HomeMy WebLinkAbout95-5354
BUILDING PERMIT -_.
CITY OF ZEPHYRHILLS Permit N!
(813) 788.6611
f~535tl5
Date II -1'- 'Y,~
,
~~
Property Owner:
Job Address:
Parcell.D. #
=~~;onofWO'kCb_~~ Q~nG"~F
ELECTRICAL PLUMBING MECHANICAL
rsr;-i:1 (jf:J!:fpaz:
Sewer Conn
Water Conn:
Water Meter:
T.I.F.'s:
NO OCCUPANCY BEFORE C.O.
FINAL
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
c.o.
DATE
Permit Fee
Signature
Company
Address
Telephone#~ q4'-.:- 0 t47
Valuation or
Contract Price
~ _ .oC>
ape) -
City License Registration # rt2 tl .3
State Certified License#
<-t'7f12 7/ LI. ~f1-
~ ._-~
- BUILDI~_G....)
Ftr. 11...3..q~ 6JJ...k-.
Pre SLB
Lintel
ELE~'.'
-
. e1...UMmNG
...
MECH61\IICAL
Tp. Servo
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
FRM.
Insul. CL
WL
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 ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERMIT
CITY OF ZEPHYRBILLS
BUILDING DEPARTMENT
. KlV / rJ - p. 'f-is-:--
.'1Jij/ ' .
j ..'
OWNER'S NAME
PeJ....~
~ .Q" ;-+ez.-
PHONE
7 <t '5 ~ {p 43
OWNER'S ADDRESS
JOB ADDRESS
3~ 4S-l
c-R
'S'~ eq~
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D.' (!) Z- 24> 2..{ &0 10 0 (P 00b
~2..1
.
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition -^lteration _Repair _Install
~Sign --1Iove _Deaolish
PROPOSED USE: _Single F8IIily _M/F _' of Units _M/H
Lec-ercial _Indust. _Swta. Pool ___Other
_Restaurant &: Health Departaent Approval
BUILDING SIZE:
x
Square Feet,
&m7j$~Stht .'
..k,~."v..k.et~ C?4-q.014-7
DESCRIPTION OF WORK:
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
$ ~. S{)O'
'&l~
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
_MECHAlfI.CAL
$
Valuation of Mechanical Installation
_PLUMBING GAS ROOFING
SPECIALTY
TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel
Other
FINISHED FLOOR ELEVATIONS:
FT.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
******************************************
CONTRACTOR SECTION
BIITI.DER COMPANY rY\Df-\ Us. A
~ ^ n State Cert. or Regist. .
Signature ,~-:O}- City License Registration t
******************************************
ZZ..3
ELECTRICIAN COMPANY
State Cert. or Regist. t
Siooature City License Registration t
******************************************
PLUMBER COMPANY
State Cert. or Regist. ,
Signature City License Registration .
******************************************
MECHANICAL COMPANY
State Cert. or Regist. f
Signature City License Registration .
******************************************
OTHRR COMPANY
State Cert. or Regist. t
Signature City License Registration ,
******************************************
APPLICATION APPROVED BY PERMIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. 'NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands tbat this peClit lay be subject to Ideed restrictions" whicb lay be lOre restrictive than City
regulations. fhe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas hired a contractor or contractors to undertake wort, they lay be required to be licensed in accordance witb
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirelents laY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
788-6611.
FurtberlOre, if tbe owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, ratber than 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 pmitting 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, have been provided with a copy of .Florida's Construction Lien Law - HOIeowner's Protection
Guide" prepared by tbe Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other tban the
"owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
"owner. prior to couencelent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all tbe inforaatinn 'in this application is accurate and that all work will be done in cOlpliance witb all
applicable laws regulating construction, zoning, and land developieDt.
Application is bereby 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 peClit and that all work will be perfoCled to leet standards of all laws
regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
certify that I understand that the regulations of other goveIDlental agencies laY apply to the intended work, and that it is
If responsibility to identify what actions I lUst take to be in cOlpliance. Such agencies include but are not lilited to:
* Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
Water/Vastewater Treatlent
* Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
* Departlent of Health & Rehabilitative Services, Environtental Health Unit - Wells, Wastewater Treatlent, Septic fanks
* US Environtental 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 Dc~pensating volUle" will be sublitted wbich 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 per.it prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beCOle invalid
unless tbe work authorized by sucb peClit is cOlleDced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOntbs after the tile the work is couenced. One 90 day extension of tile, laY be
allowed for tbe perlit 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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCBIlBNT MAY RESULT IN YOUR PAYING BICE FOR IMPROVEIlBNTS TO YOUR
PROPERTY. IF YOU INTEND TO OBTAIN FlIfAlCIIfG, COIfSOLT WIIB YOUR LINDER OR AM A!!OJW:Y BEFORE RECORDING YOUR IfO'fICE OF
COMHEIfCBMBNT. JOBS UNDER $2,500 IN VALUE DO NO'f NEED TO RECORD .AID POST A "NO'flCE OF COMHEIfCEIlBNT".
