HomeMy WebLinkAbout95-5050
BUILDING PERMit .....
NO
CITY OF ZEPHYRHILLS Permit' ·
(813) 788-6611
-;- 505013
Date
6 -d.-{; ~ 9~
~~~
~opertyOwne" ~~ .~gh
Job Add,e.., c3 ~ ~.
Parcell.D. #
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
(l~
Water Meter:
T,I.F.'s:
Zoning: Energy Code:
Description of Work-----;? .e A-Lry
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
. 2:~ -~ ..;
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
P~'mit F~~
Signature
Company
Address
Telephone#
Valuation or
Contract Price
dJ /nJ . d'V
1/:2
City License Registration #
State Certified license#
_ ~.A'l.//I(/l'n4
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
.Pre-Meter
Final
Ftr.
Pre SLB
Lintel ./' ~/
FRM. ~),J' '1-,11-)
Insul. CL.:-{p.J 1r '
WL ~t \..tV
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.
ADDRESS
11-:;_~ '~~::;.~r :J t ~
~~vu- d:;~()b\' " . -- ,.:... c . ..;~'H.'
\\~ 5.~~~ C~<!1';~rSfo"-'~
OWNER -2ltt~ ~ "
3<c4-DI ~~ :::S-~~~LOT SIZE
AfPLtCAT10N FOR PERMIT
CI.TY OP'ZEPHYRHI.LLS
BUILDING DEPARTMENT ' " . .
APPLICANT
)C
"-
AREA SQ. FT.
JOB LOCATION
LEGAL DESCRIPTION: LOT(S)
BLO,CK '
SUBDIVISION '
" ."; . . , . ."'"
PARCEL I.D.4.
WORK PROPOSED:____New Construction ----Addition ~lteration ----Repair ____Install
: ,",
____Sign/Temp.
PROPOSED USE: ~Single Family
_Sign
____Move ----pemolish
~/F
____~ of Units .~/H
____commercial
~Indust.
____Swim. Pool Other
____Restaurant & Health Department APproval
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COMMERCIAL :
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.
:pF.RMTT~ REOIIESTED
_BUILDING
$_ :2 \ \c:c>. Q::)
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida power Corp.
W.R.E.C.
.
____PLUMBING
GAS
Valuation of Mechanical Installation
~ ROOFING SPE~IALTY
_MECHANICAL
$
.0#' .
TYPE OF CONSTRUCTION: _Block _Frame ____Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
******************************************
~ONTRACTOR ~ECTION
Company
State Cert. or Resist. #
City License Regis~ration ~
************************************.****.
Signature
Signatt,lre
/
/
...
Company
State Cert. or Resist. #
City License Registratio
*************************************** *
:~:::::::A~ .
/'
/
Company
. State Cert. or R~gist. #
_ City License Registration
*****************************************
PUTMRER
MECHAN1CAT. I
Signature ,./
******************************************
OTHER ~m\ Company s...~~' (i"~c-ts.~~~
State Cert. or Regist. 4. ~~QQS<o"(o'"3.
Signature ' - .~ City License Registration ~ ~..
******************************************
,
PERMIT OFFICER.
APPLICATION APPROVED BY
CONDITIONS O~ PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The und~rsigned understi~Gi thit this perlit liY be subject to "deed restrictions" which liY be lore restr.ictivt thin City
reguhhons. Tht undtnuJntd USual I rtJponlibilit(for cOlpUlnet with iny ipPUuble dttd rutrictions.
, .
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner his hired i contrictor or contrictors to undertike work, they liY be required to be licensed in accordance with
5~.tt i~d 10c~1 rtgulitions. If the contr.ctor il not licensed as required by liN, both the ONner and contrictor liY b.
clte~ for i Ilsdeleanor violiti~n under state liw. If tbe owner Dr intended contractor art uncertain a5 to what lictnsing
requ~elents liY apply for the Intended work, they are advised to contact the City of Zephyrhills Building Dtpartltnt, 18131
799-6611.
