HomeMy WebLinkAbout95-5263
BUILDING PERMIT--
CITY OF ZEPHYRHILLS Permit lI!
(813) 788-6611
~~52Q~ If
Date
9-r2?--9 ~-
BUILDING
ELECTRICAL
PLUMBING
~HANI~sewer Conn
Water Conn:
Property Owner:. 7J ~ 2!.r ~
Job Address: .Jill 9' - ~ ~
Parcel 1.0. #
Water Meter:
T.I.F.'s:
Zoning: Energ~
Description of Work -# c. ~ .f?
Radon~ ;ti
~N tUA'~' :<~fY
NO OCCUPANCY BEFORE C.O.
FINAL
.~~
DATE
Complete Plans, Specifications and Fee Must Accompany Application. C.O.
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
City license Registration #
State Certified license#
~3
Permit Fee .....d:Q, !;!).
Signature ~ Whh.
Company
Address
Telephone#
Valuation or
Contract Price
r2.~ fJ~ '. tHJ
,
~~~
BUilDING
ELECTRICAL
PLUMBING
MECHANICAL
-
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
.Pre-Meter
Final
Ftr.
Pre SlB
lintel
FRM.
Insul. Cl
Wl.
SlB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final If) ,.I/-S-~ ~
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.
~j~'..,
,*'; .>>*: ". ,
Al'PL'ICATION FOR PERKIT
(;ln' oeo ~l!rorRUU.ts
D1l11tDlRG DUPAR1UE'm'
'.:s'~..,r .;f;,
.' OWNER. S NAM.E iJ/ E 1....1-1 ~
OWNER'S ADDRESS j 9 1-.3 5.
. .Jon ADDBBSS .,. -3 <9 ~3 9
w ;q.:T,,- Q. tV
9M /7u ~
<7 J'7--I /1u C
l~JO~m .8/.:? - 7~2- ~"2 9 L
LEGAL DESCRIPTION: tDT(s)
n~sonDIVISIOR
P~CEL X.D'.# __ .--'
~~RK PROPOSED:~~ew Construction ~ditioQ ~eration ~ep3ir ~lnst311
I
PROPOSJro US,E :'
_Sien
~inele Fa.ily
_Hove
_Dc.-olish
_---1f/J!
_' of Units,
--H/D
. _eo..cX'cbl
--Xndust. _Swia. Pool . ,
Other
:B.cstaUX'(l1'\t & JIc.a1th DCp3.-ct-.ent ,^pproval
BUILDING SIZE:
x
Square Feet,
RESIDIDn'lATA
COKKlmCIAL :
A'ITACJJ (2) PlOT PU\NS << (2) SIL'I'S OF BUILDItvG fI..MS Ii (1) SET ENERGY FORKS. it.
ATrACU (3) SETS OF nUILDX~G PLANS << (1) Set F..NI!.RGY FORtIS. **
".COX'!' Of' CONTkACT lUlQUlRIlD.
J)f.lmlTS ln~OUP'....')'rP.D
, .
-DUILDING
---..ELECTRICAL
$
ValU3tiOQ of Toul ConstJ:'\Jc::t:lon
AMP Service
$ 4';; Lj 9S-o~
_---"lox:;ida P<x<<:r Corp.
W.R.l:.C.
----1{ECUANlCAL
V3l.WJtion of Hcch..onica.l Installation
-----"pLUMBING -"CAS ROOFINC
TYPE OF CONSTRUCTION: _Block ---Y'rae _Steel
SPECIALn
.Othet'
nmsl'IEO nooR EUVATIO~DS =
FT.
'IS PROJ'ECT IN FLOOD ZONE AREA? .
, YES
. -
~...*eta*t...e...**.*~*..........tt.ti...*
NO
Q'"rnA:::P,ctlQ! fI/ if
State Cert. Or Recist. I
City T.iccnse Registration' ..
t.*..t~.*~*.*~.~.~..........*.t..t...t.tt.
