HomeMy WebLinkAbout95-5233
BUILDING PERMIT 0
CITY OF ZEPHYRHILLS Permit N ·
(813) 788-6611
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-; ~ 5233 t3
Date
9- J- f:~~
Jt}. d7J
BUILDING
d.-tJ ., tJU
ELECTRICAL
PLUMBING
MECHANICAL
Sewer Conn
Water Conn:
Property Owne" ~ -=:z . 11Z-
Job Address: 6> ?It? ~A.-- tf1~
Parcel 1.0, # ...3- .:1-6 -:J..j - (;) /;;;... 0 - D OtJCJ 0- / vg-O
Water Meter:
T.I.F.'s:
Zoning: Energy Code:
Description of Work 0>-~#4 ~ p7 ~-4---J
~adon ~s:
..,,_~ ,-<~ .~__A./J!?~ ,-tZ4'l< -,
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordance with City Codes and Ordinances,
FINAL
C.O.
NO OCCUPANCY BEFORE C.O.
Inspector
Valuation or h
Contract Price ~ /.5-...$ . c/C:)
City License Registration # g-p--
State Certified License#
Telephone#
)/J/
JJ1~"\ If I
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
-
Breakers
Ducts Insl.
Compressor
Final
Tp.SeN. ~
Rough In 1-2i>'Y)
Meter Can
Const. Pole
Pool
Pre-Me~,~
Final It- D- '1:) &. 0
SLB
Tub Set
Water
Sewer
Final
Ftr,
Pre SLB
Lintel
FRM. O;-2Dc,r ,gilL-
Insul. CL
WL
bN~l, I(f>.c, i $,f).-
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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APPLICAnON FOR PERKIT
CITY OF ZEPBYImILLS
BUILDING DEPAR'l1IENT
OWNER' S NAHE tit I( 't- <<1 ( ~ ~e..-
6\\vu DeW D^ive
S\ \verocJ< Dr,'ve
LEGAL DBSCRIP'J'ION: LOT(S) JD1 BLOCIL.--SUBDIVISION <2) \ \ vcr- ()q)cs.
PARCEL I.D.,Q:?-.;2(o- al-O\2..0-DOCCO-\DaO (OBTAIN FROM PROPERTY TAX NOTICE)
PHONE '813-7'8~- 4s:g~
OWRER' S ADDllESS ~4CJ3
JOB ADDRESS Lc>L\ ()3
WORK PROPOSED:~ew Coostruction ~ition -..Alteration ---Repair _Install
---Sign. -.JIove -Deaolish
PROPOSED USE: -Xsingle F_ily ---1f/F _, of Units ---1f/H
_ec-ercial _Indust. _Swia. Pool _Otl1er
---Restaurant & Health De~taent Approval ;:l
DESCIIIPTIOII OF _. <21 ass KoO<<fl/ ~ . ~())~
BUILDING SIZE: X Square Feet. Height
R&CiIDEI1TIAL: ATrACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COItKERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOIDIS.
PROPERTY SURVEY BEQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
-.-JIUILDIIIG
$ d'lS~~
Valuation of Total Construction
RI.RCTRICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
--llEClWlICAL
$
Valuation of llechanica1 Installation
~D1G
GAS ROOFING
SPECIALTY
TYPE OF COBS'I'JlUCrIOIf:
FIBISIIED PJ.OOB. ELEVAnOBS:
Rloc1t _Fraae _Steel
Other
FT.
IS PROJECT IR FLOOD ZOO ABEA.?
YES NO
..........................................
S
COIfTRACTOR SECTION
a>>IPABY V ctd .. Co1 cl: ru.-c;t-z. ~
State Cert. or Regist. ,
City License Registration , '8'&
..........................
RI.Rr.'I'RTCIAII
lei 1'1~
COHPAlfYJY,lo ( to ()
State Cert. or Regist. I.
City License Registration.'
..........................................
E \ectY I'~
~\
PLlDlBER
COIIPAIfY
State Cert. or Regist. I.
City License Registration ,
..........................................
-- Sigoature
KECllAlfICAT.
COHPAIfY
State Cert. or Regist. I.
City License Registration f
..........................................
Sigoature
OTRRR
COKPAIfY
State Cert. or Regist. I.
City License Registration ,
..........................................
APPLICAnD>> _ ~~~
Sigoature
PERKIT OFFICER.
,<~,~.;"~-:,,-~,..~~,,....>- ..
? . CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
!be undersigned understands that this perlit lilY be subject to 'deed restrictions' lhich lilY be lOre restrictive than .city
regwations. !be undersigned asSUlllS respousibility for CCIIpliance lith any applicable deed restrictions. J.-
B. UNLICENSED ~CTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas hired a contractor or contractors ~ to undertake work, they lilY be reguired to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by la1r, both the 0IIDeI and contractor lilY be
cited for a lisdelleaDOr violation under state lal. If the owner or intended contractor are uncertain as to wbat licensing
requirl!lents lily apply for the intended IOrk, they are advised to coa.t.act the City of Zepbyrbills Building DepartJent, (813)
788-6611.
~" . '- . .
