HomeMy WebLinkAbout95-5335
.--
BUILDING PERMIT-
CITY OF ZEPHYRHILLS Permit l\1!
(813) 788-6611 ~D
c:1 cJ c:< tJ C-..'.'...
~~ Cj,~ ,-:,,~~ Sewe' Cone
. Water Conn:
Water Meter:
?7 fry} (fr /i;f1A~u? . TIF',
. .
i~533~,6
f~--
~--
~
Date
II) -~7-96--
Property Owner:
Job Address:
Parcell.D. #
Zoning:
Description of Work
Radon Gas:
FINAL,_
NO OCCUPANCY BEFORE C.O.
Complete Plans, Specifications and Fee Must Accompany Application. C.O. -
All work shall be performed in accordance with City Codes and Ordinances.
Inspector
~
Valuation or......d _ , CJ ~
Contract Price l'f -6 I ~ iJO ---
Permit Fee z:! ' ,,0, U
Signature ~ tAb j} a... . ~.-~ .NV'\...C> JL)
Company . ~~:\J.A +0 ~t.l\,Y". (.2,r;'W\(\
Address
Telephone# t~~?>-092 '"1
@~d7l-e.I ~<r7?)
C;ty Ucense Reg;s"..;on # ~
State Certified License#
(j) 14>-nt1 - Q AJ?7.p.1
BUILDING ELECTRICAL
PLUMBING
SLB IL' ),~ S- r61
Tub Set Il~ l2.'i'-S- 6 t~L
Water
Sewer
Final
MECHANICAL
Tp. Servo
Rough In I L-t.'2-~') &.h
Meter Can 1-1 J - f'''&
Const. Pole
Pool
Pre-Meter
Final
~ 1"':2"#o~Io.&8
Breakers
Ducts Insl. J ;L-l1.--c; s-
Compressor
Final
t~J
Ftr.
Pre SLB
Lintel
1];2--'2-<-))' i31~
FRM. _ _
Insul. CL
WL
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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"
.,
APPLICATION FOR PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
OWNER'S NAME
-=w h",
:J
{; r:- I Fr<r0
(' <6'-1 A 5;r
PHONE
)( I ~ 7 ~ ~ 2 ~ CPt>
2 e ( ~ 1 ".;", / 1<) f I-.
J cg-n- ~+- :z.ef LIY t J() ;:- L .:s.3 5' Yo
...... St>U~ tv I , I I I I
LEGAL DESCRIPTION: LOT(S) 1'/ i / ') f J,k BLOCK 10ft SUBDIVISIotlif1ot 2Q.~v kd 5
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED :_New Construction _Addition ./Alteration /' Repair _Install
OWNER'S ADDRESS
e;-~ y(
Slp3Y
~.~ 5''/0
JOB ADDRESS
PARCEL 1.D.'
_Sign
---1Iove
_Deaolish
PROPOSED USE: ~ingle Faaily
_KIF
_' of Units _M/H
_~ercial
_Indust.
_Swia. Pool _Other
DESCRIPTION OF WORK:
_Restaurant & Health Departaent Approval
A- -\-\-1\ ck J
BUILDING SIZE: ~x 1./ D. ,2<?(O 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
~UILDING
$
'i b 00 *
Valuation of Total Construction
_ELECTRICAL
/KECllAlfICAL
AMP Service
Florida Power Corp.
W.R.E.C.
$
Valuation of Mechanical Installation
_PLUMBING
GAS
ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fraae _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA? /'
YES NO
******************************************
CONTRACTOR SECTION
BIJTUlER . COMPANY /'."~(Y'-P n, q)Y\ -R't~
/~~ Q.~ State Cert. or Regist. .
Signature 1_ T\ , City License Registration .
*****. **** *****************************
ELECTRICIAN
COMPANY
~ ~ ~~ State Cert. or Regist. ,
"'-'.'Nr-... .. J\ City License Registration t
. ******.***********************************
SillmAture
PLUMBER
~
COMPANY
~ ~ ~ ~ State Cet<. or Regist. .
f\ City License Registration t
*** * ***********************************
Signature
MECHANICAL
Signature
~
~ COMPANY
~ ~ State Cert. or Regist. .
~ City License Registration ,
***** * **********************************
OTRRR COMPANY
State Cert. or Regist. ,
Signature City License Registration f
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
"
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands tbat this perlit JaY be subject to Ideed restrictions" which lay be lOre restrictive than City
regulations. tbe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
"
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired 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 owner and contractor laY be
cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requireJents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
788-6611.
FurtherlOre, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
IContractor Sections" of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wisbes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perJitting priVileges 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 I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - HOJeOWner's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is sOJeone other than the
"owner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
"ownern prior to couencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, zoning, and land developlent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas cOllenced prior to issuance of a perlit and that all work will be perfolled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveruental agencies laY apply to the intended work, and that it is
IY responsibility to identify what actions I lUst take to be in cOlpliance. Sucb agencies include but are not lilited to:
* Departlent of HnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and HnviroDJentally Sensitive Lands,
Water/Wastewater TreatJent
* Southwest Florida Water ManageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* DepartJent of Health & Rebabilitative Services, HnvirODJental Health Unit - Wells, Wastewater treatJent, Septic tanks
* US HnvirODlental Protection Agency - Asbestos abateJent
I also certify that, if filllaterial is to be used in Flood Zone IAI or "A, etc. ", it is understood that a drainage plan
addressing a uc~pensating VOlUle'1 will be sublitted which is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit 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 the technical codes, nor sball issuance of a perlit prevent the Building Official frOl tbereafter
requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall beCOle invalid
unless the work authorized by such perlit is COII8Ilced within six IODthS of issuance, or if work authorized by the pellit is
suspended or abandoned for a period of six IOntbs after the tile the work is COlleJlced. One 90 day extension of tile, laY be
allowed for the pellit with fee cbarge of $15.00. tbe extension sball be requested in writing to the Building Official. An
approved inspection lust be logged during each sixlOnth period, or the project will be considered abandoned.
WARlHHG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMEHCHMEIft' MAY RESULt IN YOOR PAYING twiCE FOR IMPROVEIIBNTS to YOUR
PROPERTY. IF YOO IIft'EHD to OBtAIB FIJlAHCING, CONSULt WIIH YOUR LEHDER OR AN AnORNBY BEFORE RECORDING YOUR BOTICE OF
COHMKNCHKKIft' . JOBS UJlDHR $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A "NOTICE OF COMMEJICHKKIft'".
..;J,~ 0 I.Q f\;' r
SIGNAtURE: COH1'RACtOR
SIGNATURE: OWNER OR AGE1ft'
c_
StATE OF FLORIDA
COOIft'Y OF
The foregoing instrument was acknowledged
before me this , 19____ by
STATE 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 oa.th.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
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