HomeMy WebLinkAbout95-5057
BUILDING PERMIY'o
Cull "" ~ ~ OTY OF ZEPHYRHILLS Po,m.W' '~5057 /J
..;Lo.'~ -()'~~7J' ~cJ.(J, cr0 (813) 788-6611 Date b -clR--y-S-
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn 9,~--g-.....s"Z>
Water Conn: ~b:Jt~()
P,"pertyOwne" f- ~,C J Q
Job Address: ptJ 0 ~ AL, ,
Parcel I. D. #
Water Meter:
T.I.F.'s:
Zoning: ~
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Description of Work ~
Radon Gas:
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Inspector
NO OCCUPANCY BEFORE C.O.
FINAL
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Permit Fee /~ ~~
Sig~ture f~'Vrn--
Company
Address
Telephone#
Valuation or
Contract Price
City License Registration # S, 5'~
State Certified License#
BUILDING
ELECTRICAL
)/~A ht'd;/
, PLUMBING A-s-~
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MECHANICAL
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Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final Ie. t---b --ej' '.)
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL:
WL
Breakers
Ducts Insl.
Compressor
g Final
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SLB
Tub Set
Water
Sewer
Final l~r2 6.-/~
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Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
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CENTRAL PROCES5lNCA
,DEPARTMENT
PI'IOJECTtA5T PASCO MEDICAL CfNTfR
ZfPHYRHLL5. FLORIDA
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ANlate'AM anAluna C'OfltIlPAN' ure, PENNSYLYANIA '6$,,,
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TABLE A - WORKSHRF.T
fUf\Y~ 11 c:.;J
CITY OF ZEPHYRHIl.LCi CONNECTION FEES
S'vtt&ilJ'l "1 \) fL.9 T .
ORD. #395 & RESOLUTION #312 WATER $1.75/GALLON SEWER $6. 39/GALLON
RESIDENTIAL (Each Lot or Unit) "
Residence $ 350.00 $1,278.00
Travel Trailer Park 131. 25 479.25
COMMERCIAL (PER FIXTURE)
Sinks 87.50 J19.50
Water Closet 131. 25 479.25
Urinal 87.50 319.50
Lavatory 4J.75 159.75
Tub/Shower 87.50 319.50
Washing Machines-Commercial Size 350.00 1,278.00
Washing Machines-Domestic Size 87.50 319.50
FOOD SERVICE - Dishwasher 700.00 2,556.00
Sinks (J Compartment) 175.00 639.00
Car Wash (Per Stall) 1,000.00 6,390.00
FIXTURE G.P.D. /1 WATER SEWER TOTAL PER FIXTURE
Sinks 50 '2 11'- :--0 0"3Q:;,0 ~ 'Jt.f~ eo
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Water Closets 75
Urinals 50
Lavatories 25
Tubs/Showers 50
Wasbing Machine 200
Washing Machine 50 \ cgl,5D .511'.'50 ' tfO'l, 0 0
Dishwasher 400
Sinks-J Comprt 100
Car Wash-p/st. 1,000
-2-0'2- I '50 q;<3, .50 i, 2-2..1, be
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WATER METER
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APPLICAITON FOR PERIIIT
CITY OF ZEPBYRBILLS
BUILDIRG DEPARTHBNT
PHONE
/H''t)~//
JOB ADDRESS
WORK PROPOSED:-1!:..Jiew Construction -----Addition --..Alteration ____epair _Insta11
_Sign
-Ifove
--Peaolish
PROPOSED USE: ~iDg1e F_ily
...2Leo-ercia1
-1t/F _, of Units -1t/B
_Indust. _Swia. Pool _Other
Restaurant Ii Health Departaent Approval
DESCIUP1'IOII OF _: ~ ~,~ :$.d~
BUlLDIRG SIZE: X ,1.9~[) Sq~e Feet, ~~ I Height
RE5IDEI1TIAL: ATTACH (2) PLOT PLAlIS Ii (2) SETS OP BUlLDIRG PLARS Ii (1) SET EHERGY PORKS.
COMMERCIAL: ATTACH (3) SETS OF BUlLDIRG PLANS Ii (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED POR ALL NEW CONSTRUCTION.
PERIIITS REOUESTED
~UILDIRG
$ ~~()/()60 I -
Va1uation of Total Construction
/ RT .RCI'llICAL
AIIP Service
Plorida Power Corp.
W.R.E.C.
~CBAlJIcu.
L-PLlIIBDfG
$
Valuation of Hechanica1 InStallation
GAS
ROOFING
SPECIALTY
TYPE QF OORSTllUCTIOR: ~loclt _Praae _Steel
Other
FDIISIIED FLOOR ELEVAnOIfS:
n.
IS PROJEC'l III FLOOD ZONE AREA?
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-
YES NO
..........................................
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City License Registration , '2f.t1-
..........................................
Signature
Signature
COMPANY /I~# &~
State Cert. or Regist. ,
City License Registration' ~//?"
..........................................
WtPARY ~ ~'I/!~J )}U~)
State Ceri. Reai t. , -r-~t;74(1)..2;
City License Registr tion' /f6
.......................................... . ,
RT.RCTRICIAII
SiDnAture
PLlDlBER
Signature
COHP
State Cer .
City License Resist tion'
..........................................
IlEClWiICAL
OTRRR
COMPANY
State Cert. or Regist. ,
City License Registration ,
..........................................
Signature
APPLICAITON APPBOVBD BY
PERKIT OPPICER.