Furfberlore, if the o.mel bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
'Contractor Sections' of this application for Ibich they lill be responsible. If JOUr as the OIIJler sign as the contractor,
you are inclicating that you, rather than the contractor, are responsible for the IOrk. If the contractor lishes you to sign
as contractor that lilY 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 applicantr have been provided lith a copy of 'Plorida's construction Lien Law - lkIIeolmer's Protection
Guide' prepared by the Flori4a DepartJent of Agriculture and ConsUJel' Affairs. If the applicant is 8QIl!ODa other than the
'owner'r I certify that I bave obtained a copy of the above described docuJent and pICEse in good faith to deliver it to the
'owner' prior to COlleDCl!IeDt.
E. CONTRACTOR'SIOWNER'S AFFIDAVIT .
I 'certi!y that all the inforlation in this application is accurate and that alllOrt lill-be done in ClJlpliance lith all
applicable Ian regulating construction, JODing, and land deve1op1eDt.
Application is hereby Jade to obtain a perlit to do IOrt and installation as indicated. I certify that DO IOrt or
installation bas cmleDced prior to issuance of a perlit and that all IOrt lill be perfOlled to _t standards of all laws
regulating constructionr City codesr loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other gOYeIIIII8Jltal agenCies lilY apply to the intendecJ IOltr and that it is
IIY respousibility to identify lbat actions I lUSt tate to be in COJpliance. Such agencies include but are not lilited to:
.. DepartJent of EnviIOlllleDtal Regulation - Cypress Baybeads, Wetland Areas and EnnroDleDtally Sensitive Landa,
Water /Wastewater !reat:lent
.. Soutbwest Plorida Water HanageJellt District - Wellsr Cypress Baybeadsr Wetland Areas, Altering Watercourses
.. ArIy Corps of Bngineers - Sealallsr Docks, Hangable Watenays
.. DepartJent of Health i Rebabilitative Services, BnviIODl8lltal Health unit - Wellsr Mastewater !reatJentr Septic ,ants
.. US Bnvil'Ol1l8Dtal Protection Agency - Asbestos abatl!l8Jlt
I also certify thatr if fill Iilterial is to be used in Flood ZoDe 'A' or 'Aretc.', it is understood that a drainage plan
addressing a 'COIpeII8ating voJUJe' lill be subJittedlhich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A ~it issued shall be construed to be a license to proceed lith the IOrk and not as autbority to violate, cancel alterr or
set aside any provisions of the technical codesr nor shall issuance of a perlit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued aba11 hecme invalid
unless the IOrt autboriled by such perlit is C088I1cec111ithin slllODtbs of issuance, or if trOrt authoriled by the perlit is
suspended or abandoned for a period of slllODtbs after the tile the IOlt is C088I1ced. One 90 day atension of u., Jay be
allowed for the perlit lith fee charge of $15.00. !be atension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IODth period, or the project lill be considered abanc1onec1.
WWIIIG !O lMfER: YOUR FAILURE !O RECORD A IfO'I'ICE OF aJIIIDCIIIIIft' lilY RBSUL'f IH YOOR PAYIHS DICE FORIIIPROVIIIIIlS '10 YOOR
PROPEm. IF YOU IJI'fIIfD '10 081111 PIIWICIIG, COIfSUL'f 11Im YOUR LBIfDIR OR 1If AnoRIIY BB10RB BICOIIDIHG YOUR DICE OP
aIIHI . JOBS UlfDIR.,2 ,500 IIf LUB 00 IO! IfDD !O RECORD un POS! I ' OF C<IIIDCIIIIII!f.
St'A!1 OF FLORIDA
~
sun: OF FLORIDA
Proverbs 22:29
JIrnpnsaI/ (!Innfrad
m([o]]~
Aluminum &. Concrete
6017 Gall Blvd,
Zephyrhills, FL 33541
(813) 782-7497 1-800-308-8274 Beeper
Page No.
of
Pages
PROPOSAL SUBMITTED TO
PHONE
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STREET
3.1 1\:
CITY. STATE AND ZIP CODE
ATTENTION:
r ~ I . (
JOB LOCATION
JOB PHONE
We hereby subm,l soeC.f,c3hons and estimates lor:
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Dlr Jroposr hereby to furnish malerial and labor - complete in accordance with above specifications. 10r Ihe sum of:
Payment to be made as 101l0ws:
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", ('dOllars ($,
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All m_1erial is ,".rantHd to be .. specified. All WOI'k to be completed in . workmanlik.
manner accOI'din. to standard practices. An, alteratton or deviiitloft from above specifica.
tions .nvolvinl .d.r. costs will be ..ecUled only upon w'itt~n orders. and will become an
..tra char.. over and above I.... estimal.. All alr.ements conlin.ent upon slrikes. accidents
01' delays beyond our contra" Own., to carry fire. tornado and other necesUlty Insurance.
Our wott&ers are fully covered by Wortcmen.s Com"nsation Insurance.
Authorized
Signalure
/
//
Note: This proposal may be
wilhdrawn by us if not accepted within
days.
Arr.rptanr.r uf Jrupusul- The above prices. speCIfications
and conditions are satisfactory and are hereby accepted, You are authOrized
10 do the work as specified. Paymenl will be made as outlined above.
Signature
Date of Acceptance:
Signature