SIGIIArURB: OWIfER OR AGENT
~W\ t. '1..,~
SIGNATURE: COlft'RAC'l'OR
STATE OF FLORIDA
COUNl'Y OF
The foregoing instrument was acknowledged
before me this , 19____ by
STArE 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 oath.
(Signature)
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
. OWNER
JOB LOCATION
" .
~J ;6
ern. or ?RDIIYRRTT_T~ BUXLDDIG DBPAR'l"IJIIrZ-.
&/:\I,.te~
~')\l4<, ( ~Il- s~ ~+
Q ~ --::2 6 ~ ..:< J - Of) in ()f..t.n 00 D02 \
PARCEL I.D. #
SHOW ALL BnS'I'DIG 6: PROPOSED S'I'IUJC'I'UJtBs G:IVDIG DDlBHSXOIIS 6: SBTBACKs.
"'t-
~
t'-
ALLEYWAY ACCESS FOR
GARAGE OR CARPORT -
15 FOOT SETBACK
REQUIRED.
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.5'
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
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STREET
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,
(NOTE BXAMPLES 1 & 2)
1. SETBACKS FOR R1, R2 ZONING
60'
10'
P E_
R X
0 I
10' P S 10'
0 T
S I
E N
D G
20'
2. SETBACKS FOR R3 ZONING
60'
1 0'
,-
10'
10' EXISTING 10'
PROPOSED
20'SGL FAM 30' DUPLEX
I
1 0'
!'ROllI' PROPBRTY LDIB
nt.OIft" PROPEIln LDIB
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"\)~( WESLEY B. Mc[1'ADE, P.E.
0..,/2:) ,.,1203 CEDAR TR',::E LANE
~EFn~EA, FLORIDA 33584
Letter Of Authorization
PROJECT:
ADDRESS: ~e... \=-\~,<,\c9c> -=s~k ~t.i~
Z"'1?'f51
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OWNER: pe [l ~ Q J 3 e/l// . Z;-c
TYPE OF SIGN:
?o\e S ~3 "
/l /'?
(AUTHORIZING SIGNATURE)
Permission is hereby given to G
COAST SIGN to erect the above sign.
NOTARY:
JOB NEEDS:
Site Plans
Legal Description
Folio Number
GULF COAST SIGNS
. 25224 S.R. 54
LUTZ, FL 33549
972-3685
CONTRACT
GULF COAST SIGNS agrees to prQvide tile following products and service to:
CUSTOMER:-11,( i/-IC'ot-.c.t..! .:::,1,"'-'.1h j-!c,,':'<'
PHONE NUM~BER & CONTACT: I:J{' ,,,,,, t. I:~e L" l~. ,. '1/3 - 7r 5- c.;.?.. i(;
ADDRESS: S~L(<;'-/ c.f" <;uLI I~,P; z..(-I.,I\ f~1
DATE: c"1' -" I L( - 'i~-
******************************************************************************
Description of Sign
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******************************************************l***********************
NOTICE
All product manufactured and installed by GULF COAST SIGNS are guaranteed for
o~e year. Title on sign(s) does not pass to buyer until seller has been paid
in full. Seller reserves the right to remove any sign from the buyer's loca-
tions if that sign is not paid for as per the terms of this agreement. In
consideration of this agreement, the BUYER does hereby agree, jointly and
severally, to pay for all goods, wares, merchandise and services supplied to
any of us and/or the named business. In event it becomes necessary to place
the account with an attorney or agency for collection, I/we, the undersigned,
agree to pay all cost of collection, including reasonable attorneys fee. Un-
less otherwise specified, final PAYMENT on work is C.O.D. Please be prepared
to make payment at time of installation or delivery of your sign.
***********~******************************************************************
Se 11 ing Price: 2f;DD. -,'
T a x 6 % : ) -S c', c,'
Combined Total: 2-(.0(;,,-' ..-~
Less Deposit: \ t~':>(' ,"'J
After Production:
Due on Complet~on:
j:J J. ;L. /3 J
Buyer's Name nd
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Title(Please Print)
AccePt~BY BUY~
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Ac~d By'Seller(Owner)
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