CONDITIONS OF PERMIT AFFIDAVIT
A~ NOTICE OF DEED RESTRICTIONS
rbe undersigned understaDds that this penlt lay be subject to .deed restrictions. wbieb laY be lOre restrictive than City
regulations. tbe undersigned a&8U188 responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner baa hired a contractor or contractors ~ to undertake IOrk, they laY be required to be licensed In accordance with
state and local regulations. If the contractor is not licensed as required bJ law, both the 0IIDer and, contractor IaJ be
cited for a .isd_anar violation under state law. If the OlDer or Intended contractor are uncertain as to what licensing
reguir.ents laY apply for the intendecllOrk, they are advised to CODt.act the City of Zepbyrhil1s Building Departlent, (813)
788-6611.
Purthenore, if the ovner has bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
.Contractor Sections. of this application for wbieb they will be responsible. If JOU, as the OlDer Sign as the contractor,
you are indicating that JOU, rather than the contractor, are responsible for the IOrk. If the contractor wi8hes you to sign
as contractor that laY be an indication that be is not properly licensed and is not entitled to penitting privileges in the
City of Zepbyrbllls.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN'LAW (CHAPTER 713, FLORIDA STATUTES, AS AMBHDED)
I certify that I, the applicant, have been provided with a copy of .Plorida's Construction Lien Law - &.owner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUll!I' Affairs. If the applicant is SOI8OD8 other than the
.000er., I certify that I bave obtained a copy of the above described c10cuIent and prllllse in good faith to deliver it to the
.owner. prior to ~Cl!l8l1t.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infonation in this application is accurate and that all work will-be done in COIpliance with all
applicable laws regulating CODBtruCtion, loning, and land developent.
Application is hereby lade to obtain a penit to do IOrt and installation as indicated. I certify that no IOrk or
installation has CDl8Dced prior to issuance of a penit and that alllOrt will be perfomed to _t standards of all laws
regulating construction, City codes, loning regulations, and land develo(lll8Jlt regulations in the jurisdictioo. I also
certify that I understand that the regulations of other gDY8l1II8Iltal agenCies laY apply to the intenc1ed wort, and that it is
.Y responsibility to identify what actions I lUSt tate to be in COIpliance. Sueb agencies include but are not luited to:
t Departlent of EnvirOlll8lltal Regulation - Cypress Bayheads, Wetland Areas and EnviroDleDtally SensiUve Lanc1s,
Ifater/lastewater rreatlent
t Soutbvest Florida Ifater Jlanagel8Dt District - Ifells, Cypress Baybeads, lfetland Areas, Altering Ifatercourses
t Ir8y Corps of Inqineers - Seawalls, Docks, Ratigable Ifaterways
t DepartJent of Health i Rehabilitative Senices. BnvirODl8Dtal Health Unit - lIells, lIastewater rreatlent. Septic tanks
t US Bnvil'OllleJ1tal Protection Agency - Asbestos abatel8Dt
I also certify that, if fllllaterla! is to be used in Flood lone .A. or "A, etc. ", it is understood that a draiDage plan
addressing a .COIP8D8ilting volUle. will be saitted wbieb Is prepared by a professional engineer registered In the State of
Florida prior to peIllt Issuance.
A ~it' issued sball be construed to be a license to proceed with the wort and not as authority to violate, caDC:el alter, or
Bet aside any provisIons of the technical codes, nor shall i88uance of a penit prevent the Building Official frol thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery penit i88ued sball hecme invalid
unless the IIOrt autboriJed by sueb pemit is ~ced lIithin slllODtbs of issuance, or if wort authoriled by the penit is
suspended or abandoned for a period of slllOl1tbs after the tile the wort is ~ced. ODe 90 day 81tension of tile, ., be
allowed for the penit with fee ebarge of $15.00. rhe 81tension &ball be requested in writing to the Building Official. 10
approved inspection lUSt be logged during eaeb slllOl1th period, or the project will be considered abanc1onecl.
IfARIIING ro (IfDR: YOOR FIILURI to BICORD I ROIIC! OP c-.ClllBllIlAY RlSULr IR YOUR PAYIMG IIIIC! PORIJIPROVIIIII!S ro YOUR
PROPIRIY. IF YOU ImIID to oarm PIIARClIG, COISOLr IUD YOOR LIIDIR 01 AI lnomY BIPORI RICORDIIG YOUR JOIIC! OF
aJlMllCIIIIlII. JOBS UlfDIR $2,500 III VILUI DO 101 IBID to RECORD AID POS! A 'II01ICB OF CCJIIIIICIlIIIII.
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SIGlAIURI: ~OI AGIII! ~~R
srATE OF FWRIDI
COUIft OF Pasco
The foregoing instrument was acknowledged
before me this 26th, 19 95 by
srAD OP FLORIDA
coum OP Pasco
The foregoing instrument was acknowledged
before me this 26th , 19 95 by
Charles D. Poole
who is personally known to me ........e-ltes
~8~-------------------------
as identification and who -did/did not
ke an 0
David Hauaen
who is personally known to lie OI'-wh&-bas
~~-------------~---~~-------
as identification and who l'Iitl/did not
an oath.
~
(Si ature) otary Public, Statf' of FlorIda
JUNE M. HU,NIJON
(Name Typed, 'tr~~~I'()rl:.ft~&dJ.1)1)1
NOTARY PUBLIC mrn. 140. 252 2
. "
,Ii. I I I[ r.1. HUmDON
My COllllllis.ihHl Exp. Feb. 1 1997
(NilIIe Typed, Pribted l'OI'2Stmlped)
NOTARY PUBLIC