HomeMy WebLinkAbout95-5136
BUILDING PERMITlft-
CITY OF ZEPHYRHILLS Permit
(813) 788-6611
BUILDING ELECTRICAL ~BING.:)
PmpertyOwne, ii~~
JobAddress:.~Sl:J /__ _ __~
Parcel I. D. #
Zoning: Energy Code:
Description of workJA> J r~
:
. ~~51S~ P
Date
P-;lJ-y-S-
tS p~ ~
I 75'* tro
MECHANICAL
Sewer Conn
Water Conn:
Water Meter:
T,I.F.'s:
- .f
-?./~~
Radon Gas:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
Valuation or
Contract Price
City License Registration #
State Certified License#
Inspector
,/
Permit Fee
Signature
Company
Address
Telephone#
~~~
....s ''''j
,
BUILDING
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
ELECTRICAL
~JtJ4~
PLUMBING
MECHANICAL
-
Breakers
Ducts Insl.
Compressor
Final
Tp.Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
SLB
Tub Set
Water
Sewer
Final
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Doll.... '$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.
CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET
ORD. 1395/RESOLUTIONS 312/372 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 B7.50 V 319.50 V
Water Closet 131.25. 479.ee ,
Urinal 87.50 319.50
Lavatory 43.75 159.75
Tub/Shower 87.50 319.50
Washing Machines-Commercial Size 350.00 1,278.00
Washing Machines-Domestic Size B7.50 319.50
Dishwasher - Limited Use 87.50 319.50
FOOD SERVICE - Dishwasher 700.00 e,556.00
Sinks (3 Compartment) 175.00 639.00
Car Wash (Per Stall) 1,000.00 6,390.00
FIXTURE G.P.D. # WATER SEWER TOTAL PER FIXTURE
Sinks 50 .bt /74-' O(J 6, '39' 'c?J) q /1/" 1l..Q.....
Water Closets 75
Urinals 50
Lavatories 25
Tubs/Showers 50
Wash. Mach.Com. 200
Wash. Mach.Dom. 50
Dishwasher-Comm 400
Di shw.L1mt .Use 60
Sinks-3 Comprt 100
Car Wash-p/st. 1,000
.
WATER tlETER
GRAND TOTAL
APPLICATIdN FOR PERKIT
CITY OF ZEPIIYlUIILLS
BUILDING DEPARTMENT
OWNER'S NAME
~ I6u Jo e //PcZ-n-
~719 ElA'l1V6 "))"e.
(XA // ~ / C/o.
PHONE
7.r ;:J, '- f./ J"2 S-
OWNER'S ADDRESS
LEGAL DESCRIP'l'ION: LOT(S)
2~4~1.I(s
, f
BLOCIL--SUBDIVISION
If.
~ 35 r-yo
JO~ ADDRESS
'fO/7
PARCEL I.D.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction -----..Addition ---..Alteration ~epair _Install
_Sign
-"<>ve
_Deaolish
P~POSED~E: ___S~eF_ily
-"IF
_' of Units _H./H
_ec-ercial
_Indust.
_Swia. Pool _Other
-Restaurant &: Health Departaent Approval
DESCRIP'l'ION OF WORK:
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.
PERMITS REOUESTED
_BUILDING
$
Valuation of Total Construction
_ELEcnuCAL
AIIP Service
Florida Power Corp.
W.R.E.C.
~CllAllICAL
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUC'l'ION: _Block _F~e _Steel
Other
FDlISBED FLOOR ELEVATIONS:
FT.
15 PROJEct' IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRACTOR SECTION
RUTlDRR
COMPANY V cV A-/e 1/7
/~A~ State Cert. or Reaist. .
City License Registration ,
..........................................
Signature
RI.RCTRICIAII
COMPANY
State Cert. or Regist. ,
City License Registration .
..........................................
SiimAture_
PLUMBER
Signature t/
COKPANY
State Cert. or Regist. ,
City License Registration ,
.....................................*****
IlECHANlGAL
COMPANY
State Cert. or Regist. .
City License Registration ,
.............*.***...*.....*....********.*
Signature
OTRRR
COMPANY
State Cert. or Regist. .
City License Registration ,
.............*.*.....**.*....**.**.**.***.
Signature
APPLICATION APPROVED BY
PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this perlit JaY be subject to Ddeed restrictions" wbieb JaY be lOre restrictive than City
regulations. !be undersigned assUJes responsibility for cmpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake work, they JaY be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as reguired by law, both the owner and contractor JaY be
cited for a lisdeJeanOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
reguirl!lents JaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
. 788-6611.
FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
DContractor SectionsD of this application for wbieb they will be responsible. If JOU, 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 JaY be an indication that be is not properly licensed and is not entitled to perlitting 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, bave been provided with a copy of DFlorida's Construction Lien Law - BoIeowner's Protection
Guide" prepared by the Florida Departlent of Agriculture and COnsUler Affairs. If the applicant is sOJll!One other than the
DownerU, I certify that I bave obtained a copy of the above described clocUIent and prOlise in good faith to deliver it to the
"owner" prior to COllellCl!lent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforJation in this application is accurate and that all work will be done in cQIPliance with all
applicable laws regulating construction, loning, and land developlent.
Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas CDlenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveDlll!lltal agencies laY apply to the intended work, and that it is
If responsibility to identify wbat actions I lUSt take to be in colpliance. Sueb agencies include but are not lilited to:
t Departlent of EnviroDleDtal Regulation - Cypress Baybeau, Wetland Areas and BnviroDleDtally Sensitive Lands,
Water /Wastewater !reablent
t Southwest Florida Water Hanagl!lent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
t Departlent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatlent, Septic tanks
t US EnviIODlelltal Protection Agency - Asbestos abatelent
I also certify that, if fill laterial is to be used in Flood ZOne "AD or "A,etc.", it is understood that a drainage plan
addressing a DCOlpeDsating vol_D will be sublitted wbieb is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued shall 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 peIlit prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every Perlit issued shall becoIe invalid
unless the work authoriled by sueb perlit is COllellCed within six IODthS of issuance, or if work authoriled by the perlit is
suspended or abandoned for a period of sillODtbs after the tile the work is co.enced. One 90 day eltension of tile, JaY be
allowed for the perlit with fee charge of $15.00. !be eltension sball be reguested in writing to the Building Official. An
approved inspection lUst be logged during eaeb six IODth period, or the project will be considered abandoned.
WARlUG !O omR: YOUR FAILURE !O RECORD A IOIICE OF COIIMBICBIIIlft' MAY RESUL! III YOUR PAYING 'NICE FOR IMPROYBMmS !O YOUR
PROPBRfY. IF YOU IJI!EIID !O OBlJIII FIIIJIICIIIG, COIISUL! WID YOUR LllDBR OR III AnoRIBY BEFORE RECORDIIIG YOUR IIO!ICE OF
C(JOfBJICBIIIlft'. JOBS UllDBR $2,500 III VALUE DO 101 IIIED !O RECORD lIID POS! A 'IOIICE OF C(JOfBJICBIIBM!".
SIGlA!URB: (MIER OR AGBII'J'
SIGlATURB: COJmlAC!OR
S!A!B OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19____ by
S!A!B OF FLORIDA
coum 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
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