Furtherlore, if the owner hiS hired a contrictor Dr contractors, he is advised to have the contractorls) sign portions of the
"Contrictor Sections" of this ipplicition for which they will be responsible. If you, is the ONner sign as the contr.ctor
you are indicating that you, rather than the contractor, are responsible for the work. If th. contrictor wishes you to si~n
as contractor that liY be an indication thit 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 thit I, the ipplicant, have been provided with a copy of "Floridi's Construction Lien LiN - HOleowner's Protection
Guidi" prtpared by the Florida Depirtaent of Agriculture and Consuler Aff.irs. If the .pplicant is sOle6nt other than tht
"owner", I certify th.t I have obtained I, copy of tbl aboye described docuaent and proaise in good f.ith to deliYfr it to the
"owner" prior to cOlaenceaent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaition in this .pplic.tion is iccurite ind th.t all work will be done in cOlpliince with ill
.pplicable li"S regulating construction, zoning, and land developlent. '
Applicition is hereby .ade to obtain a perlit to do work and install~tion as indicated. I certify that no work or
installition has cOI.eneed prior to issuince of a perlit and that all work Nill be perforled to aeet stindirds of all l.w5
reguliting construction, City codes, zoning regulitions, ind lind developaent regulations in the jurisdiction. I ilso
certify thit I understind that the regulitions of other goyernlentil agencies lay ipply'to the intended work, ind thit it is
IY responsibil i ty to ident ify whit ictions I lust tike to be in cOlplhnce. Such igencies i nc lude but j. e not lili led to:
...
. DeDartle~t of Envir~nleni.1 Reaulition - Cypress Bayheids, Wetland Areas and Environaentally Sensitive Lands,
Water/Wastewater Treatlent
f Southwest Florida Water "anaaelent District - Wells; Cypress Bayheads, Wetland Areas, Altering Watercourses
. Arlv Corps of Enaineers - Seawalls, Docks, Navigable Waterways
f Deoart.ent of Health L Rehabilititive Services. Environlentil Health Unit - Wells,' Wastewater Treatlen~. Septic Tanks
. US Enyironlental Protection Aaency - Asbestos abatelent
I ilso certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.', it is understoDd that a drainige plan
iddressing a "colpfnsating Y01Ule" will be sublitted which is prepared by a professional engineer regist~i~d in the State Df
Floridi prior to perlit issuance.
A per.it issued shall be construed to be a license to proceed with the work and not as authority to viol~te, cancel alter, O(
set aside iny provisions of the technicil codes, nor shill issuance of a perlit prevent the Building Official frol thereifter
requiring a cDrrfctiDn of errors in plinsj construction, or violations of any code. Every perlit issll~d ;hall becoae invalld
unless the Nork authurized by such perlit is cOI.enced within six IDnths of issuance, or if work iuthollzed by the per.it is
suspended Of" abandoned fH a period of six lonths after the tile the wClrk is co..enced. One 90 day e=h,i\sioll of tilt, uy ~l'
allowed for the per.it Nith fee charge of 515.00. The extension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each six lonth period, or the project "ill be considered ilblilldoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YDU
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 NEED TO R CORD AND POST A "NOTICE OF COMMENCEME
~GNATURE__~_ _____________ SIGNATURE__~_ --
D~:::~~::~~~---:------------------ ~~~~_~c:~~~~-~------~--- -----
NOTARY AS TO _ " :_+_1 J A I NOTARY AS T J
OWNER OR AGENT ___ ~~_'{2{'A/:J.~' CONTRACTOR___ _(2{~ - - -
..
MY COMMISSION
MY COMMISSIO
~
1.i.~
---JuDnH l. SCHAPER
Notay Public. State of florida
My Comm. Exp. June 6. ]997
No. CC 292351
~
W
JUDITH L. SCHAPER
Notay Public. State of FlorIda
My Comm. Exp. June 6. 1991
No. CC 292351
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:1 11250 South Highway 98, Dade City, Flot~ida 33525
ii Phone # (904)567-8580
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RESIDENTIAL & COMMERCIAL
RegIstered BuildIng Contractor
r,e91::.ter'ed F(cH':Jflng Contr'actor'
RB 0032524
RC 00567<'..;:::
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REMOVE EXISTING SHINGLES, DRIP EDGE, AND DAMAGED WbOD
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- INSTALL NEW VALLEY METAL AND FLASHING
... I N'3T ?-)LL NEW
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DHIP EDGE
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