HomeMy WebLinkAbout95-5283
BUILDING PERMII-
CITY OF ZEPHYRHILLS Permi~ lI!
(813) 788-6611
-; 5283/3
Date
-. c-./
/ tJ :!:J - ,r~
BUILDING ELECTRICAL PLUMBING
ProP'rtyowne'~~ ~i.,.
Job Address; ~//)S p;Z;< /r
Parcel 1.0. #
Zoning; Energy Code;
Oescript;on of wo;; /? -,,-, A~
MECHANICAL
Sewer Conn
Water Conn;
Water Meter;
T.I.F.'s;
Radon Gas:
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.
DATE
Inspector
Valuation or
Contract Price ;}.r cJ-t) - crv
f
City License Registration # c2~;J...
State Certified License#
Pe'm;t F~ -fj
S;gnaMe _ _- 'Zf- Iv-~----.
Company .I .
Address
Telephone#
~~Lf'21J~A
,
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
Ftr.
P,e Sl~~ ~/
Lintel' 'Nf ._
~)
FRM. .' rl~1
Insul. CL I V . I ()/
WL ~6(
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 ($15.001 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.
APPLXCAT10N FOR PERMIT
CITY OF'ZEPHYRHILLS
BUILD-ING DEPARTMENT "
"\
". ~'~',T; :~_:.,s):.~J'.. .:j ~:
APPLICANT SC)\'Mbt-.(jcN:~~~~A.."
ADDRESS ~ \"2-S(J S ~. ~~~ -6;~ I k-
~\\\h-~O ""J)M~LS . '
5l~S (9~ ,3t
'- .~.; :'-., .:;.,
PJ}m'E~+/;:s<n ~ :-~Q
OWNER
.....
JOB LOCATION
2l\
-_', .r' ", "-,-:-';:-.::_::' ;'__
.LOT SIZE
x
--,
AREA SQ. FT.
f r::
LEGAL DESCRIPTIO~: LOT(S)
BLOCK
SUBDIVISION'
. ,. . ,', .... .,' .........
PARCEL I.D.4~
WORK PROPOSED:____New Construction -Addition -^lteration -Repair
____Sign/Temp. _Sign _Move
PROPOSED USE: ~Single Family ---'l/F _4~ of Units
____Commercial ~Indust. _Swim. . Pool
_Install
-Demolish
, .--M/H
Other
____Restaurant & Health Department Approval
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.& {I) SET ENERGY FORMS.**
**COPY OF CONTRACT REQUIRED.
PF.RM1TS RF.OUF.STED
____BUILDING
$'
2. ~"20.~
l
Valuation of Total Construction
____ELECTRICAL
AMP Service
Florida Power Corp.
W.R.E.C.
~ECHANICAL
$
Valuation of Mechanical Installation
.
____PLUMBING
."" .
GAS
")<... ROOFING
SPEC<IALTY
TYPE OF CONSTRUCTION: ____Block _Frame _Steel
Other
FINISHED FLOOR ELEVATIONS: FT.
Signature
******************************************
CONTRACTOR SECTION
Company
State Cert. or Regist. #
City License Regis~ration
******************************************
:::::::::AN
/
/
./
Company
State Cert. or R~gist. #
City License Registratio
****************************************
/
/.
Signature
Company
State Cert. or Resist. #
City License Registrati
*************************************** **
Signat~re
Company
State Cert. or Regist.
City License Registra
*************************************
Signature
Company ~~~,~
State Cert. or Regist. 1~ ~_co~~
City License Registration #
******************************************
'.
APPLICATION APPROVED BY
. ..
PERMIT OFFICER.
CONDITIONS O~ PERMIT AfFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understa;ds that this perlit lay bl subject to "deed restrictions' which lay be lore~restrictive than City
regulations, lhe undersign.d assuael rl'Ponlibility"for cOlplianel with any applicable d.ed r.str~ctions.
. .
B.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIE~ .
If the owner has hired a contr~ctor Dr contractors tD undertakl wDrk, they lay be requir.d to be licensed in accordanc~ with
It.t. 'nd local regulations, If the contractor il not lictnl.d al required by law, both \h. owner and contractor lay be
cit~d for a lisde.tanor violation under I\ate law. If thl owner Dr intended contractor art uncertain as to whit lic.nsing
requirelents lay apply for the intended work, th.y arl advised to contact the City of Zephyrhills Building D.partllnt, (813)
788-6611.
Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
'Contractor Sections' of thil application for which they will b. responsible, If you, al th. owner sign as the contractor,
you are indicating that you, rather than the cDntractor, are responsible for the Mork, 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 perlitting privil.g's in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that [, the applicant, have been provided with a copy of "Florida's Const~uction Lien L.w - HOleowner's Protection
6uid." pr,par.d by th. Florida Departl.nt Df Agricultur. and Consuler Affairs, If the applicant is 10leon. other than the
'owner", I certify that I have obtained' copy. of the a~vI d.lcribed doculent and prolise in good faith to deliver it to the
'owner" prior to cOllencelent,
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
1 certify that all the inforlation in this application is accurate and that all work .ill be done in cOlpliante with all
applicable laws regulating construction, loning, and land dlVIIDplent. '
Application is hereby tade to obtain a perlit to do wDrk and, install~tion as indicated. I certify that no work Dr
installation has cOlleneed prior to issuante Df a perlit and that all work .ill be perf Dried to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. 1 also
e.,tify Ih.1 I und.,sl.nd Ih.1 Ih. r.g.l.li... .f .Ihtr g...,...nl.l ".nei.s ..y .pply'I' Ih. inl.ndo4 ..,1, .ud Ih.1 il is
'y ",p"sibili Iy to id"lify .hot .ctions I ...1 tol. I. b. i. ,""II.ne.. Such .g.neitS ine I.d. b,,~ .11 ...t lI.i I.d '0:
....
1 ilso certify that, if fillliterial il to be ulld in Flood Zone "A" Dr "A,etc,., it 11 under stolid t11,t iI drainage plin
.ddr...iag . 'e..p.n..ling ..I.It' .111 be ....illo4 Obi,b I. p,.p.ro4 by . pr.f...i.n.l .ngi..., ''9i.I,'" in Ih. S,.I. .f
Florida prior to perlit issuance.
A p.,.il iss..d sh.ll b. e.nsl,..d I. b. . lie.... I. p,.eeed .llh lb. ..rt .nd ..I .. ..Ih.,i'y t. .i.I.I., e.ne.l .It." .,
s.1 ..id. .ny pr..isi.ns .f Ih. I.ebnie.l ,.d.., ..' ...11 iss.'''' .f . p.r.i. pr...nl .h. B.ilding Uffie,.1 f'.' Ih.,..f~"
r...iring . e.r,,,".n .f .".'s in pl...; e.nsl,.eli.n, .r .1.1.li.ns .f .ny e.d.. E..,y p.r.il iss',~ ,h.11 b.e... in..\"
..l..s ......'1 ..'h.ri,.d .y ouch p.,.il i. e....ne" .llhi. .i. ..n'h. .f i.s..ne., ., if ..,1 ..'b.",.. b, lb. p"'" 's
s.sp.nd.d or ..b.nd.n.d f.' . p.rl.d .f .i. ..nlh. .flor lho Ii.. Ih. ..rl i. c...,,,,,, .n. ,. d., .,t,ns"" .f Ii.., .., b.
.ll...d f.r Ih. p.,.il .ith f.. eh.'g' .f .15.... lb. ..I...I.n sh.ll b. r.....lo4 I. .ri.in, .. Ih. Bu.lding .fflei.l. ,.
ipproved inspection lust be logged during each 5ix lonth period, or the project will be considered ~b.udDned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAV
RESULT IN YOUR PAVING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEV
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
DO NOT NEED TO _ RECORD AND POST A "NOn CE OF CQ ENT".
SIGNATURE_~~Cl~~____-------- SIGNATURE___ _: -----------
':;'~j ~i~/OWNEtOR AGENT I a" '"lee. YVlcCQr..f.
LS Ol:#-:D5<lJ. -710"s' - 1 /1- u I. .' ~
DATE___~___J!D.I~L2;.C----------------------- DATE___J::=~~1o!-~-----------~---------
NOTARV AS T . I J Y j
CONTRACTOR___ _ ~~Ii1._-
JuDITH l. SCHAPER
~ Public. State of FIolIda
M'(cm",~-:nHW,icm-
No. CC 292357
..
I R61BDITH L. SCHAPER
NotOlV~~ofi~-
M'/ COIYlm, Exp. June 6. 1 W7
No, CC 292357