1
~ \~ t lbooK S
~}ll\e C \-EC,:J\
~QJe 5$~
S \-- ~ ~.\ v \ ~:;Of\-
.b ~ /1 - d c) '\~ S ~~et-t
GOOD NEWS INVOICE
tf574
SATELLITE & TV
SALES, SERVICE & SUPPLIES
5922 GAll BLVD.
ZEPHYR HIllS, Fl 33541
948-3474 · 780-1000
.
j
-CUSTOMER_
NAME
REMARKS OR SERVICES PERFORMED
AMOUNT
SERVICE AUTHORIZED BY:
//h1 /1 -f-. ~ ~
(,~~_/ .f ~
PAYMENT OF THIS INVOICE, INS.
CLAIM #:
MATERIALS
INSTALL &
PROGRAM
SERVICE CALL
& TECH. CHG.
ASSIGNED TO GOOD NEWS SATELLITE
SUBTOTAL
TAX
TOTAL
DOWN
PAYMENT
BALANCE
All Malerlals Used Are Of Firsl Quality.
BY:
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