HomeMy WebLinkAbout95-5081
BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit N~
(813) 788-6611
~~508113
Date
7- 6 - f-!:J-
~ ELECTRICAL PLUMBING
Prop.rtyowne'~;1 zI-::i=
Job Address: ~ ~ __ ~ _
Parcel I. D. #
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
Zoning:
Description of Work
Energy Code:
'-...~.--tt --'
Radon Gas:
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NO OCCUPANCY BEFORE C.O.
FINAL
-/2-9S
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
Permit F.. ~.:L{J. ~
Signilture 1 c<: ~..rj.\~, -0. ___
Company
Address
Valuation or
Contract Price
d...-5 () . 0-0
City License Registration #
State Certified License#
7 ~ }- .~I(O ~.)'-
Telephone#
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BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
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 ($15.00) 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.
~0\ .. \
OWNER' S NAHB J CI ~\ \ (' K-
OWNER'S ADDRESS C' f \ ~ 0..
.
JOB ADDRESS _l\' ~(f)
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
(~ \' ~ ~ c, 1'\'\
Gr C\ ~~ W1..--
PHONE / Fi 3, DJ fa ~ [J
LfIJ1\. ST
7 1-11'/ h
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LEGAL DESGRIPTION: LOT(S)
BWCK
SUBDIVISION
PARCEL LD.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition ---Alteration -Jepair ....,AInstall
_Sign
_Move
_Deaolish
PROPOSED USE: _Single Feaily
----.J4/ F
_' of Units ----.J4/H
_~ercial
_Indust.
_Swia. Pool _Other
-Jestaurant & Health Depar~ent Approval
DESCRIPTION OF WORK: F-F'r\C (J I Y\ '\u I'C{ ~
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.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERHIlS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELEC'fRICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
_MECHAlO.CAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUClION: _Block _Frue _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
..........................................
YES . NO
CONTRACTOR SECTI;ON'
BlJIl.DER GOtIPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
RI.RGTRICIAR COMPANY
State Cert. or Regist. .
SiRnature City License Registration .
..........................................
PLUMBER COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
MECHANICAL COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
omRR COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands tbat tbis perlit lay be subject to "deed restrictions" wbich laY be lOre restrictive than City
regulations. !be undersigned asSUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired 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 mmer and contractor lilY be
cited for a lisdl!leanor violation under state law. If the olfIler or intended contractor are uncertain as to wbat licensing
requirelents laY apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
788-6611.
FurtberlOre, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of tbe
"Contractor Sections" of this application for wbicb they will be responsible. If you, as the mmer 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 he is not properly licensed and is not entitled to per.itUng privileges in the
City of Zephyrbills.
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 - lDeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUIeC Affairs. If the applicant is sOlBODe other than the
"mmer", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner" prior to coaenCeleDt.
E. CONTRACTOR'SjOWNER'S AFFIDAVIT
I certify that all the inforlation in tbis application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developleBt.
Application is bereby lade to obtain a perlit to do work and installation as indicated. 1 certify that no work or
installation bas COIIenced prior to issuance of a perlit and tbat all work will be perforJed to leet standards of all laws
regulating construction, City codes, loning regulations, and land developtent regulations in the jurisdiction. 1 also
certify that 1 understand that the regulations of other goveroJental agenCies laY apply to the intended wort, and that it is
IY responsibility to identify what actions 1 lust take to be in coapliance. Such agencies include but are not lilited to:
t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
Water/Wastewater TreatleDt
t Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater !reableDt, Septic ranks
t US BnvirODleDtal Protection Agency - Asbestos abateIeDt
I also certify that, if fill lateria1 is to be used in Flood Zone "A' or "A,etc.', it is understood that a drainage plan
addressing a 'cOlpensating volllle" will be sublitted wbicb is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A per.it 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 tbe technical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Bvery perllt Issued shall beCOle Invalid
unless the work authorized by sucb perlit is cOllenced within sil IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of sil IOntha after the tile the work Is cOBeDced. One 90 day l!Itenslon of tile, laY be
allowed for tbe perlit with fee cbarge of $15.00. The extension sball be requested in writing to the Building Official. An
approved inspection lust be logged during each sil IOnth period, or the project will be considered abandoned.
WARHING TO OWNBR: YOUR FAILURE TO RBCORD A NOTICE OF C<IIMBNClIlEtI1' MAY RESUL! IN YOUR PAYING !lICE FOR IMPROVBHEIft'S TO YOUR
PROPERTY. IF YOU IJI'J'END TO OBTAlH FIMAKCING, CONSOLT WITH YOOR LENDBR OR All AnORREY BBFORE RECORDING YOOR NOTICE OF
COHHBNCBHBJI'J'. JOBS UNDBR '2,500 IN VALOB DO NOT NBBD TO RECORD AIID POST A IINOTICE OF C(JOlBHCBHBHlII.
SIGNATURB: COJl'J'RACTOR
SIGNAtURE: OVIIBR OR AGBJI'J'
STATB OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_ by
STATB OF FLORIDA
COUNTY 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 oQ.th.
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
(Signature)
(Na.e Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
~
DEScRrPIlON: Lots 19 & 20 LESS a strip of land 5.0 feet wide nf the South,
156, eIlY OF 7..EPHYRImlS fonnerly lUm OF ZEl'JlYRHIllS as per n
ZEPlIYrUJIUS filed in Plat Book 1, page S4 of the Public Recore
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