BUILDER
Si.c,n.atuX'e
Et.ECTRICIAl{
CUlH.l'ANY
Stat.e Ccrt. or Regist. ,
City License Registration f
e~.***.**<<s...~~t.tttt.ttt.t.*t.*~t~t~~*..
rv19
SiP.n:J t~J're
. ,
...'
OOlU'ANY'
State Cert. Q~ Rccist~ .
City Lic~ose Registration .
.*~**.*.***....t*..*...t.tt....t~*tt~A.~t*
(UJ4
PLOKnm
Si&n3ture
II&a1ANICAJ. ~ . C:OOPiI!<Y: .sOU 'r r-l jZ.~>v
. . Stat~ Ccrt. or Rcgist.. ,
Signatur"-\~ . ,. /~"f'-'~ Ci,ty Lieense lteCistratiuR , .
*~*.*..*...t.tt*tt*.***~*t**.*.*.*.*...*t.
,e 0 Yh- f ()~'t.-l IL-:::r
~r11 00 i.s:O G ~ .
~ ~'--3
Sienatw.-o
conpc~ IV ;/J-
State Ccrt. Or R~ei$t. .
Ci~ Licenso R~ci$trQtion .
*.....*........*..*.*.tt..tt...t.~.tt...t*
~
APPL'ICAnOK Al'PROVeo Dr
PE.Rl{IT OFFICER.
~F,'R':-21-94 THU
9:05 GENERAL HOME DEVELQPMENT P.02
cor.i!HTI0NS OF F'ERI'HT (~FFID(WIT,
A. ~OTIC~ OF DEED REST~ICTIONa ' .
The under51gnrd und~r5tand$ t~at this per.it kay ~. sub"ct to 'dtcd restrictions- which lay be .or. ~c~~rlctlve than Clty
regulations. The .undrrslgned aS5U.r5 responsibility for cOlpliancf "i~h any applicahle deed rcslrlc\lons.
El. UNL I CEN5E:D CONTRACTClr,S AND CO~TRAC"OI, RESr::.pN~.Ll!I LIT 1 ~~
If the ownQr has hlr~d a contractor or c;ntractors to undQrt~kQ work, they .ay b~ requlrcd to be licensed In Iccordantl Mlth
st~te and local regulations. If the ,tontractor l~ not licansed as requircd by laM, both the OMner and contractor lay be
cited fur I 11sdeleanor violation u~dcr state law. If t~~ owner or intanded contractor are uncertain as to Mhat llcenslng
requlrelents lay apply for the intended !lork, they are advised to contact the Ci~y of Zcphyrhills Building Departient, (813)
78a-6611.
Furtherlore, if the o"n~r has hired a t~otractor or cDntrac\ors, he is advised to h~ve the contractorls) sign portions of the
'Contr~ctor Se~ti6ns' of this application for which they Mill be re5po~sibl~. If you, as the owner siqn as the contractor,
you are indicating that you, rather thdn the contractor, are responsible for the Mork. If the contractor _ishe, you to sl9n
. as contractor that Day be an indication ~hat he is not pr~perly licensed and is not entitled to perlitting privileges in, the
City of Zephyrhllls.
c.
TRANSPORTATION IMPACT FE~S AND UTILITY CONN~CTION FEES
.
0, CONSTRUCTION LIEN LAW (CHAPTER 713. FLORIOA STATUT~S, AS AMENDED)
I certify that I, the applicant, have b~;; provided with a copy of 'Florida's Construction Lien LaM - H~.eowner'l Protection
Guide' prep~red by the Florida Deparl.~nt of Agriculture and Consu.er Affairs. If the applicant is soaeone other than the
'oNner", 1 certify that I have obtain~d a copy of lhe above described doculcnt and proii5~ in good faith to deliver It tD the
'o~ner' prior.Jo co..ence.ent,
I E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infur.ation in this application is accurate and that all Mork will be don~ in co.plianc! ~ith all
applicable Ia., rcqulatinq construction, ~onln9, and land developlent.
Application is hereby .~de to obtain a p~rlit to do work and installation as indicated. t certify that no work or
In~lallation has co..~nced prior tD issuance of a p@rlit and that all work Hill be perforled to leet st~ndard5 of all laws
re9ulating construction, City codes, %oning requlalions, and land develop.ant regulations in the jurisdiction. 1 1150
certify that I understand that the r~gulations of other govern.ental agencies tay apply to the int~nded work, and that it 15
.Y responsibility to identify what actiolls 1 .ust take to be in cOlpliance. 5uth agencies Include but are not tl.it~d to:
. Dpoartlent of Environ.enlal R~~ul~ti~n ~ Cypr~5s Bayheads, Wetland Areas and Environ.entally Sensitive Lands,.
. WaterJ~a5tewaler Tr~at4tnt
t Southwest Florida ~iter ~~naQ~5ent District. Wells, Cypress B~yhcads, Wetland Areas, Alterinq Watercourses
t ArlY Corps of Enqineers . Seawalls, Do~ks, Navi9~blt w~ter~ays .
t Depart.ent of Health' Rehabilitative S~rvice51 Environ.cnlal Health U~ . Wells, Wastewater Treat.ent, Septic Tank,
t US Environ.ental Protection AQcncy . A:hestos ab~teeent
1 also certify that, if fill laterlal Is l~ be used in Flood Zone lA' Dr 'A,~tt.', it is und~rstood that a drainage plan
addresslnq a 'co~pensating volu.~' Kill be sublitted which is prepared by a professional enQineer registered in the State of
Florida prior to per.it issuance.
A perl it issued shall be construed to be a license to proceed Nith the Hork and not as authority to violate, cancel alter, pr
set aside any provisions of the technic~1 codes, nor shall issuance of a pertit prevent the Building Official frOI thereafter
requiring I correction of errDrs in plan,;, construction, or violations of any code. Every per.it issued shall beco.e invalid
unless the Nork authorized by 5uch peroit is co.~enced Kithin six Bonths of issuance,' or if work authQrized by the per.it is
suspended or abandoned for a period of ~IX Donths after the tile the work is cOI~enced. . One 90 day extension of ti.e, .ay be
alloNed for the perlit Hith fee charge or $15.00. The extension shall be requeiledin writing to the Buildlno Official. An
approved inspection eust be loggcd durin) each six month period, or th~ projett Mill be considered abandoned.
WARNING TO O~NER; YOUR fAILU~E TO RECORI) A NOTICE OF COHMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR JHPROVEKENTS TO YOUR
PROPERTY. IF YOU INTEND TO OSTAIN FIHn!ll:lllG, COllSULT WtTH YOUR lENDER OR AN ATTORNEY DEFORE RECORDING YOUR !lenCE OF
COHKENCE"EHT. JOBS UHDER $2,500 IN V~LUi: DO tlOT IIEED TO RECORD flUD POST A 'NOTICE OF COf1KENCEIIENT'.
""""""-
SIGNATUREs OWNER OR AGENT
J....')..~-:A-- ~,~o "~- - ~9S-0
STATE OF FLORIDA
COUNTY OF ~
The foregoing instrument was ~cknowledged
before me this , l(J_ by
- " .' T ~'MI"""L '-""'IMtudT
SIGNATUREI COHT~ACTOR
L '2..J-~ -;-~ 0 &;-.J- - '2... 9'.s-- 0
STAlE OF FLORIDA
coulm OF .
The fDreg~lng instrument
befc.re me this
was ~cknowledged
, 19_ by
who is personally known to me or who h~s
produced
as identification and Hho did/did not
take an oath.
~ho 1s personally known to me or who has
produced
as identification and who did/did not
tOlI'e an 001 tM.
(Signa.ture)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY 'PUBLIC
,(Name Typed, Printed ClI. StCllTlped)
NOTARY PUBLIC